 |
ARIZONA STATE SENATE
Fifty-Fifth Legislature, Second Regular Session
AMENDED
full-time equivalent student; expenditure limitation
(NOW: immunizations; pharmacists)
As passed by the Senate, S.B. 1374 redefined full-time equivalent student for the calculation of a community college district's (CCD) expenditure limitation, beginning in FY 2023. Modified the amounts withheld from the state aid of a CCD that exceeds the expenditure limit in FYs 2023 and 2024
The House of Representatives adopted a strike-everything amendment that does the following:
Purpose
Allows pharmacists to order and administer immunizations or vaccines recommended by the U.S. Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) for children at least six years old, as well as children at least three years old with a prescription order or under a collaborative practice agreement.
Background
Licensed pharmacists that meet outlined requirements may administer immunizations or vaccines without a prescription if they are recommended for adults by the CDC and the CDC's Health Information for International Travel. Pharmacists are authorized to provide the following services to minors without a prescription: 1) influenza immunizations or vaccines to a person who is at least three years old; 2) booster doses for the primary adolescent series as recommended by the CDC; and 3) immunizations recommended by the CDC to a person who is at least 13 years old. Pharmacists are additionally allowed to administer vaccines to a person who is at least 6 years old and under 13 years old with a prescription order (A.R.S. § 32-1974).
The ACIP provides advice and guidance to the CDC Director regarding use of vaccines and related agents for control of vaccine-preventable diseases in the U.S. civilian population. Recommendations made by ACIP are reviewed by the CDC Director and, if adopted, are published as official CDC recommendations in the Morbidity and Mortality Weekly Report (MMWR). The ACIP currently has 26 vaccine-specific ACIP recommendations (CDC).
The Arizona State Board of Pharmacy (Board) protects the health, safety and welfare of Arizona citizens by: 1) establishing bylaws and adopting rules that are necessary to protect the public regarding the practice of pharmacy; 2) issuing licenses to qualified applicants; 3) conducting compliance inspections of permitted facilities; 4) investigating complaints and adjudicating violations of applicable state and federal laws and rules; and 5) fixing standards and requirements to register and reregister pharmacies (A.R.S. § 32-1904).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
1. Permits licensed pharmacists to order and administer immunizations or vaccines to a person who is at least:
a) three years old, for influenza immunizations or vaccines, as recommended by ACIP;
b) six years old, as recommended by ACIP; and
c) 18 years old, as recommended by ACIP for international travel.
2. Allows a licensed pharmacist to administer immunizations and vaccines to a person aged three or older with a prescription order or under a collaborative practice agreement.
3. Removes the authorization for pharmacists to administer booster doses for the primary adolescent series and immunizations recommended for those age 13 and older by the CDC to minors without a prescription order.
4. Replaces the requirement for a pharmacist to be Board-certified to order and administer immunizations and vaccines with a requirement that pharmacists update their online profile with the Board, indicating that they are an active immunizer.
5. Allows an authorized pharmacist to order and administer an emergency medication to manage an acute allergic reaction to an immunization, vaccine or medication in accordance with the ACIP for adults and the American Academy of Pediatrics for minors.
6. Requires a pharmacist administering an immunization, vaccine or emergency medication to:
a) make a reasonable effort to identify the person's primary care physician by checking the Arizona State Immunization Information System (ASIIS) for the purpose of notification;
b) report the information to the ASIIS, rather than the vaccine registry;
c) notify the vaccine adverse event reporting system in accordance with ACIP recommendations;
d) provide vaccine information materials to those requesting immunizations or vaccines;
e) provide educational materials to the person's parent or guardian about the importance of pediatric preventive health care visits as recommended by the American Academy of Pediatrics for those under the age of 18; and
f) follow the standard operating procedures adopted by the pharmacy or other institution where the immunization, vaccine or emergency medication is administered that are based on the Vaccine Administration Protocols and Immunization Practices published in the CDC's MMWR.
7. Requires the standard operating procedures to include:
a) patient screening requirements for relevant health condition information before administering a vaccine;
b) a requirement to review the vaccine information, ASIIS and any other patient information on record to determine the person's past immunizations and adverse reactions before administering a vaccine; and
c) emergency management policies and procedures.
8. Requires the Board to adopt rules for the ordering and administering of emergency medications.
9. Removes the authority of the Board to adopt rules for the ordering and administering of vaccines, immunizations and emergency medications regarding:
a) protocols approved by the CDC and any appointed advisory committee; and
b) vaccine information and educational materials for those requesting vaccines and immunizations.
10. Removes the requirement that the Department of Health Services:
a) adopt a list of immunizations or vaccines to be administered by a pharmacist only under a prescription order within six months of receipt of the Board-appointed advisory committee recommendations; and
b) hold a public hearing before implementing the rules or any amendments to the rules.
11. Replaces the requirement that pharmacy interns be Board-certified with the requirement that interns be trained in administering immunizations and vaccines.
12. Includes corticosteroids, albuterol and oxygen in the emergency medication definition.
13. Becomes effective on the general effective date.
Amendments Adopted by the House of Representatives
ˇ Adopted the strike-everything amendment relating to pharmacist administration of immunizations and vaccines.
ˇ Makes technical changes.
House Action
APPROP 2/21/22 DPA/SE 8-5-0-0
3rd Read 3/2/22 45-13-2
Prepared by Senate Research
June 23, 2022
MM/CC/sr