Florida Senate - 2012                        COMMITTEE AMENDMENT
       Bill No. SB 850
       
       
       
       
       
       
                                Barcode 348686                          
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  02/10/2012           .                                
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       The Committee on Budget Subcommittee on Health and Human
       Services Appropriations (Oelrich) recommended the following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Subsections (2) through (7) of section 465.189,
    6  Florida Statutes, are renumbered as subsections (4) through (9),
    7  respectively, and new subsections (1), (2), and (3) are added to
    8  that section, to read:
    9         465.189 Administration of vaccines and epinephrine
   10  autoinjection influenza virus immunizations.—
   11         (1) In accordance with guidelines of the Centers for
   12  Disease Control and Prevention for each recommended immunization
   13  or vaccine, a pharmacist may administer the following vaccines
   14  within the framework of an established protocol under a
   15  supervising physician licensed under chapter 458 or chapter 459:
   16         (a) Influenza vaccine.
   17         (b) Pneumococcal vaccine.
   18         (2) In accordance with guidelines of the Centers for
   19  Disease Control and Prevention, a pharmacist may administer the
   20  shingles vaccine within the framework of an established protocol
   21  and pursuant to a written or electronic prescription issued to
   22  the patient by a physician licensed under chapter 458 or chapter
   23  459.
   24         (3) In order to address any unforeseen allergic reaction, a
   25  pharmacist may administer epinephrine using an autoinjector
   26  delivery system within the framework of an established protocol
   27  under a supervising physician licensed under chapter 458 or
   28  chapter 459.
   29         (1) Pharmacists may administer influenza virus
   30  immunizations to adults within the framework of an established
   31  protocol under a supervisory practitioner who is a physician
   32  licensed under chapter 458 or chapter 459. Each protocol shall
   33  contain specific procedures for addressing any unforeseen
   34  allergic reaction to influenza virus immunizations.
   35         (4)(2) A pharmacist may not enter into a protocol unless he
   36  or she maintains at least $200,000 of professional liability
   37  insurance and has completed training in administering vaccines
   38  authorized under influenza virus immunizations as provided in
   39  this section.
   40         (5)(3) A pharmacist administering vaccines under this
   41  section influenza virus immunizations shall maintain and make
   42  available patient records using the same standards for
   43  confidentiality and maintenance of such records as those that
   44  are imposed on health care practitioners under s. 456.057. These
   45  records shall be maintained for a minimum of 5 years.
   46         (6)(4) The decision by a supervising physician licensed
   47  under chapter 458 or chapter 459 supervisory practitioner to
   48  enter into a protocol under this section is a professional
   49  decision on the part of the practitioner, and a person may not
   50  interfere with a physician’s supervisory practitioner’s decision
   51  as to entering into such a protocol. A pharmacist may not enter
   52  into a protocol that is to be performed while acting as an
   53  employee without the written approval of the owner of the
   54  pharmacy. Pharmacists shall forward vaccination immunization
   55  records to the department for inclusion in the state registry of
   56  immunization information.
   57         (7)(5) Any pharmacist seeking to administer vaccines
   58  influenza virus immunizations to adults under this section must
   59  be certified to administer such vaccines influenza virus
   60  immunizations pursuant to a certification program approved by
   61  the Board of Pharmacy in consultation with the Board of Medicine
   62  and the Board of Osteopathic Medicine. The certification program
   63  shall, at a minimum, require that the pharmacist attend at least
   64  20 hours of continuing education classes approved by the board.
   65  The program shall have a curriculum of instruction concerning
   66  the safe and effective administration of such vaccines influenza
   67  virus immunizations, including, but not limited to, potential
   68  allergic reactions to such vaccines influenza virus
   69  immunizations.
   70         (8)(6) The written protocol between the pharmacist and
   71  supervising physician under this section must include particular
   72  terms and conditions imposed by the supervising physician upon
   73  the pharmacist relating to the administration of vaccines
   74  influenza virus immunizations by the pharmacist pursuant to this
   75  section. The written protocol shall include, at a minimum,
   76  specific categories and conditions among patients for whom the
   77  supervising physician authorizes the pharmacist to administer
   78  such vaccines influenza virus immunizations. The terms, scope,
   79  and conditions set forth in the written protocol between the
   80  pharmacist and the supervising physician must be appropriate to
   81  the pharmacist’s training and certification for administering
   82  such vaccines immunization. Pharmacists who have been delegated
   83  the authority to administer vaccines under this section
   84  influenza virus immunizations by the supervising physician under
   85  the protocol shall provide evidence of current certification by
   86  the Board of Pharmacy to the supervising physician. A
   87  supervising physician physicians shall review the administration
   88  of such vaccines influenza virus immunizations by the pharmacist
   89  pharmacists under such physician’s supervision pursuant to the
   90  written protocol between them, and this review shall take place
   91  as outlined in the written protocol. The process and schedule
   92  for the review shall be outlined in the written protocol between
   93  the pharmacist and the supervising physician.
   94         (9)(7) The pharmacist shall submit to the Board of Pharmacy
   95  a copy of his or her protocol or written agreement to administer
   96  vaccines under this section influenza virus immunizations.
   97         Section 2. Subsection (13) of section 465.003, Florida
   98  Statutes, is amended to read:
   99         465.003 Definitions.—As used in this chapter, the term:
  100         (13) “Practice of the profession of pharmacy” includes
  101  compounding, dispensing, and consulting concerning contents,
  102  therapeutic values, and uses of any medicinal drug; consulting
  103  concerning therapeutic values and interactions of patent or
  104  proprietary preparations, whether pursuant to prescriptions or
  105  in the absence and entirely independent of such prescriptions or
  106  orders; and other pharmaceutical services. For purposes of this
  107  subsection, “other pharmaceutical services” means the monitoring
  108  of the patient’s drug therapy and assisting the patient in the
  109  management of his or her drug therapy, and includes review of
  110  the patient’s drug therapy and communication with the patient’s
  111  prescribing health care provider as licensed under chapter 458,
  112  chapter 459, chapter 461, or chapter 466, or similar statutory
  113  provision in another jurisdiction, or such provider’s agent or
  114  such other persons as specifically authorized by the patient,
  115  regarding the drug therapy. However, nothing in this subsection
  116  may be interpreted to permit an alteration of a prescriber’s
  117  directions, the diagnosis or treatment of any disease, the
  118  initiation of any drug therapy, the practice of medicine, or the
  119  practice of osteopathic medicine, unless otherwise permitted by
  120  law. “Practice of the profession of pharmacy” also includes any
  121  other act, service, operation, research, or transaction
  122  incidental to, or forming a part of, any of the foregoing acts,
  123  requiring, involving, or employing the science or art of any
  124  branch of the pharmaceutical profession, study, or training, and
  125  shall expressly permit a pharmacist to transmit information from
  126  persons authorized to prescribe medicinal drugs to their
  127  patients. The practice of the profession of pharmacy also
  128  includes the administration of vaccines influenza virus
  129  immunizations to adults pursuant to s. 465.189.
  130         Section 3. Effective October 1, 2012, subsection (6) is
  131  added to section 465.009, Florida Statutes, to read:
  132         465.009 Continuing professional pharmaceutical education.—
  133         (6) Notwithstanding subsections (1)-(5):
  134         (a) Each pharmacist certified to administer a vaccine or
  135  epinephrine autoinjection under s. 465.189 must complete a 3
  136  hour continuing education course, which shall be offered by a
  137  statewide professional association of physicians in this state
  138  accredited to provide educational activities designated for the
  139  American Medical Association Physician’s Recognition Award (AMA
  140  PRA) Category 1 credit, on the safe and effective administration
  141  of vaccines and epinephrine autoinjection as part of biennial
  142  relicensure or recertification. This course may be offered in a
  143  distance-learning format and must be included in the 30 hours of
  144  continuing professional pharmaceutical education specified in
  145  subsection (1).
  146         (b) Each pharmacist must submit confirmation of having
  147  completed the course specified in paragraph (a) on a form
  148  provided by the board when submitting fees for license renewal.
  149         (c) Failure to comply with paragraphs (a) and (b) results
  150  in the revocation of the authorization for a pharmacist to
  151  administer a vaccine or epinephrine autoinjection under s.
  152  465.189. Such authorization may be restored upon completion of
  153  such requirements.
  154         Section 4. Except as otherwise expressly provided in this
  155  act, this act shall take effect July 1, 2012.
  156  
  157  ================= T I T L E  A M E N D M E N T ================
  158         And the title is amended as follows:
  159         Delete everything before the enacting clause
  160  and insert:
  161                        A bill to be entitled                      
  162         An act relating to pharmacy; amending s. 465.189,
  163         F.S.; revising the types of vaccines that pharmacists
  164         may administer under certain circumstances;
  165         authorizing pharmacists to administer an influenza
  166         vaccine, an epinephrine autoinjection, or a shingles
  167         vaccine within the framework of an established
  168         protocol under certain circumstances; amending s.
  169         465.003, F.S.; revising the definition of the term
  170         “practice of the profession of pharmacy” to conform to
  171         changes made by the act; amending s. 465.009, F.S.;
  172         revising continuing professional pharmaceutical
  173         educational requirements with respect to administering
  174         such vaccines or autoinjection; providing effective
  175         dates.