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One year after TPA passage, Pennsylvania ready to certify ODs to prescribe
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HARRISBURG, Pa. - It has been 1 year since Pennsylvania Gov. Tom Ridge signed therapeutic pharmaceutical agent (TPA) legislation for optometrists, and in that time more than 400 ODs have completed the required course work and exam to become certified to prescribe. Their ability to use the new law, however, is on hold until final regulations regarding certification are approved.
Two separate regulations must be approved before any Pennsylvania OD can be certified to prescribe therapeutics. The State Board of Optometry must first establish the certification criteria which, depending on an applicant's date of licensure, may include completion of a 100-hour therapeutics course and passage of the Therapeutic Management of Ocular Disease exam. Also, the state Secretary of Health must approve the list of drugs certified optometrists can prescribe.
Both issues are close to being resolved, according to Ted Mowatt, Government Affairs Director for the Pennsylvania Optometric Association.
"We would have liked for this process to be finished by now, but that's not the way it is. However, we are getting to a place where we can soon start getting people certified to prescribe," Mr. Mowatt said. Certification could come early next year, mainly because the State Board of Optometry met last month to consider final regulations.
Mr. Mowatt said the state board will be responsible for sending applications to ODs for "therapeutic" certification once the Secretary of Health approves the specific drugs they can prescribe.
"Then optometrists can apply their course work credentials for certification approval. Once they get approval, they can begin prescribing," he said.
Orals, topicals allowed
Pennsylvania was the 49th state to grant its ODs prescribing privileges. The bill, signed in October 1996, allows them to prescribe oral and topical medications for treating anterior segment disease, the eyelids, lacrimal system and conjunctiva. Optometrists can also perform superficial foreign body removal of the ocular surface and adnexa.
Exclusions include steroids, glaucoma medications and Schedule I and II controlled substances. In addition, the legislation specifies that any condition being treated by a prescribing optometrist that does not improve within 6 weeks must then involve a consult with a licensed physician.
Although ophthalmology continues to challenge final regulations concerning TPAs, Mr. Mowatt said, "I believe the relationship with MDs will improve once there is more interaction between professionals. For instance, the primary care physicians will have more help treating eye diseases."
There are approximately 2,350 licensed optometrists in Pennsylvania and, so far, Mr. Mowatt estimates, more than 400 have completed the course and exam for TPA certification. Getting a handle, however, on the number of practitioners who have graduated recently and may be exempt from the exam is more difficult.
Getting certified
"Right now, the proposed State Board regulations use April 1993 as the cutoff date," Mr. Mowatt said, which means that if it is approved, ODs who graduated after that date will not be required to take the 100-hour course and exam.
"We average about 100 new licensees a year, and if we assume that they are all still here in Pennsylvania, a reasonable guess is that there are 400 to 500 optometrists in this category of exemption," he said.
Add to that number the more than 400 ODs who have completed the course work and exam, and it could mean that nearly half of Pennsylvania's optometrists are ready to apply for TPA certification.
While details about last year's TPA law are still being finalized, Mr. Mowatt said, the state association is also looking toward the future and another legislative effort to continue to expand optometry's scope of practice here.
For Your Information:
- Ted Mowatt may be contacted at the Pennsylvania Optometric Association, 218 North Street, P.O. Box 3312, Harrisburg, PA 17105; (717) 233-6455; fax: (717) 233-6833; e-mail: POAEyes@aol.com.