NY State Senate Bill 2015-S2063

Senate Bill S2063

2015-2016 Legislative Session

Authorizes optometrists to prescribe certain drugs that may be used for therapeutic purposes and taken orally

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Archive: Last Bill Status - In Senate Committee Higher Education Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 21, 2015	referred to higher education

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2015-S2063 (ACTIVE) - Details

See Assembly Version of this Bill:: A2803
Current Committee:: Senate Higher Education
Law Section:: Education Law
Laws Affected:: Amd §7101-a, Ed L

2015-S2063 (ACTIVE) - Summary

Authorizes optometrists certified to use therapeutic pharmaceutical agents for the treatment or prevention of ocular disease, to also use specified oral pharmaceutical agents in their practices; requires completion of a 30 hour phase three therapeutic pharmaceutical agent certification course; permits the commissioner of health to recommend other categories of drugs that may also be prescribed.

2015-S2063 (ACTIVE) - Sponsor Memo

                                BILL NUMBER:S2063

TITLE OF BILL:

An act to amend the education law, in relation to the practice of
optometry

PURPOSE OR GENERAL IDEA OF BILL:

To allow licensed optometrists who are already certified to prescribe
diagnostic and topical pharmaceutical agents to prescribe certain oral
medications

SUMMARY OF SPECIFIC PROVISIONS:

Section one amends subdivision 1 of section 7101-a of the education
law by adding a new paragraph (g) that provides the definition of
phase three therapeutic pharmaceutical agents, to include those
pharmaceutical agents listed and limitations on the duration of some
prescriptions.

Section two amends subdivision 4 of section 7101-a of the education
law by re-lettering paragraphs (c) and (d) of said subdivision
paragraphs (d) and (e), and by adding a new paragraph (c). Paragraph
(c) provides that optometrists must first be certified to prescribe
diagnostic pharmaceutical agents and phase one and phase two

therapeutic pharmaceutical agents and complete a thirty hour phase
three therapeutic pharmaceutical agent certification course with a
curriculum developed by a New York state-accredited college of
optometry in collaboration with an accredited medical school and
approved by the education department, before using or prescribing
phase three pharmaceutical agents. The curriculum shall include
instruction in pharmacology and drug interaction and be taught through
clinical case scenarios and emphasize clinical decision-making.

Section three amends subdivision 5 of section 7101-a of the education
law, as added by chapter 517 of the laws of 1995, by providing that
the department shall suspend the certification for the use and
prescribing of phase one and phase two therapeutic agents of any
optometrist who fails to receive certification for phase three
therapeutic pharmaceutical agents within three years of approval by
the department of the thirty-hour certification course.

Section four amends the opening paragraph of subdivision 6 of section
7101-a of the education law, as added by chapter 517 of the laws of
1995, and adds new subdivisions 6-a and 6-b to require that an
optometrist document, as soon as practicable, in the patient's record
the prescription or use of an oral medication. In addition, within 72
hours of prescribing or using an oral medication, an optometrist shall
notify the patient's primary care practitioner and document such
notification concerning the agent used or prescribed, the dose,
frequency of use and duration of prescription. The bill would also
require that if a patient's condition does not result in an adequate
clinical response with the use of an oral medication, an optometrist
shall consult with the patient's primary care practitioner or the
appropriate healthcare provider as soon as clinically prudent.


Section five amends subdivision 7 of section 7101-a of the education
law, as added by chapter 517 of the laws of 1995, by providing that at
least six hours of the thirty-six hours of continuing education that
is required per triennial registration period shall relate
specifically to systemic drug use and interaction.

Section six amends the opening paragraph of subdivision 8 of section
7101-a, as added by chapter 517 of the laws of 1995, to clarify the
applicability of a separate notice to patients regarding the use of
certain topical medications.

Section seven amends subdivision 10 of section 7101-a of the education
law, as added by chapter 517 of the laws of 1995, to provide that
optometrists certified to use and prescribe oral medications shall be
authorized to use and prescribe those oral medications that are FDA
approved and commercially available. In addition, optometrists
certified for phase one, phase two or phase three therapeutic
pharmaceutical agents shall be authorized to use and recommend all
nonprescription medications, whether intended for topical or oral use,
appropriate for the treatment of the eye and adnexa.

Section eight amends subdivision 12 of section 7101-a of the education
law, as added by chapter 517 of the laws of 1995, to clarify that the
commissioner of health shall recommend to the commissioner of
education additions or deletions to the list of approved categories of
medications used or prescribed by optometrists which are consistent
with the standard of care in the diagnosis and treatment of diseases
of the eye and adnexa.

Section nine provides the effective date.

JUSTIFICATION:

In 1995, the Legislature enacted a law authorizing a specialty
certification for optometrists with training and experience to use
topically applied therapeutic pharmaceutical agents for the treatment
or prevention of ocular disease. By law, such certified optometrists
are required to be held to the same standard of care in diagnosis, use
of such agents, and treatment as that degree of skill and proficiency
commonly exercised by a physician.

In the years since the 1995 legislation was enacted, New Yorkers have
enjoyed enhanced access to and a higher quality of primary eye care
services provided by optometrists who meet the qualifications set
forth in the legislation. This new legislation extends the 1995
legislation another modest step by permitting optometrists to
prescribe for their patients oral medications for the treatment of eye
disease in some cases, and permit optometrists (who satisfy certain
continuing education requirements) to prescribe oral medications
solely in the context of treating eye disease.

The bill would further establish consistency over the categories of
diagnostic, therapeutic and orals drugs that optometrists shall be
authorized to use by providing that the Commissioner of Health shall
recommend additions to or deletions from such categories based on
whether they are the standard of care for the diagnosis and treatment
of eye disease and adnexa.


Currently, 48 states and the District of Columbia allow optometrists
to prescribe and use a range of oral pharmaceutical agents for ocular
conditions. This bill mirrors certain provisions and restrictions in
many of those other states to authorize the minimum authority needed
for optometrists to appropriately treat their patients.

Optometric students at SUNY College of Optometry and optometric
schools across the country are required to be thoroughly educated and
trained in the prescription and use of these medications. The
enactment of this legislation will provide New Yorkers access to the
most effective and appropriate medications that are necessary in the
treatment of ocular diseases and will ensure that the prescribing
optometrist is fully prepared to fulfill this responsibility. This
bill is significantly more narrow than previously introduced
legislation in that it would conform New York's statute with that of
other states and improve patient care by promoting greater
communication among a patient's health care providers, enhancing the
educational and training requirements for optometrists, and limiting
the duration of certain oral drugs that are authorized to be used.

PRIOR LEGISLATIVE HISTORY:

A.2192-A, 2013 and 2014 referred to higher education.
Same as S.7678-A, 2013 and 2014 referred to higher education.
Similar to A.363-B, 2011 and 2012 referred to higher education.
Same as S.3027-B, 2011 and 2012 referred to higher education.
Similar to A.3718, 2009 and 2010 referred to higher education.
Same as S.2667, 2009 and 2010 referred to higher education.
Similar to A.8001, 2007 and 2008 referred to higher education.
Same as S.4519, 2007-2008 referred to higher education.
Similar to A.4329A, 2005 and 2006 referred to higher education.
Same as S.2719-A, 2005 and 2006.
Similar to A.7223, 2003 and 2004 referred to higher education.
Same as S.2761, 2003 and 2004 referred to higher education.
Similar to A.8814, 2001 and 2002 referred to higher education.
Same as S.4482, 2001 and 2002 referred to higher education.

FISCAL IMPLICATION:

None to the State.

EFFECTIVE DATE:

This act shall take effect on the one hundred twentieth day after it
shall have become a law; provided that any rule or regulation
necessary for the timely implementation of this act on its effective
date shall be promulgated on or before such effective date.

2015-S2063 (ACTIVE) - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  2063

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                            January 21, 2015
                               ___________

Introduced  by  Sen.  LIBOUS -- read twice and ordered printed, and when
  printed to be committed to the Committee on Higher Education

AN ACT to amend the education law, in relation to the practice of  opto-
  metry

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Subdivision 1 of section 7101-a of  the  education  law  is
amended by adding a new paragraph (g) to read as follows:
  (G)  PHASE THREE THERAPEUTIC PHARMACEUTICAL AGENTS. PHASE THREE THERA-
PEUTIC PHARMACEUTICAL AGENTS SHALL MEAN THOSE ORALLY ADMINISTERED  DRUGS
USED  FOR  THERAPEUTIC PURPOSES FOR THE TREATMENT OF DISEASES OF THE EYE
AND ADNEXA AND SHALL BE LIMITED TO:
  (I) ANTIBIOTICS;
  (II) DECONGESTANTS/ANTI-ALLERGENIC/ANTIHISTAMINES;
  (III) ANTIGLAUCOMAS; PROVIDED HOWEVER, WHEN PRESCRIBED OR ADMINISTERED
FOR THE TREATMENT OF ACUTE ANGLE CLOSURE GLAUCOMA, THE PRESCRIBING OPTO-
METRIST SHALL MAKE ALL  REASONABLE  EFFORTS  IMMEDIATELY  THEREAFTER  TO
REFER  THE  PATIENT  TO A LICENSED PHYSICIAN SPECIALIZING IN DISEASES OF
THE EYE AND PROVIDE NOTIFICATION IN ACCORDANCE WITH SUBDIVISION SIX-A OF
THIS SECTION;
  (IV) ANTIVIRALS;
  (V) ONE THREE-DAY SUPPLY OF ANALGESICS, BUT SHALL  NOT  INCLUDE  THOSE
LISTED IN SCHEDULES I AND II OF THE UNIFORM CONTROLLED SUBSTANCES ACT;
  (VI) NONSTEROIDAL ANTI-INFLAMMATORY DRUGS;
  (VII) ONE FOURTEEN-DAY SUPPLY OF CORTICOSTEROIDS.
  S  2. Paragraphs (c) and (d) of subdivision 4 of section 7101-a of the
education law are relettered paragraphs (d) and (e) and a new  paragraph
(c) is added to read as follows:
  (C) BEFORE USING OR PRESCRIBING PHASE THREE THERAPEUTIC PHARMACEUTICAL
AGENTS, AN OPTOMETRIST MUST BE CERTIFIED TO PRESCRIBE DIAGNOSTIC PHARMA-
CEUTICAL  AGENTS  AND PHASE ONE AND PHASE TWO THERAPEUTIC PHARMACEUTICAL

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD05046-02-5

S. 2063                             2

AGENTS AND HAVE COMPLETED A THIRTY HOUR PHASE THREE THERAPEUTIC  PHARMA-
CEUTICAL  AGENT  CERTIFICATION COURSE, WITH A CURRICULUM DEVELOPED BY AN
ACCREDITED COLLEGE OF OPTOMETRY IN COLLABORATION WITH A NEW  YORK  STATE
ACCREDITED  MEDICAL  SCHOOL.  THE CURRICULUM, WHICH SHALL BE APPROVED BY
THE DEPARTMENT, SHALL INCLUDE, BUT NOT BE  LIMITED  TO,  INSTRUCTION  IN
PHARMACOLOGY  AND  DRUG  INTERACTION AND BE TAUGHT THROUGH CLINICAL CASE
SCENARIOS AND EMPHASIZE CLINICAL DECISION MAKING.    SUCH  COURSE  SHALL
QUALIFY TOWARDS MEETING THE THIRTY-SIX HOURS OF CONTINUING EDUCATION PER
TRIENNIAL  REGISTRATION  PERIOD  REQUIRED  BY  SUBDIVISION SEVEN OF THIS
SECTION. THIS REQUIREMENT FOR THE THIRTY HOUR  PHASE  THREE  THERAPEUTIC
PHARMACEUTICAL AGENT CERTIFICATION COURSE SHALL NOT APPLY TO THOSE OPTO-
METRISTS  WHO  (I)  GRADUATED  FROM  AN  ACCREDITED COLLEGE OF OPTOMETRY
SUBSEQUENT TO JANUARY FIRST, TWO THOUSAND FOUR AND (II) HAVE  TAKEN  AND
SUCCESSFULLY  PASSED  EITHER  THE  TREATMENT  AND  MANAGEMENT  OF OCULAR
DISEASES PORTION OF THE NATIONAL BOARD OF EXAMINERS IN OPTOMETRY  OR  AN
EXAMINATION ACCEPTABLE TO THE BOARD.
  S 3. Subdivision 5 of section 7101-a of the education law, as added by
chapter 517 of the laws of 1995, is amended to read as follows:
  5.  Suspension  of  certification.  The  department  shall suspend the
certification for the use  and  prescribing  of  phase  one  therapeutic
agents  of  any optometrist who fails to receive certification for phase
two therapeutic pharmaceutical agents within three years of having  been
certified  for phase one therapeutic pharmaceutical agents.  THE DEPART-
MENT SHALL SUSPEND THE CERTIFICATION FOR  THE  USE  AND  PRESCRIBING  OF
PHASE  ONE AND PHASE TWO THERAPEUTIC AGENTS OF ANY OPTOMETRIST WHO FAILS
TO RECEIVE CERTIFICATION  FOR  PHASE  THREE  THERAPEUTIC  PHARMACEUTICAL
AGENTS WITHIN THREE YEARS OF APPROVAL BY THE DEPARTMENT OF A THIRTY HOUR
PHASE THREE THERAPEUTIC PHARMACEUTICAL AGENT CERTIFICATION COURSE PURSU-
ANT TO PARAGRAPH (C) OF SUBDIVISION FOUR OF THIS SECTION.
  S  4.  The opening paragraph of subdivision 6 of section 7101-a of the
education law, as added by chapter 517 of the laws of 1995,  is  amended
and two new subdivisions 6-a and 6-b are added to read as follows:
  Consultation  WITH USE OF CERTAIN PHASE TWO THERAPEUTIC PHARMACEUTICAL
AGENTS.
  6-A. NOTIFICATION OF USE OF  PHASE  THREE  THERAPEUTIC  PHARMACEUTICAL
AGENTS.  AN  OPTOMETRIST  SHALL, AS SOON AS PRACTICABLE, DOCUMENT IN THE
PATIENT'S RECORD THE PRESCRIPTION OR  USE  OF  PHASE  THREE  THERAPEUTIC
PHARMACEUTICAL  AGENTS. WITHIN SEVENTY-TWO HOURS OF PRESCRIBING OR USING
A PHASE THREE THERAPEUTIC PHARMACEUTICAL  AGENT,  AN  OPTOMETRIST  SHALL
NOTIFY  THE  PATIENT'S  PRIMARY  CARE  PRACTITIONER,  AND  DOCUMENT SUCH
NOTIFICATION WITH THE FOLLOWING INFORMATION:
  (I) THE NAME OF SUCH AGENT;
  (II) THE DOSE;
  (III) THE FREQUENCY OF USE; AND
  (IV) THE DURATION OF USE OR PRESCRIPTION.
  6-B. CONSULTATION WITH USE OF PHASE THREE  THERAPEUTIC  PHARMACEUTICAL
AGENTS.  IF IN THE PROFESSIONAL JUDGMENT OF THE OPTOMETRIST, A PATIENT'S
CONDITION DOES NOT RESULT IN AN ADEQUATE CLINICAL RESPONSE TO THE  PHASE
THREE  THERAPEUTIC  PHARMACEUTICAL  AGENT THERAPY, THE OPTOMETRIST SHALL
CONSULT WITH THE PATIENT'S PRIMARY CARE PRACTITIONER OR THE  APPROPRIATE
HEALTHCARE PROVIDER AS SOON AS CLINICALLY PRUDENT.
  S 5. Subdivision 7 of section 7101-a of the education law, as added by
chapter 517 of the laws of 1995, is amended to read as follows:
  7.  Continuing  education. Each optometrist certified to use phase one
[or], phase two, OR PHASE THREE therapeutic pharmaceutical agents  shall
complete  a  minimum  of  thirty-six  hours  of continuing education per

S. 2063                             3

triennial registration period. The education shall be  in  the  area  of
ocular  disease  and  pharmacology,  AT  LEAST  SIX HOURS OF WHICH SHALL
RELATE SPECIFICALLY TO  SYSTEMIC  DRUG  USE  AND  INTERACTION,  and  may
include both didactic and clinical components. Such educational programs
shall  be  approved  in  advance  by  the department and evidence of the
completion of this requirement shall be submitted with each  application
for  license  renewal  as  required by section sixty-five hundred two of
this chapter.
  S 6. The opening paragraph of subdivision 8 of section 7101-a  of  the
education  law,  as added by chapter 517 of the laws of 1995, is amended
to read as follows:
  Notice to patient WITH USE OF CERTAIN PHASE TWO THERAPEUTIC PHARMACEU-
TICAL AGENTS.
  S 7. Subdivision 10 of section 7101-a of the education law,  as  added
by chapter 517 of the laws of 1995, is amended to read as follows:
  10.  Pharmaceutical  agents.  Optometrists  who have been approved and
certified by the department shall be  permitted  to  use  the  following
drugs:
  (a) Diagnostic pharmaceuticals.
  (b) Those optometrists having been certified for phase one therapeutic
pharmaceutical  agents shall be authorized [(i) to use and recommend all
nonprescription  medications  appropriate  for  ocular  disease  whether
intended  for  topical  or  oral use; and (ii)] to use and prescribe all
phase one therapeutic pharmaceutical agents which are FDA  approved  and
commercially available.
  In the event an optometrist treats a patient with topical antiviral or
steroidal  drugs  and the patient's condition either fails to improve or
worsens within five days,  the  optometrist  shall  notify  a  physician
designated by the patient or, if none, by the treating optometrist.
  (c) Those optometrists having been certified for phase two therapeutic
pharmaceutical agents shall be authorized to use and prescribe phase two
therapeutic pharmaceutical agents which are FDA approved and commercial-
ly available.
  (D) THOSE OPTOMETRISTS HAVING BEEN CERTIFIED FOR PHASE THREE THERAPEU-
TIC PHARMACEUTICAL AGENTS SHALL BE AUTHORIZED TO USE AND PRESCRIBE PHASE
THREE  THERAPEUTIC  PHARMACEUTICAL  AGENTS  WHICH  ARE  FDA APPROVED AND
COMMERCIALLY AVAILABLE.
  (E) THOSE OPTOMETRISTS HAVING BEEN CERTIFIED FOR PHASE ONE, PHASE  TWO
OR  PHASE THREE THERAPEUTIC PHARMACEUTICAL AGENTS SHALL BE AUTHORIZED TO
USE AND RECOMMEND ALL NONPRESCRIPTION MEDICATIONS, WHETHER INTENDED  FOR
TOPICAL  OR  ORAL  USE,  APPROPRIATE  FOR  THE  TREATMENT OF THE EYE AND
ADNEXA.
  S 8. Subdivision 12 of section 7101-a of the education law,  as  added
by chapter 517 of the laws of 1995, is amended to read as follows:
  12. Responsibilities of the commissioner of health.  [The] IN ORDER TO
SATISFY THE REQUIREMENT THAT AN OPTOMETRIST AUTHORIZED TO USE PHARMACEU-
TICAL AGENTS FOR USE IN THE DIAGNOSIS, TREATMENT OR PREVENTION OF OCULAR
DISEASE  SHALL BE HELD TO THE SAME STANDARD OF CARE IN DIAGNOSIS, USE OF
SUCH AGENTS, AND TREATMENT AS  THAT  DEGREE  OF  SKILL  AND  PROFICIENCY
COMMONLY EXERCISED BY A PHYSICIAN IN THE SAME COMMUNITY, THE commission-
er  of  health [may recommend to the commissioner additions or deletions
to the department's regulations relating  to  optometric  use  of  drugs
except  that  such  recommendations  shall  be limited only to additions
which have been determined to  be  equivalent  to  those  drugs  already
authorized or deletions based upon a finding that the drugs are no long-
er  appropriate  for  their  current  use or for other similar reasons.]

S. 2063                             4

SHALL RECOMMEND TO THE COMMISSIONER ADDITIONS OR DELETIONS TO  THE  LIST
OF  APPROVED  CATEGORIES  OF DIAGNOSTIC, THERAPEUTIC AND ORAL PHARMACEU-
TICAL AGENTS WHICH ARE CONSISTENT WITH  THE  STANDARD  OF  CARE  IN  THE
COMMUNITY  FOR  THE  DIAGNOSIS  AND TREATMENT OF DISEASES OF THE EYE AND
ADNEXA.
  S 9. This act shall take effect on the one hundred twentieth day after
it shall have become a law; provided that any rule or regulation  neces-
sary  for  the  timely  implementation of this act on its effective date
shall be promulgated on or before such effective date.

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