December 2015 Florida Pharmacy Journal by Florida Pharmacy Today

The Official Publication Of The Florida Pharmacy Association DEC. 2015

2016 LEGISLATIVE PREVIEW

Endorsed* by:

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florida PHARMACY TODAY Departments 4 Calendar 4 Advertisers 5 President’s Viewpoint 7 Executive Insight 20 FPA News & Notes 27 Buyer’s Guide

VOL. 78 | NO. 12 DECEMBER 2015 THE OFFICIAL PUBLICATION OF THE FLORIDA PHARMACY ASSOCIATION

Features

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FPA 2016 Legislative Preview

Governmental Affairs Committee Call for Nominations Norm Tomaka & Family Community Service Award Let’s Face It… Facebook Utilization as a Tool in Pharmacy Education

DECEMBER 2015

Mission Statements:

FPA Calendar 2015-16

DECEMBER 24-25 Christmas Holidays (FPA Office Closed) JANUARY 1

New Year’s Day (FPA Office Closed)

2016 Legislative Session Begins

19-20 Florida Pharmacist Legislative Days Event 23 - 24 FPA Law and Regulatory Conference 23-24 Law Conference Sandestin 31

Last day to submit election ballots FEBRUARY

28 - Awards Nomination Due

of the Florida Pharmacy Today Journal MARCH

4 - 7

APhA Annual Meeting Baltimore, MD

Legislative Session ends

19-20 FPA Committee and Council Meetings Orlando APRIL 16 - 17 FPA Clinical Conference Tampa MAY 1 - 3

NASPA Leadership Retreat

Deadline for FPA Resolutions

Deadline for Vice Speaker and Director nominations

21-22 FPA CE Conference Jacksonville

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. There is a new 2 hour CE requirement for pharmacists on the dispensing of controlled substances effective this biennial renewal period. Pharmacists should have satisfied all continuing education requirements for this biennial period by September 30, 2017 or prior to licensure renewal. Consultant pharmacists and technicians will need to review their licenses and registrations by December 31, 2016. For Pharmacy Technician Certification Board Application, Exam Information and Study materials, please contact the FPA office. For more information on CE programs or events, please contact the Florida Pharmacy Association at (850) 222-2400 or visit our website at www.pharmview.com

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 THE HEALTH LAW FIRM............................... 12 KAHAN HEIMBERG, PLC............................... 23 PHARMACISTS MUTUAL................................ 2 PPSC..................................................................... 21

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 is 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. 4 |

FLORIDA PHARMACY TODAY

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

The President’s Viewpoint BY GUEST COLUMNIST SCOTT TOMERLIN – PRESIDENT-ELECT

Pharmacists as Health Care Providers

What’s in a Name, and Why is it Important?

t is widely accepted that pharmacists are experts in medication therapy management (MTM) and are also considered to be the most accessible of all health care professionals. In many areas of pharmacy, pharmacists have multiple daily patient care interactions that lead to improved patient outcomes. Over the years, pharmacy has adapted its practice to meet the needs of the changing health care environment. For example, consider the adoption of patient care standards, MTM and immunizations as expanded areas of pharmacy practice. Additionally, registered pharmacy interns are now able, with proper training and supervision, to administer all vaccines recommended by the CDC to adults. We are dedicated to the empowerment of pharmacists in the advancement of our profession, so as to remain a viable partner in the health care continuum for both ourselves and future pharmacists. FPA Past President Karen Whalen’s presidential theme, “Collaboration is Key,” is especially pertinent now. The Florida Pharmacy Association (FPA), Florida Society of Health-Systems Pharmacists (FSHP) and Florida Independent Pharmacy Network (FIPN) have collaborated on the language for a new Senate Bill (SB 692), sponsored by Sen. Denise Grimsley, and a House companion bill (HR 547) sponsored by Rep. Edwin Narain. This new legislation is entitled Access to Pharmacist Services Act of 2016. The FPA Board of Directors endorses this bill. Passage of the Access to Pharmacist Services Act of 2016 would allow a consultant pharmacist or Doctor of Pharmacy licensed in Florida to per-

form such acts already occurring in the Veteran’s Administration, U.S. Public Health Services Corps, nursing homes and home health care institutions to occur in all areas of pharmacy practice and would further define and clarify the pharmacist scope of practice to include:

FPA Past President Karen Whalen’s presidential theme, “Collaboration is Key,” is especially pertinent now. The Florida Pharmacy Association (FPA), Florida Society of Health-Systems Pharmacists (FSHP) and Florida Independent Pharmacists Network (FIPN) have collaborated on the language for a new Senate Bill (SB 692), sponsored by Sen. Denise Grimsley, and a House companion bill (HR 547) sponsored by Rep. Edwin Narain.

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Medication management, patient health and wellness assessments, counseling and referrals related to

Scott Tomerlin, FPA President-Elect

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medications and health care services for all pharmacists in all practice settings. Order and evaluate any laboratory, diagnostic or clinical testing in all practice settings when, in the judgment of that pharmacist, it is considered necessary for patient care, as currently allowed by consultant pharmacists and Pharm. D.s in licensed home health care agencies and nursing home facilities. Initiate, modify, discontinue and administer drugs within the context of a drug therapy management order or in collaboration with one or more providers in all practice settings.

This act, if passed, directly spells out in legislation, that pharmacists are health care providers and that, in collaboration with other health care colleagues, we are part of the health care DECEMBER 2015

2015-16 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.

Suzanne Kelley..................................................................................................Board Chair Timothy Rogers..........................................................................................FPA President Alexander Pytlarz.................................................................................... FPA Treasurer Scott Tomerlin...........................................................................................President-Elect Jackie Donovan........................................................................Speaker of the House Carol Motycka................................................................Vice Speaker of the House Thomas Johns......................................................................................... FSHP President Jennifer Raquipo................................................................................. Region 1 Director Michael Hebb.........................................................................................Region 2 Director Tom Cuomo.............................................................................................Region 3 Director Linda Lazuka.........................................................................................Region 4 Director Robert Parrado...................................................................................Region 5 Director Luther Laite IV.....................................................................................Region 6 Director David Mackarey.................................................................................. Region 7 Director Humberto Martinez..........................................................................Region 8 Director Mitchell Fingerhut.............................................................................Region 9 Director

Florida Pharmacy Today Journal Board Chair.............................................................. Carol Motycka, motycka@cop.ufl.edu Vice Chair....................................................Cristina Medina, cmmedina@cvs.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@flhealth.gov Member.................................................Patricia Nguebo, notablep@hotmail.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

team. This opens the door to allow health benefit plans or insurers to provide payment or reimbursement for pharmacist’s patient care services when the services are provided under the pharmacist’s lawful scope of practice. Benefits of achieving pharmacist provider status may include: ■■ Improved patient access to pharmacist-provided patient care services. ■■ Deeper integration of pharmacist collaboration with other health care providers in patient care and medication adherence outcomes. ■■ Defined opportunities for pharmacists in provision of patient care. ■■ Greater professional satisfaction as a result of positive impact in patient care outcomes. ■■ Increase in demand of pharmacistprovided patient care services. ■■ A pathway for third-party reimbursement of pharmacist-provided patient care services. ■■ The ability to help play a role in quality measures that are now the mainstay of many health care systems. This legislation further creates a greater demand for pharmacist patient care services. Data consistently illustrates that investment in pharmacistprovided patient care services yields a return in overall health care cost savings and improved patient care outcomes far greater than the amount invested in providing these services. Since 1997, Doctors of Pharmacy and consultant pharmacists were given the authority to order laboratory and diagnostic assessments in the nursing home and home health care settings under Florida law. Through the joint partnership of FPA and FSHP, both associations are working together to modify this existing law to allow a greater number of patients to be served (in all settings) by including pharmacists who are currently excluded from this law. The FPA has a longstanding House of Delegates-approved policy that advocates for the expansion of laboratory services that Doctors of Pharmacy and See Viewpoint continued on p. 8

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FLORIDA PHARMACY TODAY

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

Reducing Competition to Save Money

lorida has undergone significant changes within its Medicaid program over the past five years. What started out as a pilot project has now expanded into a statewide managed care program for Medicaid recipients, essentially privatizing health care services for the poor and indigent. As part of this project, Medicaid patients were asked to select available health plans in their region with the assistance of a choice counselor. There is even a tool available online so patients can use their computers from the comfort of their homes. Enrollment is mandatory for all Medicaid recipients with the exception of: ■■ Women who are eligible only for family planning services; ■■ Women who are eligible only for breast and cervical cancer services; and ■■ Persons who are eligible for emergency Medicaid for aliens. The purpose of such a program was created by the Legislature under Part IV of Chapter 409 of the Florida Statutes, and likely its purpose was to better ensure predictability and sustainability of the costs associated with Florida Medicaid. Let’s keep in mind that Medicaid is actually a state and federal collaboration of health care for the indigent with funding from both state and federal agencies. According to an October presentation to the Senate Health and Human Services Subcommittee, the federal government pays about 60.5 percent of the Medicaid program costs, with the state picking up the remaining 39.5 percent. Changes in the pharmacy costs for Medicaid, and likely for health care in

general, are being attributed to the costs of hepatitis C and cystic fibrosis drugs. Many of our member providers are also seeing very large increases in the costs of prescription drugs, and may be the focus on any policy decisions that the legislature may look at. This is all very interesting, but let us get back to the subject of this article and

According to an October presentation to the Senate Health and Human Services Subcommittee, the federal government pays about 60.5 percent of the Medicaid program costs, with the state picking up the remaining 39.5 percent. open up what is happening to pharmacy. Recent activity in the managed care industry for this patient population saw a number of pharmacies learning that they were no longer part of their area’s Medicaid managed care network for pharmacy services. We are seeing a side effect of the statewide Medicaid managed care program, no pun intended. In response to inquiries from the FPA membership, a letter was sent to the Agency for Health Care Adminis-

Michael Jackson, B.Pharm

tration expressing dismay over the retraction of pharmacy networks. The FPA was concerned over patient access and choice and asked that the Agency provide more information to Medicaid recipients on how they can seek assistance when choosing plans. Of course, there isn’t much of a choice when some regions of Florida have only two plan options to select. It is also troubling to discover that provider network access standards required of these plans include that a pharmacy has to be within a 20-mile drive in an urban area, or within 45 miles if the patient lives in a rural area. Let us put this particular discussion on the geographic map for an area in Northwest Florida. Meeting these network access standards by the plans means that it is OK for a Medicaid patient to travel from Century to Pensacola to get a prescription filled. For

See Executive Insight continued on p. 9 DECEMBER 2015 |

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

Viewpoint continued from p. 6

consultant pharmacists can provide. The intent of the Access to Pharmacist Services Act of 2016 is to be inclusive to ALL pharmacists, B.S. and Pharm. D. degree holders alike, allowing B.S. pharmacist practitioners the ability to participate in this opportunity. We believe that a pharmacist becomes a pharmacist upon completion of licensure, regardless of the terminal

■■ ■■ ■■

Scott Tomerlin, President Elect Jackie Donovan, Speaker of the House Carol Motycka, Vice Speaker of the House

FSHP OFFICERS ■■ Tom Johns, President ■■ Christine Gegeckas, Immediate Past President

FLORIDA PHARMACY TODAY BOARD Chair..................................... Carol Motycka, St. Augustine Vice Chair................................Cristina Medina, Hollywood Treasurer...............................Stephen Grabowski, Tampa Secretary.........................Verender Gail Brown, Orlando Member..................................... Joseph Koptowsky, Miami Member..............................Rebecca Poston, Tallahassee Member.............................................. Patricia Nguebo, Ocala 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. ©2015, FLORIDA PHARMACY JOURNAL, INC. ARTICLE ACCEPTANCE: The Florida Pharmacy Today is a publication that welcomes articles that have a direct pertinence to the current practice of pharmacy. All articles are subject to review by the Publication Review Committee, editors and other outside referees. Submitted articles are received with the understanding that they are not being considered by another publication. All articles become the property of the Florida Pharmacy Today and may not be published without written permission from both the author and the Florida Pharmacy Today. The Florida Pharmacy Association assumes no responsibility for the statements and opinions made by the authors to the Florida Pharmacy Today. The Journal of the Florida Pharmacy Association does not accept for publication articles or letters concerning religion, politics or any other subject the editors/ publishers deem unsuitable for the readership of this journal. In addition, The Journal does not accept advertising material from persons who are running for office in the association. The editors reserve the right to edit all materials submitted for publication. Letters and materials submitted for consideration for publication may be subject to review by the Editorial Review Board. FLORIDA PHARMACY TODAY, Annual subscription - United States and foreign, Individual $36; Institution $70/year; $5.00 single copies. Florida residents add 7% sales tax. FLORIDA PHARMACY ASSOCIATION

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

The Pharmacist Services Act of 2016 is a step toward advancement of pharmacist-direct patient care services regardless of worksite, improved patient outcomes and a reduction in overall health care spending. degree. It is for this reason we have advocated on behalf of ALL pharmacists to have the opportunity to be included in this bill. If ever there was a time for pharmacists to unite and be active, it is now. A unified profession is a strong profession, active in its resolve, and embracing new horizons without fear. As was stated at the beginning of this article, we are the most patientaccessible health care professionals. The Pharmacist Services Act of 2016 is a step toward advancement of pharmacist-direct patient care services regardless of worksite, improved patient outcomes and a reduction in overall health care spending. When we join together to collaborate with each other, the advancement of pharmacy will be successful. At the end of the day, our patients win, we win, and there are no losers! Please join us today in this endeavor. Ask your state representative to support HB547 by Rep. Edwin Narain and SB692 sponsored by Sen. Denise Grimsley. FPA PRESIDENTS COMMITTEE ■■ Timothy Rogers, FPA President ■■ Suzanne Kelley, Board Chair ■■ Alexander Pytlarz, FPA Treasurer

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Kathy Baldwin, President Elect Tony Frezza, Treasurer Steve Kessinger, Treasurer Elect Jennifer Austin, House of Delegates Chair George Malone, House of Delegates Chair Elect

FIPN OFFICERS Steven Nelson, President ■■ Lois Adams, Vice President and PAC Vice-Chair ■■ Scott Paramore, Secretary and Treasurer ■■

EDITOR’S NOTE: House Bill 547 was heard in the Heath Quality Subcommittee at their meeting on Dec. 1. While this bill had general support by the committee, questions were raised on several amendments that were approved to go on the bill. This created some confusion, along with objections from the medical associations. The committee elected to temporarily postpone further action on the bill. The Florida Pharmacy Association and Florida Society of Health-System Pharmacists met with the Florida Medical Association in an attempt to sort out the confusion and craft a plan to achieve the intent of the legislation. The 2016 legislative session will begin on Jan. 12 and this bill may have another opportunity for review.

Executive Insight continued from p. 7

our members that may not be familiar with that area of Florida, a patient would have to travel from the Florida â&#x20AC;&#x201C; Alabama line in the northern end of Escambia County to the southern end, a few miles from the Gulf of Mexico. Donâ&#x20AC;&#x2122;t forget that after the prescription is picked up, the patient must then travel home, which would be a 90-mile round trip. Remember that we are talking about a patient population that has limited income or resources and must rely upon public support for their health care. Many of these patients may already be transportation-challenged. In some cases, there may be a pharmacy in the communities where these patients live that is willing to provide high-quality pharmacy services but, for whatever reason, the pharmacy is not considered eligible to be a participating

Many of these patients may already be transportation-challenged. In some cases, there may be a pharmacy in the communities where these patients live that is willing to provide highquality pharmacy services but, for whatever reason, the pharmacy is not considered eligible to be a participating provider. provider. So what is the purpose and reason for restricting access to pharmacies by these plans? Some of what we are hearing is that limiting the network makes it easier to get favorable pricing on pre-

scription drugs from pharmacy providers. In theory, if a pharmacy is able to get a larger market share, then that should lower costs to the payer. Retraction of the pharmacy market through

local newspaper can be an opportunity to get your message on the desks of decision makers. I imagine that members of the Florida House and Senate read news from their districts on the

If you are affected by these network closures, the comment pages in your local newspaper can be an opportunity to get your message on the desks of decision makers. network restrictions may lower prescription drug costs in theory, but that is not what we see happening with claims of pharmacy costs increasing. Somewhere, the math is not adding up. While we are on this discussion, why is it that a pharmacy business that has been serving patients for years, that can provide value-added services such as medication therapy management, comprehensive medication review, home delivery, increasing immunization rates and other similar services, is denied the ability to care for the citizens in their community? Remember that these are the same business entities that support the local little league baseball teams, school functions and other charitable events. They are the local businesses that pay the taxes and fees used to fund the very entitlement programs that their neighbors may rely upon in periods of financial need. Why are the dollars that they pay to the state and federal government to support health care and other services OK, but their professional services are not acceptable? Obviously, we will not get the answers to those questions, so the best thing to do is to change public opinion and public policy. You change public opinion by getting those you have been serving over the years to speak for you. If you are affected by these network closures, the comment pages in your

issues. There might be some things in this article that you can use to shape your messaging. On the public policy side, the Legislature has to be made aware of what is happening with Medicaid. They need to understand how restricting networks and limiting access affects quality of care for the indigent. We believe that pharmacy providers want to compete in an open marketplace and create jobs and opportunities. You cannot do that if the only door of opportunity you have to go through is closed, locked and sealed. The FPA is in conversation with key members of the House and Senate on this issue. While we are having this conversation, we need for each of our members to do the same with your state legislators. Watch future Stat News for action items for the 2016 legislative session.

DECEMBER 2015

FPA 2016 Legislative Preview By Michael Jackson, FPA EVP/CEO tools, such as our Facebook page, our Twitter account and our breaking news section on the FPA website. Watch for our Stat News messaging on emerging issues that you may need to be aware of. Should the FPA send you an alert asking you to reach out to members of the House and Senate or to the Governor’s Office, your active participation can make a difference. We have enjoyed several years of proactive legislative campaigns and want to keep that momentum going. Also, mark your calendars for Jan. 19 – 20, 2016 and plan to attend the Florida Pharmacists Legislative Days here in Tallahassee. Below are some of the issues of interest that we are either monitoring or advocating for. A full report will be made available during the annual meeting in Ft. Lauderdale on June 30 – July 3, 2016. We hope that you will attend. CURRENT LEGISLATION KEY BILLS

The 2016 legislative session is right around the corner, with an early start in January. Normally, the session begins in March and runs 60 days. The House and Senate will begin their work Jan. 12 and will end on March 11, unless there is a need to extend. For the past several years, the Florida Pharmacy Association has been working on numerous pharmacy issues, including expansion of immunization services, getting clarity on maximum allowing cost pricing by the PBMs and changing the clinical laboratory statutes to recognize pharmacists as health care providers. These issues, and many more, are included in the legislative report that you can find on the Pharmview.com menu under “FPA Advocacy Program.” You can also find information in the May 2015 issue of Florida Pharmacy Today in an article entitled “Another Home Run Session.” Planning for the 2016 session began back in July after the annual meeting, when the Governmental Affairs Committee met to craft our 2015-2016 advocacy plan. This plan was presented to the FPA Board of Directors at their August meeting and (with some minor changes) approved. Our lobbyists and FPA staff are already working on issues related to that plan and collaborating with the Florida Society of Health System Pharmacists. Information is being published on proposed legislation that can be found on Phamrivew.com in our “Legislative Action Center.” There is already an action alert related to closed pharmacy networks that our journal readers need to pay close attention to. You can follow the progress on these issues through our website and through the FPA’s social media 10

FLORIDA PHARMACY TODAY

Bill Name: SB 748 - Physician Assistants Bill Summary: Revising circumstances under which a physician assistant may prescribe medication; authorizing a licensed physician assistant to perform certain services as delegated by a supervising physician; deleting provisions related to examination by the Department of Health; requiring a designated supervising physician to maintain a list of approved supervising physicians at the practice or facility, etc. Position: Monitoring Bill Name: SB 676 - Prescribing of Medications Bill Summary: Expanding the categories of persons who may prescribe brand name drugs under the prescription drug program when medically necessary; requiring a hospital to provide specified advance notice to certain obstetrical physicians before it closes its obstetrical department or ceases to provide obstetrical services; requiring the Board of Nursing to establish a committee to recommend a formulary of controlled substances that may not be prescribed, or may be prescribed only on a limited basis, by an advanced registered nurse practitioner; requiring that certain health insurers that do not already use a certain form use only a prior authorization form approved by the Financial Services Commission, etc. Position: Monitoring Bill Name: SB 210 - Prescribing of Medications Bill Summary: Health Care; Expanding the categories of persons who may prescribe brand name drugs under the prescription drug program when medically necessary; exempt-

ing controlled substances prescribed by an advanced registered nurse practitioner or a physician assistant from the disqualifications for certification or licensure, and for continued certification or licensure, as a deputy pilot or state pilot; applying existing penalties for violations relating to the prescribing or dispensing of controlled substances by an advanced registered nurse practitioner; redefining the term “practitioner” to include advanced registered nurse practitioners and physician assistants under the Florida Comprehensive Drug Abuse Prevention and Control Act for the purpose of prescribing controlled substances if a certain requirement is met, etc. Position: Monitoring

pharmaceutical services exclusively from a mail order pharmacy, etc. Position: We support this legislation

Bill Name: SB 152 - Ordering of Medication Bill Summary: Revising the authority of a licensed physician assistant to order medication under the direction of a supervisory physician for a specified patient; authorizing an advanced registered nurse practitioner to order medication for administration to a specified patient; authorizing a licensed practitioner to authorize a licensed physician assistant or advanced registered nurse practitioner to order controlled substances for a specified patient under certain circumstances, etc. Position: Monitoring

Bill Name: HB 583 - Provision of Pharmaceutical Services Bill Summary: HB 583 Mail Order Services - Provides requirements for health insurers & HMOs with respect to pharmaceutical services received from mail order pharmacies; requires health insurers & HMOs to provide insured & subscribers living with chronic illness explanation & comparison of payment methods & charges for pharmaceutical services from mail order pharmacies & other providers of pharmaceutical services. Position: We support this legislation

Bill Name: HB 423 - Drug Prescription by Advanced Registered Nurse Practitioners & Physician Assistants Bill Summary: Expands categories of persons who may prescribe brand drugs under prescription drug program when medically necessary; exempts controlled substances prescribed by ARNP or physician assistant from disqualifications for certification or licensure as deputy or state pilot; applies certain existing penalties to ARNPs; requires ARNPs & physician assistants who prescribe controlled substances to make certain designation, comply with registration requirements, & follow specified standards of practice; redefines term “practitioner” to include ARNPs & physician assistants under Florida Comprehensive Drug Abuse Prevention & Control Act. Position: Monitoring

Bill Name: HB 547 - Access to Pharmacist Services Act Bill Summary: Provides responsibilities of consultant pharmacist & doctors of pharmacy; provides for payment or reimbursement for certain pharmacist services. Position: We support this legislation

PHARMACY PRACTICE Bill Name: SB 780 - Provision of Pharmaceutical Services Bill Summary: Providing that an insured living with a chronic illness may not be required to obtain pharmaceutical services exclusively from a mail order pharmacy; requiring health insurers to provide to an insured living with a chronic illness an explanation and comparison of payment methods and charges for pharmaceutical services from mail order pharmacies and other providers of pharmaceutical services; providing that a health maintenance organization subscriber living with a chronic illness may not be required to obtain

Bill Name: SB 692 - Access to Pharmacist Services Act Bill Summary: SB 692 - Practice of Pharmacy - Citing this act as the “Access to Pharmacist Services Act”; providing duties and responsibilities of a consultant pharmacist and a doctor of pharmacy; providing for payment or reimbursement for a pharmacist’s patient care services separate and apart from payment or reimbursement for prescription medications, etc. Position: We support this legislation

CONTROLLED SUBSTANCE ISSUES Bill Name: SB 852 - Medical Marijuana Bill Summary: Repealing provisions relating to the compassionate use of low-THC cannabis; creating the “Florida Medical Marijuana Act”; authorizing a registered patient or a designated caregiver to purchase, acquire, and possess up to the allowed amount of medical marijuana for a patient’s medical use; requiring a registered patient or a designated caregiver to demonstrate certain actions in order to maintain the specified protections; requiring the department to notify law enforcement of the expired or cancelled identification card in certain circumstances, etc. Position: Monitoring Bill Name: SB 616 – Cannabis Bill Summary: Removing cannabis from the schedule of controlled substances, etc. Position: Monitoring Bill Name: SB 554 - Hemp Production Bill Summary: Citing this act as the “Hemp Industry Development Act”; specifying that hemp is an agricultural crop; DECEMBER 2015 |

requiring the registration of hemp growers; providing registration requirements; allowing the department to assess registration fees; providing exemptions; providing for an affirmative defense to certain charges relating to cannabis; providing exceptions to other laws, etc. Position: Monitoring Bill Name: SB 460 - Experimental Treatments for Terminal Conditions Bill Summary: Revising the definition of the term “investigational drug, biological product, or device”; providing for eligible patients or their legal representatives to purchase and possess cannabis for medical use; authorizing certain licensed dispensing organizations to manufacture, possess, sell, deliver, distribute, dispense, and dispose of cannabis; exempting such organizations from specified laws, etc. Position: Monitoring Bill Name: SB 422 - Health Insurance Coverage For Opioids Bill Summary: Providing that a health insurance policy that covers opioid analgesic drug products may impose a prior authorization requirement for an abuse-deterrent opioid analgesic drug product only if the insurer imposes the same requirement for each opioid analgesic drug product without an abuse-deterrence labeling claim, etc. Position: Monitoring

Representing Health Care Professionals

• DOH Investigations • Licensure Discipline • Medicare/Medicaid Defense • Administrative Hearings • Contract Litigation George F. Indest III, J.D., M.P.A., LL.M.

1101 Douglas Avenue Altamonte Springs, FL 32714 Telephone: (407) 331-6620 www.TheHealthLawFirm.com

FLORIDA PHARMACY TODAY

Bill Name: HB 4021 – Cannabis Bill Summary: Removes cannabis from schedule of controlled substances; conforms provisions. Position: Monitoring Bill Name: HB 363 - Health Insurance Coverage For Opioids Bill Summary: Provides that health insurance policy covering opioid analgesic drug products may impose prior authorization requirement for abuse-deterrent opioid analgesic drug product only if insurer imposes same requirement for each opioid analgesic drug product without abuse-deterrence labeling claim; prohibits such health insurance policy from requiring use of opioid analgesic drug product without abuse-deterrence labeling claim before providing coverage for abuse-deterrent opioid analgesic drug product. Position: Monitoring Bill Name: HB 271 - Hemp Production Bill Summary: Designates act “Hemp Industry Development Act”; specifies that hemp is agricultural crop; requires registration of hemp growers; provides registration requirements; provides exemptions; requires rulemaking; provides for affirmative defense to certain charges relating to cannabis; provides exceptions to other laws. Position: Monitoring Bill Name: HB 65 - Pub Rec/Low-THC Cannabis Patient Registry/DOH Bill Summary: Exempts from public records requirements personal identifying information of patients & physicians held by DOH in low-THC cannabis patient registry or former compassionate use registry; exempts information related to ordering & dispensing low-THC cannabis; authorizes specified persons & entities access to exempt information; requires that information released from registry remain confidential; provides penalty; provides for future legislative review & repeal; provides statement of public necessity. Position: Monitoring Bill Name: HB 63 - Medical Use of Low-THC Cannabis Bill Summary: Allows registered patients & designated caregivers to purchase, acquire, & possess low-THC cannabis subject to specified requirements; allows cultivation or processing licensee, employee, or contractor to acquire, cultivate, transport, & sell low-THC cannabis; allows retail licensee to purchase, receive, possess, store, dispense, & deliver low-THC cannabis; prohibits certain actions regarding acquisition, possession, transfer, use, & administration of low-THC cannabis; clarifies that person is prohibited from driving or boating under influence of low-THC cannabis; provides duties of DOH; provides implementation requirements; specifies act does not require or restrict health insurance coverage for purchase of low-THC cannabis. Position: Monitoring

Governmental Affairs Committee By Bill Garst

The Governmental Affairs Committee (GAC) is charged with providing guidance to the Board of Directors on legislative or regulatory issues. This past summer, the GAC met in Orlando to discuss plans for FPA’s upcoming legislative agenda. The following items were approved for guidance to the Board of Directors: 1. Advocate for standalone legislation and rule making a. FPA should advocate for changes to F.S. 400.0121 that would help provide relief to pharmacies that are struggling with getting adequate supplies of pain medications to treat their patients. b. Intern registry should have a designated expiration date. c. The three-hour vaccine safety requirements in F.S. 465.009 should allow ACPE providers to deliver this program. d. Continue efforts to support national provider status initiatives. e. Advocate for changes to Florida laws to allow pharmacists to dispense a 30-day supply of maintenance medications (currently it is only a three-day supply) when the provider cannot be contacted.

2. Advocate for, if opportunity presented a. Consider recommended changes to the pharmacy practice act as identified in the draft revisions to F.S. 463.0125 to help pharmacists with patient health and wellness issues and advocate for changes if an opportunity is presented. 3. Monitor a. Continue to monitor for development of Florida’s medical marijuana initiatives. What can you do to help? Right now there is movement to “shrink” Medicaid networks to exclude many pharmacies. Go to the FPA website (pharmview.com), click on FPA Advocacy Program, then Legislative Action Center, scroll down to Action Alert and click on Take Action under Medicaid Pharmacy Networks Shrinking. Follow the instructions and you will find your state senator’s and state representative’s office phone numbers, along with talking points. Give them a call and tell them that limiting access to pharmacy services is a bad idea. The talking points contain eight succinct points that explain FPA’s position very well. DECEMBER 2015

Call for Nominations Norm Tomaka & Family Community Service Award The Florida Pharmacy Foundation invites FPA members to nominate a pharmacy student who has rendered outstanding service for the 2016 Norm Tomaka & Family Community Service Award. Established last year by Norm Tomaka, this award recognizes a pharmacy student who has demonstrated a sustained involvement in a charitable organization or community service program at a state or local level, promoted community service within the pharmacy profession and served as a positive motivator for student pharmacists involved in the Florida Pharmacy Association. Eligible nominees are students enrolled in a pharmacy school in the state of Florida who are also active members of the FPA. The lucky winner will be recognized at the 2016 Florida Pharmacy Association Annual Meeting with a $1,000 check. If you would like to obtain an official nomination form or learn more about the Norm Tomaka & Family Community Service Award, please contact Anne Wade at the Florida Pharmacy Foundation Office, annewfpf@gmail.com or 800222-2400. The deadline for nominations is January 13, 2016.

FLORIDA PHARMACY TODAY

Let’s Face It… Facebook Utilization as a Tool in Pharmacy Education

Andreina Ottman, PharmD Candidate1*, Jacqueline Walker, PharmD Candidate1, Krisy-Ann Thornby, Pharm.D.1, Assistant Professor of Pharmacy Practice Lloyd L. Gregory School of Pharmacy Palm Beach Atlantic University 901 South Flagler Drive P.O. Box 24708 West Palm Beach, Florida 33416 andreina_ottman@pba.edu Tel: 407-340-3337 *Corresponding author

Conflict of interest: The authors report no conflicts of interest. Main text word count: 2280 Separate references word count: 197 Number of references: 8 Number of tables: 2 Number of figures: 0

Introduction The life of a current pharmacy student is driven by the evolution of technology and its effect on education. With the advancement of technology came the introduction of social media (SM)—an interactive platform for sharing, creating, discussing and modifying user-generated content; and social networking sites (SNS)—a platform to build social networks or social relations among people who share similar interests, activities, backgrounds or real-life connections.1 The birth of SM has infused the current generation to increase its utilization for numerous reasons. The most popular SNS is Facebook and as such, it is a great medium for enhancing communication, generating revenue and even increasing awareness. A review article published in 20141 evaluated the use of social media among students, faculty, administrators and pharmacists. This review included studies using content sharing (e.g. Twitter, YouTube) and relationshipbuilding applications (e.g. Facebook). Of the 24 studies included on social media, Facebook was the most common SNS used in nine studies. Results showed that 76 to100 percent of pharmacy students have a Facebook profile, with as many as 75 percent logging in daily.1 Additionally, between 45 to 65 percent of pharmacy faculty members have a Facebook profile, and a small

proportion are using it for teaching purposes.1 Almost half of the faculty members on social media used it for professional networking, and one quarter employed it to increase their professional knowledge and skills or to stay abreast of news and information pertaining to their professional interests.1 Most importantly, 50 percent of pharmacy faculty with Facebook profiles expressed a willingness to use Facebook for teaching purposes in the future.1 While social media has not been explicitly mentioned in the Accreditation Council for Pharmacy Education (ACPE) guidelines, there is language that could encompass the use of SM. The accrediting standards for pharmacy schools discuss student engagement in the 2016 ACPE guidelines. Standard 10 (Curriculum Design, Delivery and Oversight) includes a section about actively engaging learners, integrating and reinforcing content across the curriculum and addressing/accommodating diverse learning styles.2 This standard could provide rationale for schools to consider exploring greater use of Facebook in the classroom. An increasing number of professional programs are developing guidelines on e-professionalism, which will be important with integration of social media and as a result of increased student use. For current pharmacy practitioners, Facebook is already being used to promote pharmacy organizations,

The purpose of this article is to discuss potential opportunities for Facebook utilization in pharmacy schools, review how pharmacy students may already be using it, discuss barriers for its use and discuss how building this skill set could translate to being a connected pharmacist not only within the pharmacy profession, but other professions as well. DECEMBER 2015

pharmacy events, as well as providing a quick glimpse of up-to-date drug information. There are other popular SM sites that are widely used, but Facebook has gained the most nationwide recognition. The purpose of this article is to discuss potential opportunities for Facebook utilization in pharmacy schools,

sities already have course management systems (CMS) such as eCollege, Blackboard, Schoology, etc., which is a multifunction program intended to serve as a teaching and learning resource between students and faculty.5 Current CMS software functions give access to students for course content, announcements, assignments, e-mail, assess-

Facebook has the potential to serve as an academic tool for both students and faculty. review how pharmacy students may already be using it, discuss barriers for its use and discuss how building this skill set could translate to being a connected pharmacist not only within the pharmacy profession, but other professions as well. Facebook in the Classroom On Aug. 24, 2015, Facebook reached 1 billion daily users for the first time, which correlates to one in seven people on Earth using Facebook that day.3 With numbers like these, it is hard to ignore the popularity of this SM outlet. The authors conducted a survey at the Gregory School of Pharmacy at Palm Beach Atlantic University. Results showed that 87.4 percent of pharmacy students used Facebook to access updates on classes, study guides and other activities related to the classroom.4 These results are consistent with a previous study1 and suggest that the use of social media among pharmacy students is increasing. Taking these studies into account, there is a possible synergistic relationship between Facebook integration and pharmacy education. Facebook has the potential to serve as an academic tool for both students and faculty. Table 1 lists examples of how Facebook can be used in the classroom as well as the concept, benefit and implementation behind those uses. While not all students will adopt Facebook for academic reasons, those who do may find it to be convenient, timely and a method to increase faculty and student interaction. Currently, many colleges and univer16

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ments, calendar, learning modules, discussion, web links, who’s online, roster, chat, media library and goals of the course.5 Chickering and Gamson developed the seven principles for good practices in undergraduate education. These principles are based on 50 years of research, and the goal of these principles is to create an environment of enduring and powerful education.6 Although the Pharm.D. degree is a professional degree, these principles can be useful when applied to this program. The seven principles include encouraging contact between faculty and students, reciprocity and cooperation among students, active learning, giving prompt feedback, communicating high expectations, emphasizing time on task and respecting diverse talents and ways of learning.6 A 2011 study5 sought to determine if current CMS software correctly captures these seven principles. The research was conducted at a residential Association to Advance Collegiate Schools of Business (AACSB)-accredited business school in California. Courses selected for participation included consumer behavior, services marketing, e-marketing and strategic marketing management. Surveys were collected from 195 business students. Most of the students were marketing majors (81 percent) and all were upper division students (92.5 percent seniors and 7.5 percent juniors).5 The average respondent was 22 years old. The results showed that many students assumed technology would be integrated into

their college experience by faculty.5 Additionally, the study revealed that students dislike using CMS software for discussion, web links and media library; they rarely use it for calendar, chat, and goals.5 Lastly, this study showed students’ perceptions of CMS in regards to enhancing the “seven principles.” Students felt that CMS did not communicate high expectations, encourage cooperation among students, or emphasize time on task.5 While these CMS systems contain more tools than Facebook, students are likely to use Facebook for many of the programs’ more simple features described in Table 1. Not all course management programs have mobile applications, which make logging in and receiving updates more cumbersome. Taking into account students’ negative perceptions about CMS and Facebook’s ease of use, it is evident that Facebook as an academic tool has great potential. Barriers of Implementing Facebook Although Facebook may have many benefits to students, there may be barriers prohibiting pharmacy faculty to readily adopt features of this social media tool. These barriers include not wanting to incorporate new technology into the pharmacy curriculum, lack of Facebook knowledge and fear of technology failure. Faculty may have reservations about how to integrate its use in the classroom for many reasons. For one, not all faculty may want or have a Facebook account. For those who do, a systematic planning method should be in place. The faculty will need to set up verbiage or a course policy for its use. Some questions faculty might ask before integrating may be: will groups be used; what about students who do not want to create a Facebook account; will information posted on Facebook also be duplicative to what is posted on CMS; is this a greater workload for faculty; should Facebook hours be set for when faculty are expected to post/respond; does the course syllabi have policies to handle misuse or lack of participation. Considering the logistics of set-up, faculty may need to evaluate the benefits relevant to each class and anticipate set-

Table 1: Examples of How to Use Facebook (FB) in the Classroom

FB Use v Real-time Q&A v Muddy Points v Threaded Discussion v Substitution of Email

v Document Sharing v Video Sharing v Providing Links to Videos

Description of Concept, Benefits, How to Implement Concept o Assess concepts learned during class in real-time and clarify confusing or muddy points by using FB to ask students questions o Start a threaded discussion with students to further clarify points or to assess student’s understanding of the material o Students can post a question on the group wall instead of emailing the professor ●● Benefits o Faculty can ask/post questions before/during lecture and have students respond on FB o Students can ask questions during the lecture by posting on FB without interrupting the professor. If the class has an intermission, faculty can use this time to review questions or comments posted and reply verbally or with a post on FB o Faculty and students have unlimited access to view questions and answers posted on FB o Decreases repetitive emails from students and allows faculty to answer questions for all to see ●● How to Implement o Log into FB o Create a professor group for class of 20xx (no quantity limit on members) and invite students to join the group o Prompt students to ask questions and post them on the wall of the group o Answer questions by writing in the comment field of the post ●●

●●

v Create Groups for Projects

●●

Concept o Course management systems (CMS) such as eCollege, Blackboard, or Schoology are not habitually checked by students. These CMS programs are typically the area where professors post important and helpful information/documents for students o Unfortunately, there is no system in place to alert students of any new documents that have been uploaded or shared by the professor o By using FB to upload documents, the student will receive a notification that a new document posted o Professors and students can share videos or links to videos that may enhance the material being covered in class Benefits o Students will stay up-to-date on materials uploaded by professors due to instant notifications of any uploaded documents o Professors and students can share videos or links to videos, which may facilitate learning for all students How to Implement o Log into FB and click on group that the professor created for the class o Click on “add file” to upload a document then click on “add photo/video” to upload a video o Post link of video on wall of group Concept o Professors often assign group work to students, which can create many challenges for the students and professors involved o To facilitate group work, professors can create groups for projects and encourage students to communicate via FB Benefits o Professors can monitor the group to see which students are actively participating in the group work o Professors can have students upload drafts of assignments and view them at any time to monitor progress of the group o Students can work remotely on the group work and do not need to meet as frequently face-toface How to Implement o Log into FB o Click on the group that the professor made for the class and click on “create group” on the right-hand side of the screen o Add a group name in the “group name” box, then add members by typing student’s names in the “members” box o Click on “secret” so that only members of the group can find the group and see posts o Click create DECEMBER 2015

backs with Facebook integration. LACK OF FACEBOOK KNOWLEDGE

A lack in utilization can be secondary to a lack of knowledge or awareness. Not all faculty are acquainted with Facebook and its uses. This lack of knowledge can lead to resistance in implementing its use. Fortunately, there

While there are many benefits to the implementation of technology in the classroom, the possibility of its failure cannot be ignored. Integration of Facebook into the curriculum would increase reliance on technology, which may deter faculty from using it because setbacks in technology or internet capabilities would represent a loss of infor-

Technology can aid in standardized exam taking, help reduce academic dishonesty and allow information for accreditation to be compiled using statistics. are many helpful step-by-step guidance documents regarding Facebook available on the internet. Additionally, there are many “how to” videos on YouTube detailing how to register for Facebook, explore the toolbar and tabs, find and add friends, use chat, add photos, set privacy settings, etc. With much information available on how to use Facebook, it should be feasible for faculty to learn and implement its use. FEAR OF TECHNOLOGY FAILURE

Facebook is a SM tool that is free and accessible to anyone who has access to the internet. The pharmacy curriculum is constantly advancing, especially with regards to technology. As more pharmacy programs move from paper to computer exams, reliance on technology is becoming the standard. Technology can aid in standardized exam taking, help reduce academic dishonesty and allow information for accreditation to be compiled using statistics.

mation and productivity. It may be prudent for faculty to have a contingency plan and instructions for students in the event of Facebook failure. Per Facebook’s website, the last time Facebook was unavailable for longer than 2 hours was in September 2010.7 Professionalism Current SM policies are varied but overall discourage any representation of unprofessionalism. Instances of unprofessionalism include but are not limited to: dissemination of electronic insults to, or verbal attacks on, university administration, faculty, staff or students; use of social media in a manner that interferes with academic responsibilities; or posting of potentially inflammatory or unflattering material on another individual’s website.8 Guidelines for professional and ethical behavior generally follow the concept that any accessible postings on social media are subject to the same

professional standards as any other personal interaction. The written nature, persistence and potential accessibility of these postings make them subject to particular scrutiny. Unprofessional public postings by others on a student’s social media can reflect poorly on the student. Students should monitor their sites and ensure that the content will not be viewed as unprofessional. The expansion of social media into the realm of education allows for ease of use that other course management systems do not provide, but it also has the potential to meld the lines between personal use and professional use. Although a perceived barrier, a study conducted in 2013 on social media and unprofessional pharmacist conduct revealed that less than 50 percent of the boards of pharmacy that participated had to deal with incidents of unprofessional online behavior.8 The most common online professional behaviors that caused complaints consisted of inappropriate use of internet for clinical practice and inappropriate communication or contact with patients.8 Because best practices of online professionalism have yet to catch up with actual online activities, professional interactions should continue to be expanded in an effort to obtain a broader consensus. While each school may already have varied guidances for misuse of social media, future best practices developed by national pharmacy organizations could greatly pave the foundation for this topic.

Table 2: Examples of Methods to Utilize Facebook as Pharmacists in the Pharmacy Profession

Facebook Use v Connecting and networking with other pharmacy/non-pharmacy professionals v Keeping abreast of the newest issues affecting pharmacists (e.g. joining and sharing links from medical websites (Medscape, pharmacist’s letter, etc.) v Sharing links on updated drug shortages v Updating patients on immunizations being offered at local facilities v Encouraging patients to participate in events at local facilities and in the community v Notices from pharmacy organizations about what they are involved in for the pharmacy profession v Receiving important information on “news feed” from the FDA and CDC (new drug approvals, immunizations schedule, national disease outbreak updates, etc.) 18

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Facebook in the Profession of Pharmacy As many changes in health care systems are expected, so is the pharmacists’ use of the internet and pharmacists’ services. This change presents pharmacists with both challenges and opportunities in regards to Facebook integration. Developing this skill set as a pharmacy student can translate into being a connected pharmacist not only within the pharmacy profession, but other professions as well. In pharmacy, ASHP, APhA, ACCP, ASCP and NCPA are just a few of the organizations that lead the way in uniting pharmacy as well as advancing the profession. All of these national organizations have a Facebook page. Each Facebook page is unique, but generally includes videos, upcoming events, announcements and links to articles pertinent to pharmacy practice. Some organizations also provide information on policy issues affecting pharmacy and advice on how to get involved. Additionally, once you “like” the page of an organization, it tends to show up regularly in your “news feed.” This allows students and pharmacists alike to stay up-to-date on information, which is essential because pharmacy practice changes constantly. Even government agencies, including The Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDC) and Medicare, have Facebook pages with resources for pharmacy professionals. These resources include new drug approvals, public health issues, links to vaccine schedules, information on current outbreaks and information on different Medicare plans. This information can be accessed quickly and efficiently, leading to greater patient education and satisfaction. The fact that all of these important agencies and organizations have Facebook pages gives insight into the importance of Facebook on a professional level. It also signifies the need to develop etiquette for professional Facebook use, which can be developed while in pharmacy school. The ability to stay abreast of current events that pharmacists are impacted by on a daily basis is now limitless and within reach as a result of so-

cial media like Facebook. Capitalizing on this opportunity can very well start in the pharmacy classroom. Table 2 lists possible ways to use Facebook in the pharmacy profession, which includes connecting and networking with nonpharmacy professionals. Conclusion While barriers and limitations exist with Facebook integration in the classroom, evidence has shown that many pharmacy students use Facebook regularly. This suggests that Facebook could be a potential medium to facilitate learning in the pharmacy classroom. Integrating Facebook into the pharmacy curriculum could be a recipe for creating well-rounded future pharmacists. Pharmacists with this skill set are likely to stay ahead of the curve as the pharmacy curriculum and our profession continues to evolve with the increased use of technology and social media. Further research studying how pharmacy schools are using Facebook and students’ perception of its use and feasibility may help new adopters incorporate this tool to propel our future pharmacists, advancing the profession. References

1 Benetoli A, Chen TF, Aslani P. The use of social media in pharmacy practice and education. Res Social Adm Pharm. 2014; 15. pii: S1551-7411(14)00038-2. doi: 10.1016/j.sapharm.2014.04.002. [Epub ahead of print]. 2 Accreditation Council for Pharmacy Education. Accreditation Standards and Key Elements for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree (Standards 2016). Chicago, IL: ACPE. Released February 2, 2015. https:// www.acpe-accredit.org/pdf/ Standards2016FINAL.pdf. 3 Fuller J. 1 billion people, probably including you, used Facebook on Monday. NY magazine. August 27, 2015. September 14, 2015. http://nymag.com/daily/ intelligencer/2015/08/1-billionpeople-used-facebook-in-one-day.html. 4 Walker J, Ottman A, Fairclough J, Thornby K. Facebook utilization and academic performance among pharmacy students. ASHP Midyear Clinical Meeting. Anaheim, CA.

December 2014. 5 McCabe DB, Meuter ML. A student View of Technology in the Classroom: Does it enhance the Seven Principles of Good Practice in Undergraduate Education. Journal of Marketing Education. 2011; 22(2):149-159. 6 Chickering AW, Gamson ZF. Seven principles for good practice in undergraduate education. AAHE Bulletin. 1987; 39(7): 3-7. 7 Facebook. Facebook Engineering. https://www.facebook.com/notes/ facebook-engineering/more-detailson-todays-outage/431441338919. Published September 23, 2010. Accessed September 14, 2015. 8 Skelley J, Hughes P, Elmore L. Social Media and Unprofessional Pharmacist Conduct: A Cross-Sectional Survey of Boards of Pharmacy. Innovations. 2013;4(3)125.

2016 F PA CAN DIDATES

Online Voting is Open for the Election of FPA Officers and Regional Directors Members voting in the FPA election are encouraged to go to www.pharmview.com and sign in with your username and password. Once signed in you will see the menu item for the 2016 FPA election of officers. Voting is now done online and only takes a few minutes.

DECEMBER 2015

FPA News & Notes Action Alert for Pharmacy Medicaid Providers The Florida Pharmacy Association has learned that some Medicaid plans are removing pharmacies from their managed care network, limiting access to only a few pharmacy providers. Florida has undergone significant changes within its Medicaid program over the past five years. What started out as a pilot project has now expanded into a statewide managed care program for Medicaid recipients, essentially privatizing health care services for the poor and indigent. The purpose of such a program was created by the Legislature under Part IV of Chapter 409 of the Florida Statutes, and its purpose was likely to somehow get more predictability and sustainability of the costs associated with Florida Medicaid.

Michael Jackson, FPA EVP & CEO testifies at AHCA Hearing on Medicaid Managed Care

Our members need to be aware that this program of limiting of access to pharmacy providers is problematic and that the Legislature will need to intervene on this issue. Members of the Florida House and Senate will be in their districts over the holidays. Each of us will need to take action to reverse this onerous policy. Take Action Here Contact Your State Legislator (The tool at the above link will connect you to your state senator and state representative.) The FPA is working with key members of the House and Senate on proposed legislation to reign in this behavior, and your state senator and state representative need to be educated and asked to support this effort. Here are some talking points that you (or your patients) should use when reaching out to your state legislator.

FLORIDA PHARMACY TODAY

In 2011, Florida Statute 409.975 was created to grant authority for managed care plans to limit the providers in their Medicaid networks based upon based on credentials, quality indicators and price. ■■ Many of our Florida-based businesses are finding out through notices that they are being excluded from Medicaid networks. ■■ These pharmacies have cared for these patients for many years and have managed the health of not only those patients, but their family members as well. ■■ These Florida-based businesses are locally owned and operated and pay taxes and fees for the privilege of serving their communities. ■■ Taxes and fees paid by Florida-based pharmacy businesses and Florida-licensed pharmacy personnel are used to fund these health care entitlement programs to treat the indigent. It is disturbing that the language in Statute 409.975 gives managed care plans the authority to discriminate against these very same pharmacies and that they are not allowed to care for citizens in their own communities. ■■ Many of these Florida-based businesses are supporting their communities through sponsorship of local charities and events and are contributing to the local economy and the creation of jobs. The have a corporate footprint on Florida soil, but they are being banned from helping those who cannot help themselves. ■■ Pharmacies that can provide the credentials, show the quality of care and are willing to accept the terms and conditions of a managed care contract should not simply be brushed off as an undesired provider of pharmacy services. ■■ Current network access standards for Florida Medicaid only require plans to have a pharmacy within a 30-minute travel time for patients in an urban area and a 60-minute travel time for patients in rural areas. This means that in Florida’s population centers, a round trip to the pharmacy that takes an hour (two hours for rural areas) is an acceptable standard. This is very troubling when Medicaid patients are already transportation challenged. The “ask” is simple on this issue. Florida Statute 409.975 needs to be changed to correct the discrimination of qualified pharmacy providers in the Medicaid program. Pharmacies that have not had any adverse incidents, are qualified, can show positive outcomes and value-added services and are willing to accept the terms and conditions of a managed care agreement should be al■■

lowed to care for Medicaid patients in their communities. There are other statutes in Florida laws that need to be reviewed as well, and the FPA and our coalition are working together to expose this issue. YOU need to make sure that your state legislator is thoroughly briefed on this problem so that that this is clearly on their radar when they return to Tallahassee on Jan. 12 for the legislative session. PLEASE MAKE THE CALL TODAY AND SET UP AN APPOINTMENT TO TALK WITH YOUR STATE LEGISLATOR. Chronic Diseases and Mail Order Prescriptions Senate Bill 780 and House Bill 583 have been filed to create Florida Statute 627.6442. The bill also revises Florida Statute 641.31 related to health maintenance contracts. The proposed legislation does not allow a patient’s health insurance policy, plan or other contract for health care services to restrict pharmacy services to mail order for certain chronic diseases. This bill allows patients who are suffering from HIV infection, epilepsy, hypertension or diabetes to get their prescriptions filled at any pharmacy willing to accept the terms and conditions of the patient’s health plan. The Florida Pharmacy Association supports this legislation.

FPA on the Move Pharmacy advocates visit with Florida Chief Financial Officer Jeff Atwater to discuss pharmacy MAC pricing issues. (L to R - Bill Mincy and Lois Adams of FIPN, Florida CFO Jeff Atwater and FPA’s Michael Jackson)

FPA visits with Representatives Mayfield and Lee on pharmacy access and network closure issues. (L to R EVP Michael Jackson, Rep. Debbie Mayfield, Rep-Vero Beach & Rep. Larry Lee, DemFort Pierce)

DECEMBER 2015

Pharmacist in Command of the Florida National Guard EVP Michael Jackson was honored to meet one of our dist i n g u i s h e d me mbers in service to our state. Maj. Gen. Mic hael Ca l hou n of the Florida National Guard assumed his duties as adjutant general of Florida on March 29, 2015. General Calhoun is a recipient of the Legion of Merit, Bronze Star Medal, the Humanitarian Service Medal, the Florida Cross, the Florida Distinguished Service Medal, the Alabama Commendation Medal and the Mississippi State Emergency Medal. He was the Army National Guard recipient of the Department of Defense African American History Month Recognition Award for 2008 for his contributions to the global war on terrorism, and a recipient of the Ancient Order of Saint Barbara. In addition to a Bachelor of Science degree in pharmacy from Florida A&M University, General Calhoun holds a master’s degree in strategic studies from the U.S. Army War College. Florida Continues Advocacy Support of Provider Status FPA Past President Bob Parrado visits with U.S. Rep. Kathy Castor to discuss H.R. 592. Currently, there are 245 cosponsors who have signed onto this legislation in the U.S. House. Seventeen members of the Florida delegation have signed on in support of this initiative. There are 37 members of the U.S. Senate who are signed on as cosponsors; however, we are still waiting on a decision from Senators Rubio and Nelson. Your messaging continues to have a positive effect on this issue. The 10 House members from Florida who have not signed on as cosponsors are as follows: Rep. Ted Yoho, Rep. Ander Crenshaw, Rep. John Mica, Rep. Bill Posey, Rep. Kathy Castor,

FLORIDA PHARMACY TODAY

President Elect Scott Tomerlin visits with pharmacy students at LECOM

Rep. Vern Buchannan, Rep. Lois Frankel, Rep. Federica Wilson, Rep. Mario Diaz-Balart and Rep. Ileana RosLehtinen. If these members of Congress are home in their districts over the holidays, please consider visiting with them for a discussion on H.R. 592. Talking points and information are available on the FPA web site. Proposed Legislation on Access to Pharmacist Services filed SB692 and HB547, which would create an act related to access to pharmacist services, has been filed and is sponsored by Senator Denise Grimsley and Representative Edwin Narain. This legislation, if signed into law, would provide more opportunities for patients to have access to pharmacist-provided patient care services. Data consistently illustrates that investment in pharmacist-provided patient care services yields a return in overall health care cost savings and improved patient care outcomes far greater than the amount invested in providing these services. The Florida Pharmacy Association is supporting SB692 and HB547 and will be working with the bill sponsors. ARNP and PA Prescribing Proposals Pending Each year, legislation is filed that seeks to give additional prescribing authority (including controlled substances) to advanced registered nurse practitioners and physician assistants. There are several bills that the FPA is monitoring that are seeking to implement these changes. These include SB152, SB210, HB375, HB423 and SB676. Revisions to Prescription Drug Monitoring Program Requirements HB313 was filed to exempt certain post-surgical administration and dispensing of controlled substances in certain facilities from having to report to the PDMP. Under the provisions of this bill, in rehabilitative hospitals, assisted living facilities or nursing homes, if a certain dosage of a controlled substance that is needed is dispensed, it does not have to be reported to the PDMP if ordered by the treating physician. This bill has already passed the House Health Quality Subcommittee and is now in the House Health and Human Services Committee.

Cannabis and Medical Marijuana Legislative Proposals Similar to last year, the Florida Legislature will be entertaining a number of bills on the use of cannabis and medical marijuana. Included in the 2016 legislative session inventory of proposals on this issue are HB63, HB65, HB271, HB307, HB460, SB554, SB616, SB852 and HB4021. The provisions in the bills range from minor changes to the existing law on the use of THC to removing cannabis from the list of controlled substances. The FPA will continue to monitor these proposals. AMA Calls for Ban on DTCA The American Medical Association released a policy statement this week raising concerns over how direct-toconsumer advertising is affecting the increasing cost of prescription drugs.

A Pharmacist And A Lawyer Board of Pharmacy Licensure Disciplinary Proceedings Compounding Violations, DEA Investigations Mergers and Acquisitions Pharmacy Risk Assessment/Management Evaluations KAHAN â&#x2014;&#x2020; HEIMBERG, PLC

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

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SAVE THE DATE 126TH ANNUAL MEETING AND CONVENTION OF THE FLORIDA PHARMACY ASSOCIATION Marriott Harbor Beach 3030 Holiday Drive Fort Lauderdale, Florida 33316 June 30 - July 3, 2016

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DECEMBER 2015

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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

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.

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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 fewer. ■■ 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.

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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. 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. Applica-

tions 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, 2016 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, 2016)  APhA Foundation and NASPA Bowl of Hygeia  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  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, 2016

DECEMBER 2015

CALL FOR RESOLUTIONS TO THE 2016 HOUSE OF DELEGATES The House of Delegates Board of Directors will meet in May 2016 to review and approve resolutions for the Annual Meeting. The deadline for submitting resolutions is May 6, 2016! 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

FLORIDA PHARMACY TODAY

florida BUYER’S GUIDE 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 PPSC Retail Pharmacy Purchasing Program (888) 778-9909

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

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

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

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.

RECOVERING PHARMACISTS NETWORK OF FLORIDA (407) 257-6606 “Pharmacists Helping Pharmacists”

DECEMBER 2015