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HB770:  Pharmacy Technician Registration and Training

Click to Review Bill and History
Primary Sponsor: Rep. Anthony DeLuca (R-32)
House Co-Sponsorship Memoranda by Rep. DeLuca: Click HERE

Current Status: Referred to House Licensure Committee on March 11, 2019: Approved by committee on May 8. Approved by House on May 15. Referred to Senate Consumer Protection and Professional Licensure Committee; Chair Senator Tomlinson.
 
Key Provisions of Bill

  • Pharmacy Technicians will be registered by the PA Board of Pharmacy (SBOP)
    • A fee will be established for initial registration and renewal
    • Technicians will complete a criminal background check at the time of initial registration
  • New pharmacy technicians will be required to successfully complete an SBOP approved training programs based on regulations to be developed by the SBOP
    • Those working as pharmacy technicians in a licensed pharmacy for more than a year will not be required to complete the training program (they will be “grandfathered” as a registered pharmacy technicians)
  • Those training as pharmacy technicians will be designated as a trainee and will work under a permit until they have completed the training program and become registered with the SBOP
  • Pharmacy technicians are required to work under the direct and immediate supervisor of a licensed pharmacist. The bill states that "Direct and immediate personal supervision" means:
(i)  Review by the pharmacist of the prescription or drug order prior to dispensing.
(ii)  Verification by the pharmacist of the final product.
(iii)  Immediate availability of the pharmacist on the premises to direct the work of the supervised individual and to respond to questions or problems.
  • Applicants can be denied and a registration can be revoked based on criminal convictions and other criteria defined in the Act.

 
PSHP supports because:

  • Pennsylvania is one of only 3 states (per the Emily Jerry Foundation) that do not require registration or licensure and/or certification (usually PTCB) of pharmacy technicians.
  • When SBOP investigators investigate cases of drug diversion involving pharmacy techs, they have no legal authority to take action. Many pharmacy owners elect to fire these technicians instead of filing criminal charges. They then seek employment in other pharmacies.
  • Pharmacy technicians playing an increasingly important role in supporting pharmacists in the safe and timely preparation and dispensing of medications in all practice settings.
  • In hospitals and health systems the majority of compounded intravenous medications are prepared by pharmacy technicians. Most other medications dispensed with the support of information systems and technology involve participation by pharmacy technicians.
  • The growing complexity of medications and medication systems and related use of technology requires foundational education and training of pharmacy technicians to assure the accuracy of medication preparation and to minimize the risk of errors.
  • Actions by the SBOP to deny or revoke a technician’s registration will reduce the risk of hiring individuals with problematic work backgrounds.
  • ASHP has set a goal for each state to register or license pharmacy technicians as a key patient safety mandate.
  • HB 770 as proposed also has the support of PPA and PACDS.

 

Electronic Prescribing of Controlled Substance (EPCS)

The Pennsylvania Department of Health is going live with the mandatory implementation of electronic prescribing of controlled substances (Schedule II – V) effective October 24, 2019. Per Act 96 (passed into law in Oct of 2018), all practitioners must comply by electronically sending prescriptions for controlled substances directly to pharmacies.  There are exceptions for a patient, for example patients enrolled in a hospice program or residing in a nursing home or residential health care facility, periods of unplanned technology down time.  There is also ability for practitioners to apply for a waiver for delayed implementation, such as prescribers without an electronic medical record.    The Department of Health’s website (which was just update in Sept 2019) is a good source of specifics.  Additionally, an FAQ from the commonwealth is attached.  

The Board of Pharmacy is making it clear that pharmacists are not the regulators, and cannot deny filling a controlled substance to patients based solely to the presentation of a paper prescription.  It is expected for pharmacists to continue to scrutinize paper prescriptions for fraud, and act accordingly if fraud is suspected.  It is not expected for pharmacists to report prescriber or to request information as to if a prescriber has a waiver. 

The Department of Health intends to audit practitioners with administrative penalties of $100 per violation for the first – 10th violations and moving up to $250 per violation thereafter with a max of $5,000 per year.  However, this shall not be reported by the DOH to the practitioner’s appropriate licensing board and shall not be considered disciplinary action.

Department of Health Website on Electronic Prescribing of Controlled Substance (EPCS)


SB 978: The Hospice and Home Health Prescription Medication Disposal Act

Signed into law on June 22, 2018 by Governor Wolfe.

Became effective in 60 days.
Relevance: to health systems and pharmacy programs that have or work with hospice or home care programs / agencies. 

Bill highlights: 
“A home health agency or hospice is authorized, upon the death or discharge of a patient and with the permission of the patient or the patient's family member, caregiver or health care representative, to accept for disposal a patient's unused prescription medications that were prescribed, dispensed or otherwise used by the patient while under the care of the home health agency or hospice.”

Intent is to facilitate timely disposal of medications in the home of patients by a nurse employed by a home health agency or hospice. Key provisions are:

  • Provider must have policy to implement practice
  • Permission of caregiver or patient is required
  • A nurse employed must prepare a list of medications with quantity to be disposed
  • Medications must be disposed of in the home: transport from home is not permitted; a witness is required.
  • The method of disposal is not addressed
  • A copy of the disposal list must be provided to caregiver or patient

For complete SB 978: The Hospice and Home Health Prescription Medication Disposal Act: here.

 

Other Issues of Concern

BILLS THAT WERE NOT PASSED BEFORE THIS CURRENT SESSIONS ENDED (10/17), THUS THEY WOULD NEED TO BE REINTRODUCED IN 2019:

  • SB 780: Telemedicine Act
  • SB 418 (Reintroduced as SB 456): Pharmacy Technician and Pharmacy Trainee Requirements (Pharm Tech Registration)
  • HB 1987 Restrictions on Fentanyl Prescribing and Care Settings
  • SB655 Opioid Advisory Committee 

 

SB 780: Telemedicine Act

Primary Sponsor: Senator Vogel.

Introduced in June 2017, Passed by Senate in June 2018.
Referred to House Professional Licensure Committee on June 19, 2018, Report Bill as Amended 9/24/18, amendments including adding podiatrists and changing wording on insurance coverage, and defining what can be provided via telemedicine.  But removed from the table 9/25/18.

  • Pharmacists are included in the definition of “Provider” also known as “Health Care Provider” throughout the bill.
  • Providers that are licensed in Pennsylvania will be able to practice telemedicine as long as they follow the regulations developed by the corresponding licensure board.
  • Each board will be responsible to develop temporary regulations within 120 days after the proposed bill goes into effect and promulgate regulations for telemedicine within 24 months.
  • Providers must obtain informed consent from the patient.
  • Providers must administer an appropriate assessment when utilizing telemedicine services.
  • Providers may use interactive audio without video if used with store and forward.
  • A health insurer must reimburse a participating network provider the same amount as if the encounter was in person.
  • Services that would be covered by medical assistance if completed in person shall be covered if completed by telemedicine.

The current bill and its history can be found here

Important for pharmacists to be considered independent practitioners and not to have the state board structure this in terms of collaborative practice. An area where PSHP would need to make recommendations to the Board (after reviewing NABP documents related to telemedicine). Our main priority was to help support the Board of Pharmacy in addressing the requirement for temporary regulations to implement the bill. We are developing a statement for the board the differentiates “dispensing” telepharmacy that usually includes remote oversight of pharmacy technicians, remote verification of medication orders or prescriptions, or use of technology for drug dispensing vs drug therapy management via telepharmacy that involves direct engagement with patients and use of their medications which would be relevant for the telemedicine bill regulations. 

 

HB 1987 Restrictions on Fentanyl Prescribing and Care Settings

Primary Sponsor: Rep. Bryan Barbin (Cambria and Somerset Counties)

For complete bill information: here.

PSHP worked with HAP, PA Medical Society, the Emergency Medicine Group and directly with the Primary sponsor to amend this bills.  It still appears that if would have resulted in a documentation burden for the justification of use.

PSHP legislative group is happy it did not more forward this legislative session.

 

SB655 Opioid Advisory Committee 

Primary Sponsor Senator Yaw (Bradford, Lycoming, Sullivan, Susquehanna (part) and Union Counties). 
Referred to Senate Health and Human Services in May 2017; Re-referred to the Appropriations Committee September 2017.

Passed Senate and referred to the House Health Committee in June 2018, where is remained until session ended.
 
An Act amending the act of April 14, 1972 (P.L.233, No.64), known as The Controlled Substance, Drug, Device and Cosmetic Act, further providing for definitions, providing for Pennsylvania Safe Effective Opioid Prescribing Advisory Council and further providing for promulgation of regulations.
 
PSHP was successful in working directly with Senator Yaw to amending the bill to add one health system and one community pharmacist.

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