Texas 2009 - 81st Regular

Texas House Bill HB1924 Compare Versions

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1	1	H.B. No. 1924
2	2
3	3
4	4	AN ACT
5	5	relating to the performance of pharmacy services in certain rural
6	6	areas.
7	7	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
8	8	SECTION 1. Subchapter C, Chapter 562, Occupations Code, is
9	9	amended by adding Section 562.1011 to read as follows:
10	10	Sec. 562.1011. OPERATION OF CLASS C PHARMACY IN CERTAIN
11	11	RURAL HOSPITALS. (a) In this section:
12	12	(1) "Nurse" has the meaning assigned by Section
13	13	301.002. The term includes a nurse who is also registered as a
14	14	pharmacy technician.
15	15	(2) "Rural hospital" means a licensed hospital with 75
16	16	beds or fewer that:
17	17	(A) is located in a county with a population of
18	18	50,000 or less; or
19	19	(B) has been designated by the Centers for
20	20	Medicare and Medicaid Services as a critical access hospital, rural
21	21	referral center, or sole community hospital.
22	22	(b) If a practitioner orders a prescription drug or device
23	23	for a patient in a rural hospital when the hospital pharmacist is
24	24	not on duty or when the institutional pharmacy is closed, a nurse or
25	25	practitioner may withdraw the drug or device from the pharmacy in
26	26	sufficient quantity to fill the order.
27	27	(c) The hospital pharmacist shall verify the withdrawal of a
28	28	drug or device under Subsection (b) and perform a drug regimen
29	29	review not later than the seventh day after the date of the
30	30	withdrawal.
31	31	(d) In a rural hospital that uses a floor stock method of
32	32	drug distribution, a nurse or practitioner may withdraw a
33	33	prescription drug or device from the institutional pharmacy in the
34	34	original manufacturer's container or a prepackaged container.
35	35	(e) The hospital pharmacist shall verify the withdrawal of a
36	36	drug or device under Subsection (d) and perform a drug regimen
37	37	review not later than the seventh day after the date of the
38	38	withdrawal.
39	39	(f) A rural hospital may allow a pharmacy technician to
40	40	perform the duties specified in Subsection (g) if:
41	41	(1) the pharmacy technician is registered and meets
42	42	the training requirements specified by the board;
43	43	(2) a pharmacist is accessible at all times to respond
44	44	to any questions and needs of the pharmacy technician or other
45	45	hospital employees, by telephone, answering or paging service,
46	46	e-mail, or any other system that makes a pharmacist accessible; and
47	47	(3) a nurse or practitioner or a pharmacist by remote
48	48	access verifies the accuracy of the actions of the pharmacy
49	49	technician.
50	50	(g) If the requirements of Subsection (f) are met, the
51	51	pharmacy technician may, during the hours that the institutional
52	52	pharmacy in the hospital is open, perform the following duties in
53	53	the pharmacy without the direct supervision of a pharmacist:
54	54	(1) enter medication order and drug distribution
55	55	information into a data processing system;
56	56	(2) prepare, package, or label a prescription drug
57	57	according to a medication order if a licensed nurse or practitioner
58	58	verifies the accuracy of the order before administration of the
59	59	drug to the patient;
60	60	(3) fill a medication cart used in the rural hospital;
61	61	(4) distribute routine orders for stock supplies to
62	62	patient care areas;
63	63	(5) access and restock automated medication supply
64	64	cabinets; and
65	65	(6) perform any other duty specified by the board by
66	66	rule.
67	67	(h) The pharmacist-in-charge of an institutional pharmacy
68	68	in a rural hospital shall develop and implement policies and
69	69	procedures for the operation of the pharmacy when a pharmacist is
70	70	not on-site.
71	71	(i) On or after September 1, 2011, the board may establish,
72	72	by rule, a requirement for prospective and retrospective drug use
73	73	review by a pharmacist for each new drug order. A drug use review is
74	74	not required when a delay in administration of the drug would harm
75	75	the patient in an urgent or emergency situation, including sudden
76	76	changes in a patient's clinical status.
77	77	(j) Rural hospitals may establish standing orders and
78	78	protocols, to be developed jointly by the pharmacist and medical
79	79	staff, that may include additional exceptions to instances in which
80	80	prospective drug use review is required.
81	81	(k) This section does not restrict or prohibit the board
82	82	from adopting a rule related to authorizing the withdrawal of a drug
83	83	or device by a nurse or practitioner from, or the supervision of a
84	84	pharmacy technician in, an institutional pharmacy not located in a
85	85	rural hospital. As part of the rulemaking process, the board shall
86	86	consider the effect that a proposed rule, if adopted, would have on
87	87	access to pharmacy services in hospitals that are not rural
88	88	hospitals.
89	89	(l) The board shall adopt rules to implement this section,
90	90	including rules specifying:
91	91	(1) the records that must be maintained under this
92	92	section;
93	93	(2) the requirements for policies and procedures for
94	94	operation of a pharmacy when a pharmacist is not on-site; and
95	95	(3) the training requirements for pharmacy
96	96	technicians.
97	97	SECTION 2. Chapter 568, Occupations Code, is amended by
98	98	adding Section 568.008 to read as follows:
99	99	Sec. 568.008. TECHNICIANS IN HOSPITALS WITH CLINICAL
100	100	PHARMACY PROGRAM. (a) In this section, "clinical pharmacy program"
101	101	means a program that provides pharmaceutical care services as
102	102	specified by board rule.
103	103	(b) A Class C pharmacy that has an ongoing clinical pharmacy
104	104	program may allow a pharmacy technician to verify the accuracy of
105	105	work performed by another pharmacy technician relating to the
106	106	filling of floor stock and unit dose distribution systems for a
107	107	patient admitted to the hospital if the patient's orders have
108	108	previously been reviewed and approved by a pharmacist.
109	109	(c) The pharmacist-in-charge of the clinical pharmacy
110	110	program shall adopt policies and procedures for the verification
111	111	process authorized by this section.
112	112	(d) A hospital must notify the board before implementing the
113	113	verification process authorized by this section.
114	114	(e) The board shall adopt rules to implement this section,
115	115	including rules specifying:
116	116	(1) the duties that may be verified by another
117	117	pharmacy technician;
118	118	(2) the records that must be maintained for the
119	119	verification process; and
120	120	(3) the training requirements for pharmacy
121	121	technicians who verify the accuracy of the work of other pharmacy
122	122	technicians.
123	123	SECTION 3. This Act takes effect immediately if it receives
124	124	a vote of two-thirds of all the members elected to each house, as
125	125	provided by Section 39, Article III, Texas Constitution. If this
126	126	Act does not receive the vote necessary for immediate effect, this
127	127	Act takes effect September 1, 2009.
128	128	______________________________ ______________________________
129	129	President of the Senate Speaker of the House
130	130	I certify that H.B. No. 1924 was passed by the House on April
131	131	24, 2009, by the following vote: Yeas 140, Nays 0, 1 present, not
132	132	voting; that the House refused to concur in Senate amendments to
133	133	H.B. No. 1924 on May 29, 2009, and requested the appointment of a
134	134	conference committee to consider the differences between the two
135	135	houses; and that the House adopted the conference committee report
136	136	on H.B. No. 1924 on May 31, 2009, by the following vote: Yeas 145,
137	137	Nays 0, 1 present, not voting.
138	138	______________________________
139	139	Chief Clerk of the House
140	140	I certify that H.B. No. 1924 was passed by the Senate, with
141	141	amendments, on May 25, 2009, by the following vote: Yeas 31, Nays
142	142	0; at the request of the House, the Senate appointed a conference
143	143	committee to consider the differences between the two houses; and
144	144	that the Senate adopted the conference committee report on H.B. No.
145	145	1924 on May 31, 2009, by the following vote: Yeas 31, Nays 0.
146	146	______________________________
147	147	Secretary of the Senate
148	148	APPROVED: __________________
149	149	Date
150	150	__________________
151	151	Governor