2016 -- H 7949 SUBSTITUTE A

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LC005383/SUB A

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2016

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A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS - COLLABORATIVE PHARMACY

PRACTICE

     

     Introduced By: Representative Raymond H. Johnston

     Date Introduced: March 16, 2016

     Referred To: House Health, Education & Welfare

     It is enacted by the General Assembly as follows:

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     SECTION 1. Sections 5-19.2-2 and 5-19.2-3 of the General Laws in Chapter 5-19.2

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entitled "Collaborative Pharmacy Practice" are hereby amended to read as follows:

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     5-19.2-2. Definitions. -- (a) "Collaborative practice agreement" is a written and signed

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agreement, entered into voluntarily, between a pharmacist, with advanced training and experience

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relevant to the scope of collaborative practice, one or more licensed pharmacist(s), with advanced

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training and experience relevant to the scope of collaborative practice and one or more physicians

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that defines the collaborative pharmacy practice in which the pharmacist pharmacist(s) and

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physician(s) propose to engage. Collaborative practice agreements shall be made in the best

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interest of public health.

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      (b) "Collaborative practice committee" shall consist of six (6) individuals: three (3)

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individuals to be appointed by the board of pharmacy from nominees provided by the Rhode

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Island Pharmacists Association and three (3) individuals to be appointed by the board of medical

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licensure and discipline from nominees provided by the Rhode Island Medical Society. The

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collaborative practice committee shall advise the director on all issues pertinent to the regulation

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of collaborative practice agreements.

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      (c) "Collaborative pharmacy practice" is that practice of pharmacy whereby a

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pharmacist, with advanced training and experience relevant to the scope of collaborative practice

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one or more licensed pharmacist(s), with advanced training and experience relevant to the scope

 

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of collaborative practice agrees to work in collaboration with one or more physicians for the

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purpose of drug therapy management of patients, such management to be pursuant to a protocol

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or protocols authorized by the physician(s) and subject to conditions and/or limitations as set

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forth by the department. A health care professional who has prescribing privileges and is

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employed by a collaborating physician may be in such an agreement.

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      (d) "Drug therapy management" means the review, in accordance with a collaborative

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practice agreement, of drug therapy regimen or regimens of patients by a pharmacist one or more

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licensed pharmacist(s) for the purpose of rendering advice to one or more physicians who are

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party to the agreement, or their physician designees, regarding adjustment of initiating, adjusting,

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monitoring, or discontinuing the regimen. Decisions involving drug therapy management shall be

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made in the best interests of the patient. In accordance with a collaborative practice agreement,

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drug therapy management may include:

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      (1) Modifying and managing Initiating, adjusting, monitoring, or discontinuing drug

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therapy;

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      (2) Collecting and reviewing patient histories;

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      (3) Obtaining and checking vital signs, including pulse, height, weight, temperature,

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blood pressure, and respiration; and

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      (4) Under the supervision of, or in direct consultation with a physician one or more

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physician(s), ordering and evaluating the results of laboratory tests directly related to drug

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therapy when performed in accordance with approved protocols applicable to the practice setting

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and providing such evaluation does not include any diagnostic component.

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      (e) "Limited-function test" means those tests listed in the federal register under the

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Clinical Laboratory Improvement Amendments of 1988 (CLIA) as waived tests. For the purposes

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of this chapter, limited-function test shall include only the following: blood glucose, hemoglobin

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Alc, cholesterol tests, and/or other tests that are classified as waived under CLIA and are

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approved by the United States Food and Drug Administration for sale to the public without a

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prescription in the form of an over-the-counter test kit.

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      (f) "Pharmacist with advanced training and experience relevant to the scope of

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collaborative practice" means a licensed pharmacist in this state with post-graduate educational

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training. Such training shall include, but not be limited to, residency training; board certification;

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certification from an accredited professional organization educational institution; or any other

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continuing education provider approved by the director of health relevant to the proposed scope

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of the collaborative practice agreement. "Pharmacist with advanced training and experience

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relevant to the scope of collaborative practice" means a licensed pharmacist in this state with a

 

LC005383/SUB A - Page 2 of 5

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Bachelor of Science in Pharmacy and post-graduate educational training or a Doctor of Pharmacy

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degree. Such training shall include, but not be limited to, residency training; board certification;

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certification from an accredited professional organization educational institution; or any other

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continuing education provider approved by the director of health relevant to the proposed scope

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of the collaborative practice agreement.

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      (g) "Practice of pharmacy" means the interpretation, evaluation, and implementation of

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medical orders, including the performance of clinical laboratory tests, provided such testing is

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limited to limited function tests as defined herein; the dispensing of prescription drug orders;

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participation in drug and device selection; drug regiment reviews and drug or drug-related

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research; provision of patient counseling and the provision of those acts or services necessary to

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provide pharmaceutical care; drug therapy management pursuant to a collaborative practice

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agreement; and the responsibility for the supervision for compounding and labeling of drugs and

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devices (except labeling by a manufacturer, repackager, or distributor of nonprescription drugs

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and commercially packaged legend drugs and devices); proper and safe storage of drugs and

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devices; and maintenance of proper records for them.

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     5-19.2-3. Collaborative pharmacy practice. -- (a) A pharmacist may engage in

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collaborative pharmacy practice pursuant to a collaborative practice agreement in accordance

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with provisions of this chapter or other applicable sections of the regulations. Any pharmacist or

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physician desiring to engage in collaborate pharmacy practice shall execute a collaborative

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practice agreement in accordance with regulations promulgated by the department. Each

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collaborative practice agreement shall set forth at least the following: (1) site and setting where

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the collaborative practice is to take place; (2) informed consent procedures; (3) qualifications of

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participating pharmacist pharmacists and physicians; (4) the role of any employed health care

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professional with prescriptive privileges participating in the collaborative practice; (5) scope of

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conditions or diseases to be managed; (6) practice protocols; (7) risk management activities; and

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(8) outcomes measurements. Each collaborative practice agreement shall be subject to review and

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renewal on an annual a biennial basis.

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      (b) Any pharmacist or physician who deviates from or practices in a manner inconsistent

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with the terms of a collaborative practice agreement shall be in violation of this chapter; such

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shall constitute grounds for disciplinary action pursuant to this chapter. There shall be no civil

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liability on the part of, or cause of action of any nature against, a physician or physician's agents

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or employees for participation in collaborative pharmacy practice as the result of negligence or

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fault on the part of the pharmacist participating in such collaborative practice agreement.

 

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     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS - COLLABORATIVE PHARMACY

PRACTICE

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     This act would redefine the type of advanced training and experience that is needed for

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pharmacists to engage in collaborative practice and provides for biennial review of collaborative

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practice agreements.

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     This act would take effect upon passage.

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