ISSUE: Should local governments regulate the operation and practice of pharmacies.

DISCUSSION: In the past several years, Florida has struggled with the growing problem of prescription drug abuse and trafficking. In the 2011 Legislative Session, a sweeping reform bill was passed bringing stricter regulation to the entire prescription drug industry. From manufacturers, to distributors, to community pharmacies, controlled substances will be tracked and reported into the Prescription Drug Monitoring Program. Additionally, physicians will no longer be able to dispense controlled substances. With all of the reforms that were implemented at the State level, Florida will begin to see a drastic drop in the illicit pill mill industry. During the time that the legislature was struggling with exactly how to address the problem, local governments were becoming desperate to control this very real threat to their communities. They began to pass strict local ordinances in an effort to mitigate the problem, and understandably so. However, now that there is very strict regulation from the state, these local ordinances may not only be unnecessary, they may be in conflict with the state regulation. Because the practice of healthcare already operates in a highly regulated environment, streamlining is crucial to ensuring compliance; there should be one ultimate authority responsible for the regulation of pharmacy and pharmacists.

POSITION: The Florida Retail Federation supports restricting the regulation of the practice of pharmacy to the state level. The Florida Board of Pharmacy, which operates under the Department of Health, is best equipped to oversee regulatory issues related to the practice of pharmacy.

ISSUE: Should pharmacists be given expanded authority to provide vaccinations for shingles and pneumonia to senior citizens.

DISCUSSION: Florida is one of only 4 states that do not allow pharmacists to administer a wide range of vaccinations. In fact, across the border into Alabama, pharmacists can administer a number of different vaccinations to patients as young as nine years of age. Vaccinations are a simple service that can be provided safely by a pharmacist, expanding low cost preventive health care to a large segment of Florida’s population. Since pharmacists were allowed to begin administering the influenza immunization in 2008, they have provided vaccinations for approximately 3 million patients with the Department of Health reporting NO adverse incidents. If we allow pharmacists the expanded authority to provide immunizations for shingles and pneumonia, Florida’s 65 and older population will have an additional resource for low cost health care.

POSITION: The Florida Retail Federation supports expanded vaccination authority for pharmacists.

RELATED BILLS
HB 509 Relating to Pharmacists, Rivas-Logan
SB 850 Relating to Pharmacy, Oelrich

UPDATES

1/27/12
Currently in the State of Florida, specially trained and certified pharmacists are authorized to administer the influenza immunization. On Wednesday, legislation which would allow immunizing pharmacists to also administer vaccinations for Shingles and Pneumonia was heard in its first committees of reference in both the House and the Senate.

HB 509 by Representative Ana Rivas-Logan was heard in the House Health Quality Subcommittee. Special thanks to John Hickman, an immunizing pharmacist with Walgreen's, for giving a presentation before the committee on the requirements for training, assessing patients, administering the shot, and patient follow-up. We are also very appreciative of the efforts of Committee Chair John Wood and Representative Matt Hudson for their advocacy on this important issue. The bill passed out of committee by a vote of 10 to 5. We do expect the bill to be heard in its next committee, Health Care Appropriations, next Wednesday.

SB 850 by Senator Steve Oelrich was heard in the Senate Health Regulation Committee. The bill met with quite a bit of resistance and it had two unfriendly amendments put on it in the end. However, we are in discussions with the Florida Medical Association, the chief opponents of the legislation, to strike a compromise palatable to both the doctors and the pharmacies.

2/3/12
HB 509 by Rep Rivas Logan is expected to be on the House Health Care Committee agenda next Tuesday. We have spent the week working with the Florida Medical Association on their concerns regarding increasing the types of vaccinations administered by pharmacists. We were able to come to an agreement with them which will allow pharmacists to begin administering the pneumonia vaccine without a prescription; and administer the shingles vaccine with a prescription. Additionally, the amended language provides for the medical association to provide continuing education credits for immunizing pharmacists.

The senate companion, SB 850 by Sen. Oelrich, after being amended in the Senate Health Regulation Committee, did receive an additional committee assignment this week. It now has two more stops prior to going to the Senate floor. This was almost certainly a maneuver to ensure that there would be an agreement reached between us and the FMA. We are confident that it will swiftly move through the committees now that a deal has, in fact, been reached.

2/10/12
This week legislation, which will expand the types of vaccinations that can be administered by a pharmacist had two more hearings. On Tuesday HB 509, by Rep. Rivas-Logan, passed out of the House Health and Human Services Committee on a 16 to 1 vote. The lone dissenting vote was cast by Rep. Renuart, who remains staunchly opposed to the bill. That was the last committee stop for the House Bill and we will now focus on getting it on the Special Order Calendar to be heard on the House Floor.

On Thursday the Senate Companion, SB 850 by Sen. Oelrich, passed out of the Senate Health and Human Services Appropriations Committee. This bill still has one final committee reference, the Budget Committee. Because it has no obvious fiscal impact, we are working with Senate Leadership to get that committee reference removed. We would like to see both Chambers pass the legislation within the next two weeks, before the annual legislative logjam occurs.

2/17/12
Late on Thursday afternoon, the House took up HB 509, by Rep. Ana Rivas Logan. This bill expands the types of vaccinations which may be administered by a pharmacist. Currently, pharmacists in Florida are only authorized to give the flu shot. Under HB 509, pharmacists would also be able to administer a pneumonia vaccination to patients 18 and older, and a shingles vaccination to adult patients with a physician prescription. Additionally, the bill requires that immunizing pharmacists take 3 credit hours of continuing education in a course on vaccination safety. The Senate bill, SB 850, by Sen. Steve Oelrich, has one more committee of reference prior to being heard on the Senate Floor. We are working with Senate Leadership to have that committee reference removed so that the bill can move on to the floor and receive a final vote.

ISSUE: Should State Employees be required to use mail order to fill their maintenance prescription medications.

DISCUSSION: Last year, Florida adopted a policy which forces state employees to obtain their maintenance medications through mail order in an effort to control the costs associated with prescription drug plans. However, because of the competitive environment of retail pharmacy, it is doubtful that mail order plans offer a significant savings to the consumer; particularly when a retail pharmacy location can dispense a 90-day supply of medications at the same cost. Furthermore, it is clear that mandating the use of mail order pharmacy robs patients of vital interaction with their local community pharmacist. These highly trained experts provide guidance to patients on appropriate use of medications and offer a range of patient-oriented services to maximize a medication’s effectiveness.

POSITION: The Florida Retail Federation supports convenient, cost-effective access to prescription medications by authorizing Rep. Denise Grimsley (R-Sebring), Chairwoman of the House Appropriations Committee, and FRF President/CEO Rick McAllister share a laugh at the Capitol. FRF Issues Guide 2012final.indd 9 11/29/11 9:58 PM pharmacies to dispense 90-day maintenance prescription medications to State Employees.