Florida Senate - 2024 SENATOR AMENDMENT Bill No. CS/CS/HB 159, 1st Eng. Ì581084-Î581084 LEGISLATIVE ACTION Senate . House . . . Floor: 1/AD/2R . Floor: C 03/05/2024 06:28 PM . 03/06/2024 04:55 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 To be certified, a pharmacist must, at a minimum, meet all of 38 the following criteria: 39 (a) Hold an active and unencumbered license to practice 40 pharmacy under this chapter. 41 (b) Be engaged in the active practice of pharmacy. 42 (c) Have earned a degree of doctor of pharmacy or have 43 completed at least 3 years of experience as a licensed 44 pharmacist. 45 (d) Maintain at least $250,000 of liability coverage. A 46 pharmacist who maintains liability coverage pursuant to s. 47 465.1865 or s. 465.1895 satisfies this requirement. 48 (e) Have completed a course approved by the board, in 49 consultation with the Board of Medicine and the Board of 50 Osteopathic Medicine, which includes, at a minimum, instruction 51 on all of the following: 52 1. Performance of patient assessments. 53 2. Point-of-care testing procedures. 54 3. Safe and effective treatment of HIV exposure with HIV 55 infection prevention drugs, including, but not limited to, 56 consideration of the side effects of the drug dispensed and the 57 patient’s diet and activity levels. 58 4. Identification of contraindications. 59 5. Identification of patient comorbidities in individuals 60 with HIV requiring further medical evaluation and treatment, 61 including, but not limited to, cardiovascular disease, lung and 62 liver cancer, chronic obstructive lung disease, and diabetes 63 mellitus. 64 (f) Any other criteria as established by the board with the 65 approval of the Board of Medicine and the Board of Osteopathic 66 Medicine. 67 (7)(a) A pharmacy in which a pharmacist is providing 68 services under a written collaborative practice agreement 69 pursuant to subsection (4) must submit an access-to-care plan to 70 the board and department annually. If the board or the 71 department determines that a pharmacy has failed to submit an 72 access-to-care plan required under this section or if a 73 pharmacy’s access-to-care plan does not comply with this section 74 or applicable rules of the board, the board must notify the 75 pharmacy of its noncompliance and the pharmacy must submit an 76 access-to-care plan that brings the pharmacy into compliance 77 according to parameters provided in board rule. The board may 78 fine a pharmacy that fails to comply with this paragraph or may 79 prohibit such pharmacy from allowing its pharmacists to screen 80 adults for HIV exposure or order and dispense HIV postexposure 81 prophylaxis drugs under a collaborative practice agreement until 82 the pharmacy complies with this paragraph. 83 (b) An access-to-care plan shall assist patients in gaining 84 access to appropriate care settings when they present to a 85 pharmacist for HIV screening and indicate that they lack regular 86 access to primary care. An access-to-care plan must include, but 87 need not be limited to: 88 89 ================= T I T L E A M E N D M E N T ================ 90 And the title is amended as follows: 91 Delete lines 5 - 13 92 and insert: 93 screen adults for HIV exposure and provide the results 94 to such adults, with advice to consult with or seek 95 treatment from a physician; authorizing pharmacists to 96 dispense HIV preexposure prophylaxis drugs pursuant to 97 a prescription; authorizing pharmacists to order and 98 dispense HIV postexposure prophylaxis drugs pursuant 99 to a written collaborative practice agreement with a 100 physician; specifying requirements for the practice 101 agreements; requiring the supervising physician to 102 review the pharmacist’s records and actions in 103 accordance with the practice agreement; requiring 104 pharmacists who enter into such practice agreements to 105 submit the agreements to the Board of Pharmacy; 106 requiring such pharmacists to provide certain written 107 information when dispensing such drugs to patients; 108 requiring pharmacists to comply with certain 109 procedures under certain circumstances; requiring 110 pharmacists, before ordering and dispensing HIV 111 postexposure prophylaxis drugs, to be certified by the 112 Board of Pharmacy; specifying minimum requirements for 113 the certification; requiring certain pharmacies to 114 submit an access-to-care plan to the Board of Pharmacy 115 and the Department of Health annually; authorizing the 116 board to fine or place certain prohibitions on a 117 pharmacy that does not comply with the requirements 118 for access-to-care plans; specifying requirements for 119 the plans; requiring the