| 1 | 1 | | FIRSTREGULARSESSION |
|---|
| 2 | 2 | | HOUSEBILLNO.797 |
|---|
| 3 | 3 | | 103RDGENERALASSEMBLY |
|---|
| 4 | 4 | | INTRODUCEDBYREPRESENTATIVEINGLE. |
|---|
| 5 | 5 | | 1633H.01I JOSEPHENGLER,ChiefClerk |
|---|
| 6 | 6 | | ANACT |
|---|
| 7 | 7 | | Torepealsection338.010,RSMo,andtoenactinlieuthereoftwonewsectionsrelatingto |
|---|
| 8 | 8 | | contraceptives. |
|---|
| 9 | 9 | | BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows: |
|---|
| 10 | 10 | | SectionA.Section338.010,RSMo,isrepealedandtwonewsectionsenactedinlieu |
|---|
| 11 | 11 | | 2thereof,tobeknownassections338.010and338.720,toreadasfollows: |
|---|
| 12 | 12 | | 338.010.1.The"practiceofpharmacy"includes: |
|---|
| 13 | 13 | | 2 (1)Theinterpretation,implementation,andevaluationofmedicalprescriptionorders, |
|---|
| 14 | 14 | | 3includinganylegenddrugsunder21U.S.C.Section353,andthereceipt,transmission,or |
|---|
| 15 | 15 | | 4handlingofsuchordersorfacilitatingthedispensingofsuchorders; |
|---|
| 16 | 16 | | 5 (2)Thedesigning,initiating,implementing,andmonitoringofamedication |
|---|
| 17 | 17 | | 6therapeuticplaninaccordancewiththeprovisionsofthissection; |
|---|
| 18 | 18 | | 7 (3)Thecompounding,dispensing,labeling,andadministrationofdrugsanddevices |
|---|
| 19 | 19 | | 8pursuanttomedicalprescriptionorders; |
|---|
| 20 | 20 | | 9 (4)TheorderingandadministrationofvaccinesapprovedorauthorizedbytheU.S. |
|---|
| 21 | 21 | | 10FoodandDrugAdministration,excludingvaccinesforcholera,monkeypox,Japanese |
|---|
| 22 | 22 | | 11encephalitis,typhoid,rabies,yellowfever,tick-borneencephalitis,anthrax,tuberculosis, |
|---|
| 23 | 23 | | 12dengue,Hib,polio,rotavirus,smallpox,andanyvaccineapprovedafterJanuary1,2023,to |
|---|
| 24 | 24 | | 13personsatleastsevenyearsofageortheagerecommendedbytheCentersforDisease |
|---|
| 25 | 25 | | 14ControlandPrevention,whicheverisolder,pursuanttojointpromulgationofrules |
|---|
| 26 | 26 | | 15establishedbytheboardofpharmacyandthestateboardofregistrationforthehealingarts |
|---|
| 27 | 27 | | 16unlessrulesareestablishedunderastateofemergencyasdescribedinsection44.100; |
|---|
| 28 | 28 | | EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis |
|---|
| 29 | 29 | | intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 17 (5)Theparticipationindrugselectionaccordingtostatelawandparticipationindrug |
|---|
| 30 | 30 | | 18utilizationreviews; |
|---|
| 31 | 31 | | 19 (6)Theproperandsafestorageofdrugsanddevicesandthemaintenanceofproper |
|---|
| 32 | 32 | | 20recordsthereof; |
|---|
| 33 | 33 | | 21 (7)Consultationwithpatientsandotherhealthcarepractitioners,andveterinarians |
|---|
| 34 | 34 | | 22andtheirclientsaboutlegenddrugs,aboutthesafeandeffectiveuseofdrugsanddevices; |
|---|
| 35 | 35 | | 23 (8)Theprescribinganddispensingofanynicotinereplacementtherapyproductunder |
|---|
| 36 | 36 | | 24section338.665; |
|---|
| 37 | 37 | | 25 (9)ThedispensingofHIVpostexposureprophylaxispursuanttosection338.730; |
|---|
| 38 | 38 | | 26[and] |
|---|
| 39 | 39 | | 27 (10)Thedispensingofself-administeredhormonalcontraceptivesundersection |
|---|
| 40 | 40 | | 28338.720;and |
|---|
| 41 | 41 | | 29 (11)Theofferingorperformingofthoseacts,services,operations,ortransactions |
|---|
| 42 | 42 | | 30necessaryintheconduct,operation,managementandcontrolofapharmacy. |
|---|
| 43 | 43 | | 31 2.Nopersonshallengageinthepracticeofpharmacyunlessheorsheislicensed |
|---|
| 44 | 44 | | 32undertheprovisionsofthischapter. |
|---|
| 45 | 45 | | 33 3.Thischaptershallnotbeconstruedtoprohibittheuseofauxiliarypersonnelunder |
|---|
| 46 | 46 | | 34thedirectsupervisionofapharmacistfromassistingthepharmacistinanyofhisorherduties. |
|---|
| 47 | 47 | | 35Thisassistanceinnowayisintendedtorelievethepharmacistfromhisorherresponsibilities |
|---|
| 48 | 48 | | 36forcompliancewiththischapterandheorshewillberesponsiblefortheactionsofthe |
|---|
| 49 | 49 | | 37auxiliarypersonnelactinginhisorherassistance. |
|---|
| 50 | 50 | | 38 4.Thischaptershallnotbeconstruedtoprohibitorinterferewithanylegally |
|---|
| 51 | 51 | | 39registeredpractitionerofmedicine,dentistry,orpodiatry,orveterinarymedicineonlyforuse |
|---|
| 52 | 52 | | 40inanimals,orthepracticeofoptometryinaccordancewithandasprovidedinsections |
|---|
| 53 | 53 | | 41195.070and336.220inthecompounding,administering,prescribing,ordispensingofhisor |
|---|
| 54 | 54 | | 42herownprescriptions. |
|---|
| 55 | 55 | | 43 5.Apharmacistwithacertificateofmedicationtherapeuticplanauthoritymay |
|---|
| 56 | 56 | | 44providemedicationtherapyservicespursuanttoawrittenprotocolfromaphysicianlicensed |
|---|
| 57 | 57 | | 45underchapter334topatientswhohaveestablishedaphysician-patientrelationship,as |
|---|
| 58 | 58 | | 46describedinsubdivision(1)ofsubsection1ofsection191.1146,withtheprotocolphysician. |
|---|
| 59 | 59 | | 47Thewrittenprotocolauthorizedbythissectionshallcomeonlyfromthephysicianandshall |
|---|
| 60 | 60 | | 48notcomefromanurseengagedinacollaborativepracticearrangementundersection |
|---|
| 61 | 61 | | 49334.104,orfromaphysicianassistantengagedinacollaborativepracticearrangementunder |
|---|
| 62 | 62 | | 50section334.735. |
|---|
| 63 | 63 | | 51 6.Nothinginthissectionshallbeconstruedastopreventanyperson,firmor |
|---|
| 64 | 64 | | 52corporationfromowningapharmacyregulatedbysections338.210to338.315,providedthat |
|---|
| 65 | 65 | | 53alicensedpharmacistisinchargeofsuchpharmacy. |
|---|
| 66 | 66 | | HB797 2 54 7.Nothinginthissectionshallbeconstruedtoapplytoorinterferewiththesaleof |
|---|
| 67 | 67 | | 55nonprescriptiondrugsandtheordinaryhouseholdremediesandsuchdrugsormedicinesas |
|---|
| 68 | 68 | | 56arenormallysoldbythoseengagedinthesaleofgeneralmerchandise. |
|---|
| 69 | 69 | | 57 8.Nohealthcarrierasdefinedinchapter376shallrequireanyphysicianwithwhich |
|---|
| 70 | 70 | | 58theycontracttoenterintoawrittenprotocolwithapharmacistformedicationtherapeutic |
|---|
| 71 | 71 | | 59services. |
|---|
| 72 | 72 | | 60 9.Thissectionshallnotbeconstruedtoallowapharmacisttodiagnoseor |
|---|
| 73 | 73 | | 61independentlyprescribepharmaceuticals. |
|---|
| 74 | 74 | | 62 10.Thestateboardofregistrationforthehealingarts,undersection334.125,andthe |
|---|
| 75 | 75 | | 63stateboardofpharmacy,undersection338.140,shalljointlypromulgaterulesregulatingthe |
|---|
| 76 | 76 | | 64useofprotocolsformedicationtherapyservices.Suchrulesshallrequireprotocolstoinclude |
|---|
| 77 | 77 | | 65provisionsallowingfortimelycommunicationbetweenthepharmacistandtheprotocol |
|---|
| 78 | 78 | | 66physicianorsimilarbodyauthorizedbythissection,andanyotherpatientprotection |
|---|
| 79 | 79 | | 67provisionsdeemedappropriatebybothboards.Inordertotakeeffect,suchrulesshallbe |
|---|
| 80 | 80 | | 68approvedbyamajorityvoteofaquorumofeachboard.Neitherboardshallseparately |
|---|
| 81 | 81 | | 69promulgaterulesregulatingtheuseofprotocolsformedicationtherapyservices.Anyruleor |
|---|
| 82 | 82 | | 70portionofarule,asthattermisdefinedinsection536.010,thatiscreatedundertheauthority |
|---|
| 83 | 83 | | 71delegatedinthissectionshallbecomeeffectiveonlyifitcomplieswithandissubjecttoallof |
|---|
| 84 | 84 | | 72theprovisionsofchapter536and,ifapplicable,section536.028.Thissectionandchapter |
|---|
| 85 | 85 | | 73536arenonseverableandifanyofthepowersvestedwiththegeneralassemblypursuantto |
|---|
| 86 | 86 | | 74chapter536toreview,todelaytheeffectivedate,ortodisapproveandannularuleare |
|---|
| 87 | 87 | | 75subsequentlyheldunconstitutional,thenthegrantofrulemakingauthorityandanyrule |
|---|
| 88 | 88 | | 76proposedoradoptedafterAugust28,2007,shallbeinvalidandvoid. |
|---|
| 89 | 89 | | 77 11.Thestateboardofpharmacymaygrantacertificateofmedicationtherapeutic |
|---|
| 90 | 90 | | 78planauthoritytoalicensedpharmacistwhosubmitsproofofsuccessfulcompletionofa |
|---|
| 91 | 91 | | 79board-approvedcourseofacademicclinicalstudybeyondabachelorofscienceinpharmacy, |
|---|
| 92 | 92 | | 80includingbutnotlimitedtoclinicalassessmentskills,fromanationallyaccreditedcollegeor |
|---|
| 93 | 93 | | 81university,oracertificationofequivalenceissuedbyanationallyrecognizedprofessional |
|---|
| 94 | 94 | | 82organizationandapprovedbytheboardofpharmacy. |
|---|
| 95 | 95 | | 83 12.Anypharmacistwhohasreceivedacertificateofmedicationtherapeuticplan |
|---|
| 96 | 96 | | 84authoritymayengageinthedesigning,initiating,implementing,andmonitoringofa |
|---|
| 97 | 97 | | 85medicationtherapeuticplanasdefinedbyawrittenprotocolfromaphysicianthatmaybe |
|---|
| 98 | 98 | | 86specifictoeachpatientforcarebyapharmacist. |
|---|
| 99 | 99 | | 87 13.Nothinginthissectionshallbeconstruedtoallowapharmacisttomakea |
|---|
| 100 | 100 | | 88therapeuticsubstitutionofapharmaceuticalprescribedbyaphysicianunlessauthorizedby |
|---|
| 101 | 101 | | 89thewrittenprotocolorthephysician'sprescriptionorder. |
|---|
| 102 | 102 | | HB797 3 90 14."Veterinarian","doctorofveterinarymedicine","practitionerofveterinary |
|---|
| 103 | 103 | | 91medicine","DVM","VMD","BVSe","BVMS","BSe(VetScience)","VMB","MRCVS",or |
|---|
| 104 | 104 | | 92anequivalenttitlemeansapersonwhohasreceivedadoctor'sdegreeinveterinarymedicine |
|---|
| 105 | 105 | | 93fromanaccreditedschoolofveterinarymedicineorholdsanEducationalCommissionfor |
|---|
| 106 | 106 | | 94ForeignVeterinaryGraduates(EDFVG)certificateissuedbytheAmericanVeterinary |
|---|
| 107 | 107 | | 95MedicalAssociation(AVMA). |
|---|
| 108 | 108 | | 96 15.Inadditiontootherrequirementsestablishedbythejointpromulgationofrulesby |
|---|
| 109 | 109 | | 97theboardofpharmacyandthestateboardofregistrationforthehealingarts: |
|---|
| 110 | 110 | | 98 (1)Apharmacistshalladministervaccinesbyprotocolinaccordancewithtreatment |
|---|
| 111 | 111 | | 99guidelinesestablishedbytheCentersforDiseaseControlandPrevention(CDC); |
|---|
| 112 | 112 | | 100 (2)Apharmacistwhoisadministeringavaccineshallrequestapatienttoremainin |
|---|
| 113 | 113 | | 101thepharmacyasafeamountoftimeafteradministeringthevaccinetoobserveanyadverse |
|---|
| 114 | 114 | | 102reactions.Suchpharmacistshallhaveadoptedemergencytreatmentprotocols. |
|---|
| 115 | 115 | | 103 16.Inadditiontootherrequirementsbytheboard,apharmacistshallreceive |
|---|
| 116 | 116 | | 104additionaltrainingasrequiredbytheboardandevidencedbyreceivingacertificatefromthe |
|---|
| 117 | 117 | | 105boarduponcompletion,andshalldisplaythecertificationinhisorherpharmacywhere |
|---|
| 118 | 118 | | 106vaccinesaredelivered. |
|---|
| 119 | 119 | | 107 17.Apharmacistshallinformthepatientthattheadministrationofavaccinewillbe |
|---|
| 120 | 120 | | 108enteredintotheShowMeVaxsystem,asadministeredbythedepartmentofhealthandsenior |
|---|
| 121 | 121 | | 109services.Thepatientshallattesttotheinclusionofsuchinformationinthesystembysigning |
|---|
| 122 | 122 | | 110aformprovidedbythepharmacist.Ifthepatientindicatesthatheorshedoesnotwantsuch |
|---|
| 123 | 123 | | 111informationenteredintotheShowMeVaxsystem,thepharmacistshallprovideawritten |
|---|
| 124 | 124 | | 112reportwithinfourteendaysofadministrationofavaccinetothepatient'shealthcareprovider, |
|---|
| 125 | 125 | | 113ifprovidedbythepatient,containing: |
|---|
| 126 | 126 | | 114 (1)Theidentityofthepatient; |
|---|
| 127 | 127 | | 115 (2)Theidentityofthevaccineorvaccinesadministered; |
|---|
| 128 | 128 | | 116 (3)Therouteofadministration; |
|---|
| 129 | 129 | | 117 (4)Theanatomicsiteoftheadministration; |
|---|
| 130 | 130 | | 118 (5)Thedoseadministered;and |
|---|
| 131 | 131 | | 119 (6)Thedateofadministration. |
|---|
| 132 | 132 | | 120 18.Apharmacistlicensedunderthischaptermayorderandadministervaccines |
|---|
| 133 | 133 | | 121approvedorauthorizedbytheU.S.FoodandDrugAdministrationtoaddressapublichealth |
|---|
| 134 | 134 | | 122need,aslawfullyauthorizedbythestateorfederalgovernment,oradepartmentoragency |
|---|
| 135 | 135 | | 123thereof,duringastateorfederallydeclaredpublichealthemergency. |
|---|
| 136 | 136 | | 338.720.1.Forpurposesofthissection,theterm"self-administeredhormonal |
|---|
| 137 | 137 | | 2contraceptive"shallmeanadrugcomposedofoneormorehormonesthatisapproved |
|---|
| 138 | 138 | | 3bytheUnitedStatesFoodandDrugAdministrationtopreventpregnancy. |
|---|
| 139 | 139 | | HB797 4 4 2.Apharmacistmaydispenseself-administeredhormonalcontraceptivestoa |
|---|
| 140 | 140 | | 5personunderaprescriptionorderformedicationtherapyservicesasdescribedin |
|---|
| 141 | 141 | | 6section338.010.Aprescriptionorderforaself-administeredhormonalcontraceptive |
|---|
| 142 | 142 | | 7shallhavenoexpirationdate. |
|---|
| 143 | 143 | | 8 3.Theboardofpharmacy,undersection338.140,andtheboardofregistration |
|---|
| 144 | 144 | | 9forthehealingarts,undersection334.125,shalljointlypromulgaterulesregulatingthe |
|---|
| 145 | 145 | | 10useofprotocolsforprescriptionordersforself-administeredhormonalcontraceptives. |
|---|
| 146 | 146 | | 11Anyruleorportionofarule,asthattermisdefinedinsection536.010,thatiscreated |
|---|
| 147 | 147 | | 12undertheauthoritydelegatedinthissectionshallbecomeeffectiveonlyifitcomplies |
|---|
| 148 | 148 | | 13withandissubjecttoalloftheprovisionsofchapter536and,ifapplicable,section |
|---|
| 149 | 149 | | 14536.028.Thissectionandchapter536arenonseverable,andifanyofthepowersvested |
|---|
| 150 | 150 | | 15withthegeneralassemblypursuanttochapter536toreview,todelaytheeffectivedate, |
|---|
| 151 | 151 | | 16ortodisapproveandannularulearesubsequentlyheldunconstitutional,thenthegrant |
|---|
| 152 | 152 | | 17ofrulemakingauthorityandanyruleproposedoradoptedafterAugust28,2025,shall |
|---|
| 153 | 153 | | 18beinvalidandvoid. |
|---|
| 154 | 154 | | 19 4.Therulesadoptedunderthissectionshallrequireapharmacistto: |
|---|
| 155 | 155 | | 20 (1)Completeatrainingprogramapprovedbytheboardofpharmacythatis |
|---|
| 156 | 156 | | 21relatedtodispensingself-administeredhormonalcontraceptivesunderthissection; |
|---|
| 157 | 157 | | 22 (2)Provideaself-screeningriskassessmenttoolthatthepatientshalluseprior |
|---|
| 158 | 158 | | 23tothepharmacist'sdispensingtheself-administeredhormonalcontraceptiveunderthis |
|---|
| 159 | 159 | | 24section; |
|---|
| 160 | 160 | | 25 (3)Atleastonceeverytwelvemonths,verballyreferthepatienttothehealth |
|---|
| 161 | 161 | | 26careproviderwithwhomthepharmacisthasaprescriptionorderbeforedispensingthe |
|---|
| 162 | 162 | | 27self-administeredhormonalcontraceptivetothepatient; |
|---|
| 163 | 163 | | 28 (4)Providethepatientwithawrittenrecordoftheself-administeredhormonal |
|---|
| 164 | 164 | | 29contraceptivedispensedandadvisethepatienttoconsultwithahealthcareprovider; |
|---|
| 165 | 165 | | 30and |
|---|
| 166 | 166 | | 31 (5)Dispensetheself-administeredhormonalcontraceptivetothepatientassoon |
|---|
| 167 | 167 | | 32aspracticable. |
|---|
| 168 | 168 | | 33 5.Allstateandfederallawsgoverninginsurancecoverageofcontraceptive |
|---|
| 169 | 169 | | 34drugs,devices,products,andservicesshallapplytoself-administeredhormonal |
|---|
| 170 | 170 | | 35contraceptivesdispensedbyapharmacistunderthissection. |
|---|
| 171 | 171 | | 36 6.Nothinginthissectionshallbeconstruedtoallowapharmacisttomakea |
|---|
| 172 | 172 | | 37therapeuticsubstitutionofapharmaceuticalprescribedbyaphysicianunless |
|---|
| 173 | 173 | | 38authorizedbythewrittenprotocolorthephysician'swrittenprescriptionorder. |
|---|
| 174 | 174 | | âś” |
|---|
| 175 | 175 | | HB797 5 |
|---|