Assigned to RAGE AS PASSED BY COMMITTEE
ARIZONA STATE SENATE
Fifty-Seventh Legislature, First Regular Session
AMENDED
FACT SHEET FOR S.B. 1214
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
(ASPB). Prospective pharmacists applying to ASPB for licensure must: 1) be a graduate of a school
or college of pharmacy or department of pharmacy of a university recognized by ASPB 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 ASPB; 3)
pass the pharmacist licensure examination and jurisprudence examination approved by ASPB; 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
federal 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 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. 1214
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 treatment to eligible persons six years old or the
age authorized by the treatment, using whichever age is older, who test positive for:
a) influenza;
b) group A streptococcus pharyngitis;
c) COVID-19 or other coronavirus respiratory illnesses;
d) HIV preexposure prophylaxis or postexposure prophylaxis; or
e) a condition related to an emerging or existing public health threat identified by DHS for
which a statewide standing order, rule or executive order is issued.
3. Requires ASPB to develop a statewide written protocol including, at a minimum, the
following:
a) documentation;
b) records retention;
c) referrals;
d) patient screening requirements and obtaining relevant medical history;
e) exclusion criteria;
f) treatment instructions based on the patient's age and medical history;
g) follow up maintenance and care plans; and
h) any necessary pharmacist training certification.
4. 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 CLIA or
federal law or any screening procedure that is established by the statewide written protocol.
5. Directs pharmacists to use evidence-based clinical guidelines published by the Center for
Disease Control and Prevention, the Infectious Diseases Society of America, the American
Academy of Pediatrics Committee on Infectious Disease or other clinically recognized
recommendation in providing patient treatment.
6. Requires an eligible person to meet criteria for treatment based on current clinical guidelines,
if available, or the statewide written protocol that specify:
a) patient inclusion and exclusion criteria; and
b) explicit medical referral criteria.
7. 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. FACT SHEET – Amended
S.B. 1214
Page 3
8. Directs a pharmacist who initiates treatment of a patient to:
a) notify the patient's 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 entry into an electronic health record, 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 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.
9. Allows a pharmacist to delegate the task of performing a test waived by CLIA 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 delegate only ancillary duties permitted by ASPB rules.
10. 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.
11. Prohibits a pharmacist from independently initiating treatment using opioids for a patient.
12. Prohibits a pharmacist from independently ordering a test or screening or treating a minor
without consent of the minor's parent or guardian.
13. Requires a pharmacy to either display a notice or include in a patient's consent paperwork that
the testing and treatment being performed is being performed by a pharmacist.
14. Establishes an independent testing and treatment advisory committee (Advisory Committee)
that is appointed by ASPB to assist ASPB in developing the state's protocols relating to
pharmacists' independent authority to order testing and initiate treatments.
15. Allows the Advisory Committee to also make recommendations to ASPB regarding protocols.
16. Requires the Advisory Committee include at least the following:
a) two licensed pharmacists;
b) one physician licensed through the Arizona Medical Board who specializes in primary
care;
c) one licensed physician through the Arizona Board of Osteopathic Examiners in Medicine
and Surgery who specializes in primary care; and
d) one representative from a nonprofit patient advocacy program.
17. Prohibits Advisory Committee members from receiving compensation or reimbursement of
expenses. FACT SHEET – Amended
S.B. 1214
Page 4
18. Terminates the Advisory Committee on January 1, 2027.
19. Becomes effective on the general effective date.
Amendments Adopted by Committee
1. Includes COVID-19 or other coronavirus respiratory illnesses as authorized for testing and
treatment, rather than a respiratory illness, condition or disease that does not require additional
diagnostic imaging.
2. Removes the requirement for ASPB to consult with the Arizona Medical Board when
developing the statewide protocol.
3. Removes the evidence-based research findings from the criteria that a pharmacist must consult
when treating an eligible patient.
4. Requires a pharmacy to either display a notice or include in a patient's consent paperwork that
the testing and treatment being performed is being performed by a pharmacist.
5. Establishes an independent testing and treatment advisory committee (Advisory Committee)
that is appointed by ASPB to assist ASPB in developing the state's protocols relating to
pharmacists' independent authority to order testing and initiate treatments.
6. Allows the Advisory Committee to also make recommendations to ASPB regarding protocols.
7. Requires the Advisory Committee include at least the following:
a) two licensed pharmacists;
b) one physician licensed through the Arizona Medical Board who specializes in primary
care;
c) one licensed physician through the Arizona Board of Osteopathic Examiners in Medicine
and Surgery who specializes in primary care; and
d) one representative from a nonprofit patient advocacy program.
8. Prohibits Advisory Committee members from receiving compensation or reimbursement of
expenses.
9. Terminates the Advisory Committee on January 1, 2027.
Senate Action
RAGE 2/5/25 DPA 5-2-0
Prepared by Senate Research
February 6, 2025
JT/KP/ci