HB2001

SECTION 1. The legislature finds that Hoola Lahui Hawaii/Kauai community health center is a nonprofit corporation organized as a federally qualified health center and native Hawaiian health care system that provides primary care services on the island of Kauai to those in need, including a high percentage of individuals without health insurance. Hoola Lahui Hawaii began operating its own pharmacy in Kauai community health center clinics in October 2005 and dispensing federal 340B pharmaceutical purchasing program prescriptions to its patients. The 340B Pharmaceutical Purchasing Program, enacted in 1992, is administered by the federal Pharmacy Affairs Branch of the Health Resources and Services Administration within the Department of Health and Human Services. The 340B Pharmaceutical Purchasing Program allows certain federally funded grantees serving primarily indigent and other underserved populations to obtain special pricing on pharmaceutical products. Hoola Lahui Hawaii's community health center clinics qualify for the Pharmaceutical Purchasing Program as designated federally qualified health centers.

The legislature also finds that Hoola Lahui Hawaii has installed remote dispensing units, or telepharmacy units, to ensure that patients receive necessary acute medications before leaving Kauai community health center clinic settings in Waimea and Kapaa. Since 2005, easier access to acute prescription drugs through these telepharmacy units has made patients more compliant with their medication regimens and improved the efficiency of the distribution of low-priced medications. The physician-prescribed acute medications dispensed at telepharmacy units are hand pre-packaged, reviewed by a pharmacist, and dispensed from a machine by a licensed pharmacist through remote software provided to patients. A nurse then retrieves the dispensed medication, scans the barcode to confirm the prescription, prints the appropriate medication label, and rescans the label to reconfirm the prescription. Only medications for acute conditions are dispensed at telepharmacy units; medications for chronic conditions are not so dispensed.

The legislature further finds that no incorrect medications have been dispensed through the telepharmacy units and that Hoola Lahui Hawaii would not be able to afford to hire full-time on-site pharmacists to staff its two clinics given the infrequency of the need to dispense acute medications at the two clinics.

The purpose of this Act is to allow telepharmacy units to dispense acute medications according to rules adopted by the board of pharmacy.

SECTION 2. Chapter 461, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§461- Telepharmacy; limitation; rules. (a) The board shall permit the operation in the State of telepharmacy only by certain federally qualified health centers participating in the federal 340B Pharmaceutical Purchasing Program administered by the Pharmacy Affairs Branch of the Health Resources and Services Administration of the United States Department of Health and Human Services.

(b) The board of pharmacy shall adopt rules in accordance with chapter 91 to implement the purpose of this section."

SECTION 3. Section 461-1, Hawaii Revised Statutes, is amended by adding a new definition to be appropriately inserted and to read as follows:

""Telepharmacy" means the integration of pharmacy software, remotely controlled dispensing cabinetry, and telecommunications technologies to enable the provision of pharmaceutical services from a distance; provided that only prescription medications for acute medical conditions, as opposed to chronic medical conditions, may be dispensed through telepharmacy."

SECTION 4. New statutory material is underscored.

SECTION 5. This Act shall take effect upon its approval.

INTRODUCED BY:	_____________________________

HOUSE OF REPRESENTATIVES	H.B. NO.	2001
TWENTY-FOURTH LEGISLATURE, 2008
STATE OF HAWAII