CS for SB 848                                    First Engrossed
       
       
       
       
       
       
       
       
       2018848e1
       
    1                        A bill to be entitled                      
    2         An act relating to telepharmacy; amending s. 465.003,
    3         F.S.; revising and providing definitions; amending s.
    4         465.014, F.S.; authorizing a certified pharmacy
    5         technician to dispense medicinal drugs under certain
    6         conditions; amending s. 465.015, F.S.; conforming
    7         provisions to changes made by the act; creating s.
    8         465.0198, F.S.; providing permit requirements for
    9         remote dispensing site pharmacies; providing operating
   10         requirements and prohibitions for a remote dispensing
   11         site pharmacy; requiring the prescription department
   12         manager or other pharmacist employed by the
   13         supervising pharmacy to visit the remote dispensing
   14         site pharmacy; providing certification and experience
   15         requirements for a certified pharmacy technician
   16         working at a remote site pharmacy; prohibiting a
   17         certified pharmacy technician from performing sterile
   18         or nonsterile compounding; providing an exception;
   19         providing construction; amending s. 465.022, F.S.;
   20         authorizing a Florida licensed pharmacist to serve as
   21         the prescription drug manager at more than one remote
   22         dispensing site pharmacy under certain conditions;
   23         amending s. 465.0265, F.S.; conforming provisions to
   24         changes made by the act; providing an effective date.
   25          
   26  Be It Enacted by the Legislature of the State of Florida:
   27  
   28         Section 1. Subsection (11) of section 465.003, Florida
   29  Statutes, is amended to read:
   30         465.003 Definitions.—As used in this chapter, the term:
   31         (11)(a) “Pharmacy” includes a community pharmacy, an
   32  institutional pharmacy, a nuclear pharmacy, a special pharmacy,
   33  and an Internet pharmacy, and a remote dispensing site pharmacy.
   34         1. The term “community pharmacy” includes every location
   35  where medicinal drugs are compounded, dispensed, stored, or sold
   36  or where prescriptions are filled or dispensed on an outpatient
   37  basis.
   38         2. The term “institutional pharmacy” includes every
   39  location in a hospital, clinic, nursing home, dispensary,
   40  sanitarium, extended care facility, or other facility,
   41  hereinafter referred to as “health care institutions,” where
   42  medicinal drugs are compounded, dispensed, stored, or sold.
   43         3. The term “nuclear pharmacy” includes every location
   44  where radioactive drugs and chemicals within the classification
   45  of medicinal drugs are compounded, dispensed, stored, or sold.
   46  The term “nuclear pharmacy” does not include hospitals licensed
   47  under chapter 395 or the nuclear medicine facilities of such
   48  hospitals.
   49         4. The term “special pharmacy” includes every location
   50  where medicinal drugs are compounded, dispensed, stored, or sold
   51  if such locations are not otherwise defined in this subsection.
   52         5. The term “Internet pharmacy” includes locations not
   53  otherwise licensed or issued a permit under this chapter, within
   54  or outside this state, which use the Internet to communicate
   55  with or obtain information from consumers in this state and use
   56  such communication or information to fill or refill
   57  prescriptions or to dispense, distribute, or otherwise engage in
   58  the practice of pharmacy in this state. Any act described in
   59  this definition constitutes the practice of pharmacy as defined
   60  in subsection (13).
   61         6.The term “remote dispensing site pharmacy” includes
   62  every location where medicinal drugs are prepared by a certified
   63  pharmacy technician who is electronically supervised by an
   64  offsite pharmacist and dispensed pursuant to s. 465.014(1) to
   65  the patient after verification, certification, and counseling by
   66  the pharmacist.
   67         (b) The pharmacy department of any permittee shall be
   68  considered closed whenever a Florida licensed pharmacist is not
   69  present and on duty. The term “not present and on duty” may
   70  shall not be construed to prevent:
   71         1. A pharmacist from exiting the prescription department
   72  for the purposes of consulting or responding to inquiries or
   73  providing assistance to patients or customers;,
   74         2. A pharmacist attending to personal hygiene needs;, or
   75         3. A pharmacist performing any other function for which the
   76  pharmacist is responsible, provided that such activities are
   77  conducted in a manner consistent with the pharmacist’s
   78  responsibility to provide pharmacy services; or
   79         4. An offsite pharmacist from remotely supervising a
   80  certified pharmacy technician at a remote dispensing site
   81  pharmacy.
   82         Section 2. Subsection (1) of section 465.014, Florida
   83  Statutes, is amended to read:
   84         465.014 Pharmacy technician.—
   85         (1) A person other than a licensed pharmacist or pharmacy
   86  intern may not engage in the practice of the profession of
   87  pharmacy, except that a licensed pharmacist may delegate to
   88  pharmacy technicians who are certified registered pursuant to
   89  this section those duties, tasks, and functions that do not fall
   90  within the purview of s. 465.003(13). However, a certified
   91  pharmacy technician may dispense medicinal drugs when operating
   92  under the electronic supervision of an offsite Florida licensed
   93  pharmacist pursuant to s. 465.0198. All such delegated acts must
   94  be performed under the direct supervision of a licensed
   95  pharmacist who is responsible for all such acts performed by
   96  persons under his or her supervision. A certified registered
   97  pharmacy technician, under the supervision of a pharmacist, may
   98  initiate or receive communications with a practitioner or his or
   99  her agent, on behalf of a patient, regarding refill
  100  authorization requests. A licensed pharmacist may not supervise
  101  more than one certified registered pharmacy technician unless
  102  otherwise permitted by the guidelines adopted by the board. The
  103  board shall establish guidelines to be followed by licensees or
  104  permittees in determining the circumstances under which a
  105  licensed pharmacist may supervise more than one pharmacy
  106  technician.
  107         Section 3. Subsections (1) and (2) of section 465.015,
  108  Florida Statutes, are amended to read:
  109         465.015 Violations and penalties.—
  110         (1) It is unlawful for any person to own, operate,
  111  maintain, open, establish, conduct, or have charge of, either
  112  alone or with another person or persons, a pharmacy:
  113         (a) Which is not registered under the provisions of this
  114  chapter.
  115         (b) In which a person not licensed as a pharmacist in this
  116  state or not registered as an intern in this state or in which
  117  an intern who is not acting under the direct and immediate
  118  personal supervision of a licensed pharmacist fills, compounds,
  119  or dispenses any prescription or dispenses medicinal drugs. This
  120  paragraph does not apply to any person who owns, operates,
  121  maintains, opens, establishes, conducts, or has charge of a
  122  remote dispensing site pharmacy pursuant to s. 465.0198.
  123         (2) It is unlawful for any person:
  124         (a) To make a false or fraudulent statement, either for
  125  herself or himself or for another person, in any application,
  126  affidavit, or statement presented to the board or in any
  127  proceeding before the board.
  128         (b) To fill, compound, or dispense prescriptions or to
  129  dispense medicinal drugs if such person does not hold an active
  130  license as a pharmacist in this state, is not registered as an
  131  intern in this state, or is an intern not acting under the
  132  direct and immediate personal supervision of a licensed
  133  pharmacist. This paragraph does not apply to a certified
  134  pharmacy technician dispensing medicinal drugs pursuant to s.
  135  465.0198.
  136         (c) To sell or dispense drugs as defined in s. 465.003(8)
  137  without first being furnished with a prescription.
  138         (d) To sell samples or complimentary packages of drug
  139  products.
  140         Section 4. Section 465.0198, Florida Statutes, is created
  141  to read:
  142         465.0198 Remote dispensing site pharmacy permits.—
  143         (1) Any person desiring a permit to operate a remote
  144  dispensing site pharmacy must apply to the department for a
  145  remote dispensing site pharmacy permit. If the board certifies
  146  that the application complies with the laws and board rules
  147  governing the practice of the profession of pharmacy, the
  148  department must issue the permit. A permit may not be issued
  149  unless a licensed pharmacist or consultant pharmacist is
  150  designated as the prescription department manager responsible
  151  for the oversight of the remote dispensing site pharmacy. The
  152  permittee must notify the department within 10 days after any
  153  change of the prescription department manager.
  154         (2) As a prerequisite to issuance of an initial permit or a
  155  permit for a change of location, the remote dispensing site
  156  pharmacy must pass an onsite inspection. The department must
  157  make the inspection within 90 days before issuance of the
  158  permit.
  159         (3) The remote dispensing site pharmacy must:
  160         (a) Be jointly owned by a supervising pharmacy or operated
  161  under a contract with a supervising pharmacy. For purposes of
  162  this subsection, “supervising pharmacy” means a licensed
  163  pharmacy in this state which employs a Florida licensed
  164  pharmacist who remotely supervises a certified pharmacy
  165  technician at a remote dispensing site pharmacy.
  166         (b) Display a sign visible to the public indicating that
  167  the location is a remote dispensing site pharmacy and that the
  168  facility is under 24-hour video surveillance. The remote
  169  dispensing site pharmacy must retain the video surveillance
  170  recordings for at least 45 days.
  171         (c) Be located in a rural hospital as defined in s.
  172  395.602.
  173         (4) A remote dispensing site pharmacy may not lose its
  174  permit based on the subsequent opening of a community pharmacy
  175  within 10 miles of the remote dispensing site pharmacy.
  176         (5) A remote dispensing site pharmacy may store, hold, and
  177  dispense all medicinal drugs including those listed in s.
  178  893.03(3)-(5). A remote dispensing pharmacy may not store, hold,
  179  or dispense controlled substances listed in s. 893.03(2).
  180         (6) A remote dispensing site pharmacy may not perform
  181  centralized prescription filling, as defined in s. 465.003(16).
  182         (7) A remote dispensing site pharmacy must maintain a
  183  policy and procedures manual, which shall be made available to
  184  the board or its agent upon request. The policy and procedures
  185  manual shall include:
  186         (a) A description of how the pharmacy will comply with
  187  federal and state laws, rules, and regulations.
  188         (b) The procedure for supervising the remote dispensing
  189  site pharmacy and counseling its patients before the dispensing
  190  of any medicinal drug pursuant to this section.
  191         (c) The procedure for reviewing the prescription drug
  192  inventory and drug records maintained by the remote dispensing
  193  site pharmacy.
  194         (d) The policy and procedure for providing appropriate
  195  security to protect the confidentiality and integrity of patient
  196  information.
  197         (e) The written plan for recovery from an event that
  198  interrupts or prevents the pharmacist from supervising the
  199  remote dispensing site pharmacy’s operation.
  200         (f) The procedure by which a supervising pharmacist
  201  consults the state prescription drug monitoring program before
  202  authorizing any controlled substance for dispensing and reports
  203  the dispensing of a controlled substance as required under s.
  204  893.055.
  205         (g) The specific duties, tasks, and functions that a
  206  certified pharmacy technician is authorized to perform at the
  207  remote dispensing site pharmacy.
  208         (8) The prescription department manager or other pharmacist
  209  employed by the supervising pharmacy must visit the remote
  210  dispensing site pharmacy, based on a schedule designated by the
  211  board, to inspect the pharmacy, address personnel matters, and
  212  provide clinical services for patients.
  213         (9) A certified pharmacy technician must be certified by a
  214  pharmacy technician certification program that is accredited by
  215  the National Commission of Certifying Agencies and have
  216  completed at least 2,080 hours of experience at a pharmacy
  217  within the 2 years immediately preceding the date on which the
  218  certified pharmacy technician begins employment at the remote
  219  dispensing site pharmacy.
  220         (10) A certified pharmacy technician working at a remote
  221  dispensing site pharmacy may not perform sterile or nonsterile
  222  compounding, except that a certified pharmacy technician may
  223  reconstitute orally administered powder antibiotics.
  224         (11)This section does not alter the supervision
  225  requirements established in s. 465.014.
  226         Section 5. Paragraph (c) of subsection (11) of section
  227  465.022, Florida Statutes, is amended to read:
  228         465.022 Pharmacies; general requirements; fees.—
  229         (11) A permittee must notify the department of the identity
  230  of the prescription department manager within 10 days after
  231  employment. The prescription department manager must comply with
  232  the following requirements:
  233         (c) A Florida licensed registered pharmacist may not serve
  234  as the prescription department manager in more than one location
  235  unless approved by the board. However, a Florida licensed
  236  pharmacist may serve as a prescription department manager for no
  237  more than two remote dispensing site pharmacies, if such
  238  pharmacies are under common control.
  239         Section 6. Subsection (1) of section 465.0265, Florida
  240  Statutes, is amended to read:
  241         465.0265 Centralized prescription filling.—
  242         (1) Except as otherwise provided in this chapter, a
  243  pharmacy licensed under this chapter may perform centralized
  244  prescription filling for another pharmacy, provided that the
  245  pharmacies have the same owner or have a written contract
  246  specifying the services to be provided by each pharmacy, the
  247  responsibilities of each pharmacy, and the manner in which the
  248  pharmacies will comply with federal and state laws, rules, and
  249  regulations.
  250         Section 7. This act shall take effect July 1, 2018.