Bill Text: IA SF2322 | 2017-2018 | 87th General Assembly | Introduced

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Bill Title: A bill for an act relating to the practice of pharmacy, including the administration of certain drugs and vaccines and the establishment of technician product verification programs. (Formerly SSB 3146.) Effective 7-1-18.

Sponsorship: Committee Bill

Status: (Passed) 2018-05-16 - Signed by Governor. S.J. 1087. [SF2322 Detail]

Download: Iowa-2017-SF2322-Introduced.html

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Senate File 2322 - Introduced




                                 SENATE FILE       
                                 BY  COMMITTEE ON STATE
                                     GOVERNMENT

                                 (SUCCESSOR TO SSB
                                     3146)

                                      A BILL FOR

  1 An Act relating to the practice of pharmacy, including the
  2    administration of certain drugs and vaccines and the
  3    establishment of technician product verification programs.
  4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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PAG LIN



  1  1    Section 1.  Section 147.107, subsection 2, Code 2018, is
  1  2 amended to read as follows:
  1  3    2.  a.  A pharmacist, physician, dentist, podiatric
  1  4 physician, or prescribing psychologist who dispenses
  1  5 prescription drugs, including but not limited to controlled
  1  6 substances, for human use, may delegate nonjudgmental
  1  7 dispensing functions to staff assistants only when verification
  1  8 of the accuracy and completeness of the dispensing is
  1  9 determined by the pharmacist or practitioner in the
  1 10 pharmacist's or practitioner's physical presence. However, the
  1 11 physical presence requirement does not apply when a pharmacist
  1 12 or practitioner is utilizing an automated dispensing system;
  1 13 when a pharmacist is utilizing a tech=check=tech program, as
  1 14 defined in section 155A.3; or when a pharmacist is remotely
  1 15 supervising a certified pharmacy technician practicing
  1 16 at a telepharmacy site approved by the board of pharmacy.
  1 17 When using an automated dispensing system, the pharmacist
  1 18 or practitioner shall utilize an internal quality control
  1 19 assurance plan that ensures accuracy for dispensing. When
  1 20 using a tech=check=tech program or when remotely supervising
  1 21 a certified pharmacy technician practicing at an approved
  1 22 telepharmacy site, the pharmacist shall utilize an internal
  1 23 quality control assurance plan, in accordance with rules
  1 24 adopted by the board of pharmacy, that ensures accuracy
  1 25 for dispensing. Verification of automated dispensing,
  1 26 tech=check=tech, and telepharmacy practice accuracy and
  1 27 completeness remains the responsibility of the pharmacist
  1 28 or practitioner and shall be determined in accordance with
  1 29 rules adopted by the board of pharmacy, the board of medicine,
  1 30 the dental board, the board of podiatry, and the board of
  1 31 psychology for their respective licensees.
  1 32    b.  A dentist, physician, podiatric physician, or prescribing
  1 33 psychologist who dispenses prescription drugs, other than drug
  1 34 samples, pursuant to this subsection, shall report the fact
  1 35 that they dispense prescription drugs with the practitioner's
  2  1 respective board at least biennially.
  2  2    c.  A physician, dentist, podiatric physician, or prescribing
  2  3 psychologist who dispenses prescription drugs, other than drug
  2  4 samples, pursuant to this subsection, shall offer to provide
  2  5 the patient with a written prescription that may be dispensed
  2  6 from a pharmacy of the patient's choice or offer to transmit
  2  7 the prescription orally, electronically, or by facsimile in
  2  8 accordance with section 155A.27 to a pharmacy of the patient's
  2  9 choice.
  2 10    d.  A pharmacist who dispenses prescription drugs, including
  2 11 but not limited to controlled substances, for human use, may
  2 12 delegate nonjudgmental dispensing functions to a certified
  2 13 pharmacy technician only when verification of the accuracy and
  2 14 completeness of the dispensing is determined by the pharmacist
  2 15 in the pharmacist's physical presence. The pharmacist's
  2 16 verification of the accuracy of the prescription drug dispensed
  2 17 shall not be required when verified by a certified pharmacy
  2 18 technician in a technician product verification program or a
  2 19 tech=check=tech program as defined in section 155A.3. The
  2 20 pharmacist's physical presence shall not be required when
  2 21 the pharmacist is remotely supervising pharmacy personnel
  2 22 operating in an approved telepharmacy site or when utilizing
  2 23 an automated dispensing system that utilizes an internal
  2 24 quality control assurance plan. When utilizing a technician
  2 25 product verification program or tech=check=tech program, or
  2 26 when remotely supervising pharmacy personnel operating at an
  2 27 approved telepharmacy site, the pharmacist shall utilize an
  2 28 internal quality control assurance plan, in accordance with
  2 29 rules adopted by the board of pharmacy, that ensures accuracy
  2 30 for dispensing. Automated dispensing verification, technician
  2 31 product verification, and telepharmacy practice accuracy and
  2 32 completeness remains the responsibility of the pharmacist and
  2 33 shall be determined in accordance with rules adopted by the
  2 34 board of pharmacy.
  2 35    Sec. 2.  Section 155A.3, Code 2018, is amended by adding the
  3  1 following new subsections:
  3  2    NEW SUBSECTION.  42A.  "Statewide protocol" means a framework
  3  3 developed and issued by the board that specifies the conditions
  3  4 under which pharmacists are authorized to dispense a medication
  3  5 or category of medications when providing a clinical service.
  3  6    NEW SUBSECTION.  43A.  "Technician product verification"
  3  7 means the process by which a certified pharmacy technician
  3  8 provides the final product verification for prescription
  3  9 drugs or devices filled or prepared by a registered pharmacy
  3 10 technician, pharmacist=intern, or with an automated dispensing
  3 11 system.
  3 12    Sec. 3.  Section 155A.6A, subsection 4, Code 2018, is amended
  3 13 to read as follows:
  3 14    4.  The board shall adopt rules in accordance with
  3 15 chapter 17A on matters pertaining to pharmacy technician
  3 16 registration, application, forms, renewals, fees, termination
  3 17 of registration, tech=check=tech programs, technician product
  3 18 verification programs, national certification, training, and
  3 19 any other relevant matters.
  3 20    Sec. 4.  Section 155A.33, Code 2018, is amended to read as
  3 21 follows:
  3 22    155A.33  Delegation of technical functions.
  3 23    A pharmacist may delegate technical dispensing functions
  3 24 to pharmacy technicians, but only if the pharmacist is
  3 25 physically present to verify the accuracy and completeness
  3 26 of the patient's prescription prior to the delivery of the
  3 27 prescription to the patient or the patient's representative.
  3 28 However, the physical presence requirement does not apply
  3 29 when a pharmacist is utilizing an automated dispensing system
  3 30 or a tech=check=tech technician product verification program
  3 31 or when a pharmacist is remotely supervising a certified
  3 32 pharmacy technician practicing at a telepharmacy site approved
  3 33 by the board. When using an automated dispensing system or
  3 34 a tech=check=tech technician product verification program,
  3 35 or when remotely supervising a certified pharmacy technician
  4  1 practicing at an approved telepharmacy site, the pharmacist
  4  2 shall utilize an internal quality control assurance plan that
  4  3 ensures accuracy for dispensing. Verification of automated
  4  4 dispensing, tech=check=tech technician product verification,
  4  5 and telepharmacy practice accuracy and completeness remains the
  4  6 responsibility of the pharmacist and shall be determined in
  4  7 accordance with rules adopted by the board.
  4  8    Sec. 5.  NEW SECTION.  155A.33A  Technician product
  4  9 verification programs.
  4 10    1.  A pharmacist in charge of a pharmacy located in this
  4 11 state may formally establish a technician product verification
  4 12 program to optimize the provision of pharmacist patient care
  4 13 services. The board shall require a pharmacist in charge
  4 14 intending to implement a technician product verification
  4 15 program to submit a program plan for board consideration and
  4 16 approval. The plan shall demonstrate that onsite practice
  4 17 hours for a pharmacist will not be reduced but will be
  4 18 redistributed directly to patient care activities.
  4 19    2.  The board shall adopt rules for the development,
  4 20 implementation, and oversight of technician product
  4 21 verification programs. The rules shall address program policy
  4 22 and procedures, pharmacist and pharmacy technician training,
  4 23 program quality assurance and evaluation, recordkeeping,
  4 24 redistribution of pharmacist activities, and other matters
  4 25 necessary for the development, implementation, and oversight
  4 26 of the program.
  4 27    Sec. 6.  NEW SECTION.  155A.46  Statewide protocols.
  4 28    1.  a.  A pharmacist may, pursuant to statewide protocols
  4 29 developed by the board in consultation with the department
  4 30 of public health and consistent with subsection 2, order and
  4 31 administer the following to patients ages eighteen years and
  4 32 older:
  4 33    (1)  Naloxone.
  4 34    (2)  Nicotine replacement tobacco cessation products.
  4 35    (3)  An immunization or vaccination recommended by the
  5  1 United States centers for disease control and prevention
  5  2 advisory committee on immunization practices in its approved
  5  3 vaccination schedule for adults.
  5  4    (4)  An immunization or vaccination recommended by the
  5  5 United States centers for disease control and prevention for
  5  6 international travel.
  5  7    (5)  A Tdap (tetanus, diphtheria, acellular pertussis)
  5  8 vaccination in a booster application.
  5  9    (6)  Other emergency immunizations or vaccinations in
  5 10 response to a public health emergency.
  5 11    b.  A pharmacist may, pursuant to statewide protocols
  5 12 developed by the board in consultation with the department
  5 13 of public health and consistent with subsection 2, order and
  5 14 administer the following to patients ages six months and older:
  5 15    (1)  A vaccine or immunization for influenza.
  5 16    (2)  Other emergency immunizations or vaccines in response
  5 17 to a public health emergency.
  5 18    c.  A pharmacist may, pursuant to statewide protocols
  5 19 developed by the board in consultation with the department
  5 20 of public health and consistent with subsection 2, order and
  5 21 administer the final two doses in a course of vaccinations for
  5 22 HPV to patients ages eleven years and older.
  5 23    d.  Prior to the ordering and administration of a vaccination
  5 24 or immunization authorized by this subsection,  pursuant  to
  5 25 statewide protocols, a licensed pharmacist shall consult
  5 26 and review the statewide immunization registry or  health
  5 27 information network. The board shall adopt rules requiring the
  5 28 reporting of the administration of vaccines and immunizations
  5 29 authorized by this subsection to a patient's primary health
  5 30 care provider, primary physician, and a statewide immunization
  5 31 registry or health information network.
  5 32    2.  A pharmacist administering a prescription drug, product,
  5 33 test, or treatment pursuant to subsection 1 shall do all of the
  5 34 following:
  5 35    a.  Maintain a record of all prescription drugs, products,
  6  1 tests, and treatments administered pursuant to this section.
  6  2    b.  Notify the patient's primary health care provider
  6  3 of any prescription drugs, products, tests, or treatments
  6  4 administered to the patient, or enter such information in a
  6  5 patient record system also used by the primary health care
  6  6 provider, as permitted by the primary health care provider. If
  6  7 the patient does not have a primary health care provider, the
  6  8 pharmacist shall provide the patient with a written record of
  6  9 the prescription drugs, products, tests, or treatment provided
  6 10 to the patient and shall advise the patient to consult a
  6 11 physician.
  6 12    c.  Complete annual continuing pharmacy education related to
  6 13 administration protocols recognized and approved by the board.
  6 14    Sec. 7.  REPEAL.  Sections 155A.34 and 155A.44, Code 2018,
  6 15 are repealed.
  6 16                           EXPLANATION
  6 17 The inclusion of this explanation does not constitute agreement with
  6 18 the explanation's substance by the members of the general assembly.
  6 19    This bill alters the practice of pharmacy by modifying
  6 20 the circumstances under which a pharmacist can delegate
  6 21 prescription verification duties to employees. The bill
  6 22 also permits pharmacists to prescribe and administer certain
  6 23 medications and treatments.
  6 24    The bill creates a technician product verification program
  6 25 by which a pharmacist can instruct a pharmacy technician
  6 26 to verify the accuracy of any dispensed prescriptions and
  6 27 undertake other technical functions for the purpose of
  6 28 allowing the pharmacist to spend more time on patient care
  6 29 activities. The bill directs the board of pharmacy to adopt
  6 30 rules establishing the requirements for technician product
  6 31 verification programs.
  6 32    The bill also permits pharmacists to order and administer
  6 33 to a person 18 years of age or older naloxone, nicotine
  6 34 replacement, tobacco cessation products, immunizations
  6 35 or vaccinations recommended by the United States centers
  7  1 for disease control and prevention advisory committee on
  7  2 immunization practices in its approved vaccination schedule
  7  3 for adults, immunizations recommended by the United States
  7  4 centers for disease control and prevention for international
  7  5 travel, Tdap vaccinations in booster applications, and other
  7  6 emergency immunizations or vaccinations in response to a
  7  7 public health emergency, pursuant to statewide protocols
  7  8 adopted by the board of pharmacy in consultation with the
  7  9 department of public health. A pharmacist may also administer,
  7 10 pursuant to statewide protocols, to patients six months of
  7 11 age or older a vaccine or immunization for influenza and
  7 12 other emergency immunizations or vaccinations in response to
  7 13 a public health emergency. A pharmacist may administer to
  7 14 patients 11 years of age or older the final two doses in a
  7 15 course of vaccinations for HPV pursuant to statewide protocols.
  7 16 A pharmacist must keep a record of all prescription drugs,
  7 17 products, and treatments administered, notify the patient's
  7 18 primary health care provider or provide a written record to the
  7 19 patient, consult the statewide immunization registry or health
  7 20 information network, and complete annual continuing pharmacy
  7 21 education related to the protocols adopted by the board.
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