July 2015 Florida Pharmacy Journal by Florida Pharmacy Today

The Official Publication Of The Florida Pharmacy Association JULY 2015

2015-2016 FPA PRESIDENT

TIM ROGERS

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florida PHARMACY TODAY Departments

VOL. 78 | NO. 7 JULY 2015 THE OFFICIAL PUBLICATION OF THE FLORIDA PHARMACY ASSOCIATION

Features

4 Calendar

Handbook of Association Information

4 Advertisers

Take part in the full benefits of Florida Pharmacy Association membership. Included is information you can use to participate in legislative activities and information you need to contact association leadership.

5 President’s Viewpoint 7 Executive Insight 25 Buyer’s Guide

Executive Committee ........................... 6 Address ............................................................8 Staff ....................................................................8 Mission Statement ..................................8 Past Presidents .........................................8 Organization ...............................................10 CE Calendar .................................................12 CE Requirements ....................................12

11 20 22

Code of Ethics ...........................................14 Unit Associations ...................................15 History .............................................................15 #1 Club ..............................................................16 FPA Officer and Director Nominations....................... 17 Mission Statement and Strategic Plan of the FPA.............18

E-FORCSE®: An Invaluable Tool for Clinical Decision-making Community Pharmacists’ Obligation to Expanded Practice Under Just Culture

The Pharmacy and Medically Underserved Areas Enhancement Act is Important for Our Future

JULY 2015

Mission Statements:

FPA Calendar 2015

AUGUST 2-5

32nd Annual Southeastern Education Gatherin’ Destin

14-16 45th Annual Southeastern Officers Conference Destin 22-23 FPA Committees, Councils and Board of Directors Meetings Orlando 10-12 Florida Board of Pharmacy Meetings Deerfield Beach

of the Florida Pharmacy Today Journal 12-13 FPA Regulatory and Law Conference Ft. Lauderdale OCTOBER 10-14 NCPA Annual Meeting Washington, D.C. 17-18 FPA Mid-year Clinical Conference Orlando 17-18 FPA Nuclear Conference Orlando NOVEMBER 7-8

FPA Council and Committee Meetings

Veterans Day (FPA Office Closed)

SEPTEMBER 1

Deadline to Submit Nominations for FPA Office

Labor Day (FPA Office Closed)

APhA Diabetes and Immunization Certificate Program

26-27 Thanksgiving Holiday (FPA Office Closed)

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, 2015. 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.............................. 13 KAHAN HEIMBERG, PLC................................ 9 PHARMACISTS MUTUAL............................. 24 PPSC...................................................................... 9 Rx OWNERSHIP................................................. 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 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.

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FLORIDA PHARMACY TODAY

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

The President’s Viewpoint TIM ROGERS, RPh, FPA PRESIDENT

Progress Has Been Made, But Challenges Await

ow is the time for all of the pharmacists and technicians to come and stand together to shape the future of the profession of pharmacy so that we, and not others, may stand “United to Advance Healthcare and Pharmacy Practice.” First, I would like to thank you all for your vote of confidence in electing me to be the FPA president for 2015-2016. I am humbled by the honor and excited to work with you to continue to strive to better our profession of pharmacy and improve the care that we can provide our patients. We have many tasks to face in the coming years. Many of our fights are ongoing. Some are new, while others we haven’t even recognized. We are making great strides in our insistence on obtaining provider status. We have started our fight for honest and fair MAC pricing. We have gotten legislation passed to enable us to expand our immunization capabilities. But, we have many challenges ahead. Some of the biggest challenges include: ■■ Redefining our standards of practice. ■■ Standing up for our patients’ rights to receive the controlled drug medications that they require for a better quality of life. ■■ Defining guidelines for the prescribing and dispensing of controlled drugs. ■■ Attaining provider status for pharmacists as health care providers. ■■ Defining our role in selecting the appropriate medications our patients are to receive. ■■ Addressing stress in the workplace. ■■ Clarifying technicians’ responsibilities.

■■

Moderating the ability of others (the DEA, PBMs, insurance companies and other professions) to control our pharmacy practice. Determining the pharmacist’s role in the dispensing and use of cannabis. Establishing the pharmacist’s abil-

I am humbled by the honor and excited to work with you to continue to strive to better our profession of pharmacy and improve the care that we can provide our patients.

■■

ity to dispense opioid antagonists to first responders. Evaluating and recommending policy for technology use in telepharmacy services. Monitoring and taking appropriate actions to changes in Medicaid managed care programs and the state prescription benefit programs, to obtain fair and equitable reimbursement for pharmacists’ services.

Tim Rogers, RPh 2015-2016 FPA President

My philosophy of leadership was developed through my decades as a leader in both Boy Scouts and Girl Scouts. That is a style that I call: shared leadership. We have a lot of pharmacists and others in our profession with great and innovative ideas. We need to all come together, stand together, and with one voice shape our profession into a champion of the rights of those we serve, our patients. It is not just I who will come up with the ideas and methods that we will use to achieve these goals. It is all of us working together. Pharmacy is a grassroots profession, where all of our practitioners should and do have control of our future. Every one of us must participate in the decision-making process or we condemn ourselves to working at a job under the direction of others. I would like to see everyone belonging to and being active in the FPA, FSHP and their national associations. But, more importantly, everyone beJULY 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 Christine Gegeckas............................................................................. 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

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FLORIDA PHARMACY TODAY

longing and being active in their local grassroots organizations. It is through our pharmacy organizations that we unite and are able to achieve the goals we seek. Meet with your fellow pharmacists and technicians, discuss whatâ&#x20AC;&#x2122;s happening, learn what others are doing, and get off your duff and do something. Through your elected representatives, your voice will be heard, but only if you speak out. If you have a few practitioners in your area and no local organization, start one. Contact me so that FPA and I can help you to get started. I have worked for many years as an independent pharmacist, as a chain pharmacist, and as a consultant to nursing homes and a detention center. I look forward to meeting the upcoming challenges with you, overcoming them with you and continuing to build our profession that we are so proud of. My goals over the next year are to make sure that the FPA remains at the forefront on the issues affecting pharmacy. We will be exploring new ideas, such as The Pharmacy Nation Web TV site. I will strive to increase our membership so that our voice will be louder when it speaks. I will strive to get more students and the young pharmacists more involved in the profession, because the changes we seek now will impact them the longest. I will listen and invite comments from all pharmacists on their views, so that we can represent them. I will make sure that we remain active in directing our legislative efforts. I will search out the resources we need to accomplish our goals. I will help support our Foundation and PAC activities, so that we may move forward. The FPA is changing with the times to remain current and relevant as the leader and champion for the profession. We need your voice and your support. I, and a few people, canâ&#x20AC;&#x2122;t do this alone. It is up to every one of you to commit yourself to our future for the sake of our profession and the welfare of our patients. n

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

FPA Launching Pharmacist Nation TV Network

f you were at the convention in St. Augustine last month, you not only heard about it but you saw it, experienced it and gave it a test ride. I am referring to the Pharmacist Nation TV Network powered by the Florida Pharmacy Association. These days, a lot of the information we receive is being delivered to devices attached to our side, inside our handbags or in pockets of our backpacks. Society is spending a lot of time looking at smart phones, thumbing through volumes of information or responding to posts from a number of news feeds. The Florida Pharmacy Association realizes this new trend in networking and is stepping-up our game to give the membership new and innovative ways of interconnecting. We started with the building of our tech-heavy website Pharmview.com. Now we are adding a web-based TV network in anticipation of the media trends in today’s fastpaced market. That’s right. Pharmacists of Florida will have their own television network with programming for and by pharmacists and the pharmacy profession all the time. Imagine our own television network composed of specific channels for the needs of the pharmacist and the pharmacy profession. From the FPA Student Channel to the FPA Partner Channel, and everything in-between – including the FPA Development Channel where you can earn your CEs online like never before – it’s all going to be here! The Internet has become a fascinating place where people are expressing themselves through social media. Pharmacist Nation will be a tool that targets our industry and uses the power of vid-

eo libraries to build pharmacy’s professional and business brands. This system is not exclusive to pharmacies and pharmacy owners, but has specialized channels for technicians, our journal Florida Pharmacy Today, students, con-

That’s right. Pharmacists of Florida will have their own television network with programming for and by pharmacists and the pharmacy profession all the time. sultants, hospital pharmacists, compounding and even a custom channel within the Pharmacist Nation network designed for women in pharmacy. The content on Pharmacist Nation is what you deliver to it, along with content provided by the Florida Pharmacy Association and its partners. This simply is the FPA on steroids connecting to its members, and the membership connecting with each other. Pharmacy business owners will be able to use the enhanced features of this media tool through the installation of a pharmacy TV monitor screen airing Pharmacist Nation. Other features that will be included are smart texting, a mobile wallet linking customers to redeemable mobile coupons, the Pharma-

Michael Jackson, B.Pharm

cist Nation radio commercial for your business phone and other features. What our members saw during the 125th Annual Meeting is creating excitement within our community never seen before. Watch our website at www.pharmview.com for emerging announcements.

JULY 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

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 8 Address: | F L O Rhttp://www.pharmview.com IDA PHARMACY TODAY

HANDBOOK OF ASSOCIATION INFORMATION Information you need to participate & take advantage of your FPA membership.

FPA Past Presidents 1956-57 Wesley D. Owens

1971-72 Mark Sullivan*

1985-86 Max A. Lemberger*

2000-01 Robert Wilson

1957-58 Grover F. Ivey*

1972-73 George B. Browning

1986-87 Robert Fishman

2001-02 Joy Marcus

1958-59 James Love*

1973-74 John W. Davies

1987-88 Kenneth R. Norfleet

2002-03 Tom Cuomo

1959-60 Rufus I. Thomas*

1974-75 Bernard J. Cimino*

1988-89 Allen Nichol

2003-04 Theresa W. Tolle

1960-61 Lucien W. Watson

1975-76 William Nestor

1989-90 Red N. Camp

2004-05 Glenn Boyles

1990-91 Ed L. Hamilton

2005-06 Kathy Petsos

1991-92 Betty J. Harris

2006-07 Lee Fallon

1992-93 S. Mark Hobbs

2007-08 Don Bergemann

1993-94 M. Peter Pevonka

2008-09 Norman Tomaka

1994-95 Allen David Knee

2009-10 Karen Whalen

1995-96 James Koivisto

2010-11

1996-97 James Powers

2011-12

1997-98 Paul Ackerman

2012-13

Jacksonville, FL

Tallahassee, FL

Orlando, FL

Melbourne, FL

Delray Beach, FL

Orlando, FL

New Smyrna Beach, FL Marianna, FL

1961-62 L. W. Harrell* Palatka, FL

1962-63 Dan Davis* Miami, FL

1963-64 Walter Griffin* Jacksonville, FL

1964-65 Freeman Oikle* Miami, FL

1965-66 Felix Donatelli Lakeland, FL

1966-67 Arnold Albert* Orlando, FL

1967-68 Harold S. Osteen Jacksonville, FL

1968-69 John W. White* Tallahassee, FL

1969-70 Neil Bitting* Ocala, FL

1970-71 Sidney Simkowitz* Miami, FL

Tampa, FL

Palm Beach Gardens, FL

1976-77 Gilbert N. Weise, Sr. Jacksonville, FL

1977-78 Robert T. Showerman* St. Petersburg, FL

1978-79 John Stadnik*

Miami Springs, FL

1979-80 Lawrence A. Diaz Gainesville, FL

1980-81 Joe Cuellar*

Temple Terrace, FL

1981-82 Peter C. Demro Ocala, FL

1982-83 John C. King Bartow, FL

1983-84 Michael W. Stamitoles Pensacola, FL

1984-85 George B. Browning Melbourne, FL

St. Augustine, FL Hollywood, FL

Brooksville, FL

Coral Gables, FL Titusville, FL

Lake Alfred, FL

Delray Beach, FL Merritt Island, FL Gainesville, FL Sunrise, FL

Jacksonville, FL Tallahassee, FL

Palm Beach Gardens, FL

1998-99 Rebecca R. Poston Winter Springs, FL

1999-2000 Eric M. Alvarez Miami, FL

Pensacola, FL

North Miami, FL Cape Coral, FL Grant, FL

Wellington, FL

Cape Canaveral, FL The Villages, FL Tarpon Springs, FL Melbourne, FL

Gainesville, FL

Humberto Martinez Miami, FL Bob Parrado Tampa, FL Goar Alvarez Cooper City, FL

2013-14

Terry Gubbins Riverview, FL

2014-15 Suzanne Kelley Pensacola, FL

Mission Statement United to Advance Healthcare and Pharmacy Practice

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Florida Pharmacy Association

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HANDBOOK OF ASSOCIATION INFORMATION Information you need to participate and take advantage of your FPA membership.

FPA ORGANIZATIONAL CHART

FPA Member

House of Delegates

Board of Directors

President’s Committee of the Board of Directors

ACPP

(Advisory Council on Pharmacy Practice)

Invited and Affiliated Organizations

EVP and CEO

AD Hoc Committees

FPA Staff Governmental Affairs Committee

Budget and Finance Committee

Standing Councils Public Affairs Professional Affairs Organizational Affairs Educational Affairs Membership Affairs Student Affairs

FLORIDA PHARMACY TODAY

E-FORCSE®: An Invaluable Tool for Clinical Decision-making Rebecca Poston, B.Pharm., MHL. The Electronic Florida Online Reporting of Controlled Substances Evaluation program (E-FORCSE®), Florida’s Prescription Drug Monitoring Program (PDMP), has proven to be an effective tool for protecting public health and safety, while supporting sound clinical prescribing, dispensing and use of controlled substances. Evidence of the effectiveness of E-FORCSE® is documented in its 2014 annual report, which shows a 53 percent decrease in the number of individuals obtaining controlled substance prescriptions from multiple prescribers. Healthcare practitioner registration has increased by 16 percent in the last year, and utilization has increased 64 percent. Additional evidence of effectiveness is reported in the 2013 Medical Examiner’s Drugs Identified in Deceased Persons Report, which shows an 8.3 percent decrease in the number of deaths in which one or more controlled substance prescriptions was identified as the primary cause of death, while oxycodone deaths declined by 27.3 percent and overall drug deaths fell by 7.3 percent, when compared with 2012. Created by the Florida Legislature in 2009, E-FORCSE® is part of an initiative to encourage safer prescribing of controlled substances and reduce drug abuse and diversion within the state of Florida. E-FORCSE® provides information to healthcare practitioners that help guide prescribing and dispensing decisions regarding highly abused prescription drugs. The web-based program facilitates the collection, storage, maintenance and analysis of controlled substance dispensing data. Confidential and exempt information is only released in accordance with Florida law. On January 5, 2015, E-FORCSE® released an extensive system update designed to improve the user experience. This included adding three new features, described here:

Morphine Equivalent Dosage (MED) A new column has been added to the Patient Advisory Report (PAR) identifying the MED for each opioid prescription dispensed to the patient. Also, a MED Summary section, located at the bottom of the report, displays the cumulative MED values by unique recipient. The “MED MAX” value is the maximum cumulative MED sustained for any three consecutive days. This value is calculated based on prescriptions dispensed during the date range requested. The MED is important to know because recent studies indicate a dramatic increase in accidental deaths associated with an average daily MED greater than 120mg of prescription opioids per day. For more information, please view our MED Quick Reference Guide. DEA Prescriber’s Query The new DEA Prescriber’s Query allows healthcare practitioners to view their prescribing history for a specified timeframe. This feature can help protect against controlled substance prescription fraud by allowing healthcare practitioners to review the prescrip-

tions being dispensed under their DEA registration. For more information, please view our Prescriber DEA Query Quick Reference Guide. User Name and Password Retrieval The new User Name and Password feature allows a user to retrieve their user name and password without intervention by program or help desk staff. For more information, please view our brief tutorial on User Name and Password Retrieval. As of March 31, 2015, 50 percent (14,193) of licensed pharmacists have registered for access to E-FORCSE® and 90 percent of those registered pharmacists have requested a Patient Advisory Report (PAR). For information on how to register for access to E-FORCSE®, please refer to the Training Guide for Florida Practitioners and Pharmacists. For more information visit www.eforcse.com, or to register to use the database visit www.hidesigns.com/flpdmp.

JULY 2015 |

HANDBOOK OF ASSOCIATION INFORMATION Information you need to participate and take advantage of your FPA membership.

Continuing Education Requirements for Florida Pharmacists and Pharmacy Technicians 2015-2016 LIVE FPA CONTINUING EDUCATION CALENDAR SEPTEMBER 11-13, 2015 Regulatory & Law Conference Hyatt REGENCY PIER 66 Room Rate $105 AND UP plus tax Call (888) 421-1442 by August 20, 2015 15 hrs of General or 12 Consultant Recertification Credit available plus 2-hour Medication Error CE Also offering APhA Diabetes and Immunization Certificate Programs Ft. Lauderdale, Florida OCTOBER 17-18, 2015 Midyear Clinical Conference Embassy Suites-Lake Buena Vista South Room Rate $139 plus tax Call (407) 597-4000 by September 25, 2015 15 hrs General, 12 hrs nuclear or 12 Consultant Recertification Credit available plus 2-hour Medication Error CE Orlando, Florida DECEMBER 5-6, 2015 Regulatory & Law Conference Hyatt Regency Sarasota Room Rate $151 AND UP plus tax Call (888) 421-1442 by November 13, 2015 15 hrs of General or 12 Consultant Recertification Credit available plus 2-hour Medication Error CE

JANUARY 23-24, 2016 Clinical Conference Sandestin Golf & Beach Resort Room Rate $119 AND UP plus tax Call (800) 267-8000 by January 8, 2016 15 hrs of General or 12 HRS Consultant Recertification Credit available plus 2-hour Medication Error CE Destin, Florida APRIL 16-17, 2016 Clinical Conference Grand Hyatt Tampa Bay Room Rate $159 plus tax Call (888) 421-1442 by March 25, 2016 15 hrs of General or 12 HRS Consultant Recertification Credit available plus 2-hour Medication Error CE Tampa, Florida MAY 21-22, 2016 Regulatory & Law Conference Hotel TBD Room Rate $ AND UP plus tax TBD by April 22, 2016 15 hrs of General or 12 Consultant Recertification Credit available plus 2-hour Medication Error CE Jacksonville, Florida JUNE 29-JULY 3, 2016 126th FPA Annual Meeting & Convention Marriott Harbor Beach Resort & Spa Room Rate $159 plus tax Call (888) 789-3090 by June 10, 2016 General & Consultant Recertification Credit available plus 2-hr Medication Error

Continuing Education Requirements for Florida Pharmacists and Pharmacy Technicians General Continuing Education Requirements Florida licensed pharmacists are required to obtain 30 hours of approved courses of continued professional pharmaceutical education within the 24-month period prior to the expiration date of the license. For example, approved continuing education courses will need to be completed between October 1, 2013 and September 30, 2015 before the “PS” license expires on September 30, 2015. (64B16-26.103) Ten (10) of the 30 hours of approved courses of continued professional pharmaceutical education must be LIVE continuing education hours. LIVE con12

FLORIDA PHARMACY TODAY

Exhibit and Sponsorship Opportunities Available Ft. Lauderdale, Florida July 17 – July 24, 2015 FPA CE at SEA 2016 Mediterranean and Europe Departing Barcelona, Spain for Palma De Mallorca, Spain, Marseilles, France and Florence, Rome, and Naples, Italy AUGUST 7-10, 2016 Clinical Conference The Henderson Beach & Spa Resort Room Rate: $189 plus tax Call by July 15, 2016 General & Consultant Recertification Credit available plus 2-hr Medication Error Exhibit and Sponsorship Opportunities Available Destin, Florida ONLINE HOME STUDY COURSES 3-Hour Consultant Credit Hypertension 3-Hour Consultant Credit Diabetes 6-Hour Consultant Credit Geriatric 3-Hour Immunization Ama Pr1 Course 2-Hour Board-Approved Medication Errors 1-Hour Board-Approved HIV/AIDS Update Register @ www.pharmview.com *Schedule Subject to Change

tinuing education is defined as either a live seminar, a live video teleconference or through an interactive computer-based application. (64B16-26.103) HIV/AIDS Continuing Education Requirements Effective July 1, 2006, applicants for licensure are no longer required by Chapter 456, F.S., to show proof of a course on HIV/ AIDS as part of the initial licensure process. You will, however, be required by Chapter 456, F.S., to take an HIV/AIDS course approved by the board for your first renewal. This includes pharmacy technicians as well. As of July 1, 2006, licensees will no longer be required by Chapter 456, F.S., to take an HIV/AIDS course for each renewal.

HANDBOOK OF ASSOCIATION INFORMATION Information you need to participate and take advantage of your FPA membership.

Medication Error Continuing Education Requirements As a part of the biennial renewal, pharmacists are required to complete a two (2) hour Florida Board of Pharmacy-approved course on Medication Errors. The course must contain the following components: (a) root-cause analysis; (b) error reduction and prevention; and (c) patient safety. The two-hour program may be applied towards the 30-hour continuing education requirement. (64B16-26.103) Consultant Recertification Continuing Education Requirements Florida licensed consultant pharmacists must complete no less than 24 hours of Board-approved consultant continuing education (64B16-26.302) within the 24 month period prior to the expiration date of the consultant license. (64B16-26.103) For example, Florida-approved consultant CE programs must be completed between January 1, 2013 and December 31, 2014 for consultant licenses that expire December 31, 2014. Course content for consultant recertification programs must consist of at least three (3) hours of training in specified subjects. Duplicated courses are not acceptable. (64B16-26.302) Ordering and Evaluation of Laboratory Tests Florida Consultant pharmacists and pharmacists holding the Doctor of Pharmacy degree that wish to order and evaluate laboratory tests and who are practicing under the provisions of Florida Statute 465.0125* are required to complete at least a three (3) hour initial certification course and at least a one (1) hour recertification course. Successful completion of the course will certify the pharmacist for this practice for two (2) years from the date of completion. (64B16-26.320)

Immunizing Pharmacists Pharmacists wishing to provide immunizations must take a Board-approved immunization training program. The program must be at least 20 hours in length and include a review of immunization laws and CPR training. (64B16-26.1031) During the 2012 legislative session, House Bill 509 passed and created a new requirement for pharmacists who wish to maintain their immunization registry. Those requirements include the following: the three (3) hour CE program must be done once each biennial renewal period ending September 30 and must be offered by a Florida statewide professional association of physicians; the statewide association must be accredited to provide AMA PRA Category I CME; the program must cover the safe and effective administration of vaccines and epinephrine auto-injection; a distance learning format allowed for the three (3) hour CE program; The three (3) hours required to meet immunization “recertification” can be included within the 30-hour CE biennial requirement for pharmacists; and failure to get the recertification CE will result in the pharmacist’s immunization registry being revoked. Credit for any Continuing Education course may not be used more than once in any given year. The above information should only be used as a guide and cannot be considered advice. This information is subject to change. Revised 4/4/2013.

Representing Health Care Professionals

*Florida Statute 465.0125 defines practice settings as nursing homes or licensed home health agencies for Consultant Pharmacists and only licensed home health agencies for the Doctor of Pharmacy.

• DOH Investigations • Licensure Discipline

Nuclear Pharmacy Continuing Education Requirements Florida Nuclear Pharmacists must complete no less than 24 additional hours of coursework each two (2) year period designed to provide in-depth treatment of nuclear pharmacy practice. (64B16-26.304) Registered Pharmacy Technician Beginning January 1, 2011, technicians interested in working in Florida permitted pharmacies will need to complete a Florida Board of Pharmacy approved training program. Upon successful completion of that program, technicians can then submit an application to the Board for full registration status. Registered pharmacy technicians must complete 20 hours of appropriate CE (four (4) hours live, two (2) hours med errors and one (1) hour HIV for initial renewal) by December 31, 2014. See rule 64B16-26.355 and Florida Statutes 465.014.

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JULY 2015

HANDBOOK OF ASSOCIATION INFORMATION Information you need to participate and take advantage of your FPA membership.

Code of Ethics for Pharmacists PREAMBLE Pharmacists are health professionals who assist individuals in making the best use of medications. This Code, prepared and supported by pharmacists, is intended to state publicly the principles that form the fundamental basis of the roles and responsibilities of pharmacists. These principles, based on moral obligations and virtues, are established to guide pharmacists in relationships with patients, health professionals and society. I. A pharmacist respects the covenantal relationship between the patient and pharmacist. Considering the patient-pharmacist relationship as a covenant means that a pharmacist has moral obligations in response to the gift of trust received from society. In return for this gift, a pharmacist promises to help individuals achieve optimum benefit from their medications, to be committed to their welfare, and to maintain their trust. II. A pharmacist promotes the good of every patient in a caring, compassionate and confidential manner. A pharmacist places concern for the well-being of the patient at the center of professional practice. In doing so, a pharmacist considers needs stated by the patient as well as those defined by health science. A pharmacist is dedicated to protecting the dignity of the patient. With a caring attitude and a compassionate spirit, a pharmacist focuses on serving the patient in a private and confidential manner. III. A pharmacist respects the autonomy and dignity of each patient. A pharmacist promotes the right of self-determination and recognizes individual self-worth by encouraging patients to participate in decisions about their health. A pharmacist communicates with patients in terms that are understandable. In all cases, a pharmacist respects personal and cultural differences among patients. IV. A pharmacist acts with honesty and integrity in professional relationships. A pharmacist has a duty to tell the truth and to act with conviction of conscience. A pharmacist avoids discriminatory practices, behavior or work conditions that impair professional judgment, and actions that compromise dedication to the best interests of patients. V. A pharmacist maintains professional competence. A pharmacist has a duty to maintain knowledge and abilities as new medications, devices and technologies become available and as health information advances.

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VI. A pharmacist respects the values and abilities of colleagues and other health professionals. When appropriate, a pharmacist asks for the consultation of colleagues or other health professionals or refers the patient. A pharmacist acknowledges that colleagues and other health professionals may differ in the beliefs and values they apply to the care of the patient. VII. A pharmacist serves individual, community and societal needs. The primary obligation of a pharmacist is to individual patients. However, the obligations of a pharmacist may at times extend beyond the individual to the community and society. In these situations, the pharmacist recognizes the responsibilities that accompany these obligations and acts accordingly. VIII. A pharmacist seeks justice in the distribution of health resources. When health resources are allocated, a pharmacist is fair and equitable, balancing the needs of patients and society. Approved by: FPA House of Delegates and APhA Active and Life members October 1994.

HANDBOOK OF ASSOCIATION INFORMATION Information you need to participate and take advantage of your FPA membership.

UNIT ASSOCIATIONS REGIONAL MAP History of The Florida Pharmacy Association Established in 1887, The Florida Pharmacy Association (FPA) has been serving the pharmacists and pharmacy technicians of the state of Florida for over a century. FPA encompasses all aspects of pharmacy (hospital, independent and chain, nursing home, consulting home health care, managed care, etc.) and strives to stay abreast of the needs of a rapidly changing pharmacy practice community.

The Florida Pharmacy Association Needs Your Involvement. The Florida Pharmacy Association is currently filling positions for its 2016-2017 Standing Councils. If you are interested in serving as a member of an FPA Council, please fill out the form below.

Florida Pharmacy Standing Councils The Florida Pharmacy Association (FPA) has created six standing councils to assist in the development of Association policy and activities as well as to better serve the FPA membership. The councils have also been formed to provide members with a mechanism for representation. FPA's councils include Educational Affairs, Organizational Affairs, Professional Affairs, Public Affairs, Membership Council and Student Affairs Council. EDUCATIONAL AFFAIRS: The Educational Affairs Council proposes policy and programs designed to provide quality continuing education to the pharmacists and technicians of Florida. ORGANIZATIONAL AFFAIRS: The Organizational Affairs Council considers issues pertaining to the structure, function and development of the Association, including membership issues. PROFESSIONAL AFFAIRS: The Professional Affairs Council monitors issues of interest to the profession of pharmacy, including legislative changes and Florida Board of Pharmacy law changes, and interfaces with other professions as they relate to pharmacy. PUBLIC AFFAIRS: The Public Affairs Council disseminates material relating to the practice of pharmacy to the public, in order to enhance the image of the profession of pharmacy.

MEMBERSHIP COUNCIL: The council was formed to facilitate the Association’s membership recruitment and retention programs, as well as to oversee the activities of the #1 Club or any other matters referred to it for consideration. STUDENT AFFAIRS : The Student Affairs Council promotes and encourages student involvement in the FPA, and serves as a liaison between the FPA and Florida Colleges of Pharmacy. Council meetings are held three times a year in central Florida. Meetings are held on Saturdays from 10 a.m. to 3 p.m. allowing members to drive in and out the same day. As a member of a Council, the FPA will assist in your travel expenses. Council members will serve two-year terms.

Please complete the form today and return by April 1, 2016, to: Florida Pharmacy Association, Attn: Christopher Heil, 610 N. Adams St., Tallahassee, FL 32301 or FAX (850) 561-6758. YES, I am interested in serving on an FPA Council. The council I am most interested in is:  Educational Affairs  Organizational Affairs  Professional Affairs  Public Affairs  Membership Council  Student Affairs Council

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JULY 2015

HANDBOOK OF ASSOCIATION INFORMATION Information you need to participate and take advantage of your FPA membership.

The Officers and Executive Committee of the Florida Pharmacy Association cordially invite you to join the

#1 CLUB

This exclusive organization recognizes outstanding contributors to membership development within the Florida Pharmacy Association. The Florida Pharmacy Association’s (FPA) prestigious #1 Club, established in 1985, recognizes those members who demonstrate extraordinary commitment to increasing membership in the FPA. You are challenged to become one of the select few who achieve #1 Club membership. Eligibility requirements and benefits of membership are described below. Each new member sponsored brings you a step closer to becoming a part of this elite organization, and increases the strength and influence of the entire pharmacy profession.

Eligibility Requirements:

Membership in the #1 Club may be attained by sponsoring 10 new active regular members to the FPA and participation in one retention program. The 10 recruited member records shall be current and active just prior to the annual meeting of the FPA, as determined by FPA staff. Active membership in the #1 Club must be maintained by sponsoring three (3) new regular members to the FPA each year following that of your installation and participation in two membership retention programs per year, or preparation of a Journal article on the advantages of membership.

Benefits of Membership:

1. One complimentary registration for you to the FPA Annual Meeting and Convention EACH YEAR that active membership in the #1 Club is maintained. 2. Engraved membership plaque to be awarded at the FPA Annual Meeting and Convention when installed into the #1 Club. 3. Distinctive red jacket with #1 Club crest indicating membership in the #1 Club.

Florida Pharmacy Association Retention Programs:

1. Call 20 members who have not renewed their membership dues. 2. Coordinate bringing a group of local pharmacists to Florida Pharmacy Association’s Legislative Days. 3. Serve on the Membership Council to develop new retention programs, discuss membership issues or to develop membership satisfaction surveys. 4. Call and welcome 20 new members who were not sponsored in the #1 Club program. 5. Use the online “Refer a Friend” tool to invite 10 pharmacists to become members. 6. Visit a graduating class with an invitation to FPA membership. For more information on the #1 Club, contact: Chris Heil, 610 North Adams Street Tallahassee, FL 32301 850-222-2400 16

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#1 CLUB MEMBERS Carmen Aceves Paul Ackerman Ann Marie Aldrich Eric Alvarez Goar Alvarez Eli Berkofsky Glenn Boyles Joseph Burghardt Leonard “Red” Camp Tom Cuomo Ana De La Huerta Art Diaz Marcus Dodd-O Jackie Donovan*** Leo “Lee” Fallon*** Raul Gallo Mayra Gonzalez-Abreu Terry Gubbins Ed Hamilton Betty Harris Carl “Fritz” Hayes S. Mark Hobbs Thomas Isbon Michael Jackson*** Alan Katz Suzanne Kelley*** David Laven David Mackarey*** Joy J. Marcus Humberto Martinez Robert Miller Tian Merren Owens*** Allen Nichol Mary Kay Owens Bob Parrado*** Kathy Petsos Rebecca Poston James Powers Michael Stamitoles Theresa Tolle Norman P. Tomaka*** Scott Tomerlin*** Alton Tower*** Robert H. Wilson*** *** Denotes active #1 Club Members

HANDBOOK OF ASSOCIATION INFORMATION Information you need to participate and take advantage of your FPA membership.

FPA Officer and Director Nominations Although we have just finished the election for a President-Elect and Directors for the odd-numbered regions who were installed at the 2015 annual meeting, it is time to start thinking about nominees for the 2016 election, since the nomination deadline is September 1 of this year (9/1/15). As the form below indicates, this year we will need candidates for President-Elect, Treasurer and Directors for the even-numbered regions. Please note that you may nominate yourself. CALL FOR FPA OFFICER AND DIRECTOR NOMINATIONS for 2016 Elections The FPA bylaws specify that any subdivision or any member in good standing may nominate one person for the office of President-Elect and one person for the office of Treasurer. A President-Elect shall be elected every year and shall assume the duties of the President on the last day of the annual meeting of the year following election as President-Elect. The Treasurer shall serve a two-year term and may succeed to one consecutive term of office in that capacity. Nominees must be Florida registered pharmacists in good standing with the Florida Pharmacy Association and the Florida Board of Pharmacy. Nominees for President-Elect should have a good understanding of how the Association functions and should be current on the issues impacting pharmacy. Nominees for Treasurer should have good analytical skills and experience and ability in financial management and budget preparation. There are nine regional Board Directors who shall serve two-year terms. A nominee must be a Florida registered pharmacist in good standing with the Florida Pharmacy Association and the Florida Board of Pharmacy. Additionally, each Board Director must be a member of at least one the FPA Unit Associations within their region. Board Directorsâ&#x20AC;&#x2122; terms are staggered such that even-numbered regions shall be elected in even-numbered years and odd-numbered regions shall be elected in odd-numbered years. All newly elected Board of Directors Regional Directors shall take office on the last day of the annual meeting, and shall continue in office until the last day of annual meeting of the second ensuing year.

FPA CANDIDATE NOMINATION FORM I AM PLEASED TO SUBMIT THE FOLLOWING NOMINATION: NAME: ADDRESS:

FOR THE FOLLOWING OFFICE:

(Nomination deadline: September 1, 2015)

q President-Elect q Board Director Region 2 Region 4 Region 6 Region 8 NOMINATED BY: NAME: DATE SUBMITTED: SIGNATURE:

MAIL NOMINATIONS TO: Election Nominations, Florida Pharmacy Association, 610 N. Adams St., Tallahassee, FL 32301 (850) 222-2400 FAX (850) 561-6758 DEADLINE FOR NOMINATIONS IS SEPTEMBER 1, 2015

JULY 2015

HANDBOOK OF ASSOCIATION INFORMATION Information you need to participate and take advantage of your FPA membership.

The Mission Statement and Strategic Plan of the FPA Approved March 23, 2014 by FPA Board of Directors

“United to Advance Healthcare and Pharmacy Practice” FPA Strategic Issues: 1. Membership Services, Recruitment and Retention 2. Public Policy, Politics and Advocacy 3. The Transitioning Role of the Profession of Pharmacy 4. Financial Viability of the Association Introductory Statement on the FPA Strategic Plan Strategic planning is an organization’s process of defining its strategy, or direction, and making decisions on allocating its resources to pursue this strategy, including its capital and people. Strategic planning is the formal consideration of an organization’s future course. Resources of any organization are not unlimited and, as such, leadership or management has to make critical decisions to maximize organizational assets to the benefit of the membership, the profession and the organization, all of which depend on each other. Usually a SWOT analysis is performed to assist in plan development. All strategic planning deals with at least one of three key questions:

“What do we do?” “For whom do we do it?” “How do we excel?” Simply put, strategic planning determines where an organization is going over the next year or more, how it’s going to get there and how its leadership will know if it got there or not. The focus of a strategic plan is usually on the entire organization, while the focus of a business plan is usually on a particular product, service or program. In18

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cluded in the FPA’s strategic plan is a series of measurable projects designed to achieve the various objectives. These projects, objectives and goals will be monitored by the FPA Board of Directors. FPA Strategic Issue #1: Membership Services, Recruitment and Retention Goals and Objectives Goal 1: Increase net membership by 18% annually • Objective 1: Increase pharmacist membership by 5% annually • Objective 2: Increase technician membership by 100% the first year, 80% the second year, 60% third year and so on • Objective 3: Increase student membership by 30% annually • Objective 4: Increase associate membership by 10% annually Goal 2: Set attrition of current members to no more than 20% annually • Objective 1: Increase opportunities for involvement • Objective 2: Identify reasons for not renewing • Objective 3: Identify member retention benefits Goal 3: Expand the offering of value-added member services and opportunities by two annually. • Objective 1: Identify and create value-added services and programs • Objective 2: Assess current FPA member value-added services

FPA Strategic Issue #2: Public Policy, Politics and Advocacy Goal 1: Increase involvement of FPA members in public policymaking • Objective 1: Connecting FPA members with those who make and shape public policy • Objective 2: Increase number of contributing members to the Florida Pharmacist Political Committee by 10% • Objective 3: Increase the dollar amount of contributions to the Florida Pharmacist Political Committee by 20% • Objective 4: Educate FPA members about public policymaking Goal 2: Increase involvement of members in politics • Objective 1: Educate FPA members about getting elected/selected for political/ governmental positions • Objective 2: Seek to get a member in the Florida Legislature and on the Board of Pharmacy Goal 3: Increase involvement of members in advocacy • Objective 1: Increase pharmacist involvement in legislative days and the health fair to 100 participants • Objective 2: Connect FPA members with those who make and shape public policy • Objective 3: Educate FPA members about effective

HANDBOOK OF ASSOCIATION INFORMATION Information you need to participate and take advantage of your FPA membership.

FPA Strategic Issue #3: The Transitioning Role of the Profession of Pharmacy Goal 1: Achieve provider status • Objective 1: Implement two projects to support national provider status • Objective 2: Implement two projects to support statewide provider status • Objective 3: Showcase, bi-monthly, those pharmacists providing clinical services in Florida • Objective 4: Educate pharmacy stakeholders on the transitioning role of the profession of pharmacy Goal 2: Expand the role of pharmacy technicians • Objective 1: Advocate for additional credentialing of registered pharmacy technicians

• Objective 2: Advocate for revisions in statutes and rules to allow for the expansion of the role for pharmacy technicians FPA Strategic Issue #4: The Financial Viability of the Association Goal 1: Evaluate the office building and other fixed assets • Objective 1: Examine our real estate position in the Tallahassee market • Objective 2: Determine longterm viability of the FPA office • Objective 3: Review other fixed assets or technology for purchase, replacement or repair Goal 2: Evaluate current reserves for purpose and intent to continue to achieve our operating objectives and fulfill the Association’s mission and vision

• Objective 1: Review the purpose for FPA reserves • Objective 2: Create an endowment that could be used for specific projects or expenses Goal 3: Increase revenue and manage expenses • Objective 1: Identify and grow new revenue sources • Objective 2: Evaluate, modify and improve financial reporting of FPA revenue and expenses to the Board of Directors • Objective 3: Review all revenuegenerating programs and events for viability and purpose • Objective 4: Review association expenses and operations for opportunities

SAVE THE DATE

126th FPA Annual Meeting & Convention June 29- July 3, 2016 Marriott Harbor Beach Resort & Spa Ft. Lauderdale, Florida

JULY 2015

Community Pharmacists’ Obligation to Expanded Practice Under Just Culture By: Petra Estep, Pharm.D. | Pharmacy Resident at the University of Florida, Jacksonville Campus Medication errors continue to pose a substantial threat to patient safety within the healthcare system. Improvement in the accuracy of medication orders and administered drug products continues to progress as an interdisciplinary effort. Currently, Just Culture represents the widely accepted approach to addressing these errors. Just Culture is defined by an outlined set of principles intended to maintain profes-

with or without the occurrence of adverse drug event.”2 In 1999, the Institute of Medicine published “To Err is Human: Building a Safer Health System,” which stated that medication errors represent the eighth leading cause of death in the United States.3 Medication errors within the hospital continue to receive substantial attention; however, it cannot be ignored that one of out every 131 outpatient deaths is related to

Through encouraging trust among co-workers, process improvement and education, Just Culture works to decrease errors within the healthcare system. sional accountability without imposing punitive consequences for system failings over which healthcare professionals have no control.1 Through encouraging trust among co-workers, process improvement and education, Just Culture works to decrease errors within the healthcare system. As a key part of the error reduction initiative in the community setting, pharmacists must continue to strive to advance their practice through clinical evaluation of medication orders, effective patient counseling and accurate dispensing. With this, pharmacists can ensure they are contributing substantially to patient safety and supporting a Just Culture. Medication errors can be defined as “any barrier that prevents the right patient from receiving the right drug in the right dose at the right time through the right route of administration, at any stage in the medication use process, 20

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medication errors.2 Medication errors, both inpatient and outpatient, have been estimated to cost the United States healthcare system approximately $177 billion each year.2 In most cases, these errors are completely preventable, and Just Culture works to improve our daily practice to address recurrent issues and mitigate error-prone situations. Just Culture has not always been the standard for addressing medication errors. Before 1990, a punitive culture was generally accepted.4 Punishment was expected in response to negative patient outcomes, and the fear of such ramifications led to under-reporting and concealment of errors. While logic may have initially suggested that fear of punishment would improve accuracy of therapies, it was learned that errors were driven underground, resulting in the perpetuation of broken processes and dangerous work-

arounds. As a result, a blame-free culture emerged to alleviate fear of rash punishment for honest errors. However, reckless actions went unpunished in this model. It was clear that the healthcare system needed to develop a means of addressing medication errors that did not apply broad-sweeping responses and provided deeper consideration of the cause of the error. Just Culture falls within this middle ground between the punitive and blame-free cultures. It has shown to emphasize a learning environment in which accountability for outcomes is divided and workers share the responsibility of identifying potential and actual threats. Just Culture also responds differently to the various types of errors: human errors, errors resulting from at-risk behavior and errors resulting from recklessness. Human errors are defined as unintentional mistakes that are not made due to a behavioral choice.5 These errors are difficult to avoid, but continuous process assessment and improvement help to prevent these honest errors from occurring. On the other end of the spectrum, reckless errors are intentional and consciously committed. Recklessness is not tolerated and results in punishment. The errors that prove most challenging to address are errors resulting from atrisk behaviors. These occur as a result of lackadaisical behaviors of which we mistakenly justify or underestimate the associated risk. In community practice, we must charge ourselves with remaining aware of our actions, our processes and our attitudes, to avoid slipping into these at-risk behaviors that could unintentionally place our patients at risk. We should be asking ourselves, “How can I improve patient safety within my community practice?” This takes us back to the 5 R’s: right medi-

cation, right dose, right time (or frequency), right route and right patient. For some, determining the correctness of dose, drug and duration involves a clinical assessment including consideration of the drug’s indication. Unfortunately, others are solely concerned with confirming that the dispensed product matches the physician order. A survey of 100 community pharmacists found that 57 percent of pharmacists defined their primary role as dispensing- or product-focused.6 We must recognize that merely confirming that a product matches a prescription cannot be accepted as sufficient to ensure patient safety and optimization of the therapy. One could argue that merely dispensing a prescription without clinical evaluation could represent at-risk behavior. Prescribing errors, or “a prescribing decision or prescription writing process that results in an unintentional, significant reduction in the probability of treatment being timely and effective or increase in the risk of harm,” occur frequently.2 It has been estimated that upwards of 11 percent of all new prescriptions contain at least one error upon which a community pharmacist could (and should) intervene.7 On average, a typical community pharmacist intervention takes approximately six minutes.7 In Just Culture, to blindly accept prescriptions as written without questioning clinical appropriateness to save six minutes could easily be classified as at-risk behavior. As pharmacists fight for provider status in the State of Florida, we must recognize our obligation to promote patient safety and serve as active participants in our patients’ care. Working to recognize the most common prescribing errors and taking steps to rectify these errors can advance pharmacy practice and improve patient safety. One study identified that the most common prescribing errors include incorrect drug, incorrect dose, allergies and drug-drug interactions.2 Furthermore, the authors concluded that reviewing the indication for the medication allowed for correction of 35 percent of these errors prior to reaching the patient.2 Questioning uncertainties regarding a prescription is in the best

interest of our patients and maintains a trusting relationship between healthcare team members. While some physicians may omit the indication from the face of a written or electronic prescription, discussing the medication with the patient may reveal this information. Not only can this discussion obtain the necessary information more quickly than contacting the physician directly, but it can also serve as a segue into patient counseling. Studies have demonstrated that patient counseling can lead to reduction in non-adherence, treatment failure, wasted healthcare resources and medication errors.8,9 Counseling patients allows pharmacists to reinforce safe medication use, obtain an accurate medication and allergy list and discuss the importance of medications in the patient’s disease states. This conversation is beneficial for the prescriber, the pharmacist and the patient, as it facilitates communication among the outpatient care team members and the patient. So, then, why do some pharmacists hesitate to intervene when patients need them most? One study placing “secret shoppers” within pharmacies found that states with stricter regulations surrounding the requirement to counsel had a higher rate of patient counseling.7 Additionally, the study found that “patients” visiting pharmacies with younger pharmacists were more likely to receive counseling. The article did not speculate as to the reasons for the age association, however one may suggest that younger pharmacists were trained with a greater emphasis on direct patient care or that those working in the community setting for a longer period of time are more likely to have experienced burn out. Regardless of the reason, we as community pharmacists must make the effort to make ourselves available for the safety of our patients. Pharmacists must work to be seen as the authority on medications by improving visibility, expanding clinical roles and offering meaningful counseling to patients. A 1999 American Society of Health-System Pharmacists patient survey revealed that a greater

percentage of patients would prefer to have their doctors explain their medications than their pharmacist (56 vs. 32 percent).3 A sustainable practice change is required to align pharmacy culture with legislative initiatives to advance pharmacy practice.6 Each prescription serves as our opportunity to improve patient safety and ensure the future of our profession. 1 Marx D. Patient Safety and the “Just Culture”: A Primer for Health Care Executives. New York, NY: Columbia University; 2001. Available at: http://www.safer.healthcare.ucla.edu/safer/ archive/ahrq/FinalPrimerDoc.pdf 2 Al-Khani S, Moharram A, Aljadhey H. Factors contributing to the identification and prevention of incorrect drug prescribing errors in the outpatient setting. Saudi Pharm J 2014 Nov;22(5):429-32. 3 Gulley TL. Investigation into workplace culture for medication error reporting in pharmacy. Graduate Theses and Dissertations 2007. Available from: http://scholarcommons.usf. edu/etd/2194. 4 Cohen MR. Learning aids: Medication errors, 2nd edition. American Pharmacists Association. 2015. Available from: http:// www.pharmacist.com/learning-aidsmedication-errors-2nd-edition. 5 Just Culture and its critical link patient safety (part I). Institute for Safe Medication Practices. 2012. Available from: http://www.ismp. org/newsletters/acutecare/showarticle. aspx?id=22. 6 Rosenthal MM, Breault RR. Austin Z, Tsuyuki RT. Pharmacists’ self-perception of their professional role: insights into community pharmacy culture. J Am Pharm Assoc 2011;51:363-7. 7 Warholak TL, Rupp MT. Analysis of community chain pharmacists’ interventions on electronic prescriptions. J Am Pharm Assoc 2009;49:5964. 8 Svarstad BL, Bultman DC, Mount JK. Patient counseling provided in community pharmacies: effects of state regulation, pharmacist age, and busyness. J Am Pharm Assoc 2004;44:22-9. 9 Kuyper AR. Patient counseling detects prescription errors. Hosp Pharm 1993 Dec;28(12):1180-9.

JULY 2015

The Pharmacy and Medically Underserved Areas Enhancement Act is Important for Our Future By Scott Tomerlin, President-elect, Florida Pharmacy Association First and foremost, I want to thank all of you who serve our profession as ambassadors by example, providing patient care services each and every day to those who desperately need them. I thank you, and your eternally grateful patients do, as well. As many of you may already know, we are making progress with the bipartisan legislation H.R.592/S.314, the Pharmacy and Medically Underserved Areas Enhancement Act, but we still need your help to ensure its passage. This bill, once passed, would amend title XVIII (Medicare) of the Social Security Act to cover Pharmacist services, allowing pharmacists to help fill the gap in the healthcare system in providing much needed patient care services to our state’s most needy and underserved communities. Some statistics you may find helpful, as provided by APhA, ASHP and the IHS Global Health Survey: ■■ 30 out of 67 Florida counties include areas designated as “medically underserved” ■■ Florida will be short 7,000 doctors by 2025, with 253 active physicians per 100,000 residents as of 2012, according to the Association of American Medical Colleges ■■ Southwest Florida is of three regions in the state where medical demand is expected to exceed supply by the highest amounts 10 years from now

For every $1 that is invested in Pharmacist-provided services, a return on investment of $4 is realized in healthcare savings, according to: Improving Patient and Health System Outcomes through Advanced Pharmacy Practice; A Report to the U.S. Surgeon General 2011 ■■ In Florida alone, there are over 19,900 Pharmacists ready to help While we can all agree that the demand for Pharmacists has shifted dramatically over the past decade, not only in Florida but in other parts of the U.S., this bill has the potential to be a viable step in creating even more demand for Pharmacist-provided services. We know the positive impact of Pharmacist-provided services in the healthcare setting, and certainly those patients who receive these services do, but do our legislators? How will they ever know if we sit silently on the sideline and wait for others to dictate the direction of our profession? Here is Where We Are and Where We Need to Act A special thanks to those legislators in our state who have already co-sponsored this legislation, as well as those constituents in their districts who have reached out to those members. Currently, there are 166 co-sponsors (eight from Florida) in the U.S. House of Representatives and 23 co-sponsors (0 from Florida) in the U.S. Senate. ■■

This bill, once passed, would amend title XVIII (Medicare) of the Social Security Act to cover Pharmacist services, allowing pharmacists to help fill the gap in the healthcare system... 22

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Current H.R.592 co-sponsors from Florida, as of July 21, 2015 (and date of co-sponsorship): Rep. Hastings, Alcee L. [D-FL-20] (02/02/2015) Rep. Jolly, David W. [R-FL-13] (02/03/2015) Rep. Ross, Dennis A. [R-FL-15] (02/10/2015) Rep. Murphy, Patrick [D-FL-18] (02/26/2015) Rep. Bilirakis, Gus M. [R-FL-12] (03/23/2015) Rep. Curbelo, Carlos [R-FL-26] (04/13/2015) Rep. DeSantis, Ron [R-FL-6] (07/07/2015) Rep. Nugent, Richard B. [R-FL-11] (07/07/2015) Current S.314 co-sponsors (Florida): None If you do not see your representative or senator on this list, I urge you to contact them today. How Do I Contact My Legislator? FPA’s link to CAPWIZ will allow you to send email directly to your legislator, so that you can urge them to cosponsor H.R.592 and S.314. Here is the link. Please do not forget about your Florida Pharmacists Political Committee (FPPC). No amount is too small, and your donation is key to advocating for our profession and supporting those legislators who stand up for our profession on the legislative front. If everyone today donated just $10 (or the price of a take-out lunch) to the FPPC, we could add over $1000 to fund! It’s that simple! Please visit this link and consider a generous donation today. Now is the time that we act, not re-

act, to what is happening around us in the practice of Pharmacy and healthcare in general. I ask with the strongest urgency that you reach out TODAY to your local legislator to co-sponsor H.R.592 and S.314, the “Pharmacy and Medically Underserved Areas Enhancement Act.” Please keep in mind that the legislators whom you have voted into office are there to represent you and your interests – your beliefs, morals and ideals, just to name a few. I would hope you would consider YOUR profession of Pharmacy that you practice, to be of utmost concern as you are interacting with your legislators (and eventually voting for in the polls!). I would like to conclude with a quote recently made by Past FPA President, Tom Cuomo. He said: “It is time for us to be paid for our cognitive services and not for only the products we sell.” I could not agree more. We are very highly trained healthcare professionals, and arguably the highest trained in medication therapy management. What better opportunity than this to put it into practice? Let’s work together to make this happen.

FPA Mourns Loss of Leonard Kohn

The FPA is mourning the loss of respected pharmacist and FPA Life Member Leonard W. Kohn who passed away on July 7, 2015. Leonard was from West Palm Beach and served his family, his patients and his profession well over his long and honorable career. He was laid to rest in the South Florida National Cemetery in Lake Worth. Our thoughts and prayers go out to his family and friends.

JULY 2015

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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

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”

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. JULY 2015