Florida Senate - 2020                             CS for SB 1094
       By the Committee on Health Policy; and Senator Diaz
       588-03469-20                                          20201094c1
    1                        A bill to be entitled                      
    2         An act relating to consultant pharmacists; amending s.
    3         465.003, F.S.; revising the definition of the term
    4         “practice of the profession of pharmacy”; amending s.
    5         465.0125, F.S.; requiring a pharmacist to complete
    6         additional training to be licensed as a consultant
    7         pharmacist; authorizing a consultant pharmacist to
    8         perform specified services under certain conditions;
    9         prohibiting a consultant pharmacist from modifying or
   10         discontinuing medicinal drugs prescribed by a health
   11         care practitioner under certain conditions; revising
   12         the responsibilities of a consultant pharmacist;
   13         requiring a consultant pharmacist and a collaborating
   14         practitioner to maintain collaborative practice
   15         agreements; requiring collaborative practice
   16         agreements to be made available upon request from or
   17         upon inspection by the Department of Health;
   18         prohibiting a consultant pharmacist from diagnosing
   19         any disease or condition; defining the term “health
   20         care facility”; providing an effective date.
   22  Be It Enacted by the Legislature of the State of Florida:
   24         Section 1. Subsection (13) of section 465.003, Florida
   25  Statutes, is amended to read:
   26         465.003 Definitions.—As used in this chapter, the term:
   27         (13) “Practice of the profession of pharmacy” includes
   28  compounding, dispensing, and consulting concerning contents,
   29  therapeutic values, and uses of any medicinal drug; consulting
   30  concerning therapeutic values and interactions of patent or
   31  proprietary preparations, whether pursuant to prescriptions or
   32  in the absence and entirely independent of such prescriptions or
   33  orders; and conducting other pharmaceutical services. For
   34  purposes of this subsection, the term “other pharmaceutical
   35  services” means the monitoring of the patient’s drug therapy and
   36  assisting the patient in the management of his or her drug
   37  therapy, and includes reviewing, and making recommendations
   38  regarding, review of the patient’s drug therapy and health care
   39  status in communication with the patient’s prescribing health
   40  care provider as licensed under chapter 458, chapter 459,
   41  chapter 461, or chapter 466, or a similar statutory provision in
   42  another jurisdiction, or such provider’s agent or such other
   43  persons as specifically authorized by the patient, regarding the
   44  drug therapy. However, nothing in this subsection may not be
   45  interpreted to permit an alteration of a prescriber’s
   46  directions, the diagnosis or treatment of any disease, the
   47  initiation of any drug therapy, the practice of medicine, or the
   48  practice of osteopathic medicine, unless otherwise permitted by
   49  law. The term “practice of the profession of pharmacy” also
   50  includes any other act, service, operation, research, or
   51  transaction incidental to, or forming a part of, any of the
   52  foregoing acts, requiring, involving, or employing the science
   53  or art of any branch of the pharmaceutical profession, study, or
   54  training, and shall expressly permit a pharmacist to transmit
   55  information from persons authorized to prescribe medicinal drugs
   56  to their patients. The practice of the profession of pharmacy
   57  also includes the administration of vaccines to adults pursuant
   58  to s. 465.189 and the preparation of prepackaged drug products
   59  in facilities holding Class III institutional pharmacy permits.
   60  The term also includes ordering and evaluating any laboratory or
   61  clinical testing; conducting patient assessments; and modifying,
   62  discontinuing, or administering medicinal drugs pursuant to s.
   63  465.0125 by a consultant pharmacist.
   64         Section 2. Section 465.0125, Florida Statutes, is amended
   65  to read:
   66         465.0125 Consultant pharmacist license; application,
   67  renewal, fees; responsibilities; rules.—
   68         (1) The department shall issue or renew a consultant
   69  pharmacist license upon receipt of an initial or renewal
   70  application that which conforms to the requirements for
   71  consultant pharmacist initial licensure or renewal as adopted
   72  promulgated by the board by rule and a fee set by the board not
   73  to exceed $250. To be licensed as a consultant pharmacist, a
   74  pharmacist must complete additional training as required by the
   75  board.
   76         (a)A consultant pharmacist may provide medication
   77  management services in a health care facility within the
   78  framework of a written collaborative practice agreement between
   79  the pharmacist and a health care facility medical director or a
   80  physician licensed under chapter 458 or chapter 459, a podiatric
   81  physician licensed under chapter 461, or a dentist licensed
   82  under chapter 466 who is authorized to prescribe medicinal
   83  drugs. A consultant pharmacist may provide medication management
   84  services, conduct patient assessments, and order and evaluate
   85  laboratory or clinical testing only for patients of the health
   86  care practitioner with whom the consultant pharmacist has a
   87  written collaborative practice agreement.
   88         (b)A written collaborative practice agreement must outline
   89  the circumstances under which the consultant pharmacist may:
   90         1.Order and evaluate any laboratory or clinical tests to
   91  promote and evaluate patient health and wellness, and monitor
   92  drug therapy and treatment outcomes.
   93         2.Conduct patient assessments as appropriate to evaluate
   94  and monitor drug therapy.
   95         3.Modify or discontinue medicinal drugs as outlined in the
   96  agreed-upon patient-specific order or preapproved treatment
   97  protocol under the direction of a physician. However, a
   98  consultant pharmacist may not modify or discontinue medicinal
   99  drugs prescribed by a health care practitioner who does not have
  100  a written collaborative practice agreement with the consultant
  101  pharmacist.
  102         4.Administer medicinal drugs.
  103         (c)A The consultant pharmacist shall maintain be
  104  responsible for maintaining all drug, patient care, and quality
  105  assurance records as required by law and, with the collaborating
  106  practitioner, shall maintain written collaborative practice
  107  agreements that must be available upon request from or upon
  108  inspection by the department.
  109         (d)This subsection does not authorize a consultant
  110  pharmacist to diagnose any disease or condition.
  111         (e)For purposes of this subsection, the term “health care
  112  facility” means an ambulatory surgical center or hospital
  113  licensed under chapter 395, an alcohol or chemical dependency
  114  treatment center licensed under chapter 397, an inpatient
  115  hospice licensed under part IV of chapter 400, a nursing home
  116  licensed under part II of chapter 400, an ambulatory care center
  117  as defined in s. 408.07, or a nursing home component under
  118  chapter 400 within a continuing care facility licensed under
  119  chapter 651 for establishing drug handling procedures for the
  120  safe handling and storage of drugs. The consultant pharmacist
  121  may also be responsible for ordering and evaluating any
  122  laboratory or clinical testing when, in the judgment of the
  123  consultant pharmacist, such activity is necessary for the proper
  124  performance of the consultant pharmacist’s responsibilities.
  125  Such laboratory or clinical testing may be ordered only with
  126  regard to patients residing in a nursing home facility, and then
  127  only when authorized by the medical director of the nursing home
  128  facility. The consultant pharmacist must have completed such
  129  additional training and demonstrate such additional
  130  qualifications in the practice of institutional pharmacy as
  131  shall be required by the board in addition to licensure as a
  132  registered pharmacist.
  133         (2) Notwithstanding the provisions of subsection (1), a
  134  consultant pharmacist or a doctor of pharmacy licensed in this
  135  state may also be responsible for ordering and evaluating any
  136  laboratory or clinical testing for persons under the care of a
  137  licensed home health agency when, in the judgment of the
  138  consultant pharmacist or doctor of pharmacy, such activity is
  139  necessary for the proper performance of his or her
  140  responsibilities and only when authorized by a practitioner
  141  licensed under chapter 458, chapter 459, chapter 461, or chapter
  142  466. In order for the consultant pharmacist or doctor of
  143  pharmacy to qualify and accept this authority, he or she must
  144  receive 3 hours of continuing education relating to laboratory
  145  and clinical testing as established by the board.
  146         (3) The board shall adopt promulgate rules necessary to
  147  implement and administer this section.
  148         Section 3. This act shall take effect July 1, 2020.