Florida Senate - 2024                        COMMITTEE AMENDMENT
       Bill No. SB 1320
       
       
       
       
       
       
                                Ì587166EÎ587166                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                   Comm: WD            .                                
                  01/29/2024           .                                
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       The Committee on Health Policy (Calatayud) recommended the
       following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Section 465.1861, Florida Statutes, is created
    6  to read:
    7         465.1861 Ordering and dispensing HIV drugs.—
    8         (1)As used in this section, the term:
    9         (a)“HIV” means the human immunodeficiency virus.
   10         (b)“HIV infection prevention drug” means preexposure
   11  prophylaxis, postexposure prophylaxis, and any other drug
   12  approved by the United States Food and Drug Administration for
   13  the prevention of HIV infection as of March 8, 2024.
   14         (c)HIV postexposure prophylaxis drug” means a drug or
   15  drug combination that meets the clinical eligibility
   16  recommendations of the United States Centers for Disease Control
   17  and Prevention guidelines for antiretroviral treatment following
   18  potential exposure to HIV issued as of March 8, 2024.
   19         (d)HIV preexposure prophylaxis drug” means a drug or drug
   20  combination that meets the clinical eligibility recommendations
   21  of the United States Centers for Disease Control and Prevention
   22  guidelines for antiretroviral treatment for the prevention of
   23  HIV transmission issued as of March 8, 2024.
   24         (2)A pharmacist may screen an adult for HIV exposure and
   25  provide the results to that adult, with the advice that the
   26  patient should seek further medical consultation or treatment
   27  from a physician.
   28         (3)A pharmacist may dispense HIV preexposure prophylaxis
   29  drugs only pursuant to a valid prescription issued by a licensed
   30  health care practitioner authorized by the laws of the state to
   31  prescribe such drugs.
   32         (4)A pharmacist may order and dispense HIV postexposure
   33  prophylaxis drugs only pursuant to a collaborative practice
   34  agreement between the pharmacist and a physician licensed under
   35  chapter 458 or chapter 459 who practices medicine or osteopathic
   36  medicine in the same geographic area as the pharmacist. As used
   37  in this subsection, the term “geographic area” means the county
   38  or counties, or any portion of the county or counties, within
   39  which the pharmacist and the physician provide health care
   40  services.
   41         (5)A pharmacist who orders and dispenses HIV postexposure
   42  prophylaxis drugs pursuant to subsection (4) shall provide the
   43  patient with written information advising the patient to seek
   44  follow-up care from his or her primary care physician. If the
   45  patient indicates that he or she lacks regular access to primary
   46  care, the pharmacist must comply with the procedures of the
   47  pharmacy’s approved access-to-care plan as provided in
   48  subsection (7).
   49         (6)Before ordering or dispensing HIV postexposure
   50  prophylaxis drugs under this section, a pharmacist must be
   51  certified by the board, according to the rules adopted by the
   52  board, in consultation with the Board of Medicine and the Board
   53  of Osteopathic Medicine. To be certified, a pharmacist must, at
   54  a minimum, meet all of the following criteria:
   55         (a)Hold an active and unencumbered license to practice
   56  pharmacy under this chapter.
   57         (b)Be engaged in the active practice of pharmacy.
   58         (c)Have earned a degree of doctor of pharmacy or have
   59  completed at least 3 years of experience as a licensed
   60  pharmacist.
   61         (d)Maintain at least $250,000 of liability coverage. A
   62  pharmacist who maintains liability coverage pursuant to s.
   63  465.1865 or s. 465.1895 satisfies this requirement.
   64         (e)Have completed a course approved by the board, in
   65  consultation with the Board of Medicine and the Board of
   66  Osteopathic Medicine, which includes, at a minimum, instruction
   67  on all of the following:
   68         1.Performance of patient assessments.
   69         2.Point-of-care testing procedures.
   70         3.Safe and effective treatment of HIV exposure with HIV
   71  infection prevention drugs, including, but not limited to,
   72  consideration of the side effects of the drug dispensed and the
   73  patient’s diet and activity levels.
   74         4.Identification of contraindications.
   75         5.Identification of patient comorbidities in individuals
   76  with HIV requiring further medical evaluation and treatment,
   77  including, but not limited to, cardiovascular disease, lung and
   78  liver cancer, chronic obstructive lung disease, and diabetes
   79  mellitus.
   80         (7)The board shall adopt by rule reasonable and fair
   81  minimum standards to ensure that all pharmacies that provide
   82  adult screening for HIV exposure submit to the department for
   83  approval an access-to-care plan (ACP) for assisting patients to
   84  gain access to appropriate care settings when they present to
   85  the pharmacy for HIV screening and indicate that they lack
   86  regular access to primary care.
   87         (a)An ACP must include:
   88         1.Procedures to educate such patients about care that
   89  would be best provided in a primary care setting and the
   90  importance of receiving regular primary care.
   91         2.A collaborative partnership with one or more nearby
   92  federally qualified health centers, county health departments,
   93  or other primary care settings. The goals of such partnership
   94  must include, but need not be limited to, identifying patients
   95  who have presented to the pharmacy for HIV screening or access
   96  to HIV infection prevention drugs, and, if such a patient
   97  indicates that he or she lacks regular access to primary care,
   98  proactively seeking to establish a relationship between the
   99  patient and a federally qualified health center, county health
  100  department, or other primary care setting so that the patient
  101  develops a medical home at such setting for primary health care
  102  services. A pharmacy that establishes one or more collaborative
  103  partnerships under this subparagraph may not enter into an
  104  arrangement relating to such partnership which would prevent a
  105  federally qualified health center, county health department, or
  106  other primary care setting from establishing collaborative
  107  partnerships with other pharmacies.
  108         (b)Effective July 1, 2025, a pharmacy’s ACP must be
  109  approved by the department before the pharmacy may receive
  110  initial licensure or licensure renewal occurring after that
  111  date. A pharmacy with an approved ACP must submit data to the
  112  department regarding the implementation and results of its plan
  113  as part of the licensure renewal process, or as directed by the
  114  department, before each licensure renewal.
  115         (8)The board shall adopt rules to implement this section.
  116         Section 2. This act shall take effect July 1, 2024.
  117  
  118  ================= T I T L E  A M E N D M E N T ================
  119  And the title is amended as follows:
  120         Delete everything before the enacting clause
  121  and insert:
  122                        A bill to be entitled                      
  123         An act relating to HIV infection prevention drugs;
  124         creating s. 465.1861, F.S.; defining terms;
  125         authorizing pharmacists to screen adults for HIV
  126         exposure and provide the results to such adults, with
  127         advice to seek consultation or treatment from a
  128         physician; authorizing pharmacists to dispense HIV
  129         preexposure prophylaxis drugs only pursuant to a
  130         prescription; authorizing pharmacists to order and
  131         dispense HIV postexposure prophylaxis drugs only
  132         pursuant to a collaborative practice agreement with a
  133         physician; defining the term “geographic area”;
  134         requiring such pharmacists to provide certain written
  135         information when dispensing such drugs to patients;
  136         requiring pharmacists to comply with certain
  137         procedures under certain circumstances; requiring
  138         pharmacists to be certified by the Board of Pharmacy
  139         before ordering or dispensing HIV postexposure
  140         prophylaxis drugs; requiring the board, in
  141         consultation with the Board of Medicine and the Board
  142         of Osteopathic Medicine, to adopt rules for such
  143         certification; specifying minimum requirements for the
  144         certification; requiring the board to adopt by rule
  145         certain minimum standards to ensure that pharmacies
  146         providing adult screenings for HIV exposure submit to
  147         the department for approval an access-to-care plan
  148         (ACP) for a specified purpose; specifying requirements
  149         for ACPs; requiring that, beginning on a specified
  150         date, such ACPs be approved before a license may be
  151         issued or renewed; requiring such pharmacies to submit
  152         specified data to the department as part of the
  153         licensure renewal process and update their ACPs as
  154         needed, or as directed by the department, before each
  155         licensure renewal; requiring the board to adopt rules;
  156         providing an effective date.