Florida Senate - 2024                          SENATOR AMENDMENT
       Bill No. CS/CS/HB 159, 1st Eng.
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                 Floor: WD/2R          .                                
             03/05/2024 01:59 PM       .                                

       Senator Calatayud moved the following:
    1         Senate Amendment (with title amendment)
    3         Delete lines 63 - 128
    4  and insert:
    5         3.A requirement that the pharmacist maintain records for
    6  any HIV postexposure prophylaxis drugs ordered and dispensed
    7  under the collaborative practice agreement.
    8         4.The physician’s instructions for obtaining relevant
    9  patient medical history for the purpose of identifying
   10  disqualifying health conditions, adverse reactions, and
   11  contraindications to the use of HIV postexposure prophylaxis
   12  drugs.
   13         5.A process and schedule for the physician to review the
   14  pharmacist’s records and actions under the practice agreement.
   15         6.Evidence of the pharmacist’s current certification by
   16  the board as provided in subsection (6).
   17         7.Any other requirements as established by the board with
   18  the approval of the Board of Medicine and the Board of
   19  Osteopathic Medicine.
   20         (b)A physician who has entered into a written
   21  collaborative practice agreement pursuant to this section is
   22  responsible for reviewing the pharmacist’s records and actions
   23  to ensure compliance with the agreement.
   24         (c)The pharmacist shall submit a copy of the written
   25  collaborative practice agreement to the board.
   26         (5)A pharmacist who orders and dispenses HIV postexposure
   27  prophylaxis drugs pursuant to subsection (4) must provide the
   28  patient with written information advising the patient to seek
   29  follow-up care from his or her primary care physician. If the
   30  patient indicates that he or she lacks regular access to primary
   31  care, the pharmacist must comply with the procedures of the
   32  pharmacy’s approved access-to-care plan as provided in
   33  subsection (7).
   34         (6)To provide services under a collaborative practice
   35  agreement pursuant to this section, a pharmacist must be
   36  certified by the board, according to rules adopted by the board
   37  with the approval of the Board of Medicine and the Board of
   38  Osteopathic Medicine. To be certified, a pharmacist must, at a
   39  minimum, meet all of the following criteria:
   40         (a)Hold an active and unencumbered license to practice
   41  pharmacy under this chapter.
   42         (b)Be engaged in the active practice of pharmacy.
   43         (c)Have earned a degree of doctor of pharmacy or have
   44  completed at least 3 years of experience as a licensed
   45  pharmacist.
   46         (d)Maintain at least $250,000 of liability coverage. A
   47  pharmacist who maintains liability coverage pursuant to s.
   48  465.1865 or s. 465.1895 satisfies this requirement.
   49         (e)Have completed a course approved by the board, in
   50  consultation with the Board of Medicine and the Board of
   51  Osteopathic Medicine, which includes, at a minimum, instruction
   52  on all of the following:
   53         1.Performance of patient assessments.
   54         2.Point-of-care testing procedures.
   55         3.Safe and effective treatment of HIV exposure with HIV
   56  infection prevention drugs, including, but not limited to,
   57  consideration of the side effects of the drug dispensed and the
   58  patient’s diet and activity levels.
   59         4.Identification of contraindications.
   60         5.Identification of patient comorbidities in individuals
   61  with HIV requiring further medical evaluation and treatment,
   62  including, but not limited to, cardiovascular disease, lung and
   63  liver cancer, chronic obstructive lung disease, and diabetes
   64  mellitus.
   65         (7)(a)A pharmacy in which a pharmacist is providing
   66  services under a written collaborative practice agreement
   67  pursuant to subsection (4) must submit an access-to-care plan to
   68  the board and department annually. If the board or the
   69  department determines that a pharmacy has failed to submit an
   70  access-to-care plan required under this section or if a
   71  pharmacys access-to-care plan does not comply with this section
   72  or applicable rules of the board, the board must notify the
   73  pharmacy of its noncompliance and the pharmacy must submit an
   74  access-to-care plan that brings the pharmacy into compliance
   75  according to parameters provided in board rule. The board may
   76  fine a pharmacy that fails to comply with this paragraph or may
   77  prohibit such pharmacy from allowing its pharmacists to screen
   78  adults for HIV exposure or order and dispense HIV postexposure
   79  prophylaxis drugs under this section until the pharmacy complies
   80  with this paragraph.
   81         (b)An access-to-care plan shall assist patients in gaining
   82  access to appropriate care settings when they present to a
   83  pharmacist for HIV screening and indicate that they lack regular
   84  access to primary care. An access-to-care plan must include, but
   85  need not be limited to:
   87  ================= T I T L E  A M E N D M E N T ================
   88  And the title is amended as follows:
   89         Delete lines 5 - 13
   90  and insert:
   91         screen adults for HIV exposure and provide the results
   92         to such adults, with advice to consult with or seek
   93         treatment from a physician; authorizing pharmacists to
   94         dispense HIV preexposure prophylaxis drugs pursuant to
   95         a prescription; authorizing pharmacists to order and
   96         dispense HIV postexposure prophylaxis drugs pursuant
   97         to a written collaborative practice agreement with a
   98         physician; specifying requirements for the practice
   99         agreements; requiring the supervising physician to
  100         review the pharmacist’s records and actions in
  101         accordance with the practice agreement; requiring
  102         pharmacists who enter into such practice agreements to
  103         submit the agreements to the Board of Pharmacy;
  104         requiring such pharmacists to provide certain written
  105         information when dispensing such drugs to patients;
  106         requiring pharmacists to comply with certain
  107         procedures under certain circumstances; requiring
  108         pharmacists, before ordering and dispensing HIV
  109         postexposure prophylaxis drugs, to be certified by the
  110         Board of Pharmacy in accordance with rules adopted by
  111         the board and approved by the Board of Medicine and
  112         the Board of Osteopathic Medicine; specifying minimum
  113         requirements for the certification; requiring certain
  114         pharmacies to submit an access-to-care plan to the
  115         Board of Pharmacy and the Department of Health
  116         annually; authorizing the board to fine or place
  117         certain prohibitions on a pharmacy that does not
  118         comply with the requirements for access-to-care plans;
  119         specifying requirements for the plans; requiring the