Senate File 326 H-1166 Amend Senate File 326, as amended, passed, and reprinted by 1 the Senate, as follows: 2 1. Page 1, by striking lines 24 through 32 and inserting: 3 < Sec. ___. Section 155A.46, Code 2023, is amended by adding 4 the following new subsection: 5 NEW SUBSECTION . 3. A pharmacist may, pursuant to statewide 6 protocols developed by the board in consultation with the 7 department of health and human services, order and dispense 8 to patients eighteen years and older self-administered 9 hormonal contraceptives. For the purpose of this 10 subsection, “self-administered hormonal contraceptive” means 11 a self-administered hormonal contraceptive that is approved 12 by the United States food and drug administration to prevent 13 pregnancy. “Self-administered hormonal contraceptive” includes 14 an oral hormonal contraceptive, a hormonal vaginal ring, and 15 a hormonal contraceptive patch, but does not include any drug 16 intended to induce an abortion as defined in section 146.1. 17 a. In ordering and dispensing a self-administered hormonal 18 contraceptive to a patient under this subsection, a pharmacist 19 shall comply with all of the following: 20 (1) For an initial dispensing of a self-administered 21 hormonal contraceptive, the pharmacist may dispense only up 22 to a three-month supply at one time of the self-administered 23 hormonal contraceptive. 24 (2) For any subsequent dispensing of the same 25 self-administered hormonal contraceptive, the pharmacist 26 may dispense up to a twelve-month supply at one time of the 27 self-administered hormonal contraceptive. 28 b. The statewide protocols shall require a pharmacist who 29 dispenses a self-administered hormonal contraceptive under this 30 subsection to do all of the following: 31 (1) Retain a record of each patient to whom a 32 self-administered hormonal contraceptive is dispensed under 33 this subsection and submit the record to the department of 34 health and human services. 35 -1- SF 326.1390 (5) 90 pf/rh 1/ 4 #1.

(2) Complete a standardized training program and continuing 1 education requirements approved by the board in consultation 2 with the board of medicine and the department of health and 3 human services that are related to ordering and dispensing a 4 self-administered hormonal contraceptive and include education 5 regarding all contraceptive methods approved by the United 6 States food and drug administration. 7 (3) Obtain a completed self-screening risk assessment, 8 approved by the department of health and human services in 9 collaboration with the board and the board of medicine, from 10 each patient, verify the identity and age of each patient, and 11 perform a blood pressure screening on each patient prior to 12 dispensing the self-administered hormonal contraceptive to the 13 patient. 14 (4) Provide the patient with all of the following: 15 (a) Written information regarding all of the following: 16 (i) The importance of completing an appointment with the 17 patient’s primary care or women’s health care practitioner 18 to obtain preventative care, including but not limited to 19 recommended tests and screenings. 20 (ii) The effectiveness and availability of 21 long-acting reversible contraceptives as an alternative 22 to self-administered hormonal contraceptives. 23 (b) A copy of the record of the pharmacist’s encounter with 24 the patient that includes all of the following: 25 (i) The patient’s completed self-screening risk assessment. 26 (ii) A description of the self-administered hormonal 27 contraceptive dispensed, or the basis for not dispensing a 28 self-administered hormonal contraceptive. 29 (c) Patient counseling regarding all of the following: 30 (i) The appropriate administration and storage of the 31 self-administered hormonal contraceptive. 32 (ii) Potential side effects and risks of the 33 self-administered hormonal contraceptive. 34 (iii) The need for backup contraception. 35 -2- SF 326.1390 (5) 90 pf/rh 2/ 4

(iv) When to seek emergency medical attention. 1 (v) The risk of contracting a sexually transmitted 2 infection or disease, and ways to reduce such a risk. 3 c. The statewide protocols shall prohibit a pharmacist who 4 orders and dispenses a self-administered hormonal contraceptive 5 under this subsection from doing any of the following: 6 (1) Requiring any other prescription drug order authorized 7 by a practitioner prior to dispensing the self-administered 8 hormonal contraceptive to a patient. 9 (2) Requiring a patient to schedule an appointment 10 with the pharmacist for the ordering or dispensing of a 11 self-administered hormonal contraceptive. 12 (3) Dispensing a self-administered hormonal contraceptive 13 to a patient for more than fifteen months after the date a 14 self-administered hormonal contraceptive is initially dispensed 15 to the patient, if the patient has not consulted with a primary 16 care or women’s health care practitioner during the preceding 17 fifteen months, in which case the pharmacist shall refer the 18 patient to a primary care or women’s health care practitioner. 19 (4) Dispensing a self-administered hormonal contraceptive 20 to a patient if the results of the self-screening risk 21 assessment indicate it is unsafe for the pharmacist to dispense 22 the self-administered hormonal contraceptive to the patient, in 23 which case the pharmacist shall refer the patient to a primary 24 care or women’s health care practitioner. 25 d. A pharmacist who orders and dispenses a self-administered 26 hormonal contraceptive shall be immune from criminal and civil 27 liability arising from any damages caused by the ordering, 28 dispensing, administering, or use of a self-administered 29 hormonal contraceptive. 30 Sec. ___. INFORMATION PROGRAM FOR DRUG PRESCRIBING AND 31 DISPENSING —— SELF-ADMINISTERED HORMONAL CONTRACEPTIVES. The 32 board of pharmacy in collaboration with the board of medicine 33 and the department of health and human services shall expand 34 the information program for drug prescribing and dispensing 35 -3- SF 326.1390 (5) 90 pf/rh 3/ 4

established pursuant to section 124.551, to collect from 1 pharmacists information relating to the dispensing of 2 self-administered hormonal contraceptives as provided pursuant 3 to section 155A.46. The board of pharmacy shall adopt 4 rules pursuant to chapter 17A related to registration of 5 participating pharmacists, the information to be reported by a 6 pharmacist to the information program, access to information 7 from the program, and other rules necessary to carry out the 8 purposes and to enforce the provisions of this section. > 9 2. Title page, line 1, by striking < and administering > and 10 inserting < , administering, and dispensing > 11 ______________________________ COMMITTEE ON HEALTH AND HUMAN SERVICES A. MEYER of Webster, Chairperson -4- SF 326.1390 (5) 90 pf/rh 4/ 4 #2.