Texas 2021 - 87th Regular

Texas House Bill HB678 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1		87R12691 KKR-F
2	2		By: Cortez, Clardy, Price, et al. H.B. No. 678
	3	+	Substitute the following for H.B. No. 678:
	4	+	By: Klick C.S.H.B. No. 678
3	5
4	6
5	7		A BILL TO BE ENTITLED
6	8		AN ACT
7	9		relating to the administration of a medication and the ordering and
8	10		administration of an immunization or vaccination by a pharmacist.
9	11		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	12		SECTION 1. Section 551.003(33), Occupations Code, is
11	13		amended to read as follows:
12	14		(33) "Practice of pharmacy" means:
13	15		(A) providing an act or service necessary to
14	16		provide pharmaceutical care;
15	17		(B) interpreting or evaluating a prescription
16	18		drug order or medication order;
17	19		(C) participating in drug or device selection as
18	20		authorized by law, and participating in drug administration, drug
19	21		regimen review, or drug or drug-related research;
20	22		(D) providing patient counseling;
21	23		(E) being responsible for:
22	24		(i) dispensing a prescription drug order or
23	25		distributing a medication order;
24	26		(ii) compounding or labeling a drug or
25	27		device, other than labeling by a manufacturer, repackager, or
26	28		distributor of a nonprescription drug or commercially packaged
27	29		prescription drug or device;
28	30		(iii) properly and safely storing a drug or
29	31		device; or
30	32		(iv) maintaining proper records for a drug
31	33		or device;
32	34		(F) performing for a patient a specific act of
33	35		drug therapy management delegated to a pharmacist by a written
34	36		protocol from a physician licensed in this state in compliance with
35	37		Subtitle B; [or]
36	38		(G) subject to Section 554.052(c-1), ordering or
37	39		administering an immunization or vaccination to a patient who is at
38	40		least three years of age; or
39	41		(H) if the patient is younger than three years of
40	42		age and is referred to a pharmacist by a physician, administering an
41	43		immunization or vaccination to a patient under a physician's
42	44		written protocol.
43	45		SECTION 2. The heading to Section 554.004, Occupations
44	46		Code, is amended to read as follows:
45	47		Sec. 554.004. ADMINISTRATION OF MEDICATION; ORDERING AND
46	48		ADMINISTRATION OF IMMUNIZATION OR VACCINATION.
47	49		SECTION 3. Section 554.004(a), Occupations Code, is amended
48	50		to read as follows:
49	51		(a) The board shall specify conditions under which a
50	52		pharmacist may administer medication and order or administer [,
51	53		including] an immunization or [and] vaccination. The conditions
52	54		for ordering or administering an immunization or vaccination must
53	55		ensure that:
54	56		(1) [a licensed health care provider authorized to
55	57		administer the medication is not reasonably available to administer
56	58		the medication;
57	59		[(2) failure to administer the medication, other than
58	60		an immunization or vaccination, might result in a significant delay
59	61		or interruption of a critical phase of drug therapy;
60	62		[(3)] the pharmacist possesses the necessary skill,
61	63		education, and certification as specified by the board to order or
62	64		administer the immunization or vaccination [medication];
63	65		(2) [(4)] within a reasonable time after
64	66		administering an immunization or vaccination that is prescribed by
65	67		a licensed health care provider [medication], the pharmacist
66	68		notifies the licensed health care provider responsible for the
67	69		patient's care that the immunization or vaccination [medication]
68	70		was administered;
69	71		[(5) the pharmacist may not administer medication to a
70	72		patient at the patient's residence, except at a licensed nursing
71	73		home or hospital;
72	74		[(6) the pharmacist administers an immunization or
73	75		vaccination under a physician's written protocol and meets the
74	76		standards established by the board;] and
75	77		(3) [(7)] the authority of a pharmacist to administer
76	78		an immunization or vaccination [medication] may [not] be delegated
77	79		to a certified pharmacy technician.
78	80		SECTION 4. Sections 554.052(a), (b), (c), and (c-1),
79	81		Occupations Code, are amended to read as follows:
80	82		(a) The board by rule shall require a pharmacist to notify a
81	83		physician who prescribes an immunization or vaccination not later
82	84		than the 14th day [within 24 hours] after the date the pharmacist
83	85		administers the immunization or vaccination.
84	86		(b) The board shall establish minimum education and
85	87		continuing education standards for a pharmacist who orders or
86	88		administers an immunization or vaccination. The standards must
87	89		include Centers for Disease Control and Prevention training, basic
88	90		life support training, and hands-on training in techniques for
89	91		administering immunizations and vaccinations.
90	92		(c) Supervision by a physician is adequate if the delegating
91	93		physician:
92	94		(1) is responsible for formulating or approving an
93	95		order or protocol, including the physician's order, standing
94	96		medical order, or standing delegation order, and periodically
95	97		reviews the order or protocol and the services provided to a patient
96	98		under the order or protocol;
97	99		(2) [except as provided by Subsection (c-1),] has
98	100		established a physician-patient relationship with each patient who
99	101		is younger than three [under 14] years of age and referred the
100	102		patient to the pharmacist;
101	103		(3) is geographically located to be easily accessible
102	104		to the pharmacy where an immunization or vaccination is
103	105		administered;
104	106		(4) receives, as appropriate, a periodic status report
105	107		on the patient, including any problem or complication encountered;
106	108		and
107	109		(5) is available through direct telecommunication for
108	110		consultation, assistance, and direction.
109	111		(c-1) A pharmacist may order or administer an immunization
110	112		or [influenza] vaccination to a patient who is at least three [over
111	113		seven] years of age without an established physician-patient
112	114		relationship if the immunization or vaccination is:
113	115		(1) authorized or approved by the United States Food
114	116		and Drug Administration or listed in the routine immunization
115	117		schedule recommended by the federal Advisory Committee on
116	118		Immunization Practices published by the federal Centers for Disease
117	119		Control and Prevention; and
118	120		(2) ordered or administered in accordance with the
119	121		federal Advisory Committee on Immunization Practices
120	122		vaccine-specific recommendations.
121	123		SECTION 5. This Act takes effect September 1, 2021.