Florida Senate - 2024                          SENATOR AMENDMENT
       Bill No. CS/CS/HB 159, 1st Eng.
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                Floor: 1/AD/2R         .            Floor: C            
             03/05/2024 06:28 PM       .      03/06/2024 04:55 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  To be certified, a pharmacist must, at a minimum, meet all of
   38  the following criteria:
   39         (a)Hold an active and unencumbered license to practice
   40  pharmacy under this chapter.
   41         (b)Be engaged in the active practice of pharmacy.
   42         (c)Have earned a degree of doctor of pharmacy or have
   43  completed at least 3 years of experience as a licensed
   44  pharmacist.
   45         (d)Maintain at least $250,000 of liability coverage. A
   46  pharmacist who maintains liability coverage pursuant to s.
   47  465.1865 or s. 465.1895 satisfies this requirement.
   48         (e)Have completed a course approved by the board, in
   49  consultation with the Board of Medicine and the Board of
   50  Osteopathic Medicine, which includes, at a minimum, instruction
   51  on all of the following:
   52         1.Performance of patient assessments.
   53         2.Point-of-care testing procedures.
   54         3.Safe and effective treatment of HIV exposure with HIV
   55  infection prevention drugs, including, but not limited to,
   56  consideration of the side effects of the drug dispensed and the
   57  patient’s diet and activity levels.
   58         4.Identification of contraindications.
   59         5.Identification of patient comorbidities in individuals
   60  with HIV requiring further medical evaluation and treatment,
   61  including, but not limited to, cardiovascular disease, lung and
   62  liver cancer, chronic obstructive lung disease, and diabetes
   63  mellitus.
   64         (f) Any other criteria as established by the board with the
   65  approval of the Board of Medicine and the Board of Osteopathic
   66  Medicine.
   67         (7)(a)A pharmacy in which a pharmacist is providing
   68  services under a written collaborative practice agreement
   69  pursuant to subsection (4) must submit an access-to-care plan to
   70  the board and department annually. If the board or the
   71  department determines that a pharmacy has failed to submit an
   72  access-to-care plan required under this section or if a
   73  pharmacys access-to-care plan does not comply with this section
   74  or applicable rules of the board, the board must notify the
   75  pharmacy of its noncompliance and the pharmacy must submit an
   76  access-to-care plan that brings the pharmacy into compliance
   77  according to parameters provided in board rule. The board may
   78  fine a pharmacy that fails to comply with this paragraph or may
   79  prohibit such pharmacy from allowing its pharmacists to screen
   80  adults for HIV exposure or order and dispense HIV postexposure
   81  prophylaxis drugs under a collaborative practice agreement until
   82  the pharmacy complies with this paragraph.
   83         (b)An access-to-care plan shall assist patients in gaining
   84  access to appropriate care settings when they present to a
   85  pharmacist for HIV screening and indicate that they lack regular
   86  access to primary care. An access-to-care plan must include, but
   87  need not be limited to:
   89  ================= T I T L E  A M E N D M E N T ================
   90  And the title is amended as follows:
   91         Delete lines 5 - 13
   92  and insert:
   93         screen adults for HIV exposure and provide the results
   94         to such adults, with advice to consult with or seek
   95         treatment from a physician; authorizing pharmacists to
   96         dispense HIV preexposure prophylaxis drugs pursuant to
   97         a prescription; authorizing pharmacists to order and
   98         dispense HIV postexposure prophylaxis drugs pursuant
   99         to a written collaborative practice agreement with a
  100         physician; specifying requirements for the practice
  101         agreements; requiring the supervising physician to
  102         review the pharmacist’s records and actions in
  103         accordance with the practice agreement; requiring
  104         pharmacists who enter into such practice agreements to
  105         submit the agreements to the Board of Pharmacy;
  106         requiring such pharmacists to provide certain written
  107         information when dispensing such drugs to patients;
  108         requiring pharmacists to comply with certain
  109         procedures under certain circumstances; requiring
  110         pharmacists, before ordering and dispensing HIV
  111         postexposure prophylaxis drugs, to be certified by the
  112         Board of Pharmacy; specifying minimum requirements for
  113         the certification; requiring certain pharmacies to
  114         submit an access-to-care plan to the Board of Pharmacy
  115         and the Department of Health annually; authorizing the
  116         board to fine or place certain prohibitions on a
  117         pharmacy that does not comply with the requirements
  118         for access-to-care plans; specifying requirements for
  119         the plans; requiring the