HB 2444 — pharmacists; independent testing; treatment

Fifty-seventhHouse LegislatureEngrossed Healthpharmacists; & Human Services Second Regular Session H.B.

2444independent PROPOSEDtesting; HOUSE OF REPRESENTATIVES AMENDMENTS TO H.B.

treatment State of Arizona House of Representatives Fifty-seventh Legislature Second Regular Session HOUSE BILL 2444 (ReferenceAN toACT printedAMENDING bill)TITLE Amendment32, instructionCHAPTER key:18, ARTICLE 3, ARIZONA REVISED STATUTES, BY ADDING SECTIONS 32-1979.04, 32-1979.05 AND 32-1979.06;

[GREENRELATING UNDERLININGTO INTHE BRACKETS]ARIZONA indicatesSTATE textBOARD addedOF toPHARMACY. statute or previously enacted session law.

[Green(TEXT underliningOF inBILL brackets]BEGINS indicatesON textNEXT addedPAGE) to- newi session- lawH.B. or text restoring existing law.

[GREEN2444 STRIKEOUTBe INit BRACKETS]enacted indicatesby newthe textLegislature removedof fromthe statuteState orof previouslyArizona: enacted session law.

[Green strikeout in brackets] indicates text removed from existing statute, previously enacted session law or new session law.

<<Green carets>> indicate a section added to the bill.

<<Green strikeout in carets>> indicates a section removed from the bill.

The bill as proposed to be amended is reprinted as follows:

Title 32, chapter 18, article 3, Arizona Revised Statutes, is amended by adding sectionsections 32-1979.04, 32-1979.05 and 32-1979.06, to read:

notification and insurance requirements A.

A PHARMACIST MAY INDEPENDENTLY INITIATE TREATMENT TO ELIGIBLE PERSONS WHO ARE AT LEAST [SIX]TWELVE [TEN] YEARS OF AGE OR THE AGE AUTHORIZED BY THE TREATMENT, WHICHEVER AGE IS OLDER, AND WHO HAVE TEST RESULTS THAT INDICATE THE NEED FOR TREATMENT, BY A TEST THAT IS AUTHORIZED BY THE UNITED STATES FOOD AND DRUG ADMINISTRATION AND WAIVED UNDER THE CLINICAL LABORATORY IMPROVEMENT AMENDMENTS OF 1988, FOR ANY OF THE FOLLOWING:

[4.4.

HUMAN IMMUNODEFICIENCY VIRUS PREEXPOSURE PROPHYLAXIS OR POSTEXPOSURE PROPHYLAXIS.] [5.] [4.] A CONDITION RELATED TO AN EMERGING OR EXISTING PUBLIC HEALTH THREAT IDENTIFIED BY THE DEPARTMENT OF HEALTH SERVICES FOR WHICH A STATEWIDE STANDING ORDER, RULE OR EXECUTIVE ORDER IS ISSUED.

House2. Amendments to H.B.

2444 2.

ANY NECESSARY PHARMACIST TRAINING ORAND CERTIFICATION REQUIREMENTS.

D.- 1 - H.B.

A2444 PHARMACISTD. SHALL USE EVIDENCE-BASED CLINICAL GUIDELINES PUBLISHED BY THE UNITED STATES CENTERS FOR DISEASE CONTROL AND PREVENTION OR THE INFECTIOUS DISEASES SOCIETY OF AMERICA, THE AMERICAN ACADEMY OF PEDIATRICS COMMITTEE ON INFECTIOUS DISEASE OR ANOTHER CLINICALLY RECOGNIZED RECOMMENDATION IN PROVIDING PATIENT TREATMENT PURSUANT TO SUBSECTION A OF THIS SECTION.

A PHARMACIST SHALL USE EVIDENCE-BASED CLINICAL GUIDELINES PUBLISHED BY THE UNITED STATES CENTERS FOR DISEASE CONTROL AND PREVENTION OR THE INFECTIOUS DISEASES SOCIETY OF AMERICA, THE AMERICAN ACADEMY OF PEDIATRICS COMMITTEE ON INFECTIOUS DISEASE OR ANOTHER CLINICALLY RECOGNIZED RECOMMENDATION THAT ALIGNS WITH STANDARDS OF CARE IN PROVIDING PATIENT TREATMENT PURSUANT TO SUBSECTION A OF THIS SECTION.

MAINTAIN FOR AT LEAST SEVEN YEARS A RECORD OF THE RESULTS OF ANY TESTING OR SCREENING FOR WHICH A TREATMENT IS INITIATED PURSUANT TO THIS SECTION, INCLUDING A SUMMARY OF THE VISITVISIT, AND PATIENT ASSESSMENT INFORMATION, FORHISTORY AOF PERIODILLNESS, OFEXAMINATION SEVENFINDINGS, YEARS.VITALS AND PLAN OF CARE.

-2-3. House Amendments to H.B.

2444 3.

A PHARMACIST MAY NOT DELEGATE ANY TASKS THAT INCLUDE CLINICAL JUDGMENT- OR2 TREATMENT- ANDH.B. MAY DELEGATE ONLY ANCILLARY DUTIES AS ALLOWED BY BOARD RULES.

2444 JUDGMENT OR TREATMENT AND MAY DELEGATE ONLY ANCILLARY DUTIES AS ALLOWED BY BOARD RULES.

PURSUANT TO SECTION 32-1901.01, SUBSECTION A, PARAGRAPH 21, AN EMPLOYER MAY NOT OVERRULE A PHARMACIST'S DECISION TO NOT PROVIDE SERVICES THAT ARE AUTHORIZED BY THIS SECTION.

A PHARMACY SHALL EITHER DISPLAY A NOTICE ORAND INCLUDE IN A PATIENT'S CONSENT PAPERWORK THAT THE TESTING AND TREATMENT BEING PERFORMED PURSUANT TO THIS SECTION ARE BEING PERFORMED BY A PHARMACIST WITHOUT CONSULTATION WITH OR OVERSIGHT BY A PHYSICIAN AND THAT THE PATIENT SHOULD CONSULT WITH A PRIMARY CARE PROVIDER IF SYMPTOMS CONTINUE.

Sec.N.

2.A PHARMACIST SHALL MAINTAIN PROFESSIONAL LIABILITY INSURANCE IF PERFORMING SERVICES THAT ARE AUTHORIZED UNDER THIS SECTION.

32-1979.05.

members;members A.

delayedTHE repealBOARD A.SHALL ESTABLISH THE INDEPENDENT TESTING AND TREATMENT ADVISORY COMMITTEE TO ASSIST THE BOARD IN DEVELOPING THIS STATE'S WRITTEN PROTOCOLS RELATING TO PHARMACISTS' INDEPENDENT AUTHORITY TO ORDER TESTING AND INITIATE TREATMENTS PURSUANT TO SECTIONS 32-1979.04 AND 32-1979.06.

TheTHE ArizonaADVISORY stateCOMMITTEE boardSHALL ofALSO pharmacyMAKE shallRECOMMENDATIONS conveneTO anTHE advisoryBOARD committeeREGARDING toTHE assistPROTOCOLS theREQUIRED boardPURSUANT inTO developingTHAT thisSECTION. state's written protocols relating to pharmacists' independent authority to order testing and initiate treatments pursuant to section 32-1979.04, Arizona Revised Statutes, as added by this act.

The advisory committee shall also make recommendations to the Arizona state board of pharmacy regarding the protocols required pursuant to that section.

TheTHE advisoryADVISORY committeeCOMMITTEE shallSHALL includeINCLUDE atAT leastLEAST theTHE following:FOLLOWING:

TwoTWO pharmacistsPHARMACISTS whoWHO areARE licensedLICENSED pursuantPURSUANT toTO titleTHIS 32,CHAPTER chapterAND 18,WHO ArizonaARE RevisedAPPOINTED Statutes,BY andTHE whoBOARD. are appointed by the Arizona state board of pharmacy.

-3-2. House Amendments to H.B.

2444TWO 2.PHYSICIANS WHO ARE LICENSED PURSUANT TO THIS TITLE, ONE WHO SPECIALIZES IN PRIMARY CARE AND ONE WHO PRACTICES IN AN EMERGENCY MEDICINE SETTING, AND WHO ARE APPOINTED BY THE ARIZONA MEDICAL BOARD OR THE ARIZONA BOARD OF OSTEOPATHIC EXAMINERS IN MEDICINE AND SURGERY.

TwoAT physiciansLEAST whoONE areOF licensedTHESE pursuantMEMBERS toMUST titleHAVE 32,A chapterPATIENT 13POPULATION orTHAT 17,IS ArizonaSUBSTANTIALLY RevisedCOMPOSED Statutes,OF whoCHILDREN specializeAND inADOLESCENTS. primary care, at least one of whom has a patient population that is substantially composed of children and adolescents, and who are appointed by the Arizona medical board or the Arizona board of osteopathic examiners in medicine and surgery.