SB 1214
Initials AG/BG Page 1 Health & Human Services
ARIZONA HOUSE OF REPRESENTATIVES
Fifty-seventh Legislature
First Regular Session
Senate: RAGE DPA 5-2-0-0 | 3rd Read 22-7-1-0
SB 1214: pharmacists; independent testing; treatment
Sponsor: Senator Shope, LD 16
Committee on Health & Human Services
Overview
Allows a pharmacist to independently test and treat eligible persons for certain medical
conditions. Requires the Arizona State Board of Pharmacy (Board) to develop a statewide
written protocol regarding the independent authority and establishes the Independent
Testing and Treatment Advisory Committee (Advisory Committee) to assist with developing
the state's protocols.
History
The Board licenses and regulates pharmacists in Arizona. 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. Potential licensees who have not passed a licensure examination
in Arizona but have in another jurisdiction may be licensed if certain criteria are met (A.R.S.
§ 32-1922).
The 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 monitoring 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
pursuant to collaborative practice agreement requirements with a provider; and 10) initiating
and administering immunizations or vaccines (A.R.S. § 32-1901).
Facilities in the United States (U.S.) performing laboratory testing on human specimens for
health assessment or the diagnosis, prevention or treatment of disease are regulated under
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
approved for waivers under the CLIA criteria. CLIA requires that waived tests must be
simple and have a low risk for erroneous results (CDC).
☐ Prop 105 (45 votes) ☐ Prop 108 (40 votes) ☐ Emergency (40 votes) ☐ Fiscal Note SB 1214
Initials AG/BG Page 2 Health & Human Services
Provisions
Pharmacist Independent Testing and Treatment Statewide Protocols
1. Permits a pharmacist to independently order, perform and interpret tests that are
authorized by the FDA and waived under the CLIA. (Sec. 1)
2. Permits a pharmacist to independently initiate treatment to eligible persons 12 years of
age or the age authorized by the treatment, 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 or postexposure prophylaxis; or
e) a condition related to an emerging or existing public health threat identified by
Arizona Department Health Services for which a statewide standing order, rule or
executive order is issued. (Sec. 1)
3. Requires the Board, when developing the statewide written protocol, to address the
minimum:
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 or certification requirements. (Sec. 1)
4. Directs a pharmacist who orders or conducts testing or treats the prescribed health
conditions to use any test that may guide clinical decision-making for which a CLIA
waiver has been obtained, federal rules adopted thereunder or any screening procedure
that is established by the statewide written protocol. (Sec. 1)
5. Requires a pharmacist to use evidence-based clinical guidelines published by:
a) The Centers for Disease Control and Prevention;
b) The Infectious Diseases Society of America;
c) The American Academy of Pediatrics Committee on Infectious Disease; or
d) another clinically recognized recommendation in providing patient treatment. (Sec. 1)
6. Requires an eligible person to meet criteria for treatment based on the statewide written
protocol that specifies:
a) the patient inclusion and exclusion criteria; and
b) an explicit medical referral criteria. (Sec. 1)
7. Instructs a pharmacist to refer a patient to the patient's primary care provider, if one is
identified, or recommend follow up to the primary care provider if the patient is either:
a) ineligible for patient treatment and presents with symptoms; or
b) does not respond to the initial treatment provided by the pharmacist. (Sec. 1)
8. Directs a pharmacist who initiates treatment to 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. (Sec. 1) SB 1214
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9. Requires a pharmacist who initiates treatment to make a reasonable effort to identify the
patient's primary care provider by at least one of the following methods:
a) checking pharmacy records; or
b) requesting the information from the patient or, for patients under 18 years of age, the
patient's parent or guardian. (Sec. 1)
10. Requires a pharmacist who initiates treatment of a patient to:
a) maintain a record of the results of any testing or screening for which a treatment is
initiated, a summary of the visit and patient assessment information for a period of
seven years;
b) notify the patient's primary care provider, if one is identified, within 48 hours after
an occurrence of any adverse reaction that is reported to or witnessed by the
pharmacist because of the treatment; and
c) provide informational materials to the patient requesting treatment or, for patients
under 18 years of age, to the patient's parent or guardian about the importance of
pediatric preventative health care visits as recommended by the American Academy
of Pediatrics. (Sec. 1)
11. Permits a pharmacist to delegate the task of performing a test waived by the CLIA to a
licensed member of the pharmacy staff who is under the supervision of the pharmacist,
except that a pharmacist:
a) may not delegate any tasks that include clinical judgement or treatment; and
b) may delegate only ancillary duties as allowed by Board rules. (Sec. 1)
12. Clarifies 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. (Sec. 1)
13. Prohibits a pharmacist from independently:
a) initiating a treatment using opioids for treatment; and
b) ordering a test, screening or treatment of a minor without the written consent of the
minor's parent or guardian. (Sec. 1)
14. Requires a pharmacy to either display a notice or include in a patient's consent paperwork
that the:
a) testing and treatment are being performed by a pharmacist without consultation with
or oversight by a physician; and
b) patient should consult with a primary care provider if symptoms continue. (Sec. 1)
Independent Testing and Treatment Advisory Committee
15. Directs the Board to appoint an Advisory Committee to assist the Board in developing
Arizona's protocols relating to pharmacists' independent authority to order testing and
initiate treatments. (Sec. 2)
16. Requires the Advisory Committee to make recommendations to the Board regarding the
state's protocols relating to pharmacists' independent authority to order testing and
initiate treatments. (Sec. 2)
17. Requires the advisory committee to include at least:
a) two licensed pharmacists;
b) two licensed allopathic physicians who specialize in primary care, at least one of whom
has a patient population that is substantially composed of children and adolescents; SB 1214
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c) one person who represents a nonprofit patient advocacy organization; and
d) one licensed nurse practitioner who specializes in primary care and can prescribe
medication. (Sec. 2)
18. Specifies that Advisory Committee members are not eligible for compensation or
reimbursement of expenses. (Sec. 2)
19. Repeals the Advisory Committee on January 1, 2027. (Sec. 2)