Florida Senate - 2019                        COMMITTEE AMENDMENT
       Bill No. SB 1170
                              LEGISLATIVE ACTION                        
                    Senate             .             House              

       The Committee on Health Policy (Diaz) recommended the following:
    1         Senate Amendment (with title amendment)
    3         Before line 14
    4  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 written protocol to order and evaluate
   13  laboratory and clinical tests; any hospital licensed under part
   14  I of chapter 395; or any laboratory appropriately certified by
   15  the Centers for Medicare and Medicaid Services under the federal
   16  Clinical Laboratory Improvement Amendments, and the federal
   17  rules adopted thereunder, which diagnoses or suspects the
   18  existence of a disease of public health significance shall
   19  immediately report the fact to the Department of Health.
   20         Section 2. Subsection (13) of section 465.003, Florida
   21  Statutes, is amended to read:
   22         465.003 Definitions.—As used in this chapter, the term:
   23         (13) “Practice of the profession of pharmacy” includes
   24  compounding, dispensing, and consulting concerning contents,
   25  therapeutic values, and uses of any medicinal drug; consulting
   26  concerning therapeutic values and interactions of patent or
   27  proprietary preparations, whether pursuant to prescriptions or
   28  in the absence and entirely independent of such prescriptions or
   29  orders; and conducting other pharmaceutical services. For
   30  purposes of this subsection, “other pharmaceutical services”
   31  means the monitoring of the patient’s drug therapy and assisting
   32  the patient in the management of his or her drug therapy, and
   33  includes review of the patient’s drug therapy and communication
   34  with the patient’s prescribing health care provider as licensed
   35  under chapter 458, chapter 459, chapter 461, or chapter 466, or
   36  similar statutory provision in another jurisdiction, or such
   37  provider’s agent or such other persons as specifically
   38  authorized by the patient, regarding the drug therapy. However,
   39  nothing in this subsection may be interpreted to permit an
   40  alteration of a prescriber’s directions, the diagnosis or
   41  treatment of any disease, the initiation of any drug therapy,
   42  the practice of medicine, or the practice of osteopathic
   43  medicine, unless otherwise permitted by law. “Practice of the
   44  profession of pharmacy” also includes any other act, service,
   45  operation, research, or transaction incidental to, or forming a
   46  part of, any of the foregoing acts, requiring, involving, or
   47  employing the science or art of any branch of the pharmaceutical
   48  profession, study, or training, and shall expressly permit a
   49  pharmacist to transmit information from persons authorized to
   50  prescribe medicinal drugs to their patients. The practice of the
   51  profession of pharmacy also includes the administration of
   52  vaccines to adults pursuant to s. 465.189, the testing for and
   53  treatment of influenza and streptococcus pursuant to s.
   54  465.1895, and the preparation of prepackaged drug products in
   55  facilities holding Class III institutional pharmacy permits.
   56         Section 3. Section 465.1895, Florida Statutes, is created
   57  to read:
   58         465.1895Testing for and treatment of influenza and
   59  streptococcus.—
   60         (1)A pharmacist may test for and treat influenza and
   61  streptococcus if all of the following criteria are met:
   62         (a)The pharmacist has entered into a written protocol with
   63  a supervising physician licensed under chapter 458 or chapter
   64  459 and such protocol complies with the requirements as
   65  specified in subsection (5) and board rules.
   66         (b)The pharmacist uses an instrument and a waived test, as
   67  that term is defined in 42 C.F.R. s. 493.2.
   68         (c)The pharmacist uses a testing system that:
   69         1.Provides automated readings in order to reduce user
   70  subjectivity or interpretation of results;
   71         2.Is capable of directly or indirectly interfacing with
   72  electronic medical records systems; and
   73         3.Is capable of electronically reporting daily de
   74  identified test results to the appropriate agencies.
   75         (d)The pharmacist is certified to test for and treat
   76  influenza and streptococcus pursuant to a certification program
   77  approved by the board, in consultation with the Board of
   78  Medicine and the Board of Osteopathic Medicine, within 90 days
   79  after the date this section becomes effective. The certification
   80  program must require that the pharmacist attend, on a one-time
   81  basis, 8 hours of continuing education courses approved by the
   82  board. The continuing education curriculum must be provided by
   83  an training organization approved by the Accreditation Council
   84  for Pharmacy Education and must include, at a minimum, point-of
   85  care testing for influenza and streptococcus and the safe and
   86  effective treatment of influenza and streptococcus.
   87         (2)A pharmacist may not enter into a written protocol
   88  under this section unless he or she maintains at least $200,000
   89  of professional liability insurance and is certified as required
   90  in paragraph (1)(d).
   91         (3)A pharmacist who tests for and treats influenza and
   92  streptococcus shall maintain and make available patient records
   93  using the same standards for confidentiality and maintenance of
   94  such records as those that are imposed on health care
   95  practitioners under s. 456.057. Such records must be maintained
   96  for at least 5 years.
   97         (4)The decision by a supervising physician licensed under
   98  chapter 458 or chapter 459 to enter into a written protocol
   99  under this section is a professional decision on the part of the
  100  physician, and a person may not interfere with a physician’s
  101  decision regarding entering into such a protocol. A pharmacist
  102  may not enter into a written protocol that is to be performed
  103  while he or she is acting as an employee without the written
  104  approval of the owner of the pharmacy.
  105         (5)The board shall adopt rules establishing the
  106  requirements for the written protocol within 90 days after the
  107  date this section becomes effective. At a minimum, the written
  108  protocol must include:
  109         (a)The terms and conditions as required in s. 465.189(7);
  110         (b)Specific categories of patients for whom the
  111  supervising physician authorizes the pharmacist to test for and
  112  treat influenza and streptococcus;
  113         (c)The supervising physician’s instructions for the
  114  treatment of influenza and streptococcus, based on the patient’s
  115  age, symptoms, and test results, including negative results;
  116         (d)A process and schedule for the supervising physician to
  117  review the pharmacist’s actions under the written protocol; and
  118         (e)A process and schedule for the pharmacist to notify the
  119  supervising physician of the patient’s condition, tests
  120  administered, test results, and course of treatment.
  121         (6)A pharmacist who provides testing for or treatment of
  122  influenza and streptococcus under this section shall notify the
  123  patient’s primary care provider within 2 business days after
  124  providing any such testing or treatment.
  126  ================= T I T L E  A M E N D M E N T ================
  127  And the title is amended as follows:
  128         Delete line 2
  129  and insert:
  130         An act relating to pharmacy; amending s. 381.0031,
  131         F.S.; requiring specified licensed pharmacists to
  132         report certain information to the Department of
  133         Health; amending s. 465.003, F.S.; revising the
  134         definition of the term “practice of the profession of
  135         pharmacy”; creating s. 465.1895, F.S.; authorizing
  136         pharmacists who meet certain criteria to test for and
  137         treat influenza and streptococcus; providing
  138         requirements relating thereto; specifying requirements
  139         for the certification program and for certain
  140         continuing education; requiring that the written
  141         protocol between a pharmacist and supervising
  142         physician contain certain information, terms, and
  143         conditions; requiring the Board of Pharmacy to adopt
  144         rules within a specified time; requiring that a
  145         pharmacist notify a patient’s primary care provider
  146         within a specified time after providing any such
  147         testing or treatment;