December 2014 Florida Pharmacy Journal by Florida Pharmacy Today

The Official Publication Of The Florida Pharmacy Association DEC. 2014

GETTING READY A Sneak Peak at Issues Facing Pharmacy in the 2015 Legislative Session

Board of Pharmacy Licensure Disciplinary Proceedings Compounding Violations, Pharmacy Audit Disputes Mergers and Acquisitions Commercial, Civil and Criminal Proceedings KAHAN ◆ HEIMBERG, PLC

Pharmacist Attorney Brian A. Kahan, R.Ph., J.D. Licensed Florida Pharmacist and Attorney

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FLORIDA PHARMACY TODAY

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florida PHARMACY TODAY Departments 4 Calendar 4 Advertisers 5 President’s Viewpoint 7 Executive Insight 20 Buyer’s Guide

VOL. 77 | NO. 12 DECEMBER 2014 THE OFFICIAL PUBLICATION OF THE FLORIDA PHARMACY ASSOCIATION

Features

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Campus Corner A Student’s Perspective on Playing an Active Role in a Clinical Research Study

Getting Ready A Sneak Peak at Issues Facing Pharmacy in the 2015 Legislative Session

Adherence- It Only Takes a Minute Pill Organizers

Call for FPA Award Nominations

DECEMBER 2014

FPA Calendar 2014-2015

DECEMBER

9-10

25-26 FPA Office Closed JANUARY 1

FPA Office Closed

Advisory Council on Pharmacy Practice meeting Orlando, Florida

Emerging Leaders in Pharmacy Practice Conference Orlando

24-25 FPA Clinical Conference Sandestin 31

21-22 FPA Committee and Council meetings (The date listed appears to be incorrect) 25-26 RxImpact Day Washington DC 27-30 APhA Annual Meeting San Diego, California 25-26 FPA Committee and Council Meetings Orlando

FPA election ballots due FEBRUARY Awards nominations due MARCH

Legislative Session Begins

Continuing Education Tallahassee

Pharmacist Legislative Days and Health Fair Tallahassee

APRIL 3

Good Friday, FPA Office Closed

18-19 FPA Regulatory and Law Conference - Tampa Airport Marriott Tampa 24

Last day to submit resolutions

For a complete calendar of events go to www.pharmview.com Events calendar subject to change 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, 2015 or prior to licensure renewal. Consultant pharmacists and technicians will need to review their licenses and registrations by December 31, 2014. For Pharmacy Technician Certification Board Application, Exam Information and Study materials, please contact 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

Mission Statements: of the Florida Pharmacy Today Journal

The Florida Pharmacy Today Journal is a peer reviewed journal which serves as a medium through which the Florida Pharmacy Association can communicate with the profession on advances in the sciences of pharmacy, socio-economic issues bearing on pharmacy and newsworthy items of interest to the profession. As a self-supported journal, it solicits and accepts advertising congruent with its expressed mission.

of the Florida Pharmacy Today Board of Directors

The mission of the Florida Pharmacy Today Board of Directors is to serve in an advisory capacity to the managing editor and executive editor of the Florida Pharmacy Today Journal in the establishment and interpretation of the Journal’s policies and the management of the Journal’s fiscal responsibilities. The Board of Directors also serves to motivate the Florida Pharmacy Association members to secure appropriate advertising to assist the Journal in its goal of self-support.

Advertisers EPC........................................................................ 2 THE HEALTH LAW FIRM.............................. 13 KAHAN HEIMBERG, PLC................................ 2 PMC.................................................................... 15 PPSC...................................................................... 2

CONTACTS FPA — Michael Jackson (850) 222-2400 FSHP — Tamekia Bennett (850) 906-9333 U/F — Art Wharton (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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FLORIDA PHARMACY TODAY

E-MAIL YOUR SUGGESTIONS/IDEAS TO dave@fiorecommunications.com

The President’s Viewpoint SUZANNE KELLEY, FPA PRESIDENT

Consider Attending a Florida Board of Pharmacy Meeting in 2015

ave you ever attended a Florida Board of Pharmacy meeting? The Board meets every other month throughout the state. According to their website, “the full Board meetings include committee reports, policy and rule discussion items, correspondence items, application review, disciplinary cases and other necessary Board actions.” These meetings are open to the public and the agenda, as well as meeting materials, are available on their website prior to meetings. The next meeting, February 10–11, 2015, will be held in Gainesville. The December Board meeting was the first one I ever attended and, I must say, it was very educational. The Rules Committee and the Compounding Rules Committee met on Tuesday, December 2, prior to the Board meeting, which started in the afternoon. On Wednesday, the Board considered disciplinary cases. I found this to be a most humbling experience as well as one filled with many lessons. The Florida Board of Pharmacy is responsible for the licensure and monitoring of pharmacy professionals. It was legislatively established to ensure that every pharmacist practicing in the state of Florida is doing so safely. The board also ensures that every pharmacy permitted by the state of Florida meets minimum requirements. The Florida Board of Pharmacy, through the Department of Health, monitors the licensure and education of pharmacy professionals. Ultimately, the Board is ensuring that the people of Florida are protected in the realm of pharmacy. Value your license and protect it. It does not matter whether you are a pharmacist, technician, consultant

pharmacist, nuclear pharmacist or an immunizing pharmacist, hold tight to that license by staying within state and federal laws and rules. Don’t end up being the victim of a complaint and involved in the disciplinary process.

The Florida Board of Pharmacy is responsible for the licensure and monitoring of pharmacy professionals. It was legislatively established to ensure that every pharmacist practicing in the state of Florida is doing so safely. The complaint process begins in the Consumer Services Unit, which serves as the central intake for all complaints having to do with health care professions in this state. Each complaint is reviewed by staff, and those that appear to be legally sufficient are investigated. The Florida Statutes Chapter 456 (Health Professionals and Occupations: General Provisions) defines a complaint as “legally sufficient if it contains ultimate facts that show that a violation… has occurred.” If a pharmacist or pharmacist technician practices below the minimum

Suzanne Kelley 2014-2015 FPA President

standards or there is negligence, the result could be a complaint. A misfilled or mislabeled prescription could end up as a complaint. The excuse of being busy unfortunately is not an excuse! Failure to scan a barcode in the process of filling a prescription could help lead to a misfilled or mislabeled drug dispensed. This type of scenario, which probably sounds quite plausible, will then lead you down a route along the “Disciplinary Process Map.” A technician can face some limited discipline for misfills, however, the pharmacist is ultimately responsible for what goes to the patient. Don’t get caught up in the hectic pace and forgo the scanning or pushing through a DUR! An insurance DUR or a message from our pharmacy medication management systems could save a life and save your license! Take the time to go through all of the steps of the filling and dispensing prescriptions. These DECEMBER 2014

2014 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 diligently all year long on behalf of our members.

Terry Gubbins.......................................................................... Chairman of the Board Suzanne Kelly...............................................................................................FPA President Tim Rogers................................................................................................... President Elect Alexander Pytlarz................................................................................................Treasurer Bob Parrado................................................Speaker of the House of Delegates Jackie Donovan...........................Vice Speaker of the House of Delegates Jennifer Raquipo..............................................................Interim Director, Region 1 Michael Hebb........................................................................................ Director, Region 2 Stephen Grabowski........................................................................ Director, Region 3 Linda Lazuka........................................................................................ Director, Region 4 Jason Beattie...................................................................................... Director, Region 5 Luther Laite IV.................................................................................... Director, Region 6 Kimberly Jones................................................................Interim Director, Region 7 Humberto Martinez......................................................................., Director, Region 8 Mitchell Fingerhut......................................................... Interim Director, Region 9 Christine Gegeckas............................................................................. President FSHP Michael Jackson........................................Executive Vice President and CEO

Florida Pharmacy Today Journal Board Chair.............................................................. Carol Motycka, motycka@cop.ufl.edu Vice Chair...........................................Jennifer Pytlarz, jlc_rxdoc@hotmail.com Treasurer....................Stephen Grabowski, sgrabowski@seniormmc.com Secretary.............. Verender Gail Brown, brownvgrx4304@hotmail.com Member.................................................Joseph Koptowsky, docjik1215@aol.com Member........................Rebecca Poston, rebecca_poston@doh.state.fl.us Member........................................................Cristina Medina, cmmedina@cvs.com Member................................................................Norman Tomaka, FLRX9@aol.com Member........................................................................Stuart Ulrich, Stuarx@aol.com Member............................................................. Don Bergemann, don@bceinfo.com Executive Editor................Michael Jackson, mjackson@pharmview.com Managing Editor...................Dave Fiore, dave@fiorecommunications.com Journal Reviewer....................... Dr. Melissa Ruble, mruble@health.usf.edu Journal Reviewer....................................Dr. Angela Hill, ahill2@health.usf.edu

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FLORIDA PHARMACY TODAY

steps are necessary to ensure that prescriptions are dispensed accurately. Chemical impairment and addiction within the health professions is real and could affect up to 10 percent of our colleagues. We hope that pharmacists who fall victim to this type of disease get help and treatment before their impairment or medical condition leads to a complaint. Don’t go to work and fill prescriptions while impaired. Your lack of clarity and poor judgment could cause mistakes. The health of your patients should be very important to you. Don’t violate the trust your patients have for you. Be an advocate for your patients! You are one of their health care providers! Violations of HIPAA (Health Insurance Portability and Accountability Act) could also result in a complaint. Improperly accessing information in the PDMP without just cause can most definitely lead you down a path that could be very costly. Such violations can end up as complaints that can be prosecuted by the Board of Pharmacy. Additionally, such a violation could also result in federal sanctions. You don’t want to get involved in all of this! Should these complaints make it to a Board of Pharmacy hearing, penalties could result. A fine could be levied against you including the investigative costs. The Board could order a certain amount of targeted CE, such as specialized Medication Errors training or a comprehensive educational program on laws and rules. One of the most horrible endings would be having your licensed revoked or asked to “voluntary relinquish” your license. What a way to end your pharmacy career! So, what is the take-home message? Don’t cut corners! Value your patients’ health, your license and the pharmacy permit. Check, double check and triple check those prescription bottles before releasing them. Go to the Board of Pharmacy meetings and see what all is involved in your profession. Remember, they meet every other month and the February meeting will be in Gainesville. See you there! n

Executive Insight BY MICHAEL JACKSON, RPH MICHAEL JACKSON, BPHARM, EVP & CEO, FLORIDA PHARMACY ASSOCIATION

125th Convention Will Celebrate Proud History of Your Association

e prepare to close out 2014 in anticipation of two major events for next year. First of all, the FPA will be celebrating our 125th Annual Meeting and Convention in St. Augustine, Fla. As a member of our organization, you know these meetings occur each year, but this one is special. We would like to extend to all readers of this journal an invitation to this meeting, and ask that you put it on your calendar. While this is our 125th Annual Meeting, the FPA has actually been serving its members much longer than that. Our history began in 1887, at the corner of Adams and Main Street in Jacksonville, Fla. with pharmacists in Duval County. There were several years during our very early history where the Association either did not meet or there are not records available for those meetings. If you happen to be traveling to Jacksonville, visit that intersection and look for a specially designed bronze plaque resting on top of a concrete monument. That plaque marks the origins of this organization. In case you do not get to Jacksonville, the wording on the plaque reads as follows:

of County Commissioners, was elected as the first president. Although the minutes of this first meeting were destroyed in the great fire of 1901, reconstruction of newspaper accounts chronicled the pharmacists’ major concerns. With an initial membership total-

FLORIDA PHARMACY ASSOCIATION 1887 - 1987

ing 111 and $81.30 in the treasury, this description of one of the association’s benefits was given: “It elevates pharmacy as a profession, brightens the pathway of the pharmacist, encourages him to greater effort and consequently benefits the entire public whose servant he must be.” The Florida Pharmacy Association, today over 3,000 strong, remains true to that purpose and dedicates this monument to past and future pharmacists of Florida who have and will continue to contribute so much to the health care of the citizens of Florida.

On June 8, 1887 a group of Florida pharmacists met in Jacksonville at the Board of Trade Rooms located at the corner of Adams and Main Streets for the purpose of organizing a state pharmaceutical association. At this first meeting of the Florida State Pharmaceutical Association, Dr. Henry (Hy) Robinson, a civic leader in Jacksonville who served as mayor and chairman of the Board

Our history began in 1887, at the corner of Adams and Main Street in Jacksonville, Fla. with pharmacists in Duval County.

Michael Jackson, B.Pharm

the

Dedicated on this, 26th day of June, 1987

While this plaque was prepared during our centennial celebration year in 1987, an opportunity to have it installed in a permanent location did not occur until October 27, 2005, when FPA member and Jacksonville resident and pharmacist Howard Staats got involved. A special dedication was arranged with the media present to record the unveiling of the monument at the same location of the first meeting of the FPA. Thank you again, Howard, for your work on this project. As mentioned above, Dr. Henry Robinson (a physician) was the first president of the FPA. You may also be interested to know that Dr. Robinson was a graduate of the University of Pennsylvania School of Medicine. He was born in South Carolina and served as an asDECEMBER 2014 |

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

Educational Services Office Assistant Stacey Brooks, ext. 210 Coordinator of Membership Christopher Heil, ext. 110

FLORIDA PHARMACY TODAY BOARD Chair..................................... Carol Motycka, St. Augustine Vice Chair.........................Jennifer Pytlarz, Herndon, Va. Treasurer...............................Stephen Grabowski, Tampa Secretary.........................Verender Gail Brown, Orlando Member..................................... Joseph Koptowsky, Miami Member..............................Rebecca Poston, Tallahassee Member....................................Cristina Medina, Hollywood Member................................. Norman Tomaka, Melbourne Member..............................Stuart Ulrich, Boynton Beach Member.......................Don Bergemann, Tarpon Springs Executive Editor.........Michael Jackson, Tallahassee Managing Editor.........................Dave Fiore, Tallahassee

This is a peer reviewed publication. ©2014, 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 8 Address: | F L O Rhttp://www.pharmview.com IDA PHARMACY TODAY

sistant surgeon with the rank of Captain in the Army of the Confederacy in Marianna, Florida.1 Our second event is our Florida Pharmacists Legislative Days and Health Fair in Tallahassee. Our members are becoming more informed on the issues and want to become involved in how these issues are shaped. This one event has become a way for our student, technician and pharmacist members to influence decision making here at the Florida Capitol. According to our governmental affairs consultants, the election results for 2014 were historic in that a vast majority of house members were involved in political races. The FPA, working with our Florida Pharmacists Political Committee (FPPC) and our lobbyists, made strategic political contributions to key races that we saw were essential for supporting our legislative initiatives. We estimate that over 90 per-

cent of the campaigns supported by the FPPC were successful and were either newly elected or retained in office. We hope this project will give us the necessary access to help deliver our advocacy message to health policy decision makers. During the 2015 legislative session, we are looking to build on our successes from this year’s efforts.2 For more information on some of the key initiatives that the FPA will be taking an interest in for next year, see the article on page 12. We had a great year in 2014, and for 2015 FPA will be bringing a host of member services, educational programming and political advocacy your way that will stimulate your ability to find your pharmacy passion. Season’s Greetings and Happy New Year n

1 A History of Pharmacy in Florida by L. G. Gramling, October 1973 2 Florida Pharmacy Association 2014 Legislative Update, Florida Pharmacy Today, June 2014

JOIN US

2015 Annual Meeting and Convention Renaissance World Golf Village, St. Augustine June 24-28, 2015

Campus Corner BY JACKSON, RPH MARCUS SILVA, THIRD-YEAR STUDENT, LLOYD L. MICHAEL GREGORY SCHOOL OF PHARMACY, PALM BEACH ATLANTIC UNIVERSITY

A Studentâ&#x20AC;&#x2122;s Perspective on Playing an Active Role in a Clinical Research Study

hroughout pharmacy school, students are encouraged to appreciate the importance of continuously growing and developing professionally as well as making the most of oneâ&#x20AC;&#x2122;s education before entering the workforce. Like many other students, on a day-to-day basis this consists largely of practicing good time management and trying to waste as little time as possible while taking advantage of different learning opportunities. This mindset naturally extends through the summer months while most students are out of school. This summer, in addition to a clinical introductory pharmacy practice experience (IPPE) in the inpatient setting, several opportunities have arisen to work on projects that are quite unique and are serving as fantastic learning experiences. One of them is an independent clinical research study alongside several faculty members and students. The purpose of the study is to find out if there is a possible association between certain non-nutritive sweeteners and exacerbation of diabetic peripheral neuropathy symptoms. The sweeteners are those found in many commonly used sugar-free or artificially sweetened products, especially beverages, such as diet sodas. The research team is primarily assessing the effect of sucralose and aspartame and has thus determined SAN (Sucralose-Aspartame Neuropathy) to be an appropriate acronym for this study. The team is looking at four specific symptoms of peripheral neuropathy: burning pain, sharp shooting pain, tingling or prickly sensations, and numbness of the extremities. A monofilament foot screening is also performed as part of the numbness

assessment, both at baseline and during the follow-up period. This is not an interventional study in the sense that it does not involve the use of a study medication or the comparison of different medications. Pa-

The purpose of the study is to find out if there is a possible association between certain non-nutritive sweeteners and exacerbation of diabetic peripheral neuropathy symptoms. tients are essentially slightly modifying their diet throughout the duration of the study. Enrollment of patients is occurring at two different ambulatory care clinics in West Palm Beach. Student responsibilities include interviewing patients for possible participation based on inclusion and exclusion criteria, helping patients understand the research protocol, as well as obtaining informed consent, collecting information from patients through weekly contact, and critically evaluating the informa-

tion collected as well as assisting the investigators in data analysis. The SAN study is very similar to the clinical trials students and professionals are often reading and analyzing, whether for a journal club presentation or to become familiar with a new drug in order to give a recommendation. This is certainly not a large-scale trial involving hundreds or thousands of patients at multiple research sites. However, it does involve a full research protocol, an IRB approval from two different institutions, a patient enrollment process, a 12-week period of data collection and statistical analysis of the data. These are all components of the clinical trials one may be familiar with. Being an active part of this study has provided me with an appreciation for the complexity of a clinical trial. When reading a research article, one usually does not think about what is happenDECEMBER 2014

ing at the clinic level where the investigator is interacting with the patient and collecting data. Shortly after beginning to enroll patients, the SAN study team experienced the frustration of potential candidates being dropped due to not fitting all of the inclusion criteria, patients being unwilling to avoid certain dietary products for the purpose of the study, patients not keeping their appointments, as well as language barriers. All of these and more make it difficult to enroll the needed number of qualified participants. Therefore, whenever a prospective clinical trial involves thousands of patients, it probably took a long time and unsuccessful interviewing before getting to that point, especially if a large number of potential candidates were excluded. This is not to say, however, that just because a clinical trial has a large number of participants it is a good trial. Things such as inconsistencies in defining the primary outcome, a faulty study design or using an inappropriate statistical test to derive p-values are all reasons to be critical of the results and conclusions, no matter how large the trial or how prestigious the journal it may be published in. When trying to identify patients who might fit the requirements of our study, potential participants are prescreened based on a few criteria, primarily whether or not they have diabetes and experience neuropathy symptoms. Once possible candidates are identified, the team meets them during their next regularly scheduled appointment at the clinic after they are seen by a health care provider. The physician, nurse or pharmacist seeing a patient notifies him or her that a research study is being conducted and that a few of the researchers would like to talk with them about considering enrolling in the study. Afterwards, the patient is met right in the exam room. While in the exam room, it is explained to the patient what the study is about, why it is being conducted and what he or she as a participant would have to do. At this point, before even spending much time going into specific details, the team has a good idea of whether or not the patient is interested and willing to participate. If so, the patient is then assessed 10

FLORIDA PHARMACY TODAY

in the context of inclusion and exclusion criteria. If the patient is eligible to participate, a more detailed explanation is given of what is expected of him or her, which includes abstaining from certain products containing different sweeteners throughout different phases of the study, as well as agreeing to weekly contact, either by phone or clinic visit, for a period of 12 weeks. Also discussed is how the patient may benefit from participating in the study, the risks or discomforts from participating, how his or her information will be kept confidential and that participation is completely voluntary. Patients are given product sheets with common examples of artificially sweetened foods and beverages. The products are listed in a very easy-to-read format that allows patients to compare them and learn about which ones contain which sweetener. It also makes it easy for them to take note of which products they will be avoiding for a specified period of time, thus facilitating data collection during the weekly contact. This is followed by obtaining informed consent. Once patients understand the study and what will be expected of them, and they agree to participate and provide informed consent, the team then obtains baseline data. As previously mentioned, the aim of the research is to see if certain artificial sweeteners have an effect on patientsâ&#x20AC;&#x2122; diabetic neuropathy symptoms. Therefore, a primary component of the data collection process involves recording any changes in these symptoms. In assessing baseline characteristics, the location, severity and frequency of each of these symptoms are determined and quantified on a standard scale. Interestingly, even after enrolling a small number of patients, the enrollment process overall has provided valuable insight regarding the importance of education to patient compliance. When patients experience something new that takes them out of their comfort zone, such as being newly diagnosed with a chronic disease that requires careful management, performing dietary lifestyle modifications while making note of certain foods consumed

and being inconvenienced by weekly phone calls, they can easily become overwhelmed if not properly instructed on what to do. This has been the case for enrolled patients for whom something is not quite clear, and if clarification is not provided, a lack of patient education could be a potential confounder in the study results. Even more importantly, patient compliance to a prescribed medication regimen is an essential part of successful treatment, and pharmacists are very well positioned, both with expertise and accessibility, to play a key role in identifying sources of non-compliance and helping patients achieve desired therapeutic outcomes through education and counseling. Being a part of this study has already been a very good experience in clinical research. Although it only started a few months ago and the study still has a long way to go, the background work of logistics and understanding the study design, enrollment process and what the results could mean is exciting. In addition, the hands-on portion involving patient interaction in the clinic has been a good opportunity to practice communication skills with both patients and health care professionals. For students interested in working in the ambulatory care, inpatient or industry settings where there are good opportunities for clinical research to be conducted, taking advantage of opportunities such as this is a great way to get some firsthand experience. Even for those who are undecided about a career path or who are uninterested in this kind of work in the long run, it serves a purpose similar to a rotation by allowing one to experience something different that might spark a new interest. It is also hoped that more faculty members conducting research would offer interested students the opportunity to work with them and gain this type of experience. It is not only an enriching source of learning and professional development, but also a way to help equip students and open future doors of opportunity for post-graduate training, including residencies and fellowships. n

CALL FOR RESOLUTIONS TO THE 2015 HOUSE OF DELEGATES The House of Delegates Board of Directors will meet in May 2015 to review and approve resolutions for the Annual Meeting. The deadline for submitting resolutions is April 24, 2015! 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:

Return this form to: Membership Coordinator, Florida Pharmacy Association, 610 North Adams Street, Tallahassee, Florida 32301 or fax (850) 561-6758

DECEMBER 2014 |

2015 Legislative Session: An Early Look at the Top Issues Facing Pharmacy As the annual legislative process officially kicks off next month, this is a good time to preview what issues the Florida Pharmacy Association will be keeping an eye on during the 2015 Session. With our partners at Adams St. Advocates and through our Legislative Committee, PAC and many volunteer member and student activists, the FPA will be advocating for the good of pharmacy and our patients around the state. Here are the top issues we anticipate getting the most attention in March:

Details on these initiatives, as well as others, will be discussed during the Florida Pharmacists Legislative Days and Health Fair in Tallahassee.

FLORIDA PHARMACY TODAY

Provider Status Congress has been looking at H. R. 4190, which begins to seek recognition for pharmacists as providers in the Social Security Act. It is amazing that pharmacists do not have that designation and there is a need to correct that. This particular bill has 123 co-sponsors on it, including 14 from California, 12 from Illinois and eight from Florida. Our membership should be very active in getting our members of Congress involved. While the 113th Congress is drawing to a close and the new Congress is set to begin next year, our industry will continue to advocate for the support of the concepts of H. R. 4190 when the new year begins. There is also a need to examine the current Florida Pharmacy Practice Act to make several changes that clarify the things that pharmacists can do in the provider realm. The FPA will be working with other organizations on these policy changes and will provide more information through Stat News. Changes to Immunization Services In Florida, pharmacists can immunize patients for influenza, pneumonia, meningitis and shingles. In many other states, pharmacists are authorized to do much more. Changing current Florida laws to allow these services by pharmacists will improve access, prevent disease and lower health care costs. Consumers have come to expect these services from their pharmacists and it is a natural progression of the practice. If an opportunity is available, a simple correction of the pharmacy practice act can also help with the training and development of skills for pharmacist student interns by allowing those interns who have completed the required classroom and assessment training to administer vaccines under the supervision of a pharmacist.

MAC Pricing During the 2014 legislative session, a bill moved in the Senate designed to address the challenges of pharmacies faced with maximum allowable costs (MAC) on prescription drugs. In some cases, our members are saying that the MAC reimbursement is below what the pharmacy can purchase medications for. The Association is interested in pursuing and supporting legislation that corrects the problems with this program. MTM Payments for Medicaid Recipients Medicare Part D patients have, as part of their plan, access to MTM services. With Medicaid going primarily to the managed care industry, the FPA supports a similar program provided by Florida pharmacists to those patients. Medicaid managed care plans, patients and the state can benefit from MTM services whose goals include, but are not limited to, adherence, compliance and better outcomes. Freedom of Choice Over the years, managed care plans have implemented closed networks allowing only certain pharmacies to service their patients. If a pharmacy is willing to accept the terms and conditions of the network, has no history of discipline and can demonstrate value added services, there should be no reason why it has to be excluded. Patients should be allowed to utilize a pharmacy of their choice and not be directed to a restricted network. Medical Marijuana We all experienced the debate of the 2014 constitutional amendment proposal. The media coverage on this issue was extensive. It is anticipated that this proposal will be a subject of discussion during the 2015 legislative session, given that the Department of Health has not fully implemented the rules on a recent law allowing for the limited use of a nonaddicting form of cannabis. That law created dispensing organizations that do not utilize the services of a pharmacist. Should that debate happen, it is in the FPA plan to become involved and to provide input. PDMP Funding A recent report shared with attendees at the Sarasota Law Conference clearly showed where pharmacists were regularly querying the prescription drug monitoring database. Pharmacists have been using this tool to identify duplicate therapy and/or doctor shopping. This program was created by the Florida Legislature, however, it receives no funding from the state. The FPA advocated for permanent funding for the

PDMP, which resulted in the Florida Attorney General’s Office releasing $2 million from a settlement fund to keep it going for the next four years. The FPA will continue to look for new reoccurring revenue sources for this project as the funding from the settlement is temporary and will eventually be gone. Details on these initiatives, as well as others, will be discussed during the Florida Pharmacists Legislative Days and Health Fair in Tallahassee. That event will take place March 9-10, 2015. On March 8, there will be a half day continuingeducation meeting where we will have discussion of various legislative and regulatory issues by several speakers.

Representing Pharmacists, Pharmacies and Health Providers throughout Florida & the U.S. • • • • • • • •

DEA Hearings Contract Review DOH Investigations Disciplinary Matters Sale of Pharmacy Administrative Hearings Licensure Problems Forfeiture Defense

• • • • • • • •

Investigations NPDB Reports Board Hearings Civil Litigation Corporate Work DEA Defense Medicaid Audits Medicare Defense

George F. Indest III, J.D., M.P.A., LL.M. Retired JAGG officer, licensed in Florida, Louisiana, and Washington, D.C., Board Certified by the Florida Bar 30+ Years of experience, LL.M. from G.W.U.

The healTh law Firm

Main Office: 1101 Douglas Ave., Altamonte Springs, FL 32714 Phone: (407) 331-6620 • Fax: (407) 331-3030 Website: www.TheHealthLawFirm.com Branch Offices in Orlando and Pensacola We accept HPSO insurance. DECEMBER 2014

Pill Organizers

By Shardool Patel It’s well‐known that medication adherence remains a significant issue with patients in all areas of pharmacy practice. The facts, numbers, and trials have been published several times; so restating them is rather redundant and offers no solution on how to manage this problem. Plenty of articles have been published suggesting educating patients, enhancing vial labels, incorporating technology, and synchronizing refills (to name a few) are strategies to increase adherence. However, let’s be honest, taking a combination of maintenance medications may appear to be overwhelming for patients just by the sheer number of pills and bottles involved. Moreover, with some medications requiring greater than once daily dosing, the risk of non‐adherence increases. So, what can we do to help patients out? Two simple words: pill organizers. Although the idea may seem simple enough, there is actually a broad spectrum of options available for patients interested in using pill organizers. This can involve anything from simple once daily, seven‐day pill boxes available at retailers to more advanced medication filling systems such as Medicine‐on‐ Time®. In an ideal world, somewhere in the middle should be a good starting point. So what does this all entail? One idea is recommending patients to buy four one‐ week multi‐dose organizers (a one month supply) and have them hand it over to the pharmacy technician upon refilling medications. From here, the technician can fill the prescriptions directly into pill organizers based on time of medication doses (such as morning, lunch, evening, and bedtime). Following the fill process, pharmacists can verify what’s in each compartment to ensure proper medication administration and time of

FLORIDA PHARMACY TODAY

dosing. Patients will now have a visual reminder on the pill organizer stating the time of day the medications needs to be taken. To follow legal regulations, a single spreadsheet‐list comprised of each medication name, strength, directions, date, and name of the prescriber can be attached to the back of each pill organizer set. In addition, each pill organizer set should include the name and address of the pharmacy. There are a few key advantages to incorporating such a system. First, adherence can be evaluated by seeing what medications come back in the pill organizer when patients return for the following month’s refills. Second, this allows patients to centralize refills on a single day in addition to the pharmacist verifying all maintenance medications are refilled. Third, patients can take their scheduled medications as a combination‐single dose without having to deal with several different vials. Finally, this will ensure that patients are visually reminded what time of day each set of medications should be taken. In the booming world of medication therapy management, a marketing strategy could be to advertise filling pill organizers while discussing the medications themselves with the patients. For interested patients, they can even fill their own pill organizers with the assistance of the pharmacist to guarantee that they are taking it at the right time each day, while discussing other counseling points. This monthly program would facilitate a great patient‐ pharmacist interaction, and could serve as a source of revenue. So from here, scope out your patients who are on several different medications that you think may be good candidates for pill organizers. Talk to them about incorporating a pill organizer, and start watching those adherence numbers go up. Reprinted with permission from National Community Pharmacists Association in the May 2011 issue of America’s Pharmacist. For more information about NCPA, visit www.ncpanet.org.

www.phmic.com 800.247.5930

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Chuck Neyland

Scholarships to students at pharmacy schools. Lectures on pharmacy law to pharmacy students. C.E. speakers at conventions. Legislative support of pharmacy bills. Financial support through Pharmacy Marketing Group and the state associations. Sponsorship of the Distinguished Young Pharmacist Award nationwide.

Serves the Florida Panhandle

251.656.7219

chuck.neyland@phmic.com

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DECEMBER 2014

C A L L APhA Foundation and NASPA 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. ■■               two  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. Criteria: ■■   must be a Florida registered pharmacist and a member of the FPA. ■■   has rendered outstanding service to pharmacy within the past five years. 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: ■■ Candidate must be a member of the Florida Pharmacy Association for at least two years. ■■ Candidate must have demonstrated contributions and dedication to the advancement of pharmacy technician practice.

FLORIDA PHARMACY TODAY

F O R

N O M I N A T I O N S

■■ 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 registered 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, 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. 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. 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 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: ■■ 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. The Jean Lamberti Mentorship Award The Jean Lamberti Mentorship Award was established in 1998 to honor those pharmacists who have taken time to share their knowledge and experience with pharmacist candidates. The award is named in honor of long time FPA member Jean Lamberti for her effort in working with pharmacy students.

F P A

A W A R D S

Criteria: ■■ The recipient must be an FPA member. ■■ The recipient must serve as a role model for the profession of pharmacy. Upsher Smith Excellence in Innovation Award Awarded to honor practicing pharmacists who have demonstrated innovation in pharmacy practice that has resulted in improved patient care. Criteria: ■■ The recipient has demonstrated innovative 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.

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Cardinal Generation Rx Award The Cardinal Health Generation Rx Champions Award recognizes a pharmacist who has demonstrated excellence in community-based prescription drug abuse prevention. The award is intended to recognize outstanding efforts within the pharmacy community to raise awareness of this serious public health problem. It is also intended to encourage educational prevention efforts aimed at patients, youth and other members of the community. The nominee must be a pharmacist who is a member of the state association. Self-nominations are allowed. Applications will be evaluated based upon the following criteria: ■■ Commitment to community-based educational prevention efforts aimed

■■

■■ ■■

at prescription drug abuse Involvement of other community groups in the planning and implementation of prevention programs Innovation and creativity in the creation and implementation of prevention activities Scope/magnitude of prescription drug abuse efforts Demonstrated impact of prescription drug abuse prevention efforts

DEADLINE FOR NOMINATIONS: FEBRUARY 28, 2015 FPA AWARDS NOMINATION FORM I AM PLEASED TO SUBMIT THE FOLLOWING NOMINATION:

NOMINATED BY:

Name:

Address:

Date Submitted:

FOR THE FOLLOWING AWARD: (Nomination Deadline February 28, 2015)  APhA Foundation and NASPA Bowl of Hygeia  James H. Beal Award  Technician of the Year Award

Signature: 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  IPA Roman Maximo Corrons Inspiration & Motivation Award  The Jean Lamberti Mentorship Award  Upsher Smith Excellence in Innovation Award  Cardinal Generation Rx 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, 2015

DECEMBER 2014

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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FLORIDA PHARMACY ASSOCIATION 125TH ANNUAL MEETING AND CONVENTION Renaissance Resort at World Golf Village St. Augustine, Florida

SAVE THE DATE: June 24- 28, 2015

DECEMBER 2014

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.

PHARMACY RESOURCES Abbott Diabetes Care Hernan Castellon (305) 220-0414 PPSC Retail Pharmacy Purchasing Program (888) 778-9909

LEGAL ASSISTANCE Kahan ◆ Heimberg, PLC Brian A. Kahan, R.Ph., Attorney at Law 561-392-9000 Fried Law Office, P.A. Dennis A. Fried, M.D., J.D. (407) 476-1427 The Health Law Firm George F. Indest III, J.D., M.P.A., LL.M. (407) 331-6620

PHARMACEUTICAL WHOLESALER

PHARMACY CONSULTANTS HCC Pharmacy Business Solutions Bob Miller, BPharm, CPH (800) 642-1652 Empire Pharmacy Consultants Michael Chen PharmD., CPH President (855) 374-1029

TEMPORARY PHARMACISTS – STAFFING HealthCare Consultants Pharmacy Staffing Bob Miller (800) 642-1652 Empire Pharmacy Consultants Michael Chen PharmD., CPH President (855) 374-1029 Rx Relief (800) RXRELIEF

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

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.

FREQUENTLY CALLED NUMBERS AHCA MEDICAID PHARMACY SERVICES 2727 Mahan Drive Tallahassee, FL 32308 (850) 412-4166 www.fdhc.state.fl.us/medicaid/ pharmacy AMERICAN PHARMACISTS ASSOCIATION (APhA) Washington, D.C. (800) 237-2742 www.pharmacist.com 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 (800) 222-1222 www.fpicn.org 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”