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Ohio News: Recent Legislation Affecting Pharmacy Practice
Published in the August 2007 Ohio State Board of Pharmacy Newsletter
The Ohio General Assembly has passed, and the governor has signed, some bills that will have an impact on the practice of pharmacy in Ohio. In addition, the General Assembly is also considering other bills that you may wish to review and comment on, since they also could greatly affect the way you practice.
Senate Bill (SB) 58 – Pharmacists – Signed by the Governor; Effective Date August 30, 2007
SB 58, introduced by Senator Kevin Coughlin, modifies the list of immunizations that pharmacists may administer to patients under a protocol with a physician. Currently, pharmacists are authorized by law to administer immunizations for influenza, pneumonia, tetanus, hepatitis A, and hepatitis B to patients at least 18 years of age. This bill changes the law by adding meningitis, diphtheria, and pertussis to the list of immunizations that pharmacists may administer. In addition, it lowers the age limit for pharmacist administration of influenza vaccine to 14 years of age with parental or guardian consent for those patients between the ages of 14 and 17 years old. The bill also allows pharmacists to administer epinephrine and diphenhydramine injections to patients in an emergency situation. Finally, the bill provides authorization for properly trained pharmacy interns to administer influenza immunizations to adults under the pharmacist’s direct supervision.
Please note: while the law has an effective date of August 30, 2007, the Board of Pharmacy still has to promulgate rules to implement the changes. By the time this Newsletter arrives, the rules should be posted on the Board’s Web site. Click on the “What’s New” box to locate the notice for the public hearing and all of the Board’s proposed new and changed rules. The public hearing will be held on September 10, 2007, during the Board’s September meeting. We hope to have the rules in effect on or before November 1, 2007, so interns can participate in this year’s influenza immunization program.
Senate Bill 33 – Acupuncture – Signed by theGovernor; Effective Date August 22, 2007
SB 33, introduced by Senator J. Kirk Schuring, deals primarily with acupuncture, which is certainly not a part of the practice of pharmacy. However, it also contained language relating to the Drug Repository Program that may be of interest to those nursing home pharmacies who have not yet started to participate. After discussions with several pharmacies who were not contributing returned drugs to the repository programs in their area, language was put in this bill that added increased liability protection for people who donate drugs to the program. If your pharmacy was not participating due to liability concerns, please review this change to the law and reconsider. It seems such a waste to destroy drugs that could be used for people who really need them but cannot afford them.
House Bill (HB) 99 – Epilepsy Treatment – Introduced –In Hearings
HB 99, introduced by Representative Michelle G. Schneider, and its companion bill SB 114, introduced by Senator Coughlin, have both been introduced but are still in the hearing process. These bills, as introduced, would require a pharmacist to obtain written authorization from the prescriber and the patient or caregiver before a generically equivalent drug used for epilepsy was dispensed. In other words, the pharmacist would be required to dispense the same manufacturer’s product that the patient was stabilized on unless the pharmacist first received written permission to change to a different manufacturer’s product. One would think that the current law regarding the substitution of generically equivalent products (§4729.38 ORC) would be enough since the prescriber has the ability to write “DAW” (dispense as written) along with the brand name or the generic name and the manufacturer. In addition, the patient has the right to refuse substitution. In either case, the insurance company does not have the legal right to mandate substitution. The patient may have to pay, but many patients with epilepsy would rather pay than switch manufacturers and potentially end up with seizures. Unfortunately, this bill relies totally on the pharmacist to ascertain the current product (if not already known) and then to receive permission before a change could be made. Interested parties should review the bill in its current form on the state of Ohio’s Web site. Hearings will probably continue in the fall.
HB 149 – Optometry– Introduced – In Hearings
HB 149, introduced by Representative David Daniels, contains changes to the laws regarding the practice of optometry. Of interest to pharmacists is that this bill will remove the written formulary of drugs that optometrists may prescribe. Instead, they will be limited to prescribing those drugs that are within an optometrist’s scope of practice. This is similar to the current situation with dentists and podiatrists, both of whom are limited practitioners. Pharmacists have always made good judgments when filling prescriptions written by dentists and podiatrists, so there should be no problems with pharmacists using the same good judgment with optometrists’ prescriptions. Of more importance, however, is that this bill would add Schedule III narcotic drugs to those drugs that optometrists would be able to prescribe. Currently, optometrists do not have the ability to prescribe controlled substances and, therefore, do not have Drug Enforcement Administration numbers. If this bill passes, that will change.
HB 253 – Nurses – Introduced – In Hearings
HB 253, introduced by Representative W. Scott Oelslager, would add Schedule II controlled substances to the drugs that may be prescribed by an advanced practice nurse (APN) with prescribing privileges. Currently, the only Schedule II substances that APNs may prescribe are opiates for a terminal patient that have been previously prescribed by the patient’s physician. The current law limits the quantity to a 24-hour supply. If this bill passes, APNs would be able to prescribe any Schedule II drug as long as the drug was approved for APN prescribing by the Ohio Board of Nursing’s Committee on Prescriptive Governance (CPG). This would also be subject to any quantity or time limits that the CPG saw fit to impose, if it chose to do so.
