86R6468 BEE-F
By: Zedler H.B. No. 4285
A BILL TO BE ENTITLED
AN ACT
relating to the authority of pharmacists to furnish certain
medications.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 483.001(11), Health and Safety Code, is
amended to read as follows:
(11) "Practice of pharmacy" has the meaning assigned
by Section 551.003, Occupations Code [means:
[(A) provision of those acts or services
necessary to provide pharmaceutical care;
[(B) interpretation and evaluation of
prescription drug orders or medication orders;
[(C) participation in drug and device selection
as authorized by law, drug administration, drug regimen review, or
drug or drug-related research;
[(D) provision of patient counseling;
[(E) responsibility for:
[(i) dispensing of prescription drug orders
or distribution of medication orders in the patient's best
interest;
[(ii) compounding and labeling of drugs and
devices, except labeling by a manufacturer, repackager, or
distributor of nonprescription drugs and commercially packaged
prescription drugs and devices;
[(iii) proper and safe storage of drugs and
devices; or
[(iv) maintenance of proper records for
drugs and devices. In this subdivision, "device" has the meaning
assigned by Subtitle J, Title 3, Occupations Code; or
[(F) performance of a specific act of drug
therapy management for a patient delegated to a pharmacist by a
written protocol from a physician licensed by the state under
Subtitle B, Title 3, Occupations Code].
SECTION 2. Subchapter C, Chapter 157, Occupations Code, is
amended by adding Section 157.102 to read as follows:
Sec. 157.102. DELEGATION TO PHARMACIST TO FURNISH CERTAIN
DRUGS. (a) In this section:
(1) "Acute condition" means a condition or disease
that begins abruptly, intensifies rapidly, and is generally not
long-lasting.
(2) "Pharmacist" has the meaning assigned by Section
551.003.
(3) "Tobacco cessation drug" means a prescription drug
approved by the United States Food and Drug Administration for use
in the treatment of nicotine or smoking addiction.
(4) "Travel drug" means a prescription drug
recommended by the federal Centers for Disease Control and
Prevention for individuals traveling outside of the United States
for the prevention and management of a disease before a diagnosis of
the disease.
(5) "Waived clinical laboratory test" means a clinical
laboratory test that is classified as waived under federal
regulations issued under the Clinical Laboratory Improvement
Amendments of 1988 (42 U.S.C. Section 263a).
(6) "Written protocol" means a physician's written
order, standing medical order, standing delegation order, or other
order or protocol as defined by rule of the board.
(b) Notwithstanding any other law, a pharmacist may furnish
to a patient, as provided by a physician's written protocol, a
prescription drug that is:
(1) a drug to treat an acute condition that is
identified through performance of one of the following tests, if
the test is a waived clinical laboratory test:
(A) a rapid strep test or rapid antigen detection
test used in the identification of group A streptococcus (GAS); or
(B) a rapid influenza diagnostic test used in the
identification of influenza types A and B;
(2) a self-administered hormonal contraceptive;
(3) a travel drug;
(4) a prenatal vitamin supplement;
(5) a tobacco cessation drug;
(6) a vitamin D supplement; or
(7) a drug identified by the executive commissioner of
the Health and Human Services Commission by rule as necessary for
pharmacists to furnish to patients for public health purposes.
(c) The board shall adopt rules jointly with the Texas State
Board of Pharmacy to establish the minimum content of the written
protocol required under Subsection (b). The written protocol may
permit a pharmacist to furnish a prescription drug to a patient
without an established physician-patient relationship.
(d) A written protocol under this section must require
notice to the patient's primary care physician, as identified by
the patient if the patient has a primary care physician, and
prescribe the period for providing the notice and the form of the
notice, in accordance with prevailing practices for the provision
of notice to a patient's primary care physician. The period for
providing the notice for furnishing a drug under Subsection (b)(1)
may not be later than the 14th day after the date the drug is
furnished by the pharmacist.
SECTION 3. Section 551.003(33), Occupations Code, is
amended to read as follows:
(33) "Practice of pharmacy" means:
(A) providing an act or service necessary to
provide pharmaceutical care;
(B) interpreting or evaluating a prescription
drug order or medication order;
(C) participating in drug or device selection as
authorized by law, and participating in drug administration, drug
regimen review, or drug or drug-related research;
(D) providing patient counseling;
(E) being responsible for:
(i) dispensing a prescription drug order or
distributing a medication order;
(ii) compounding or labeling a drug or
device, other than labeling by a manufacturer, repackager, or
distributor of a nonprescription drug or commercially packaged
prescription drug or device;
(iii) properly and safely storing a drug or
device; or
(iv) maintaining proper records for a drug
or device;
(F) performing for a patient a specific act of
drug therapy management delegated to a pharmacist by a written
protocol from a physician licensed in this state in compliance with
Subtitle B; [or]
(G) administering an immunization or vaccination
under a physician's written protocol; or
(H) furnishing a prescription drug to a patient
under a physician's written protocol under Section 157.102.
SECTION 4. Subchapter B, Chapter 562, Occupations Code, is
amended by adding Section 562.058 to read as follows:
Sec. 562.058. TRAINING REQUIRED TO INITIATE DRUG ORDER OR
FURNISH CERTAIN DRUGS. (a) A pharmacist may not furnish a
prescription drug under Section 157.102 unless the pharmacist has
completed a training program that is approved by the board and is
relevant to the condition treated by the drug.
(b) The board shall adopt rules jointly with the Texas
Medical Board to establish the minimum content of the training
program required under Subsection (a).
SECTION 5. Not later than January 1, 2020, the Texas State
Board of Pharmacy and the Texas Medical Board shall adopt the rules
required under Sections 157.102 and 562.058, Occupations Code, as
added by this Act.
SECTION 6. (a) Except as provided by Subsection (b) of this
section, this Act takes effect January 1, 2020.
(b) Section 5 of this Act takes effect September 1, 2019.