Florida Senate - 2012                              CS for SB 850
       
       
       
       By the Committee on Budget Subcommittee on Health and Human
       Services Appropriations; and Senator Oelrich
       
       
       
       603-03209-12                                           2012850c1
    1                        A bill to be entitled                      
    2         An act relating to pharmacy; amending s. 465.189,
    3         F.S.; revising the types of vaccines that pharmacists
    4         may administer under certain circumstances;
    5         authorizing pharmacists to administer an influenza
    6         vaccine, an epinephrine autoinjection, or a shingles
    7         vaccine within the framework of an established
    8         protocol under certain circumstances; amending s.
    9         465.003, F.S.; revising the definition of the term
   10         “practice of the profession of pharmacy” to conform to
   11         changes made by the act; amending s. 465.009, F.S.;
   12         revising continuing professional pharmaceutical
   13         educational requirements with respect to administering
   14         such vaccines or autoinjection; providing effective
   15         dates.
   16  
   17  Be It Enacted by the Legislature of the State of Florida:
   18  
   19         Section 1. Subsections (2) through (7) of section 465.189,
   20  Florida Statutes, are renumbered as subsections (4) through (9),
   21  respectively, and new subsections (1), (2), and (3) are added to
   22  that section, to read:
   23         465.189 Administration of vaccines and epinephrine
   24  autoinjection influenza virus immunizations.—
   25         (1) In accordance with guidelines of the Centers for
   26  Disease Control and Prevention for each recommended immunization
   27  or vaccine, a pharmacist may administer the following vaccines
   28  to an adult within the framework of an established protocol
   29  under a supervising physician licensed under chapter 458 or
   30  chapter 459:
   31         (a) Influenza vaccine.
   32         (b) Pneumococcal vaccine.
   33         (2) In accordance with guidelines of the Centers for
   34  Disease Control and Prevention, a pharmacist may administer the
   35  shingles vaccine within the framework of an established protocol
   36  and pursuant to a written or electronic prescription issued to
   37  the patient by a physician licensed under chapter 458 or chapter
   38  459.
   39         (3) In order to address any unforeseen allergic reaction, a
   40  pharmacist may administer epinephrine using an autoinjector
   41  delivery system within the framework of an established protocol
   42  under a supervising physician licensed under chapter 458 or
   43  chapter 459.
   44         (1) Pharmacists may administer influenza virus
   45  immunizations to adults within the framework of an established
   46  protocol under a supervisory practitioner who is a physician
   47  licensed under chapter 458 or chapter 459. Each protocol shall
   48  contain specific procedures for addressing any unforeseen
   49  allergic reaction to influenza virus immunizations.
   50         (4)(2) A pharmacist may not enter into a protocol unless he
   51  or she maintains at least $200,000 of professional liability
   52  insurance and has completed training in administering vaccines
   53  authorized under influenza virus immunizations as provided in
   54  this section.
   55         (5)(3) A pharmacist administering vaccines under this
   56  section influenza virus immunizations shall maintain and make
   57  available patient records using the same standards for
   58  confidentiality and maintenance of such records as those that
   59  are imposed on health care practitioners under s. 456.057. These
   60  records shall be maintained for a minimum of 5 years.
   61         (6)(4) The decision by a supervising physician licensed
   62  under chapter 458 or chapter 459 supervisory practitioner to
   63  enter into a protocol under this section is a professional
   64  decision on the part of the practitioner, and a person may not
   65  interfere with a physician’s supervisory practitioner’s decision
   66  as to entering into such a protocol. A pharmacist may not enter
   67  into a protocol that is to be performed while acting as an
   68  employee without the written approval of the owner of the
   69  pharmacy. Pharmacists shall forward vaccination immunization
   70  records to the department for inclusion in the state registry of
   71  immunization information.
   72         (7)(5) Any pharmacist seeking to administer vaccines
   73  influenza virus immunizations to adults under this section must
   74  be certified to administer such vaccines influenza virus
   75  immunizations pursuant to a certification program approved by
   76  the Board of Pharmacy in consultation with the Board of Medicine
   77  and the Board of Osteopathic Medicine. The certification program
   78  shall, at a minimum, require that the pharmacist attend at least
   79  20 hours of continuing education classes approved by the board.
   80  The program shall have a curriculum of instruction concerning
   81  the safe and effective administration of such vaccines influenza
   82  virus immunizations, including, but not limited to, potential
   83  allergic reactions to such vaccines influenza virus
   84  immunizations.
   85         (8)(6) The written protocol between the pharmacist and
   86  supervising physician under this section must include particular
   87  terms and conditions imposed by the supervising physician upon
   88  the pharmacist relating to the administration of vaccines
   89  influenza virus immunizations by the pharmacist pursuant to this
   90  section. The written protocol shall include, at a minimum,
   91  specific categories and conditions among patients for whom the
   92  supervising physician authorizes the pharmacist to administer
   93  such vaccines influenza virus immunizations. The terms, scope,
   94  and conditions set forth in the written protocol between the
   95  pharmacist and the supervising physician must be appropriate to
   96  the pharmacist’s training and certification for administering
   97  such vaccines immunization. Pharmacists who have been delegated
   98  the authority to administer vaccines under this section
   99  influenza virus immunizations by the supervising physician under
  100  the protocol shall provide evidence of current certification by
  101  the Board of Pharmacy to the supervising physician. A
  102  supervising physician physicians shall review the administration
  103  of such vaccines influenza virus immunizations by the pharmacist
  104  pharmacists under such physician’s supervision pursuant to the
  105  written protocol between them, and this review shall take place
  106  as outlined in the written protocol. The process and schedule
  107  for the review shall be outlined in the written protocol between
  108  the pharmacist and the supervising physician.
  109         (9)(7) The pharmacist shall submit to the Board of Pharmacy
  110  a copy of his or her protocol or written agreement to administer
  111  vaccines under this section influenza virus immunizations.
  112         Section 2. Subsection (13) of section 465.003, Florida
  113  Statutes, is amended to read:
  114         465.003 Definitions.—As used in this chapter, the term:
  115         (13) “Practice of the profession of pharmacy” includes
  116  compounding, dispensing, and consulting concerning contents,
  117  therapeutic values, and uses of any medicinal drug; consulting
  118  concerning therapeutic values and interactions of patent or
  119  proprietary preparations, whether pursuant to prescriptions or
  120  in the absence and entirely independent of such prescriptions or
  121  orders; and other pharmaceutical services. For purposes of this
  122  subsection, “other pharmaceutical services” means the monitoring
  123  of the patient’s drug therapy and assisting the patient in the
  124  management of his or her drug therapy, and includes review of
  125  the patient’s drug therapy and communication with the patient’s
  126  prescribing health care provider as licensed under chapter 458,
  127  chapter 459, chapter 461, or chapter 466, or similar statutory
  128  provision in another jurisdiction, or such provider’s agent or
  129  such other persons as specifically authorized by the patient,
  130  regarding the drug therapy. However, nothing in this subsection
  131  may be interpreted to permit an alteration of a prescriber’s
  132  directions, the diagnosis or treatment of any disease, the
  133  initiation of any drug therapy, the practice of medicine, or the
  134  practice of osteopathic medicine, unless otherwise permitted by
  135  law. “Practice of the profession of pharmacy” also includes any
  136  other act, service, operation, research, or transaction
  137  incidental to, or forming a part of, any of the foregoing acts,
  138  requiring, involving, or employing the science or art of any
  139  branch of the pharmaceutical profession, study, or training, and
  140  shall expressly permit a pharmacist to transmit information from
  141  persons authorized to prescribe medicinal drugs to their
  142  patients. The practice of the profession of pharmacy also
  143  includes the administration of vaccines influenza virus
  144  immunizations to adults pursuant to s. 465.189.
  145         Section 3. Effective October 1, 2012, subsection (6) is
  146  added to section 465.009, Florida Statutes, to read:
  147         465.009 Continuing professional pharmaceutical education.—
  148         (6) Notwithstanding subsections (1)-(5):
  149         (a) Each pharmacist certified to administer a vaccine or
  150  epinephrine autoinjection under s. 465.189 must complete a 3
  151  hour continuing education course, which shall be offered by a
  152  statewide professional association of physicians in this state
  153  accredited to provide educational activities designated for the
  154  American Medical Association Physician’s Recognition Award (AMA
  155  PRA) Category 1 credit, on the safe and effective administration
  156  of vaccines and epinephrine autoinjection as part of biennial
  157  relicensure or recertification. This course may be offered in a
  158  distance-learning format and must be included in the 30 hours of
  159  continuing professional pharmaceutical education specified in
  160  subsection (1).
  161         (b) Each pharmacist must submit confirmation of having
  162  completed the course specified in paragraph (a) on a form
  163  provided by the board when submitting fees for license renewal.
  164         (c) Failure to comply with paragraphs (a) and (b) results
  165  in the revocation of the authorization for a pharmacist to
  166  administer a vaccine or epinephrine autoinjection under s.
  167  465.189. Such authorization may be restored upon completion of
  168  such requirements.
  169         Section 4. Except as otherwise expressly provided in this
  170  act, this act shall take effect July 1, 2012.