October 2009 Florida Pharmacy Journal by Florida Pharmacy Today

OCT. 2009

2009 H1N1 FLU: Situation Update

Buyer’s Guide florida PHARMACY TODAY

ADVERTISERS: This is a special section designed to give your company more exposure and to act as an easy reference for the pharmacist.

Support Our Advertisers! Use the “Buyer’s Guide” PHARMACY RESOURCES

PHarmaceutical WHOLESALER

PPSC Retail Pharmacy Purchasing Program (888) 778-9909

McKesson Drug Company Jim Springer (800) 804-4590 FAX: (863) 616-2953

PHARMACY CONSULTANTS HCC Pharmacy Business Solutions Bob Miller (800) 642-1652

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

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

LEGAL ASSISTANCE Kahan ◆ Shir, P.L. Brian A. Kahan, R.Ph., and Attorney at Law (561) 999-5999

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

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.

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

VOL. 72 | NO. 10 OCTOBER 2009 the official publication of the florida pharmacy association

Features

10 14 18

2009 H1N1 Flu: Situation Update Key Flu Indicators

City of Tallahassee Declares October as American Pharmacists Month The Florida Pharmacy Association 2009 Resolutions Presented to the House of Delegates

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FPA Calendar 2009

November 7-8

FPA Committee and Council Meetings Marriott Orlando Downtown Veterans Day - FPA Office Closed

13-15 NASPA Fall Symposium Naples, Florida 17-20 ASCP Senior Care Pharmacy Meeting Anaheim, California

January

5-6 Sarasota Law Conference Hyatt Regency at Sarasota Bay 8-9

Board of Pharmacy Meeting Jacksonville

6-10 ASHP Midyear Regional Conference Las Vegas, NV

of the Florida Pharmacy Today Journal

1 New Year's - FPA Office Closed

The Florida Pharmacy Today Journal is

30-31 FPA Law & Regulatory Conference Sandestin, FL

a peer reviewed journal which serves as a

31 Election ballots due

the profession on advances in the sciences of

medium through which the Florida Pharmacy Association can communicate with pharmacy, socio-economic issues bearing on

FEBRUARY 28 Awards nomination deadline March

26-27 Thanksgiving, FPA Office closed December

Mission Statements:

to the profession. As a self-supported journal, it solicits and accepts advertising congruent with its expressed mission.

Florida Legislative Session Begins

12 -15 APhA annual meeting Washington, D.C. 23 - 25 Pharmacy Legislative Day at the Florida Capital 24

pharmacy and newsworthy items of interest

of the Florida Pharmacy Today Board of Directors The mission of the Florida Pharmacy Today

Florida Pharmacists Health Fair

Board of Directors is to serve in an advisory

27 - 28 FPA Committee and Council meetings and Board of Directors

capacity to the managing editor and execu-

24-25 Christmas Holiday FPA Office Closed

tive 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, 2011 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 Healthcare consultants..................... 3 Kahan ◆ SHIR, P.L......................................... 11 MEDICAL STAFFING...................................... 12 PHARMACY PROVIDER SERVICES (PPSC)........................................ 13 Rx RElief.......................................................... 11

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

The Presidentâ&#x20AC;&#x2122;s Viewpoint BY GUEST COLUMNIST Ken Wisniewski, 2009-2010 Legislative Committee Chair

Legislative Update: 2009-2010 Have You Heard?

lmost every day you hear more about health care reform. And today is no exception. It is critical that pro-pharmacy issues be included in health care reform. Therefore, in mid-September FPA Executive Vice President and CEO Michael Jackson, and APhA President (and former FPA President) Ed Hamilton traveled to Washington, D.C., to do strategic visits on Capitol Hill. They worked together with pharmacists from other states to inform the legislators of the benefits of pharmacist-provided MTM services, and to support MTM provisions in the current health care reform proposals. In addition to all the changes on the national health care horizon, Florida is

also looking at many other legislative issues that could affect the practice of pharmacy in our own state. The Florida Pharmacy Association will be keeping a close watch on these issues for you this year. In July, the FPA Legislative Committee met to determine a priority list of issues that need to be addressed during the 2010 legislative session. The list is provided below, with the caveat that priorities and/or items may change if unforeseen issues that affect pharmacy arise during the legislative session. The list of legislative priorities for the Florida Pharmacy Association for the coming year is as follows: 1. PBM Legislation: The committee

Ken Wisniewski 2009-2010 Legislative Committee Chair

has recommended this as the No. 1 priority. This is a national issue that will be difficult to advance in the current Florida Legislature. We will work to develop language for a bill to be introduced. 2. Medicaid Appropriations: This issue is always on our agenda. Last year we were faced with multiple reductions, but were able to minimize the financial impact on pharmacy. Will Medicaid reductions once again be an issue in 2010? We believe it is necessary to be prepared. 3. Anti-substitution of epilepsy and immunosuppressant drugs: This topic continues to be an item of discussion around the country. A study group that will look at pharmacists interchanging these prescription drugs has yet to meet, but there may be more to come regarding this issue. 4. Adequate funding for state pharmacy schools: This item will be moniO C T O B ER 2 0 0 9

2009/2010 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.

Norman Tomaka.....................................Chairman of the Board of Directors Karen Whalen...............................................................................................FPA President Don Bergemann.....................................................................................................Treasurer Alexander Pytlarz..................................Speaker of the House of Delegates Dean William Riffee...................Vice 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, Director............................................................................................ Region 7 Joy Marcus, Director...........................................................................................Region 8 Ayala Fishel, Director...........................................................................................Region 9 Peter Iafrate............................................................................................. President FSHP Michael Jackson........................................Executive Vice President and CEO

Florida Pharmacy Today Journal Board Chair Designate....................................... Betty Harris, beejpharm@gmail.com Treasurer....................Stephen Grabowski, sgrabowski@seniormmc.com Secretary...................................................................Stuart Ulrich, Stuarx@aol.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

tored. When requested by the universities, we will support them on this issue. Seeking Grassroots Advocates Who makes the decisions that will affect our profession? Yes, the legislators would be one answer, but the best answer is YOU. Have you heard that if you do not stand up and speak for pharmacy that you are leaving the decisions to our legislators? Do you know your state legislators? Have you spoken to yours? It is important that they know who you are and what you stand for. Successful legislative efforts require a lot of work, specifically networking. We are asking all pharmacists to join those already working on your behalf. Getting Started 1. Send an email and then call your state legislator to introduce yourself and show your passion for pharmacy. 2. Set an appointment to meet your legislator face-to-face in their home office before December. 3. Know the key pharmacy issues so we can present a unified voice. 4. Join us and meet your legislator in Tallahassee next March during Florida Pharmacist Legislative Days. If you don’t know who your representative is, find out by going to the FPA Web site (www.pharmview.com) and click on the Advocacy tab to find the link to “Who Are My Florida State Legislators?” Our grassroots effort is how you can make a difference. If not you, then who is going to educate our representatives? If you currently provide a legislator or their family with pharmacy services, you are in a unique position to foster good will and educate them about what pharmacists can do. Leverage what you know by talking to them about their drug therapy and presenting MTM as a meaningful way to help control health care costs. You have a powerful story to tell. We hope you will take action and help move the profesSee "Viewpoint" continued on page 22

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

What is the Value of Professional Organizations?

hese days, we are all going to have to watch our spending habits and scrutinize which bills get paid, which bills get delayed and which bills we leave in decay. While the nation and our state struggle to right themselves during these challenging economic times, it is no wonder that participation in membership organizations rise to the top of the scrutiny list. Our personal budgets become a list of needs with the number of wants declining dramatically. Food and shelter are essential expenditures that are not included in the disposable income budgets. This is followed by transportation, communication, health care, insurance, education and training. Disposable income generally has been used for such things as entertainment, vacation, gifts and charitable contributions. It is within this part of our personal budgets that we allocate funds to support our professional associations and societies. Why sign up for membership in an organization? While we each may have our own reasons, some of the more obvious direct benefits include discounts on offered continuing-education programs, general assistance with regulatory issues, and discounts on services provided by the association’s member benefits partners such as car rentals, hotel stays and telecommunication services. There also are benefits such as competitive rates on workers compensation insurance, complimentary access to FPA’s web based law and regulatory information resource and discounts on our controlled substance inventory booklet. There also are benefits from receiving breaking information on regulatory and legislative changes to critical pharmacy rules and laws from news-

letters and the Association’s monthly journal. The FPA has a member retention program called the #1 Club. This organization within the FPA is designed for members who believe so much in the Florida Pharmacy Association’s mis-

[The #1 Club] within the FPA is designed for members who believe so much in the Florida Pharmacy Association’s mission and vision that they are willing to reach out to others to encourage their joining our organization. sion and vision that they are willing to reach out to others to encourage their joining our organization. There is a direct benefit here in that those members who actively recruit 10 regular members into the FPA receive a complimentary registration at the annual meeting, a sporty red blazer and a plaque with recognition for their commitment. In addition, complimentary registration is awarded for the continued participation each year as an active #1 Club member through the recruitment of three new regular members during each convention year.

Michael Jackson, BPharm

This is all great information, however there are other reasons to support your professional organizations that may not necessarily fall into direct benefit categories. Over the years, the careers of pharmacists have blossomed into areas that produced significant personal financial growth. Part of this has been through the demand for pharmacist dispensing services, the building of many venues requiring licensed pharmacists and the development and advertising of new prescription drugs. This demand for pharmacists, though moderating in recent years, has created a number of new career options for currently practicing pharmacists as well as for new pharmacy candidates enrolled in our five colleges and universities here in Florida. We hope that our members are aware that this profession was advocated for by the Florida Pharmacy Association through the creation of the Board of Pharmacy. The purpose was to ensure that only those who qualify should be allowed to practice this profession. The intent was also O C T O B ER 2 0 0 9

FPA Staff 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 Membership Coordinator Ranada Simmons , ext. 110 Educational Services Office Assistant Stacey Brooks , ext. 210 Florida Pharmacy Today Board Chair Designate........Betty Harris, Lighthouse Point Treasurer...............................Stephen Grabowski, Tampa Secretary.........................Stuart Ulrich, Boynton Beach 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

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to advocate for consumer confidence in the services that we provide and that our profession has individuals with the skills and knowledge to resolve patient medication issues without causing harm. Keep in mind that other benefits include the vast networking opportunities to gain knowledge from others within our organization who have developed innovative practices or who have resolved a health care service re-

generally were at a competitive advantage over a pharmacist candidate who could only produce a great transcript and time behind the workbench. Finally, simply reporting legislative or regulatory changes to the practice act are not the sole task of professional organizations. They also invest a considerable amount of resources into advocating for change or revisions to the laws and rules that affect how you provide services to patients as well as de-

Over half of your dues go into the funding of our advocacy program. lated issue. While we can learn much from what is published in the pharmacy press, there is a wealth of knowledge from peer dialog at conferences and leadership meetings. Organizations also share information of interest and value with their members. The value of information in today’s competitive world is truly underestimated. I know of pharmacists who received lucrative promotions from their employer simply because they had information provided to them by their organizations or that no one else had. It is no secret that many organizations such as the FPA have active members who have the ability to make decisions whether a pharmacist candidate has the necessary skills, training and commitment to their profession in today’s competitive hiring market. Having been a former district manager with responsibility over 58 prescription departments in three states, I can tell you from experience that I looked carefully at applicants who could demonstrate to me their involvement in their growth and development beyond standard classroom, internship training and work experience. Those who were actively involved in their professional organizations and had the experience of networking and communicating with consumers and other health care practitioners with ease

fending against policy making that creates professional barriers. In many cases, the practice evolves beyond state and federal regulations. Your professional organizations work to facilitate the change necessary to make sure that the laws are sensible and relevant in today’s modern pharmacy practice environment. Then we must be a resource to you to help integrate these changes so that you do not fall out of compliance. A portion of our membership will be receiving renewal notices for the January billing cycle. We hope that you have found some of the information in this article beneficial and encouraging enough to invest in your profession. Over half of your dues go into the funding of our advocacy program. The dues paid by our regular members are barely equal to the cost associated with drinking two bottled waters a week. We hope that the information in this article encourages you to continue your support for our profession and allow your dues to be an essential expenditure. Please consider it an investment in your future. n

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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2009 H1N1 Flu: Situation Update Key Flu Indicators

Each week CDC analyzes information about influenza disease activity in the United States and publishes findings of key flu indicators in a report called FluView. During the week of September 27 - October 3, 2009, a review of the key indictors found that influenza activity increased in the United States. Below is a summary of the most recent key indicators: ■■

■■

Visits to doctors for influenza-like illness (ILI) continued to increase in the United States, and overall, are higher than levels expected for this time of the year. Total influenza hospitalization rates for laboratory-confirmed influenza are higher than expected for this time of year for adults and children. And for children 5-17 and adults 18-49 years of age, hospitalization rates from April – October 2009 exceed average flu season rates (for October through April). The proportion of deaths attributed to pneumonia and influenza (P&I) based on the 122 Cities Report has increased and now exceeds what is normally expected at this time of year. In addition, 19 flu-related pediatric deaths were reported this week; 16 of these deaths were confirmed 2009 H1N1 and 3 were unsubtyped influenza A and likely to be 2009 H1N1. A total of 76 laboratory confirmed 2009 H1N1 pediatric deaths have been reported to CDC since April. Thirty-seven states are reporting widespread influenza activity at this time. They are: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Texas, Tennessee, Virginia, Washington, and Wyoming. Any reports of widespread influenza activity in September and October are very unusual. Almost all of the influenza viruses identified so far are 2009 H1N1 influenza A viruses. These viruses remain similar to the virus chosen for the 2009 H1N1 vaccine, and remain susceptible to the antiviral drugs oseltamivir and zanamivir with rare exception. CDC Guidance for Businesses and Employers To Plan and Respond to the 2009–2010 Influenza Season

Introduction The U.S. Department of Health and Human Services’ (HHS) Centers for Disease Control and Prevention (CDC), with input from the U.S. Department of Homeland Security (DHS), has developed updated guidance for employers of all sizes to use as they develop or review and update plans to re10

Flo r i d a P h a r m a c y T o d a Y

spond to 2009 H1N1 influenza now and during the upcoming fall and winter influenza season. Businesses and employers, in general, play a key role in protecting employees’ health and safety, as well as in limiting the negative impact of influenza outbreaks on the individual, the community, and the nation’s economy. Employers who have developed pandemic plans should review and revise their plans in light of the current 2009 H1N1 influenza outbreak to take into account the extent and severity of disease in their community as outlined in this guidance.2 Planning for Fall and Winter Influenza Season Businesses may have already been impacted by the spring and summer outbreaks of 2009 H1N1 influenza affecting their employees. CDC anticipates that more communities may be affected than were in the spring/summer 2009, and/or more severely affected reflecting wider transmission and possibly greater impact. In addition, seasonal influenza viruses may cause illness at the same time as 2009 H1N1 this fall and winter. In response to the anticipated spread of 2009 H1N1 influenza, the CDC has revised its recommendations to assist businesses and other employers of all sizes. The severity of illness that 2009 H1N1 influenza flu will cause (including hospitalizations and deaths) or the amount of illness that may occur as a result of seasonal influenza during the 2009–2010 influenza season cannot be predicted with a high degree of certainty. Therefore, employers should plan to be able to respond in a flexible way to varying levels of severity and be prepared to refine their pandemic influenza response plans if a potentially more serious outbreak of influenza evolves during the fall and winter. More people and communities are likely to be affected as influenza is more widely transmitted. The CDC and its partners will continuously monitor national and international data on the severity of illness caused by influenza, will disseminate the results of these ongoing surveillance assessments and will make additional recommendations as needed. Considerations of Appropriate Response Strategies All employers must balance a variety of objectives when determining how best to decrease the spread of influenza and lower the impact of influenza in the workplace. They should

consider and communicate their objectives, which may include one or more of the following: (a) reducing transmission among staff, (b) protecting people who are at increased risk of influenza related complications from getting infected with influenza, (c) maintaining business operations, and (d) minimizing adverse effects on other entities in their supply chains. Employers should expect to see a wide range of disease patterns across the country. Employers should base their strategies and response to influenza outbreaks on local information from local and state public health authorities. Some of the key indicators that should be used when making decisions on appropriate responses are: ■■ Disease severity (i.e., hospitalization and death rates) in the community where business is located; ■■ Extent of disease (number of people who are sick) in the community; ■■ Amount of worker absenteeism in your business or organization; ■■ Impact of disease on workforce populations that are vulnerable and at higher risk (e.g., pregnant women, employees with certain chronic medical conditions that put them at increased risk for complications of influenza); and ■■ Other factors that may affect employees’ ability to get to work, such as school dismissals or closures due to high levels of illness in children or school dismissals. Employers need to plan now to be able to obtain updated

information on these indicators from state and local health departments in each community where they have a business presence and to respond quickly to the changing reality on the ground. Employers with more than one business location are encouraged to provide local managers with the authority to take appropriate actions outlined in their business pandemic plan based on the condition in each locality. Preparedness and Response Recommendations Planning for 2009 H1N1 and the 2009–2010 influenza season This guidance is designed to help employers plan for and respond to two possible conditions: 1) a continuation of the current level of severity of influenza as was observed during the spring and summer of 2009 and 2) a more severe outbreak. The first situation is what is being experienced in some communities now—an outbreak of similar severity of 2009 H1N1 to the spring. However, even if the severity of the virus does not change, planners should expect that there will be more people who are ill in the fall and winter as 2009 H1N1 outbreaks coincide with the seasonal influenza season, and this level of absenteeism may impact business operations. A second situation involves an outbreak of greater severity including more people with severe illness and thus, more people hospitalized for influenza complications; more deaths from influenza; and a probable escalation of absenteeism.

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Businesses should have an understanding of their normal seasonal absenteeism rates and know how to monitor their personnel for any unusual increases in absenteeism through the fall and winter. Business continuity planners should assess their essential business functions now to determine at what threshold of absenteeism those functions would be threatened if absenteeism escalates. Planners can then prepare to take more aggressive measures to protect continuity as absenteeism escalates towards those thresholds. Even employers in communities that have not yet felt effects from 2009 H1N1 influenza should plan for an influenza outbreak this fall and winter, and be ready to implement strategies to protect their workforce while ensuring continuity of operations. During an influenza pandemic, all sick people should stay home and away from the workplace, hand washing and covering coughs and sneezes should be encouraged, and routine cleaning of commonly touched surfaces should be performed regularly. If the severity of illness increases, employers should be ready to implement additional measures while continuing to rigorously implement the interventions recommended for an outbreak similar to the spring/summer 2009 H1N1 outbreak. If severity increases, public health officials may recommend a variety of methods for increasing the physical distance between people (called social distancing) to reduce the spread of disease, such as school dismissal, child care program closure, canceling large community gatherings, canceling large business-related meetings, spacing workers farther apart in the workplace, canceling non-essential travel,

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and recommending work-from-home strategies for workers that can conduct their business remotely. Please remember: employers should develop capabilities to respond to both scenarios and these two conditions serve only as a planning framework. Businesses and other employers should develop flexible capabilities to respond to either situation given the difficulties in accurately predicting the extent and severity of 2009 H1N1 as it unfolds during the 2009– 2010 influenza season. Individual businesses may implement additional actions if they experience high absenteeism or business continuity is compromised. In addition, employers should be aware that other emergencies such as hurricanes or other natural disasters may happen during the fall and winter, creating additional challenging problems for businesses and communities. Work with State and Local Public Health Partners

Coordination with state and local health officials is strongly encouraged for all businesses so that timely and accurate information can guide appropriate responses in each location where their operations reside. Since the intensity of an outbreak may differ according to geographic location, local public health officials will be issuing guidance specific to their communities. Also, businesses could work with public health and community leaders to explore ways of improving accessibility of vaccination for the workforce and in the community. Keep Sick Workers Home

One of the best way to reduce the spread of influenza is to keep sick people away from well people. However, in the fall and winter, it will not be possible to quickly determine if workers who are ill have 2009 H1N1, seasonal influenza, or any number of other different conditions based on symptoms alone. Local and state health department surveillance information can be helpful to know when influenza is circulating in the community, although the availability, timeliness, and amount of local information on when influenza is circulating may vary substantially from community to community. Workers who have symptoms of influenza-like illness3 are recommended to stay home and not come to work until at least 24 hours after their fever has resolved.4 Regardless of the size of the business or the function or services that you provide, all employers should plan now to allow and encourage sick workers to stay home without fear of losing their jobs. CDC recommends this strategy for all levels of severity. Employers should plan now for how they will operate if there is significant absenteeism from sick workers. However, employers should know that some persons with influenza, including those ill with 2009 H1N1, do not have fever. Therefore it will not be possible to exclude everyone who is ill with influenza from the workplace. Be Prepared if Schools Dismiss Students or Child Care Programs Close

In some communities, schools may dismiss students and childcare programs may close, particularly if the severity in-

creases.5 Officials will make these decisions to protect public health, but they will affect your business’s functioning, especially affecting absenteeism. Plan now to determine how you will operate if absenteeism spikes from increases in sick workers, those who stay home to care for ill family members, and those who must stay home to watch their children if dismissed from school. Businesses and other employers should prepare to institute flexible workplace and leave policies for these workers. Actions Employers Should Take Now Review or establish a flexible influenza pandemic plan and involve your employees in developing and reviewing your plan; ■■ Conduct a focused discussion or exercise using your plan, to find out ahead of time whether the plan has gaps or problems that need to be corrected before flu season; ■■ Have an understanding of your organization’s normal seasonal absenteeism rates and know how to monitor your personnel for any unusual increases in absenteeism through the fall and winter. ■■ Engage state and local health department to confirm channels of communication and methods for dissemination of local outbreak information; ■■ Allow sick workers to stay home without fear of losing their jobs; ■■ Develop other flexible leave policies to allow workers to ■■

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stay home to care for sick family members or for children if schools dismiss students or child care programs close; Share your influenza pandemic plan with employees and explain what human resources policies, workplace and leave flexibilities, and pay and benefits will be available to them; Share best practices with other businesses in your communities (especially those in your supply chain), chambers of commerce, and associations to improve community response efforts; and Add a “widget” or “button” to your company Web page or employee Web sites so employees can access the latest information on influenza: www.cdc.gov/widgets/ and www.cdc.gov/SocialMedia/Campaigns/H1N1/buttons. html

Important Components of an Influenza Pandemic Plan ■■ Be prepared to implement multiple measures to protect workers and ensure business continuity. A layered approach will likely work better than using just one measure. ■■ Identify possible work-related exposure and health risks to your employees. The Occupational Safety and Health Administration (OSHA) has developed tools to determine if your employees are at risk of work-related exposures and, if so, how to respond (see www.osha.gov/dsg/topics/

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City of Tallahassee Declares October as American Pharmacists Month Tallahassee Mayor John Marks has declared October as American Pharmacist Month.Â In a proclamation signed on October 1, 2009 Mayor Marks urged all citizens to acknowledge the valuable services of pharmacists to provide safe, affordable and beneficial pharmaceutical care services and products to all citizens. The Florida Pharmacy Association wish to thank our FAMU intern Carina Davison for her work with the City of Tallahassee during her rotation here at the FPA office.

FR OM THE GOVER NING BODY OF TH E CITY OF TALLAH ASSEE

PROCLAMATION Whereas, pharmacy is one of the oldest of the health professions concerned with the health and well-being of all people; and Whereas, today, there are over 254,000 pharmacists practicing in the United States and over 400 pharmacists licensed in the city of Tallahassee providing services to assure the rational and safe use of all medications; and Whereas, the use of medication, as a cost-effective alternative to more expensive medical procedures, is becoming a major force in moderating overall health care costs; and Whereas, today's powerful medications require greater attention to the manner in which they are used by different patient population groups -both clinically and demographically; and Whereas, it is important that all users of prescription and nonprescription medications, or their caregivers, be knowledgeable about and share responsibility for their own drug therapy; and Whereas, the American Pharmacists Association, and the Florida Pharmacy Association have declared October as American Pharmacists Month with the theme Know Your Medicines - Know Your Pharmacist; Now, therefore, be it resolved that I, John Marks, do hereby proclaim October as American Pharmacists Month in the city of Tallahassee and urge all our citizens to acknowledge the valuable services of pharmacists to provide safe, affordable, and beneficial pharmaceutical care services and products to all citizens.

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pandemicflu/index.html). Review human resources policies to make sure that policies and practices are consistent with public health recommendations and are consistent with existing state and federal workplace laws (for more information on employer responsibilities, employers should visit the Department of Labor’s and the Equal Employment Opportunity Commission’s websites at www.dol.gov and www.eeoc.gov). Allow employees to stay home if they are ill, have to care for ill family members, or must watch their children if schools or childcare facilities close. Explore whether you can establish policies and practices, such as flexible worksites (e.g., telecommuting) and flexible work hours (e.g., staggered shifts), when possible, to increased the physical distance among employees and between employees and others if local public health authorities recommend the use of social distancing strategies. Ensure that you have the information technology and infrastructure needed to support multiple workers who may be able to work from home. Identify essential business functions, essential jobs or roles, and critical elements within your supply chains (e.g., raw materials, suppliers, subcontractor services/ products, and logistics) required to maintain business operations. Plan for how your business will operate if there is increasing absenteeism or these supply chains are interrupted. Set up authorities, triggers, and procedures for activating and terminating the company’s response plan, altering business operations (e.g., possibly changing or closing operations in affected areas), and transferring business knowledge to key employees. Work closely with your local health officials to identify these triggers. Plan to minimize exposure to fellow employees or the public if public health officials call for social distancing. Establish a process to communicate information to workers and business partners on your 2009 H1N1 influenza response plans and latest 2009 H1N1 influenza information. Anticipate employee fear, anxiety, rumors, and misinformation, and plan communications accordingly.

Over the past several years, HHS, CDC, DHS, OSHA, EEOC, and other federal partners have developed guidelines, including checklists, to assist businesses, industries, and other employers in planning for a pandemic outbreak. Review these resources to assist in your planning efforts: www.flu. gov/plan/workplaceplanning/index.html. The recommendations that follow provide guidance on how employers can develop strategies and respond to two levels of severity. Local conditions will influence the decisions that public health officials make regarding communitylevel strategies; employers should take the time now to learn about plans in place in each community where they have a presence.

Recommended Employer Responses for the 2009-2010 Flu Season Recommended Action Steps under Current Flu Conditions (similar severity as in Spring/Summer 2009) If the severity of illness in the fall and winter is similar to that observed in the spring and summer of 2009, the effects of 2009 H1N1 influenza may not have substantial impacts on absenteeism, though some increase in absenteeism over the spring season is anticipated. When larger numbers of people become ill, correspondingly larger numbers of people will become seriously ill and may require hospitalization. Sick persons should stay home ■■

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Advise workers to be alert to any signs of fever and any other signs of influenza-like illness6 before reporting to work each day, and notify their supervisor and stay home if they are ill. Employees who are ill should not travel while they are ill. CDC recommends that employees with influenza-like illness remain at home until at least 24 hours after they are free of fever (100° F [37.8° C] or greater), or signs of a fever, without the use of fever-reducing medications. Expect sick employees to be out for about 3 to 5 days in most cases, even if antiviral medications are used. Ensure that your sick leave policies are flexible and consistent with public health guidance and that employees are well aware of these policies. Talk with companies that provide your company with contract or temporary workers about the importance of sick workers staying home and encourage them to develop non-punitive leave policies. Do not require a doctor’s note for workers who are ill with influenza-like illness to validate their illness or to return to work, as doctor’s offices and medical facilities may be extremely busy and may not be able to provide such documentation in a timely way. Employees who are well but who have an ill family member at home with influenza can go to work as usual. However, these employees should monitor their health every day, and notify their supervisor and stay home if they become ill. Employers should maintain flexible policies that permit employees to stay home to care for an ill family member. Employers should be aware that more workers may need to stay at home to care for ill children or other ill family members than is usual.

Sick employees at work should be asked to go home ■■

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CDC recommends that workers who appear to have an influenza-like illness upon arrival or become ill during the day be promptly separated from other workers and be advised to go home until at least 24 hours after they are free of fever (100° F [37.8° C] or greater), or signs of a fever, without the use of fever-reducing medications. Those who become ill with symptoms of an influenza-like illness during the work day should be: O C T O B ER 2 0 0 9

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o Separated from other workers and asked to go home promptly. (For recommendations on personal protective equipment for a person assisting the ill employee, see Interim Recommendations for Facemask and Respirator Use to Reduce Novel Influenza A (H1N1) Virus Transmission; http://www.cdc.gov/h1n1flu/masks. htm.) o When possible and if they can tolerate it, workers with influenza-like illness should be given a surgical mask to wear before they go home if they cannot be placed in an area away from others. If an employee becomes ill at work, inform fellow employees of their possible exposure in the workplace to influenza-like illness but maintain confidentiality as required by the Americans with Disabilities Act (ADA). For more information on privacy issues, please refer to: http://www. flu.gov/faq/workplace_questions/equal_employment/index.html#PrivacyIssues. Employees exposed to a sick coworker should monitor themselves for symptoms of influenza-like illness and stay home if they are sick.

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Take measures to protect employees who are at higher risk for complications of influenza ■■

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Cover coughs and sneezes ■■

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Influenza viruses are thought to spread mainly from person to person in respiratory droplets of coughs and sneezes. Provide employee messages on the importance of covering coughs and sneezes with a tissue or, in the absence of a tissue, one’s sleeve. Place posters in the worksite that encourages cough and sneeze etiquette. Provide tissues and no-touch disposal receptacles for use by employees.

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Improve hand hygiene ■■

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Influenza may be spread via contaminated hands. Instruct employees to wash their hands often with soap and water or use an alcohol-based hand cleaner, especially after coughing or sneezing. Place posters in the worksite that encourage hand hygiene. Provide soap and water and alcohol-based hand sanitizers in the workplace. Ensure that adequate supplies are maintained. If feasible, place hand sanitizers in multiple locations or in conference rooms to encourage hand hygiene.

Clean surfaces and items that are more likely to have frequent hand contact ■■

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Frequently clean all commonly touched surfaces in the workplace, such as workstations, countertops, and doorknobs. Use the cleaning agents that are usually used in these areas and follow the directions on the label. No additional disinfection beyond routine cleaning is recommended.

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Encourage your employees to get vaccinated for seasonal influenza. For information on groups prioritized for seasonal influenza vaccines, please see http://www.cdc.gov/ flu/protect/keyfacts.htm. Encourage your employees also to get vaccinated for 2009 |

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People at higher risk for complications from influenza include pregnant women; children under 5 years of age; adults and children who have chronic lung disease (such as asthma), heart disease, diabetes, diseases that suppress the immune system and other chronic medical conditions; and those who are 65 years or older.7 Inform employees that some people are at higher risk of complications from influenza and that if they are at higher risk for complications, they should check with their health care provider if they become ill. Early treatment with antiviral medications is very important for people at high risk because it can prevent hospitalizations and deaths. Encourage employees recommended for seasonal influenza vaccine and 2009 H1N1 vaccines to get vaccinated as soon as these vaccines are available. For information on groups prioritized for seasonal and H1N1 vaccines, please see http://www.cdc.gov/flu/protect/keyfacts.htm and http://www.cdc.gov/h1n1flu/vaccination/acip.htm. Employees who become ill and are at increased risk of complications from influenza and ill employees who are concerned about their illness should call their health care provider for advice. Their health care provider might want them to take antiviral medications to reduce the likelihood of severe complications from the influenza. See http://www.cdc.gov/h1n1flu/qa.htm for more information.

Prepare for increased numbers of employee absences due to illness in employees and their family members, and plan ways for essential business functions to continue. ■■

Encourage employees to get vaccinated ■■

H1N1 influenza when vaccines are available to them. Different groups are prioritized for 2009 H1N1 influenza than for seasonal influenza. For information on groups prioritized for H1N1 influenza vaccine please see http:// www.cdc.gov/h1n1flu/vaccination/acip.htm. Offer opportunities at your worksite for influenza vaccination. Consider granting employees time off from work to get vaccinated if not offered at the worksite. Review the health benefits you offer employees and work with insurers to explore if they can cover the costs of influenza vaccination.

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Employers should plan to monitor and respond to absenteeism at the workplace. Implement plans to continue your essential functions in case you experience higher than usual absenteeism. Elevated absentee rates can be due to sick workers, those who need to stay home and care for others, or from workers with conditions that make them at higher risk for complications from influenza and who may be worried about coming to work. Cross-train personnel to perform essential functions so that the workplace is able to operate even if key staff are absent.

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Assess your essential functions and the reliance that others and the community have on your services or products. Be prepared to change your business practices if needed to maintain critical operations (e.g. identify alternative suppliers, prioritize customers, or temporarily suspend some of your operations if needed).

Advise employees before traveling to take certain steps ■■

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Advise workers to check themselves for fever and any other signs of influenza-like illness before starting travel and notify their supervisor and stay home if they are ill. Advise employees who will be traveling or on temporary assignment about precautions they may need to take to protect their health and who to call if they become ill. Employees who become ill while traveling and are at increased risk of complications from influenza and others concerned about their illness should promptly call a health care provider for advice. Ensure employees who become ill while traveling or on temporary assignment understand that they should notify their supervisor. If outside the United States, ill employees should follow your company’s policy for obtaining medical care or contact a health care provider or overseas medical assistance company to assist them with finding an appropriate health care provider in that country, if needed. A U.S. consular officer can help locate health care services. However, U.S. embassies, consulates, and military facilities do not have the legal authority, capability, and resources to evacuate or give medications, vaccines, or medical care to private U.S. citizens overseas. See CDC’s Travel Website (http://wwwn.cdc.gov/travel/content/novel-h1n1-flu.aspx) for more information for travelers.

If 2009 H1N1 becomes more severe than during spring/ summer 2009, absenteeism will likely be far greater, and additional protective measures to slow the spread of influenza may be considered. Check with your local health department for the extent and severity of disease activity in your community and for recommendations for necessary measures. Decisions about what tools should be used during a severe 2009 H1N1 outbreak should be based on the observed severity of the event; its impact on specific subpopulations; the need to protect workers; the expected benefit of the interventions; the feasibility of success of implementing these measures; the direct and indirect costs of different interventions; and the effects on critical infrastructure, health care delivery, and society. The following are measures that should be considered if influenza severity increases, and are meant for use in addition to the measures outlined above. Consider active screening of employees who report to work ■■

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Prepare for the possibility of school dismissal or temporary closure of child care programs ■■

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Although school dismissals or closures of child care programs are not likely to be generally recommended at this level of severity, they are possible in some jurisdictions. Be prepared to allow workers to stay home to care for children if schools are dismissed or child care programs are closed. Strongly recommend that parents not bring their children with them to work while schools are dismissed. Ensure that your leave policies are flexible and non-punitive. Cross-train employees to cover essential functions. Read CDC’s Guidance for State and Local Public Health Officials and School Administrators for School (K-12) Responses, which can be found at http://www.cdc.gov/h1n1flu/schools/schoolguidance.htm, to better understand the conditions under which schools may be dismissed.

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Consider alternative work environments for employees at higher risk for complications of influenza during periods of increased influenza activity in the community ■■

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Under Conditions with Increased Severity Compared to Spring/Summer 2009

If influenza severity increases, at the beginning of the workday or with each new shift, all employees should be asked about symptoms consistent with an influenza illness8, such as fever or chills AND cough or sore throat. If the severity or the impact of influenza increases, CDC recommends that persons with an influenza-like illness not come to work or travel and remain at home for at least 7 days, even if symptoms resolve sooner. Individuals who are still sick 7 days after they become ill should continue to stay home until at least 24 hours after symptoms have resolved. If influenza severity increases, CDC recommends that people stay home at least 7 days whether or not antiviral medications are used. Make sure your sick leave policies are flexible and consistent with public health guidance, and that your employees are aware of these policies. Do not require a doctor’s note for workers who are ill with influenza. Continue to advise workers to check for any signs of illness before reporting to work each day. Make contingency plans for increased absenteeism caused by illness in workers or illness in workers’ family members that would require them to stay home. Planning for absenteeism could include cross-training current employees or hiring temporary workers.

Employees with an underlying chronic medical condition or who are pregnant should consider calling their health care provider for advice about how to reduce their risk of exposure to influenza and, if they get sick, how best to get early treatment for influenza. If influenza severity increases and if influenza transmission is high in the community, employers may want to evaluate their work environment to see how they can reO C T O B ER 2 0 0 9

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duce the number of people that high-risk employees come in contact with, such as exploring options for telecommuting from home (if feasible). Employers can also think about how workers at higher risk for influenza complications could be reassigned to duties that have minimal contact with other employees, clients, or customers. If these workers cannot be reassigned duties to reduce contact with others, are concerned about their ability to avoid influenza at the workplace, or will be in crowded conditions at work or while commuting to work, then consider allowing employees at higher risk for influenza complications to stay home from work. CDC recommends that ill workers at higher risk of complications from influenza seek early treatment if they become ill. See http://www.cdc.gov/h1n1flu/qa.htm for more information.

Consider increasing social distancing in the workplace ■■

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If influenza severity increases, local public health officials may recommend that employers implement measures to increase the physical distance between people in the workplace to reduce the spread of influenza. The goal should be for there to be at least 6 feet of distance between people at most times. This is not a simple or easy strategy and would typically require considerable flexibility. These measures may include avoiding crowded work settings, canceling business-related face-to-face meetings, spacing workers farther apart, canceling non-essential travel, increasing use of teleworking, and using staggered shifts to allow fewer workers to be in the workplace at the same time.9 If appropriate for your type of business and feasible, review or develop policies for teleworking including an assessment of the capabilities and gaps of your current computer systems and availability of technical support. Take remedial steps if needed, and test your system in advance to assure it can handle an increase in remote users. Recommendations to increase social distancing may affect community functioning. Because supply chain issues may be affected, make sure you have plans for back-up suppliers.

Consider canceling non-essential business travel and advising employees about possible disruptions while traveling overseas ■■

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If the severity of the outbreak worldwide increases in the fall or winter, public health officials may recommend social distancing strategies which include canceling non-essential travel and travel restrictions may be enacted by some countries which may limit the ability of employees to return home if they become ill while on travel status. If influenza severity increases, travelers should also be prepared for travel delays, health screenings, and other activities targeted towards travelers. Provide information to travelers about contingency plans and how their travel |

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can be rebooked for these possible delays. Prepare for school dismissal or closure of child care programs ■■

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School dismissals and closure of child care programs are more likely at higher levels of severity. Be prepared to allow workers to stay home to care for their children if schools are dismissed or child care programs are closed. If dismissal is needed, schools are being advised to dismiss students for at least 5 to 7 calendar days or longer if necessary. Encourage employees who perform essential functions and who have children to plan for contingencies should local child care programs close or schools dismiss students. Be prepared for prolonged absenteeism if schools dismiss students for an extended time. Make sure your leave policies are flexible and non-punitive. Employers should strongly recommend that parents not bring their children with them to work while schools are dismissed. Implement flexible workplace policies like teleworking and staggered shifts. Cross-train employees to cover essential functions. Read CDC’s school guidance, which can be found at http://www.cdc.gov/h1n1flu/schools/schoolguidance. htm, to better understand the conditions under which schools may be dismissed.

Other considerations ■■

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As part of their comprehensive pandemic planning, some public and private sector employers have stockpiled or otherwise arranged for influenza antiviral drugs to be available for their employees during a pandemic. To guide these efforts, HHS released guidance to businesses in 2008 entitled Considerations for Antiviral Drug Stockpiling by Employers in Preparation for an Influenza Pandemic (http://www.flu.gov/vaccine/antiviral_employers. html). See updated interim guidance on the use of antiviral agents for treatment and prophylaxis of 2009 H1N1 influenza infection at http://www.cdc.gov/h1n1flu/recommendations.htm. Employers should be aware that the severity of 2009 H1N1 influenza could change rapidly; therefore, local public health recommendations to communities and businesses could be revised quickly. Planners should identify sources of timely and accurate information so they are aware of changes to recommendations and can promptly implement revised or additional measures recommended by local public health officials.

The Florida Pharmacy Association 2009 Resolutions Presented to the House of Delegates It is an honor to serve as your 2009-2010 FPA Speaker of the House of Delegates. I have the privilege of following in the footsteps of some of FPA’s most effective and prominent leaders and speakers including most recently Suzanne Kelly. The House meeting held during the 2009 FPA Annual Meeting in St Augustine, was a lively and exciting meeting for our association. If you missed the meeting or unaware of how the FPA House of Delegates serves it’s membership, I strongly encourage you to contact myself directly or any of the FPA House of Delegates Board of Directors. Any one of us will be happy to get you involved and excited about this group and share with you how every resolution directly impacts the direction of the association and you its member. The FPA Board of Directors of the House of Delegates is made up of the following faithful members: Suzanne Kelly – Chair of the House of Delegates Board of Directors Alexander Pytlarz – Speaker of the House of Delegates William Riffee – Vice-Speaker Shannon Zandy – Director Caridad Ferree – Director Josh Fields – Director Karen Whalen – FPA President Humberto Martinez – FPA President-Elect Michael A Mone – Parliamentarian Michael A Jackson – FPA Executive Vice President & CEO On behalf of the House Board of Directors, I’d like to welcome the newest members of the House Board of Di-

rectors. Dean William Riffee, Vice-Speaker and Caridad Ferree, Director, were elected at this years FPA Annual Meeting. We look forward to their involvement!! The House also had the privilege of introducing two new invited organizations to the House. They are: Nigerian Pharmacists Association and Florida Independent Pharmacy Network If any member represents an organization that wants to be involved in the House of Delegates, please contact me directly. I will be happy to work with you and your organization so you are represented within the House and have your voice heard by all FPA members. At this past year’s meeting the House reviewed eight submitted resolutions. Below is a summary of the actions of the each resolution that the House took and to what committee the adopted resolutions were referred to by your President Karen Whalen. Please review these resolutions, as they will impact the policies and direction of our association. If you have any comments or questions, please feel free to contact me or any member of the House Board. As always, it’s never too early to start thinking about possible resolutions for next years House. Thank you for the opportunity to serve you and the Florida Pharmacy Association Best regards,

Alexander Pytlarz 2009-2010 Speaker of the House of Delegates

Whereas, over the last few years internet practices and non-pharmacist owned pharmacies have flourished in practice settings that were poorly supervised. Be it Resolved, that the FPA propose that the Florida Pharmacy Board promulgate rules which safeguard the public by having a Responsible party (Pharmacy Manager of Record) on

premises 24 hrs per given week. Contact: Broward County Pharmacist Assoc Daniel P. Sweet RPh Past President, Board Member 954-232-8202 Intent: To protect the public from nonpharmacist owners to influence the practice of pharmacy by placing a pharO C T O B ER 2 0 0 9

macist on record without reviewing the day to day operations of Pharmacy Practice and its Rules and Statues

tion of the House on voice vote Standing vote called for by the House Speaker Resolution adopted on standing vote

Resolution Not Adopted Respectfully Submitted, RESOLUTION #3 Broward County Pharmacist Association

RESOLUTION #2 Repeal 40 hr Rule for Community Pharmacy Permit Broward County Pharmacist Association Whereas, the Practice of Pharmacy is evolving to an Information Profession, where pharmacists will be reviewing medication therapy, Whereas, in populated areas there are multiple pharmacies in a compact radius. Be it Resolved, that the Florida Board of Pharmacy act in repealing the 40 hr rule for Community Pharmacy Permit, withstanding that there is a pharmacy within 5 miles with extended hours or a 24 hr pharmacy within 2 miles. Contact: Daniel P. Sweet RPh Past President, Board Member, Broward County Pharmacist Assoc 954-232-8202 Intent: With Pharmacy Practice evolving with more Pharmacists are going to use there education to create office type practice. The Pharmacist will need to be off-site to review medications and council patients on the use of their medication. Respectfully Submitted, Broward County Pharmacist Association Motion to amend Amendment passed Speaker unable to determine the posi20

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Physician Dispensing – Limiting Scope as Pertains to Controlled Substances Broward County Pharmacists Association Whereas a significant problem regarding the misuse of controlled substances in our State has been identified and Whereas the checks and balances that the pharmacist brings to the equation of reducing the potential for misuse of controlled substances due to conflicts of interest is circumvented in the physician dispensing model Be it Resolved, that the FPA seek legislative changes to limit the in-office dispensing of controlled substances up to and not more than a three (3) day supply. Contact: Broward County Pharmacists Association Daniel P. Sweet R.Ph. Past President, Board Member 954-232-8202 Motion to amend the phrase “work with the respective Boards” Amendment is adopted Motion to amend by adding the words “up” and the words “and not more than” to the first sentence Motion to amend passes Motion to amend by striking the last sentence of the resolve Motion to amend passes Resolution Adopted Intent: With the advent of Pain Management Clinics with Dispensaries, Patient safety and control is lost by not having a Pharmacist oversee the patients’ therapeutic management within the guidelines of the FDA and Controlled Substance Abuse Act.

RESOLUTION #4 Pharmacy Service Tax Broward County Pharmacists Association Whereas, Pharmacy has assumed the burden of absorbing the costs associated with receiving and sending data to all sources. Whereas, these costs continue to grow and are not associated with the cost of the product or filling fee received, then Be it Resolved that the FPA work with the proper legislative process for the State to create a TAX for prescriptions to cover all communication costs inherent in Rx processing for E-prescribing, communications to PBM’s, and data reporting costs for handling in-State reporting of Controlled Substances. Be it Further Resolved that the collected tax be used only for Pharmacy Claims, Administrative Costs in handling the claims and bear no economic and/or administrative burdens on the pharmacy. Resolution Not Adopted. Contact: Broward County Pharmacists Association Daniel P. Sweet R.Ph. Past President, Board Member 954-232-8202 Intent: With greater dependency on data network and associated costs to all pharmacies, we have been placed in a pinch. With the State controlling the process, we gain on many fronts. First, no back-end costs on any Rx claim, next the State can legally charge PBM’s under contract and will be responsible for collecting the tax, and lastly the State can use their collective bargaining power to reduce the costs associated with data transmission. Respectfully Submitted, Broward County Pharmacists Association

RESOLUTION #5 RPh Not a Degree Designation Leon County Pharmacy Association W H EREAS, pharmacists with a PharmD degree very proudly and rightfully use their degree designation of PharmD with their name and WHEREAS, pharmacists with a BSP degree generally use RPh with their name, and WHEREAS, the designation of RPh for Registered Pharmacist is not a degree designation, and was enacted into the original Florida Pharmacy Practice Act of 1889. The current practice act defines a pharmacist as a Licensed Pharmacist, LPh . THEREFORE, the Leon County Pharmacy Association moves that the FPA promote the use of the BPharm designation for the BSP degree in place of the RPh designation which no longer is referenced in the Florida Pharmacy Practice Act. Motion to amend Motion to amend fails Resolution Adopted Contact persons: Michael A. Jackson(850) 222- 2400 Jim Powers- (850) 422- 0079 Background: The resolution pretty well speaks for itself, however, it should be noted that in most national pharmacy publications pharmacists with a BSP degree are using the BPharm designation behind their names. In researching Dr. Gene Gramling’s book “A History of Pharmacy in Florida,” it has the Florida Pharmacy Practice Act of 1889 which reads as follows: Section 4. Be it further enacted, that the Board of Pharmacy shall register in a suitable book the names and places of residence of all persons to whom they issue certificates, and dates thereof. It shall be the duty of said Board of Pharmacy to register without examination, as registered pharmacists, all pharmacists and druggists who are engaged in business in

the State of Florida at the passage of this act, as owners or principals of stores or pharmacies. In any village, town or city of more than 200 inhabitants …”

derstand the impact of these changes. Pharmacists practicing in long-term care must collaborate with state boards of pharmacy to update practice acts to ensure the protection of the health, safety and welfare of the public.

RESOLUTION #6 Long Term Care regulatory framework Florida Chapter of American Society of Consultant Pharmacist Whereas, the Florida regulatory framework for long-term care pharmacy should be reviewed periodically to ensure that it is consistent with current practice, the FPA legislative committee resolves to coordinate with the Florida Chapter of the American Society of Consultant Pharmacists to review the current regulatory framework for LongTerm Care pharmacy in Florida. Resolved that the FPA Legislative Committee coordinate with the Florida Chapter of the American Society of Consultant Pharmacists to review the current regulatory framework for LongTerm Care Pharmacy in Florida. Resolve substituted by the sponsor and accepted by the House Substitute Resolution Adopted Contact Name and Phone #: Stephen J. Grabowski (727) 945-0760 Problem: As the number of our nation’s seniors has grown, so to have the demands and challenges placed upon the pharmacists serving those seniors who live in long-term care facilities. Since the practice of pharmacy has evolved over the years with increased workload demands, changing roles of pharmacy technicians, and new technologies, so too have the regulatory guidelines and oversight responsibilities of the state boards. Intent: Not only will the practice of pharmacy need to adapt to the needs of seniors in long-term care facilities, but state board of pharmacies and pharmacists under their preview must un-

RESOLUTION #7 Evaluation of the “Pedigree Documentation Program” as stated in Florida Statue 499. Alachua County Association of Pharmacists Whereas, Florida Statue 499 states that its purpose is to: Safeguard the public health and promote the public welfare by protecting the public from injury by product use and by merchandising deceit involving drugs, devices, and cosmetics. Whereas, Pharmacies, Pharmacists, Pharmacy Wholesalers, Pharmaceutical Manufacturers, and Pharmacy Repackagers are all an integral part of this program. Whereas, there is financial costs associated with this program. Whereas, there are penalties associated with this program. RESOLVED - The FPA request the Agency for Health Care Administration to evaluate the “Pedigree Documentation Program” (499.01212) to determine effectiveness and identification of improvements in the program for the protection of the public safety Problem - The State of Florida enacted the “Pedigree Documentation Program” (499.01212) to keep adulterated and misbranded pharmaceuticals from consumers. Intent - To determine the effectiveness of the “Pedigree Documentation Program” in achieving its purpose. Resolution Adopted

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Respectfully Submitted, Alachua County Association of Pharmacists

RESOLUTION #8 Continuous Quality Improvement Program-Program Evaluation Alachua County Association of Pharmacists Whereas, the CQI Program is a system of standards and procedures to identify and evaluate quality-related events and improve patient care. Whereas, some of the main goals of FPA and the Board of Pharmacy is to improve patient care and safety. Whereas, an evaluation of the CQI Program may identify improvements that could be incorporated into the program.

Whereas, information about patient safety practices obtained from the program evaluation would be helpful if shared with the pharmacists of Florida and the Nation. Resolved, that the FPA request the Florida Board of Pharmacy to conduct a Program Evaluation of the Continuous Quality Improvement Program (64B1627.300). Problem- Since the enactment of 64B1627.300 Continuous Quality Improvement (CQI) Program, there has not been a program evaluation. Intent- The evaluation of the CQI Program for effectiveness. Respectfully Submitted, Alachua County Association of Pharmacists Resolution Adopted

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Viewpoint, continued from page 5 sion forward. Please join us in Tallahassee next March. FPA Legislative Key Contact Network The FPA Legislative Committee would like to match up at least one pharmacist with every key legislator in the state. If you currently have a relationship with one of your state legislators, or if you are willing to take the steps listed above to be one of our grassroots advocates, we want to know! Sign up to be a member of our Key Legislative Contacts. If you can help, please let us know by contacting any member of the Legislative Committee listed below, or you may contact me directly at klwiz@ comcast.net. Lastly, your Legislative Committee deserves a BIG â&#x20AC;&#x153;Thank Youâ&#x20AC;? for their time and effort. These members have stepped up to help our profession grow and prosper. Following is a list of the members of the 2009-2010 FPA Legislative Committee: David Andrews Don Bergemann Gary Dalin Mitchell Fingerhut Amy Ferrol Ramy Gabriel Mark Hobbs Michael Jackson Humberto Martinez Mark Percifield Manny Prieguez Alexander Pytlarz Teysha Richardson William Riffee Theresa Tolle Norman Tomaka Amanda Waltemath Lori Weems Karen Whalen Robert Wilbur Christine Yocum

Ken Wisniewski 2009-2010 Legislative Committee Chair

RESOLUTION #1 Pharmacy Manager in Charge: Mandate rule changes for the State require to be on-site 24 hr per/week Broward County Pharmacist Association Whereas, There is no statutory or rule requirement for a Manager in Charge to be present in the Pharmacy, Whereas, over the last few years internet practices and non-pharmacist owned pharmacies have flourished in practice settings that were poorly supervised. Be it Resolved, that the FPA propose that the Florida Pharmacy Board promulgate rules which safeguard the public by having a Responsible party In(Pharmacy keepingManager with aof Record) on premises 24 hrs given week. tradition ofper offering our Contact: members real benefits, Broward County Pharmacist Assoc the Florida Pharmacy Daniel P. Sweet RPh Association (FPA) is Past President, Board Member proud to announce 954-232-8202 the introduction of from nonIntent: To protect the public pharmacist owners to influence the sponsored Discount practice of pharmacy by placing a pharBenefits Program. macist on record without reviewing These vendors are the day to day operations of Pharmacy dedicated to providing Practice and its Rules and Statues an excellent value to Resolution Not Adopted all FPA members Respectfully Submitted, and Broward County To Pharmacist associates. take Association advantage of benefits

Daniel P. Sweet RPh Past President, Board Member, Broward County Pharmacist Assoc 954-232-8202 Intent: With Pharmacy Practice evolving with more Pharmacists are going to use there education to create office type Email/Fax Network Hotline practice. The Pharmacist will need to Receive up-to-date and up-to-the-minbe to review medications and uteoff-site information on Legislative Developcouncil patients on the use of their ments, Board of Pharmacy changes and medication. other topics affecting the profession of Respectfully Submitted, pharmacy. Call FPA Member Services Broward Countyext. Pharmacist Associaat (850) 222-2400 110 – rsimmons@ pharmview.com. tion Motion to amend Tax Resource Amendment passed Providesunable defensetoand protection ofposiSpeaker determine the your assets when you are audited. Tax tion of the House on voice vote Resource will defend their clients for Standing vote called for by the House any income tax audit, Federal or State, Speaker for any tax year. Tax Resource pioResolution adopted on standing vote neered the tax audit service business,

Motion to amend by striking the last sentence of the resolve Motion to amend passes Resolution Adopted Intent: With the advent of Pain Management Clinics with Dispensaries, Patient safety and control is lost by not Other Member Benefits having a Pharmacist oversee the pa Discounted Continuing Education tients’ therapeutic management withPrograms in the guidelines andPharCon Monthly Issuesofofthe theFDA Florida trolled Substance Abuse Act. macy Today Journal

MEMBERSHIP MATTERS!

Florida Pharmacy Association

contact the vendors directly at the numbers RESOLUTION #2 listed below and identify yourself a FPA Repeal 40 hras Rule for Community member and Pharmacy Permit have your Broward County Pharmacist Associamembership ID number tion handy.

Whereas, the Practice of Pharmacy is evolving to an Information Profession, where pharmacists will be reviewing medication therapy, Whereas, in populated areas there are multiple pharmacies in a compact radius. Be it Resolved, that the Florida Board of Pharmacy act in repealing the 40 hr rule for Community Pharmacy Permit, withstanding that there is a pharmacy within 5 miles with extended hours or a 24 hr pharmacy within 2 miles. Contact:

and is the largest audit defense firm in the United States. Call (800) 92-AUDIT RESOLUTION (800-922-8348).#3 Atlantic Coupon Physician Dispensing – Limiting Redemption Center Scope as Pertains to Controlled SubReceive payment in 25 working days stances of coupon’s face value plus a rebate of Broward County Pharmacists Associa1/6 cents based on store volume. Call tion Meredith McCord (800) 223-0398. Whereas a significant problem regarding the misuse of controlled substances Florida Commerce in our State has been identified and Federal Credit Union Whereas the checks balances The chief objective of and a credit union that is the bringsfor tostockholders, the equation not pharmacist generating profits of theservice potential for misuse of butreducing to provide to its member. The members benefit bydue getting attraccontrolled substances to conflicts tive returnsison savings, loansinmade at of interest circumvented the phyfair rates of interest plus enhanced and sician dispensing model expanded services. is probably Be it Resolved, thatThis the FPA seek legisone of the best deals around. Call (850) lative changes to limit the in-office dis488-0035. pensing of controlled substances up to and not more than a three (3) day supCollection Services ply. For past due accounts call I. C. System, Contact: Inc. Call (800) 328-9595. Broward County Pharmacists Association Daniel P. Sweet R.Ph. Past President, Board Member 954-232-8202 Motion to amend the phrase “work with the respective Boards” Amendment is adopted Motion to amend by adding the words “up” and the words “and not more than” to the first sentence Motion to amend passes

ITC Deltacom Offering FPA members exclusive associaRESOLUTION #4 tion discounts on telecommunication services including local services, long disPharmacy Service Tax tance, data networks, telephoneAssociasystems Broward County Pharmacists and dedicated internet access. Call 850tion 701-3200 or visit www.itcdeltacom.com

Whereas, Pharmacy has assumed the burden of absorbing the Materials costs associatPharmacy Resource ed with receiving and sending data to FPA provides the most recent and releall sources. vant resources necessary to meet your Whereas, these costsThis continue to grow professional needs. includes the and are not Quality associated with the cost of Continuous Improvement Manual, Controlled the product orSubstance filling feeInventory received, Bookthen letsitand Pharmacy Please callwith FPA Be Resolved thatSigns. the FPA work Members Services for more information: the proper legislative process for the 850-222-2400 ext. State to create a 110. TAX for prescriptions to cover all communication costs inherFPA Website ent in Rx processing for E-prescribing, Visit our FPA Website at ww.pharmview. communications to PBM’s, and data recom. The site, launched in December 2004 porting costsinfor handling re-a and revised October 2008,in-State includes porting ofonly Controlled members section.Substances. The website ofBe Resolved fersita Further secure server so thatthat you the can colreglected tax used only for Pharmacy isters for CEbeprograms, renew your memClaims, Administrative Costsmaterials in hanbership or purchase resources with your credit card. dling the claims and bear no economic and/or administrative burdens on the pharmacy. Resolution Not Adopted. Contact: Broward County Pharmacists Association Daniel P. Sweet R.Ph. Past President, Board Member 954-232-8202 Intent: With greater dependency on data network and associated costs to all pharmacies, we have been placed in a pinch. With the State controlling the process, we gain on many fronts. First, no back-end costs on any Rx claim, next the State can legally charge PBM’s under contract and will be responsible for collecting the tax, and lastly the State can use their collective bargaining power to reduce the costs associatO C T O B ER 2 0 0 9

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f o r

Wyeth Bowl of Hygeia Awarded to a pharmacist for outstanding community service above and beyond professional duties. The use of the following selection criteria is required: ■■ The recipient must be a Florida licensed pharmacist and a member of FPA. ■■           ■■ T recipient has not previously received the award. ■■                 on its award committee or an officer of the association in other than an ex officio capacity. ■■   has compiled an outstanding record of community service, which, apart from his/her specific identification as a pharmacist, reflects well on the profession. James H. Beal Award Awarded to the "Pharmacist of the Year." The criteria established for this award is that the recipient be a Florida registered pharmacist and a member of FPA, who has rendered outstanding service to pharmacy within the past five years.

■■

Candidate must be a member of the Florida Pharmacy Association for at least 2 years. Candidate must have demonstrated contributions and dedication to the advancement of pharmacy technician practice. Candidate must have demonstrated contributions to the Florida Pharmacy Association and/or other pharmacy organizations. Candidate must have demonstrated commitment to community service. Candidate is not a past recipient of this award.

R.Q. Richards Award This award is based on outstanding achievement in the field of pharmaceutical public relations in Florida.

Criteria: ■■  recipient must be a Florida reg-

istered pharmacist and a member of the FPA. ■■   has displayed outstanding achievement in the field of pharmaceutical public relations in Florida. Frank Toback/AZO Consultant Pharmacist Award

Criteria: ■■ Candidate must be an FPA member,

■■   must be a Florida reg-

registered with the Florida Board of Pharmacy as a consultant pharmacist in good standing. ■■ Candidate should be selected based on their outstanding achievements in the field of consultant pharmacy.

Technician of the Year Award Awarded annually to a Florida pharmacy technician who is recognized for his/her outstanding performance and achievement during his/ her career. Criteria:

■■

Criteria: istered pharmacist and a member of the FPA. ■■   has rendered outstanding service to pharmacy within the past five years.

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DCPA Sidney Simkowitz Pharmacy Involvement Award

Presented annually to a Florida pharmacist who has been active at the local and state pharmacy association level in advancement of the profession of pharmacy in Florida.

F P A

Criteria: ■■ A minimum of five years of active

involvement in and contributions to the local association and FPA. ■■ Candidate must have held office at local level pharmacy association. ■■ Member in good standing for a period of at least five years in the FPA and must have served as a member or chairman of a committee of the association. ■■ Candidate must have been actively involved in a project that has or could potentially be of benefit to members of the profession. Pharmacists Mutual Companies Distinguished Young Pharmacist Award Awarded to a young pharmacist for their involvement and dedication to the practice of pharmacy. Criteria: ■■ Licensed to practice for nine (9) years or less. ■■ Licensed to practice in the state in which selected. ■■ Participation in national pharmacy association, professional programs, and/or community service. IPA Roman Maximo Corrons Inspiration & Motivation Award Interamerican Pharmacists Association created this award to honor the memory of Roman M. Corrons who inspired and motivated countless pharmacists to participate actively and aspire to take on leadership roles in their profession. Roman was always there with guidance and support that motivated pharmacists and encouraged visionary leadership, approachable active membership and succession planning. This award recognizes the motivators among us who inspire others to continue to advance the profession. Criteria:

A W A R D S

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The recipient must be a Florida Licensed Pharmacist and a member of the FPA. ■■ Candidate should motivate others to excel within the profession by encouraging them to be leaders. ■■ Candidate is not necessarily an association officer, but guides, supports and/or inspires others. A brief description on the candidate’s motivational/inspirational skills must accompany the nomination.

perience with pharmacist candidates. The award is named in honor of long time FPA member Jean Lamberti for her effort in working with pharmacy students. Criteria

The Jean Lamberti Mentorship Award

Awarded to honor practicing pharmacists who have demonstrated innovation in pharmacy practice that has resulted in improved patient care. Criteria:

■■

The Jean Lamberti Mentorship Award was established in 1998 to honor those pharmacists who have taken time to share their knowledge and ex-

■■ The recipient must be an FPA mem-

ber. ■■ The recipient must serve as a role

vative pharmacy practice resulting in improved patient care. ■■ The recipient should be a practicing pharmacist within the geographic area represented by the presenting Association. Qualified Nominee: A pharmacist practicing within the geographic area represented by the presenting Association.

model for the profession of pharmacy. Innovative Pharmacy Practice Award

■■ The recipient has demonstrated inno-

Deadline FOR NOMINATIONS: February 28, 2010 FPA AWARDS NOMINATION FORM I am pleased to submit the following nomination:

Nominated by:

Name:

Address:

Date Submitted: Signature:

For the following Award: (Nomination Deadline February 28, 2009)  Wyeth Bowl of Hygeia Award  James H. Beal Award

Please describe briefly below the nominee's accomplishments, indicating why you feel he or she should receive this award. (Attach additional sheets if necessary.)

 R.Q. Richards Award  Frank Toback/AZO Consultant Pharmacist Award  DCPA Sydney Simkowitz Award  Pharmacists Mutual Co. Distinguished Young Pharmacist Award  Academy of Pharmacy Practice Practitioner Merit Award  The Jean Lamberti Mentorship Award  IPA Roman Maximo Corrons Inspiration & Motivation Award  Innovative Pharmacy Practice Award  Technician of the Year Award

Mail nominatons to: Annual Awards, Florida Pharmacy Association, 610 N. Adams St., Tallahassee, FL 32301 (850) 222-2400 FAX (850) 561-6758 DEADLINE FOR NOMINATIONS IS FEBRUARY 28, 2010

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CALL FOR RESOLUTIONS TO THE 2010 HOUSE OF DELEGATES The House of Delegates Board of Directors will meet in March 2010 to review and approve resolutions for the Annual Meeting. The deadline for submitting resolutions is March 15, 2010! PLEASE NOTE THIS DEADLINE.

The following information will be needed when submitting resolutions: 1. Name of organization: The name of the organization submitting the resolutions(s); 2. Name and telephone number of individuals: A contact in the event clarification Or further information is needed; 3. Problem: A statement of the problem addressed by the resolution; 4. Intent: A statement of what passage of the resolution will accomplish; 5. Resolution Format: (please type and use double spacing) Title of Resolution Name of Organization Whereas

, and

Whereas

Therefore be it Resolved (that the FPA or Subdivision of FPA)

Contact name and phone #: Problem: Intent:

Flo r i d a P h a r m a c y T o d a Y