HOUSE OF REPRESENTATIVES

H.B. NO.

1950

TWENTY-NINTH LEGISLATURE, 2018

 

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

RELATING TO THE PRACTICE OF PHARMACY.

 

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 

     SECTION 1.  The legislature finds that there is a need for more access to healthcare professionals, particularly registered pharmacists, who can safely provide certain health care services to achieve positive health outcomes for patients.  Pharmacists provide the most direct access for patients to resolve public health issues with minimum impact to the overall health system.  Technology has changed the delivery of healthcare over the last thirty years, leaving the description of the practice of pharmacy inaccurate.  Pharmacy education has changed over the years from an apprentice program to a six-year doctorate program that includes education assessment training and a year of internship working as a pharmacist intern team member.  Pharmacy education now includes immunization and smoking cessation training, along with other specialty training so that pharmacists are well prepared to take some of the public health burden to give all patients the access they deserve to improve their quality of life.  A good example of how the pharmacists' role can impact public health and cost is shown with immunization since pharmacists were given limited providership about fifteen years ago.  Pharmacists now immunize more patients than any other healthcare professionals and immunization rates have grown, reducing disease and morbidity in the overall population.

     Registered pharmacists who receive proper training, working under written protocols, will be able to:

     (1)  Provide healthcare services such as furnishing Naloxone and Epi-pens;

     (2)  Administer immunizations and vaccines for bacterial and viral infections such as influenza, pneumonia, and hepatitis A;

     (3)  Furnish and counsel patients on self-administered hormonal conception and smoking cessation replacement therapy; and

     (4)  Order and perform laboratory tests to determine appropriate medication use and outcomes.

     The legislature further finds that the disciplines of medicine, nursing, and naturopathy are complemented by registered pharmacists and that pharmacists are essential as part of the primary healthcare team to serve the interests of the patient and the public health in general.

     The purpose of this Act is to modernize the scope of the practice of pharmacy to allow pharmacists to furnish specific medications and services that directly impact public health and the cost of healthcare.

     SECTION 2.  Section 461-1, Hawaii Revised Statutes, is amended as follows:

     1.  By adding a new definition to be appropriately inserted and to read:

     ""Furnish" or "furnishing" means to supply by any means, by sale or otherwise."

     2.  By amending the definition of "practice of pharmacy" to read:

     ""Practice of pharmacy" means:

     (1)  (A)  The interpretation and evaluation of prescription orders; the compounding, dispensing, and labeling of drugs and devices (except labeling by a manufacturer, packer, or distributor of nonprescription drugs and commercially legend drugs and devices); the participation in drug selection and drug utilization reviews; the proper and safe storage of drugs and devices and the maintenance of proper records therefor; the responsibility for advising when necessary or where regulated, of therapeutic values, content, hazards, and use of drugs and devices;

          (B)  Ordering drug therapy related laboratory tests;

          (C)  Administering:

              (i)  Immunizations orally, by injection, or by intranasal delivery, to persons eighteen years of age or older by a pharmacist having appropriate training that includes programs approved by the Accreditation Council for Pharmacy Education (ACPE), curriculum-based programs from an ACPE-accredited college of pharmacy, or programs recognized by the board; provided that after the vaccination is administered, the pharmacist shall provide within five business days to the department of health immunization registry a vaccination record including the patient's name and date of birth, the type of vaccine administered, and the date and location that the vaccine was administered, the name of the vaccine product that was administered, including the manufacturer, lot number, and expiration date, the method of administration, and the anatomical site of administration;

             (ii)  Immunizations orally, by injection, or by intranasal delivery to persons between fourteen and seventeen years of age pursuant to section 461-11.4 by a pharmacist having appropriate training that includes programs approved by the ACPE, curriculum-based programs from an ACPE-accredited college of pharmacy, or programs recognized by the board; and

            (iii)  Human papillomavirus, Tdap (tetanus, diphtheria, pertussis), meningococcal, and influenza vaccines to persons between eleven and seventeen years of age pursuant to section 461-11.4 by a pharmacist having appropriate training that includes programs approved by the ACPE, curriculum-based programs from an ACPE-accredited college of pharmacy, or programs recognized by the board;

          (D)  Transmitting a valid prescription to another pharmacist for the purpose of filling or dispensing;

          (E)  Providing consultation, information, or education to patients and health care professionals based on the pharmacist's training and for which no other licensure is required; and

          (F)  Furnishing an opioid antagonist, epinephrine auto injector, hormonal contraception, travel medications, and tobacco cessation nicotine replacement therapy by a pharmacist who has received appropriate training, including programs approved by the ACPE, curriculum-based programs from an ACPE-accredited college of pharmacy, or programs recognized by the board;

     (2)  Performing the following procedures or functions as part of the care provided by and in concurrence with a "health care facility" and "health care service" as defined in section 323D-2, or a "pharmacy" or a licensed physician or a licensed advanced practice registered nurse with prescriptive authority, or a "managed care plan" as defined in section 432E-1, in accordance with written policies, procedures, [or] protocols, or standing orders issued to an individual pharmacist or a pharmacy and developed collaboratively by health professionals, including physicians and surgeons, pharmacists, and registered nurses, and for which a pharmacist has received appropriate training required by these policies, procedures, or protocols:

          (A)  Ordering or performing routine drug therapy related patient assessment procedures;

         [(B)  Ordering drug therapy related laboratory tests;

         (C)]  (B)  Initiating emergency contraception oral drug therapy in accordance with a written collaborative agreement approved by the board, between a licensed physician or advanced practice registered nurse with prescriptive authority and a pharmacist who has received appropriate training that includes programs approved by the [American Council of Pharmaceutical Education (]ACPE[)], curriculum-based programs from an ACPE-accredited college of pharmacy, state or local health department programs, or programs recognized by the board of pharmacy;

        [(D)]  (C)  Administering drugs orally, topically, by intranasal delivery, or by injection, pursuant to the order of the patient's licensed physician or advanced practice registered nurse with prescriptive authority, by a pharmacist having appropriate training that includes programs approved by the ACPE, curriculum-based programs from an ACPE-accredited college of pharmacy, [state or local health department programs,] or programs recognized by the board of pharmacy; 

         [(E)  Administering:

              (i)  Immunizations orally, by injection, or by intranasal delivery, to persons eighteen years of age or older by a pharmacist having appropriate training that includes programs approved by the ACPE, curriculum-based programs from an ACPE-accredited college of pharmacy, state or local health department programs, or programs recognized by the board of pharmacy;

             (ii)  Vaccines to persons between fourteen and seventeen years of age pursuant to section 461-11.4; and

            (iii)  Human papillomavirus, Tdap (tetanus, diphtheria, pertussis), meningococcal, and influenza vaccines to persons between eleven and seventeen years of age pursuant to section 461-11.4;

         (F)]  (D)  As authorized by the written instructions of a licensed physician or advanced practice registered nurse with prescriptive authority, initiating or adjusting the drug regimen of a patient pursuant to an order or authorization made by the patient's licensed physician or advanced practice registered nurse with prescriptive authority and related to the condition for which the patient has been seen by the licensed physician or advanced practice registered nurse with prescriptive authority; provided that the pharmacist shall issue written notification to the patient's licensed physician or advanced practice registered nurse with prescriptive authority or enter the appropriate information in an electronic patient record system shared by the licensed physician or advanced practice registered nurse with prescriptive authority, within twenty-four hours;

         [(G)  Transmitting a valid prescription to another pharmacist for the purpose of filling or dispensing;

          (H)  Providing consultation, information, or education to patients and health care professionals based on the pharmacist's training and for which no other licensure is required; or

          (I)  Dispensing an opioid antagonist in accordance with a written collaborative agreement approved by the board, between a licensed physician and a pharmacist who has received appropriate training that includes programs approved by the ACPE, curriculum-based programs from an ACPE-accredited college of pharmacy, state or local health department programs, or programs recognized by the board;]

     (3)  The offering or performing of those acts, services, operations, or transactions necessary in the conduct, operation, management, and control of pharmacy; and

     (4)  Prescribing and dispensing contraceptive supplies pursuant to section 461-11.6."

     SECTION 3.  This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun before its effective date.

     SECTION 4.  Statutory material to be repealed is bracketed and stricken.  New statutory material is underscored.

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

 

INTRODUCED BY:

_____________________________

 

 

 

 

Report Title:

Healthcare; Practice of Pharmacy

 

Description:

Amends the definition of "practice of pharmacy" to expand the scope of services and specific medications that pharmacists may furnish.

 

 

 

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.