Florida Senate - 2017 SB 1180
By Senator Rodriguez
37-01607C-17 20171180__
1 A bill to be entitled
2 An act relating to pharmacists; amending s. 465.003,
3 F.S.; expanding the practice of pharmacy to include
4 consultation with patients regarding certain
5 preparations, health care products, and services;
6 providing that the practice of pharmacy includes
7 making recommendations in communication with other
8 health care providers; providing that the practice of
9 pharmacy includes services relating to the treatment
10 of influenza under certain conditions; amending s.
11 465.0125, F.S.; authorizing consultant pharmacists to
12 provide additional services when authorized by a
13 medical director or within the context of a patient
14 specific order or treatment protocol, or at the
15 request of or referral from a patient’s treating
16 health care provider; removing a certain limitation on
17 the ordering of laboratory or clinical testing;
18 removing a training and qualifications requirement
19 relating to the practice of institutional pharmacy;
20 removing certain requirements relating to persons
21 under the care of a licensed home health agency;
22 removing a continuing education requirement; amending
23 s. 465.189, F.S.; authorizing qualified pharmacists to
24 provide certain services related to the treatment of
25 influenza within the framework of an established
26 protocol under a supervising physician; providing an
27 effective date.
28
29 Be It Enacted by the Legislature of the State of Florida:
30
31 Section 1. Subsection (13) of section 465.003, Florida
32 Statutes, is amended to read:
33 465.003 Definitions.—As used in this chapter, the term:
34 (13) “Practice of the profession of pharmacy” includes
35 compounding, dispensing, and consulting concerning contents,
36 therapeutic values, and uses of any medicinal drug; consulting
37 concerning therapeutic values and interactions of patent, or
38 proprietary, or other preparations, health care products, and
39 services, whether pursuant to prescriptions or in the absence
40 and entirely independent of such prescriptions or orders; and
41 other pharmaceutical services. For purposes of this subsection,
42 “other pharmaceutical services” means the monitoring of the
43 patient’s drug therapy and assisting the patient in the
44 management of his or her drug therapy, and includes review and
45 recommendations in of the patient’s drug therapy and
46 communication with the patient’s prescribing health care
47 provider as licensed under chapter 458, chapter 459, chapter
48 461, or chapter 466, or similar statutory provision in another
49 jurisdiction, or such provider’s agent or such other persons as
50 specifically authorized by the patient, regarding the patient’s
51 drug therapy and health care status. However, nothing in this
52 subsection may be interpreted to permit an alteration of a
53 prescriber’s directions, the diagnosis or treatment of any
54 disease, the initiation of any drug therapy, the practice of
55 medicine, or the practice of osteopathic medicine, unless
56 otherwise permitted by law. “Practice of the profession of
57 pharmacy” also includes any other act, service, operation,
58 research, or transaction incidental to, or forming a part of,
59 any of the foregoing acts, requiring, involving, or employing
60 the science or art of any branch of the pharmaceutical
61 profession, study, or training, and shall expressly permit a
62 pharmacist to transmit information from persons authorized to
63 prescribe medicinal drugs to their patients. The practice of the
64 profession of pharmacy also includes the administration of
65 vaccines to adults and services relating to the treatment of
66 influenza pursuant to s. 465.189.
67 Section 2. Section 465.0125, Florida Statutes, is amended
68 to read:
69 465.0125 Consultant pharmacist license; application,
70 renewal, fees; responsibilities; rules.—
71 (1) The department shall issue or renew a consultant
72 pharmacist license upon receipt of an initial or renewal
73 application which conforms to the requirements for consultant
74 pharmacist initial licensure or renewal as promulgated by the
75 board by rule and a fee set by the board not to exceed $250. For
76 consultant pharmacist licensure, the Florida-licensed pharmacist
77 must complete additional training as required by the board.
78 (2) A consultant pharmacist may:
79 (a) Order and evaluate laboratory and clinical tests to
80 promote and evaluate patient health and wellness, as well as
81 monitor medication therapy and treatment outcomes;
82 (b) Administer medications; and
83 (c) Initiate, modify, or discontinue medications.
84 (3) A consultant pharmacist’s services may be provided to
85 patients when authorized by a medical director or within the
86 context of a patient-specific order or treatment protocol, or at
87 the request of or referral from a patient’s treating health care
88 provider who is authorized by Florida law or a similar statutory
89 provision in another jurisdiction to prescribe medication.
90 (4) The consultant pharmacist shall be responsible for the
91 maintenance of medication, patient care, and quality assurance
92 records as required by law maintaining all drug records required
93 by law and for establishing drug handling procedures for the
94 safe handling and storage of drugs. The consultant pharmacist
95 may also be responsible for ordering and evaluating any
96 laboratory or clinical testing when, in the judgment of the
97 consultant pharmacist, such activity is necessary for the proper
98 performance of the consultant pharmacist’s responsibilities.
99 Such laboratory or clinical testing may be ordered only with
100 regard to patients residing in a nursing home facility, and then
101 only when authorized by the medical director of the nursing home
102 facility. The consultant pharmacist must have completed such
103 additional training and demonstrate such additional
104 qualifications in the practice of institutional pharmacy as
105 shall be required by the board in addition to licensure as a
106 registered pharmacist.
107 (2) Notwithstanding the provisions of subsection (1), a
108 consultant pharmacist or a doctor of pharmacy licensed in this
109 state may also be responsible for ordering and evaluating any
110 laboratory or clinical testing for persons under the care of a
111 licensed home health agency when, in the judgment of the
112 consultant pharmacist or doctor of pharmacy, such activity is
113 necessary for the proper performance of his or her
114 responsibilities and only when authorized by a practitioner
115 licensed under chapter 458, chapter 459, chapter 461, or chapter
116 466. In order for the consultant pharmacist or doctor of
117 pharmacy to qualify and accept this authority, he or she must
118 receive 3 hours of continuing education relating to laboratory
119 and clinical testing as established by the board.
120 (5)(3) The board shall promulgate rules necessary to
121 implement and administer this section.
122 Section 3. Section 465.189, Florida Statutes, is amended to
123 read:
124 465.189 Administration of vaccines and epinephrine
125 autoinjection; treatment of influenza.—
126 (1) In accordance with guidelines of the Centers for
127 Disease Control and Prevention for each recommended immunization
128 or vaccine, a pharmacist, or a registered intern under the
129 supervision of a pharmacist who is certified under subsection
130 (7)(6), may administer the following vaccines to an adult within
131 the framework of an established protocol under a supervising
132 physician licensed under chapter 458 or chapter 459:
133 (a) Immunizations or vaccines listed in the Adult
134 Immunization Schedule as of February 1, 2015, by the United
135 States Centers for Disease Control and Prevention. The board may
136 authorize, by rule, additional immunizations or vaccines as they
137 are added to the Adult Immunization Schedule.
138 (b) Immunizations or vaccines recommended by the United
139 States Centers for Disease Control and Prevention for
140 international travel as of July 1, 2015. The board may
141 authorize, by rule, additional immunizations or vaccines as they
142 are recommended by the United States Centers for Disease Control
143 and Prevention for international travel.
144 (c) Immunizations or vaccines approved by the board in
145 response to a state of emergency declared by the Governor
146 pursuant to s. 252.36.
147
148 A registered intern who administers an immunization or vaccine
149 under this subsection must be supervised by a certified
150 pharmacist at a ratio of one pharmacist to one registered
151 intern.
152 (2) In order to address any unforeseen allergic reaction, a
153 pharmacist may administer epinephrine using an autoinjector
154 delivery system within the framework of an established protocol
155 under a supervising physician licensed under chapter 458 or
156 chapter 459.
157 (3) A pharmacist certified under subsection (7) may, within
158 the framework of an established protocol under a supervising
159 physician licensed under chapter 458 or chapter 459, perform the
160 following services related to the treatment of influenza:
161 (a) Order and evaluate laboratory and clinical tests; and
162 (b) Administer, modify, and discontinue medications.
163 (4)(3) A pharmacist may not enter into a protocol unless he
164 or she maintains at least $200,000 of professional liability
165 insurance and has completed training in administering vaccines
166 authorized under this section.
167 (5)(4) A pharmacist administering vaccines or treating
168 influenza under this section shall maintain and make available
169 patient records using the same standards for confidentiality and
170 maintenance of such records as those that are imposed on health
171 care practitioners under s. 456.057. These records shall be
172 maintained for a minimum of 5 years.
173 (6)(5) The decision by a supervising physician licensed
174 under chapter 458 or chapter 459 to enter into a protocol under
175 this section is a professional decision on the part of the
176 practitioner, and a person may not interfere with a physician’s
177 decision as to entering into such a protocol. A pharmacist may
178 not enter into a protocol that is to be performed while acting
179 as an employee without the written approval of the owner of the
180 pharmacy. Pharmacists shall forward vaccination records to the
181 department for inclusion in the state registry of immunization
182 information.
183 (7)(6) Any pharmacist or registered intern seeking to
184 administer vaccines to adults under this section must be
185 certified to administer such vaccines pursuant to a
186 certification program approved by the Board of Pharmacy in
187 consultation with the Board of Medicine and the Board of
188 Osteopathic Medicine. The certification program shall, at a
189 minimum, require that the pharmacist attend at least 20 hours of
190 continuing education classes approved by the board and the
191 registered intern complete at least 20 hours of coursework
192 approved by the board. The program shall have a curriculum of
193 instruction concerning the safe and effective administration of
194 such vaccines, including, but not limited to, potential allergic
195 reactions to such vaccines.
196 (8)(7) The written protocol between the pharmacist and
197 supervising physician under this section must include particular
198 terms and conditions imposed by the supervising physician upon
199 the pharmacist relating to the administration of vaccines or the
200 treatment of influenza by the pharmacist pursuant to this
201 section. The written protocol for the administration of vaccines
202 shall include, at a minimum, specific categories and conditions
203 among patients for whom the supervising physician authorizes the
204 pharmacist to administer such vaccines. The terms, scope, and
205 conditions set forth in the written protocol between the
206 pharmacist and the supervising physician must be appropriate to
207 the pharmacist’s training and certification for administering
208 such vaccines or the treatment of influenza. Pharmacists who
209 have been delegated the authority to administer vaccines under
210 this section by the supervising physician under the protocol
211 shall provide evidence of current certification by the Board of
212 Pharmacy to the supervising physician. A supervising physician
213 shall review the administration of such vaccines or the
214 treatment of influenza by the pharmacist pursuant to the written
215 protocol between them, and this review shall take place as
216 outlined in the written protocol. The process and schedule for
217 the review shall be outlined in the written protocol between the
218 pharmacist and the supervising physician.
219 (9)(8) The pharmacist shall submit to the Board of Pharmacy
220 a copy of his or her protocol or written agreement to administer
221 vaccines or engage in the treatment of influenza under this
222 section.
223 Section 4. This act shall take effect July 1, 2017.