CS/CS/HB 159, Engrossed 1 2024
CODING: Words stricken are deletions; words underlined are additions.
hb0159-03-e1
Page 1 of 6
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
A bill to be entitled 1
An act relating to HIV infection prevention drugs; 2
providing a short title; creating s. 465.1861, F.S.; 3
defining terms; authorizing licensed pharmacists to 4
screen for HIV exposure and order and dispense HIV 5
infection prevention drugs under a collaborative 6
practice agreement; requiring pharmacists to be 7
certified by the Board of Pharmacy before ordering and 8
dispensing HIV infection prevention drugs; requiring 9
the board, in consultation with the Board of Medicine 10
and the Board of Osteopathic Medicine, to adopt rules 11
for such certification; specifying minimum 12
requirements for the certification; requiring the 13
board to adopt rules; providing an effective date. 14
15
Be It Enacted by the Legislature of the State of Florida: 16
17
Section 1. This act may be cited as the "John W. Rheay 18
Act." 19
Section 2. Section 465.1861, Florida Statutes, is created 20
to read: 21
465.1861 Ordering and dispensing HIV infection prevention 22
drugs.— 23
(1) As used in this section, the term: 24
(a) "HIV" means the human immunodeficiency virus. 25
CS/CS/HB 159, Engrossed 1 2024
CODING: Words stricken are deletions; words underlined are additions.
hb0159-03-e1
Page 2 of 6
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
(b) "HIV infection prevention drug" means preexposure 26
prophylaxis, postexposure prophylaxis, and any other drug 27
approved by the United States Food and Drug Administration for 28
the prevention of HIV infection. 29
(c) "Postexposure prophylaxis" means a drug or drug 30
combination that meets the clinical eligibility recommendations 31
of the United States Centers for Disease Contro l and Prevention 32
guidelines for antiretroviral treatment following potential 33
exposure to HIV. 34
(d) "Preexposure prophylaxis" means a drug or drug 35
combination that meets the clinical eligibility recommendations 36
of the United States Centers for Disease Cont rol and Prevention 37
guidelines for antiretroviral treatment for the prevention of 38
HIV transmission. 39
(2) A pharmacist may screen an adult for HIV exposure and 40
provide the results to the adult, with the advice that the 41
patient should seek further medical co nsultation or treatment 42
from a physician. 43
(3) A pharmacist may dispense HIV preexposure prophylaxis 44
drugs pursuant to a valid prescription issued by a licensed 45
health care practitioner authorized by law to prescribe such 46
drugs. 47
(4) A pharmacist who is certified under subsection (6) may 48
order and dispense HIV postexposure prophylaxis drugs pursuant 49
to a written collaborative practice agreement between the 50
CS/CS/HB 159, Engrossed 1 2024
CODING: Words stricken are deletions; words underlined are additions.
hb0159-03-e1
Page 3 of 6
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
pharmacist and a physician licensed under chapter 458 or chapter 51
459. 52
(a) A written collaborative practice agreement between a 53
pharmacist and a physician under this section must include, at a 54
minimum, all of the following: 55
1. Terms and conditions relating to the screening for HIV 56
and the ordering and dispensing of HIV postexposure prophylaxis 57
drugs by the pharmacist. Such terms and conditions must be 58
appropriate for the pharmacist's training. 59
2. Specific categories of patients the pharmacist is 60
authorized to screen for HIV and for whom the pharmacist may 61
order and dispense HIV postexposure pr ophylaxis drugs. 62
3. The physician's instructions for obtaining relevant 63
patient medical history for the purpose of identifying 64
disqualifying health conditions, adverse reactions, and 65
contraindications to the use of HIV postexposure prophylaxis 66
drugs. 67
4. A process and schedule for the physician to review the 68
pharmacist's actions under the practice agreement. 69
5. Evidence of the pharmacist's current certification by 70
the board as provided in subsection (6). 71
6. Any other requirements as established by th e board in 72
consultation with the Board of Medicine and the Board of 73
Osteopathic Medicine. 74
(b) A physician who has entered into a written 75
CS/CS/HB 159, Engrossed 1 2024
CODING: Words stricken are deletions; words underlined are additions.
hb0159-03-e1
Page 4 of 6
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
collaborative practice agreement pursuant to this section is 76
responsible for reviewing the pharmacist's actions to en sure 77
compliance with the agreement. 78
(c) The pharmacist shall submit a copy of the written 79
collaborative practice agreement to the board. 80
(5) A pharmacist who orders and dispenses HIV postexposure 81
prophylaxis drugs pursuant to subsection (4) must provid e the 82
patient with written information advising the patient to seek 83
follow-up care from his or her primary care physician. If the 84
patient indicates that he or she lacks regular access to primary 85
care, the pharmacist must comply with the procedures of the 86
pharmacy's approved access -to-care plan as provided in 87
subsection (7). 88
(6) To provide services under a collaborative practice 89
agreement pursuant to this section, a pharmacist must be 90
certified by the board, according to rules adopted by the board 91
in consultation with the Board of Medicine and the Board of 92
Osteopathic Medicine. To be certified, a pharmacist must, at a 93
minimum, meet all of the following criteria: 94
(a) Hold an active and unencumbered license to practice 95
pharmacy under this chapter. 96
(b) Be engaged in the active practice of pharmacy. 97
(c) Have earned a degree of doctor of pharmacy or have 98
completed at least 3 years of experience as a licensed 99
pharmacist. 100
CS/CS/HB 159, Engrossed 1 2024
CODING: Words stricken are deletions; words underlined are additions.
hb0159-03-e1
Page 5 of 6
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
(d) Maintain at least $250,000 of liability coverage. A 101
pharmacist who maintains liabi lity coverage pursuant to s. 102
465.1865 or s. 465.1895 satisfies this requirement. 103
(e) Have completed a course approved by the board, in 104
consultation with the Board of Medicine and the Board of 105
Osteopathic Medicine, which includes, at a minimum, instructio n 106
on all of the following: 107
1. Performance of patient assessments. 108
2. Point-of-care testing procedures. 109
3. Safe and effective treatment of HIV exposure with HIV 110
infection prevention drugs, including, but not limited to, 111
consideration of the side effec ts of the drug dispensed and the 112
patient's diet and activity levels. 113
4. Identification of contraindications. 114
5. Identification of patient comorbidities in individuals 115
with HIV requiring further medical evaluation and treatment, 116
including, but not limit ed to, cardiovascular disease, lung and 117
liver cancer, chronic obstructive lung disease, and diabetes 118
mellitus. 119
(7)(a) A pharmacy in which a pharmacist is providing 120
services under a written collaborative practice agreement 121
pursuant to subsection (4) must submit an access-to-care plan to 122
the board and department annually. 123
(b) An access-to-care plan shall assist patients in 124
gaining access to appropriate care settings when they present to 125
CS/CS/HB 159, Engrossed 1 2024
CODING: Words stricken are deletions; words underlined are additions.
hb0159-03-e1
Page 6 of 6
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
a pharmacist for HIV screening and indicate that they lack 126
regular access to primary care. An access -to-care plan must 127
include: 128
1. Procedures to educate such patients about care that 129
would be best provided in a primary care setting and the 130
importance of receiving regular primary care. 131
2. The pharmacy's plan for collabor ative partnership with 132
one or more nearby federally qualified health centers, county 133
health departments, or other primary care settings. The goals of 134
such partnership must include, but need not be limited to, 135
protocols for identifying and appropriately ref erring a patient 136
who has presented to the pharmacist for HIV screening or access 137
to HIV infection prevention drugs and indicates that he or she 138
lacks regular access to primary care. 139
(8) The board shall adopt rules to implement this section. 140
Section 3. This act shall take effect July 1, 2024. 141