88R654 KKR-F
By: Price, Cortez, Allison, Darby, Shine, H.B. No. 1105
et al.
A BILL TO BE ENTITLED
AN ACT
relating to the administration of a medication and the ordering and
administration of an immunization or vaccination by a pharmacist.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. 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) subject to Section 554.052(c-1), ordering or
administering an immunization or vaccination to a patient who is at
least three years of age; or
(H) if the patient is younger than three years of
age and is referred to a pharmacist by a physician, administering an
immunization or vaccination to a patient under a physician's
written protocol.
SECTION 2. The heading to Section 554.004, Occupations
Code, is amended to read as follows:
Sec. 554.004. ADMINISTRATION OF MEDICATION; ORDERING AND
ADMINISTRATION OF IMMUNIZATION OR VACCINATION.
SECTION 3. Section 554.004(a), Occupations Code, is amended
to read as follows:
(a) The board shall specify conditions under which a
pharmacist may administer medication and order or administer [,
including] an immunization or [and] vaccination. The conditions
for ordering or administering an immunization or vaccination must
ensure that:
(1) [a licensed health care provider authorized to
administer the medication is not reasonably available to administer
the medication;
[(2) failure to administer the medication, other than
an immunization or vaccination, might result in a significant delay
or interruption of a critical phase of drug therapy;
[(3)] the pharmacist possesses the necessary skill,
education, and certification as specified by the board to order or
administer the immunization or vaccination [medication];
(2) [(4)] within a reasonable time after
administering an immunization or vaccination that is prescribed by
a licensed health care provider [medication], the pharmacist
notifies the licensed health care provider responsible for the
patient's care that the immunization or vaccination [medication]
was administered;
[(5) the pharmacist may not administer medication to a
patient at the patient's residence, except at a licensed nursing
home or hospital;
[(6) the pharmacist administers an immunization or
vaccination under a physician's written protocol and meets the
standards established by the board;] and
(3) [(7)] the authority of a pharmacist to administer
an immunization or vaccination [medication] may [not] be delegated
to a certified pharmacy technician.
SECTION 4. Sections 554.052(a), (b), (c), and (c-1),
Occupations Code, are amended to read as follows:
(a) The board by rule shall require a pharmacist to notify a
physician who prescribes an immunization or vaccination not later
than the 14th day [within 24 hours] after the date the pharmacist
administers the immunization or vaccination.
(b) The board shall establish minimum education and
continuing education standards for a pharmacist who orders or
administers an immunization or vaccination. The standards must
include federal Centers for Disease Control and Prevention
training, basic life support training, and hands-on training in
techniques for administering immunizations and vaccinations.
(c) Supervision by a physician is adequate if the delegating
physician:
(1) is responsible for formulating or approving an
order or protocol, including the physician's order, standing
medical order, or standing delegation order, and periodically
reviews the order or protocol and the services provided to a patient
under the order or protocol;
(2) [except as provided by Subsection (c-1),] has
established a physician-patient relationship with each patient who
is younger than three [under 14] years of age and referred the
patient to the pharmacist;
(3) is geographically located to be easily accessible
to the pharmacy where an immunization or vaccination is
administered;
(4) receives, as appropriate, a periodic status report
on the patient, including any problem or complication encountered;
and
(5) is available through direct telecommunication for
consultation, assistance, and direction.
(c-1) A pharmacist may order or administer an immunization
or [influenza] vaccination to a patient who is at least three [over
seven] years of age without an established physician-patient
relationship if the immunization or vaccination is:
(1) authorized or approved by the United States Food
and Drug Administration or listed in the routine immunization
schedule recommended by the federal Advisory Committee on
Immunization Practices published by the federal Centers for Disease
Control and Prevention; and
(2) ordered or administered in accordance with the
federal Advisory Committee on Immunization Practices
vaccine-specific recommendations.
SECTION 5. This Act takes effect September 1, 2023.