Florida Senate - 2018                        COMMITTEE AMENDMENT
       Bill No. SB 524
                              LEGISLATIVE ACTION                        
                    Senate             .             House              

       The Committee on Health Policy (Brandes) recommended the
    1         Senate Amendment (with title amendment)
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Subsection (2) of section 381.0031, Florida
    6  Statutes, is amended to read:
    7         381.0031 Epidemiological research; report of diseases of
    8  public health significance to department.—
    9         (2) Any practitioner licensed in this state to practice
   10  medicine, osteopathic medicine, chiropractic medicine,
   11  naturopathy, or veterinary medicine; any licensed pharmacist
   12  authorized pursuant to a protocol to order and evaluate
   13  laboratory and clinical tests; any hospital licensed under part
   14  I of chapter 395; or any laboratory licensed under chapter 483
   15  that diagnoses or suspects the existence of a disease of public
   16  health significance shall immediately report the fact to the
   17  Department of Health.
   18         Section 2. Subsection (13) of section 465.003, Florida
   19  Statutes, is amended to read:
   20         465.003 Definitions.—As used in this chapter, the term:
   21         (13) “Practice of the profession of pharmacy” includes
   22  compounding, dispensing, and consulting concerning contents,
   23  therapeutic values, and uses of any medicinal drug; consulting
   24  concerning therapeutic values and interactions of patent or
   25  proprietary preparations, whether pursuant to prescriptions or
   26  in the absence and entirely independent of such prescriptions or
   27  orders; and other pharmaceutical services. For purposes of this
   28  subsection, “other pharmaceutical services” means the monitoring
   29  of the patient’s drug therapy and assisting the patient in the
   30  management of his or her drug therapy, and includes review of
   31  the patient’s drug therapy and communication with the patient’s
   32  prescribing health care provider as licensed under chapter 458,
   33  chapter 459, chapter 461, or chapter 466, or similar statutory
   34  provision in another jurisdiction, or such provider’s agent or
   35  such other persons as specifically authorized by the patient,
   36  regarding the drug therapy. However, nothing in this subsection
   37  may not be interpreted to permit an alteration of a prescriber’s
   38  directions, the diagnosis or treatment of any disease, the
   39  initiation of any drug therapy, the practice of medicine, or the
   40  practice of osteopathic medicine, unless otherwise permitted by
   41  law. The term “Practice of the profession of pharmacy” also
   42  includes any other act, service, operation, research, or
   43  transaction incidental to, or forming a part of, any of the
   44  foregoing acts, requiring, involving, or employing the science
   45  or art of any branch of the pharmaceutical profession, study, or
   46  training, and shall expressly permit a pharmacist to transmit
   47  information from persons authorized to prescribe medicinal drugs
   48  to their patients. The term practice of the profession of
   49  pharmacy also includes the administration of vaccines to adults
   50  pursuant to s. 465.189 and testing for and treating influenza
   51  pursuant to s. 465.1895.
   52         Section 3. Section 465.1895, Florida Statutes, is created
   53  to read:
   54         465.1895 Testing for and treating influenza.—
   55         (1)A pharmacist may test for and treat influenza within
   56  the framework of an established written protocol under a
   57  supervising physician who is licensed under chapter 458 or
   58  chapter 459 if all of the following criteria are met:
   59         (a)The pharmacist uses a test that the federal Centers for
   60  Medicare and Medicaid Services have determined qualifies for a
   61  certificate of waiver under the federal Clinical Laboratory
   62  Improvement Amendments of 1988, and the federal rules adopted
   63  thereunder.
   64         (b)The pharmacist uses a test system that integrates with
   65  certified electronic health record technology as defined in s.
   66  408.051.
   67         (c)The pharmacist submits test results to a health care
   68  practitioner designated by the patient.
   69         (d)The pharmacist reports a diagnosis or suspected
   70  existence of a disease of public health significance to the
   71  department as required under s. 381.0031.
   72         (2)A pharmacist may only enter into a protocol under this
   73  section if he or she maintains at least $200,000 of professional
   74  liability insurance and has completed the training required by
   75  this section.
   76         (3)A pharmacist testing for and treating influenza shall
   77  maintain and make available patient records using the same
   78  standards for confidentiality and maintenance of such records as
   79  those that are imposed on health care practitioners under s.
   80  456.057. These records must be maintained for a minimum of 5
   81  years.
   82         (4)A supervising physician’s decision to enter into a
   83  protocol under this section is a professional decision and a
   84  person may not interfere with a supervising physician’s decision
   85  to enter into such a protocol. A pharmacist may not perform a
   86  protocol while acting as a pharmacy employee without the written
   87  approval of the pharmacy owner.
   88         (5)Any pharmacist seeking to test for and treat influenza
   89  under this section must be certified to do so pursuant to a
   90  certification program approved by the board in consultation with
   91  the Board of Medicine and the Board of Osteopathic Medicine. The
   92  certification program must, at a minimum, require that the
   93  pharmacist attend at least 8 hours of continuing education
   94  classes approved by the board. The program must have a
   95  curriculum of instruction concerning, at a minimum, point-of
   96  care testing for influenza and the safe and effective treatment
   97  of influenza.
   98         (6)The board may adopt rules establishing the requirements
   99  for a protocol between a pharmacist and a supervising physician.
  100  The protocol must be in writing and, at a minimum, must include
  101  all of the following:
  102         (a)Any terms and conditions imposed by the supervising
  103  physician relating to testing for and treating influenza
  104  pursuant to this section. The terms and conditions set forth in
  105  the protocol must be appropriate to the pharmacist’s training.
  106         (b) Specific categories of patients for whom the
  107  supervising physician authorizes the pharmacist to test for and
  108  treat influenza.
  109         (c)The supervising physician’s instructions for the
  110  treatment of influenza based on the patient’s age, symptoms, and
  111  test results, including negative results.
  112         (d)A process and schedule for the supervising physician to
  113  review the pharmacist’s actions under the protocol.
  114         (e)A process and schedule for the pharmacist to notify the
  115  supervising physician of the patient’s condition, tests
  116  administered, test results, and course of treatment.
  117         (7)Pharmacists who have been delegated the authority to
  118  test for and treat influenza by a supervising physician shall
  119  provide the supervising physician with evidence of current
  120  certification by the board. A supervising physician shall review
  121  the pharmacist’s actions pursuant to the protocol in effect, and
  122  this review shall take place as outlined in the protocol.
  123         (8)The pharmacist shall submit to the board a copy of his
  124  or her protocol to test for and treat influenza.
  125         Section 4. This act shall take effect upon becoming a law.
  127  ================= T I T L E  A M E N D M E N T ================
  128  And the title is amended as follows:
  129         Delete everything before the enacting clause
  130  and insert:
  131                        A bill to be entitled                      
  132         An act relating to the testing for and treatment of
  133         influenza; amending s. 381.0031, F.S.; requiring
  134         certain licensed pharmacists to report certain
  135         information to the Department of Health; amending s.
  136         465.003, F.S.; expanding the definition of the term
  137         “practice of the profession of pharmacy” to include
  138         testing for and treating influenza; creating s.
  139         465.1895, F.S.; authorizing a pharmacist to test for
  140         and treat influenza within the framework of an
  141         established written protocol under a supervising
  142         physician if certain requirements are met; requiring a
  143         pharmacist testing for and treating influenza to
  144         maintain patient records using certain standards and
  145         for a specified time; prohibiting a person from
  146         interfering with a supervising physician’s decision to
  147         enter into a protocol; prohibiting a pharmacist from
  148         performing a protocol while acting as a pharmacy
  149         employee without the written approval of the pharmacy
  150         owner; requiring a pharmacist seeking to test for and
  151         treat influenza to be certified by a certification
  152         program approved by the Board of Pharmacy in
  153         consultation with the Board of Medicine and the Board
  154         of Osteopathic Medicine; providing criteria for
  155         certification programs; authorizing the Board of
  156         Pharmacy to adopt rules establishing the requirements
  157         for a protocol; requiring that the protocol be in
  158         writing and contain certain information, terms, and
  159         conditions; requiring that pharmacists authorized to
  160         test for and treat influenza provide their supervising
  161         physician with evidence of current certification by
  162         the board; requiring a supervising physician to review
  163         the pharmacist’s actions; requiring a pharmacist to
  164         submit his or her protocol to the board; providing an
  165         effective date.