Senate Study Bill 1095 - Introduced SENATE FILE _____ BY (PROPOSED COMMITTEE ON HUMAN RESOURCES BILL BY CHAIRPERSON EDLER) A BILL FOR An Act relating to the practice of pharmacy, including 1 the prescription and administration of vaccines and 2 collaborative pharmacy practice. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 2138XC (2) 89 ss/rh

S.F. _____ Section 1. Section 155A.46, Code 2021, is amended to read 1 as follows: 2 155A.46 Statewide Administration of drugs —— statewide 3 protocols. 4 1. a. A pharmacist may, pursuant to statewide protocols 5 developed by the board in consultation with the department of 6 public health and consistent with subsection 2 3 , order and 7 administer the following to patients ages eighteen years and 8 older: 9 (1) a. Naloxone. 10 (2) b. Nicotine replacement tobacco Tobacco cessation 11 products. 12 c. Point-of-care testing and treatment for influenza, 13 streptococcus A, and COVID-19 as defined in section 686D.2 at 14 the point of interaction between a pharmacist and a patient. 15 d. Point-of-care testing at the point of interaction between 16 a pharmacist and a patient in response to a public health 17 emergency. 18 2. a. A pharmacist may prescribe and administer the 19 following to patients ages three years and older: 20 (3) (1) An immunization or vaccination recommended by 21 the United States centers for disease control and prevention 22 advisory committee on immunization practices in its approved 23 vaccination schedule for adults . 24 (4) (2) An immunization or vaccination recommended by the 25 United States centers for disease control and prevention for 26 international travel. 27 (5) A Tdap (tetanus, diphtheria, acellular pertussis) 28 vaccination in a booster application. 29 (3) Vaccines currently licensed for use in the United 30 States on the list issued by the United States food and drug 31 administration, including those related to COVID-19. 32 (6) (4) Other emergency immunizations or vaccinations in 33 response to a public health emergency. 34 b. A pharmacist may , pursuant to statewide protocols 35 -1- LSB 2138XC (2) 89 ss/rh 1/ 5

S.F. _____ developed by the board in consultation with the department of 1 public health and consistent with subsection 2 , order prescribe 2 and administer the following to patients ages six months and 3 older: 4 (1) A vaccine or An immunization or vaccination for 5 influenza. 6 (2) Other emergency immunizations or vaccines vaccinations 7 in response to a public health emergency. 8 c. A pharmacist may, pursuant to statewide protocols 9 developed by the board in consultation with the department 10 of public health and consistent with subsection 2 , order and 11 administer the final two doses in a course of vaccinations for 12 HPV to patients ages eleven years and older. 13 d. c. Prior to the ordering prescribing and administration 14 of a vaccination or an immunization or vaccination authorized 15 by this subsection , pursuant to statewide protocols, a licensed 16 pharmacist shall consult and review the statewide immunization 17 registry or health information network. The board shall 18 adopt rules requiring the reporting of the administration of 19 vaccines and immunizations and vaccinations authorized by this 20 subsection to a patient’s primary health care provider, primary 21 physician, and a statewide immunization registry or health 22 information network. 23 2. 3. A pharmacist prescribing, ordering , or administering 24 a prescription drug, product, test, or treatment pursuant to 25 subsection 1 or 2 shall do all of the following: 26 a. Maintain a record of all prescription drugs, products, 27 tests, and treatments administered pursuant to this section . 28 b. Notify the patient’s primary health care provider 29 of any prescription drugs, products, tests, or treatments 30 administered to the patient, or enter such information in a 31 patient record system also used by the primary health care 32 provider, as permitted by the primary health care provider. If 33 the patient does not have a primary health care provider, the 34 pharmacist shall provide the patient with a written record of 35 -2- LSB 2138XC (2) 89 ss/rh 2/ 5

S.F. _____ the prescription drugs, products, tests, or treatment provided 1 to the patient and shall advise the patient to consult a 2 physician. 3 c. Complete continuing pharmacy education related to 4 statewide protocols and immunizations and vaccinations 5 recognized and approved by the board. 6 Sec. 2. NEW SECTION . 155A.47 Collaborative pharmacy 7 practice —— agreements —— payment. 8 1. For the purposes of this section: 9 a. “Collaborative pharmacy practice” means a practice of 10 pharmacy whereby a pharmacist provides patient care and drug 11 therapy management services not otherwise permitted to be 12 performed by a pharmacist to patients under a collaborative 13 pharmacy practice agreement with another pharmacist or 14 practitioner which defines the nature, scope, conditions, and 15 limitations of the patient care and drug therapy management 16 services to be provided by a pharmacist in order to ensure that 17 a patient achieves the desired outcomes. 18 b. “Health benefit plan” means the same as defined in 19 section 514J.102. 20 c. “Health carrier” means the same as defined in section 21 514J.102. 22 2. Notwithstanding any provision of law to the contrary, a 23 pharmacist may engage in a collaborative pharmacy practice, in 24 accordance with rules adopted by the board pursuant to chapter 25 17A and under a collaborative pharmacy practice agreement, to 26 provide patient care and drug therapy management services to 27 a patient. 28 3. Notwithstanding any provision of a health benefit plan 29 to the contrary, whenever a health benefit plan provides for 30 payment or reimbursement for a service that is within the 31 lawful scope of practice of a practitioner or pharmacist 32 and the service is provided by a pharmacist pursuant to a 33 collaborative pharmacy practice agreement under this section, 34 the health carrier may provide payment or reimbursement for the 35 -3- LSB 2138XC (2) 89 ss/rh 3/ 5

S.F. _____ service. 1 EXPLANATION 2 The inclusion of this explanation does not constitute agreement with 3 the explanation’s substance by the members of the general assembly. 4 This bill relates to the ordering, prescribing, and 5 administration of certain drugs to patients by pharmacists. 6 With respect to patients 18 years and older, and pursuant 7 to statewide protocols, the bill removes the authority of 8 pharmacists to order and administer nicotine replacement 9 products and Tdap (tetanus, diphtheria, acellular pertussis) 10 vaccinations in a booster application and allows pharmacists 11 to order and administer testing and treatment for influenza, 12 streptococcus A, and COVID-19 as defined in the bill at the 13 point-of-care testing between a pharmacist and a patient. The 14 bill also removes the authority of pharmacists to order and 15 administer the final two doses in a course of vaccinations for 16 HPV (human papilloma virus) to patients 11 years of age and 17 older. 18 The bill allows a pharmacist to prescribe and administer to 19 patients three years of age and older all of the following: 1) 20 an immunization or vaccination recommended by the United States 21 centers for disease control and prevention advisory committee 22 on immunization practices in its approved vaccination schedule, 23 including those related to COVID-19, 2) an immunization or 24 vaccination recommended by the United States centers for 25 disease control and prevention for international travel, 3) 26 vaccines currently licensed for use in the United States on the 27 list issued by the United States food and drug administration, 28 and 4) other emergency immunizations or vaccinations in 29 response to a public health emergency. Current law permits 30 pharmacists to order and administer such immunizations and 31 vaccinations to patients age 18 years and older pursuant to 32 statewide protocols. 33 The bill allows a pharmacist to prescribe and administer 34 a vaccine or immunization for influenza and other emergency 35 -4- LSB 2138XC (2) 89 ss/rh 4/ 5

S.F. _____ immunizations or vaccines in response to a public health 1 emergency to patients ages six months and older. 2 The bill allows a pharmacist to engage in a collaborative 3 pharmacy practice under a collaborative pharmacy practice 4 agreement to provide patient care and drug therapy management 5 services to a patient. 6 The bill allows a health carrier to pay for a service 7 provided by a pharmacist under a collaborative pharmacy 8 practice agreement if the health benefit plan provides for 9 payment or reimbursement for a service when the service is 10 within the lawful scope of practice of a practitioner or 11 pharmacist. 12 -5- LSB 2138XC (2) 89 ss/rh 5/ 5