Senate Engrossed pharmacists; independent testing; treatment State of Arizona Senate Fifty-seventh Legislature First Regular Session 2025 SENATE BILL 1214 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)
Senate Engrossed pharmacists; independent testing; treatment
State of Arizona Senate Fifty-seventh Legislature First Regular Session 2025
SENATE BILL 1214
Senate Engrossed
pharmacists; independent testing; treatment
State of Arizona
Senate
Fifty-seventh Legislature
First Regular Session
2025
SENATE BILL 1214
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, 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 twelve 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. SARS-COV-2 or other coronavirus respiratory illnessES. 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, 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 or certification requirements. 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, the american academy of pediatrics committee on infectious disease 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 THE STATEWIDE WRITTEN PROTOCOL that SPECIFIES the following: 1. Patient inclusion and exclusion criteria. 2. Explicit medical referral criteria. F. A pharmacist shall refer a patient to the patient's primary care provider, if one is identified, or recommend follow up with a primary provider, if the patient either: 1. Is not eligible for patient treatment pursuant to this section and presents with 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 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, including a summary of the visit and patient assessment information, FOR A PERIOD OF SEVEN YEARS. 3. Notify the patient's 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 or treatment 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. 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. L. A pharmacy shall either display a notice or include in a patient's consent paperwork THAT the testing and treatment being performed pursuant to this section ARE being performed by a pharmacist without consultation with or oversight by a physician and that the patient should consult with a primary care provider if symptoms continue.pursuant to this section ARE being performed by a pharmacist{{without consultation with or oversight by a physician and that the patient should consult with a primary care provider if symptoms continue}}.] END_STATUTE Sec. 2. Independent testing and treatment advisory committee; duties; members; delayed repeal A. The Arizona state board of pharmacy shall appoint an advisory committee to assist the board in developing this state's protocols relating to pharmacists' independent authority to order testing and initiate treatments pursuant to section 32-1979.04, Arizona Revised Statutes, as added by this act. The advisory committee shall also make recommendations to the Arizona state board of pharmacy regarding the protocols required pursuant to that section. B. The advisory committee shall include at least the following: 1. Two pharmacists who are licensed pursuant to title 32, chapter 18, Arizona Revised Statutes. 2. Two physicians who are licensed pursuant to title 32, chapter 13, Arizona Revised Statutes, and who specialize in primary care, at least one of whom has a patient population that is substantially composed of children and adolescents. 2. {{One physician}}{{Two physicians}} who {{is}}{{are}} licensed pursuant to title 32, chapter 13, Arizona Revised Statutes, and who {{specializes}}{{specialize}} in primary care{{, at least one of whom has a patient population that is substantially comprised of children and adolescents}}. 3. One person who represents a nonprofit patient advocacy organization. 4. One nurse practitioner who is licensed pursuant to title 32, chapter 15, Arizona Revised Statutes, who specializes in primary care and who is able to prescribe medication. {{4. One nurse practitioner who is licensed pursuant to title 32, chapter 15, Arizona Revised Statutes, who specializes in primary care and who is able to prescribe medication.}} C. Advisory committee members are not eligible for compensation or reimbursement of expenses. D. This section is repealed from and after December 31, 2026.
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, 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 twelve 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. SARS-COV-2 or other coronavirus respiratory illnessES.
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, 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 or certification requirements.
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, the american academy of pediatrics committee on infectious disease 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 THE STATEWIDE WRITTEN PROTOCOL that SPECIFIES the following:
1. Patient inclusion and exclusion criteria.
2. Explicit medical referral criteria.
F. A pharmacist shall refer a patient to the patient's primary care provider, if one is identified, or recommend follow up with a primary provider, if the patient either:
1. Is not eligible for patient treatment pursuant to this section and presents with 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 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, including a summary of the visit and patient assessment information, FOR A PERIOD OF SEVEN YEARS.
3. Notify the patient's 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 or treatment 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.
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.
L. A pharmacy shall either display a notice or include in a patient's consent paperwork THAT the testing and treatment being performed pursuant to this section ARE being performed by a pharmacist without consultation with or oversight by a physician and that the patient should consult with a primary care provider if symptoms continue.pursuant to this section ARE being performed by a pharmacist{{without consultation with or oversight by a physician and that the patient should consult with a primary care provider if symptoms continue}}.] END_STATUTE
Sec. 2. Independent testing and treatment advisory committee; duties; members; delayed repeal
A. The Arizona state board of pharmacy shall appoint an advisory committee to assist the board in developing this state's protocols relating to pharmacists' independent authority to order testing and initiate treatments pursuant to section 32-1979.04, Arizona Revised Statutes, as added by this act. The advisory committee shall also make recommendations to the Arizona state board of pharmacy regarding the protocols required pursuant to that section.
B. The advisory committee shall include at least the following:
1. Two pharmacists who are licensed pursuant to title 32, chapter 18, Arizona Revised Statutes.
2. Two physicians who are licensed pursuant to title 32, chapter 13, Arizona Revised Statutes, and who specialize in primary care, at least one of whom has a patient population that is substantially composed of children and adolescents.
2. {{One physician}}{{Two physicians}} who {{is}}{{are}} licensed pursuant to title 32, chapter 13, Arizona Revised Statutes, and who {{specializes}}{{specialize}} in primary care{{, at least one of whom has a patient population that is substantially comprised of children and adolescents}}.
3. One person who represents a nonprofit patient advocacy organization.
4. One nurse practitioner who is licensed pursuant to title 32, chapter 15, Arizona Revised Statutes, who specializes in primary care and who is able to prescribe medication.
{{4. One nurse practitioner who is licensed pursuant to title 32, chapter 15, Arizona Revised Statutes, who specializes in primary care and who is able to prescribe medication.}}
C. Advisory committee members are not eligible for compensation or reimbursement of expenses.
D. This section is repealed from and after December 31, 2026.