Florida Senate - 2024 SENATOR AMENDMENT Bill No. CS/CS/HB 159, 1st Eng. Ì504434ÈÎ504434 LEGISLATIVE ACTION Senate . House . . . Floor: WD/2R . 03/05/2024 01:59 PM . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— Senator Calatayud moved the following: 1 Senate Amendment (with title amendment) 2 3 Delete lines 63 - 128 4 and insert: 5 3. A requirement that the pharmacist maintain records for 6 any HIV postexposure prophylaxis drugs ordered and dispensed 7 under the collaborative practice agreement. 8 4. The physician’s instructions for obtaining relevant 9 patient medical history for the purpose of identifying 10 disqualifying health conditions, adverse reactions, and 11 contraindications to the use of HIV postexposure prophylaxis 12 drugs. 13 5. A process and schedule for the physician to review the 14 pharmacist’s records and actions under the practice agreement. 15 6. Evidence of the pharmacist’s current certification by 16 the board as provided in subsection (6). 17 7. Any other requirements as established by the board with 18 the approval of the Board of Medicine and the Board of 19 Osteopathic Medicine. 20 (b) A physician who has entered into a written 21 collaborative practice agreement pursuant to this section is 22 responsible for reviewing the pharmacist’s records and actions 23 to ensure compliance with the agreement. 24 (c) The pharmacist shall submit a copy of the written 25 collaborative practice agreement to the board. 26 (5) A pharmacist who orders and dispenses HIV postexposure 27 prophylaxis drugs pursuant to subsection (4) must provide the 28 patient with written information advising the patient to seek 29 follow-up care from his or her primary care physician. If the 30 patient indicates that he or she lacks regular access to primary 31 care, the pharmacist must comply with the procedures of the 32 pharmacy’s approved access-to-care plan as provided in 33 subsection (7). 34 (6) To provide services under a collaborative practice 35 agreement pursuant to this section, a pharmacist must be 36 certified by the board, according to rules adopted by the board 37 with the approval of the Board of Medicine and the Board of 38 Osteopathic Medicine. To be certified, a pharmacist must, at a 39 minimum, meet all of the following criteria: 40 (a) Hold an active and unencumbered license to practice 41 pharmacy under this chapter. 42 (b) Be engaged in the active practice of pharmacy. 43 (c) Have earned a degree of doctor of pharmacy or have 44 completed at least 3 years of experience as a licensed 45 pharmacist. 46 (d) Maintain at least $250,000 of liability coverage. A 47 pharmacist who maintains liability coverage pursuant to s. 48 465.1865 or s. 465.1895 satisfies this requirement. 49 (e) Have completed a course approved by the board, in 50 consultation with the Board of Medicine and the Board of 51 Osteopathic Medicine, which includes, at a minimum, instruction 52 on all of the following: 53 1. Performance of patient assessments. 54 2. Point-of-care testing procedures. 55 3. Safe and effective treatment of HIV exposure with HIV 56 infection prevention drugs, including, but not limited to, 57 consideration of the side effects of the drug dispensed and the 58 patient’s diet and activity levels. 59 4. Identification of contraindications. 60 5. Identification of patient comorbidities in individuals 61 with HIV requiring further medical evaluation and treatment, 62 including, but not limited to, cardiovascular disease, lung and 63 liver cancer, chronic obstructive lung disease, and diabetes 64 mellitus. 65 (7)(a) A pharmacy in which a pharmacist is providing 66 services under a written collaborative practice agreement 67 pursuant to subsection (4) must submit an access-to-care plan to 68 the board and department annually. If the board or the 69 department determines that a pharmacy has failed to submit an 70 access-to-care plan required under this section or if a 71 pharmacy’s access-to-care plan does not comply with this section 72 or applicable rules of the board, the board must notify the 73 pharmacy of its noncompliance and the pharmacy must submit an 74 access-to-care plan that brings the pharmacy into compliance 75 according to parameters provided in board rule. The board may 76 fine a pharmacy that fails to comply with this paragraph or may 77 prohibit such pharmacy from allowing its pharmacists to screen 78 adults for HIV exposure or order and dispense HIV postexposure 79 prophylaxis drugs under this section until the pharmacy complies 80 with this paragraph. 81 (b) An access-to-care plan shall assist patients in gaining 82 access to appropriate care settings when they present to a 83 pharmacist for HIV screening and indicate that they lack regular 84 access to primary care. An access-to-care plan must include, but 85 need not be limited to: 86 87 ================= T I T L E A M E N D M E N T ================ 88 And the title is amended as follows: 89 Delete lines 5 - 13 90 and insert: 91 screen adults for HIV exposure and provide the results 92 to such adults, with advice to consult with or seek 93 treatment from a physician; authorizing pharmacists to 94 dispense HIV preexposure prophylaxis drugs pursuant to 95 a prescription; authorizing pharmacists to order and 96 dispense HIV postexposure prophylaxis drugs pursuant 97 to a written collaborative practice agreement with a 98 physician; specifying requirements for the practice 99 agreements; requiring the supervising physician to 100 review the pharmacist’s records and actions in 101 accordance with the practice agreement; requiring 102 pharmacists who enter into such practice agreements to 103 submit the agreements to the Board of Pharmacy; 104 requiring such pharmacists to provide certain written 105 information when dispensing such drugs to patients; 106 requiring pharmacists to comply with certain 107 procedures under certain circumstances; requiring 108 pharmacists, before ordering and dispensing HIV 109 postexposure prophylaxis drugs, to be certified by the 110 Board of Pharmacy in accordance with rules adopted by 111 the board and approved by the Board of Medicine and 112 the Board of Osteopathic Medicine; specifying minimum 113 requirements for the certification; requiring certain 114 pharmacies to submit an access-to-care plan to the 115 Board of Pharmacy and the Department of Health 116 annually; authorizing the board to fine or place 117 certain prohibitions on a pharmacy that does not 118 comply with the requirements for access-to-care plans; 119 specifying requirements for the plans; requiring the