Texas 2023 - 88th Regular

Texas Senate Bill SB749 Compare Versions

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1	1	88R654 KKR-F
2	2	By: Flores S.B. No. 749
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the administration of a medication and the ordering and
8	8	administration of an immunization or vaccination by a pharmacist.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 551.003(33), Occupations Code, is
11	11	amended to read as follows:
12	12	(33) "Practice of pharmacy" means:
13	13	(A) providing an act or service necessary to
14	14	provide pharmaceutical care;
15	15	(B) interpreting or evaluating a prescription
16	16	drug order or medication order;
17	17	(C) participating in drug or device selection as
18	18	authorized by law, and participating in drug administration, drug
19	19	regimen review, or drug or drug-related research;
20	20	(D) providing patient counseling;
21	21	(E) being responsible for:
22	22	(i) dispensing a prescription drug order or
23	23	distributing a medication order;
24	24	(ii) compounding or labeling a drug or
25	25	device, other than labeling by a manufacturer, repackager, or
26	26	distributor of a nonprescription drug or commercially packaged
27	27	prescription drug or device;
28	28	(iii) properly and safely storing a drug or
29	29	device; or
30	30	(iv) maintaining proper records for a drug
31	31	or device;
32	32	(F) performing for a patient a specific act of
33	33	drug therapy management delegated to a pharmacist by a written
34	34	protocol from a physician licensed in this state in compliance with
35	35	Subtitle B; [or]
36	36	(G) subject to Section 554.052(c-1), ordering or
37	37	administering an immunization or vaccination to a patient who is at
38	38	least three years of age; or
39	39	(H) if the patient is younger than three years of
40	40	age and is referred to a pharmacist by a physician, administering an
41	41	immunization or vaccination to a patient under a physician's
42	42	written protocol.
43	43	SECTION 2. The heading to Section 554.004, Occupations
44	44	Code, is amended to read as follows:
45	45	Sec. 554.004. ADMINISTRATION OF MEDICATION; ORDERING AND
46	46	ADMINISTRATION OF IMMUNIZATION OR VACCINATION.
47	47	SECTION 3. Section 554.004(a), Occupations Code, is amended
48	48	to read as follows:
49	49	(a) The board shall specify conditions under which a
50	50	pharmacist may administer medication and order or administer [,
51	51	including] an immunization or [and] vaccination. The conditions
52	52	for ordering or administering an immunization or vaccination must
53	53	ensure that:
54	54	(1) [a licensed health care provider authorized to
55	55	administer the medication is not reasonably available to administer
56	56	the medication;
57	57	[(2) failure to administer the medication, other than
58	58	an immunization or vaccination, might result in a significant delay
59	59	or interruption of a critical phase of drug therapy;
60	60	[(3)] the pharmacist possesses the necessary skill,
61	61	education, and certification as specified by the board to order or
62	62	administer the immunization or vaccination [medication];
63	63	(2) [(4)] within a reasonable time after
64	64	administering an immunization or vaccination that is prescribed by
65	65	a licensed health care provider [medication], the pharmacist
66	66	notifies the licensed health care provider responsible for the
67	67	patient's care that the immunization or vaccination [medication]
68	68	was administered;
69	69	[(5) the pharmacist may not administer medication to a
70	70	patient at the patient's residence, except at a licensed nursing
71	71	home or hospital;
72	72	[(6) the pharmacist administers an immunization or
73	73	vaccination under a physician's written protocol and meets the
74	74	standards established by the board;] and
75	75	(3) [(7)] the authority of a pharmacist to administer
76	76	an immunization or vaccination [medication] may [not] be delegated
77	77	to a certified pharmacy technician.
78	78	SECTION 4. Sections 554.052(a), (b), (c), and (c-1),
79	79	Occupations Code, are amended to read as follows:
80	80	(a) The board by rule shall require a pharmacist to notify a
81	81	physician who prescribes an immunization or vaccination not later
82	82	than the 14th day [within 24 hours] after the date the pharmacist
83	83	administers the immunization or vaccination.
84	84	(b) The board shall establish minimum education and
85	85	continuing education standards for a pharmacist who orders or
86	86	administers an immunization or vaccination. The standards must
87	87	include federal Centers for Disease Control and Prevention
88	88	training, basic life support training, and hands-on training in
89	89	techniques for administering immunizations and vaccinations.
90	90	(c) Supervision by a physician is adequate if the delegating
91	91	physician:
92	92	(1) is responsible for formulating or approving an
93	93	order or protocol, including the physician's order, standing
94	94	medical order, or standing delegation order, and periodically
95	95	reviews the order or protocol and the services provided to a patient
96	96	under the order or protocol;
97	97	(2) [except as provided by Subsection (c-1),] has
98	98	established a physician-patient relationship with each patient who
99	99	is younger than three [under 14] years of age and referred the
100	100	patient to the pharmacist;
101	101	(3) is geographically located to be easily accessible
102	102	to the pharmacy where an immunization or vaccination is
103	103	administered;
104	104	(4) receives, as appropriate, a periodic status report
105	105	on the patient, including any problem or complication encountered;
106	106	and
107	107	(5) is available through direct telecommunication for
108	108	consultation, assistance, and direction.
109	109	(c-1) A pharmacist may order or administer an immunization
110	110	or [influenza] vaccination to a patient who is at least three [over
111	111	seven] years of age without an established physician-patient
112	112	relationship if the immunization or vaccination is:
113	113	(1) authorized or approved by the United States Food
114	114	and Drug Administration or listed in the routine immunization
115	115	schedule recommended by the federal Advisory Committee on
116	116	Immunization Practices published by the federal Centers for Disease
117	117	Control and Prevention; and
118	118	(2) ordered or administered in accordance with the
119	119	federal Advisory Committee on Immunization Practices
120	120	vaccine-specific recommendations.
121	121	SECTION 5. This Act takes effect September 1, 2023.