Print
Amend Senate File 326, as amended, passed, and reprinted by
the Senate, as follows:
1. Page 1, by striking lines 24 through 32 and inserting:
<Sec. ___. Section 155A.46, Code 2023, is amended by adding
the following new subsection:
NEW SUBSECTION. 3. A pharmacist may, pursuant to statewide
protocols developed by the board in consultation with the
department of health and human services, order and dispense
to patients eighteen years and older self-administered
hormonal contraceptives. For the purpose of this
subsection, “self-administered hormonal contraceptive” means
a self-administered hormonal contraceptive that is approved
by the United States food and drug administration to prevent
pregnancy. “Self-administered hormonal contraceptive” includes
an oral hormonal contraceptive, a hormonal vaginal ring, and
a hormonal contraceptive patch, but does not include any drug
intended to induce an abortion as defined in section 146.1.
a. In ordering and dispensing a self-administered hormonal
contraceptive to a patient under this subsection, a pharmacist
shall comply with all of the following:
(1) For an initial dispensing of a self-administered
hormonal contraceptive, the pharmacist may dispense only up
to a three-month supply at one time of the self-administered
hormonal contraceptive.
(2) For any subsequent dispensing of the same
self-administered hormonal contraceptive, the pharmacist
may dispense up to a twelve-month supply at one time of the
self-administered hormonal contraceptive.
b. The statewide protocols shall require a pharmacist who
dispenses a self-administered hormonal contraceptive under this
subsection to do all of the following:
(1) Retain a record of each patient to whom a
self-administered hormonal contraceptive is dispensed under
this subsection and submit the record to the department of
health and human services.
(2) Complete a standardized training program and continuing
education requirements approved by the board in consultation
with the board of medicine and the department of health and
human services that are related to ordering and dispensing a
self-administered hormonal contraceptive and include education
regarding all contraceptive methods approved by the United
States food and drug administration.
(3) Obtain a completed self-screening risk assessment,
approved by the department of health and human services in
collaboration with the board and the board of medicine, from
each patient, verify the identity and age of each patient, and
perform a blood pressure screening on each patient prior to
dispensing the self-administered hormonal contraceptive to the
patient.
(4) Provide the patient with all of the following:
(a) Written information regarding all of the following:
(i) The importance of completing an appointment with the
patient’s primary care or women’s health care practitioner
to obtain preventative care, including but not limited to
recommended tests and screenings.
(ii) The effectiveness and availability of
long-acting reversible contraceptives as an alternative
to self-administered hormonal contraceptives.
(b) A copy of the record of the pharmacist’s encounter with
the patient that includes all of the following:
(i) The patient’s completed self-screening risk assessment.
(ii) A description of the self-administered hormonal
contraceptive dispensed, or the basis for not dispensing a
self-administered hormonal contraceptive.
(c) Patient counseling regarding all of the following:
(i) The appropriate administration and storage of the
self-administered hormonal contraceptive.
(ii) Potential side effects and risks of the
self-administered hormonal contraceptive.
(iii) The need for backup contraception.
(iv) When to seek emergency medical attention.
(v) The risk of contracting a sexually transmitted
infection or disease, and ways to reduce such a risk.
c. The statewide protocols shall prohibit a pharmacist who
orders and dispenses a self-administered hormonal contraceptive
under this subsection from doing any of the following:
(1) Requiring any other prescription drug order authorized
by a practitioner prior to dispensing the self-administered
hormonal contraceptive to a patient.
(2) Requiring a patient to schedule an appointment
with the pharmacist for the ordering or dispensing of a
self-administered hormonal contraceptive.
(3) Dispensing a self-administered hormonal contraceptive
to a patient for more than fifteen months after the date a
self-administered hormonal contraceptive is initially dispensed
to the patient, if the patient has not consulted with a primary
care or women’s health care practitioner during the preceding
fifteen months, in which case the pharmacist shall refer the
patient to a primary care or women’s health care practitioner.
(4) Dispensing a self-administered hormonal contraceptive
to a patient if the results of the self-screening risk
assessment indicate it is unsafe for the pharmacist to dispense
the self-administered hormonal contraceptive to the patient, in
which case the pharmacist shall refer the patient to a primary
care or women’s health care practitioner.
d. A pharmacist who orders and dispenses a self-administered
hormonal contraceptive shall be immune from criminal and civil
liability arising from any damages caused by the ordering,
dispensing, administering, or use of a self-administered
hormonal contraceptive.
Sec. ___. INFORMATION PROGRAM FOR DRUG PRESCRIBING AND
DISPENSING — SELF-ADMINISTERED HORMONAL CONTRACEPTIVES. The
board of pharmacy in collaboration with the board of medicine
and the department of health and human services shall expand
the information program for drug prescribing and dispensing
established pursuant to section 124.551, to collect from
pharmacists information relating to the dispensing of
self-administered hormonal contraceptives as provided pursuant
to section 155A.46. The board of pharmacy shall adopt
rules pursuant to chapter 17A related to registration of
participating pharmacists, the information to be reported by a
pharmacist to the information program, access to information
from the program, and other rules necessary to carry out the
purposes and to enforce the provisions of this section.>
2. Title page, line 1, by striking <and administering> and
inserting <, administering, and dispensing>
______________________________
the Senate, as follows:
1. Page 1, by striking lines 24 through 32 and inserting:
<Sec. ___. Section 155A.46, Code 2023, is amended by adding
the following new subsection:
NEW SUBSECTION. 3. A pharmacist may, pursuant to statewide
protocols developed by the board in consultation with the
department of health and human services, order and dispense
to patients eighteen years and older self-administered
hormonal contraceptives. For the purpose of this
subsection, “self-administered hormonal contraceptive” means
a self-administered hormonal contraceptive that is approved
by the United States food and drug administration to prevent
pregnancy. “Self-administered hormonal contraceptive” includes
an oral hormonal contraceptive, a hormonal vaginal ring, and
a hormonal contraceptive patch, but does not include any drug
intended to induce an abortion as defined in section 146.1.
a. In ordering and dispensing a self-administered hormonal
contraceptive to a patient under this subsection, a pharmacist
shall comply with all of the following:
(1) For an initial dispensing of a self-administered
hormonal contraceptive, the pharmacist may dispense only up
to a three-month supply at one time of the self-administered
hormonal contraceptive.
(2) For any subsequent dispensing of the same
self-administered hormonal contraceptive, the pharmacist
may dispense up to a twelve-month supply at one time of the
self-administered hormonal contraceptive.
b. The statewide protocols shall require a pharmacist who
dispenses a self-administered hormonal contraceptive under this
subsection to do all of the following:
(1) Retain a record of each patient to whom a
self-administered hormonal contraceptive is dispensed under
this subsection and submit the record to the department of
health and human services.
(2) Complete a standardized training program and continuing
education requirements approved by the board in consultation
with the board of medicine and the department of health and
human services that are related to ordering and dispensing a
self-administered hormonal contraceptive and include education
regarding all contraceptive methods approved by the United
States food and drug administration.
(3) Obtain a completed self-screening risk assessment,
approved by the department of health and human services in
collaboration with the board and the board of medicine, from
each patient, verify the identity and age of each patient, and
perform a blood pressure screening on each patient prior to
dispensing the self-administered hormonal contraceptive to the
patient.
(4) Provide the patient with all of the following:
(a) Written information regarding all of the following:
(i) The importance of completing an appointment with the
patient’s primary care or women’s health care practitioner
to obtain preventative care, including but not limited to
recommended tests and screenings.
(ii) The effectiveness and availability of
long-acting reversible contraceptives as an alternative
to self-administered hormonal contraceptives.
(b) A copy of the record of the pharmacist’s encounter with
the patient that includes all of the following:
(i) The patient’s completed self-screening risk assessment.
(ii) A description of the self-administered hormonal
contraceptive dispensed, or the basis for not dispensing a
self-administered hormonal contraceptive.
(c) Patient counseling regarding all of the following:
(i) The appropriate administration and storage of the
self-administered hormonal contraceptive.
(ii) Potential side effects and risks of the
self-administered hormonal contraceptive.
(iii) The need for backup contraception.
(iv) When to seek emergency medical attention.
(v) The risk of contracting a sexually transmitted
infection or disease, and ways to reduce such a risk.
c. The statewide protocols shall prohibit a pharmacist who
orders and dispenses a self-administered hormonal contraceptive
under this subsection from doing any of the following:
(1) Requiring any other prescription drug order authorized
by a practitioner prior to dispensing the self-administered
hormonal contraceptive to a patient.
(2) Requiring a patient to schedule an appointment
with the pharmacist for the ordering or dispensing of a
self-administered hormonal contraceptive.
(3) Dispensing a self-administered hormonal contraceptive
to a patient for more than fifteen months after the date a
self-administered hormonal contraceptive is initially dispensed
to the patient, if the patient has not consulted with a primary
care or women’s health care practitioner during the preceding
fifteen months, in which case the pharmacist shall refer the
patient to a primary care or women’s health care practitioner.
(4) Dispensing a self-administered hormonal contraceptive
to a patient if the results of the self-screening risk
assessment indicate it is unsafe for the pharmacist to dispense
the self-administered hormonal contraceptive to the patient, in
which case the pharmacist shall refer the patient to a primary
care or women’s health care practitioner.
d. A pharmacist who orders and dispenses a self-administered
hormonal contraceptive shall be immune from criminal and civil
liability arising from any damages caused by the ordering,
dispensing, administering, or use of a self-administered
hormonal contraceptive.
Sec. ___. INFORMATION PROGRAM FOR DRUG PRESCRIBING AND
DISPENSING — SELF-ADMINISTERED HORMONAL CONTRACEPTIVES. The
board of pharmacy in collaboration with the board of medicine
and the department of health and human services shall expand
the information program for drug prescribing and dispensing
established pursuant to section 124.551, to collect from
pharmacists information relating to the dispensing of
self-administered hormonal contraceptives as provided pursuant
to section 155A.46. The board of pharmacy shall adopt
rules pursuant to chapter 17A related to registration of
participating pharmacists, the information to be reported by a
pharmacist to the information program, access to information
from the program, and other rules necessary to carry out the
purposes and to enforce the provisions of this section.>
2. Title page, line 1, by striking <and administering> and
inserting <, administering, and dispensing>
______________________________