House Study Bill 202 - Introduced HOUSE FILE _____ BY (PROPOSED COMMITTEE ON HEALTH AND HUMAN SERVICES BILL BY CHAIRPERSON MEYER) A BILL FOR An Act relating to the practice of pharmacy, and providing for 1 administrative penalties. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 1556YC (5) 90 ss/rh
H.F. _____ Section 1. NEW SECTION . 155A.2B Practice of pharmacy 1 general principles. 2 To evaluate whether an act by a licensee or registrant under 3 this chapter violates the appropriate standard of care, a 4 licensee or registrant of the board must consider all of the 5 following: 6 1. Whether performance of the act is expressly prohibited 7 by a provision of this chapter. 8 2. Whether performance of the act is expressly prohibited 9 by a rule adopted by the board. 10 3. Whether performance of the act is expressly prohibited by 11 another applicable state or federal law or regulation. 12 4. Whether performance of the act is consistent with 13 the education, training, and experience of a licensee or 14 registrant. 15 5. Whether performance of the act is within the accepted 16 standard of care that would be provided in a similar setting by 17 a reasonable and prudent licensee or registrant with similar 18 education, training, and experience. 19 Sec. 2. Section 155A.3, subsection 39, Code 2023, is amended 20 to read as follows: 21 39. Practitioner means a physician, dentist, podiatric 22 physician, prescribing psychologist, veterinarian, optometrist, 23 pharmacist, physician assistant, advanced registered nurse 24 practitioner, or other person licensed or registered to 25 prescribe, distribute, or dispense a prescription drug or 26 device in the course of professional practice in this state or 27 a person licensed by another state in a health field in which, 28 under Iowa law, licensees in this state may legally prescribe 29 drugs. 30 Sec. 3. Section 155A.3, Code 2023, is amended by adding the 31 following new subsection: 32 NEW SUBSECTION . 49A. Therapeutic substitution means the 33 replacement of a prescribed drug with an alternative molecule 34 with assumed equivalent therapeutic effect. The alternative 35 -1- LSB 1556YC (5) 90 ss/rh 1/ 15
H.F. _____ drug may be within the same class or from another class with 1 assumed therapeutic equivalence. 2 Sec. 4. Section 155A.7, Code 2023, is amended by striking 3 the section and inserting in lieu thereof the following: 4 155A.7 Pharmacist-intern, pharmacy technician, and pharmacy 5 support person registration. 6 1. Registration programs for pharmacist-interns, pharmacy 7 technicians, and pharmacy support persons are established for 8 the purposes of identification, tracking, and disciplinary 9 action for the violation of federal drug laws or regulations, 10 state drug or pharmacy laws, or rules of the board. 11 2. A person who is or desires to be a pharmacist-intern, 12 pharmacy technician, or pharmacy support person in this state 13 shall apply to the board for registration on a form prescribed 14 by the board. 15 a. A pharmacist-intern shall be registered during internship 16 training and thereafter pursuant to rules adopted by the board. 17 b. An applicant for a new pharmacy technician registration 18 or for a pharmacy technician renewal shall provide proof of 19 current certification by a national technician certification 20 authority approved by the board. A person who is in the 21 process of acquiring national certification as a pharmacy 22 technician and who is in training to become a pharmacy 23 technician shall register with the board as a pharmacy 24 technician. 25 3. The board shall adopt rules pursuant to chapter 17A on 26 matters pertaining to pharmacist-intern, pharmacy technician, 27 and pharmacy support person registration, renewals, fees, 28 training, national certification for pharmacy technicians, 29 approval of preceptors for pharmacist-interns, and other 30 relevant matters. 31 a. The board shall establish standards for pharmacist-intern 32 registration. 33 b. The board shall not adopt rules pertaining to pharmacy 34 support person registration which include any determination of 35 -2- LSB 1556YC (5) 90 ss/rh 2/ 15
H.F. _____ the competency of the registered person and, notwithstanding 1 section 272C.2, subsection 1, shall not require continuing 2 education for renewal. 3 4. The board may deny, suspend, or revoke the registration 4 of a pharmacist-intern, pharmacy technician, or pharmacy 5 support person, or otherwise impose disciplinary penalties upon 6 the registration of a pharmacy technician or pharmacy support 7 person, for any violation of the laws of this state, another 8 state, or the United States relating to prescription drugs, 9 controlled substances, or nonprescription drugs, or for any 10 violation of this chapter or chapter 124, 124B, 126, 147, 205, 11 or 272C, or any rule of the board. The board may deny, suspend, 12 or revoke a pharmacist-intern registration for failure to meet 13 the standards prescribed by the board pursuant to subsection 3. 14 5. Responsibility for the actions of a pharmacist-intern, 15 pharmacy technician, or pharmacy support person working under 16 a licensed pharmacists delegated functions and reasonable 17 professional oversight shall remain with the licensed 18 pharmacist. 19 Sec. 5. Section 155A.8, Code 2023, is amended to read as 20 follows: 21 155A.8 Requirements for pharmacist Pharmacist license. 22 1. A person shall not engage in the practice of pharmacy in 23 this state without a license. The license shall be identified 24 as a pharmacist license. 25 2. A pharmacist may dispense, administer, monitor, and 26 issue prescription drugs, biological products, and medication 27 orders commensurate with the pharmacists training and 28 education and in accordance with the appropriate standard of 29 care. 30 3. To qualify for a pharmacist license, an applicant shall 31 meet the following requirements: 32 1. a. Be a graduate of a school or college of pharmacy 33 or of a department of pharmacy of a university recognized and 34 approved by the board. 35 -3- LSB 1556YC (5) 90 ss/rh 3/ 15
H.F. _____ 2. b. File proof, satisfactory to the board, of internship 1 for a period of time fixed by the board. 2 3. c. Pass an examination prescribed by the board. 3 4. The board shall specify by rule procedures and fees to 4 renew a pharmacist license and penalties for late renewal or 5 failure to renew a pharmacist license. 6 Sec. 6. Section 155A.9, subsection 2, Code 2023, is amended 7 to read as follows: 8 2. An applicant who is a graduate of a school or college of 9 pharmacy located outside the United States but who is otherwise 10 qualified to apply for a pharmacist license in this state may 11 be deemed to have satisfied the requirements of section 155A.8, 12 subsection 1 section 155A.8, subsection 3, paragraph a , by 13 verification to the board of the applicants academic record 14 and graduation and by meeting other requirements established 15 by rule of the board. The board may require the applicant 16 to pass an examination or examinations given or approved by 17 the board to establish proficiency in English and equivalency 18 of education as a prerequisite for taking the licensure 19 examination required in section 155A.8, subsection 3 . 20 Sec. 7. Section 155A.12, subsection 1, Code 2023, is amended 21 to read as follows: 22 1. Violated any provision of this chapter or any rules of 23 the board adopted under this chapter , the pharmacy or drug 24 laws or rules of the United States, or any other state laws 25 or rules of the United States while under the other states 26 jurisdiction . 27 Sec. 8. Section 155A.12, subsections 8, 9, and 10, Code 28 2023, are amended by striking the subsections. 29 Sec. 9. Section 155A.12, Code 2023, is amended by adding the 30 following new subsections: 31 NEW SUBSECTION . 11. Engaged in conduct outside the accepted 32 standard of care that would be provided in a similar setting by 33 a reasonable and prudent applicant or licensee. 34 NEW SUBSECTION . 12. Displayed incapacity of a nature 35 -4- LSB 1556YC (5) 90 ss/rh 4/ 15
H.F. _____ preventing engagement in the practice of pharmacy with 1 reasonable skill, competence, and safety to the public. 2 Sec. 10. Section 155A.13, subsection 3, paragraph b, Code 3 2023, is amended by striking the paragraph and inserting in 4 lieu thereof the following: 5 b. The board shall adopt rules for the issuance of a special 6 or limited-use pharmacy license to a telepharmacy site. 7 Sec. 11. Section 155A.13, subsection 3, paragraphs c, d, and 8 e, Code 2023, are amended by striking the paragraphs. 9 Sec. 12. Section 155A.13, subsection 8, Code 2023, is 10 amended by striking the subsection. 11 Sec. 13. Section 155A.13A, Code 2023, is amended by adding 12 the following new subsection: 13 NEW SUBSECTION . 6. Nonresident pharmacy license. The 14 board shall specify by rule procedures and fees to renew a 15 nonresident pharmacy license and the penalties for late renewal 16 or failure to renew a nonresident pharmacy license. 17 Sec. 14. Section 155A.18, Code 2023, is amended to read as 18 follows: 19 155A.18 Penalties. 20 1. The board shall impose penalties as allowed under section 21 272C.3 . In addition, civil penalties not to exceed twenty-five 22 thousand dollars, may be imposed. 23 2. The board may impose an administrative penalty of up to 24 five hundred dollars on a licensee or registrant who does any 25 of the following: 26 a. Engages in a practice regulated by this chapter without a 27 current license or registration. 28 b. Employs a person without a current license or 29 registration to engage in a practice regulated by this chapter. 30 c. Fails to complete the continuing education required for 31 renewal of a license or registration. 32 d. Fails any component of a routine inspection conducted by 33 the board. 34 e. The assessment and payment of a penalty imposed pursuant 35 -5- LSB 1556YC (5) 90 ss/rh 5/ 15
H.F. _____ to this subsection shall not be considered a disciplinary 1 action or reported as discipline and shall be confidential. 2 Sec. 15. Section 155A.19, Code 2023, is amended by striking 3 the section and inserting in lieu thereof the following: 4 155A.19 Notifications to board. 5 Individuals and businesses licensed or registered pursuant 6 to this chapter shall notify the board of pertinent changes 7 related to activities performed pursuant to a license or 8 registration issued under this chapter, pursuant to rules of 9 the board. 10 Sec. 16. Section 155A.23, Code 2023, is amended by adding 11 the following new subsection: 12 NEW SUBSECTION . 4. a. A person found in possession of a 13 drug or device limited to dispensation by prescription, unless 14 the drug or device was so lawfully dispensed, commits a serious 15 misdemeanor. 16 b. Paragraph a does not apply to a licensed pharmacy, 17 licensed wholesaler, physician, veterinarian, dentist, 18 podiatric physician, optometrist, advanced registered nurse 19 practitioner, physician assistant, pharmacist, a nurse 20 acting under the direction of a physician, staff acting 21 under the direction of a person licensed to prescribe, or 22 the board of pharmacy, its officers, agents, inspectors, 23 and representatives, or to a common carrier, manufacturers 24 representative, or messenger when transporting the drug or 25 device in the same unbroken package in which the drug or device 26 was delivered to that person for transportation. 27 Sec. 17. Section 155A.26, unnumbered paragraph 1, Code 28 2023, is amended to read as follows: 29 The board, its officers, agents, inspectors compliance 30 officers , and representatives, and all peace officers 31 within the state, and all county attorneys shall enforce 32 all provisions of this chapter , except those specifically 33 delegated, and shall cooperate with all agencies charged 34 with the enforcement of the laws of the United States, of 35 -6- LSB 1556YC (5) 90 ss/rh 6/ 15
H.F. _____ this state, and of all other states relating to prescription 1 drugs. Officers, agents, inspectors compliance officers , and 2 representatives of the board shall have the powers and status 3 of peace officers when enforcing the provisions of this chapter 4 and chapters 124 , 126 , and 205 . Officers, agents, inspectors 5 compliance officers , and representatives of the board of 6 pharmacy may: 7 Sec. 18. Section 155A.26, subsection 3, Code 2023, is 8 amended to read as follows: 9 3. Conduct routine and unannounced inspections of 10 pharmacies, drug wholesalers, and the offices or business 11 locations of all individuals and institutions authorized to 12 have possession of prescription drugs including any entity 13 licensed by the board or location authorized to possess 14 controlled substances or prescription devices, regardless of 15 the location of the office or business. 16 Sec. 19. Section 155A.27, subsection 2, paragraph a, Code 17 2023, is amended to read as follows: 18 a. Beginning January 1, 2020, every Every prescription 19 issued for a prescription drug shall be transmitted 20 electronically as an electronic prescription to a pharmacy by a 21 prescriber or the prescribers authorized agent unless exempt 22 under paragraph b . 23 Sec. 20. Section 155A.27, subsection 3, unnumbered 24 paragraph 1, Code 2023, is amended to read as follows: 25 For prescriptions issued prior to January 1, 2020, or 26 for prescriptions exempt from the electronic prescription 27 requirement in subsection 2 , paragraph b , a prescriber or the 28 prescribers authorized agent may transmit a prescription for a 29 prescription drug to a pharmacy by any of the following means: 30 Sec. 21. Section 155A.27, Code 2023, is amended by adding 31 the following new subsections: 32 NEW SUBSECTION . 8. Except as specified in subsection 9, a 33 prescription for any prescription drug or device which is not a 34 controlled substance shall not be filled or refilled more than 35 -7- LSB 1556YC (5) 90 ss/rh 7/ 15
H.F. _____ eighteen months after the date on which the prescription was 1 issued and a prescription which is authorized to be refilled 2 shall not be refilled more than twelve times. 3 NEW SUBSECTION . 9. A pharmacist may exercise professional 4 judgment by refilling a prescription drug order without 5 prescriber authorization in accordance with the appropriate 6 standard of care and pursuant to rules established by the 7 board. 8 NEW SUBSECTION . 10. An authorization to refill a 9 prescription drug order shall be transmitted to a pharmacy by 10 a prescriber or the prescribers authorized agent pursuant 11 to this section, except that prescription drug orders for 12 controlled substances shall be transmitted pursuant to section 13 124.308, and, if not transmitted directly by the practitioner, 14 shall also include the name and title of the practitioners 15 agent completing the transmission. 16 Sec. 22. Section 155A.32, Code 2023, is amended by striking 17 the section and inserting in lieu thereof the following: 18 155A.32 Drug product selection restrictions. 19 1. If an authorized practitioner prescribes a drug, the 20 pharmacist may exercise professional judgment in the interest 21 of the patient by providing a therapeutic substitution for 22 dispensing and sale to the patient. 23 2. The pharmacist shall not provide a therapeutic 24 substitution if dispense as written is indicated on the 25 prescription. 26 3. The board shall adopt rules on proper recording and 27 notification when a therapeutic substitution is made under this 28 section. 29 Sec. 23. Section 155A.39, subsection 6, Code 2023, is 30 amended to read as follows: 31 6. Funds and surcharges collected under this section shall 32 be deposited in an account and may be used by the board to 33 administer a program authorized by this section , but shall 34 not be used for costs incurred for a participants initial 35 -8- LSB 1556YC (5) 90 ss/rh 8/ 15
H.F. _____ evaluation, referral services, treatment, or rehabilitation 1 subsequent to intervention and to assist licensees and 2 registrants with costs incurred for participation in the 3 program . 4 Sec. 24. Section 155A.40, subsection 1, Code 2023, is 5 amended to read as follows: 6 1. The board may request and obtain, notwithstanding 7 section 692.2, subsection 5 , criminal history data for any 8 applicant for an initial or renewal license or registration 9 issued pursuant to this chapter or chapter 147 , any applicant 10 for reinstatement of a license or registration issued pursuant 11 to this chapter or chapter 147 , or any licensee or registrant 12 who is being monitored as a result of a board order or 13 agreement resolving an administrative disciplinary action, 14 for the purpose of evaluating the applicants, licensees, 15 or registrants eligibility for licensure, registration, or 16 suitability for continued practice of the profession. Criminal 17 history data may be requested for all owners, managers, and 18 principal employees of a pharmacy , third-party logistics 19 provider, or drug wholesaler wholesale distributor licensed 20 pursuant to this chapter . The board shall adopt rules 21 pursuant to chapter 17A to implement this section . The board 22 shall inform the applicant, licensee, or registrant of the 23 criminal history requirement and obtain a signed waiver from 24 the applicant, licensee, or registrant prior to submitting a 25 criminal history data request. 26 Sec. 25. Section 155A.46, Code 2023, is amended by adding 27 the following new subsection: 28 NEW SUBSECTION . 01. A pharmacist may, pursuant to 29 statewide protocols developed and approved by the board in 30 consultation with the department of health and human services, 31 order and administer prescription drugs, products, tests, or 32 treatments. Each protocol, as established by rule, may define 33 the prescription drugs, products, tests, or treatments allowed 34 to be ordered and administered, any training or qualification 35 -9- LSB 1556YC (5) 90 ss/rh 9/ 15
H.F. _____ required to implement the protocol, and any additional 1 requirements deemed appropriate by the board. 2 Sec. 26. Section 155A.46, subsection 1, Code 2023, is 3 amended to read as follows: 4 1. A pharmacist may, pursuant to statewide protocols 5 developed and approved by the board in consultation with 6 the department of health and human services and consistent 7 with subsection 2, order and administer an immunization or 8 vaccination. Each protocol, as established by rule, may 9 define the immunization or vaccination allowed to be ordered 10 and administered, any training or qualification required to 11 implement the protocol, and any additional requirements deemed 12 appropriate by the board. 13 a. A pharmacist may , pursuant to statewide protocols 14 developed by the board in consultation with the department 15 of public health and consistent with subsection 2 , order and 16 administer the following to patients ages eighteen years and 17 older: 18 (1) Naloxone. 19 (2) Nicotine replacement tobacco cessation products. 20 (3) (1) An immunization or vaccination recommended by 21 the United States centers for disease control and prevention 22 advisory committee on immunization practices in its approved 23 vaccination schedule for adults. 24 (4) (2) An immunization or vaccination recommended by the 25 United States centers for disease control and prevention for 26 international travel. 27 (5) (3) A Tdap (tetanus, diphtheria, acellular pertussis) 28 vaccination in a booster application. 29 (6) (4) Other emergency immunizations or vaccinations in 30 response to a public health emergency. 31 (7) (5) An immunization or vaccination for COVID-19 as 32 defined in section 686D.2 . 33 b. A pharmacist may , pursuant to statewide protocols 34 developed by the board in consultation with the department 35 -10- LSB 1556YC (5) 90 ss/rh 10/ 15
H.F. _____ of public health and consistent with subsection 2 , order and 1 administer the following to patients ages six months and older: 2 (1) A vaccine or An immunization or vaccination for 3 influenza. 4 (2) Other emergency immunizations or vaccines in response 5 to a public health emergency. 6 c. A pharmacist may, pursuant to statewide protocols 7 developed by the board in consultation with the department 8 of public health and consistent with subsection 2 , order and 9 administer the final two doses in a course of vaccinations for 10 HPV to patients ages eleven years and older. 11 d. Prior to the ordering and administration of a 12 vaccination or an immunization or vaccination authorized by 13 this subsection , pursuant to statewide protocols, a licensed 14 pharmacist shall consult and review the statewide immunization 15 registry or health information network. The board shall 16 adopt rules requiring the reporting of the administration of 17 vaccines and immunizations and vaccinations authorized by this 18 subsection to a patients primary health care provider, primary 19 physician, and a statewide immunization registry or health 20 information network. 21 e. A pharmacist may, pursuant to statewide protocols 22 developed by the board in consultation with the department 23 of public health and consistent with subsection 2 , order and 24 administer the following to patients ages six years and older: 25 (1) Point-of-care testing and treatment for influenza, 26 streptococcus A, and COVID-19 as defined in section 686D.2 at 27 the point of interaction between a pharmacist and a patient. 28 (2) Point-of-care testing at the point of interaction 29 between a pharmacist and a patient in response to a public 30 health emergency. 31 Sec. 27. Section 155A.46, subsection 2, Code 2023, is 32 amended by striking the subsection and inserting in lieu 33 thereof the following: 34 2. Notwithstanding any provision of law to the contrary, 35 -11- LSB 1556YC (5) 90 ss/rh 11/ 15
H.F. _____ a pharmacist may develop policies, procedures, and protocols 1 to carry out the practices identified in section 155A.8, 2 subsection 2. 3 Sec. 28. Section 155A.47, subsection 1, Code 2023, is 4 amended to read as follows: 5 1. Notwithstanding any provision of section 147.107, 6 subsection 2 , or section 155A.33 this chapter to the contrary, 7 the board may approve a pilot or demonstration research project 8 of innovative applications in the practice of pharmacy to 9 provide enhanced patient care. 10 Sec. 29. REPEAL. Sections 155A.6, 155A.6A, 155A.6B, 11 155A.21, 155A.28, and 155A.29, Code 2023, are repealed. 12 EXPLANATION 13 The inclusion of this explanation does not constitute agreement with 14 the explanations substance by the members of the general assembly. 15 This bill relates to the practice of pharmacy. The bill 16 creates general principles that licensees and registrants of 17 the board of pharmacy (board) must consider when determining 18 whether an act violates the appropriate standard of care. The 19 bill also reorganizes Code chapter 155A (pharmacy) by combining 20 and repealing certain Code sections, and makes conforming Code 21 changes. The bill combines Code section 155A.21 (unlawful 22 possession of prescription drug or device penalty) into Code 23 section 155A.23 (prohibited acts) and Code section 155A.29 24 (prescription refills) into Code section 155A.27 (requirements 25 for prescriptions). 26 The bill adds pharmacists to the definition of 27 practitioner for the purposes of Code chapter 155A and 28 defines therapeutic substitution as the replacement of a 29 prescribed drug with an alternative molecule with assumed 30 equivalent therapeutic effect. 31 The bill repeals and amends current Code provisions 32 regarding the registration of pharmacist-interns, pharmacy 33 technicians, and pharmacy support persons. The bill requires 34 the board to adopt rules regarding the registration and 35 -12- LSB 1556YC (5) 90 ss/rh 12/ 15
H.F. _____ practice of pharmacist-interns, pharmacy technicians, and 1 pharmacy support persons. The bill prohibits the board 2 from adopting rules pertaining to pharmacy support person 3 registration which include any determination of the competency 4 of the registered person or requiring continuing education. 5 The bill allows the board to deny, suspend, or revoke a 6 registration of a pharmacist-intern, pharmacy technician, 7 or pharmacy support person based on a violation of certain 8 laws and regulations. Responsibility for the actions of a 9 pharmacist-intern, pharmacy technician, or pharmacy support 10 person working under a pharmacist remains with the pharmacist. 11 The bill allows a pharmacist to dispense, administer, 12 monitor, and issue prescription drugs, biological products, 13 and medication orders according to the pharmacists training 14 and education and in accordance with the appropriate standard 15 of care. The bill requires the board to specify by rule the 16 procedures and fees to renew a pharmacist license and the 17 penalties for late renewal or failure to renew a pharmacist 18 license. 19 The bill allows the board to discipline a pharmacist or 20 refuse to issue a pharmacist license to a person for engaging 21 in conduct outside the accepted standard of care that would 22 be provided in a similar setting by a reasonable and prudent 23 applicant or licensee and for displaying incapacity of a 24 nature preventing engagement in the practice of pharmacy with 25 reasonable skill, competence, and safety to the public. 26 The bill strikes provisions regarding the issuance of a 27 telepharmacy license and requires the board to adopt rules for 28 the issuance of a telepharmacy license. The bill also strikes 29 a requirement that a pharmacy license be issued in the name of 30 the pharmacist in charge and not be transferable or assignable. 31 The bill requires the board to adopt rules regarding the 32 renewal of a nonresident pharmacy license and the penalties 33 for a late renewal or failure to renew a nonresident pharmacy 34 license. 35 -13- LSB 1556YC (5) 90 ss/rh 13/ 15
H.F. _____ The bill allows the board to impose an administrative 1 penalty of up to $500 on a licensee or registrant who engages 2 in a practice regulated by Code chapter 155A without a current 3 license or registration, employs a person without a current 4 license or registration to engage in a practice regulated by 5 Code chapter 155A, fails to complete the continuing education 6 required for renewal of a license or registration, or fails any 7 component of a routine inspection conducted by the board. An 8 administrative penalty shall not be considered a disciplinary 9 action or reported as discipline and shall be confidential. 10 Under current law, the board can impose civil penalties not to 11 exceed $25,000. 12 The bill strikes current law regarding notifications 13 submitted by a pharmacy to the board and requires the board 14 to adopt rules for the reporting of pertinent changes related 15 to activities performed pursuant to a license or registration 16 issued under Code chapter 155A to the board by a licensed or 17 registered person or business. 18 The bill changes references to inspectors of the board 19 to compliance officers of the board. The bill allows the 20 board to conduct routine and unannounced inspections of any 21 entity licensed by the board or location authorized to possess 22 controlled substances or prescription devices. 23 The bill strikes provisions allowing prescriptions issued 24 before January 1, 2020, to be issued by nonelectronic means. 25 The bill allows a pharmacist to exercise professional judgment 26 by refilling a prescription without prescriber authorization in 27 accordance with the appropriate standard of care and pursuant 28 to rules established by the board. 29 The bill allows a pharmacist to dispense a therapeutic 30 substitution in lieu of a prescribed drug according to the 31 professional judgment of the pharmacist unless the prescription 32 states dispense as written. The board shall adopt rules on 33 proper recording and notification of therapeutic substitutions. 34 The bill allows funds and surcharges collected for a 35 -14- LSB 1556YC (5) 90 ss/rh 14/ 15
H.F. _____ program to monitor impaired pharmacists, pharmacist-interns, 1 or pharmacy technicians to be used to assist licensees and 2 registrants with costs incurred for participation in the 3 program. 4 The bill allows the board to request criminal history 5 data for all owners, managers, and principal employees and 6 third-party logistics providers and wholesale distributors. 7 The bill amends current provisions regarding statewide 8 protocols under which a pharmacist can order and administer 9 certain drugs. The bill allows the board to develop statewide 10 protocols for the ordering and administration of prescription 11 drugs, products, tests, treatments, immunizations, and 12 vaccinations in consultation with the department of health and 13 human services. Each protocol may define the prescription 14 drugs, products, tests, treatments, immunizations, or 15 vaccinations allowed to be ordered and administered, any 16 training or qualification required to implement the protocol, 17 and any additional requirements deemed appropriate by the 18 board. The bill strikes provisions allowing a pharmacist to 19 order and administer naloxone and nicotine replacement tobacco 20 cessation products to patients ages 18 years and older and to 21 order and administer certain forms of point-of-care testing 22 to patients ages 6 years and older. The bill also strikes 23 provisions requiring a pharmacist who orders or administers 24 prescription drugs, products, tests, or treatments to maintain 25 certain records, provide notice to a patients primary health 26 care provider, and complete continuing education requirements. 27 The bill allows the board to approve a pilot or demonstration 28 research project of innovative applications in the practice of 29 pharmacy to provide enhanced patient care, notwithstanding any 30 provision of Code chapter 155A to the contrary. Current law 31 allows the board to approve such a project notwithstanding Code 32 section 155A.33 (delegation of functions). 33 -15- LSB 1556YC (5) 90 ss/rh 15/ 15