June 2010 Florida Pharmacy Journal by Florida Pharmacy Today

The Official Publication Of The Florida Pharmacy Association JUNE 2010

Skin Care is Key to Fun in the Sun

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florida PHARMACY TODAY Departments 4 Calendar 4 Advertisers 5 President’s Viewpoint 8 Executive Insight 29 Buyer’s Guide

VOL. 73 | NO. 6 JUNE 2010 the official publication of the florida pharmacy association

Features

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Skin Care is Key to Fun in the Sun

Pharmacy Time Capsule 2010

What to Expect from the Oil Spill and How to Protect Your Health

JUNE 2010

FPA Calendar 2010

June 30 –7/4 FPA Annual Meeting and Convention Marco Island Marriott July 5

FPA Office Closed Independence Day

10 – 14 AACP Annual Meeting Seattle, Washington 30

FPA Legislative Committee Meeting Orlando, Florida

28 – 29 FPA Council, Committee and Board Meetings Marriott Orlando Airport September

6 – 8 Southeastern Officers Conference New Orleans, Louisiana 8 – 11 27th Annual Southeastern Educational Gatherin Hilton Sandestin Beach 10 – 11 Board of Pharmacy Meeting Crowne Plaza Orlando Airport 15 – 17 NABP District 3 Meeting Blowing Rock, North Carolina

of the Florida Pharmacy Today Journal

The Florida Pharmacy Today Journal is a

peer reviewed journal which serves as a medium through which the Florida Pharmacy Association

1 Deadline for Nomination for FPA President Elect and Regional Director Office

can communicate with the profession on advances

6 Labor Day FPA Office Closed

of interest to the profession. As a self-supported

11 – 12 FPA Clinical Consultant Conference PGA National Resort, Palm Beach Gardens

30 – 1 FSHP Annual Meeting August

Mission Statements:

October 2 - 3

FPA Midyear Clinical Conference Renaissance Orlando Airport

23 – 27 NCPA Annual Meeting Philadelphia, Pennsylvania November 6 - 7

FPA Committee and Council and Board Meetings (By conference call)

in the sciences of pharmacy, socio-economic issues bearing on pharmacy and newsworthy items

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 Associa-

tion members to secure appropriate advertising to assist the Journal in its goal of self-support.

For a complete calendar of events go to www.pharmview.com CE CREDITS (CE cycle) The Florida Board of Pharmacy requires 10 hours LIVE Continuing Education as part of the required 30 hours general education needed every license renewal period. Pharmacists should have satisfied all continuing education requirements for this biennial period by September 30, 2011 or prior to licensure renewal. *For Pharmacy Technician Certification Board Application, Exam Information and Study materials, please contact Ranada Simmons in the FPA office. For More Information on CE Programs or Events: Contact the Florida Pharmacy Association at (850) 222-2400 or visit our Web site at www. pharmview.com

Advertisers Healthcare consultants........................ 3 Kahan ◆ SHIR, P.L.......................................... 11 PPSC...................................................................... 6 philadelphia college.............................. 12 Rx RElief.......................................................... 11

CONTACTS FPA — Michael Jackson (850) 222-2400 FSHP — Michael McQuone (850) 906-9333 U/F — Dan Robinson (352) 273-6240 FAMU — Leola Cleveland (850) 599-3301 NSU — Carsten Evans (954) 262-1300 DISCLAIMER Articles in this publication are designed to provide accurate and authoritative information with respect to the subject matter covered. This information is provided with the understanding that neither Florida Pharmacy Today nor the Florida Pharmacy Association are engaged in rendering legal or other professional services through this publication. If expert assistance or legal advice is required, the services of a competent professional should be sought. The use of all medications or other pharmaceutical products should be used according to the recommendations of the manufacturers. Information provided by the maker of the product should always be consulted before use.

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

The President’s Viewpoint GUEST COLUMNIST Don Bergemann, RPh, MBA

Florida Pharmacy Association Financial Report Card

began the process of becoming FPA treasurer for the second time by penning the following position statement. I will now examine whether the issues listed are still pertinent and if so, what has been done to address them. Candidate Position Statement I served as treasurer of the FPA a decade ago. At that time, I stated that as cultural, economic, or technological environments change so must organizational design change to keep pace and that those same dynamics may also impact an organization’s financial position. At that time, many state pharmacy associations, historically considered bastions of independent pharmacy owners, were experiencing the reality of the marketplace. As the number of independent pharmacies dwindled; so too did monetary contributions above and beyond membership dues for legal and political action purposes. That continues to be true today. We were also beginning to experience a decrease in donation and grant dollars from the pharmaceutical industry as mergers and consolidations were taking place; dollars that helped support functions that took place at our annual meeting. Those dollars will continue to decrease as PhRMA’s new voluntary code of conduct will begin to change how the industry will market drugs. Today, we are faced with another reality of the marketplace, the loss of the retrospective DUR program brought about by the state changing its fiscal intermediary. Thus, we must now go forward with significantly less non-dues

revenue than we were accustomed to. We need to reevaluate our financial dynamics. Until we can identify new sources of revenue consistent with the association’s mission statement, we must operate on a much tighter budget.

As the number of independent pharmacies dwindled; so too did monetary contributions above and beyond membership dues for legal and political action purposes. That continues to be true today. Issue Examination The marketplace changes have continued to erode the independent practitioner base, particularly here in Florida. According to NACDS statistics, independent drug stores only accounted for 21 percent of Florida pharmacy permittees in 2005. Whereas the percentage in other large states were: 44 percent

Don Bergemann, RPh, MBA FPA Treasurer

■■

in New York, 39 percent in Texas, and 35 percent in California. By 2007, those numbers had dropped to: 18.7 percent in Florida, 27.9 percent in Texas, and 33.8 percent in California. However, they increased in New York to 46.9 percent. While there are still some donation and grant dollars available from the pharmaceutical industry, obtaining those dollars has become very difficult. Additionally, as the pharmaceutical industry has shifted it marketing to direct-to-consumer advertising, the dollars associated with exhibits at our annual meeting has also declined. We may eventually reach point where the funding for the annual meeting will come exclusively from registration dollars. As to non-dues revenue, we have not yet identified a program or proJUNE 2010

2009/2010 FPA Board of Directors The Florida Pharmacy Association gratefully acknowledges the hard work and dedication of the following members of the FPA leadership who work deligently all year long on behalf of our members.

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

Florida Pharmacy Today Journal Board Chair Designate....................................... Betty Harris, beejpharm@gmail.com Treasurer....................Stephen Grabowski, sgrabowski@seniormmc.com Secretary...................................................................Stuart Ulrich, Stuarx@aol.com Member............................................................. Don Bergemann, don@bceinfo.com Member.................................................Joseph Koptowsky, docjik1215@aol.com Member...............................................Jennifer Pytlarz, jlc_rxdoc@hotmail.com Executive Editor................Michael Jackson, mjackson@pharmview.com Managing Editor...................Dave Fiore, dave@fiorecommunications.com

grams to replace the retrospective DUR program. We did conduct a facilitated ‘think tank’ forum to discuss potential sources on March 27. Once we receive the written report of that forum, we will begin evaluating the potential of the ideas put forth. Financial Health Right now, in the absence of the DUR program, our primary revenue sources are dues income and continuing education programming. Those sources of revenue cannot sustain this association and its sizable advocacy campaigns, at the current service level, over the longterm. In order to maintain the current service level, we must increase membership. It is imperative for all current members to recruit new members for this association. For calendar year 2009, this association’s board of directors approved a deficit budget. Fortunately, due to significant cost cutting and a better than forecast year in terms of continuing education revenue, we ended up in the black. Again this year, 2010, the board of directors approved a deficit budget. However, this year, it will be very difficult, if not impossible, to end on the positive side. Thus far, we have avoided tapping into the association’s long-term reserves. How long we can continue to do so will depend on how effective the membership is in recruiting new members.

JOIN TODAY! Florida Pharmacy Association 6 |

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FPA OFFICE

YOUR NAME HERE

e: n li 5 d y1 ea l D Ju

THE WALKWAY OF RECOGNITION

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

ORDER FORM

The Walkway of Recognition

❑ YES, I want to order _______ concrete brick/s at $250.00 each. (Please copy form for additional inscriptions). PLEASE PRINT INSCRIPTION

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

❑ Master Card

CARD #

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

❑ Visa EXP. DATE

AUTHORIZED SIGNATURE NAME ADDRESS CITY

STATE

PHONE (W)

(H)

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

ZIP

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

Financial Statements The table below contains a comparative summary of our Statements of Financial Position as drafted by the Association’s auditors. Assets 2009

2008

Cash & cash equivalents

$ 996,745

$ 904,579

Investments

$ 722,562

$ 655,604

Accounts receivable

3,967

Net property & equipment

$ 127,389

$ 128,656

Total assets

$1,846,696

$1,692,806

Liabilities & Net Assets 2009

2008

Accounts payable

5,317

6,178

Accrued expenses

41,568

31,444

Deferred revenue

$ 234,931

$ 200,232

Net assets (unrestricted)

$1,515,516

$1,405,588

Net assets (temporarily restricted)

Total liabilities & net assets

$1,846,696

49,364

$1,692,806

paigns, and our self- funded health fair and legislative day events in Tallahassee were a huge success. Our wins could be significantly greater if you, the member, will reach out and touch those colleagues who are not part of our family. I want to thank the members of this year’s Budget & Finance Committee for their dedication and insights. ■■ Michael Mone’, Vice-Chair ■■ Norman Tomaka, Board of Directors Chair ■■ Karen Whalen, President ■■ Bert Martinez, President-Elect ■■ Alexander Pytlarz, Speaker of the House ■■ William Riffee, Vice-Speaker ■■ Preston McDonald ■■ Suzy Wise ■■ Mike Bonkowski, student ■■ Michael Jackson, Executive Vice President/CEO Final Thought As you may have noted, I mentioned membership more than once above. Let me share with you the philosophy of a pharmacist that influenced me as a student. He stated that “membership in your state pharmacy association is the price you pay to be a professional.” While those of you who are reading this are believers in what the FPA is doing, I find it disturbing that the majority of Florida pharmacists do not share that philosophy. n

Thus far, we have avoided tapping into the association’s long-term reserves. How long we can continue to do so will depend on how effective the membership is in recruiting new members. Kudos There is good news that the membership needs to know. Even though we have slashed our expenses by 27 percent and considerably reduced staff, we are still providing the same if not more services and products to the members. Our members still have access to 12 monthly issues of Florida Pharmacy Today and are recipients of numerous electronic newsletters with current information on the profession and business of pharmacy. The majority of the dues that you pay for membership go toward offsetting the costs associated with advocacy before the Florida Legislature and representation before the Board of Pharmacy and other regulatory agencies. Nearly 100 percent of your PACCE contributions supported political campaigns and candidates who understand our profession and our business. While we are far from our PACCE fund raising goal, we have strategically placed our support where it would do the most good. We are also beginning to see renewed energy and interest in our legislative cam8 |

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JUNE 30-JULY4 2010

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

2010 Legislative and Regulatory Report of the FPA FPA Advocacy Efforts At the heart of professional organizations is the need to provide input to state and federal policy makers. The Association wishes to give thanks to our legislative consultants Lori Weems, Manny Prieguez and their staff for their tireless efforts to work our issues before the House, Senate, Board of Pharmacy and Governor’s Office. We also would like to thank the staff at Pharmacy Provider Services Corporation for their assistance with the Medicaid funding issue. In the past, our policywork has concentrated on the Florida Legislature and various state agencies that regulate the profession and business of pharmacy. Perhaps the most compelling issue that we found in this election year is the host of bills that were filed that were not approved. This is not unusual given the upcoming election season with a large candidate pool and incumbents seeking reelection. As we go to press with this report, the Governor has made a decision on most of the legislation that passed. We should have more current information available at the annual meeting. On occasion, members may ask why the FPA continues to monitor issues with Medicare and Medicaid. It is very important that we all understand how pharmacy services are reimbursed. In Florida, this state will spend $8 billion providing health care access to the 2.7 million citizens of this state that are Medicaid eligible. The federal government will kick in an additional $11 billion. If you look at Medicaid and Medicare it is quite obvious that the largest payer of pharmacy services is state and federal governments. Major policy de-

cisions in both those arenas have a very significant impact on many sectors of our industry. This year, the FPA traveled to Washington, DC, on several occasions to ensure that efforts to reform health care included a viable place for our profession. Hill visits were performed by FPA members and leadership under the guidance of NACDS, NCPA and APhA. While the final legislation that Congress approved is not perfect, a number of corrections to pharmacy issues were included in the health care reform bill that passed. Michael Jackson, B.Pharm

State Legislation that Passed SB2272 – Regulation of Pain Management Clinics Senate bill 2272 added pain management clinics to the list of entities

that are regulated under Florida statutes 456.037. That list includes but is not limited to dental laboratories, massage establishments and pharmacies. There were some exemptions to the requirement for certain clinics to register. These exceptions include the following: ■■ Clinics licensed under 395 ■■ Clinics where the majority of physicians provide surgical services ■■ Clinics owned by entities with large assets ■■ Clinics affiliated with accredited medical schools ■■ Clinics that do not prescribe or dispense controlled substances used for pain ■■ Charitable clinics The Department of Health was also granted authority to investigate possible violations related to pain management clinics without having to get a patient release or subpoena. The clinic must also designate a responsible physician. Physician cannot practice in unregistered clinics. The clinic must JUNE 2010

FPA Staff Executive Vice President/CEO Michael Jackson (850) 222-2400, ext. 200 Director of Continuing Education Tian Merren-Owens, ext. 120 Controller Wanda Hall , ext. 211 Membership Coordinator Ranada Simmons , ext. 110 Educational Services Office Assistant Stacey Brooks , ext. 210 Florida Pharmacy Today Board Chair Designate........Betty Harris, Lighthouse Point Treasurer...............................Stephen Grabowski, Tampa Secretary.........................Stuart Ulrich, Boynton Beach Member................. Don Bergemann, don@bceinfo.com Member..................................... Joseph Koptowsky, Miami Member...................................... Jennifer Pytlarz, Brandon Executive Editor.........Michael Jackson, Tallahassee Managing Editor.........................Dave Fiore, Tallahassee

This is a peer reviewed publication. ©2010, 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 10

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be owned by a Florida licensed physician with a clear license and has not been convicted or pled guilty to certain crimes. Anyone named in the registration of a clinic that has been revoked could not apply to operate a pain management clinic for 5 years after the registration is revoked. Only a licensed physician and dispense medication on the premises of a pain management clinic. Of interest to our members are provisions of SB2272 that require the following: ■■ The physician must perform a physical examination on the same day prior to prescribing or dispensing a controlled substance. ■■ Physician must document in the patient record a reason for prescribing or dispensing more than a 72 hour supply of a controlled substance for the treatment of nonmalignant pain. ■■ Physicians practicing in pain clinics are responsible for the security of prescription blanks or any other method used to prescribe controlled substances ■■ The bill appears to require physicians to be compliant with the counterfeit proof prescription blanks laws in 896.065 ■■ Physicians are required to notify the Department within 24 hours following theft or loss of a prescription blank or any other related breach of prescribing security of pain medications. ■■ The Department to adopt rules related to inspection and registration of clinics ■■ The bill directs the Department to write rules limiting the number of prescriptions for Schedule II or Schedule III controlled substances or alprazolam written over a 24 hour period. ■■ Requires the Department to write rules on standard of practice for physicians in privately owned pain clinics ■■ The Department of Health is granted new enforcement authority and the ability to asses penalties for violations ■■ Dispensing practitioner (in a registered pain clinic) who is registered under 465.0276 restricted from dis-

pensing more than a 72 hour supply of controlled substances if the patient pays by cash, check or credit card. ■■ Directs the prescription drug monitoring program manager to share information on possible violations with law enforcement agencies. ■■ Modifies the public records exemption language in 893.0551 to allow the Department of Health to disclose confidential information to law enforcement as articulated in the bullet point above. This bill was signed into law by Governor Crist HB5603 – Reimbursement for Worker’s Compensation Prescriptions This bill revised 440.13 (12) (c) that defined current pharmacy reimbursement. The bill applied the current pharmacy reimbursement to all provider types. This likely included dispensing practitioners who care for work comp patients. Dispensing providers who used repackaged products would have to bill using the average wholesale price of the original manufacturer and not the AWP price provided by the repackager. Also if the worker’s compensation carrier had contracted for a lower rate the provider would have to bill at that rate. Another provision in the bill required the Division of Risk management to analyze return to work efforts of state agencies for workers compensation patients. This bill was vetoed by Governor Crist. CS/CS/HB747 – Treatment of Diabetes for Students in Schools This bill was designed to give guidance to school districts on their students who have diabetes. Not all schools have nurses or other trained personnel and as such some may have restricted assignment of students with diabetes to schools that did have them. Under this bill, districts could assign students with diabetes to schools without trained personnel if authorized by both the parent and physician. The State Board of Education working with the Department of Health is being encouraged by the

bill to write rules on personnel training for the management and care of diabetes by students. This bill was signed by Governor Crist. HB1565 – Revisions to Rulemaking Authority Regulatory entities like the Florida Board of Pharmacy and Agency for Health Care Administration are given general authority to write rules defining how laws are implemented. HB1565 further defined rulemaking authority by revising the “Statement of Estimated Regulatory Cost” obligation. When rules are written each agency or board must evaluate the rule to determine if it would have an adverse fiscal impact on small businesses. Added into the bill is a section where if it were found that the rule would create over $200,000 in expenses to small businesses over a 5 year period that the rule will need to be ratified by the legislature. This bill was vetoed by Governor Crist. CS/CS/SB1050 – Regulating the Sale of Ephedrine

While there are Federal laws governing the sale of Ephedrine the Florida legislature has further defined this in SB1050. It is now prohibited to knowingly obtain or deliver ephedrine or related compounds in excess of the following amounts: ■■ In any single day, any number of packages that contain a total of 3.6 grams of ephedrine or related compounds; ■■ In any single retail, over-the-counter sale, three packages, regardless of weight, containing ephedrine or related compounds; or ■■ In any 30-day period, in any number of retail, over the-counter sales, a total of 9 grams or more of ephedrine or related compounds These products as before will need to be kept behind the counter where the public is not permitted or other location not accessible to the public. Employees will be required to go through training on state and federal regulations. It is our understanding that the Federal government requires this training to

be done annually. Any person who obtains ephedrine related products must: ■■ Be at least 18 years of age ■■ Produce an appropriate government issued ID ■■ Sign a record of the purchase either on paper or electronic form The Florida Department of Law Enforcement (FDLE) is designated with the task of approving the electronic recordkeeping system. The bill also requires the electronic record keeping system be provided to pharmacies or retailers without any cost or expense. The bill also requires pharmacies that get this system to use it for purposes of submitting sales data to the electronic recordkeeping system. This data would have to be submitted before the transaction is completed or in real time. This data in the electronic system would have to be kept for at least 2 years. Pharmacies that lack the ability to use this technology can file for an exemption through FDLE provided that they do not sell more than 72 grams of ephedrine or related compounds over a 30 day period.

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The electronic recordkeeping system must include the following features: ■■ The date and time of the transaction. ■■ The name, date of birth, address, and photo identification number of the purchaser, as well as the type of identification and the government of issuance. ■■ The number of packages purchased, the total grams per package, and the name of the compound, mixture, or preparation containing ephedrine or related compounds. ■■ The signature of the purchaser, or a unique number relating the transaction to a paper signature maintained at the retail premises. ■■ Real-time tracking of nonprescription over-the-counter sales and ■■ The ability to block nonprescription over-the-counter sales in excess of those allowed by the laws of this state or federal law. Entities that are exempted from this electronic recordkeeping program in-

clude licensed manufacturers, wholesalers, hospitals or facilities licensed under F.S.395, licensed long term care facilities, government operated health departments, physicians’ offices, public prisons or other related facilities, public or private educational institutions with health care programs and government or industry operated medical facilities serving their employees. The electronic data in the system can only be disclosed to law enforcement or used for purposes of managing product recalls. There is some immunity from liability for releasing this information to law enforcement. This bill was signed into law by Governor Crist. CS/HB 573 – Relaxing of Physician Assistant Law Before physician assistants could prescribe or dispense there was a requirement that they file evidence with the Department of Health that they have taken a minimum of 3 months of clinical experience in the specialty area of their supervising physician. HB573

removed this requirement from Florida law. This bill was signed by Governor Crist. SB1484 – Medicaid Reform The House version of Medicaid reform was designed to move all of Florida Medicaid into the managed care market greatly expanding the pilot projects in Broward, Duval, Clay, Baker and Nassau counties. The Senate version which passed is much more conservative in its approach. Included in this bill are the following: Directs the Agency for Health Care Administration (AHCA) to request an extension of the current Medicaid Reform waiver obtained under section 1115 of the Social Security Act and to preserve the Low Income Pool provisions of the waiver by no later than July 1, 2010. The AHCA is required to provide the Legislature and the Governor with monthly progress reports on the waiver extension negotiations with the federal Centers for Medicare and Medicaid Services.

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Directs the AHCA to develop methodologies to maintain the use of intergovernmental transfers and certified public expenditures in a Medicaid managed care environment. Requires the Secretary of the AHCA to convene a workgroup of stakeholders that will include individuals representing hospitals, counties, medical schools, managed care plans, and Medicaid provider-service-networks and directs the AHCA to provide a report by January 1, 2011, on the developed methodologies. Creates the Medicaid and Public Assistance Fraud Strike Force (Strike Force) within the Department of Financial Services (DFS) to develop a statewide strategy and coordinate state and local efforts and resources to prevent, investigate and prosecute Medicaid and public assistance fraud. The Strike Force will hold its organization meeting by no later than March 1, 2011, and is required to meet at least four times annually. The Strike Force will consist of 11 members with Chief Financial Officer (CFO) serving as chair, and the Attorney General serving as vice-chair. Directs the Strike Force to provide recommendations and advice to the CFO on initiatives that include, but are not limited to: ■■ Conducting a census of current Medicaid and public assistance fraud efforts; ■■ Developing a strategic plan targeting state and local resources to prevent, detect, and deter Medicaid and public assistance fraud; ■■ Developing innovative technology and data sharing among affected entities; ■■ Establishing a program that provides grants to state and local agencies to implement effective antifraud measures; ■■ Providing grants, contingent upon appropriation, for multiagency Medicaid and public assistance fraud efforts; ■■ Providing assistance to state attorneys for support services or for the hiring of assistant state attorneys to prosecute Medicaid and public assistance fraud; and

■■

Providing assistance to judges for support services or for the hiring of senior judges so that Medicaid and public assistance fraud cases can be heard expeditiously. Requires the CFO to develop model interagency agreements to coordinate the investigation of Medicaid and public assistance fraud. Transfers the Public Assistance Fraud Division from the Florida Department of Law Enforcement to the DFS on January 1, 2011. Authorizes Medicaid related fraud units to be collocated, to the extent possible and requires the Medicaid managed care fraud investigators within the Attorney General’s Office to collocate with the Division of Insurance Fraud within the DFS. Requires the Auditor General and the Office of Program Policy Analysis and Government Accountability to review and evaluate the AHCA’s Medicaid fraud and abuse systems and requires a report to the Legislature and Governor by December 1, 2011. Requires each Medicaid managed care plan to adopt an antifraud plan to address overpayment, abuse, and fraud in the provision of Medicaid services and to submit the plan for approval to the Office of Medicaid Program Integrity within the AHCA. The amendment establishes minimum standards for antifraud plans and requires each Medicaid managed care plan to establish a fraud investigative unit or contract with such an entity. In addition, the amendment provides penalties for Medicaid managed care plans that fail to comply with these provisions. Requires all Medicaid managed care plans to report any suspected instance of overpayment, fraud, or abuse to the Office of Medicaid Program Integrity within 15 days. Revises the requirements for the selection of a behavioral health care provider in Broward County for children who have a case open in the Department of Children and Family Services’s HomeSafeNet (HSN, Florida’s child welfare reporting system), to allow those chil-

dren who are in the custody of the State to enroll in a managed care plan which provides both physical and mental health care services. Authorizes a participating specialty plan to receive an administrative fee for coordination of services based upon the receipt of the state share of the fee from intergovernmental transfers. ■■ Allows a provider service network to provide behavioral health services in addition to physical health services in areas of the state not under Medicaid reform. ■■ Extends the guidelines for phasing in financial risk for approved provider service networks and Children’s Medical Services Networks over the period of the waiver and the extension thereof. This bill was signed into law by Governor Crist. CS/CS/CS/HB 1143 – Legislation Designed to Reduce and Simplify Health Care Provider Regulation This bill had 137 pages of various issues that affect the regulation of health care provider as well as some unrelated health care issues. We will report on those issues that we believe may have a direct effect on or relationship to pharmacy providers. The bill amends regulation of prescription drug wholesale distribution by DOH. The Original version of the bill attempted to eliminate the requirement for exempt entities to maintain separate inventories for drugs purchased under the federal 340B discount drug program and other drugs however it appears that was removed. The bill does clarify that claims billed to the state Medicaid program using 340B drugs must have an NDC code and be billed at actual acquisition cost or payment will be denied. The bill replaces the named organization “Joint Commission on Accreditation on the Accreditation of Health Organizations to “The Joint Commission”. The bill exempts sealed medical convenience kits meeting certain specifications from pedigree paper requirements. These specifications are as follows: JUNE 2010

1) The medical convenience kit is assembled in an establishment that is registered as a medical device manufacturer with the United States Food and Drug Administration; 2) The medical convenience kit manufacturer purchased the prescription drug directly from the manufacturer or from a wholesaler that purchased the prescription drug directly from the manufacturer; 3) The medical convenience kit manufacturer complies with federal law for the distribution of the prescription drugs within the kit; and 4) The drugs contained in the medical convenience kit are: a) Intravenous solutions intended for the replenishment of fluids and electrolytes; b) Products intended to maintain the equilibrium of water and minerals in the body; c) Products intended for irrigation or reconstitution; d) Anesthetics; or e) Anticoagulants The exemptions do not apply to convenience kits containing any controlled substances. Tacked onto the bill on the last day of the session was an unrelated issue on abortion ultrasounds. The bill (if not vetoed by Governor Crist) would require physicians to perform an ultrasound prior to performing the abortion and to share the results with the patient. There is also a section that restricts the use of state or federal funds to pay for elective abortions. This is shared with FPA members not to stir debate but to inform the members that this controversial issue may be the reason why the Governor may consider a veto. If vetoed the other pharmacy provisions would not become law. The bill also grants permission for insurance entities to offer rewards or incentives for participating in voluntary wellness programs. These awards or incentives could include, but not limited to merchandise, gifts, debit card, modifications to copayments etc. Included in this bill is a declaration 14

Florida Pharmacy TodaY

that it is state policy that federal, state or local governments could not compel a person to purchase health insurance or services under certain circumstances. This is likely in response to the federal health care reform measures passed by Congress in 2009 requiring insurance coverage for everyone including those in public service and high risk occupations. The bill also takes away a requirement for the Agency for Health Care Administration to use certified mail to notify licensees under the Agency banner when the expiration date is nearing. This bill was vetoed by Governor Crist. HB5001 – General Appropriations Bill (Medicaid Mail Order) Included in this bill is a provision that creates a mail order service for chronically ill patients. The language in this bill reads as follows: The agency shall issue an invitation to negotiate with a pharmacy or pharmacies to provide mail order delivery services at no cost to the patients who elect to receive their drugs in this manner for patients with chronic disease states including but not limited to congestive heart failure, diabetes, HIV/ AIDS, patients suffering from end stage renal disease or cancer in order to assist Medicaid patients in securing prescriptions and to reduce program costs. The agency shall select patients appropriate for this mail order project and shall limit the number of participants to 20,000 patients statewide. This issue presented itself in the last week of the legislative session with no committee review. The Florida Pharmacy Association began an immediate campaign to oppose the language including a call to Governor Crist to veto the item. It is very possible that the 20,000 patient population of chronically diseased represents a significant majority of the Medicaid prescription drug spend. Members need to also note that the Florida House had proposed a significant reimbursement reduction for pharmacy providers. Prior to the beginning of the legislative session Medicaid pharmacy reimbursement was the lower of:

■■ ■■ ■■ ■■ ■■

WAC + 4.75% AWP – 16.4% Usual and Customary State maximum allowable cost (SMAC) or Federal upper limit (FUL)

While the Association was successful in defending against the proposed drastic cuts in the House, the legislature did not alter the effect of the First Databank settlement resulting in what was published as AWP. This means that Florida Pharmacy providers will continue to suffer through the 4% dollar reduction since the republishing of AWP back in September of 2009. Also found in the budget is a provision on page 402 where state employees can get their first 3 fills of certain maintenance drugs through a community pharmacy with the remainder required to be dispensed from mail order. The Governor has signed the bill but also has vetoed certain sections including the facility funding for the USF Pharmacy school program in Polk County. The mail order section was not vetoed as this action likely would have negatively affected the entire drug budget. HB5003 – Implementing Appropriations Bill (State Employee Prescription Benefit) We found in this bill a revision to the state employee prescription benefit plan copays. The new formulas are as follows: New copay

Old copay

For generic drug with card

$10

For preferred brand name drug with card

$30

$25

For nonpreferred brand name drug with card

$50

$40

For generic mail order drug

$14

$20

For preferred brand name mail order drug

$60

$50

For nonpreferred brand name mail order drug

$100

$80

PLAN

The governor has signed the bill but vetoed specific portions.

HB5201 – Doctor of Pharmacy Degree Program at USF House bill 5201 (budget conference report) authorized a doctor of pharmacy degree program at the University of South Florida. The bill requires that the program be physically located on the new campus of the University of South Florida Polytechnic. The university is authorized to develop and implement the program within existing facilities only until the construction of a pharmacy facility on the new campus of the University of South Florida Polytechnic is completed. This proposal was also introduced in S838 and HB101. While the governor has signed this bill the facility funding on the section associated with the USF pharmacy program was vetoed.

Included in this bill is language that transfers all of the statutory powers, duties and functions, records, personnel etc related to the administration and management of Florida Statutes from the Department of Health to the Department of Business and Professional Regulation (DBPR). This means that DBPR will be regulating prescription drug wholesaling and everything association with 499 rather than the Department of Health. It is likely that pharmacies that are holding active wholesaling licenses will renew through DBPR. The bill was signed into law by Governor Crist with the effective date of the transfer being October 1, 2011.

HB5311 – Defining Medical Convenience Kits in F.S. 499 – Transfer of Wholesaling to DBPR This bill eliminates the need for a pedigree for the wholesale distribution of a medical convenience kit if the following conditions are met: 1) The medical convenience kit is assembled in an establishment that is registered with the United States Food and Drug Administration as a medical device manufacturer. 2) The medical convenience kit manufacturer purchased the prescription drug directly from the manufacturer or from a wholesaler that purchased the prescription drug directly from the manufacturer 3) The medical convenience kit manufacturer complies with federal law for the distribution of the prescription drugs within the kit 4) The drugs contained in the medical kit are: a) Intravenous solutions intended for the replenishment of fluids and electrolytes; 1294 b) Products intended to maintain the equilibrium of water and minerals in the body; c) Products intended for irrigation or reconstitution; d) Anesthetics; or e) Anticoagulants.

H1503 – Revisions to General Health Care Regulation FPA advocates monitored this proposed bill very carefully during the closing moments of the 2010 legislative session. This 119 page bill as originally filed appeared to focus on a number of health regulation issues such as but not limited to changes to the requirements for licensing facilities, redefining the term “Joint Commission on the Accreditation of Hospitals” and further defining the role of the Division of Medical Quality Assurance within the Florida Department of Health. As the session continued a number of amendments were tacked on or tossed at this bill that could have some impact to pharmacy. For example there was language that created a pilot “full service” health and wellness program for state employees through a single vendor. Other amendments seemed to define who could own a health care clinic and pharmacists were not listed.

FPA Monitored Bills that Did Not Pass

S1064 - Resolution on Sales Tax Exemption on DMEPOS Products This bill proposed an amendment to the State Constitution to permanently prohibit the state from imposing a sales tax on the sale of food and medical products and supplies. This bill was never heard in Committee.

S1260 – Revision of the Florida Controlled Substance Act The bill schedules a number of chemicals as controlled substances. The proposed scheduling of these chemicals in S1260 would have moved F.S. 893 to be more consistent with federal scheduling of these chemicals. This bill was never heard in Committee. S2194, H1149 – Audits of Pharmacy Records These bills were designed to expand auditing standards in Florida Medicaid as published in 465.188 to make them applicable to all third party administrators. These FPA supported provisions were never heard in committee due to our redirected efforts to fight against Medicaid cuts and mandatory mail order. H911, S958 – Electronic Health Records These bills as originally filed were designed to future facilitate the use of electronic health records by health care practitioners. While these bills ultimately died the FPA was successful in getting licensees under Florida Statutes 465 listed as “health care practitioners” for purposes of unquestionable access to the electronic health records. These bills unfortunately died on the calendar. S652, H517 – Requirement for Pharmacies to Dispensed Contraceptive Products without Delay As anticipated this year 2 bills were filed to require pharmacies to dispense contractive products. The bill defined the duties of the pharmacy and required that its employees do not: ■■ Intimidate, threaten, or harass a patient in the delivery of services relating to a request for contraception; ■■ Interfere with or obstruct the delivery of services relating to a request for contraception; ■■ Intentionally misrepresent or deceive a patient about the availability of contraception or its mechanism of action; ■■ Breach medical confidentiality with respect to a request for contraception or threaten to breach such confiJUNE 2010

■■

dentiality; or Refuse to return a valid, lawful prescription for contraception upon a patient’s or patient representative’s request.

These bills included language negotiated by the FPA during the 2008 legislative session that allowed for a basis for refusing to provide a contraceptive such as patient’s inability to pay, lack of a valid prescription and also on the basis of a professional or clinical judgment of the pharmacists. Additional language was also included to allow for refusal under religions reasons so long as the patient is accommodated by the pharmacy. These bills were never heard in committee. H275, S516 – Required Insurance Coverage for Prescription Drugs These bills required coverage for prescription drugs once started at the beginning of a plan year to be consistent to the end of the plan year for patients

with preexisting conditions. It appears that the language would prohibit plans from revising their covered formularies and implementing prior authorization program revisions after a patient has enrolled in a prescription drug plan. Neither of these bills was heard in committee. S330, H135 – Expansion of Optometrist Prescribing Authority The bill authorizes certified optometrists to administer and prescribe certain oral ocular pharmaceutical agents in addition to topical agents. The bill revises requirements for the existing formulary of topical ocular pharmaceutical agents that certified optometrists may administer and prescribe to include those topical pharmaceutical agents appropriate to treat and diagnose ocular disease or disorders within the scope of optometric practice. There also appears to be some language that would permit optometrists to prescribe certain controlled substances. The bill

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Florida Pharmacy TodaY

passed one committee in the Senate but was never heard in the House. Both bills died. HB225 – Controlled Substance Dispensing Restrictions for Practitioners This bill as originally filed would have restricted practitioners registered under 465.0276 (dispensing practitioners) from dispensing more than a 72 hour supply of controlled substances. During various committee stops language was added that required pharmacies to connect to a multistate electronic prescribing network as a condition of obtaining or renewing a pharmacy permit. The Florida Pharmacy Association prepared 4 pages of written comment to the staff director of the House Health Regulation Committee and met several times with the House sponsor and his aid explaining the challenges to this part of the bill’s amended language. Additional language was added in an attempt to further regulate pain clinics. At some point during the

Every day, pharmacies depend on PPSC to simplify purchasing, reduce costs and identify new revenue sources – making a significant impact on their bottom line. PPSC can help you: EXPAND use of high-profit generics CREATE effective store layout ENHANCE third-party profits CAPTuRE MTM revenue EsTAblisH new business niches INCREASE your overall margins

legislative debate the 72 hour restriction was removed against the objections of the FPA. The FPA was successful in getting a version of that language amended onto SB2272. This bill ultimately died on the calendar. Federal Health Care Reform Legislation Monitored by the FPA IMPACT ON COMMUNITY PHARMACY (See Stat News, March 22, 2010) On March 21st, the U.S. House of Representatives passed H.R. 3590, the Patient Protection and Affordable Care Act. This is the same health care reform bill that cleared the Senate on December 24th, 2009. However, the House also passed H.R. 4872, the Health Care Reconciliation Bill, which makes amendments to H.R. 3590 (the Senate Health Care Reform bill). The Senate must still act on the reconciliation bill, but NCPA wanted to ensure that pharmacists had current information about the bill’s impact on pharmacy. This document represents NCPA’s best interpretation at this time of the new law, once signed by the President. In many cases, new regulations will have to be drafted, and NCPA will assure that the intent of Congress is followed by the agencies. Medicaid Generic Drug Pharmacy Reimbursement (AMP Fix) Background: The Deficit Reduction Act of 2005 (DRA) would have reimbursed pharmacies below their acquisition cost for Medicaid generic drugs. Since 2007, these cuts have been delayed because of a December 2007 court injunction that was won by NCPA and NACDS. NCPA has advocated a legislative solution to permanently reverse these generic drug cuts, and this bill provides that relief in part. The health care reform bill improves the definition of Average Manufactures Price (AMP) so that it includes only manufacturers’ sales to retail pharmacies. It directs the Center for Medicare and Medicaid Services (CMS) to set Medicaid Federal Upper Limit (FUL) for reimbursement of generics a rate of “no less than 175% of average weighted

AMP.” NCPA secured report language to the bill that encourages the Secretary to increase the reimbursement even higher for small independent community pharmacies. This increase in the FUL is especially important now because the bill also expands Medicaid coverage – starting in 2014 - to individuals up to 133% of the Federal poverty level. This is expected to add 16 million more individuals to the Medicaid program. What this mean for YOU: The bill requires the Secretary to implement the new Medicaid generic rates as early as October 2010. This means that pharmacies in some states may see a reduction in generic drug reimbursement at that time. However, this new law mitigates the impact of the more draconian generic drug cuts that would have gone into effect had these changes not been made, saving pharmacies approximately $3 billion in Medicaid generic drug cuts. AMPs for brand and generic drugs will be made public later this year. This will give payers access to more AMP data, which are generally assumed to be close to retail pharmacy’s acquisition costs for drugs. Pharmacy Benefit Manager (PBM) Transparency in Health Exchanges Background: PBMs continue to operate in relative secrecy, with payers and the Federal government having little information on whether PBMs actually reduce drug costs, or pass through rebates and discounts to plan sponsors. To begin to rectify unacceptable situation, the health care reform bill requires the PBMs to confidentially disclose important financial information to the Secretary of Health and Human Services for those health plans operating in new health insurance exchanges and Medicare Part D plans. These new state-based exchanges are set to begin in 2014. This is the first federal requirement for oversight and accountability in the PBM marketplace. These provisions also establish an important initial Federal framework for the regulation of these unregulated entities, which can be enhanced in the future. What this means for YOU: Transpar-

ency helps to level the playing field between mail order and community pharmacy by encouraging plans to hold PBMs accountable for excessive profits and the tactics used to drive those profits up. This new law creates an important foundation for future federal regulation. As federal officials learn more about the games PBMs play, they may strengthen disclosure requirements or apply them to additional federal health programs. Hopefully, the private sector will follow suit. Pharmacists Exempted from Medicare DME Accreditation Requirement Background: The bill provides an exemption for most pharmacies from the burdensome accreditation requirements to provide Medicare DME, and changes current law so that pharmacy accreditation requirements are not effective until January 2011. (Pharmacies that want to competitively bid would still be required to be accredited regardless). A pharmacy can be exempt from the accreditation requirements if the pharmacy: ■■ Has total Medicare DME billings that are 5 percent or less of total prescription sales. ■■ Has had no adverse fraud or abuse determination against it for the last 5 years ■■ Submits an attestation that its total Medicare DMEPOS billings are and continue to be less than a rolling three year average of five percent of total pharmacy sales. ■■ Submits documentation to the Secretary (based on a random sample of pharmacies) that would allow the Secretary to verify the information. What this means for YOU: If you’re already accredited under current CMS guidelines, you are exempt from the re-accreditation requirements if you meet the criteria above. This will save you thousands of dollars and countless hours to comply. If you’re not accredited now, you are required to be accredited after January, 2011, but only if you do not meet the criteria above. Most pharmacies are likely JUNE 2010

going to meet the criteria above and will not have to be accredited. If you have already stepped down from selling DME, anticipating that Congress would enact an exemption, we expect CMS to allow pharmacies to step back up soon. This will likely require the submission to the NSC of an application to “step up”. Pharmacist-Delivered Medication Therapy Management Services Background: The health care reform bill envisions an expanded patient care role for pharmacists in new health care system models. These new responsibilities will help assure more appropriate use of prescription medications, especially for those patients who have chronic illnesses. These include pharmacist roles in accountable care organizations, medical homes, “transitions of care” teams, and medication reconciliation activities. The bill also includes a Medication Therapy Management (MTM) grant program that will help test new and innovative methods to provide medication therapy management, which will help to reduce the estimated $290 billion in health care expenditures that result from inappropriate medication use or non compliance with taking medications. What this means for YOU: Community pharmacies may be eligible for grant funding to help provide MTM services, though the government’s process for establishing grant criteria, applications, etc. will take many months and will be subject to the annual appropriations process. Closes the Medicare Part D “Donut Hole” Background: The health care reform bill closes the Medicare Part D “donut hole” over the next ten years (2010-2020), through new Federal funds as well as discounts from pharmaceutical manufacturers on brand name drugs. Beneficiaries that hit the donut hole in 2010 would receive a one-time $250 rebate. Beginning January 1 2011, beneficiaries would also automatically receive a 50 percent discount off the negotiated price for brand-name prescription 18

Florida Pharmacy TodaY

drugs that are covered under Part D and covered by their plan‘s formulary or are treated as being on plan formularies through exceptions and appeals processes. These discounts would be provided by the pharmacy at point of sale. The discount increases to 75% on brand-name and generic drugs by 2020. The bill also allows 100% of the negotiated price of discounted drugs (excluding dispensing fees) to count toward the annual out-of-pocket threshold that is used to annually define the coverage gap. Beginning in 2020, the 25% copay applies until Medicare’s catastrophic coverage kicks in. What this means for YOU: Medicare patients who previously struggled financially when in the “donut hole” should be able to purchase their full medication regimen as prescribed – leading to increased adherence. However, the law requires that these brand name manufacturer discounts be paid to the pharmacy by a third party entity under contract with the Secretary. The new prompt pay provisions apply to the payments that these third party entities would have to make to pharmacies, which means that pharmacies should be paid within 14 days of dispensing the brand name drug. New Requirements for Long Term Care Pharmacies Background: The health care reform bill requires Part D plans to use specific dispensing techniques to reduce pharmaceutical waste in long term care facilities. In order to reduce waste associated with unused medications, starting in 2012, Medicare Part D drug plans and MA-PD plans must have in place utilization management techniques such as daily, weekly, or automated dose dispensing to reduce the quantities of part D drugs dispensed to enrollees residing in long-term care facilities. The Health and Human Services Secretary will consult with appropriate stakeholders, including State Boards of Pharmacy and pharmacy and physician organizations, to study and determine additional methods to reduce waste. What this mean for YOU: You may have to provide dispensing services to

long term care facilities more frequently, with no statutory requirement that there would be corresponding increases in dispensing fees. NCPA is already advocating with the Centers for Medicare and Medicaid Services (CMS) that full dispensing fees be paid for an increase in the frequency of providing medications to residents of long term care facilities. Small Business Provisions Background: The health care reform bill includes provisions that would penalize businesses that do not provide health insurance and whose employees purchase plans through the exchange. However, there are no penalties on businesses with 50 or fewer employees that do not provide health care coverage. The bill also includes small business tax credits to encourage small employers to purchase insurance for their employees, but NCPA is concerned about the income caps and other eligibility requirements. What this means for YOU: You are not required under law to provide health insurance for your employees: ■■ If you do not provide health insurance coverage for your employees and have more than 50 employees, you may be subject to a $2,000 fine for some of the employees if any of the employees is subsidized to obtain coverage through the new health insurance exchanges. ■■ If you have fewer than 25 employees you may be eligible for tax credits to provide health insurance coverage to your employees. 340B Provisions Background: The health care reform bill substantially expands the number of entities eligible to obtain pharmaceutical discounts under the 340B program. These 340B entities are supposed to provide discounted prescription medications to uninsured individuals. However, many NCPA members report that eligible entities are using these 340B drugs for ineligible patients, such as a hospital’s own employees and for patients that have good insurance. The final bill prevents the extension of 340B discount pricing to inpatient

services provided by a hospital, which will reduce the number of discounted prescriptions dispensed to potentially inappropriate patients. What this means for YOU: While the bill’s expansion language will mean that an increasingly larger number of covered entities will be able to provide discount 340B drugs, NCPA members also have an increased opportunity to participate in the 340B program due to a recently issued HRSA guidance that allows 340B covered entities to contract with multiple pharmacies to provide pharmacy services. Proposed Board of Pharmacy Rule Changes Two issues that the Florida Pharmacy Association is monitoring at the Board of Pharmacy include further development of the Board’s technician training program rules and a request to consider modification of the rule requiring Florida permitted community pharmacies to be open 4 hours per week. Technician Training Rules The Florida Board of Pharmacy has been in rule development since passage of Senate bill 1360 during the 2008 legislative session. This bill required pharmacy technicians to register with the Florida Department of Health. Rule drafts have been exchanged at a number of Board of Pharmacy meetings along with requests for workshops and hearings by interested stakeholders. All individuals who are presenting as pharmacy technicians in Florida must wear a name badge with the words “Registered Pharmacy Technician” on it. These individuals must also have registered with the Florida Department of Health by December 31, 2009. Registered Florida technicians will have until December 31, 2010 to do one of the following three things: ■■ Completed a Board approved training program or ■■ Have completed a certification program approved by NCCA or ■■ Have worked a minimum of 1,500 under a licensed pharmacist Beginning January 1, 2011 the only way that an individual can function as

a pharmacy technician in Florida is to complete a Board approved technician training program and register with the Department of Health or be currently enrolled in a Florida Department of Health approved technician training program. After January 1, 2011 the option to use certification or work experience to become eligible for registration will cease to exist as the grandfather period would have ended December 31, 2010. Members need to be aware that rule 64B16-26.351 will take effect on June 23, 2010. The FPA will be looking at ways to assist our members with the training of their technician candidates. A copy of the current rule draft has been published on the FPA web site. We also understand that the Board will continue revising this rule at their next meeting. Requirement for Community Pharmacies to be Open 40 Hours The Florida Pharmacy Association filed a request before the Florida Board of Pharmacy for consideration and review of rule 64B16-28.1081 which requires community pharmacy permits to be open a minimum of 40 hours and 5 days per week with certain exceptions. The Florida Pharmacy Association through the House of Delegates has since 1995 been supportive of removing regulations that dictate the operating hours of pharmacies. We are not aware of any regulations that define the hourly operating standards for other critical health care providers such as physicians or dentists. The Board agreed to agenda this issue at meetings of the rules committee. This rule was discussed at their meetings in Jacksonville, Ft. Lauderdale and Orlando. The FPA also presented results of a survey where 71% of 28 states that responded indicated that they had no regulations that govern the number of hours that a pharmacy should be open.

care for our patients. Many decisions are also made that could adversely (or positively) affect a pharmacy’s financial posture. Members who know who their state and federal legislators can have a significant impact on health care rules and regulations. We are also very excited about the new opportunities for services that our profession can get into. With the need for medication therapy management, adherence and disease management the Florida pharmacist is key to a healthier population. Members networking with other members can build lasting relationships with the entire industry through collaborative care. The Florida Pharmacy Association is proud to be the catalyst behind the development of state and national leaders. Running for APhA trustee is Merritt Island pharmacist Mark Hobbs, past president FPA. Also in the leadership pipeline for the National Community Pharmacists Association is Lynn Haven pharmacist DeAnn Mullins who is serving as secretary treasurer. Your current Chair of the FPA Board of Directors was honored by APhA with the Good Government of the Year award. Past FPA President Kathy Petsos received her fellow status with APhA. Finally we all witnessed history this year with our own Ed Hamilton, FPA past president, concluding his term as president of the American Pharmacists Association. Ed is only the second Floridian to ever reach that goal. During Dr. Hamilton’s leadership APhA facilitated the renovation and move into its new building. Congratulations Ed from your FPA family.

Summary Members need to be aware of the need for an ever watchful eye on the policy making process. In many cases a policy decision may have a positive or negative effect on our ability to JUNE 2010

Smart Summer Skin Care is Key to Fun in the Sun Centers for Disease Control and Prevention

Protection from sun exposure is important all year round, not just during the summer or at the beach. Ultraviolet (UV) rays can reach you on cloudy and hazy days, as well as bright and sunny days. UV rays also reflect off of surfaces like water, cement, sand, and snow. The hours between 10 a.m. and 4 p.m. daylight savings time (9 a.m. to 3 p.m. standard time) are the most hazardous for UV exposure in the continental United States. UV rays are the greatest during the late spring and early summer in North America. CDC recommends easy options for sun protection1— ■■ Use sunscreen with sun protective factor (SPF) 15 or higher, and both UVA and UVB protection. ■■ Wear clothing to protect exposed skin. ■■ Wear a hat with a wide brim to shade the face, head, ears, and neck. ■■ Wear sunglasses that wrap around and block as close to 100% of both UVA and UVB rays as possible. ■■ Seek shade, especially during midday hours. 20

Florida Pharmacy TodaY

Sunscreen The sun’s UV rays can damage your skin in as little as 15 minutes. Put on sunscreen before you go outside, even on slightly cloudy or cool days. Don’t forget to put a thick layer on all parts of exposed skin. Get help for hard-to-reach places like your back. How sunscreen works. Most sun protection produc t s wo rk b y ab s o r b ing, reflecting, or scattering sunlight. They contain chemicals that interact with the skin to protect it from UV rays. All products do not have the same ingredients; if your skin reacts badly to one product, try another one or call a doctor. SPF. Sunscreens are assigned a sun protection factor (SPF) number that rates their effectiveness in blocking UV rays. Higher numbers indicate more protection. You should use a sunscreen with at least SPF 15. Reapplication. Sunscreen wears off. Put it on again if you stay out in the sun for more than two hours, and after you swim or do things that make you sweat. Expiration date. Check the sunscreen’s expiration date. Sunscreen without an expiration date has a shelf life of no more than three years, but its shelf life is shorter if it has been exposed to high temperatures. Cosmetics. Some make-up and lip balms contain some of the same chemicals used in sunscreens. If they do not have at least SPF 15, don’t use them by themselves. Clothing Loose-fitting long-sleeved shirts and long pants made from tightly woven fabric offer the best protection from the sun’s UV rays. A wet T-shirt offers

The hours between 10 a.m. and 4 p.m. daylight savings time (9 a.m. to 3 p.m. standard time) are the most hazardous for UV exposure in the continental United States. much less UV protection than a dry one. Darker colors may offer more protection than lighter colors. If wearing this type of clothing isn’t practical, at least try to wear a T-shirt or a beach cover-up. Keep in mind that a typical T-shirt has an SPF rating lower than 15, so use other types of protection as well. Hats For the most protection, wear a hat with a brim all the way around that shades your face, ears, and the back of your neck. A tightly woven fabric, such as canvas, works best to protect your skin from UV rays. Avoid straw hats with holes that let sunlight through. A darker hat may offer more UV protection. If you wear a baseball cap, you should also protect your ears and the back of your neck by wearing clothing that covers those areas, using sunscreen with at least SPF 15, or by staying in the shade.

Pharmacy Time Capsule 2010 ■■ ■■

1985

1935

Twenty-five years ago:

Seventy-five year ago

The Campbell University School of Pharmacy is founded in Buies Creek, NC. Pharmacy Directors of Pediatric Hospitals (PDPH) formed in 1985. Name changed to Pediatric Pharmacy Administrative Group (PPAG) in 1987.

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Property owned by the American Pharmaceutical Association in the District of Columbia where the headquarters was to be erected, was exempted from general taxes as long as it was to be used by the Association. The Rockefeller Foundation developed the first vaccine for Yellow Fever, once prevalent in the southern United States. It was tested and released the following year.

1960

1910

Fifty years ago

One hundred years ago

Enovid (Searle) was the first combination (norethynodrel with ethynylestradiol 3-methyl ether) oral contraceptive approved by the FDA. The 1960 Lilly Digest reported that the average prescription price was $$3.19.

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The Carnegie Foundation supported Abraham Flexner’s study of the state of medical education in the United States and Canada thus changing medical education forever. Pharmacy leaders later approached Flexner to do a similar study. He refused noting that pharmacy was not a profession. Sir Edward Albert Sharpey-Schafer hypothesized that diabetes was the consequence of deficit of a pancreatic chemical which he called insulin—11 years before the discovery of Banting and Best.

By: Dennis B. Worthen Lloyd Scholar, Lloyd Library and Museum, Cincinnati, OH One of a series contributed by the American Institute of the History of Pharmacy, a unique non-profit society dedicated to assuring that the contributions of your profession endure as a part of America’s history.  Membership offers the satisfaction of helping continue this work on behalf of pharmacy, and brings five or more historical publications to your door each year. To learn more, check out: www.aihp.org

JUNE 2010

What to Expect from the Oil Spill and How to Protect Your Health Centers for Disease Control and Prevention

People can be exposed to hazardous substances related to the spill by breathing them (air), by swallowing them (food, water), or by touching them (skin). People should avoid close contact to the spill and fumes from any burning oil. Air Quality: ■■ Smell: People may be able to smell the oil spill from the shore. The odor comes from chemicals in the oil that people can smell at levels well below those that would make most people sick. However, exposure to low levels of these chemicals may cause irritation of the eyes, nose, throat, and skin. People with asthma or other lung diseases may be more sensitive to these effects. ■■ Burning oil: When responders burn some of the oil, some “Particulate Matter” (PM) may reach the shore. PM is a mix of very small particles and liquid droplets found in the air. PM may pose a greater risk for people who have a chronic condition such as asthma or heart disease. If you smell gas or see smoke or know that fires are nearby, stay indoors, set your air conditioner to reuse indoor air, and avoid physical activities that put extra demands on your lungs and heart. Food: The Food and Drug Administration (FDA) and National Oceanic and Atmospheric Administration (NOAA) are monitoring the oil spill and its potential impact on the safety of seafood harvested from the area. Although crude oil has the potential to taint seafood with flavors and odors caused by exposure to hydrocarbon chemicals, the public should not be concerned about the safety of seafood in the stores at this time. For more information about seafood 22

Florida Pharmacy TodaY

This image from video provided by BP PLC

Oil spill dispersants break an oil slick into small drops. For most people, brief contact with a small amount of oil spill dispersants will do no harm. However, longer contact can cause a rash and dry skin. and the oil spill, visit http://www.fda. gov/Food/ucm210436.htm. Water: Drinking water and household water are not expected to be affected by the spill. However, water used for recreation may be affected. Swimming in water contaminated with chemicals from the oil spill could cause health effects. For more information about water and the oil spill, visit http://www.cdc. gov/nceh/oil_spill/information_residents.htm#5. Follow local and state public health guidelines and warnings about the use of beaches and coastal water for swim-

ming, boating, and fishing. For more information about beach safety, visit http://www.deepwaterhorizonresponse.com/go/doc/2931/542551/. Dispersants: Oil spill dispersants break an oil slick into small drops. For most people, brief contact with a small amount of oil spill dispersants will do no harm. However, longer contact can cause a rash and dry skin. Dispersants can also irritate your eyes. Breathing or swallowing dispersants can also cause health effects. If you are concerned that you have been exposed to oil or dispersants, see your doctor. Health care providers can find more information on CDC’s oil spill web site at http://emergency.cdc.

Florida Pharmacy Association

n o i t a r o b a oll

120th Annual Meeting and Convention Marco Island Marriott Resort, Golf Club & Spa Marco Island, FL

June 30 - July 4, 2010

Mark Your Calendar!

Collaboration is a process where two or more people or organizations work together in an intersection of common goals. Pharmacists collaborate with healthcare professionals in order to provide optimal patient care. Pharmacists are an integral part of the healthcare delivery system and make a powerful impact on improving patient’s quality of life. FPA would like to educate, equip and enhance pharmacists’ therapeutic knowledge with practical tools as they collaborate with other healthcare professionals and make a diﬀerence in patient care. FPA’s mission is to “serve, represent and assist pharmacists and pharmacy technicians to advance the profession and practice of pharmacy.” This year’s convention will offer a variety of important topics that will be applicable to your pharmacy practice setting. We are offering consultant and general continuing education hours, in addition to a pre-convention conference on Current Trends in Medication Therapy Management. Come and Collaborate at FPA’s 120th Annual Meeting and Convention!

General Information General Information Room Rates

$149 (rate cut oﬀ date is Friday, June 11, 2010) The special Florida Pharmacy Association Group room rate is $149 single/double occupancy plus tax per night. Please be sure to ask for the Florida Pharmacy Association group rate. The check-in time is after 4:00pm and the checkout time is before 11:00am. Room reservations can be made by calling (800) 438-4373 or calling (239) 394-2511. Valet parking is $18 per car per day. Guest self parking is $12 per car per day.

Keynote Speaker

Tom E. Menighan, is Executive Vice President and Chief Executive Oﬃcer of APhA, a position he assumed July 2009. Mr. Menighan received his Bachelor of Science in Pharmacy from West Virginia University School of Pharmacy and a Masters in Business from Averett College. He represents and is the chief spokesman for the American Pharmacists Association. Throughout his career, Menighan has served volunteer roles within the profession of pharmacy, including president of APhA from 2001 to 2002 and a member of the APhA Board of Trustees between 1995 and 2003. Also, he was a senior staﬀ member of APhA from 1987 to 1992.

General Education Track

Thursday - Sunday The general education track will offer courses designed to educate pharmacists on a wide variety of important topics pertaining to the profession of pharmacy practice. Specific courses being offered are Reducing Medication Errors, Third Party audits, and a Board of Pharmacy Update as well as the always-popular offerings of Florida Regulatory and Legislative Update. 24

Florida Pharmacy TodaY

Consultant Education Track

Thursday- Sunday The consultant education track will provide pharmacists with the most current information available on various disease states and focus on collaboration with other healthcare professionals. Some speciﬁc therapeutic topics being oﬀered include Diabetes Management, HIV/AIDS, Cardiovascular Disease, Neurological Disorders, and Oncology. There are 18 hours available for consultant pharmacists.

Student and Technician Track

Thursday – Sunday Students and Technicians will benefit from interacting with practicing pharmacists and attending student and technician focused continuing education programs. The technician track offers several hours of continuing education on a variety of topics, including a course on What Technicians Can and Cannot Do in Pharmacy. The student track consists of 10 hours of fun and exciting continuing education. Some specific courses being offered include Pharmacy Law, The Career Forum, and the NASPA/NMA Game Show.

Pre-Convention Education

Wednesday Only Our traditional Wednesday program will discuss current trends in Medication Therapy Management (MTM). This outstanding MTM Program will oﬀer 6 hours of live continuing education credit. Register for these programs and walk away with valuable information for your pharmacy practice. A separate registration fee is required for the pre-convention program.

Special Events

Exhibits: Participate in our grand opening reception in the exhibit hall! Poster Presentations: Browse submissions from students. Contact Tian Merren Owens in the FPA oﬃce for more information if you would like to submit a poster presentation. Awards Ceremony Reception entitled An

Evening in Margaritaville: Honor outstanding practitioners during the awards presentation. The dress code is resort wear casual or evening beach attire. President’s Breakfast: Attend the Sunday morning installation of new officers. Receptions: Enjoy catching up with your colleagues as the Universities entertain their alumni and friends, and as the FPA Foundation thank their supporters at a reception. House of Delegates: Be a delegate or observer and see how important member participation is to the direction of the Association. Student Events: Students will benefit from interacting with practicing pharmacists, attending student focused continuing education programs and learning first hand about the FPA and how involvement can improve their chosen profession. Call the FPA office and offer to mentor or sponsor a student. PharmPACCE Wine and Cheese Reception: Purchase a ticket to this reception to support your Political Action Committee. Golf Tournament: Join us Friday morning for the PACCE Golf Tournament. Please register early to save your space.

Waiver of Liability

Each individual attending FPA’s Annual Meeting assumes all risks associated with his/her attendance and participation in all on-and oﬀ-site activities that occur during this time. By registering for this meeting, you agree to indemnify and hold harmless, FPA and its governing bodies, oﬃcers and employees from all loss, damage or liability arising out of or related to your attendance and participation at FPA’s Annual Meeting.

Cancellation Policy

If cancellation is made in writing 30 days prior to the program a refund will be made less a $10 service charge. If cancellation is made 29-10 days prior to the program, a refund will be made, less a $50 service charge. Cancellation requested in writing after that date will result in credit for another FPA CE program or service valid for one year.

JUNE 2010

Florida Pharmacy Association 27th Annual Southeastern Gatherin’ August 8-11, 2010

Hilton Sandestin Beach Golf Resort & Spa, Destin, FL Meeting Site Location:

Four ways to register: PHONE (850) 222-2400 FAX (850) 561-6758 MAIL 610 North Adams St., Tallahassee, FL 32301 ONLINE at www.pharmview.com

Hilton Sandestin Beach Golf Resort & Spa 4000 Sandestin Boulevard South ~ Miramar Beach, FL 32550 For Room Reservation Call: (800) 367-1271 or (850) 267-9500 Sleeping Room Reservation Deadline: July 16, 2010

FPA room rate is $129 / $179 / $229 / $279 plus tax (single/double occupancy). The sleeping room reservation deadline is July 16, 2010. Thereafter, reservations will be taken on a space availability basis and group rate may not be offered. Check in time is 4:00pm. Check out time is 11:00am. There will be complimentary self parking. Valet parking is $20 per night. Printed booklets for our CE “Handouts” will no longer be available on-site at the conference. The “Handouts” will be posted on our websitewww.pharmview.com - the week of the conference for you to print out and bring with you to the meeting. Printed booklets of the Handouts are available to purchase for $25.00.

Registration Form (Deadline: Friday, July 23, 2010) Name:

Badge Name:

Address:

City, State, Zip:

Phone (Hm):

Phone (Wk):

Fax number:

Email address:

License Number : PS:

PU:

Registration Fees

Target Audience: Community Pharmacists, Hospital Pharmacists Consultant Pharmacists, Pharmacy Technicians Manage Care Pharmacists Long-term Care Pharmacists

RPT: ___________________________

Before July 23 Member

After July 23

Non Member

Member

Non Member

Full Registration Pharmacists

$250

$310

$280

$350

One Day Registration (includes CE & exhibit)

$150 ◊ Sunday $110

$190 ◊ Monday $145

$160 ◊ Tuesday $140

$200 ◊ Wednesday $175

$55 ◊ Monday $120

$60 ◊ Tuesday

$75 ◊ Wednesday

Includes all CE, Exhibits, Final Night Party, & a T-shirt Select the day you will attend

Full Registration Technicians

Includes all CE, Exhibits, Final Night Party, & a T-shirt

One Day Registration (includes CE & exhibits) Select the day you will attend

Guest Registration

$40 ◊ Sunday $120

Includes Exhibits, Final Night Party, & a T-shirt Names: __________________________________________________________________________________

Children from Ages 5-12

@ $50=

Exhibit Hall Pass

@$30=

Golf Tournament

@$80=

Includes Exhibits & T-shirt

Name:

Handicap:

Final Night Party

Gatherin’ T-shirts Adult (Included w/Full & Guest Reg.) Child Handouts Payment Method (accounting code: 6522 class 230) Visa Card #

MasterCard

AMEX

Discover

@$65= # # #

@$15= @$10=__________________ @$25= Total Amount Due: ________________

Check payable to FPA Security Code__________ Exp Date_________

Signature_________________________________________________________________________________

Cancellation Policy: If cancellation is made in writing 30 days prior to the program a refund will be made less a $10 service charge. If cancellation is made 29-10 days prior to the program, a refund will be made, less a $50 service charge. Cancellation requested in writing after that date will result in credit for another FPA CE program or service. Credits are valid for one year from date of original cancellation. Policy on Industry Support: The FPA Adheres to the US Food and Drug Administrator’s policy on industry supported educational activities. The FDA policy requires, among other things, that we conduct the educational program supported by any corporate educational grants independently and without control by the grantor of the program’s planning, content or execution. Furthermore, the programs must be free of commercial bias for or against any product. Tax Deduction: The expense of continuing education, when taken to maintain and improve professional skills is tax deductible. Please contact your accountant for complete details.

27th Annual Southeastern Gatherin’

General or Consultant Recertification Continuing Education August 8-11, 2010 Sunday, August 8th 5 hours GCE/TECH

11:00-6:00 PM

Registration Desk Open

1:00-1:15 PM

Welcome

1:15-2:15 PM Education 1 hour GCE/TECH Keynote Address: Advancing Pharmacy Practice Through Your Leadership and Involvement

Harold N. Godwin, BS Pharm, MS, FAPhA, FASHP, Professor and Chair of Pharmacy Practice, Associate Dean, University of Kansas, School of Pharmacy, Current President of the American Pharmacist Association (APhA) Upon completion pharmacists and technicians will be able to: Describe the traits that are characteristics of great leaders; Identify the actions and support that the national pharmacy organizations have developed to achieve Health Care Reform; Describe the value of involvement in Pharmacy Organizations and their influence in creating change; Describe the status of Health Care Reform relative to the action steps that our national pharmacy organizations are taking to implement an effective Medication Therapy Management program for patients. UAN: 0165-0000-10-053-L04-P UAN: 0165-0000-10-053-L04-T

2:15-3:15 PM Education 1 hour GCE/TECH Disaster Preparedness for Healthcare: The Role of Pharmacy in Natural and Manmade Disasters Dwayne Steele, PharmD, MS, FABC, Chief Operating Officer, St. Theresa Specialty Hospital

Upon completion pharmacists will be able to: Discuss the importance of natural and manmade disaster preparedness; Assess the current readiness status of their organization; Create checkpoints and timelines for purchases of equipment and materials that may be needed in the event of a disaster; Implement a successful natural or manmade disaster preparedness training program; Explain to clinicians and administrators on how to prepare their facility in order to ensure patient safety, staff readiness, and minimize potential financial losses. Upon completion technicians will be able to: Define natural and man made disasters; Assess the current readiness of their facility; Identify necessary tools that are needed in the pharmacy in case a disaster strikes. UAN: 0165-0000-10-054-L04-P UAN: 0165-0000-10-054-L04-T (Pending Approval from Georgia State Board of Pharmacy)

3:15-3:30 PM

Break

3:30-4:30 PM Education 1 hour GCE/TECH HIV/AIDS Update 2010

Antonio Carrion, PharmD, Florida A & M University, Leon County Health Department

Upon completion pharmacists will be able to: Review current modes of transmission; Identify high risk behaviors; Discuss the pharmacist role in providing care for HIV infected patients; Describe the mechanism of action of antivirals; Describe the rationale behind combination therapies; Interpret current Florida law on HIV/AIDS. Upon completion technicians will be able to: Define HIV and AIDS; List methods of transmission of HIV/AIDS; Identify high risk behaviors. UAN: 0165-0000-10-012-L02-P UAN: 0165-0000-10-012-L02-T

4:30-6:30 PM Education: 2 hours GCE/TECH Reducing Medication Errors Through Implementing a Continuous Quality Improvement Program Michael Jackson, RPh, FPA EVP & CEO

Upon completion pharmacists will be able to: Define elements of a Continuous Quality Improvement Program; Restructure a pharmacy practice to address quality related events; Analyze some common causes of quality related events; Implement an action plan to address quality of care in pharmacies with a goal towards

error reduction and prevention; Recite quality improvement regulations for Florida Pharmacies. Upon completion technicians will be able to: Define CQI; List the most common medication errors; Employ techniques used to reduce medication errors by using CQI. UAN: 0165-0000-10-025-L05-P UAN: 0165-0000-10-025-L05-T

6:30-8:30 PM

Exhibit Hall Grand Opening

Monday, August 9th 4 hours GCE/RC/TECH

7:00-8:00 AM

Continental Breakfast (Exhibit Hall)

7:00-1:00 PM

Registration Desk Open

8:00-10:00 AM Education 2 hours GCE/RC/TECH Current Trends in Peptic Ulcer Disease, Diagnosis and Management Patricia Lieveld, PharmD, M.P.H., Professor, Pharmacy Practice, Feik School of Pharmacy, University of the Incarnate Word

Upon completion pharmacists will be able to: List the major causes of PUD and recognize its multifactorial nature; Describe the proposed mechanisms by which H. pylori is transmitted; Discuss the procedures used in the diagnosis of PUD and H. Pylori infection; Discuss the clinical manifestations of PUD and H. Pylori infection; Compare and contrast the pharmacological agents and therapeutic strategies used in the management of PUD and H. Pylori; Explain the importance of managing H. pylori infections along with PUD. Upon completion technicians will be able to: Define PUD and H. Pylori; List the major causes of PUD; Identify medications used to treat PUD and H. Pylori. UAN: 0165-0000-10-055-L01-P UAN: 0165-0000-10-055-L01-T

10:00-10:15 AM

Break

10:15-12:15 PM Education 2 hours GCE/RC/TECH Hapless Against Heartburn No More! GERD Assessment and Treatment Katherine Heller, PharmD, Walgreens Health Initiatives, Clinical Director

Upon completion pharmacists will be able to: Discuss the epidemiology of gastro esophageal reflux disease (GERD); Define and differentiate GERD; List lifestyle changes linked to reduction of GERD symptoms; List and differentiate effective empirical drug treatments for GERD; Discuss potential patient concerns related to long-term acid suppression therapy; Recommend appropriate treatment and triage strategies based on patient presentation. Upon completion technicians will be able to: Define gastro esophageal reflux disease; Identify signs and symptoms associated with GERD; List drug treatments used for GERD. UAN: 0165-0000-10-056-L01-P UAN: 0165-0000-10-056-L01-T

12:15 PM 1:00 PM

Afternoon On Your Own Golf Tournament (Links Course)

Golf Tournament:

The tradition continues! If you are a golfer, you can’t come to this beautiful resort and not take advantage of at least one of the many outstanding golf courses in the area. FPA will once again organize a golf tournament at the Links on Monday, August 9. Tee times from 1:01PM-1:27PM!

Exhibit Hours: Sunday Evening, 6:30-8:30PM; Monday Morning, 7:00-8:00AM; Tuesday Morning, 7:00-8:00AM. Exhibit Information:

The exhibitors are a very important part of Florida Pharmacy Association’s conferences. These companies send their representatives to educate you about their products and services at great expense. Please show them your appreciation! Visit with them, introduce yourself, shake their hands, tell them you appreciate them and invite them back next year!

27th Annual Southeastern Gatherin’

General or Consultant Recertification Continuing Education August 8-11, 2010 Tuesday, August 10th 4 hours GCE/RC/TECH

Wednesday, August 11th 4 hours GCE/RC/TECH

7:00-8:00 AM

Continental Breakfast (Exhibit Hall) 7:00-8:00 AM

Continental Breakfast in Foyer

7:00-1:00 PM

Registration Desk Open

8:00-9:00 AM Education 1 hour GCE/RC/TECH Gastroparesis: When Good Stomachs Go Bad Melissa Murfin, PA-C, PharmD, Assistant Professor, Department of Pharmacy Practice, LECOM Bradenton School of Pharmacy

Upon completion of this activity, pharmacists will be able to: Define gastroparesis; Explain pathophysiology and causes of gastroparesis; Discuss dietary changes for gastroparesis; Discuss drug and surgical treatments for gastroparesis; Apply knowledge to patient cases; Counsel patients on living with gastroparesis. Upon completion technicians will be able to: Define gastroparesis; List the causes of gastroparesis; List some dietary changes for the gastroparesis. UAN: 0165-0000-10-057-L01-P UAN: 0165-0000-10-057-L01-T

9:00-10:00 AM Education 1 hour GCE/RC/TECH Celiac Disease: Life Without Wheat Melissa Murfin, PA-C, PharmD, Assistant Professor, Department of Pharmacy Practice, LECOM Bradenton School of Pharmacy

7:00-1:00 PM

8:00-10:00 AM Education 2 hours GCE/RC/TECH Inflammatory Bowel Disease & Irritable Bowel Syndrome: Where are We Now?

Ann Snyder, PharmD, BCPS, Clinical Specialist, Internal Medicine Professor, UF College of Pharmacy Upon completion of this activity, pharmacists will be able to: Differentiate between ulcerative colitis (UC) and Crohn’s disease (CD); Design a treatment plan for varying stages of UC and CD; Design a treatment plan for irritable bowel syndrome (IBS); Identify specific considerations for each of these therapeutic treatment plans including efficacy, adverse events, and monitoring parameters. Upon completion technicians will be able to: Define ulcerative colitis; Define Crohn’s disease; Define irritable bowel syndrome; Distinguish the differences among each disease; List medications used to treat UC, CD, and IBS. UAN: 0165-0000-10-060-L01-P UAN: 0165-0000-10-060-L01-T

10:00-10:15 AM

Break

Upon completion of this activity, pharmacists will be able to: Define 10:15-11:15 AM Education 1 hour GCE/RC/TECH celiac disease; Explain pathophysiology and causes of celiac disease; Discuss dietary changes for patients with celiac disease; Discuss treatDrug Induced Hepatotoxicity and Nephrotoxicity ments for celiac disease; Apply knowledge to patient cases; Counsel Mara Poulakos, PharmD, RPh, Assistant Professor of Pharpatients on living with celiac disease. Upon completion technicians will be able to: Define celiac disease; List the causes of celiac disease; List macy Practice, Lloyd Gregory School of Pharmacy, PBAU some dietary changes for the celiac patient. UAN: 0165-0000-10-058-L01-P UAN: 0165-0000-10-058-L01-T Upon completion of this activity, pharmacists will be able to: Identify the most common offending pharmacologic agents that can cause renal and hepatic toxicities; Recognize the clinical presentation, pathogenesis and risk factors 10:00-10:15 AM Break of drug-induced kidney disease; Implement strategies for prevention of drugacute kidney injury, including the selection of pharmacologic alterna10:15-12:15 PM Education 2 hours GCE/RC/TECH induced tives that do not affect kidney function; Describe the several different clinical Nutrition and Gastrointestinal Disorders presentations and mechanisms of drug-induced liver disease; Design a pharAngela Clauson, PharmD, Assistant Professor of macist-directed strategy for assessment and monitoring of drug-induced hepatotoxicity. Upon completion technicians will be able to: Define hepatoPharmacy Practice, Lloyd Gregory School of Pharmacy, toxicity; Define nephrotoxicity; List the most common agents affecting the Palm Beach Atlantic University kidney and the liver. UAN: 0165-0000-10-061-L01-P UAN: 0165-0000-10-061-L01-T Upon completion pharmacists will be able to: Investigate strategies to proactively combat nutrition related gastrointestinal conditions; Discuss nutritionally mediated health issues; Prioritize the three most common 11:15-12:15 PM Education 1 hour GCE/RC/TECH nutrition induced gastrointestinal health issues. Upon completion techniEtiology, Pathophysiology and Treatment of Non-Viral cians will be able to: Identify the role of nutrition in gastrointestinal disorHepatitis and Cirrhosis ders; List the three most common health issues affected by nutrition; Mara Poulakos, PharmD, RPh, Assistant Professor of PharIdentify ways to improve nutritional eating habits. UAN: 0165-0000-10-059-L01-P UAN: 0165-0000-10-059-L01-T macy Practice, Lloyd Gregory School of Pharmacy, PBAU

12:15-6:30 PM

Afternoon on Your Own

7:00-10:00 PM

Final Night Party

Final Night Party:

Join the crowd the last night we are all together for fun, food, dancing and a room full of Gatherin’ friends.

Hotel Information:

In an effort to better serve your needs, the following are included in the room charge: resort membership with discounted pricing on golf, tennis, marina and bicycle rentals; complimentary transportation to any facility on the Sandestin resort; complimentary use of Serenity by the 28 | facility; F l o rand i d acomplimentary P h a r m a c ynewspaper T o d a Y each day. sea’s fitness

Upon completion of this activity, pharmacists will be able to: Describe hepatic anatomy and vascular supply as well as the functions of the liver; Discuss the different pathologies of the liver: jaundice, cholestasis and cirrhosis; Describe the anatomic and physiologic effects of cirrhosis, including ascites, portal hypertension and varices, hepatic encephalopathy, coagulopathy and spontaneous bacterial peritonitis; Identify signs, symptoms & laboratory abnormalities of cirrhosis and associated complications; Recommend treatment strategies for cirrhosis and common complications of cirrhosis: Portal HTN and Variceal Bleeding; Ascites and Spontaneous Bacterial Peritonitis; Hepatic Encephalopathy; Coagulopathy. Upon completion technicians will be able to: Identify the functions of the liver; List diseases that affect the liver; Recognize sign and symptoms associated with liver disorders. UAN: 0165-0000-10-062-L01-P UAN: 0165-0000-10-062-L01-T

12:15 PM

PROGRAM ENDS

Buyer’s Guide florida PHARMACY TODAY

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

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

PHarmaceutical WHOLESALER

PPSC Retail Pharmacy Purchasing Program (888) 778-9909

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

PHARMACY CONSULTANTS HCC Pharmacy Business Solutions Dean Pedalino (800) 642-1652 Mobile: (727) 460-1855

TEMPORARY PHARMACISTs – STAFFING

INSURANCE

Medical Staffing Network (800) 359-1234

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

HealthCare Consultants Pharmacy Staffing Bob Miller (800) 642-1652

Rx Relief (800) RXRELIEF

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

FREQUENTLY CALLED NUMBERS AHCA MEDICAID PHARMACY SERVICES 2727 Mahan Drive Tallahassee, FL 32308 (850) 487-4441 www.fdhc.state.fl.us/medicaid/ pharmacy AMERICAN PHARMACISTS ASSOCIATION (APhA) Washington, D.C. (800) 237-2742 www.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 1-800-282-3171 http://ora.umc.ufl.edu/ pcc/fpicjax.htm National Community Pharmacists Association 100 Daingerfield Road Alexandria, VA 22314 703.683.8200 703.683.3619 fax info@ncpanet.org Recovering Pharmacists Network of Florida (407) 257-6606 “Pharmacists Helping Pharmacists”

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

JUNE 2010