Assigned to HHS AS PASSED BY COW
ARIZONA STATE SENATE
Fifty-Sixth Legislature, Second Regular Session
AMENDED
FACT SHEET FOR S.B. 1085
pharmacists; independent testing; treatment
Purpose
Allows a pharmacist to independently test for and treat eligible persons for outlined
medical conditions.
Background
Pharmacists in Arizona are licensed and regulated by the Arizona State Board of Pharmacy
(Board). Prospective pharmacists applying to the Board for licensure must: 1) be a graduate of a
school or college of pharmacy or department of pharmacy of a university recognized by the Board
or the Accreditation Council for Pharmacy Education; 2) have successfully completed a program
of practical experience under the direct supervision of a licensed pharmacist approved by the
Board; 3) pass the pharmacist licensure examination and jurisprudence examination approved by
the Board; and 4) pay the prescribed application fee. Prospective licensees who have not passed a
licensure examination in Arizona but have in another jurisdiction may be licensed if outlined
criteria are met (A.R.S. § 32-1922).
Practice of pharmacy means furnishing the following health care services as a medical
professional: 1) interpreting, evaluating and dispensing prescription orders in the patient's best
interests; 2) compounding drugs pursuant to or in anticipation of a prescription order; 3) labeling
drugs and devices in compliance with state and federal requirements; 4) participating in drug
selection and drug utilization reviews, drug administration, drug or drug-related research and drug
therapy or management; 5) providing patient counseling necessary to provide pharmaceutical care;
6) properly and safely storing drugs and devices in anticipation of dispensing; 7) maintaining
required records of drugs and devices; 8) offering or performing acts, services, operations or
transactions that are necessary to conduct, operate, manage and control a pharmacy; 9) providing
patient care services under a collaborative practice agreement with a provider; and 10) initiating
and administering immunizations or vaccines (A.R.S. § 32-1901).
All facilities in the United States that perform laboratory testing on human specimens for
health assessment or the diagnosis, prevention or treatment of disease are regulated under the
Clinical Laboratory Improvement Amendments of 1988 (CLIA). Waived tests include test systems
cleared by the U.S. Food and Drug Administration (FDA) for home use and those tests approved
for waiver under the CLIA criteria. CLIA requires that waived tests must be simple and have a low
risk for erroneous results (CDC).
There is no anticipated fiscal impact to the state General Fund associated with this
legislation.
FACT SHEET – Amended
S.B. 1085
Page 2
Provisions
1. Allows a pharmacist to independently order, perform and interpret tests authorized by the FDA
and waived under CLIA.
2. Allows a pharmacist to independently initiate therapy to eligible persons who are at least six
years old that test positive for:
a) influenza;
b) group A streptococcus pharyngitis;
c) a respiratory illness, condition or disease; or
d) a condition related to an emerging or existing public health threat identified by the
Department of Health Services for which a statewide standing order, rule or executive order
is issued.
3. Requires a pharmacist who orders, conducts testing or treats a health condition to use any test
that may guide clinical decision-making for which a waiver has been obtained under federal
law or any screening procedure that is established by the statewide written protocol.
4. Directs pharmacists to use evidence-based clinical guidelines published by the Centers for
Disease Control, the statewide written protocol or other clinically recognized
recommendations in providing patient treatment.
5. Requires an eligible person to meet criteria for treatment based on current clinical guidelines,
if available, or evidence-based research findings that specify:
a) patient inclusion and exclusion criteria; and
b) explicit medical referral criteria.
6. Requires a pharmacist to refer a patient to the patient's primary care provider, if one is
identified, if the patient:
a) is not eligible for treatment by a pharmacist under state law and presents with differential
symptoms; or
b) does not respond to the initial treatment provided by the pharmacist.
7. Directs a pharmacist who initiates treatment of a patient to:
a) notify the patient's identified primary care provider, if one is identified, within 72 hours
after initiating treatment, including notice of the patient's name, treatment method and the
date of treatment by phone, fax, mail or email;
b) make a reasonable effort to identify the patient's primary care provider by checking
pharmacy records or requesting the information from the patient or patient's parent or
guardian, if applicable;
c) maintain a record of any testing or screening results for seven years;
d) notify the patient's identified primary care provider, if one is identified, within 48 hours
after an adverse reaction is reported to or witnessed by the pharmacist as a result of
treatment; and
e) provide informational materials to the patient or patient's parent or guardian, if applicable,
about the importance of pediatric preventive health care visits as recommended by the
American Academy of Pediatrics. FACT SHEET – Amended
S.B. 1085
Page 3
8. Allows a pharmacist to delegate the task of performing a test to a licensed member of the
pharmacy staff who is under the supervision of the pharmacist, except that the pharmacist:
a) may not delegate any tasks that include clinical judgment; and
b) may only delegate ancillary duties permitted by Board rules.
9. Specifies that a pharmacist's ability to test and treat outlined conditions does not establish a
cause of action against a patient's primary care provider for any adverse reaction, complication
or negative outcome arising from the treatment initiated by the pharmacist, if the treatment is
initiated without a prescription order written by the provider.
10. Prohibits a pharmacist from independently ordering a test or screening or treating a minor
without consent of the minor's parent or guardian.
11. Requires the Board's statewide written protocol for medical testing and treatment by a
pharmacist to be made in consultation with the Arizona Medical Board.
12. Becomes effective on the general effective date.
Amendments Adopted by Committee of the Whole
1. Increases, from three to six, the age of a person that a pharmacist may independently test and
treat.
2. Removes the authority of a pharmacist to independently test for and treat COVID-19.
3. Allows the criteria for treatment of an eligible person to be based on the Arizona State Board
of Pharmacy's statewide written protocol.
4. Requires pharmacists to maintain the results of any testing or screening for a period of seven
years.
5. Limits the ability of a pharmacist to delegate the task of performing a test to only licensed,
rather than trained, staff members.
6. Removes the prohibition on health insurers denying reimbursement for any test, screening or
treatment performed by a pharmacist that would have been covered if otherwise performed by
a medical or osteopathic physician, nurse practitioner or physician assistant.
Senate Action
HHS 1/30/24 DP 6-1-0
Prepared by Senate Research
February 20, 2024
MM/slp