June 2009 Florida Pharmacy Journal by Florida Pharmacy Today

JUNE 2009

Pharmacist Legislative Days and Health Fair

Buyer’s Guide florida PHARMACY TODAY

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PHARMACY CONSULTANTS HCC Pharmacy Business Solutions Bob Miller (800) 642-1652 Hayslip and Zost Pharmacy Brokers LLC (713) 829-7570 (727) 415-3659

TEMPORARY PHARMACISTs – STAFFING HealthCare Consultants Pharmacy Staffing Bob Miller (800) 642-1652 Medical Staffing Network (800) 359-1234

INSURANCE Meadowbrook Workers Comp Insurance Endorsed by FPA (800) 825-9489

Rx Relief (800) RXRELIEF PharmacyMax Inc. Professional Staffing Solutions (800) 889-8737

LEGAL ASSISTANCE Kahan ◆ Shir, P.L. Brian A. Kahan, R.Ph., and Attorney at Law (561) 999-5999 Kenneth J. Metzger Attorney at Law (850) 681-0847

FREQUENTLY CALLED NUMBERS AHCA MEDICAID PHARMACY SERVICES 2727 Mahan Drive Tallahassee, FL 32308 (850) 487-4441 www.fdhc.state.fl.us/medicaid/ pharmacy AMERICAN PHARMACISTS ASSOCIATION (APhA) Washington, D.C. (800) 237-2742 www.aphanet.org AMERICAN SOCIETY OF HEALTH SYSTEM PHARMACISTS Bethesda, MD (301) 657-3000 www.ashp.com/main.htm Drug Information Center Palm Beach Atlantic University (561) 803-2728 druginfocenter@pba.edu DRUG INFORMATION CENTER Florida A&M University College of Pharmacy (800) 451-3181 UF College of Pharmacy Gainesville, FL (352) 395-0408 www.cop.ufl.edu/vdis FLORIDA BOARD OF PHARMACY 4052 Bald Cypress Way Bin #C04 Tallahassee, FL 32399-3254 (850) 245-4292 www.doh.state.fl.us/mqa FLORIDA POISON INFORMATION CENTER NETWORK 1-800-282-3171 http://ora.umc.ufl.edu/ pcc/fpicjax.htm National Community Pharmacists Association 100 Daingerfield Road Alexandria, VA 22314 703.683.8200 703.683.3619 fax info@ncpanet.org

Advertising in Florida Pharmacy Today Display Advertising: please call (850) 264-5111 for a media kit and rate sheet. Buyers’ Guide: A signed insertion of at least 3X per year, 1/3 page or larger display ad, earns a placement in the Buyers’ Guide. A screened ad is furnished at additional cost to the advertiser. Professional Referral Ads: FPA Members: $50 per 50 words; Non‑members: $100 per 50 words; No discounts for advertising agencies. All Professional Referral ads must be paid in advance, at the time of ad receipt. 2 |

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Recovering Pharmacists Network of Florida (407) 257-6606 “Pharmacists Helping Pharmacists”

florida PHARMACY TODAY Departments 2 Buyer’s Guide 4 Calendar 4 Advertisers 5 President’s Viewpoint 7 Executive Insight

VOL. 72 | NO. 6 JUNE 2009 the official publication of the florida pharmacy association

Features

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A Team Effort Key representatives of pharmacy profession ensure success of Pharmacist Legislative Days and Health Fair

Swine Flu: A Pandemic Is Declared FPA 119th Meeting & Convention

JUNE 2009

FPA Calendar 2009

JUNE 19-22 AACP Annual meeting Boston, Massachusetts JULY 3

FPA Office Closed for Independence Day

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FPA Annual Meeting St. Augustine, Florida

18-22 AACP Annual Meeting Boston, Massachusetts 30

FPA Legislative Committee Meeting (Tentative) Orlando

30-8/2 FSHP Annual meeting

August 9-12 Southeastern Education Gatherin Villages at Baytowne Wharf

Mission Statements: of the Florida Pharmacy Today Journal The Florida Pharmacy Today Journal is a peer reviewed journal which serves as a

11-12 Board of Pharmacy Meeting Orlando

medium through which the Florida Phar-

14-16 Southeastern Officer's Conference Sandestin, Florida

the profession on advances in the sciences of

29-30 FPA Committee and Council Meetings Orlando

to the profession. As a self-supported journal,

macy Association can communicate with pharmacy, socio-economic issues bearing on pharmacy and newsworthy items of interest it solicits and accepts advertising congruent with its expressed mission.

September 7 Labor Day, FPA Office closed 12-13 Law and Regulatory Conference Hyatt Regency Bonaventure, Weston, Florida 20 - 27 Florida Pharmacy Association CE at SEA Port of Canaveral, Florida

of the Florida Pharmacy Today Board of Directors The mission of the Florida Pharmacy Today Board of Directors is to serve in an advisory capacity to the managing editor and executive editor of the Florida Pharmacy Today

Journal in the establishment and interpretation of the Journal’s policies and the management of the Journal’s fiscal responsibilities. The Board of Directors also serves to motivate the Florida Pharmacy Association members

For a complete calendar of events go to www.pharmview.com CE CREDITS (CE cycle) The Florida Board of Pharmacy requires 10 hours LIVE Continuing Education as part of the required 30 hours general education needed every license renewal period. Pharmacists should have satisfied all continuing education requirements for this biennial period by September 30, 2009 or prior to licensure renewal. *For Pharmacy Technician Certification Board Application, Exam Information and Study materials, please contact Ranada Simmons in the FPA office. For More Information on CE Programs or Events: Contact the Florida Pharmacy Association at (850) 222-2400 or visit our Web site at www.pharmview.com CONTACTS FPA — Michael Jackson (850) 222-2400 FSHP — Michael McQuone (850) 906-9333 U/F — Dan Robinson (352) 273-6240 FAMU — Leola Cleveland (850) 599-3301 NSU — Carsten Evans (954) 262-1300 DISCLAIMER Articles in this publication are designed to provide accurate and authoritative information with respect to the subject matter covered. This information is provided with the understanding that neither Florida Pharmacy Today nor the Florida Pharmacy Association are engaged in rendering legal or other professional services through this publication. If expert assistance or legal advice is required, the services of a competent professional should be sought. The use of all medications or other pharmaceutical products should be used according to the recommendations of the manufacturers. Information provided by the maker of the product should always be consulted before use.

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to secure appropriate advertising to assist the

Journal in its goal of self-support.

Advertisers HAYSLIP & ZOST............................................. 10 Healthcare consultants..................... 3 Kahan ◆ SHIR, P.L......................................... 12 MEDICAL STAFFING...................................... 14 PHARMACY PROVIDER SERVICES (PPSC)........................................ 15 Rx RElief.......................................................... 12 University of Florida............................ 10

E-mail your suggestions/ideas to dave@fiorecommunications.com

The President’s Viewpoint By Ayala Fishel MS, PharmD, Cph, GUEST COLUMNIST

Safe Medication Disposal

s pharmacists, we are always concerned about proper medication administration and commonly ignore the issue of safe medication disposal. Each year, enormous quantities of unused and expired medications are dumped into recycling bins or flushed down toilets and sinks. While the concentrations of these medications are so small they have to be measured in parts-per-billion or even part-per-trillion, some water companies insist these levels are within safety limits. Despite the chemical levels being low, they can still be sufficient enough to cause harmful effects on our health and the environment. Water companies treat the waste before discharging it into local rivers, lakes and reservoirs, and then treat it again before it enters the drinking water system. However, the various treatments don't remove all traces of drugs. For example, investigators discovered that drugs have been found in the drinking water of 24 major metropolitan areas across the country. Here are some of the key findings: ■■ Southern California: A portion of drinking water that supplies 18.5 million people contained traces of anti-epileptic and anti-anxiety drugs. ■■ Philadelphia: Treated drinking water contained 56 drugs or byproducts, including pharmaceuticals for pain, infection, cholesterol control, heart conditions, and asthma. ■■ San Francisco: A sex hormone was detected in the drinking water. ■■ Washington DC: Six drugs were found in the drinking water supply of the capital and surrounding area. ■■ Tucson, Arizona: An antibiotic and two other medications were found in the drinking water. ■■ Northern New Jersey: Drinking wa-

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ter for 850,000 residents was found to contain carbamazepine, a mood stabilizer, and a metabolized byproduct of angina medication. This was found by US Geological Survey researchers who analyzed a treatment plant. It also is noted by researchers that even aquifers, deep underground water systems that supply 40 percent of the US water demand, are affected.

The U.S. Food and Drug Administration (FDA) and the White House Office of National Drug Control Policy issued the following guidelines in 2007 for the proper disposal of prescription medications: ■■ Follow any specific disposal instructions on the drug label or patient information that accompanies the medication. Do not flush prescription drugs down the toilet unless this information specifically instructs you to do so. ■■ If no instructions are given, throw the drugs in the household trash, but first, remove the drugs from their original containers and mix them with an undesirable substance, such as used coffee grounds or kitty litter. The medication will be less appealing to children and pets, and unrecognizable to people who intentionally may go through your trash. ■■ Put the drugs (or the mixture of drugs with an undesirable substance) in a sealable bag, empty can, or other container to prevent the medication from leaking or breaking out of a garbage bag. ■■ Take advantage of community drug take-back programs that allow the public to bring unused drugs to a

Ayala FIshel MS, Pharm D., CPH

central location for proper disposal. Call your city or county government's household trash and recycling service (see the blue pages in a phone book) to determine if a takeback program is available in your community. The government recommends that the following drugs be flushed down the toilet instead of thrown in the trash: Actiq (fentanyl citrate), Avinza Capsules (morphine sulfate), Baraclude Tablets (entecavir), Daytrana Transdermal Patch (methylphenidate), Duragesic Transdermal System (fentanyl), Fentora (fentanyl buccal tablet), Meperidine HCl Tablets, OxyContin Tablets (oxycodone), Percocet (Oxycodone and Acetaminophen), Reyataz Capsules (atazanavir sulfate), Tequin Tablets (gatifloxacin), Xyrem (Sodium Oxybate), Zerit for Oral Solution (stavudine). The goal is to reduce the danger of unintentional use or overdose and illegal abuse. Florida is one of the states that disagrees with the federal recommendaJUNE 2009

2008/2009 FPA Board of Directors The Florida Pharmacy Association gratefully acknowledges the hard work and dedication of the following members of the FPA leadership who work deligently all year long on behalf of our members.

Don Bergemann......................................Chairman of the Board of Directors Norman Tomaka.........................................................................................FPA President Karen Whalen............................................................................................ President Elect Michael Moné...........................................................................................................Treasurer Suzanne Kelley.........................................Speaker of the House of Delegates Alexander Pytlarz......................................................................................Speaker Elect Preston McDonald............................................................................. Director Region 1 Marcus Dodd-o ..................................................................................Director Region 2 Al Tower, Director ..................................................................................................Region 3 Raul N. Correa, Interim Director ................................................................Region 4 John Noriega, Director ......................................................................................Region 5 Chris Lent Director................................................................................................Region 6 Kim Murray (Interim Director)....................................................................... Region 7 Joy Marcus............................................................................................Director Region 8 Ayala Fishel............................................................................................Director Region 9 Richard Montgomery.......................................................................... President FSHP Michael Jackson........................................Executive Vice President and CEO

Florida Pharmacy Today Journal Board Chairman............................................................ Dick Witas, witas@moffitt.usf.edu Treasurer....................Stephen Grabowski, sgrabowski@seniormmc.com Secretary...................................................................Stuart Ulrich, Stuarx@aol.com Member.......................................................... Betty Harris, beejpharm@gmail.com Member.................................................Joseph Koptowsky, docjik1215@aol.com Member...............................................Jennifer Pytlarz, jlc_rxdoc@hotmail.com Executive Editor................Michael Jackson, mjackson@pharmview.com Managing Editor...................Dave Fiore, dave@fiorecommunications.com

tion. The Florida Department of Environmental Protection states that, “Although this method of disposal prevents immediate accidental ingestion, it can cause contamination in our aquatic environment because wastewater treatment systems, including septic tanks, are not designed to remove many of these medications.” Instead, this Florida agency outlines a step-by-step method for the safe disposal of all prescription and over-the-counter medications: ■■ Keep the medicines in the original container. This will help identify the contents if they are accidentally ingested. ■■ Remove your name and prescription number to safeguard your identity. ■■ For pills, add some water or soda to start dissolving them. ■■ For liquids, add something inedible like cat litter, dirt or cayenne pepper. ■■ Close the lid and secure with duct tape or packing tape. ■■ Place the bottle(s) inside an opaque (non see-through) container like a coffee can or plastic laundry bottle. ■■ Tape that container closed. ■■ Hide the container in the trash. Do not put in the recycle bin. ■■ Do not give drugs to anyone else. ■■ Do not flush drugs down the toilet. ■■ Do not put drugs in the trash without disguising them; human and animal scavengers may find them and misuse them. A large problem appears to be lack of funding to investigate the long-term effects of traceable amounts of pharmaceuticals, or the disproportionate way that limited funds are being used. We also lack funding to initiate programs to collect expired or unused medications from people. Currently, there are several states that are implementing safe medication disposal programs. For example, The Safe Medicine Disposal for ME program provides Maine's residents with a safe disposal option for unused and unwanted medicine. Free medicine mailback envelopes are available at participating sites. This program is funded through a grant from the United States Environmental Protection Agency's AgSee “Viewpoint”, continued on page 10

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Executive Insight By Michael Jackson, FPA Executive by michael jackson, Vice RPh President/CEO

2009 Legislative Session Report FPA Advocacy Efforts A comprehensive advocacy program is not for the weak of heart. Monitoring legislation and pharmacy rule development is a mission-critical aspect of the Florida Pharmacy Association. This speaks to the core of any professional organization that works to represent its membership on matters that affect the core business and profession of its constituents. The costs associated with running these programs has been consuming up to 50 percent of the dues paid by the membership. So far, the FPA has been successful in writing budgets that allow us to continue to focus on governmental-affairs issues. This year, the Florida Legislature was primarily preoccupied with finding money to write into an approved budget. The year 2009 will probably be known for what did not get done as opposed to what passed into law. This is typical when states are facing severe economic issues. Some of these issues include, but are not limited to, the following:

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Legislation that Passed SB 1868 (Revisions of the Practice of Pharmacy) Senate Bill 1868 was originally filed to create a formulary system in most nursing homes similar to what you would find in hospitals. It became quite clear during the legislative session that certain elements of the proposal to add a formulary in nursing homes would be an uphill battle. Elements of the original bill as filed included the following: ■■ Unlike hospitals, physicians would

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have the ability to exercise an option to not participate; Be approved by the medical staff; Openly provide detailed methods and criteria for the selection and objective evaluation of all available pharmaceuticals; Include policies for the development, maintenance, approval, dissemination, and notification to prescribers of the drug formulary and for continuous and comprehensive review of formulary drugs; Provide for regular monitoring of compliance with the policies and procedures and of clinical outcomes in circumstances in which a substitution of drugs has occurred; Provide a mechanism to inform the prescriber before any substitution of drugs by using a method of communication designated by the prescriber on the prescription for such purpose, require the method of communication to be noted in the patient’s chart, and require the prescriber to provide annual written prior approval for the substitution of drugs on the institutional formulary to be allowed for the prescriber’s patients; Establish a process that allows any individual prescriber to opt out of the formulary system entirely; Establish a process that allows any individual prescriber to opt out of the formulary system with respect to a particular patient; Provide a mechanism to ensure that patients or guardians are informed of any change of an existing prescription to a formulary substitute; Include policies stating that practitioners are not penalized for pre-

Michael Jackson

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scribing non-formulary drug products that are medically necessary; and Be consistent with applicable state and federal laws and with rules of the Department of Health and the Board of Pharmacy.

Due primarily to aggressive lobbying efforts by the prescription drug manufacturers, all of the above issues were removed from the bill. What remained in the final legislation approved by the House and Senate were the following issues: ■■ The bill redefines what a standard reference compendium is under Florida statutes 627.4239 for cancer drugs by deleting the United States Pharmacopeia Drug Information, the American Medical Association Drug Evaluation and the American Hospital Formulary Service Drug Information and replacing it with a much broader reference. This broader reference simply allows whatever authoritative comJUNE 2009

FPA Staff

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Executive Vice President/CEO Michael Jackson (850) 222-2400, ext. 200 Director of Continuing Education Tian Merren-Owens, ext. 120 Controller Wanda Hall , ext. 211

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Membership Coordinator Ranada Simmons , ext. 110 Educational Services Office Assistant Stacey Brooks , ext. 210 Florida Pharmacy Today Board Chairman................................................... Dick Witas, Odessa Treasurer...............................Stephen Grabowski, Tampa Secretary.........................Stuart Ulrich, Boynton Beach Member...........................Betty Harris, Lighthouse Point Member..................................... Joseph Koptowsky, Miami Member...................................... Jennifer Pytlarz, Brandon Executive Editor.........Michael Jackson, Tallahassee Managing Editor.........................Dave Fiore, Tallahassee

This is a peer reviewed publication. ©2009, FLORIDA PHARMACY JOURNAL, INC. ARTICLE ACCEPTANCE: The Florida Pharmacy Today is a publication that welcomes articles that have a direct pertinence to the current practice of pharmacy. All articles are subject to review by the Publication Review Committee, editors and other outside referees. Submitted articles are received with the understanding that they are not being considered by another publication. All articles become the property of the Florida Pharmacy Today and may not be published without written permission from both the author and the Florida Pharmacy Today. The Florida Pharmacy Association assumes no responsibility for the statements and opinions made by the authors to the Florida Pharmacy Today. The Journal of the Florida Pharmacy Association does not accept for publication articles or letters concerning religion, politics or any other subject the editors/ publishers deem unsuitable for the readership of this journal. In addition, The Journal does not accept advertising material from persons who are running for office in the association. The editors reserve the right to edit all materials submitted for publication. Letters and materials submitted for consideration for publication may be subject to review by the Editorial Review Board. FLORIDA PHARMACY TODAY, Annual subscription - United States and foreign, Individual $36; Institution $70/year; $5.00 single copies. Florida residents add 7% sales tax. Florida Pharmacy Association

610 N. Adams St. • Tallahassee, FL 32301 850/222-2400 • FAX 850/561-6758 Web Address: http://www.pharmview.com 8 |

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2009 LEGISLATIVE SESSION REPORT

pendium identified by the Secretary of the US Department of Health and Human Services and recognized by the Center for Medicare and Medicaid Services (CMS). This bill also repeals language in the legible prescription law under Florida Statutes 456.42 that requires all prescriptions to be written with the quantity of the drug prescribed in both the textual and numerical format. Removed also was a requirement for the month to be written out in textual letters as well. These changes were advocated by the FPA in order to protect members from aggressive auditing and reimbursement reversal decisions by managed care. SB 1868 did add to Florida statutes 456.42 language that referenced a requirement for the quantity of drugs prescribed under 893 (controlled substances) to be in textual and numerical formats and the “abbreviated” month written out on the face of the prescription to comply with requirements under federal law. In Florida Statutes 893.04, additional language was added to clarify that it was not necessary for prescriptions to be written with the quantity in textual and numerical format and the abbreviated month written out IF that pharmacy had previously dispensed another prescription for the patient. Again, these changes were advocated by the FPA to address recent predatory auditing practices by managed care companies. The law also allows a pharmacist to “insist” a person to whom the controlled substance is dispensed to provide a photographic ID if the prescriber is not available to verify a prescription.

SB 1720 - Change in Requirements for Physician Assistants Senate Bill 1720 removed requirements for supervising physicians to cosign charts or medical records prepared by physician assistants. When PAs pre-

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scribe medications there is also a concurrent entry inserted in the patient’s medical record. These entries were required to be reviewed and signed by the supervising physician. Senate Bill 1720 removed that requirement granting PAs greater independent prescribing authority. Of note is that the bill also prohibits physicians to hold them out to be boardcertified specialists in dermatology unless the recognizing agency (by rule or statute) is reviewed and reauthorized every three years. SB 462 - Prescription Drug Monitoring Program For over seven years, the Florida Legislature had been entertaining legislation designed to address the illegal use of legal prescription drugs. Various versions of the draft legislation had been considered only to fail passage. This year was different with a significant number of bills filed to address this issue. Senate Bill 462 created a comprehensive prescription drug monitoring program. The original version of the bill that was filed started with four pages with the final version endorsed by both the House and Senate containing 32 pages of text. Features of this bill include the following: ■■ Requires DOH to establish CS monitoring database ■■ Requires pharmacies and dispensing practitioners to report the dispensing of CS using ASAP standards. ■■ Includes provisions to protect records ■■ Requires the Department to make available an advisory report. (No provider responsibility) ■■ Program must be designed by 12/1/2010 ■■ Must not infringe on prescriber or dispenser acting in good faith. ■■ Must be compliant with HIPAA ■■ Department required to work with the FPA and other organizations on rule development ■■ Data must be reported within 15 days of dispensing ■■ Can be reported by Internet, disk or by mail

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Data Required to be Reported Patient Information Full name ■■ Address ■■ Date of birth ■■

Dispensing practitioner information ■■ Practitioner’s name ■■ Practitioner’s address ■■ DEA license number ■■ Practitioner’s NPI

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Exempted from reporting; o Practitioners administering CS in ER o Practitioners administering to persons under 16 o Pharmacists or practitioners dispensing a one-time, 72-hour emergency resupply Costs to “dispenser” may not be material or extraordinary Requests for CS information by law enforcement, AG’s office or regulatory boards require authentication. DOH can study redacted information in the program Program costs are to be funded by grants Direct support organization created under the Florida Office of Drug Control Requires the presentation of a valid photo ID (May verify ID with prescriber or prescriber’s agent) Program Implementation and Oversight Task Force created. Reports to the Governor: o Two members are required to be Florida licensed pharmacists o Serve three-year terms o Must meet quarterly o Created to monitor the implementation and safeguarding of the monitoring system

Prescriber Information Name of prescribing practitioner ■■ DEA number ■■ Practitioner’s NPI ■■ Date of the prescription

Pharmacy Information Name of pharmacy ■■ DEA number of pharmacy ■■ Address of pharmacy

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Prescription Information Date prescription filled ■■ Method of payment (minus any credit card information) ■■ Name of drug ■■ NDC code of drug ■■ Quantity and strength of drug

Other Appropriate Data as Determined by Department of Health Rules

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Pain clinics required to register with the Department SB440 - Public Records Exemption o Designates records of controlled substances reported to the state as confidential

SB 440 - Public Records Exemption In order for the prescription drug monitoring program to work it is necessary for a bill to pass to allow the state to receive confidential health information and secure it from public records requests. Florida has an open-records law that means that most information that it receives is required to be released whenever there is a request. Senate Bill 440 was approved by both the House and Senate and protects from discovery the release of data transmitted by pharmacies under the requirements of Senate Bill 462 under certain circumstances. The Department of Health can, however, release identifying information that it receives in the database (after verification of the requesting agency) to the Attorney General (AG) and his or her designee when working on Medicaid fraud cases. The AG can then release this information to law enforcement involved in active criminal investigations. Identifying information in the data-

base can be released to the Department of Health’s regulatory boards when investigating a practitioner, however the regulatory boards cannot have direct access to the database. The boards can release information that it receives to law enforcement. Law enforcement agencies can receive confidential information directly from the Department of Health if involved in an active investigation. The law-enforcement agency is not granted direct access to the database. Others who may request confidential information from the database include the treating practitioner and dispensing pharmacists. The patient or the legal guardian or designated health care surrogate for an incapacitated patient also can request confidential information in the database. Members need to be aware that any agency or person who receives confidential information in the database has a statutory obligation to keep that information confidential. Any unauthorized release of this information done in a willful and knowing fashion is considered a third-degree felony. This section of Senate Bill 440 is subject to automatic repeal on October 2, 2014 unless reenacted by the Florida Legislature. See “Insight”, continued on page 12 JUNE 2009

"Viewpoint" continued from page 6

ing Initiative. SMARxT DISPOSAL is a unique public-private partnership between the U.S. Fish and Wildlife Service, the American Pharmacists Association, and the Pharmaceutical Research and Manufacturers of America. This support and involvement is what separates SMARxT DISPOSAL from other initiatives, and it will ultimately make this campaign successful. Currently in Utah, there is no uniform take-back system for clinics, hospitals, care centers or even doctor’s offices.There are two types of formal collection options: at law-enforcement agencies, or at household hazardouswaste collection events. In Florida, we do not have a set program to handle safe medication disposal. To to minimize medication waste and diversion, the Palm Beach County Sheriff’s Office conducted Operation “Medicine Cabinet” on May 30 from 9 a.m. to 4 p.m. in an effort to increase public awareness of pharmaceutical diversion. They collected and safe-

ly destroyed unneeded prescription drugs. People should have received a $5 gift card to CVS, Walgreens or Walmart by dropping off their unneeded prescription drugs at any of the following six Operation “Medicine Cabinet” locations in Palm Beach County: Boca Raton Town Center Mall (by the main entrance off of Glades Rd. in the north parking lot), Boynton Beach Mall (in front of the food court, enter off of Congress Ave.), CVS at 10th and Congress in Palm Springs, CVS at PGA & Military Trail in Palm Beach Gardens, Walgreens at the Wellington Mall, and Palm Beach County Sheriff’s Office Sub-Station in Belle Glade. In conclusion, ‘’Consumers - and pharmacists - should be aware that it is important to take that extra step to protect our families and our natural resources, including our many waterways, fish and other aquatic organisms." Dr. John A. Gans, former Executive Vice President and CEO of APhA. FPA members will be encouraged to know that our Association has been

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working with the Florida Department of Environmental Protection Bureau of Solid and Hazardous Waste Regulation. Along with the DEA and the Department of Transportation, your pharmacist representative, Michael Jackson, engages the difficult topic of pharmacy waste with nurses, emergency health providers, health care administrators, transporters, reverse distributors, stand-alone clinics, mobile physicians, hospice, assisted living and nursing home health staff. Through our voice on the BioMed-Pharm TAG, statewide initiatives are under review. The concept and resulting programs may eventually address pharmaceutical waste with a long-term solution. n Sources: Medical News Today-Catharine Paddock, PhD http://www.dep.state.fl.us/waste/ quick_topics/publications/shw/meds/ DEPMedicationDisposalFlyer.pdf

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A Team Effort

By Karen Bills, Pharm D., Chair, Health Fair

Key representatives of pharmacy profession ensure success of Pharmacist Legislative Days and Health Fair The 8th Annual Florida Pharmacist Legislative Days and Health Fair took place from Tuesday, March 17, through Thursday, March 19, 2009, and was an unmitigated success. We began this event on Tuesday with a legislative briefing at the Capitol building. Lori Weems and her staff were instrumental in providing our volunteers with up-to-date legislative information and talking points so that we would be fully prepared to engage in effective dialogue with our state senators and representatives. The staff from Lori’s office then sent the group of volunteers out on appointments that they had pre-arranged with key members of the Legislature so that our voices would be heard. That evening, there was a welcome reception at the FPA office. It was a special treat for the student and pharmacist volunteers to have this opportunity to meet the staff of the FPA and to see the offices where all the hard work of the association is accomplished on our behalf. Wednesday, March 18, began with a coffee and danish reception at the offices of Prieguez & Weems to help get the day started and to allow the volunteers an opportunity to meet Lori’s staff. The hard work of setting up for the Health Fair on the third floor of the Capitol Rotunda then began. We had over 70 volunteers for this event that included students from the five colleges of pharmacy, faculty from four colleges of pharmacy, and pharmacists that hailed from all areas of the state representing a virtual spectrum of pharmacy prac-

Health Fair participants received screenings that included full-panel cholesterol profile, blood glucose, bone density, blood pressure, skin cancer, body mass index and medication counseling.

tice settings. We had over 200 participants at the Health Fair and offered them a variety of health screenings including a fullpanel cholesterol profile, blood glucose, bone density, blood pressure, skin cancer, body mass index and medication counseling. The participants included many of our legislators and their staff who make a special effort to attend this event every year. While many of our volunteers were performing health screenings, while the rest of the cadre were

We had over 200 participants at the Health Fair and offered them a variety of health screenings

continuing to visit our legislators and attend council meetings, demonstrating the united front that pharmacy can present when we work together. The evening ended at the FPA office with a reception that was attended by several of our legislators. The final day of this event continued with a wrap-up, several legislative committee meetings and some final meetings with key legislators. It was a very busy and productive event, and it could not have been accomplished without the full support of the FPA office and especially Michael Jackson and the office of Prieguez & Weems. The exceptional turnout of volunteers, especially the dedicated group of students from all of our state’s colleges of pharmacy, made this a memorable and rewarding event.

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"Insight" continued from page 9

S162 - Florida Electronic Health Records Exchange Act This bill was designed to address standards related to the exchange of health information electronically between facilities and providers. The origin of this legislation actually began with an executive order under President George W. Bush encouraging the development of a nationwide interoperable health information technology infrastructure. This includes implementing incentives for physician adoption of electronic health records (EHR). In Florida, Governor Jeb Bush created the Governor’s Health Information Infrastructure Advisory Board with a mission to advise and support the Agency for Health Care Administration’s efforts to implement a strategy for the adoption and use of electronic health records. The Florida Pharmacy Association had a seat at that table and ac-

tively has been participating in various meetings on the issues. Information about this and the Florida Health Information Network can be found at this link http://ahca.myflorida.com/dhit/index.shtml . Of interest to FPA members are our advocacy efforts to ensure that any system that creates an electronic health record is accessible and viewable by pharmacy providers. Provisions in the bill if signed into law by Governor Crist will do the following: Section 1. Amends s. 395.3025, F.S., to authorize licensed facilities (hospitals, ambulatory surgical centers, and mobile surgical facilities) to disclose patient medical records, without the consent of the patient or the patient’s legal representative, to health care practitioners and providers that are currently involved in the care or treatment of

the patient for use only in connection with the treatment of the patient when the practitioners or providers are not licensed facility personnel or attending physicians. Section 2. Creates s. 408.051, F.S., the “Florida Electronic Health Records Exchange Act.” The following terms are defined: “electronic health record,” “qualified electronic health record,” “certified electronic health record technology,” “health record,” “identifiable health record,” “patient,” and “patient representative.” A health care provider is authorized to release or access an identifiable health record of a patient without patient consent for use in the treatment of that patient for an EMERGENCY MEDICAL CONDITION when the consent cannot be obtained from the patient or the patient representative due to an extraordinary medical con-

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THE WALKWAY OF RECOGNITION

FPA OFFICE

YOUR NAME HERE

Have you been searching for just the right gift or thought of placing your name in perpetuity? If so, then consider purchasing an engraved brick for you or someone else. The main sidewalk at the Florida Pharmacy Association needs replacing. The Florida Pharmacy Foundation has undertaken the project to repair and beautify the sidewalk with engraved personal bricks purchased by pharmacists or friends of pharmacy. Engraved 4x8 bricks can be purchased for $250.00 each with the donor’s name engraved (3 lines available) or you could also purchase an engraved brick for someone you feel should be honored or remembered. The monies earned from this project will be used to fulfill the goals and future of the Foundation. There are a limited number of bricks available – so, it is first come first served.

ORDER FORM

The Walkway of Recognition

❑ YES, I want to order _______ concrete brick/s at $250.00 each. (Please copy form for additional inscriptions). PL E A S E P R INT I NSC RIP TION

The concrete bricks are 4x8 and can be engraved with up to 14 characters per line, three lines available, spaces and punctuation count as one character. Please find enclosed my check for $_________ for _________ bricks. PLEASE PRINT: Please charge my

❑ Master Card

CARD #

Contributions to the Florida Pharmacy Foundation are tax deductible as a charitable contribution for federal income tax purposes. Consult your CPA for complete details. Fed Emp. I.D. #59-2190074

❑ Visa EXP. DATE

AUTHORIZED SIGNATURE NAME ADDRESS CITY

STATE

PHONE (W)

(H)

Send to Florida Pharmacy Foundation, 610 N. Adams St., Tallahassee, FL 32301, or fax to (850) 561-6758.

ZIP

A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE 1-800-435-7352 WITHIN THE STATE. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL OR RECOMMENDATION BY THE STATE.

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dition or the nature of the situation requiring immediate medical attention. There is some immunity from civil liability that is provided when a health care provider accesses or releases the identifiable health record. The Agency is required to develop a form by July 1, 2010, in paper and electronic formats, to document patient authorization for the use or release of an identifiable health record. A health care provider must accept an authorization form that requests the release of an identifiable health record as a valid authorization to release the record. Neither the provider nor the patient is required to use the form adopted and distributed by the Agency. The bill creates a rebuttable presumption that the release of an identifiable health record upon receipt of an authorization form completed and submitted in accordance with Agency instructions was appropriate and the health care provider does not violate any right of confidentiality and is immune from liability. In addition, the release or ex-

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change of an identifiable health record upon receipt of an authorization form does not violate or waive any statutory or common-law privilege. The bill provides that a person who forges a signature on an authorization form, materially alters an authorization form without permission, or obtains an identifiable health record of another person under false pretenses may be liable to the patient or health care provider for compensatory damages caused by an unauthorized release, plus attorney fees and costs. Section 3. Creates s. 408.0512, F.S., to require the Agency to operate an electronic health records system adoption loan program. This program is subject to a specific state appropriation and the availability of funding through public or private entities or the federal stimulus law. The bill does not appear to specify what types of loans are to be made. The agency is required to adopt rules related to standard terms and con-

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ditions for use in the loan program. Section 4. Amends s. 409.916(1), F.S., by providing that AHCA must deposit into the Grants and Donations Trust Fund those funds received from private donations for the purpose of funding a certified electronic health record technology loan fund. Section 5. Amends s. 483.181, F.S., to authorize a clinical laboratory to release, without patient consent, test results that have been ordered by a practitioner to other health care practitioners and providers involved in the care or treatment of the patient for use in connection with the treatment of that patient. Members may need to be aware that there was an attempt in the House to add onto the bill a requirement for physicians to transfer 50 percent of their prescribing to electronic means by a certain date. While the Association is

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supportive of electronic prescribing, we felt it necessary to inform the House sponsor that prescriptions received electronically are paid for by pharmacy providers. Also, there was some concern within the physician community that practitioners whose practice consists primarily of hospice and palliative care patients that there is a likely chance of falling out of compliance involuntarily with the law if signed by Governor Crist. The majority of prescriptions written by practitioners caring for these patients may be for pain medications that are currently not allowed by the DEA. This provision was not included in the final bill that passed.

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SB 1986 - Medicaid Fraud and Regulatory Reduction The bill addresses systemic health care fraud. The bill increases the Medicaid program’s authority to address fraud, particularly as it relates to home health services by: ■■ Requiring that home health services

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for Medicaid recipients be medically necessary and ordered by a physician via a written prescription that meets the specified requirements in law. Requiring all Medicaid recipients to receive information once a year on how to report criminal Medicaid fraud, the Medicaid Fraud Control Unit’s toll-free hotline number, and the reward program created in the bill. Requiring the Agency for Health Care Administration (AHCA) to post a list of all Medicaid providers that have been sanctioned or terminated for cause from the Medicaid program on its website. Requiring the AHCA to use technology to address health care fraud. Requiring the Medicaid Program Integrity Unit to take action against a provider that violates s. 409.913, F.S. Previously this authority was permissive. Authorizing the AHCA to enroll a Medicaid provider located out-

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side of Florida if the provider’s location is no more than 50 miles from the Florida state line or the AHCA determines a need for that provider type. Requiring all health care facilities licensed by the AHCA to provide their clients an AHCA-written description of Medicaid fraud and the statewide toll-free telephone number for the central Medicaid fraud hotline.

The bill designates Miami-Dade County as a health care fraud crisis area and directs the AHCA to implement two pilot projects in Miami-Dade County to prevent the overutilization of home health services and control, verify, and monitor the delivery of home health services in the Medicaid program. The bill increases health care facility and health care practitioner licensing standards to keep fraudulent actors from obtaining a health care license in Florida by:

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JUNE 2009

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Requiring the AHCA to deny a license to any health care facility applicant, and the Department of Health (DOH) to deny a license, certificate, or registration to any health care practitioner applicant, if the applicant or any controlling interest has been: o Convicted of, or enters a plea of guilty or no contest to, a felony under ch. 409, 817, or 893, F.S., 21 U.S.C. ss. 801-970, or 42 U.S.C. ss. 1395-1396, unless the sentence or any subsequent period of probation ended more than 15 years ago; o Terminated for cause from the Florida Medicaid Program, unless the applicant has been in good standing with the Florida Medicaid Program for the most recent five years; or o Terminated for cause from the federal Medicare program or another state Medicaid program, unless the applicant has been in good standing with a state Medicaid program for the most recent five years and the termination occurred at least 20 years prior to the date of the application. Requiring pharmacy permit applicants to be fingerprinted and pass a state and national criminal history records check. Authorizing the AHCA to deny, revoke, or suspend the license of a home health agency, and requiring the AHCA to impose a fine of $5,000 against a home health agency that demonstrates a pattern of billing the Medicaid program for medically unnecessary services. Increasing the requirements for applicants for licensure as home health agencies, home medical equipment providers, and health care clinics to include additional financial documentation and a $500,000 surety bond for non-immigrant alien applicants. Prohibiting the AHCA from renewing a home health agency license if the applicant is located in a coun|

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ty that has at least one home health agency and the county has more than one home health agency per 5,000 persons, based on the most recent population estimates published by the Legislature’s Office of Economic and Demographic Research, and the applicant or any controlling interest has been administratively sanctioned by the AHCA in the last two years for a specified list of violations. Creating a moratorium on new and change of ownership home health agency licenses in counties that meet certain criteria until July 1, 2010.

In addition, the bill creates incentives for persons to report incidents of Medicaid fraud by: ■■ Offering monetary rewards for persons who report Medicaid fraud to the authorities; ■■ Removing a disincentive to pursue an action under the Florida False Claims Act; and ■■ Providing civil immunity for persons who report suspected Medicaid fraud. The bill creates disincentives to commit Medicaid fraud directly by creating additional criminal felonies for committing health care fraud by: ■■ Creating a first- and second-degree felony for persons who commit Medicaid provider fraud. The new penalties increase in severity based on the amount of money stolen from the Medicaid program or the amount of money the provider attempted to steal. ■■ Requiring Medicaid providers convicted of Medicaid fraud to also pay the state a fine equal to five times the amount of money stolen from the state or the total amount of money stolen from the Medicaid program, whichever is greater. ■■ Creating a third-degree felony for persons who apply for a home health agency, durable medical equipment, or clinic license and knowingly file information on the

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licensure application that is misleading or false. The bill decreases the financial surplus requirements for entities that contract with the AHCA on a prepaid basis, including Medicaid HMOs, provider services networks, and prepaid mental health plans. The surplus requirements will be the same as for commercial HMOs. The bill also directs the AHCA to develop a plan to implement a medical home pilot project that utilizes primary care case management enhanced by medical home networks to provide coordinated and cost-effective care that is reimbursed on a fee-for-service basis, and to compare the performance of medical home networks with other existing Medicaid managed care models. Language in the bill specifically states that each medical home network SHALL provide pharmacy services in addition to other services. Although this bill primarily relates to Medicaid fraud by all health care providers, the following highlights the provisions in the bill that directly impact pharmacy practice: ■■ The bill will authorize partnerships and corporations to obtain pharmacy permits; ■■ The legislation requires applicants or certain persons affiliated with an applicant for a pharmacy permit to submit a set of fingerprints for a criminal history records check and pay the costs of the criminal history records check. This fingerprinting requirement applies to corporate officers, directors and holders of significant ownership interests in the pharmacy that is being permitted; ■■ The bill also mandates that the Department of Health or Board of Pharmacy deny an application for a pharmacy permit for certain misconduct by the applicant or persons affiliated with the applicant; ■■ The legislation authorizes the Department of Health or the Board of Pharmacy to take disciplinary action against a permittee for certain misconduct by the permittee, or

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persons affiliated with the permittee relating to such permittee’s misstatements in its permit application; The bill requires that AHCA to track Medicaid provider prescription and billing patterns and evaluate them against Medicaid medical-necessity criteria and coverage limitation guidelines adopted by rule and include this information in the Medicaid Program Integrity and Medicaid Fraud Control Unit’s joint annual report.

SB 1144 - Pedigree Papers This bill revises the definition of “manufacturer” under the Florida Drug and Cosmetic Act to include: ■■ A person registered under the federal Food, Drug, and Cosmetic Act (federal act) as a prescription drug manufacturer who has entered into a written agreement with another prescription drug manufacturer to distribute that manufacturer’s prescription drugs as the drug’s manufacturer, consistent with the federal act; ■■ An affiliated group member of a prescription drug manufacturer who distributes prescription drugs manufactured only by other members of the affiliated group, whether or not the affiliated group member who is distributing the prescription drugs obtains title to the drugs prior to the distribution. An affiliated group is defined in the bill; and ■■ A licensed third party logistics provider, while providing warehousing, distribution services, or other services on behalf of the prescription drug’s manufacturer. A prescription drug manufacturer is not required to provide a pedigree paper (information about the ownership and possession of the prescription drug) upon the wholesale distribution of the prescription drugs for which it is deemed the manufacturer. The bill conforms the pedigree paper requirements to allow for a distribution within a manufacturer’s affiliated group and facilitate the subsequent wholesale distributions of the drug.

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In addition, the bill expands the types of business entities that are eligible to apply for a health care clinic establishment permit in order to purchase prescription drugs for use in providing health care or veterinary services. SB 1122 - Health Insurance/ Payment of Benefits/Claims Forms The bill requires insurers to make payments directly to any provider, including pharmacies, not under contract with the insurer if the insured makes a written assignment of benefits. Under current law, direct payment by an insurer is only required for emergency services and care. The bill provides that the Office of Program Policy and Governmental Accountability (OPPAGA) is to complete a report to the President of the Senate and the Speaker of the House by March 1, 2012, and if that report finds that the act has caused a net loss in physicians in the preferred provider plan network of the state group health plan, the provisions of the act will be repealed. This legislation was fiercely opposed by the health insurance industry because it will have the effect of meaningfully opening closed provider networks by allowing direct assignments of health care benefits by the patient to out-of-network providers. HB 675 - Medicare Supplement Policies The bill requires insurers that provide Medicare supplement policies (Medigap) to issue such policies on a guaranteed-issue basis to persons in Florida who are: under 65 years of age and eligible for Medicare due to a disability determination or diagnosis of end-stage renal disease (ESRD). Qualified Medicare beneficiaries must be enrolled in Medicare Part B and must purchase Medigap coverage within si months after initial Medicare eligibility or within two months following termination of coverage under a grouphealth insurance policy. The bill allows Medigap insurers that already offer coverage to Medicare

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beneficiaries under the age of 65 a process to make a one-time rate schedule change without activating the five-year lockout period required in s. 627.410(6) (e)2., F.S. The authorized rate change allows insurers to address concerns in the premium relativities between the premium class, which includes the under age 65 individual and the balance of the block, by redefining the age bands of the premium classes. A second rate change provided in the bill allows an insurer to address problems in the premium relativities between the premium class, which includes the under age 65 individual, and the balance of the block, in the first rate filing in 2012. This provision is intended to allow a company to consider the experience data for the premium class, including the under age 65 individuals, on a much more credible basis than the current rules authorize. SB 2600 (Pharmacy Proviso in the Budget and Pharmacy Budget Issues) In spite of dramatic reimbursement cuts to other Medicaid providers, in particular to hospital reimbursement and nursing home reimbursement, no Medicaid pharmacy cuts were included in the Fiscal Year 2009-10 budget. The dispensing fee, following the $.50 cut passed into law during the 2009 Special Session in January, remains at $3.73 and the ingredient cost remains at the lesser of average wholesale price (AWP) minus 16.4 percent, wholesaler acquisition cost (WAC) plus 4.75 percent, the federal upper limit (FUL), the state maximum allowable cost (SMAC), or the usual and customary (UAC) charge billed by the provider. A budgetary proviso was passed relating to pharmacy in the line-item appropriations for the Agency for Persons with Disabilities, as follows: Developmental Disabilities Public Facilities The Agency for Persons with Disabilities shall purchase pharmaceuticals through the Minnesota Multistate Contracting Alliance for Pharmacy (MMCAP), thereby enJUNE 2009

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abling the agency to obtain pharmaceuticals at reduced prices. Additionally, the Department of Health and the agency shall determine the feasibility of consolidating drug repackaging services under the Department of Health’s central pharmacy.

Legislation That Did Not Pass SB 75 - University of South Florida Pharmacy Program This bill proposed to authorize a doctor of pharmacy degree (PharmD) program at the University of South Florida (USF). Funding for the PharmD program would have come from a variety of sources including private funds, federal contracts and grants, tuition revenue, and state support. The legislation did not require state funding initially, although state support would have been requested beginning in fiscal year 2011-12. The Florida Pharmacy Association has a position in opposition to new pharmacy schools being established in Florida that would cause depletions of funding from existing pharmacy schools. This legislation was successfully killed in the Florida Senate because of the additional burdens that it would have placed on existing pharmacy higher-education institutions. SB 578 - Statewide Pharmaceutical Purchasing This legislation would have required all state agencies that purchase prescription drugs, with the exceptions of the Department of Veteran Affairs, AHCA and the Department of Management Services, do so through a statewide purchasing contract administered by the Department of Health. Senate Bill 578 would have created the Pharmacy and Therapeutic Advisory Council within the Executive Office of the Governor. It provided the duties of the council, provided for the appointment and qualification of members; provided for the use of subject-matter experts when necessary; provided re18

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quirements for voting and a quorum; provided for quarterly meetings of the council; provided staffing; and provided for reimbursement of per diem and travel expenses for members of the council. This Council would have had authority to exempt an agency from the centralized prescription drug purchasing requirement if the Council expressly found a more cost-effective method for such agency’s prescription drug purchases. This legislation arose out of a study conducted by the Office of Program Policy Analysis and Government Accountability (OPPAGA) as was required by Chapter 2009-15, Laws of Florida, to assess the feasibility of consolidating statewide pharmaceutical services for state agencies, including the purchasing, repackaging, and dispensing of pharmaceuticals. The OPPAGA research memorandum, released March 3, 2009, found that: ■■ Five state agencies spent $232 million on pharmaceuticals for agency clients in FY 2007-08. These five agencies purchase 92 percent of their pharmaceuticals through a bulk purchasing contract through the DOH that lowers the prices for all participating purchasers. ■■ The state could attain additional cost savings by consolidating drug repackaging under the DOH’s central pharmacy or a private vendor. The OPPAGA compared the unit dose and script dispensing fees paid by the Agency for Persons with Disabilities with the Department of Corrections’ and the Department of Juvenile Justice’s current contracts for repackaging and filling prescriptions with the DOH’s central pharmacy costs and determined that consolidation under the DOH may be the more cost-effective option. ■■ The DOH may be able to expand its drug purchasing through the federal 340B drug pricing program, which could bring significant savings to the state. Senate Bill 578 died due to never being heard in its last committee of refer-

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ence. However, the issue will continue to be looked at through proviso language that calls for the statewide purchasing of pharmaceuticals. SB 2600 - Funding for FAMU School of Pharmacy – New Crestview Campus Budgetary challenges resulted in funding for the new FAMU School of Pharmacy Crestview campus not being appropriated, making the establishment of the new school, that was authorized in substantive law during the 2008 legislative session, unlikely. The funding was necessary to consummate the acquisition of the facilities for the new school. It is unclear whether the school will go forward at all or whether it will be indefinitely delayed until such time that funding can be secured. HB 343, SB 1028 - Racial and Ethnic Minority Health Care These bills would have directed the Department of Health to assist with increasing the number of racial and ethnic minority health care professionals. Both the House and Senate versions have required the Department to collaborate with universities on the development of courses on cultural competency, sensitivity and health literacy. SB 984, HB 893 – Drug Donation Program Act These bills would have authorized and facilitated the donation of prescription drugs to the Department of Corrections. The donated drugs would have to have been in original manufacturer’s tamper-resistant container and would require inspection by a pharmacist. The drug donor and DOC would have been immune from liability under this program. SB326, H507 - Expansion of Optometrist Prescribing These bills would have redefined optometrist administration and prescribing by granting authority for optometrists to prescribe topical and oral medications to diagnosis and treat the eye. The bill would have also granted

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authority to prescribe controlled substances used in the diagnosis and treatment of the eye. SB 310, HB 129 – Reproduction Services and Family Planning (Prevention First Act) These bills would have required facilities to provide emergency contraceptive services to rape survivors if requested. The bills would have also required “pharmacies” to provide contraceptive products that are in stock if requested. Other issues published in the bill would have ensured that pharmacy employees do not: ■■ Intimidate, threaten or harass a patient ■■ Interfere with or obstruct the delivery of services ■■ Intentionally misrepresent or deceive a patient about the availability or mechanism of action ■■ Breach medical confidentiality with respect to a request for contraception ■■ Refuse to return a valid, lawful prescription for contraception The bill also would have: ■■ Granted certain exemptions from having to comply with the law such as: o No valid prescription o Patient or patient’s representative is unable to pay o Pharmacy’s employee makes a professional clinical judgment that the prescription is inappropriate o Allows for refusal for religious reasons (pharmacy must accommodate the patient without delay) ■■ Allowed the State’s Attorney General to take civil action against violators ■■ Directed the Department of Health to take action against the licensee by suspending or revoking the license. SB 70, HB 721 – Epinephrine Auto-Injectors/School Nurses These bills would have authorized school nurses to maintain supplies of epinephrine auto-injectors. The bills

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would have authorized a school nurse to write a prescription for epinephrine auto-injectors by inserting the “school district” name for the patient’s name. The prescription would have only been filled in Florida licensed pharmacies. The bill would have granted authority for school nurses to administer epinephrine in life-threatening situations. HB 39, SB 154, SB 200, SB 242 – Vaccine Safety Act These bills would have prohibited the sale, purchase, manufacturer, delivery, importation, administration or distribution of vaccines containing more than 0.1 microgram/ml of mercury.

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during a roast at their symposium banquet this year. I also want to extend a sincere note of thanks to Lori Weems, Manny Prieguez and the staff at Preiguez and Weems for their tireless work to represent the Florida Pharmacy Association and the profession of pharmacy. Many thanks also to the staff here in the FPA office and the support of volunteer leadership, who during difficult times stepped up to continue providing services while sailing through rough seas. I will be looking forward to another year of growing collaboration and networking within the Florida Pharmacy Association family. n

SB 426m HB 1259 – ARNP Prescribing of Controlled Substances These bills would have added nurse practitioners to the list of those eligible individuals with the authority to prescribe controlled substances. Summary In all, the Florida Pharmacy Association closed the year with a significant number of positives. In addition to the extensive increase in membership and a very successful legislative campaign again this year, we were able to witness firsthand the installation of past president Ed Hamilton as President of the American Pharmacists Association. In a few years we will see DeAnn Mullins of Lynn Haven, another of Florida’s bright stars, installed as president of the National Community Pharmacists Association. The list of Florida’s trained leaders making a difference on the national scene continues to grow. In the years to come, our goals include growing our advocacy network and getting the membership of the FPA more involved with policymakers here in Tallahassee and in Washington, D.C. It is clear to us that the health of not only the profession in Florida is at stake, but also those patients that we dutifully serve. It was also a great honor and pleasure to be recognized by the Florida A&M University College of Pharmacy JUNE 2009

Swine Flu:A Pandemic Is Declared

On June 11, 2009, the World Health Organization (WHO) raised the worldwide pandemic alert level to Phase 6 in response to the ongoing global spread of the novel influenza A (H1N1) virus. A Phase 6 designation indicates that a global pandemic is underway. More than 70 countries are now reporting cases of human infection with novel H1N1 flu. This number has been increasing over the past few weeks, but many of the cases reportedly had links to travel or were localized outbreaks without community spread. The WHO designation of a pandemic alert Phase 6 reflects the fact that there are now ongoing community level outbreaks in multiple parts of world. WHO’s decision to raise the pandemic alert level to Phase 6 is a reflection of the spread of the virus, not the severity of illness caused by the virus. It’s uncertain at this time how serious or severe this novel H1N1 pandemic will be in terms of how many people infected will develop serious complications or die from novel H1N1 infection. Experience with this virus so far is

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limited and influenza is unpredictable. However, because novel H1N1 is a new virus, many people may have little or no immunity against it, and illness may be more severe and widespread as a result. In addition, currently there is no vaccine to protect against novel H1N1 virus. In the United States, most people who have become ill with the newly declared pandemic virus have recovered without requiring medical treatment, however, CDC anticipates that there will be more cases, more hospitalizations and more deaths associated with this pandemic in the coming days and weeks. In addition, this virus could cause significant illness with associated hospitalizations and deaths in the fall and winter during the U.S. influenza season. Background Novel influenza A (H1N1) is a new flu virus of swine origin that first caused illness in Mexico and the United States in March and April, 2009. It’s thought that novel influenza A (H1N1)

flu spreads in the same way that regular seasonal influenza viruses spread, mainly through the coughs and sneezes of people who are sick with the virus, but it may also be spread by touching infected objects and then touching your nose or mouth. Novel H1N1 infection has been reported to cause a wide range of flu-like symptoms, including fever, cough, sore throat, body aches, headache, chills and fatigue. In addition, many people also have reported nausea, vomiting and/or diarrhea. The first novel H1N1 patient in the United States was confirmed by laboratory testing at CDC on April 15, 2009. The second patient was confirmed on April 17, 2009. It was quickly determined that the virus was spreading from person-to-person. On April 22, CDC activated its Emergency Operations Center to better coordinate the public health response. On April 26, 2009, the United States Government declared a public health emergency and has been actively and aggressively implementing the nation’s pandemic response plan. Since the outbreak was first detected, an increasing number of U.S. states have reported cases of novel H1N1 influenza with associated hospitalizations and deaths. By June 3, 2009, all 50 states in the United States and the District of Columbia and Puerto Rico were reporting cases of novel H1N1 infection. While nationwide U.S. influenza surveillance systems indicate that overall influenza activity is decreasing in the country at this time, novel H1N1 outbreaks are ongoing in parts of the U.S., in some cases with intense activity. CDC is continuing to watch the situation carefully, to support the public health response and to gather information about this virus and its characteristics. The Southern Hemisphere is just beginning its influenza season and the experience there may provide valuable clues about what may occur in

the Northern Hemisphere this fall and winter. CDC Response CDC continues to take aggressive action to respond to the outbreak. CDC’s response goals are to reduce the spread and severity of illness, and to provide information to help health care providers, public health officials and the public address the challenges posed by this new public health threat. CDC is issuing updated interim guidance in response to the rapidly evolving situation. Clinician Guidance CDC has issued interim guidance for clinicians on identifying and caring for patients with novel H1N1, in addition to providing interim guidance on the use of antiviral drugs. Influenza antiviral drugs are prescription medicines (pills, liquid or an inhaled powder) with activity against influenza viruses, including novel influenza H1N1 viruses. The priority use for influenza antiviral drugs during this outbreak is to treat people hospitalized with influenza illness, and to treat people at increased risk of severe illness, including pregnant women, young children, and people with chronic health conditions like asthma, diabetes and other metabolic diseases, heart or lung disease, kidney disease, weakened immune systems, and persons with neurologic or neuromuscular disease. Public Guidance CDC has provided guidance for the public on what to do if they become sick with flu-like symptoms, including infection with novel H1N1. CDC also has issued instructions on taking care of a sick person at home and the use of facemasks and respirators to reduce novel influenza A (H1n1) transmission. Everyone should take everyday preventive actions to stop the spread of germs, including frequent hand washing and

people who are sick should stay home and avoid contact with others in order to limit further spread of the disease. Testing CDC has developed a PCR diagnostic test kit to detect this novel H1N1 virus and has now distributed test kits to all states in the U.S. and the District of Columbia and Puerto Rico. The test kits are being shipped internationally as well. This will allow states and other countries to test for this new virus. Vaccine Vaccines are a very important part of a response to pandemic influenza and the U.S. Government is aggressively taking early steps in the process to manufacture a novel H1N1 vaccine, working closely with manufacturers. CDC has isolated the new H1N1 virus, made a candidate vaccine virus that can be used to create vaccine, and has provided this virus to industry so they can begin scaling up for production of a vaccine, if necessary. Making vaccine is a long multi-step process requiring several months to complete. Stockpile Deployment CDC has deployed 25 percent of the supplies in the Strategic National Stockpile (SNS) to all states in the continental United States and U.S. territories. This included antiviral drugs, personal protective equipment, and respiratory protection devices. The influenza A (H1N1) virus is susceptible to the prescription antiviral drugs oseltamivir and zanamivir. These supplies and medicines will help states and U.S. territories respond to novel H1N1 virus. Surveillance Novel influenza A (H1N1) activity is now being detected through CDC’s routine influenza surveillance systems and reported weekly in FluView. CDC tracks U.S. influenza activity through multiple systems across five categories.

While our influenza surveillance systems indicate that overall influenza activity is decreasing in the United States, novel H1N1 outbreaks are ongoing in different parts of the U.S., in some cases with intense influenza-like activity. Most of the influenza viruses being detected now are novel H1N1 viruses. Shared Responsibility Individuals have an important role in protecting themselves and their families. ■■ Stay informed. Health officials will provide additional information as it becomes available. ■■ Everyone should take these everyday steps to protect your health and lessen the spread of this new virus: o Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it. o Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective. o Avoid touching your eyes, nose or mouth. Germs spread this way. o Try to avoid close contact with sick people. o If you are sick with a flu-like illness, stay home for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer. This is to keep from infecting others and spreading the virus further. o Follow public health advice regarding school closures, avoiding crowds and other social distancing measures. Source: Centers for Disease Control

JUNE 2009

Mark Your Calendar! Florida Pharmacy Association

119th Annual Meeting and Convention

Pharmacists are an integral part of the healthcare system. Pharmacists provide substantial care and make a great impact on improving patient’s quality of life. FPA would like to empower pharmacists, enhance their therapeutic knowledge, and equip them with practical tools that can be utilized in their various professions as they make a difference in patient care. FPA’s mission is to “serve, represent and assist Florida pharmacists to advance the profession and practice of pharmacy.” This year’s convention will offer a variety of important topics that will be applicable to your practice setting. We will offer consultant and general continuing education hours, in addition to a Wholesaler Conference and a Compounding Conference. Come and Get Empowered at FPA’s 119th Annual Meeting and Convention!

Renaissance Resort at World Golf Village St. Augustine, FL

July 8-12, 2009

119th Annual Meeting and Convention Schedule Renaissance Resort at World Golf Village • St. Augustine, Florida Schedule is subject to change

Compounding Conference Schedule

Wednesday, July 8, 2009 7:00am 7:15am 7:30am-3:00pm 9:00am-3:30pm 4:00pm-5:00pm 5:00pm-6:00pm 6:00pm-7:00pm 6:00pm-8:00pm 7:30pm-9:00pm

Registration/Check-in Welcome and Introductory Remarks Compounding Conference Wholesaler Conference HOD Board of Directors Meeting Florida Pharmacy PACCE Meeting Budget & Finance Committee Meeting Florida Pharmacy Foundation Annual Meeting Officer’s Dinner

(6 hrs of GCE)

7:30am-8:30am

8:35am-9:35am

Wholesaler Conference Schedule (6 hrs of GCE)

9:00am-10:00am

10:05am-11:35am

11:35am-11:50am 11:50am-12:50pm

12:55pm-1:55pm

2:00pm-3:30pm

CODE KEY:

Education: 1 hr GCE The Inspector’s Perspective and Evaluation Criteria for Florida Richard Sands, RPh, CPh, Statewide Pharmaceutical Program Manager, Florida Department of Health ACPE No. 165-000-09-049-L04-P Education: 1.5hrs GCE Compliance with Florida Wholesaler Regulations and Laws Gregg Jones, RPh, Compliance Manager, Florida Department of Health ACPE No. 165-000-09-050-L04-P BREAK Education: 1 hr GCE Wholesale Drug Distributors Perspective on Pedigree Requirements Gary Cacciatore, PharmD, JD, Vice President Regulatory Affairs, Cardinal Health ACPE No. 165-000-09-051-L04-P (Lunch Symposium) Education: 1 hr GCE Drug Enforcement Administration Update John Mudri, Mudri Associates Incorporated, ADEA Consultancy ACPE No. 165-000-09-052-L04-P Education: 1.5 hrs GCE Panel Discussion: Federal and State Pedigree Requirements Panel Members: Richard Sands, Gregg Jones, Gary Cacciatore, John Mudri ACPE No. 165-000-09-053-L04-P

GCE = General Continuing Education

9:35am-9:50am 9:50am-10:50am

10:55am-11:55am

12:00pm-12:50pm 12:55pm-1:55pm

2:00pm-3:00pm

RC = Recertification Consultant

Education: 1 hr GCE Compounding Pharmacy Today Where We Are! Sam Pratt, RPh, FIACP, Founding President, Pharmacy Specialists ACPE No. 165-000-09-054-L04-P Education: 1 hr GCE USP <797> Sterile Compounding Regulations: Florida and Federal Lynette Perales, RPh, CPh, <USP 797> Certified RPh, IV Center Pharmacy Staff Pharmacist, Shands Hospital at the University of Florida ACPE No. 165-000-09-055-L04-P BREAK Education: 1 hr GCE PCAB: Regulatory Solutions for Compounding Pharmacies Tom Murry, PharmD, Esq, Executive Director, Pharmacy Compounding Accreditation Board ACPE No. 165-000-09-056-L04-P Education: 1hr GCE Compounding Veterinary Medicines Paul Franck, RPh, FIACP, Owner, Franck’s Compounding Lab, Inc. ACPE No. 165-000-09-057-L04-P LUNCH Education: 1 hr GCE Florida Compounding Regulations Richard Sands, RPh, CPh, Statewide Pharmaceutical Program Manager, Florida Department of Health ACPE No. 165-000-09-058-L04-P Education: 1 hr GCE Sports Medicine and Pain Management Compounding Paul Franck, RPh, FIACP, Owner, Franck’s Compounding Lab, Inc. ACPE No. 165-000-09-059-L04-P

Who Should Attend?

• Community Pharmacists • Consultant Pharmacists • Hospital Pharmacists • Pharmacy Technicians • Pharmacy Students • Long term Care Pharmacists • Wholesalers • Compounding Pharmacists TECH = Technician

STC = Student Continuing Education JUNE 2009

Thursday, July 9, 2009

(6 hrs of GCE/TECH or 3 hrs RC) 6:00am 7:00am-8:30am

Registration Desk Open Education: 1.5 hrs GCE/TECH/RC “The Pharmacist’s Role in HIV Care: Can You Make A Difference? Part 1” (Will also be the required BOP HIV/AIDS course)

Michael Thompson, PharmD, BCNSP, Professor of Pharmacy, Florida A&M University Lisa Inge, PharmD, BCPS, AAHIVE, Assistant Professor of Pharmacy Practice, University of Florida College of Pharmacy Upon completion of this program, pharmacists should be able to: Review the epidemiology of the current HIV/AIDS pandemic; Identify when and which antiretroviral agents are indicated HIV positive individuals; Describe the potential benefits and limitations of these antiretroviral agents; Discuss potential roles of a pharmacist and technician in a patient’s treatment success. ACPE No. 165-000-09-060-L02-P Upon completion of this program, technicians should be able to: List the risk factors associated with HIV transmission; Explain what monitoring is utilized to measure effectiveness of antiretroviral therapy; Describe the challenges patients face when taking antiretroviral therapy. ACPE No. 165-000-09-060-L02-T 8:35am-10:05am Education: 1.5 hrs GCE/TECH/RC “The Pharmacist’s Role in HIV Care: Can You Make A Difference?” Part 2 Lisa Inge, PharmD, BCPS, AAHIVE, Assistant Professor of Pharmacy Practice, University of Florida College of Pharmacy Upon completion of this program, pharmacists should be able to: Describe the role of the pharmacist in clinical patient care activities; Explain the necessary steps in the development of a pharmacist run clinic; List possible mechanisms used to obtain funding sources for interventions with an example of outcome measurement; Review the current Florida Law on HIV/AIDS. ACPE No. 165-000-09-027-L02-P Upon completion of this program, technicians should be able to: Describe the general reasoning behind the statement “take all of your medications”; State why patient interactions are important in assessing the side effects of certain antiretroviral agents; Explain the Florida laws on HIV patient confidentiality. ACPE No. 165-000-09-027-L02-T 10:05am-10:15am Break 10:15am-11:15am Education: 1 hr GCE/TECH “Legislative and Regulatory Update” Michael Jackson, RPh, Executive Vice President and CEO, Florida Pharmacy Association Upon completion of this program, pharmacists should be able to: State the recent changes in the legislature which will affect the practice of pharmacy in Florida; Describe issues of state and national interest to the profession of pharmacy; Identify changes to the Pharmacy Practice Act as a result of legislative proposals. ACPE No. 165-000-09-048-L03-P Upon completion of this program, technicians should be able to: Identify recent statutory changes that affect the role of pharmacy technicians; Describe the purpose of the Board of Pharmacy; List the requirements to become registered with the Board of Pharmacy. ACPE No. 165-000-09-048-L03-T 11:20am-12:20pm Education: 1 hr GCE/TECH “The Role of the Pharmacist in Coordination of Care and Medication Therapy Management” Mary Kay Owens R.Ph, C.Ph., President of Southeastern Consultants, Inc.

CODE KEY: 24

GCE = General Continuing Education Florida Pharmacy TodaY

Upon completion of this program, pharmacists should be able to: Describe the patterns of behavior and utilization indicative of uncoordinated care; Discuss the data and implications regarding the cost of uncoordinated care in the population; Discuss the role of the pharmacist in cooperative partnership with other providers and review the “Medical Home Model”; Discuss a “Targeted “ approach to providing medication therapy management (MTM) services to demonstrate greater return on investment and improved quality of care. ACPE No. 165-000-09-028-L04-P Upon completion of this program, technicians should be able to: Define MTM; Define the Medical Home Model; Identify the impact of uncoordinated care in the state. ACPE No. 165-000-09-028-L04-T 11:20am-1:20pm (Non CE Credit) CE Provider Workshop For Florida Department of Health Providers 12:20pm-1:20pm Lunch (Attendees on their own) 12:20pm-1:20pm Annual Business Meeting (Lunch Available for Purchase) 1:25pm-2:25pm Education: 1 hr GCE/TECH/STC Keynote Address: “Advocating for Pharmacy: The Face of Neighborhood Healthcare” Steven C. Anderson, IOM, CAE, President and Chief Executive Officer, National Association of Chain Drug Stores Upon completion of this program, pharmacists and technicians should be able to: Describe the effects on community pharmacy public policy issues resulting from changes in the legislative and executive branches of the federal government caused by the 2008 elections; Describe the effects on community pharmacy public policy issues at the federal and state levels resulting from the economic climate; Describe opportunities for pharmacists, pharmacy students and other pharmacy personnel to make their opinions known among elected officials at the federal and state levels. ACPE No. 165-000-09-029-L04-P ACPE No. 165-000-09-029-L04-T 2:30pm-6:00pm Exhibit Hall Grand Opening 4:30pm-6:00pm Adopt-A-Student and Mentor Social 4:30pm-6:30pm Journal Board Meeting 7:00pm-8:00pm Foundation Reception Social

Friday, July 10, 2009

(7 hrs of GCE/TECH or 4.5 hrs RC) 6:00am 6:30am-7:00am 6:30am-7:30am

Registration Desk Open Golf Tournament Practice Christian Pharmacist Fellowship International Breakfast 7:30am Golf Tournament 7:00am-8:30am Education: 1.5 hrs GCE/TECH/RC “Diabetes Education: Making a Difference for Your Patients” DeAnn Mullins, RPh, CDE, CPh, CPT, WeCare Mullins Pharmacy Upon completion of this program, pharmacists should be able to: Explain the importance of improving diabetes care; Identify the possibilities of pharmacist delivered diabetes self-management education; Describe payment strategies for diabetes care services; Discuss the current standards of care based on the Clinical Practice Recommendations. ACPE No. 165-000-09-030-L01-P Upon completion of this program, technicians should be able to: Define diabetes; List the different types of diabetes; Describe complications of poorly controlled diabetes. ACPE No. 165-000-09-030-L01-T

RC = Recertification Consultant

TECH = Technician

STC = Student Continuing Education

Friday, July 10, 2009...cont’d 8:00am-9:45am 8:00am-10:00am

Local Unit Leaders Meeting Education: 2 hrs GCE/TECH/STC “NASPA/NMA Game Show” Tian Merren Owens, MS, PharmD, Director of Pharmacy Services, Florida Pharmacy Association Upon completion of this program, pharmacists should be able to: Identify and explain aspects of the effective and safe practice of pharmacy self care treatments through a process of answering a selected group of questions similar to a national board exam; Analyze the usage and effectiveness of over-the-counter medications; Classify different groups of over-the-counter medications based on drug treatment classes. ACPE No. 165-000-09-031-L04-P Upon completion of this program, technicians should be able to: Identify the use of over-the-counter medications; List the classes of various OTC products; Identify proper storage and handling techniques of OTC products. ACPE No. 165-000-09-031-L04-T 8:35am-10:05am Education: 1.5 hrs GCE/TECH/RC “Insulin Pump Therapy: Better is Better” DeAnn Mullins, RPh, CDE, CPh, CPT, WeCare Mullins Pharmacy Upon completion of this program, pharmacists should be able to: Discuss the purpose and expectations of insulin pump therapy; Recognize and understand the basic calculations needed to initiate pump therapy; Identify compensation opportunities for diabetes care. ACPE No. 165-000-09-032-L01-P Upon completion of this program, technicians should be able to: List treatment options for the management of diabetes; Define insulin pump therapy; Recognize the difference between insulin pump therapy and oral anti-diabetic therapy. ACPE No. 165-000-09-032-L01-T 10:00am-12:00pm Delegate Registration 10:05am-10:15am Break 10:15am-11:15am Education: 1 hr GCE/TECH/STC “Facilitating Change in Pharmacy Practice through Empowerment” Reginal Harris, PhD, MS, PharmD, President/Founder, InfoSource Communications, LLC Upon completion of this program, pharmacists should be able to: Define “Empowerment” from the perspective of progressive change in the Pharmacy workplace; Identify opportunities to empower oneself towards the attainment of career goals in diverse Pharmacy practice settings; Explain how leaders can consolidate improvements and produce more change by fostering an environment of empowerment; Discuss strategies of empowerment needed to break from the ‘status quo of dispensing’ and move towards patient care. ACPE No. 165-000-09-033-L04-P Upon completion of this program, technicians should be able to: Define Empowerment; Identify ways technicians can be empowered in different pharmacy settings; Explain how technicians can improve changes in their work environment. ACPE No. 165-000-09-033-L04-T 10:15am-11:45am Education: 1.5 hrs GCE/TECH/RC (To receive RC credit, consultants must attend Sunday’s course, Clinical Nutrition in the Private Practice of Pharmacy: Integrative Approach) “Tried and True Method of Bio-Identical Hormone Replacement” Robert Fishman, RPh, Owner, Post Haste Pharmacy Upon completion of this program, pharmacists should be able to: Describe and understand the relationship between the endocrine system and hormone replacement management; Explain men have the same hormones, why do women have more problems? Identify osteoporosis and what we are doing wrong.

CODE KEY:

GCE = General Continuing Education

RC = Recertification Consultant

ACPE No. 165-000-09-034-L01-P Upon completion of this program, technicians should be able to: Express when hormone replacement therapy is needed; Identify hormones men and women have in common; Define osteoporosis and list available treatments. ACPE No. 165-000-09-034-L01-T 11:15am-3:00pm Student Patient Counseling Competition 11:20am-12:20pm Education: 1 hr GCE/TECH/STC “Tell Me and I Will Forget. Involve Me and I Will Understand”- A Different Approach to Counseling-By Empowering Patients Maria Maniscalco, PharmD, RPh, Assistant Professor of Pharmacy, NOVA Southeastern University Upon completion of this program, pharmacists should be able to: Explain accurately the concept of patient empowerment; List six patient factors that are involved in measuring the impact of patient empowerment; Describe medication counseling strategies utilizing the concept of patient empowerment. ACPE No. 165-000-09-035-L04-P Upon completion of this program, technicians should be able to: Describe patient empowerment; List some factors involved in empowering the patient; Describe ways the pharmacy technician can assist patients in the pharmacy. ACPE No. 165-000-09-035-L04-T 12:20pm-1:00pm Lunch Break 1:00pm-2:00pm Education: 1 hr TECH/STC “Review of Pharmacy Calculations” Carmen Aceves Blumenthal, RPh, MS, Director of Pharmacy, Sister Emmanuel Hospital for Continuing Care Upon completion of this program, technicians and students should be able to: Recognize various units of measure; Identify basic mathematics and formulas necessary to calculate pharmacy problems; Use patient demographic information to solve patient specific dosages. ACPE No. 165-000-09-036-L04-T 1:00pm-3:00pm Education: 2 hrs GCE/TECH “Reducing Medication Errors Through Implementing a Continuous Quality Improvement Program” Michael Jackson, RPh, Executive Vice President and CEO, Florida Pharmacy Association Upon completion of this program, pharmacists should be able to: Define elements of a Continuous Quality Improvement Program; Restructure a pharmacy practice to address quality related events; Analyze some common causes of quality related events; Implement an action plan to address quality of care in pharmacies with a goal towards error reduction and prevention; Recite quality improvement regulations for Florida Pharmacies. ACPE No. 165-000-09-116-L05-P Upon completion of this program, technicians should be able to: Define CQI; List most common medication errors; Employ techniques to reduce medication errors by using CQI. ACPE No. 165-000-09-116-L05-T 2:00pm-3:00pm Education: 1 hr GCE/TECH “Advancing the Pharmacy Team by Empowering the Pharmacy Technician” Melissa Murer Corrigan, RPh, ExecutiveDirector/ Chief Executive Officer, Pharmacy Technician Certification Board (PTCB) Upon completion of this program, pharmacists and technicians should be able to: Discuss the importance of PTCB certification for advancing the pharmacy team; Explain the importance of training and lifelong learning as means of advancing a pharmacy technician’s career; Describe how training and certification of pharmacy technicians may create workforce solutions that empower the pharmacist to spend more time on patient-focused services; Discuss advances at PTCB that will enhance the testing and certification process for pharmacy technicians. ACPE No. 165-000-09-037-L04-P ACPE No. 165-000-09-037-L04-T

TECH = Technician

STC = Student Continuing Education JUNE 2009

2:00pm-3:00pm

Education: 1 hr STC (Non CE Credit) Preparing For The Most Important Test in My Career Todd Rosen, PharmD, Publix Supermarkets, Inc. Upon completion of this program, students should be able to: Discuss various therapeutic disease states; Identify treatment regimens for different disease categories; Review clinical questions that may improve testing techniques. 3:00pm-4:00pm Education: 1 hr GCE/TECH/STC Issue Presentation 3:00pm-5:00pm FPA House of Delegates 4:30pm-6:00pm Student Poster Presentations 4:30pm-7:00pm Exhibit Hall Opens 5:30pm Golf Winners Announced in Exhibit Hall 7:00pm-8:30pm PACCE Wine Tasting Reception 8:00pm-9:00pm #1 Club Reception (Invitation Only) 8:00pm-9:30pm University Alumni Receptions

Saturday, July 11, 2009 (7 hrs of GCE/TECH or 6 hrs RC)

6:00am 7:00am-8:30am

Registration Desk Open Education: 1.5 hrs GCE/TECH/RC “Role of the Pharmacist in Asthma Education” Maria Maniscalco, PharmD, RPh, Assistant Professor of Pharmacy, NOVA Southeastern University Upon completion of this program, pharmacists should be able to: Describe the role of the pharmacist in provision of asthma services in various healthcare settings; Discuss implementation strategies, and barriers, to creating an asthma management service in different healthcare settings; List available resources for developing an asthma management service. ACPE No. 165-000-09-038-L01-P Upon completion of this program, technicians should be able to: Define asthma; Recognize signs and symptoms of asthma; Identify risk factors associated with asthma. ACPE No. 165-000-09-038-L01-T 8:35am-10:05am Education: 1.5 hrs GCE/TECH/RC “Controversies In Asthma Therapy” Leslie Hendeles, PharmD, Professor, Pharmacy and Pediatrics, University of Florida Upon completion of this program, pharmacists should be able to: Describe the advantages of administering albuterol by MDI through a valved holding chamber; Discuss and cite evidence indicating that levalbuterol is neither safer nor more effective than racemic albuterol, just more expensive; Explain why inhaled corticosteroids should not be used for acute asthma; Justify why ipratropium should not be used in hospitalized patients. ACPE No. 165-000-09-039-L01-P Upon completion of this program, technicians should be able to: Define MDI; List therapies available for treatment of asthma; Assess if patient is relying on quick relief medications too often. ACPE No. 165-000-09-039-L01-T 9:00am-11:00am Education: 2 hrs GCE/TECH/STC “The Pharmacy Career Forum” Facilitator: Jim Powers, RPh, FPA Past President Presenters: Don Bergemann-Consultant; Melinda Collada-Home Infusion; Brian Kahan-Law; DeAnn Mullins-Diabetic Practice; Peggy Ann Zaenger-CE Med Information Upon completion of this program, participants should be able to: Recognize various practices of pharmacy and opportunities available to pharmacists; Describe the practice setting that best suit the individual skills and abilities; Identify personal strengths and

CODE KEY: 26

GCE = General Continuing Education |

Florida Pharmacy TodaY

RC = Recertification Consultant

weaknesses to consider when contemplating career choices. ACPE No. 165-000-09-040-L04-P ACPE No. 165-000-09-040-L04-T 10:05am-10:20am Break 10:20am-11:50am Education: 1.5 hrs GCE/TECH/RC “Pharmacy Managed Hyperlipidemia Clinic: How To Get Started” Tara Henry, PharmD, Clinical Pharmacist, North Florida South Georgia Veterans Medical Center Upon completion of this program, pharmacists should be able to: Clinic Initiation- Discuss clinic setup, workflow, scheduling, permits/licenses/credentials, and communication skills needed to initiate a pharmacist managed hyperlipidemia clinic; Clinical Protocols- Discuss the best clinical practices for hyperlipidemia management and how to create algorithms based upon available formulary options; Medication Therapy Management- Discuss the role of the pharmacist in providing MTM services. ACPE No. 165-000-09-041-L01-P Upon completion of this program, technicians should be able to: Define hyperlipidemia and hypertension; Identify normal ranges for lipids and blood pressure; Identify risk factors associated with hyperlipidemia and hypertension. ACPE No. 165-000-09-041-L01-T 11:15am-1:00pm Student Luncheon 12:00N-1:00pm Lunch Break 12:00N-1:00pm Education: 1 hr GCE/TECH “Board of Pharmacy Update” (Box Lunch Available for Purchase) Rebecca Poston, RPh, Director of Florida Board of Pharmacy Upon completion of this program, pharmacists should be able to: Describe the purpose of the Board of Pharmacy and its relationship to state government; Recognize recent changes in the Board of Pharmacy administrative rules affecting the practice of pharmacy; Identify proposed changes to the Board of Pharmacy administrative rules that are under consideration. ACPE No. 165-000-09-042-L04-P Upon completion of this program, technicians should be able to: Describe the purpose of the Florida Board of Pharmacy; Recognize recent changes in the Board of Pharmacy that affect the profession of pharmacy; Recognize changes in the Board that affect pharmacy technicians. ACPE No. 165-000-09-042-L04-T 1:00pm-2: 30pm Education: 1.5 hrs GCE/TECH/RC “Pharmacy Managed Hyperlipidemia Clinic: Practice Models and Payment Mechanisms for Clinical Services” Dan Buffington, PharmD, President and CEO, Clinical Pharmacology Services Upon completion of this program, pharmacists should be able to: Practice Model Design- Discuss different clinical practice models for pharmacist-managed hyperlipidemia services; Practice Documentation- Illustrate different methods for documenting ambulatory care practice records for pharmacist-based hyperlipidemia services; Reimbursement Strategies- Identify and demonstrate the application of different methods for billing and reimbursement for pharmacist-based clinical services, including the Current Procedural Terminology (CPT) Medication Therapy Management Services (MTMS) codes. ACPE No. 165-000-09-043-L01-P Upon completion of this program, technicians should be able to: List different models available for hyperlipidemia services; List various documentation methods; Define and explain the importance of Current Procedural Terminology (CPT). ACPE No. 165-000-09-043-L01-T 1:00pm-2:30pm Education: 1.5 hrs GCE/TECH/STC “FDA’s New Guideline for Over-theCounter Pediatric Cough & Cold Drugs”

TECH = Technician

STC = Student Continuing Education

Reginal Harris, PhD, MS, PharmD, President/ Founder, InfoSource Communications, LLC Upon completion of this program, pharmacists should be able to: Discuss briefly the evolution of FDA guidelines for over-the-counter medications; Identify the challenges of using OTC cough and cold drugs in children under 4 years of age; Outline the FDA Pediatric Committee and Nonprescription Drug Advisory Committee recommendations on the use of these drugs in children; Explain why drugmakers voluntarily made label changes to over-the-counter pediatric cough and cold drugs; Discuss counseling tips for parents, caregivers and healthcare professionals as recommended by the Consumer Healthcare Products Association (CHPA). ACPE No. 165-000-09-044-L04-P Upon completion of this program, technicians should be able to: Explain the role of the FDA; List reasons why children under 4 years of age should be careful with OTC products; Identify where OTC cough and cold products are located on the shelf in the pharmacy. ACPE No. 165-000-09-044-L04-T 1:00pm-2:30pm Delegate Registration 2:30pm-4:30pm House of Delegates Reconvenes 5:00pm-6:30pm Past Presidents Reception (Invitation Only) 6:00pm-10:00pm Awards Ceremony Reception

medications; Recognize conditions in which a person may need an anticoagulant. ACPE No. 165-000-09-045-L01-T 9:35am-11:05am Education: 1.5 hrs GCE/TECH/RC “Establishment of a Pharmacist-Managed Anticoagulation Service” Kristin Morse, PharmD, Clinical Pharmacy Service’s Director and PGY1 Residency Program Director, Florida Hospital Celebration Health Upon completion of this program, pharmacists should be able to: Discuss the rationale of an anticoagulation management service; Identify the basic needs to initiate a clinic; Describe options of obtaining payment for anticoagulation services. ACPE No. 165-000-09-046-L01-P Upon completion of this program, technicians should be able to: Describe the need for an anticoagulation clinic; List laboratory work performed for anticoagulant patients; Describe complications that can develop of disease in not under control. ACPE No. 165-000-09-046-L01-T 11:05am-11:20am Break 11:20am-12:50pm Education: 1.5 hrs GCE/TECH/RC (To receive RC credit, consultants must attend Friday’s course, Tried and True Method of Bio-Identical Hormone Replacement) “Clinical Nutrition in the Private Practice of Pharmacy: Integrative Approach” Robert Fishman, RPh, and Lynn Lafferty,PharmD, ND, CNC, Post Haste Pharmacy Upon completion of this program, pharmacists should be able to: Describe disease state management with the minimal use of pharmaceuticals (help your patients and increase your profits); Explain the use of nutrition to help the body recover and achieve normal balance; Discuss the use of glandulars to heal the body; Discuss the use of herbals and homeopathics to heal the body. ACPE No. 165-000-09-047-L04-P Upon completion of this program, technicians should be able to: Explain the role of nutrition on the body; Define glandulars; List therapies available for healing the body. ACPE No. 165-000-09-047-L04-T

Sunday, July 12, 2009 (4.5 hrs of GCE/TECH/RC)

6:00am 6:30am-8:00am

Registration Desk Open President’s Breakfast and Installation of Officers 8:00am-9:30am Education: 1.5 hrs GCE/TECH/RC “Strategies to Overcome Barriers Associated with Anticoagulation Clinics” Nancy Borja Hart, PharmD, BCPS, Assistant Professor, NOVA Southeastern University Upon completion of this program, pharmacists should be able to: Describe available anticoagulation clinic models; Discuss the limitations and barriers associated with each model; Describe methods to overcome barriers related to patient tracking and emergency situations. ACPE No. 165-000-09-045-L01-P Upon completion of this program, technicians should be able to: Define anticoagulation; List some anticoagulation

The Florida Pharmacy Association is accredited by the Accreditation Council for Pharmacy Education as a provider of Continuing Pharmacy Education. Up to 30 contact hours are available upon successful completion of the program through attendance and submission of completed attendance forms. Statements of continuing pharmacy education will be mailed six weeks after the meeting. The Florida Pharmacy is also a Florida Department of Health approved provider of continuing education for pharmacists. The program is an ACPE application based activity.

CODE KEY:

GCE = General Continuing Education

Hotel Information The Renaissance Resort at World Golf Village 500 South Legacy Trail St. Augustine, Florida 32092 Phone: (904) 940-8000 or (888) 740-7020 www.pharmview.com Florida Pharmacy Association will adhere to the American Disabilities Act (ADA) policy. Please contact us in advance for any special accommodations or arrangements at (850) 222-2400. RC = Recertification Consultant

TECH = Technician

STC = Student Continuing Education JUNE 2009

Florida Pharmacy TodaY

Florida Pharmacy Association 610 North Adams Street Tallahassee, FL 32301

PRSRT STD US Postage PAID Tallahassee, FL Permit #801

Florida Pharmacy Association

119 Annual Meeting and Convention th

Renaissance Resort at World Golf Village St. Augustine, FL

July 8-12, 2009

General Information Room Rates

(Rate cut off date is Wednesday, June 17, 2009). The special Florida Pharmacy Association Group room rate is $129 plus tax per night. Please be sure to ask for the Florida Pharmacy Association group rate. The check-in time is 4:00pm and the checkout time is 12:00 noon. Room reservations can be made by calling 1-888-740-7020. Complimentary self parking is available and valet parking is optional for a nightly fee.

Keynote Speaker

Steven C. Anderson, IOM, CAE is President and Chief Executive Officer of the National Association of Chain Drug Stores, a position he assumed in 2007. He represents and is the chief spokesman for the community pharmacy industry, which has annual sales of $827 billion. In 2004, Anderson was named the “Association Executive of the Year” by Association Trends newspaper, joining only 25 men and women honored with that title since 1980.

General Education Track Thursday - Sunday

The general education track will offer courses designed to educate pharmacists on a wide variety of important topics pertaining to their pharmacy practice. Specific courses being offered are Reducing Medication Errors, Over-The-Counter Medications, and a Board of Pharmacy Update as well as the always-popular offerings of Florida Legislative Update.

Consultant Education Track Thursday- Sunday Disease State Management Clinics

The consultant education track will provide the pharmacists with the most current information available on empowerment and overcoming barriers in various disease state clinics. Some specific therapeutic topics being offered include Management of Diabetes, Asthma, Lipid/ Hypertension, Anticoagulation, HIV/AIDS, and Hormonal Therapy. There are 18 hours available for consultant pharmacists.

Student and Technician Track Thursday – Sunday

Students and Technicians will benefit from interacting with practicing pharmacists and attending student and technician focused continuing education programs. The technician track offers several hours of continuing education on a variety of topics, including a course on Empowering The Technician. The student track consists of 10 hours of fun and exciting continuing education. Some specific courses being offered include Preparing for the Most Important Test In Your Career, Review of Pharmacy Calculations, and the NASPA/NMA Game Show.

Pre-Convention Education Wednesday Only

Our traditional Wednesday programming has expanded this year to a Wholesaler’s Conference and an outstanding Pharmacy Compound-

ing Program. The wholesaler’s conference will offer live continuing education credit. The compounding conference will offer 6 hours of live continuing education credit. Register for these programs and walk away with valuable information for your pharmacy practice. A separate registration fee is required for each program.

Special Events

Exhibits: Participate in our grand opening reception in the exhibit hall! Poster Presentations: Browse submissions from students. Contact Tian Merren Owens in the FPA office for more information if you would like to submit a poster presentation. Awards Ceremony Reception: Honor outstanding practitioners during the awards presentation. The Dress code is business casual which is a business suit or sports coat for men and a dinner dress or pants suit for women. President’s Breakfast: Attend the Sunday morning installation of new officers. Receptions: Enjoy catching up with your colleagues as the Universities entertain their alumni and friends, and as the FPA Foundation thank their supporters at a reception. House of Delegates: Be a delegate or observer and see how important member participation is to the direction of the Association. Student Events: Students will benefit from interacting with practicing pharmacists, attending student focused continuing education programs and learning first hand about the FPA and how involvement can improve their chosen profession. Call the FPA office and offer to mentor or sponsor a student. PharmPACCE Wine Tasting Reception: Purchase a ticket to this reception to support your Political Action Committee. Golf Tournament: Join us Friday morning for the traditional FPA Golf Tournament. Please register early to save your space. JUNE 2009