REFERENCE TITLE: pharmacists; independent testing; treatment State of Arizona Senate Fifty-seventh Legislature First Regular Session 2025 SB 1214 Introduced by Senator Shope AN ACT amending title 32, chapter 18, article 3, Arizona Revised Statutes, by adding section 32-1979.04; relating to the Arizona state board of pharmacy. (TEXT OF BILL BEGINS ON NEXT PAGE)
REFERENCE TITLE: pharmacists; independent testing; treatment
State of Arizona Senate Fifty-seventh Legislature First Regular Session 2025
SB 1214
Introduced by Senator Shope
REFERENCE TITLE: pharmacists; independent testing; treatment
State of Arizona
Senate
Fifty-seventh Legislature
First Regular Session
2025
SB 1214
Introduced by
Senator Shope
AN ACT
amending title 32, chapter 18, article 3, Arizona Revised Statutes, by adding section 32-1979.04; relating to the Arizona state board of pharmacy.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona: Section 1. Title 32, chapter 18, article 3, Arizona Revised Statutes, is amended by adding section 32-1979.04, to read: START_STATUTE32-1979.04. Pharmacists; statewide protocol; independent testing; treatment; health conditions; notification requirements A. Pursuant to a statewide written protocol approved by the Arizona state board of pharmacy in consultation with the Arizona medical board, a pharmacist may independently order, perform and interpret tests that are authorized by the United States food and drug administration and waived under the clinical laboratory improvement amendments of 1988 (P.L. 100-578; 102 Stat. 2903; 42 United States Code section 201). A pharmacist may independently initiate treatment to eligible persons who are at least SIX years of age or the age authorized by the treatment, whichever age is older, and who have test results that indicate the need for treatment, by a test that is authorized by the United States food and drug administration and waived under the clinical laboratory improvement amendments of 1988, for any of the following health conditions: 1. Influenza. 2. Group A streptococcus pharyngitis. 3. A respiratory illness, condition or disease that does not require additional diagnostic imaging to diagnose BEYOND a test waived under the clinical laboratory improvement amendments of 1988. 4. Human immunodeficiency virus preexposure prophylaxis or postexposure prophylaxis. 5. 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. B. When developing the statewide written protocol in consultation with the Arizona medical board, the Arizona state board of pharmacy shall address at a minimum the following: 1. Documentation. 2. Records retention. 3. Referrals. 4. Patient screening requirements and obtaining relevant medical history. 5. Exclusion criteria. 6. Treatment instructions based on the patient's age and medical history. 7. Follow-up maintenance and care plans. 8. Any necessary pharmacist training certification. C. A pharmacist who orders or conducts testing or treats health conditions pursuant to subsection A of this section shall use any test that may guide clinical decision-making for which a waiver has been obtained under the clinical laboratory improvement amendments of 1988, or the federal rules adopted thereunder, or any screening procedure that is established by the statewide written protocol. D. A pharmacist shall use evidence-based clinical guidelines published by the United States centers for disease control and prevention or the infectious diseases society of America or another clinically recognized recommendation in providing patient treatment pursuant to subsection A of this section. E. An eligible person must meet criteria for treatment based on current clinical guidelines, if available, THE STATEWIDE WRITTEN PROTOCOL or evidence-based research findings that specify the following: 1. Patient inclusion and exclusion criteria. 2. Explicit medical referral criteria. F. A pharmacist shall refer a patient to the patient's identified primary care provider, if one is identified, if the patient either: 1. Is not eligible for patient treatment pursuant to this section and presents with differential symptoms. 2. Does not respond to the initial treatment provided pursuant to this section. G. A pharmacist who initiates a treatment under this section shall: 1. Notify the patient's identified primary care provider, if one is identified, within seventy-two hours after initiating treatment pursuant to this section. The notice shall include the patient's name, the treatment initiated and the date of treatment and may be submitted by entry into an electronic HEALTH record or by telephone, fax, mail or email. The pharmacist shall make a reasonable effort to identify the patient's primary care provider by at least one of the following methods: (a) Checking pharmacy records. (b) Requesting the information from the patient or, for a patient under eighteen years of age, the patient's parent or guardian. 2. Maintain a record of the results of any testing or screening for which a treatment is initiated pursuant to this section FOR A PERIOD OF SEVEN YEARS. 3. Notify the patient's identified primary care provider, if one is identified, within forty-eight hours after the occurrence of any adverse reaction that is reported to or witnessed by the pharmacist as a result of the treatment. 4. Provide informational materials to the patient requesting treatment or, for a patient under eighteen years of age, to the patient's parent or guardian about the importance of pediatric preventive health care visits as recommended by the American academy of pediatrics. H. A pharmacist may delegate the TASK of performing a test waived by the clinical laboratory improvement amendments of 1988 to a LICENSED member of the pharmacy staff who is under the supervision of the pharmacist. A pharmacist may not delegate any tasks that include clinical judgment and may delegate only ancillary duties as allowed by board rules. I. This section does not establish a cause of action against a patient's primary care provider for any adverse reaction, complication or negative outcome arising from any treatment initiated by a pharmacist pursuant to this section if the treatment is initiated without a prescription order written by the patient's primary care provider. J. A pharmacist may not independently initiate a treatment using opioids for a patient. K. A pharmacist may not independently order a test or screening or treat a minor without the written consent of the minor's parent or guardian. END_STATUTE
Be it enacted by the Legislature of the State of Arizona:
Section 1. Title 32, chapter 18, article 3, Arizona Revised Statutes, is amended by adding section 32-1979.04, to read:
START_STATUTE32-1979.04. Pharmacists; statewide protocol; independent testing; treatment; health conditions; notification requirements
A. Pursuant to a statewide written protocol approved by the Arizona state board of pharmacy in consultation with the Arizona medical board, a pharmacist may independently order, perform and interpret tests that are authorized by the United States food and drug administration and waived under the clinical laboratory improvement amendments of 1988 (P.L. 100-578; 102 Stat. 2903; 42 United States Code section 201). A pharmacist may independently initiate treatment to eligible persons who are at least SIX years of age or the age authorized by the treatment, whichever age is older, and who have test results that indicate the need for treatment, by a test that is authorized by the United States food and drug administration and waived under the clinical laboratory improvement amendments of 1988, for any of the following health conditions:
1. Influenza.
2. Group A streptococcus pharyngitis.
3. A respiratory illness, condition or disease that does not require additional diagnostic imaging to diagnose BEYOND a test waived under the clinical laboratory improvement amendments of 1988.
4. Human immunodeficiency virus preexposure prophylaxis or postexposure prophylaxis.
5. 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.
B. When developing the statewide written protocol in consultation with the Arizona medical board, the Arizona state board of pharmacy shall address at a minimum the following:
1. Documentation.
2. Records retention.
3. Referrals.
4. Patient screening requirements and obtaining relevant medical history.
5. Exclusion criteria.
6. Treatment instructions based on the patient's age and medical history.
7. Follow-up maintenance and care plans.
8. Any necessary pharmacist training certification.
C. A pharmacist who orders or conducts testing or treats health conditions pursuant to subsection A of this section shall use any test that may guide clinical decision-making for which a waiver has been obtained under the clinical laboratory improvement amendments of 1988, or the federal rules adopted thereunder, or any screening procedure that is established by the statewide written protocol.
D. A pharmacist shall use evidence-based clinical guidelines published by the United States centers for disease control and prevention or the infectious diseases society of America or another clinically recognized recommendation in providing patient treatment pursuant to subsection A of this section.
E. An eligible person must meet criteria for treatment based on current clinical guidelines, if available, THE STATEWIDE WRITTEN PROTOCOL or evidence-based research findings that specify the following:
1. Patient inclusion and exclusion criteria.
2. Explicit medical referral criteria.
F. A pharmacist shall refer a patient to the patient's identified primary care provider, if one is identified, if the patient either:
1. Is not eligible for patient treatment pursuant to this section and presents with differential symptoms.
2. Does not respond to the initial treatment provided pursuant to this section.
G. A pharmacist who initiates a treatment under this section shall:
1. Notify the patient's identified primary care provider, if one is identified, within seventy-two hours after initiating treatment pursuant to this section. The notice shall include the patient's name, the treatment initiated and the date of treatment and may be submitted by entry into an electronic HEALTH record or by telephone, fax, mail or email. The pharmacist shall make a reasonable effort to identify the patient's primary care provider by at least one of the following methods:
(a) Checking pharmacy records.
(b) Requesting the information from the patient or, for a patient under eighteen years of age, the patient's parent or guardian.
2. Maintain a record of the results of any testing or screening for which a treatment is initiated pursuant to this section FOR A PERIOD OF SEVEN YEARS.
3. Notify the patient's identified primary care provider, if one is identified, within forty-eight hours after the occurrence of any adverse reaction that is reported to or witnessed by the pharmacist as a result of the treatment.
4. Provide informational materials to the patient requesting treatment or, for a patient under eighteen years of age, to the patient's parent or guardian about the importance of pediatric preventive health care visits as recommended by the American academy of pediatrics.
H. A pharmacist may delegate the TASK of performing a test waived by the clinical laboratory improvement amendments of 1988 to a LICENSED member of the pharmacy staff who is under the supervision of the pharmacist. A pharmacist may not delegate any tasks that include clinical judgment and may delegate only ancillary duties as allowed by board rules.
I. This section does not establish a cause of action against a patient's primary care provider for any adverse reaction, complication or negative outcome arising from any treatment initiated by a pharmacist pursuant to this section if the treatment is initiated without a prescription order written by the patient's primary care provider.
J. A pharmacist may not independently initiate a treatment using opioids for a patient.
K. A pharmacist may not independently order a test or screening or treat a minor without the written consent of the minor's parent or guardian. END_STATUTE