 |
ARIZONA STATE SENATE
Fifty-Fifth Legislature, Second Regular Session
pharmacists; providers; collaborative practice agreements
Purpose
Permits licensed pharmacists to enter into collaborative practice agreements with providers to initiate, monitor and modify drug therapy or provide disease management assistance. Repeals existing statutes relating to initiating, monitoring and modifying drug therapy by pharmacists.
Background
Pharmacists in Arizona are licensed and regulated by the Board of
Pharmacy (Board). Pharmaceutical practice includes: 1) interpreting, evaluating
and dispensing prescription orders; 2) compounding drugs; 3) labeling drugs and
devices; 4) participating in drug selection and drug utilization reviews, drug
administration, drug research and drug therapy monitoring or management; 5)
providing patient counseling; 6) properly and safely storing drugs and devices;
7) maintaining required records; 8) offering or performing acts, services,
operations or transactions necessary to operate a pharmacy; 9) initiating,
monitoring and modifying drug therapy under a protocol-based drug therapy
agreement; and 10) initiating and administering immunizations or vaccines (A.R.S.
§ 32-1901).
Licensed pharmacists may initiate, monitor and modify drug therapy for a patient if the patient's drug therapy was ordered by a provider and the pharmacist complies with Board rules and follows the written drug therapy management protocols prescribed by the diagnosing provider. Each protocol must contain detailed directions concerning the permissible actions of the pharmacist and must specify: 1) the specific drug to be managed; 2) the conditions and events that require the pharmacist to notify the provider; and 3) the laboratory tests that may be ordered. Violating the terms of a drug therapy management protocol is considered to be unprofessional conduct of a pharmacist (A.R.S. § 32-1970).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
1. Permits licensed pharmacists to enter into collaborative practice agreements with providers to initiate, monitor and modify drug therapy or provide disease management assistance.
2. Allows a collaborative practice agreement to be between one or more pharmacists and one or more providers.
3. Requires a collaborative practice agreement to:
a) outline the drug therapy and disease management duties that the provider is delegating to the pharmacist to perform, including initiating, monitoring and modifying drug therapy or ordering laboratory tests;
b) outline the eligible group of patients that may be treated under the collaborative practice agreement;
c) specify, at a minimum, the conditions to be managed by the pharmacist, the circumstances under which the pharmacist must notify the provider and any documentation or recordkeeping requirements; and
d) require the pharmacist to follow the written drug therapy and disease management guidelines of the provider and limit the services provided by the pharmacist to the terms of the collaborative practice agreement, including a specific list of drugs, drug classes and conditions to be managed.
4. Requires providers that enter into collaborative practice agreements to have previously established a provider-patient relationship with a patient in order for the patient to be treated under the terms of an agreement.
5. Declares a violation of laws relating to collaborative practice agreements an act of unprofessional conduct.
6. Specifies that pharmacists operating under a collaborative practice agreement are responsible for their own negligent acts resulting from clinical decisions made under the agreement.
7. Clarifies that provider liability is not limited for negligent acts that are unrelated to a pharmacist's change of medication.
8. Requires pharmacists operating under a collaborative practice agreement to maintain a copy of the agreement and make it available to the Board upon request.
9. Allows each of the following to adopt rules relating to collaborative practice agreements:
a) the Board;
b) the Arizona Medical Board;
c) the Board of Osteopathic Examiners in Medicine and Surgery; and
d) the Board of Nursing
10. Repeals existing statutes relating to initiating, monitoring and modifying drug therapy by pharmacists.
11. Defines terms.
12. Makes conforming changes.
13. Becomes effective on the general effective date.
House Action
HHS 2/14/22 DPA 8-0-0-0
3rd Read 2/23/22 58-1-1
Prepared by Senate Research
March 7, 2022
MM/sr