ENROLLED
CS/CS/HB 159, Engrossed 2 2024 Legislature
CODING: Words stricken are deletions; words underlined are additions.
hb0159-05-er
Page 1 of 8
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
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 adults for HIV exposure and provide the results 5
to such adults, with advice to consult with or seek 6
treatment from a physician; authorizing pharmacists to 7
dispense HIV preexposure prophylaxis drugs pursuant to 8
a prescription; authorizing pharmacists to order and 9
dispense HIV postexposure prophylaxis drugs pursuant 10
to a written collaborative practice agreement with a 11
physician; specifying requirements for the practice 12
agreements; requiring the supervising physician to 13
review the pharmacist's records a nd actions in 14
accordance with the practice agreement; requiring 15
pharmacists who enter into such practice agreements to 16
submit the agreements to the Board of Pharmacy; 17
requiring such pharmacists to provide certain written 18
information when dispensing such dr ugs to patients; 19
requiring pharmacists to comply with certain 20
procedures under certain circumstances; requiring 21
pharmacists, before ordering and dispensing HIV 22
postexposure prophylaxis drugs, to be certified by the 23
Board of Pharmacy; specifying minimum req uirements for 24
the certification; requiring certain pharmacies to 25
ENROLLED
CS/CS/HB 159, Engrossed 2 2024 Legislature
CODING: Words stricken are deletions; words underlined are additions.
hb0159-05-er
Page 2 of 8
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
submit an access-to-care plan to the Board of Pharmacy 26
and the Department of Health annually; authorizing the 27
board to fine or place certain prohibitions on a 28
pharmacy that does not comply wi th the requirements 29
for access-to-care plans; specifying requirements for 30
the plans; requiring the board to adopt rules; 31
providing an effective date. 32
33
Be It Enacted by the Legislature of the State of Florida: 34
35
Section 1. This act may be cited as th e "John W. Rheay 36
Act." 37
Section 2. Section 465.1861, Florida Statutes, is created 38
to read: 39
465.1861 Ordering and dispensing HIV infection prevention 40
drugs.— 41
(1) As used in this section, the term: 42
(a) "HIV" means the human immunodeficiency virus. 43
(b) "HIV infection prevention drug" means preexposure 44
prophylaxis, postexposure prophylaxis, and any other drug 45
approved by the United States Food and Drug Administration for 46
the prevention of HIV infection. 47
(c) "Postexposure prophylaxis" means a drug o r drug 48
combination that meets the clinical eligibility recommendations 49
of the United States Centers for Disease Control and Prevention 50
ENROLLED
CS/CS/HB 159, Engrossed 2 2024 Legislature
CODING: Words stricken are deletions; words underlined are additions.
hb0159-05-er
Page 3 of 8
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
guidelines for antiretroviral treatment following potential 51
exposure to HIV. 52
(d) "Preexposure prophylaxis" means a drug or drug 53
combination that meets the clinical eligibility recommendations 54
of the United States Centers for Disease Control and Prevention 55
guidelines for antiretroviral treatment for the prevention of 56
HIV transmission. 57
(2) A pharmacist may screen an adult for HIV exposure and 58
provide the results to the adult, with the advice that the 59
patient should seek further medical consultation or treatment 60
from a physician. 61
(3) A pharmacist may dispense HIV preexposure prophylaxis 62
drugs pursuant to a valid prescripti on issued by a licensed 63
health care practitioner authorized by law to prescribe such 64
drugs. 65
(4) A pharmacist who is certified under subsection (6) may 66
order and dispense HIV postexposure prophylaxis drugs pursuant 67
to a written collaborative practice agre ement between the 68
pharmacist and a physician licensed under chapter 458 or chapter 69
459. 70
(a) A written collaborative practice agreement between a 71
pharmacist and a physician under this section must include, at a 72
minimum, all of the following: 73
1. Terms and conditions relating to the screening for HIV 74
and the ordering and dispensing of HIV postexposure prophylaxis 75
ENROLLED
CS/CS/HB 159, Engrossed 2 2024 Legislature
CODING: Words stricken are deletions; words underlined are additions.
hb0159-05-er
Page 4 of 8
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
drugs by the pharmacist. Such terms and conditions must be 76
appropriate for the pharmacist's training. 77
2. Specific categories of pat ients the pharmacist is 78
authorized to screen for HIV and for whom the pharmacist may 79
order and dispense HIV postexposure prophylaxis drugs. 80
3. A requirement that the pharmacist maintain records for 81
any HIV postexposure prophylaxis drugs ordered and dispe nsed 82
under the collaborative practice agreement. 83
4. The physician's instructions for obtaining relevant 84
patient medical history for the purpose of identifying 85
disqualifying health conditions, adverse reactions, and 86
contraindications to the use of HIV pos texposure prophylaxis 87
drugs. 88
5. A process and schedule for the physician to review the 89
pharmacist's records and actions under the practice agreement. 90
6. Evidence of the pharmacist's current certification by 91
the board as provided in subsection (6). 92
7. Any other requirements as established by the board with 93
the approval of the Board of Medicine and the Board of 94
Osteopathic Medicine. 95
(b) A physician who has entered into a written 96
collaborative practice agreement pursuant to this section is 97
responsible for reviewing the pharmacist's records and actions 98
to ensure compliance with the agreement. 99
(c) The pharmacist shall submit a copy of the written 100
ENROLLED
CS/CS/HB 159, Engrossed 2 2024 Legislature
CODING: Words stricken are deletions; words underlined are additions.
hb0159-05-er
Page 5 of 8
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 to the board. 101
(5) A pharmacist who orders and dispenses HIV postexposure 102
prophylaxis drugs pursuant to subsection (4) must provide the 103
patient with written information advising the patient to seek 104
follow-up care from his or her primary care physician. If the 105
patient indicates that he or she lacks regular access to primary 106
care, the pharmacist must comply with the procedures of the 107
pharmacy's approved access -to-care plan as provided in 108
subsection (7). 109
(6) To provide services under a collaborative practice 110
agreement pursuant to this section, a pharmacist must be 111
certified by the board, according to rules adopted by the board. 112
To be certified, a pharmacist must, at a minimum, meet all of 113
the following criteria: 114
(a) Hold an active and unencumbered license to practice 115
pharmacy under this chapter. 116
(b) Be engaged in the active pra ctice of pharmacy. 117
(c) Have earned a degree of doctor of pharmacy or have 118
completed at least 3 years of experience as a licensed 119
pharmacist. 120
(d) Maintain at least $250,000 of liability coverage. A 121
pharmacist who maintains liability coverage pursuant to s. 122
465.1865 or s. 465.1895 satisfies this requirement. 123
(e) Have completed a course approved by the board, in 124
consultation with the Board of Medicine and the Board of 125
ENROLLED
CS/CS/HB 159, Engrossed 2 2024 Legislature
CODING: Words stricken are deletions; words underlined are additions.
hb0159-05-er
Page 6 of 8
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
Osteopathic Medicine, which includes, at a minimum, instruction 126
on all of the following : 127
1. Performance of patient assessments. 128
2. Point-of-care testing procedures. 129
3. Safe and effective treatment of HIV exposure with HIV 130
infection prevention drugs, including, but not limited to, 131
consideration of the side effects of the drug dispensed and the 132
patient's diet and activity levels. 133
4. Identification of contraindications. 134
5. Identification of patient comorbidities in individuals 135
with HIV requiring further medical evaluation and treatment, 136
including, but not limited to, cardiovascular dis ease, lung and 137
liver cancer, chronic obstructive lung disease, and diabetes 138
mellitus. 139
(f) Any other criteria as established by the board with 140
the approval of the Board of Medicine and the Board of 141
Osteopathic Medicine. 142
(7)(a) A pharmacy in which a phar macist is providing 143
services under a written collaborative practice agreement 144
pursuant to subsection (4) must submit an access -to-care plan to 145
the board and department annually. If the board or the 146
department determines that a pharmacy has failed to submit an 147
access-to-care plan required under this section or if a 148
pharmacy's access-to-care plan does not comply with this section 149
or applicable rules of the board, the board must notify the 150
ENROLLED
CS/CS/HB 159, Engrossed 2 2024 Legislature
CODING: Words stricken are deletions; words underlined are additions.
hb0159-05-er
Page 7 of 8
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
pharmacy of its noncompliance and the pharmacy must submit an 151
access-to-care plan that brings the pharmacy into compliance 152
according to parameters provided in board rule. The board may 153
fine a pharmacy that fails to comply with this paragraph or may 154
prohibit such pharmacy from allowing its pharmacists to screen 155
adults for HIV exposure or order and dispense HIV postexposure 156
prophylaxis drugs under a collaborative practice agreement until 157
the pharmacy complies with this paragraph. 158
(b) An access-to-care plan shall assist patients in 159
gaining access to appropriate care settings wh en they present to 160
a pharmacist for HIV screening and indicate that they lack 161
regular access to primary care. An access -to-care plan must 162
include, but need not be limited to: 163
1. Procedures to educate such patients about care that 164
would be best provided i n a primary care setting and the 165
importance of receiving regular primary care. 166
2. The pharmacy's plan for collaborative partnership with 167
one or more nearby federally qualified health centers, county 168
health departments, or other primary care settings. The goals of 169
such partnership must include, but need not be limited to, 170
protocols for identifying and appropriately referring a patient 171
who has presented to the pharmacist for HIV screening or access 172
to HIV infection prevention drugs and indicates that he or she 173
lacks regular access to primary care. 174
(8) The board shall adopt rules to implement this section. 175
ENROLLED
CS/CS/HB 159, Engrossed 2 2024 Legislature
CODING: Words stricken are deletions; words underlined are additions.
hb0159-05-er
Page 8 of 8
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
Section 3. This act shall take effect July 1, 2024. 176