NY Educ L § 7101-A (2021)
2021 New York Laws EDN - Education Title 8 - The Professions Article 143 - Optometry 7101-A - Certification to Use Therapeutic Drugs.

§ 7101-a. Certification  to  use therapeutic drugs. 1. Definitions. As used in this section, the  following  terms  shall  have  the  following meanings:  (a)  Clinical  training.  Clinical  training shall mean the diagnosis, treatment and management of patients with ocular disease  and  shall  be comparable  to  that  acquired  by  a  current  graduate  of  the  State University College of Optometry.  (b) Consultation.  Consultation  shall  mean  a  confirmation  of  the diagnosis, a plan of co-management of the patient, and a periodic review of the patient's progress.  (c)  Education review committee. Education review committee shall mean the committee established pursuant to subdivision nine of this section.  (d) Diagnostic pharmaceuticals. Diagnostic pharmaceuticals shall  mean those  drugs  which  shall  be  limited  to  topical applications to the surface of the eye for the purpose of diagnostic examination of the  eye and shall be limited to:  (i) Anesthetic agents;  (ii) Mydriatics;  (iii) Cycloplegics;  (iv) Miotics;  (v)  Disclosing  agents  and other substances used in conjunction with these drugs as part of a diagnostic procedure.   * (e)  Phase  one  therapeutic  pharmaceutical   agents.   Phase   one pharmaceutical  agents  shall mean those drugs which shall be limited to topical application to the surface of the eye for  therapeutic  purposes and shall be limited to:  (i) antibiotic/antimicrobials;  (ii) decongestants/anti-allergenics;  (iii) non-steroidal anti-inflammatory agents;  (iv) steroidal anti-inflammatory agents;  (v) antiviral agents;  (vi) hyperosmotic/hypertonic agents;  (vii) cycloplegics;  (viii) artificial tears and lubricants.   * NB Effective until October 25, 2023   * (e)  Topical  therapeutic pharmaceutical agents. Topical therapeutic pharmaceutical agents shall mean those drugs which shall be  limited  to topical  application  to the surface of the eye for therapeutic purposes and shall be limited to:  (i) antibiotic/antimicrobials;  (ii) decongestants/anti-allergenics;  (iii) non-steroidal anti-inflammatory agents;  (iv) steroidal anti-inflammatory agents;  (v) antiviral agents;  (vi) hyperosmotic/hypertonic agents;  (vii) cycloplegics;  (viii) artificial tears and lubricants; and  (ix) immunosuppressive agents.   * NB Effective October 25, 2023   * (f)  Phase  two  therapeutic  pharmaceutical   agents.   Phase   two pharmaceutical  agents  shall mean those drugs which shall be limited to topical application to the surface of the eye and shall be limited to:  (i) beta blockers;  (ii) alpha agonists;  (iii) direct acting cholinergic agents.   * NB Effective until October 25, 2023   * (f) Therapeutic pharmaceutical agents for treatment of glaucoma  and ocular  hypertension. Therapeutic pharmaceutical agents for treatment of  glaucoma and ocular hypertension shall mean those drugs which  shall  be limited  to  topical  application to the surface of the eye and shall be limited to:  (i) beta blockers;  (ii) alpha agonists;  (iii) direct acting cholinergic agents;  (iv) prostaglandin analogs; and  (v) carbonic anhydrase inhibitors.   * NB Effective October 25, 2023   * (g)   Oral   therapeutic  pharmaceutical  agents.  Oral  therapeutic pharmaceutical agents shall mean those orally  administered  drugs  used for therapeutic purposes solely for the treatment of diseases of the eye and adnexa and shall be limited to:  (i) the following antibiotics:  (1) amoxicillin/clavulanate potassium;  (2) cephalexin;  (3) azithromycin;  (4) sulfamethoxazole/trimethoprim;  (5) doxycycline; and  (6) tetracycline;  (ii)  the  following  antiglaucoma  agents  used for the management of acute  increases  in  intraocular  pressure;   provided,   however,   an optometrist  may  use  or  prescribe  a  maximum of one twenty-four hour prescription and shall immediately  refer  the  patient  to  a  licensed physician specializing in diseases of the eye:  (1) acetazolamide; and  (2) methazolamide; and  (iii)   the   following   antiviral  agents  used  for  herpes  zoster ophthalmicus; provided an optometrist shall use or prescribe in maximum, one seven-day prescription; provided, however, if a patient is diagnosed with herpes zoster ophthalmicus and has not already been examined  by  a primary  care  physician  or  other appropriate physician for such viral condition, an optometrist shall refer the patient to a licensed  primary care  physician, licensed physician specializing in diseases of the eye, or other appropriate physician within three days of such diagnosis:  (1) valacyclovir; and  (2) acyclovir.   * NB Effective October 25, 2023   2. Standard of care. An optometrist authorized to  use  pharmaceutical 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.   3. Certificate. The commissioner shall issue appropriate  certificates to   use  therapeutic  pharmaceutical  agents  in  accordance  with  the provisions of this section to those optometrists who have satisfactorily completed a curriculum in general and ocular pharmacology at  a  college of  optometry with didactic and supervised clinical programs approved by the department are eligible to apply for the certificate issued pursuant to this section.   4. * Phase one therapeutic pharmaceutical agents. (a) Before using  or prescribing   phase   one   therapeutic   pharmaceutical   agents,  each optometrist shall  have  completed  at  least  three  hundred  hours  of clinical training in the diagnosis, treatment and management of patients with  ocular  disease  other  than glaucoma and ocular hypertension, not fewer than twenty-five hours of such training shall have been  completed subsequent   to   June  thirtieth,  nineteen  hundred  ninety-three  and additionally  shall  either  have  taken  and  successfully  passed  the  treatment  and  management  of  ocular  diseases portion of the National Board of Examiners in Optometry test  or  have  taken  and  successfully passed an examination acceptable to the board.   * NB Effective until October 25, 2023   * Topical  therapeutic  pharmaceutical  agents.  (a)  Before  using or prescribing topical therapeutic pharmaceutical agents, each  optometrist shall  have  completed at least three hundred hours of clinical training in the diagnosis, treatment  and  management  of  patients  with  ocular disease  other  than  glaucoma  and  ocular hypertension, not fewer than twenty-five hours of such training shall have been completed  subsequent to  June thirtieth, nineteen hundred ninety-three and additionally shall either have taken and successfully passed the treatment  and  management of  ocular  diseases  portion  of  the  National  Board  of Examiners in Optometry test or have taken  and  successfully  passed  an  examination acceptable to the board.   * NB Effective October 25, 2023   * (b) Before using or prescribing phase two therapeutic pharmaceutical agents,  an  optometrist  must be certified for diagnostic and phase one therapeutic agents and have completed an additional one hundred hours of clinical training in the diagnosis, treatment and management of patients with glaucoma and ocular hypertension, not fewer than twenty-five  hours of  such  training  shall  have been completed subsequent to July first, nineteen hundred ninety-four, and  shall  have  taken  and  successfully passed an oral or written examination acceptable by the board.   * NB Effective until October 25, 2023   * (b)  Before  using  or prescribing therapeutic pharmaceutical agents for treatment of glaucoma and ocular hypertension, an  optometrist  must be  certified  for  diagnostic  and  topical therapeutic agents and have completed an additional one hundred hours of clinical  training  in  the diagnosis, treatment and management of patients with glaucoma and ocular hypertension,  not  fewer  than twenty-five hours of such training shall have  been  completed  subsequent  to  July  first,   nineteen   hundred ninety-four,  and  shall  have  taken and successfully passed an oral or written examination acceptable by the board.   * NB Effective October 25, 2023   * (c) The clinical training required by this  section  may  have  been acquired  prior  to  the enactment of this section not inconsistent with paragraphs (a) and (b) of this subdivision. Approval of the pre-acquired clinical training shall be in accordance with subdivision nine-a of this section.   * NB Effective until October 25, 2023   * (c) Before using  or  prescribing  oral  therapeutic  pharmaceutical agents,  an  optometrist  must  be  certified  to  prescribe  diagnostic pharmaceutical  agents   and   topical   therapeutic   and   therapeutic pharmaceutical agents for treatment of glaucoma and ocular hypertension, have  completed  an  oral therapeutic pharmaceutical agent certification course  and  have  passed  an  examination  within  five  years  of  the department's approval of the initial certification course or the initial examination,  whichever  is  later provided, however, an optometrist who has commenced the oral therapeutic  pharmaceutical  agent  certification course  within  the  five  year  time  period  but has not yet passed an examination shall  be  allowed  to  take  such  examination  and  become certified after the five year time period provided for in this paragraph has ended.  (i)  The  curriculum  for  the  oral  therapeutic pharmaceutical agent certification course shall include, but not be limited  to,  instruction in  pharmacology  and drug interaction in treating ocular disease and be taught through clinical case scenarios and emphasize  clinical  decision  making  and  shall  be  no  less than forty hours, of which no less than twenty-four hours shall be live instruction.  (ii)   Such  course  shall  qualify  towards  meeting  the  continuing education per triennial registration requirement pursuant to subdivision seven of this section.  (iii) The examination shall assess the knowledge of materials  in  the curriculum  and  reflect  the  oral  therapeutic  pharmaceutical  agents described in paragraph (g) of subdivision one of this section, and shall be acceptable to the department.  (iv) The initial, and any subsequent, curriculum and examination shall be subject to review and approval by the department.  (v) The requirement for  the  oral  therapeutic  pharmaceutical  agent certification   course   and   examination  shall  not  apply  to  those optometrists who graduated  from  an  accredited  college  of  optometry subsequent  to January first, two thousand twenty-two and have taken and successfully  passed  the  National  Board  of  Examiners  in  Optometry examination or an examination acceptable to the department.   * NB Effective October 25, 2023   * (d)  The  provisions  of  paragraphs (a) and (b) of this subdivision shall not apply to (i) graduates of an appropriate program  approved  by the  department  who have successfully passed the examination on the use of diagnostic and therapeutic drugs  and  who  graduated  subsequent  to January  first,  nineteen hundred ninety-three; or (ii) optometrists who have been certified for at least five years to use phase one  and  phase two  drugs  in  another  jurisdiction,  have  demonstrated  such  use in independently managed patients, and have  been  licensed  in  accordance with  section  seventy-one  hundred  four  of  this  chapter.  Provided, however, no optometrist exempt under this paragraph shall  be  permitted to  use  phase  one  therapeutic  pharmaceutical  agents  or  phase  two therapeutic pharmaceutical agents prior  to  the  general  authorization provided to optometrists licensed in this state.   * NB Effective until October 25, 2023   * (d)  The  clinical  training  required by this section may have been acquired prior to the enactment of this section  not  inconsistent  with paragraphs (a) and (b) of this subdivision. Approval of the pre-acquired clinical training shall be in accordance with subdivision nine-a of this section.   * NB Effective October 25, 2023   * (e)  The  provisions  of  paragraphs (a) and (b) of this subdivision shall not apply to (i) graduates of an appropriate program  approved  by the  department  who have successfully passed the examination on the use of diagnostic and therapeutic drugs  and  who  graduated  subsequent  to January  first,  nineteen hundred ninety-three; or (ii) optometrists who have been certified for at least five years to use phase one  and  phase two  drugs  in  another  jurisdiction,  have  demonstrated  such  use in independently managed patients, and have  been  licensed  in  accordance with  section  seventy-one  hundred  four  of  this  chapter.  Provided, however, no optometrist exempt under this paragraph shall  be  permitted to  use  phase  one  therapeutic  pharmaceutical  agents  or  phase  two therapeutic pharmaceutical agents prior  to  the  general  authorization provided to optometrists licensed in this state.   * NB Effective October 25, 2023   * 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.   * NB Effective until October 25, 2023    * 5.  Suspension  of  certification.  The department shall suspend the certification for the use and prescribing of topical therapeutic  agents of  any  optometrist  who fails to receive certification for therapeutic pharmaceutical agents for treatment of glaucoma and ocular  hypertension within  three  years  of  having  been certified for topical therapeutic pharmaceutical agents.   * NB Effective October 25, 2023   6. * Consultation.   * NB Effective until October 25, 2023   * Consultation with use of certain topical therapeutic  pharmaceutical agents for treatment of glaucoma and ocular hypertension.   * NB Effective October 25, 2023 (a)  After  the initial diagnosis of glaucoma or ocular hypertension and before initiating treatment of any patient, an optometrist shall  engage in  a  written  consultation  with  a licensed physician specializing in diseases of the eye.  (b) A consultation shall be required for a period of  three  years  or until  the  optometrist has examined and diagnosed seventy-five patients having glaucoma or ocular  hypertension  which  examinations  require  a written   consultation   in   accordance  with  paragraph  (a)  of  this subdivision, whichever occurs later.  (c) The consultation provisions shall not apply to a  graduate  of  an appropriate  program  approved by the department who successfully passed an examination in the use of diagnostic and  therapeutic  pharmaceutical agents  approved  by the department and graduated such school subsequent to January first, nineteen hundred ninety-nine and who has had at  least seventy-five  documented  examinations  and  diagnosis  of patients with glaucoma or ocular hypertension which examinations were  part  of  their training and were under physician supervision.   * 7. Continuing education. Each optometrist certified to use phase one or  phase two therapeutic pharmaceutical agents shall complete a minimum of thirty-six hours of continuing education per  triennial  registration period.  The  education  shall  be  in  the  area  of ocular disease and pharmacology 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.   * NB Effective until January 1, 2023   * 7.  Continuing  education.  (a)  Each  optometrist  certified to use topical therapeutic pharmaceutical agents and therapeutic pharmaceutical agents for treatment of glaucoma and ocular hypertension, shall complete a minimum of thirty-six hours of continuing education  in  the  area  of ocular  disease and pharmacology per triennial registration period. Each optometrist certified to  use  oral  therapeutic  pharmaceutical  agents shall,  in  addition  to  the  minimum  thirty-six  hours  of continuing education provided for  in  this  subdivision,  complete  an  additional minimum  of  eighteen  hours of continuing education related to systemic disease and therapeutic treatment  per  triennial  registration  period. Such  educational  programs  may  include  both  didactic  and  clinical components and shall be approved in advance by the department. Beginning on January first, two thousand twenty-three, all sponsors of  continuing education  courses  seeking  advanced approval from the department shall file an application and pay  a  fee  determined  by  the  department  in accordance  with  the  regulations  of  the commissioner. An optometrist subject to the provisions of this subdivision whose  first  registration date following the effective date of this section occurs less than three years  from  such  effective  date,  but  on or after January first, two  thousand twenty-three, shall complete continuing education  hours  on  a prorated  basis  at  the  rate  of  one  hour  per  month for the period beginning January first, two  thousand  twenty-three  up  to  the  first registration  date  thereafter. An optometrist who has not satisfied the mandatory continuing education requirement pursuant to this  subdivision shall  not  be  issued  a  triennial  registration  certificate  by  the department and  shall  not  practice  unless  and  until  a  conditional registration  is  issued  as  provided  for  in  paragraph  (b)  of this subdivision. Continuing education hours taken during one  triennium  may not be transferred to the subsequent triennium.  (b)  The  department,  in  its  discretion,  may  issue  a conditional registration  to  an  optometrist  who  fails  to  meet  the  continuing education requirements established in paragraph (a) of this subdivision, but  who  agrees to make up any deficiencies and complete any additional education  which  the  department  may  require.  The  fee  for  such  a conditional  registration  shall be the same as, and in addition to, the fee for the triennial registration. The  duration  of  such  conditional registration shall be determined by the department, but shall not exceed one  year. Any optometrist who is notified of the denial of registration for failure to submit  evidence,  satisfactory  to  the  department,  of required   continuing   education   and   who   practices  without  such registration may be subject  to  disciplinary  proceedings  pursuant  to section sixty-five hundred ten of this title.  (c)  In  accordance with the intent of this section, adjustment to the mandatory  continuing  education  requirement  may  be  granted  by  the department  for  reasons  of health that are certified by an appropriate health care professional, for extended active duty with the armed forces of the United  States,  or  for  other  good  cause  acceptable  to  the department which may prevent compliance.  (d)  An  optometrist  not  engaged  in  practice, as determined by the department, shall be exempt  from  the  mandatory  continuing  education requirement upon the filing of a statement with the department declaring such  status.  Any  licensee  who  returns  to the practice of optometry during the triennial registration period  shall  notify  the  department prior  to  reentering  the  profession  and  shall  meet such continuing education requirements as shall be  prescribed  by  regulations  of  the commissioner.  (e)  Optometrists  subject to the provisions of this subdivision shall maintain adequate documentation of completion of  acceptable  continuing education credits and shall provide such documentation at the request of the  department.  Failure to provide such documentation upon the request of the department shall be an act of misconduct subject to  disciplinary proceedings pursuant to section sixty-five hundred ten of this title.  (f)  The mandatory continuing education fee shall be determined by the department. Such fee shall be payable on or before the first day of each triennial registration period, and shall be  paid  in  addition  to  the triennial  registration  fee  required  by  subdivision eight of section seventy-one hundred four of this article.   * NB Effective January 1, 2023   8. * Notice to patient.   * NB Effective until October 25, 2023   * Notice  to  patient  with  the  use  or  prescription   of   topical therapeutic  pharmaceutical agents and therapeutic pharmaceutical agents for treatment of glaucoma and ocular hypertension.   * NB Effective October 25, 2023 (a) * (i) An optometrist prescribing steroids  or  antiviral  medication shall  inform  each  patient  that  in  the event the condition does not  improve within five days, a physician of the patient's  choice  will  be notified.   * NB Effective until October 25, 2023   * (i)   An  optometrist  prescribing  topical  steroids  or  antiviral medication shall inform each patient that in  the  event  the  condition does  not  improve within five days, a physician of the patient's choice will be notified.   * NB Effective October 25, 2023  (ii)  An  optometrist  engaged  in  a  written  consultation  with  an ophthalmologist  shall inform a patient diagnosed with glaucoma that the optometrist will have the diagnosis confirmed  and  co-managed  with  an ophthalmologist  of  the  patient's  choice,  or  one  selected  by  the optometrist.  (b) In addition, each  optometrist  certified  to  prescribe  and  use therapeutic   drugs  shall  have  posted  conspicuously  in  the  office reception area the following notice:   "Dr. (Name), O.D. is certified by New  York  State  to  use  drugs  to diagnose  and  treat  diseases  of  the eye. In the event your condition requires the use of steroids or antiviral medication and your  condition does  not  improve  within five days, a physician of your choice will be notified.   In the event you are diagnosed with  glaucoma,  the  optometrist  will have   your   diagnosis  confirmed  and  treatment  co-managed  with  an ophthalmologist (MD) of your choice, or if you wish, one selected by Dr. (Name)."   The second paragraph of such notice  shall  only  be  required  to  be included  during the period when the optometrist is engaged in a written consultation pursuant to subdivision six of this section.   9. Education review committee. An education review committee is hereby created to advise and assist the commissioner in evaluating pre-acquired clinical training. The members of the committee shall  be  appointed  by the  commissioner  in  consultation  with  the  chancellor  of the state university of New York. The committee shall consist of five members, two of whom shall be optometrists on the faculty  of  the  SUNY  college  of optometry,  two  of  whom  shall be ophthalmologists who, in addition to being members of the faculty of any  approved  medical  school  in  this state  and  not  also faculty members of SUNY college of optometry, have surgical privileges at a New York state hospital. The fifth  member  who shall  be  designated as chair shall be an expert in the field of public health and shall be neither an ophthalmologist nor an optometrist.   The commissioner shall submit each application to  the  committee  for its  review  and  recommendation.  In  making  such  recommendation, the committee shall advise  as  to  the  number  of  hours  of  pre-acquired clinical  training,  if  any, to be approved, based upon the information submitted  with  the  application.  In  evaluating  such  training,  the committee  shall  be  authorized  to  require  the  submission  of  such reasonable documentation needed to facilitate the committee's review  of the adequacy and relevance of such training.   9-a.  Pre-acquired  clinical training. (a) Each optometrist requesting approval of  pre-acquired  clinical  training  shall  submit  a  written application  to  the  department. The commissioner, in consultation with the education review committee may provide credit for the following:  (i) clinical training acquired  at  an  institution  accredited  by  a regional  or professional accreditation organization which is recognized or approved by the United States Department of Education, the department and the Board of Regents of the University of the state of New York;  (ii) clinical training acquired at a facility licensed by the state of New York in accordance with article twenty-eight of  the  public  health  law  or  at  a  comparable  facility located in another state or country provided the licensing requirements  or  accreditation  requirements  of such institution are comparable to those of New York state;  (iii)  hospital  affiliations, including rounds and patient management for applicants having staff privileges at such facility;  (iv) consultation and co-management with ophthalmologists of  patients with ocular disease and post-surgery recovery;  (v) postdoctoral accredited residency or fellowship programs;  (vi)  experience at an accredited educational institution as a faculty instructor  in  clinical  practice,  ocular   disease   management   and pharmacology;  (vii)  experience  in  other  states  in  which the applicant has been certified to use therapeutic pharmaceutical agents.  (b)  Any  optometrist  disagreeing  with  the  recommendation  of  the education  review  committee  shall have a right to appeal in writing to the commissioner. The decision of the commissioner shall  be  final  and binding on all parties.   * 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 commercially available.   * NB Effective until October 25, 2023   * 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  topical  therapeutic pharmaceutical  agents  shall  be  authorized  to  use and prescribe all topical therapeutic pharmaceutical agents specified in paragraph (e)  of subdivision one of this section, which are FDA approved and commercially available for topical use.   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  therapeutic pharmaceutical agents for treatment of glaucoma and ocular  hypertension shall  be  authorized  to  use  and prescribe therapeutic pharmaceutical agents for treatment of glaucoma and ocular  hypertension  specified  in paragraph (f) of subdivision one of this section, which are FDA approved and commercially available.  (d)  Those  optometrists  having  been  certified for oral therapeutic pharmaceutical agents shall be authorized  to  use  and  prescribe  oral therapeutic   pharmaceutical   agents  specified  in  paragraph  (g)  of  subdivision one of this section, which are FDA approved and commercially available and shall comply with all safety information  and  side-effect and  warning  advisories  contained in the most current physicians' desk reference.  (e)  Those  optometrists having been certified for topical therapeutic pharmaceutical agents, therapeutic pharmaceutical agents  for  treatment of  glaucoma  and ocular hypertension or oral 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.   * NB Effective October 25, 2023   11. Responsibilities of the commissioner. The commissioner shall adopt regulations (a) providing for  the  certification  of  graduates  of  an appropriate  program  approved  by  the department who have successfully passed  the  examination  on  the  use  of  diagnostic  and  therapeutic pharmaceutical  agents  and  who  have  graduated  subsequent to January first,  nineteen  hundred  ninety-three;  and  (b)  providing  for   the certification  of  optometrists who have graduated from other accredited colleges  of  optometry  or  who  are  licensed  to  practice  in  other jurisdictions,  have  demonstrated  such  use  in  independently managed patients and are seeking licensure and certification in New York.   12. Responsibilities of the commissioner of health.  The  commissioner 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 longer appropriate for their current use or for other similar reasons.