Senate File 2322 - Reprinted SENATE FILE 2322 BY COMMITTEE ON STATE GOVERNMENT (SUCCESSOR TO SSB 3146) (As Amended and Passed by the Senate March 5, 2018 ) A BILL FOR An Act relating to the practice of pharmacy, including the 1 administration of certain drugs and vaccines and the 2 establishment of technician product verification programs. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 SF 2322 (2) 87 ss/rh/jh
S.F. 2322 Section 1. Section 147.107, subsection 2, Code 2018, is 1 amended to read as follows: 2 2. a. A pharmacist, physician, dentist, podiatric 3 physician, or prescribing psychologist prescriber who 4 dispenses prescription drugs, including but not limited 5 to controlled substances, for human use, may delegate 6 nonjudgmental dispensing functions to staff assistants only 7 when verification of the accuracy and completeness of the 8 dispensing is determined by the pharmacist or practitioner in 9 the pharmacist’s or practitioner’s physical presence. However, 10 the physical presence requirement does not apply when a 11 pharmacist or practitioner is utilizing an automated dispensing 12 system ; when a pharmacist is utilizing a tech-check-tech 13 program, as defined in section 155A.3 ; or when a pharmacist is 14 remotely supervising a certified pharmacy technician practicing 15 at a telepharmacy site approved by the board of pharmacy . 16 When using an automated dispensing system , the pharmacist 17 or practitioner shall utilize an internal quality control 18 assurance plan that ensures accuracy for dispensing. When 19 using a tech-check-tech program or when remotely supervising 20 a certified pharmacy technician practicing at an approved 21 telepharmacy site, the pharmacist shall utilize an internal 22 quality control assurance plan, in accordance with rules 23 adopted by the board of pharmacy, that ensures accuracy 24 for dispensing. Verification of automated dispensing , 25 tech-check-tech, and telepharmacy practice accuracy and 26 completeness remains the responsibility of the pharmacist 27 or practitioner and shall be determined in accordance with 28 rules adopted by the board of pharmacy, the board of medicine, 29 the dental board, the board of podiatry, and the board of 30 psychology for their respective licensees. 31 b. A dentist, physician, podiatric physician, or prescribing 32 psychologist prescriber who dispenses prescription drugs, 33 other than drug samples, pursuant to this subsection , shall 34 report the fact that they dispense prescription drugs with the 35 -1- SF 2322 (2) 87 ss/rh/jh 1/ 6
S.F. 2322 practitioner’s respective board at least biennially. 1 c. A physician, dentist, podiatric physician, or prescribing 2 psychologist prescriber who dispenses prescription drugs, other 3 than drug samples, pursuant to this subsection , shall offer to 4 provide the patient with a written prescription , if requested, 5 that may be dispensed from a pharmacy of the patient’s choice 6 or offer to transmit the prescription orally, electronically, 7 or by facsimile in accordance with section 155A.27 to a 8 pharmacy of the patient’s choice. 9 d. A pharmacist who dispenses prescription drugs, including 10 but not limited to controlled substances, for human use, 11 may delegate nonjudgmental dispensing functions only when 12 verification of the accuracy and completeness of the dispensing 13 is determined by the pharmacist in the pharmacist’s physical 14 presence. The pharmacist’s verification of the accuracy of the 15 prescription drug dispensed shall not be required when verified 16 by a certified pharmacy technician in a technician product 17 verification program or a tech-check-tech program as defined 18 in section 155A.3. The pharmacist’s physical presence shall 19 not be required when the pharmacist is remotely supervising 20 pharmacy personnel operating in an approved telepharmacy site 21 or when utilizing an automated dispensing system that utilizes 22 an internal quality control assurance plan. When utilizing 23 a technician product verification program or tech-check-tech 24 program, or when remotely supervising pharmacy personnel 25 operating at an approved telepharmacy site, the pharmacist 26 shall utilize an internal quality control assurance plan, 27 in accordance with rules adopted by the board of pharmacy, 28 that ensures accuracy for dispensing. Automated dispensing 29 verification, technician product verification, and telepharmacy 30 practice accuracy and completeness remains the responsibility 31 of the pharmacist and shall be determined in accordance with 32 rules adopted by the board of pharmacy. 33 Sec. 2. Section 155A.3, Code 2018, is amended by adding the 34 following new subsections: 35 -2- SF 2322 (2) 87 ss/rh/jh 2/ 6
S.F. 2322 NEW SUBSECTION . 42A. “Statewide protocol” means a framework 1 developed and issued by the board that specifies the conditions 2 under which pharmacists are authorized to order and administer 3 a medication or category of medications when providing a 4 clinical service. 5 NEW SUBSECTION . 43A. “Technician product verification” 6 means the process by which a certified pharmacy technician 7 provides the final product verification for prescription 8 drugs or devices filled or prepared by a registered pharmacy 9 technician, pharmacist-intern, or with an automated dispensing 10 system. 11 Sec. 3. Section 155A.6A, subsection 4, Code 2018, is amended 12 to read as follows: 13 4. The board shall adopt rules in accordance with 14 chapter 17A on matters pertaining to pharmacy technician 15 registration, application, forms, renewals, fees, termination 16 of registration, tech-check-tech programs, technician product 17 verification programs, national certification, training, and 18 any other relevant matters. 19 Sec. 4. Section 155A.33, Code 2018, is amended to read as 20 follows: 21 155A.33 Delegation of technical functions. 22 A pharmacist may delegate technical dispensing functions 23 to pharmacy technicians, but only if the pharmacist is 24 physically present to verify the accuracy and completeness 25 of the patient’s prescription prior to the delivery of the 26 prescription to the patient or the patient’s representative. 27 However, the physical presence requirement does not apply 28 when a pharmacist is utilizing an automated dispensing system 29 or a tech-check-tech technician product verification program 30 or when a pharmacist is remotely supervising a certified 31 pharmacy technician practicing at a telepharmacy site approved 32 by the board. When using an automated dispensing system or 33 a tech-check-tech technician product verification program, 34 or when remotely supervising a certified pharmacy technician 35 -3- SF 2322 (2) 87 ss/rh/jh 3/ 6
S.F. 2322 practicing at an approved telepharmacy site, the pharmacist 1 shall utilize an internal quality control assurance plan that 2 ensures accuracy for dispensing. Verification of automated 3 dispensing, tech-check-tech technician product verification , 4 and telepharmacy practice accuracy and completeness remains the 5 responsibility of the pharmacist and shall be determined in 6 accordance with rules adopted by the board. 7 Sec. 5. NEW SECTION . 155A.33A Technician product 8 verification programs. 9 1. A pharmacist in charge of a pharmacy located in this 10 state may formally establish a technician product verification 11 program to optimize the provision of pharmacist patient 12 care services. The board may require a pharmacist in charge 13 intending to implement a technician product verification 14 program to submit a program plan for board consideration and 15 approval. The plan shall demonstrate that onsite practice 16 hours for a pharmacist will not be reduced but will be 17 redistributed directly to patient care activities. 18 2. The board shall adopt rules for the development, 19 implementation, and oversight of technician product 20 verification programs. The rules shall address program policy 21 and procedures, pharmacist and pharmacy technician training, 22 program quality assurance and evaluation, recordkeeping, 23 redistribution of pharmacist activities, and other matters 24 necessary for the development, implementation, and oversight 25 of the program. 26 Sec. 6. Section 155A.34, Code 2018, is amended by striking 27 the section and inserting in lieu thereof the following: 28 155A.34 Transfer of prescriptions. 29 Any prescription transfer shall be from a licensed pharmacy 30 to another licensed pharmacy and be performed in accordance 31 with rules adopted by the board. 32 Sec. 7. NEW SECTION . 155A.46 Statewide protocols. 33 1. a. A pharmacist may, pursuant to statewide protocols 34 developed by the board in consultation with the department 35 -4- SF 2322 (2) 87 ss/rh/jh 4/ 6
S.F. 2322 of public health and consistent with subsection 2, order and 1 administer the following to patients ages eighteen years and 2 older: 3 (1) Naloxone. 4 (2) Nicotine replacement tobacco cessation products. 5 (3) An immunization or vaccination recommended by the 6 United States centers for disease control and prevention 7 advisory committee on immunization practices in its approved 8 vaccination schedule for adults. 9 (4) An immunization or vaccination recommended by the 10 United States centers for disease control and prevention for 11 international travel. 12 (5) A Tdap (tetanus, diphtheria, acellular pertussis) 13 vaccination in a booster application. 14 (6) Other emergency immunizations or vaccinations in 15 response to a public health emergency. 16 b. A pharmacist may, pursuant to statewide protocols 17 developed by the board in consultation with the department 18 of public health and consistent with subsection 2, order and 19 administer the following to patients ages six months and older: 20 (1) A vaccine or immunization for influenza. 21 (2) Other emergency immunizations or vaccines in response 22 to a public health emergency. 23 c. A pharmacist may, pursuant to statewide protocols 24 developed by the board in consultation with the department 25 of public health and consistent with subsection 2, order and 26 administer the final two doses in a course of vaccinations for 27 HPV to patients ages eleven years and older. 28 d. Prior to the ordering and administration of a vaccination 29 or immunization authorized by this subsection, pursuant to 30 statewide protocols, a licensed pharmacist shall consult 31 and review the statewide immunization registry or health 32 information network. The board shall adopt rules requiring the 33 reporting of the administration of vaccines and immunizations 34 authorized by this subsection to a patient’s primary health 35 -5- SF 2322 (2) 87 ss/rh/jh 5/ 6
S.F. 2322 care provider, primary physician, and a statewide immunization 1 registry or health information network. 2 2. A pharmacist ordering or administering a prescription 3 drug, product, test, or treatment pursuant to subsection 1 4 shall do all of the following: 5 a. Maintain a record of all prescription drugs, products, 6 tests, and treatments administered pursuant to this section. 7 b. Notify the patient’s primary health care provider 8 of any prescription drugs, products, tests, or treatments 9 administered to the patient, or enter such information in a 10 patient record system also used by the primary health care 11 provider, as permitted by the primary health care provider. If 12 the patient does not have a primary health care provider, the 13 pharmacist shall provide the patient with a written record of 14 the prescription drugs, products, tests, or treatment provided 15 to the patient and shall advise the patient to consult a 16 physician. 17 c. Complete continuing pharmacy education related to 18 statewide protocols recognized and approved by the board. 19 Sec. 8. FUTURE REPEAL. Section 155A.44, Code 2018, is 20 repealed effective July 1, 2019. 21 -6- SF 2322 (2) 87 ss/rh/jh 6/ 6