25 minute read
Harding University: Looking Back
Looking Back, Looking Forward
I’ve heard it said that time seems to pass more quickly the older you get. Well, that’s certainly true for me these days. This past December marked my thirteenth year as a member of the Harding University College of Pharmacy (HUCOP). I can hardly believe it, but I can truly say that my time at HUCOP has been the pleasure of my professional life. Jeff Mercer, Pharm.D. Dean
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the number of APPEs required from 9 to 10 per student. In total, today’s students will spend upwards of 1900 hours in experiential and co-curricular learning settings outside of the classroom.
Other curricular plans are intended to address our students’ preparedness to enter the workforce. Beginning this summer, fourth-year students will enroll in a new 3-part course series entitled “Professional and Career Development.” These courses will run longitudinally alongside the APPE curriculum. Students will benefit from board exam preparation assessments, interpersonal development exercises, professional portfolio requirements, and various other professional and career development activities. This course series will directly engage students in career planning and goal setting as graduation approaches.
At the beginning of each new year, I take some time to reflect on the successes and opportunities of the past. This year seemed especially meaningful, and I want to express my appreciation to all who have been a part of Harding’s place in the world of pharmacy education. I’m thankful to be part of a college that is rooted in mission and community. I’m grateful for faculty and staff that come to work every day with a focus toward student-centered teaching. God has richly blessed us over these many years with a highly qualified faculty, capable students, and a bevy of preceptors, alumni, and friends that support our program in so many ways.
With each new year also comes the opportunity to look forward and set goals and objectives for where we are going. Our new HUCOP Strategic Plan began in 2019. Now a full year into that 5-year plan, we are already seeing the fruit of our work, especially in regard to student development and readiness for graduation and practice.
This year, we are implementing a number of curricular enhancements designed to increase student readiness for graduation. The most substantial changes involve our experiential curriculum, where we have expanded the breadth and depth of our introductory and advanced pharmacy practice experiences (IPPE and APPEs) to further complement classroom learning. Students are tasked in both operational and clinical aspects of community, institutional, and ambulatory care settings necessary for today’s advancing roles of contemporary pharmacy practice. Beginning Summer 2020, the fourth-year curriculum will expand to include an additional APPE requirement, bringing
These are among the more immediate enhancements that are occurring with our program at Harding, but they represent only a small portion of our overall plans for the future. On the horizon, new degree pathways and focused educational tracks will offer students more opportunities to diversify and personalize their pharmacy education. It’s all very exciting and promises to make 2020 a signature year for us. As I mentioned at the outset, the occasion of a new year brings about a time of reflection and planning for the future. Harding has been blessed with an established place in pharmacy education that allows us to serve our students and the profession of pharmacy. Knowing that has helped shape our new strategic plan in preparation for the future. A new decade is upon us, and perhaps it’s telling of my age, but my fourteenth year at Harding sure feels a lot like the first. I’m excited for what’s to come and wish you and your family a Happy New Year. §
Editorial Note: This article was written before the coronavirus pandemic and some information may have changed.
Challenges Facing HealthSystem Pharmacy
There are many challenges affecting health-system pharmacy and these challenges are not temporary. While these challenges affect our day to day operations within the walls of the pharmacy, the ultimate effect is on the patient. These challenges affect patients directly and indirectly. Drug shortages can delay care to a patient or cause them to get a different course of therapy than would have otherwise been prescribed. Drug diversions can affect supply but also the type of care a patient may be getting if the diversion affects the actions of the one providing or administering the medication. Drug utilization can be impacted by shortages or costs, and how we utilize the medications we have affects the patient and their outcomes. Three major challenges in healthsystem pharmacy are drug shortages, drug diversion, and drug utilization.
Drug Shortages:
This is often the most disruptive challenge we face as many times we don’t see it coming and we have to react quickly to meet the patients’ needs. While stockpiling or outsourcing the medication can make us feel more secure in getting through the shortage, these are not a fail proof way of surviving shortages. It is important that the healthsystem have plans and processes in place to address these shortages. The processes don’t just involve the pharmacy buyer but also informatics to help with redesigning the EMR during this time so that shortages can be communicated to the provider. Communication is key among several stakeholders in the process of getting the medication to the patients, including ordering providers, pharmacists verifying the order, pharmacy technicians fulfilling and delivering the mediation, and nursing staff administering the medication. drugs and high cost drugs. It’s important that a health-system have processes in place to receive and account for all medication coming into the facility and recognize purchasing and usage patterns. Technology is also a great tool in helping identify potential diversion, but don’t forget to also develop relationships with co-workers so that unusual behavior can be identified and investigated.
Drug Utilization:
Drug utilization is impacted by so many factors including prescribing trends, drug costs, and drug shortages. Having a systematic approach to identifying medications that need to be reviewed for utilization patterns is important in a health-system. One way of identification is using 80/20 reports from wholesalers to find high cost medications or high volume medications. Other strategies may be to look at the current drug shortages and analyze how the shortage is affecting utilization or simply reviewing the use of a medication after a certain time frame of it being added to the formulary. Whatever the challenge is, we need processes in place to help identify the extent of these challenges and to address the challenges. In each of these challenges, communication is key to all the stakeholders across the continuum of medication delivery to the patient: provider, pharmacist, pharmacy technician and nurse. I challenge each health-system in Arkansas to review what processes they have in place to address these challenges in the next year. § Editorial Note: This article was written before the coronavirus pandemic and some information may have changed.
Whatever the challenge is, we need processes in place to help identify the extent of these challenges and to address the challenges . In each of these challenges, communication is key to all the stakeholders across the continuum of medication delivery to the patient: provider, pharmacist, pharmacy technician and nurse. Erin Beth Hays, Pharm.D.
AAHP President
Drug Diversion:
Drug diversion can include controlled substances such as opioids and benzodiazepines. But it can also involve lifestyle
A Day in the Life of A Consultant Pharmacist
Pharmacy conversation frequently focuses on independent pharmacy, PBMs and academia. You don’t hear much about the consultant side of pharmacy. Fortunately, we do have the APA Consultants Academy and this journal space. Today, I want to share a typical day in the life of a consultant pharmacist. Coffee. I know I don’t have to elaborate on this one. Second up, checking email and phone messages from colleagues or client facilities. I could be working from home or on site today. Consulting used to be strictly on site. Every resident chart must be reviewed for irregularities and adherence to state and federal regulations. Gone were the achy legs from standing all day in retail. The trade-off was a sore neck and shoulders from lifting 70-80 heavy charts full of paperwork. And let’s not forget the sore thumbs from popping hundreds of pills out of blister packs in preparation for destruction. A typical day was usually around 8 hours but could easily stretch into 9 or 10 hours if narcotics were missing or documentation was questionable. Consulting has become more streamlined since the development of EHR technology. A consultant can log into any facility EHR at any time using an ID and Password via a secure portal. I am able to quickly run several reports that simplify my Drug Utilization Review (DUR). Navigating a resident record involves a few clicks here and there. It puts lab results and progress notes within easy access. The resident drug regimen is reviewed for accuracy, interactions and conformity to state and CMS regulations. Any discrepancy that requires immediate attention can be communicated to the Director of Nursing (DON) through instant messaging. I am able to monitor a mix of disease states including Diabetes, Heart Disease, Parkinson’s and Cancer. We also track antimicrobial stewardship and psychotropic drug use. It’s clinical pharmacy at its best! and destruction. Narcotic usage is closely scrutinized for count and documentation accuracy in order to prevent and detect diversion. The consultant pharmacist assists the facility in setting and maintaining policy and procedure when it comes to medication handling. An integral part of the monthly site visit is personal interaction with the staff and residents. Time spent with the DON and Administrator reviewing current findings is vital to maintaining solid relationships. And time spent visiting with the residents is rewarding beyond explanation. A monthly comprehensive report is sent to each facility addressing all findings from the DUR and site visit. Communication letters to the attending physician or APN are included that indicate matters of attention. These can range from lab and dosing recommendations to addressing drug interactions or contraindications. I have laid out just a snippet of what consulting is all about. There will be the occasional phone call from a facility when problems arise or state surveyors show up for an annual visit. Collaboration with fellow consultants is constant. We share novel ways of approach to solving old problems and collaborate on addressing ever changing rules and regulations. We assist other healthcare organizations and professionals in keeping up with changes in pharmacy. The recent Arkansas Nursing Home Nurses Association regional meeting focused totally on pharmacy updates. We were able to get Board approval for six live pharmacy credit hours. I hope many of you were able to attend! § I have long practiced pharmacy in retail, consulting and government. I have to say that consulting is my passion. It is a rewarding practice that I believe anyone with even a slight interest should look into as a full time or part time career. § Editorial Note: This article was written before the coronavirus pandemic and some information may have changed. We share novel ways of approach to solving old problems and collaborate on addressing ever changing rules and regulations. We assist other healthcare organizations and professionals in keeping up with changes in pharmacy. Denise Robertson, P.D.
Consulting Academy President
There are still aspects of consulting that require being on site. These include monitoring medication storage, administration
Updates from USP
On September 23, 2019, the
USP Expert Committee on Compounding announced that it would be postponing the updates to USP Chapters <795>, <797>, and the new chapter, <825>, indefinitely. This decision was based on the USP’s own bylaws and their appeals process, which allows those that had previously submitted appeals to request further review. What this essentially means is that the previous version of these chapters are in effect until further notice. In the case of <795> this means the last revision in 2014 is still in effect, and for <797> the 2008 version still applies. USP <825>, being a new chapter on Radiopharmaceuticals, does not apply, but instead the section in <797> on Radiopharmaceuticals is applicable. to the practice of compounding concerning these chapters. The Board has instead adopted a “wait and see” approach to the enforcement of USP <800> to allow the chapter to be implemented in other states and then determine the proper course of action for Arkansas. Even though these chapters have been delayed, a pharmacy may choose to early adopt them if they wish. At a minimum, a pharmacy should be aware of the differences in previous versions of chapters <795> and <797> and the revised versions. With regards to USP <800>, I would encourage you to implement what you can. Revisit your Risk Assessment. Think about your practice objectively and identify areas where employee safety can be improved. Update your SOPs to reflect these changes to your practice. Train your staff. Document the training. Revisit your Risk Assessment. Think about your practice objectively and identify areas where employee safety can be improved. Update your SOPs to reflect these changes to your practice. Train your staff. Document the training. Andrew Mize, Pharm.D. Compounding Academy President
You can download a copy of the previous versions for free at: http://go.usp.org/l/323321/2019-05-31/2dfgwl.
On December 16th, USP announced public hearing dates for the affected USP chapters. A hearing for USP <795> and <797> will be held on January 21st. The appeal for these chapters is with regards to the BUD provisions set forth in each respective chapter. A hearing for USP <825> will be held on January 22nd and will address the framework and BUD provisions within the chapter.
The appeals process has two potential outcomes: 1) the appeals are denied and a new implementation date is set a minimum of six months out or 2) the appeal(s) is/are granted and the applicable standards are referred back to the appropriate Expert Committee for further evaluation. This further review would also include additional stakeholder input.
Until the appeals process and subsequent steps are completed and the chapters are implemented, USP <800> is somewhat in the air as well. Since, there are no other USP chapters that reference <800> the chapter is informational and is not applicable as part of the compounding standards.
However, enforcement agencies such as the Arkansas State Board of Pharmacy, the FDA, and OSHA may make their own determinations on enforceability of USP <800> while <795> and <797> are being appealed. The State Board of Pharmacy has not adopted USP <800> or written any regulation changes The most that will change in the current review of <795> and <797> will be the BUDs, as nothing else is being appealed. Once these chapters are implemented, USP <800> will be applicable as well. Don’t continue to wait hoping that these issues will go away. They will not. Be proactive and make the changes necessary to improve your practice, the safety of your staff, and the health of your patients. §
Editorial Note: This article was written before the coronavirus pandemic and some information may have changed.
Why Do You Need A Will? It may not sound enticing, but creating a will puts power in your hands.
This series, Financial Forum, is presented by PRISM Wealth Advisors, LLC and your State Pharmacy Association through Pharmacy Marketing Group, Inc., a company dedicated to providing quality products and services to the pharmacy community.
According to the global analytics firm Gallup, only about 44% of Americans have created a will. This finding may not surprise you. After all, no one wants to be reminded of their mortality or dwell on what might happen upon their death, so writing a last will and testament is seldom prioritized on the to-do list of a Millennial or Gen Xer. What may surprise you, though, is the statistic cited by personal finance website The Balance: around 35% of Americans aged 65 and older lack wills. 1,2
A will is an instrument of power. By creating one, you gain control over the distribution of your assets. If you die without one, the state decides what becomes of your property, with no regard to your priorities. A will is a legal document by which an individual or a couple (known as “testator”) identifies their wishes regarding the distribution of their assets after death. A will can typically be broken down into four parts:
1. Executors: Most wills begin by naming an executor. Executors are responsible for carrying out the wishes outlined in a will. This involves assessing the value of the estate, gathering the assets, paying inheritance tax and other debts (if necessary), and distributing assets among beneficiaries. It is recommended that you name an alternate executor in case your first choice is unable to fulfill the obligation. Some families name multiple children as co-executors, with the intention of thwarting sibling discord, but this can introduce a logistical headache, as all the executors must act unanimously. 2,3
2. Guardians: A will allows you to designate a guardian for your minor children. The designated guardian you appoint must be able to assume the responsibility. For many people, this is the most important part of a will. If you die without naming a guardian, the courts will decide who takes care of your children.
3. Gifts: This section enables you to identify people or organizations to whom you wish to give gifts of money or specific possessions, such as jewelry or a car. You can also specify conditional gifts, such as a sum of money to a young daughter, but only when she reaches a certain age.
4. Estate: Your estate encompasses everything you own, including real property, financial investments, cash, and personal possessions. Once you have identified specific gifts you would like to distribute, you can apportion the rest of your estate in equal shares among your heirs, or you can split it into percentages. For example, you may decide to give 45% each to two children and the remaining 10% to your sibling.
A do-it-yourself will may be acceptable, but it may not be advisable. The law does not require a will to be drawn up by a professional, so you could create your own will, with or without using a template. If you make a mistake, however, you will not be around to correct it. When you draft a will, consider enlisting the help of a legal, tax, or financial professional who could offer you additional insight, especially if you have a large estate or a complex family situation.
Remember, a will puts power in your hands. You have worked hard to create a legacy for your loved ones. You deserve to decide how that legacy is sustained. §
Citations 1 - https://news.gallup.com/poll/191651/majority-not.aspx [4/24/18] 2 - https://www.thebalance.com/wills-4073967 [4/24/18] 3 - https://www.nolo.com/legal-encyclopedia/naming-more-oneexecutor.html [12/3/18] ________________________________________________________________ Pat Reding and Bo Schnurr may be reached at 800-288-6669 or pbh@ berthelrep.com. Registered Representative of and securities and investment advisory services offered through Berthel Fisher & Company Financial Services, Inc. Member FINRA/SIPC. PRISM Wealth Advisors LLC is independent of Berthel Fisher & Company Financial Services Inc.
This material was prepared by MarketingLibrary.Net Inc., and does not necessarily represent the views of the presenting party, nor their affiliates. All information is believed to be from reliable sources; however we make no representation as to its completeness or accuracy. Please note - investing involves risk, and past performance is no guarantee of future results. The publisher is not engaged in rendering legal, accounting or other professional services. If assistance is needed, the reader is advised to engage the services of a competent professional. This information should not be construed as investment, tax or legal advice and may not be relied on for the purpose of avoiding any Federal tax penalty. This is neither a solicitation nor recommendation to purchase or sell any investment or insurance product or service, and should not be relied upon as such. All indices are unmanaged and are not illustrative of any particular investment
2020 APA Convention Update
STAFF SPOTLIGHT: ELISABETH MATHEWS
As we are all aware, the past weeks have brought massive changes to pharmacists and patients throughout the country. Just as we all adjust to these changes as a profession, the Arkansas Pharmacists Association is making adjustments based on the recommendations of Governor Asa Hutchinson, President Donald Trump, and the federal COVID-19 Task Force.
WWW.ARRX.ORG 31 Due to the imminence of the upcoming APA Annual Convention and the many questions surrounding COVID projections, APA staff is postponing an in-person convention to a date in early fall, with more details to come. In the meantime and in addition to the fall convention, APA will be offering a one day virtual conference with an expected eight hours of CE offered. The CE will be a live teleconference, but will also be recorded and made available to complete at your own pace. During this difficult time, APA is committed to being as flexible as we need to be to help our members complete their CE requirements.
Each year APA encourages members to submit the names of individuals who are deserving of special recognition for their professional activities during the past year. Any active APA member is eligible to nominate a person for the awards. Award recipients are chosen by an APA committee following a review of all nominees. Nominations are now being accepted for the following annual awards to be presented by the Association. Check APA InteRxActions email for details on the
closing date for nominations.
AWARD NOMINATIONS
To submit your nominations online, visit www.arrx.org/2020-awards. Alternatively, you can fax (501-372-0546) or email (awards@arrx.org) this written nomination form and any supporting materials. Please mark your nomination with an X. If you have more than one nomination, please feel free to copy this form.
Pharmacist of the Year _______
The Pharmacist of the Year Award was established in 1959 to honor an individual who “should possess professional standards beyond reproach, a record of outstanding civic service in the community, and as a member of the APA, who has contributed efforts toward the progress of the association.” Some previous recipients include: 2019 Duane Jones, Siloam Springs 2018 David Smith, Conway 2017 Laura Lumsden, Little Rock 2016 Keith Larkin, Fort Smith 2015 Wayne Padgett, Glenwood 2014 Michelle Crouse, Lake Village
Bowl of Hygeia Community Service Award _______
In 1958 E. Claiborne Robbins of the A.H. Robbins Company established the Bowl of Hygeia Award. The purpose of the award is to encourage pharmacists to take active roles in the affairs of their respective communities. Some previous recipients include: 2019 Max Caldwell, Wynne 2018 Cissy Clark, Earle 2017 Sue Frank, Little Rock 2016 Jon Wolfe, Little Rock 2015 Nicki Hilliard, Little Rock 2014 Eric Shoffner, Newport
The nominee must have an entry degree in Pharmacy, received nine or fewer years ago, and be a member of the APA. Nominee must be in the active practice of pharmacy in the year selected, and actively involved in the profession of pharmacy, displaying an interest in the future of the profession. Some previous recipients include: 2019 Brandon Achor, Sherwood 2018 Greta Ishmael, Cherokee Village 2017 Joshua Bright, Harrison 2016 Kevin Barton, Centerton 2015 Rachel Stafford, North Little Rock 2014 Stephen Carroll, Arkadelphia
This award was established in 1993 by the APA in cooperation with the National Council of State Pharmacy Associations and DuPont Pharmaceuticals to recognize, annually, a pharmacist who has demonstrated a prominent spirit of innovation and entrepreneurship in the practice of pharmacy. Some previous recipients include: 2019 Jett Jones, Jonesboro 2018 Whitney Bussell, Little Rock 2017 Jody Smotherman, Batesville 2016 Nikki Scott, Russellville 2015 Taylor Franklin, Fort Smith 2014 Marcus Costner, Fayetteville
This award was established in 1993 by the APA in cooperation with the National Council of State Pharmacy Associations and DuPont Pharmaceuticals to recognize, annually, a pharmacist who has demonstrated a prominent spirit of innovation and entrepreneurship in the practice of pharmacy. Some previous recipients include: 2019 Jett Jones, Jonesboro 2018 Whitney Bussell, Little Rock 2017 Jody Smotherman, Batesville 2016 Nikki Scott, Russellville 2015 Taylor Franklin, Fort Smith 2014 Marcus Costner, Fayetteville
Guy Newcomb Award _______
The APA Board of Directors created this award in 1997 to recognize individuals who, by their legislative influence and leadership, have distinguished themselves as political friends of Arkansas pharmacy. This award is named in memory of Dr. Guy Newcomb of Osceola. Dr. Newcomb was a pharmacy leader who understood, appreciated, and enthusiastically participated in the political process. Some previous recipients include: 2019 Kim Hammer, Benton 2018 Governor Asa Hutchinson, Little Rock 2017 Senator Jason Rapert, Conway & Representative Clint Penzo, Springdale 2016 Senator Ron Caldwell, Wynne & Representative Michelle Gray, Melbourne 2011 Johnny Key, State Senator, Mountain Home
Percy Malone Public Service Award _______
This award was established in 2009 by the Arkansas Pharmacists Association in honor of former state senator Percy Malone, P.D. The recipient must have made a contribution to public service by being elected to any public office and by displaying an interest in the people of Arkansas. Some previous recipients include: 2017 Representative Justin Boyd, Fort Smith 2016 Representative Justin Boyd, Fort Smith 2015 Lenora Newsome, Smackover 2011 Gene Boeckmann, Wynne 2009 Percy Malone, Arkadelphia
Friend of Pharmacy Award _______
This award honors someone that does not serve as a pharmacist but is a champion to the pharmacist community. Previous recipients include: 2019 Senator Jason Rapert & Dr. Jennifer Dillaha
Name of Nominee
_____________________________________________________________________________________________
Address
______________________________________________________________________________________________________
City/State/Zip ________________________________________________________________________________________________
Phone
________________________________________________________________________________________________________
Reasons for selecting nominee: Attach one page with description of reasons and/or the individual nominee’s resume.
Nominator’s Name: _____________________________________ Phone____________________________ Date______________
Take advantage of the opportunity to give back by serving on the Arkansas State Board of Pharmacy or the APA Board of Directors. We are seeking nominations for enthusiastic and energetic individuals who want to make an important contribution to the pharmacy profession. APA’s Board of Directors is made up of 12 representatives spread out over five regions, including two at-large representatives. Each regional representative will serve a three-year term. For questions about term lengths, please contact Susannah Fuquay at 501-372-5250. APA Board membership requires the flexibility to meet in Little Rock four times per year for Board meetings and to participate in three to four conference calls per year.
APA Board of Directors Call for Nominations
Nominations are invited for each of the following positions on the Arkansas Pharmacists Association Board of Directors. Brief job descriptions follow.
Vice President of APA (One Open Seat) Statewide (Serves four one-year terms as Vice President, President-Elect, President, and Past President, four total years as Board Member) • Attends all board and executive committee meetings • Serves on the executive committee • Assumes responsibilities of the chair in the absence of the board president or president-elect • Participates as a vital part of the board leadership
Regional Representatives
• Attends all board meetings and conducts the affairs of the association • Maintains knowledge of the organization and personal commitment to its goals and objectives • Appoints an executive committee and other committees and delegates to the executive committee power and authority of the board of directors in the management of the affairs of the association • Recruits new members; participates in APA membership drives
Region 1 – Northwest Arkansas: One Open Seat Northwest Counties: Benton, Boone, Carroll, Conway, Crawford, Faulkner, Franklin, Johnson, Logan, Madison, Marion, Newton, Pope, Searcy, Sebastian, Van Buren, Washington
Region 4 – Southwest Arkansas: No Open Seats Southwest Counties: Clark, Columbia, Garland, Hempstead, Hot Spring, Howard, Lafayette, Little River, Miller, Montgomery, Nevada, Ouachita, Perry, Pike, Polk, Scott, Sevier, Yell
Region 2 – Northeast Arkansas: One Open Seat Northeast Counties: Baxter, Clay, Cleburne, Craighead, Crittenden, Cross, Fulton, Greene, Independence, Izard, Jackson, Lawrence, Mississippi, Poinsett, Randolph, Sharp, Stone, White, Woodruff
Region 3 – Central Arkansas: One Open Seat Central Counties: Pulaski, Saline
Region 5 – Southeast Arkansas: One Open Seat Southeast Counties: Arkansas, Ashley, Bradley, Calhoun, Chicot, Cleveland, Dallas, Desha, Drew, Grant, Jefferson, Lee, Lincoln, Lonoke, Monroe, Phillips, Prairie, St Francis, Union
At-Large Representatives: No Open Seats
APA Officers and Board of Directors
The requirements for nominees of the APA Officers are as follows: Arkansas licensed pharmacist who has been a member of this Association in good standing for the past three (3) consecutive years. Board Members shall be limited to six (6) consecutive years as a Regional Representative, or six (6) consecutive years as an At-Large Representative. No member of the Board of Directors shall serve more than nine (9) years on the Board of Directors in any non-Executive Committee capacity.
Reimbursement- Members of the Board of Directors don’t receive compensation but can be reimbursed for reasonable direct and indirect expenses related to attending meetings such as mileage and/or hotel costs. Board members receive a discount on annual convention registration. Board members who are on the program at Regional Meetings (president, regional representative) do not pay registration fees..
Removal from office- Directors may be removed for being absent without reasonable cause from any two consecutive meetings or any three meetings during a 12-month period. Meeting dates for 2020-2021 are likely to be:
• Late July / Early August (Thursday afternoon, all day Friday, Saturday 8 a.m. to 12 p.m.) • December 5, 2020 (Saturday 9 a.m. to 6 p.m.) in Little Rock • March 2021 (Sunday 9 a.m. to 4 p.m.) in Little Rock • APA Annual Convention Board Meeting, June 2021 (Wednesday a.m. before convention)
