October 2011 Florida Pharmacy Journal by Florida Pharmacy Today

The Official Publication Of The Florida Pharmacy Association OCT. 2011

October is American Pharmacists Month

Alliance for Patient Medication Safety

a federally certified patient safety organization (PSO) Pharmacies that report patient safety events are provided federal legal protection to patient safety information that is reported through APMS.

Quality Assurance Reporting Services

Quality Assurance Reporting to APMS provides federal legal protection to

patient safety information. In addition, participating pharmacies will receive recommendations on best practices and workflow processes to help reduce medication errors, improve medication use and enhance patient safety and health outcomes.

Thousands of Medicare Part D pharmacy providers are meeting their QA requirements and getting legal protection of their quality assurance data with the easy to use, low cost Pharmacy Quality Commitment (PQC) program. (PQC) is a continuous quality improvement program that strives to reduce medication errors in the pharmacy by offering structures and methods for improvement and a feedback system that allows the pharmacist to elevate the quality of patient care.

Compounding Adverse Drug Events Reporting (C-ADER)

A standardized tool for compounding pharmacies to simply and effectively track and report any adverse events that are potentially associated with compounded medications.

Pharmacy and Prescriber E-prescribing Experience Reporting (PEER) Portal

A questionnaire/reporting site designed to allow practicing pharmacists and prescribers to share their experiences with e-prescribing technologies. All comments - whether suggestions for improvement or complaints about the process - are welcome. This detailed information gathered can be used to improve the quality and effectiveness of electronic prescribing technologies and overall quality and operation of the e-prescribing infrastructure.

BACKGROUND NASPA promotes leadership, sharing, learning, and policy exchange among state pharmacy associations and pharmacy leaders nationwide, and provides education and advocacy to support pharmacists, patients, and communities working together to improve public health. NASPA was founded in 1927 as the National Council of State Pharmacy Association Executives (NCSPAE). APMS, LLC was established in August 2008 by NASPA and was listed in December 2008 as a Patient Safety Organization (PSO) with the Agency for Health Research and Quality (AHRQ). The mission of APMS, LLC is to foster a culture of quality within the profession of pharmacy that promotes a continuous systems analysis to develop best practices that will reduce medication errors, improve medication use and enhance patient care.

Alliance for Patient Medication Safety www.medicationsafety.org info@medicationsafety.org 866 365-7472

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florida PHARMACY TODAY Departments 4 Calendar 4 Advertisers 5 President’s Viewpoint 7 Executive Insight 20 Pharmacy Time Capsule 22 Buyer’s Guide

VOL. 74 | NO. 10 OCTOBER 2011 the official publication of the florida pharmacy association

Features

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About American Pharmacists Month

The Florida Pharmacy Association 2011 Resolutions New Law Impacts Treatment of Chronic Nonmalignant Pain

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FPA Calendar 2011-2012

JANUARY 2012

November 12-13 Board of Directors, Budget and Finance Committee and Council Meetings 11

Veterans Day FPA Offices Closed

17-20 NASPA Fall Meeting 24-25 Thanksgiving FPA Offices Closed DECEMBER 3-4

FPA Law Conference Sarasota, Florida

13-14 Florida Board of Pharmacy Meeting Gainesville, Florida 23 & 26 FPA Office Closed for Holidays

FPA Office Closed for New Year’s Day

Legislative Session Begins

FPA Office Closed for Martin Luther King’s Birthday

Journal Board Conference Call

24-25 Pharmacy Days at the Florida Capitol 25

Florida Pharmacy Health Fair at the Florida Capitol

28 - 29 FPA Law and Consultant Conference Sandestin 31

Deadline for the submission of FPA Election Ballots

Mission Statements: of the Florida Pharmacy Today Journal

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

of the Florida Pharmacy Today Board of Directors

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

Journal in its goal of self-support.

For a complete calendar of events go to www.pharmview.com CE CREDITS (CE cycle) The Florida Board of Pharmacy requires 10 hours LIVE Continuing Education as part of the required 30 hours general education needed every license renewal period. Pharmacists should have satisfied all continuing education requirements for this biennial period by September 30, 2011 or prior to licensure renewal. *For Pharmacy Technician Certification Board Application, Exam Information and Study materials, please contact Ranada Simmons in the FPA office. For More Information on CE Programs or Events: Contact the Florida Pharmacy Association at (850) 222-2400 or visit our Web site at www. pharmview.com CONTACTS FPA — Michael Jackson (850) 222-2400 FSHP — Michael McQuone (850) 906-9333 U/F — Dan Robinson (352) 273-6240 FAMU — Leola Cleveland (850) 599-3301 NSU — Carsten Evans (954) 262-1300 DISCLAIMER Articles in this publication are designed to provide accurate and authoritative information with respect to the subject matter covered. This information is provided with the understanding that neither Florida Pharmacy Today nor the Florida Pharmacy Association are engaged in rendering legal or other professional services through this publication. If expert assistance or legal advice is required, the services of a competent professional should be sought. The use of all medications or other pharmaceutical products should be used according to the recommendations of the manufacturers. Information provided by the maker of the product should always be consulted before use.

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Advertisers Alliance for patient medical safety........................ 2 Cardinal Health........................................ 15 EPC...................................................................... 13 Healthcare consultants........................ 3 Kahan ◆ SHIR, P.L.......................................... 15 PPSC...................................................................... 9 Rx RElief.......................................................... 15

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

The President’s Viewpoint BOB PARRADO, FPA President

The Value of Professional Judgment

harmacists are asked to engage in complex and unpredictable tasks on society’s behalf on a daily basis. In the practice of pharmacy, pharmacists routinely exercise discretion. We make judgments based on what is best for the patient, rather than what may necessarily be “right” in some absolute sense. Many times these situations cannot be seen as black or white. Inevitably, some of these judgments lead to “error,” which is endemic to professional practice. At the foundation of professional judgment is a form of knowledge — called practical wisdom — which is not formally taught and learned but is acquired largely through experience and informal conversations with respected peers. Professional judgment is often described as “what would a reasonable and prudent pharmacist do under similar circumstances.” Wisdom develops through “the critical reconstruction of practice,” including deliberation, which is distinguished from mere reflection. This deliberation includes interaction with other health care providers, not just pharmacists. The phrase “professional judgment” can be found many times in Florida laws and rules. 465.003 (6) defines the act of dispensing and says: As an element of dispensing, the pharmacist shall, prior to the actual physical transfer, interpret and assess the prescription order for potential adverse reactions, interactions, and dosage regimen she or he deems appropriate in the exercise of her or his professional judgment... This is just one of many instances where this important element of our professional practice is addressed in the laws that directly im-

pact the practice of pharmacy. Why is this important for us to consider in all that we do for our patients? The Florida Pharmacy Practice Act tells us: “465.002 Legislative findings; intent. —‑ The Legislature finds that the practice of pharmacy is a learned profession.” As a learned profession,

In my opinion, the laws and rules that impact the practice of pharmacy are the basis for determining what a reasonable and prudent person would do. there is a higher level of responsibility that we as pharmacists are expected to provide to the citizens of Florida who rely on our expertise for their health care. We are expected to provide counseling. We have a duty to warn the patient if we recognize a potential for an adverse drug event. The license that we hold is a privilege to practice pharmacy and not a “right.” We have to realize that this privilege to hold a license to practice pharmacy can be taken from

Bob Parrado, 2011-2012 FPA President

us if we do not uphold the highest standards of practice and use our “professional judgment” only in the best interests of our patients. On what should we base our “professional judgment?” As I stated earlier, your actions will be judged by the question “what would a reasonable and prudent pharmacist do under similar circumstances?” In my opinion, the laws and rules that impact the practice of pharmacy are the basis for determining what a reasonable and prudent person would do. Realizing that everything is not always black or white when it comes to law, your education, experience and training will be key in making your decisions. It is in these “gray” areas that your “professional judgment” will be the determining factor in your decision. A solid knowledge of the laws and rules that relate to pharmacy will help you develop the basic element of OC T O B E R 2 0 1 1

2011/2012 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.

Humberto Martinez............................................................. Chairman of the Board Robert Parrado .........................................................................................FPA President Goar Alvarez............................................................................................... President Elect Betty Harris ............................................................................................................Treasurer Suzanne Wise............................................Speaker of the House of Delegates Eric Alvarez.....................................Vice Speaker of the House of Delegates Preston McDonald, Director............................................................................ Region 1 Marcus Dodd-o, Director .................................................................................Region 2 Eva Sunell, Director ..............................................................................................Region 3 Raul N. Correa, Director ...................................................................................Region 4 Jeffrey Parrado, Director ...............................................................................Region 5 Chris Lent, Director...............................................................................................Region 6 Paul Rohrbaugh, Director.................................................................................. Region 7 Raul Gallo, Director.................................................................................................Region 8 Paul Elias, Director.................................................................................................Region 9 Venessa Price.......................................................................................... President FSHP Michael Jackson........................................Executive Vice President and CEO

Florida Pharmacy Today Journal Board Chair......................................................Jennifer Pytlarz, jlc_rxdoc@hotmail.com Vice Chair......................................................... Don Bergemann, don@bceinfo.com Treasurer....................Stephen Grabowski, sgrabowski@seniormmc.com Secretary...................................................................Stuart Ulrich, Stuarx@aol.com Member.................................................Joseph Koptowsky, docjik1215@aol.com Member........................Rebecca Poston, rebecca_poston@doh.state.fl.us Executive Editor................Michael Jackson, mjackson@pharmview.com Managing Editor...................Dave Fiore, dave@fiorecommunications.com

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professional judgment. Having to take a test on the laws and rules as a requirement for licensure establishes the fact that you are required to know these laws and rules. This pertains to federal laws also. In the DEA Pharmacists Manual, (which is available as a link in the member’s section of www.pharmview. com), the concept of “Corresponding Responsibility” is explained. It says that a pharmacist has a corresponding responsibility to ensure the validity of a prescription before that prescription can be dispensed. By knowing that this law is considered a standard of practice, it would be difficult for a pharmacist to say, “In my professional judgment, because the physician wrote the prescription, I can fill it without question.” Another example would be a pharmacist making the statement, “In my professional judgment, I felt it was appropriate for my technician to counsel the patient because I was busy and it was a simple answer.” 64B16.27.1001 (1) (f) tells us that only a pharmacist or a pharmacy intern under the direct and immediate supervision of a pharmacist may counsel a patient. These are just two examples of how the laws and rules establish a standard of care that we must adhere to. The privilege of having a license to practice pharmacy requires us to use our “professional judgment” when dispensing medications to our patients. You may be called on to defend your professional judgment either before the Board of Pharmacy or during a civil litigation. You should base your “professional judgment” on the laws and rules that regulate the profession in conjunction with your education, training and experience and your belief that you are acting in the best interests of the patient. The Florida Pharmacy Association offers continuing-education programs that concentrate on the laws and rules regulating the practice of pharmacy. I encourage you to attend one of these conferences to update your knowledge of the constantly changing legislation that affects our practice on a daily basis. n

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

Can You Afford Not to be an Advocate?

or the past 14 years, I have shared information on a host of issues of interest to the membership. It seems that we never run short of things to talk about, including but not limited to items that can help pharmacy grow as well as the challenging things that create patient-care barriers. The resources that the FPA invests in making sure that your voice is heard are significant. Advocacy is not something that you toss a few dollars at and think the job is finished and everything goes according to plan. It is actually something that requires an ongoing commitment and stakeholder investment. Any idea what would happen if your light bill is not paid or a past due mortgage is ignored? The consequence is not something that any of us would want to have to deal with. I have come to know and realize that advocacy is not much different than any other reoccurring expenses associated with life. Consider that the profession and business of pharmacy exists primarily because of advocacy and the investments made by our predecessors many years ago. They dreamed up the unpopular notion that only a licensed pharmacist should practice that profession, and that these services can only be done within a facility that is registered and recognized by a governmentcreated oversight board (Florida Board of Pharmacy). This new trend of leaner, more efficient government means that all aspects of health care policymaking will be reviewed to see if there is a need for oversight boards in todayâ&#x20AC;&#x2122;s health care provider market place. This means that each of us must look at what we do and the services that we

provided to see if society can somehow manage to survive without our business and professional model. If you asked yourself whether or not what you do is at risk for obsolescence, then you need advocacy. If someone or something else is in control of what you get paid, what professional services you provide and what you are permitted to do with your profession and

Advocacy is not something that you toss a few dollars at and think the job is finished and everything goes according to plan. your business practice, then you need advocacy. If you cannot identify at least 100 consumers of your services willing to take a bullet or go to the wall to ensure that you remain their provider, then you need a lot of advocacy. If you are disenchanted with what you do and want a change, then you need advocacy. If your perception of quality services and positive outcomes is considered overrated by others, then you

Michael Jackson, B.Pharm

need advocacy. If you do not know who your state legislator or congressman is, then you need to know about advocacy. If your congressman or your state legislator does not know who you are, then you are at serious risk and you must have advocacy. If you are just beginning your professional career, you need some serious advocacy. If you are at the end of your professional career then do you believe that advocacy is important to you? Well, sad to say if you want to have control of the lifetime of wealth that you created during your labor-intensive years, then you better find out how to be an advocate and work with our young practitioners. If our new practitioner advocacy efforts are not successful, then those making health care policy are coming after you. The Florida Pharmacy Association has been intimately involved in this thing called advocacy for a number of years. In recent years, our efforts have been intensive due to the increasOC T O B E R 2 0 1 1 |

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 Howard, ext. 110

Educational Services Office Assistant Stacey Brooks , ext. 210 Florida Pharmacy Today Board Chair............................................. Jennifer Pytlarz, Brandon Vice Chair...................Don Bergemann, Tarpon Springs Treasurer...............................Stephen Grabowski, Tampa Secretary.........................Stuart Ulrich, Boynton Beach Member..................................... Joseph Koptowsky, Miami Member..............................Rebecca Poston, Tallahassee Executive Editor.........Michael Jackson, Tallahassee Managing Editor.........................Dave Fiore, Tallahassee

This is a peer reviewed publication. ©2011, FLORIDA PHARMACY JOURNAL, INC. ARTICLE ACCEPTANCE: The Florida Pharmacy Today is a publication that welcomes articles that have a direct pertinence to the current practice of pharmacy. All articles are subject to review by the Publication Review Committee, editors and other outside referees. Submitted articles are received with the understanding that they are not being considered by another publication. All articles become the property of the Florida Pharmacy Today and may not be published without written permission from both the author and the Florida Pharmacy Today. The Florida Pharmacy Association assumes no responsibility for the statements and opinions made by the authors to the Florida Pharmacy Today. The Journal of the Florida Pharmacy Association does not accept for publication articles or letters concerning religion, politics or any other subject the editors/ publishers deem unsuitable for the readership of this journal. In addition, The Journal does not accept advertising material from persons who are running for office in the association. The editors reserve the right to edit all materials submitted for publication. Letters and materials submitted for consideration for publication may be subject to review by the Editorial Review Board. FLORIDA PHARMACY TODAY, Annual subscription - United States and foreign, Individual $36; Institution $70/year; $5.00 single copies. Florida residents add 7% sales tax. Florida Pharmacy Association

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

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ing number of challenges we are facing both at the federal and state levels. As your association manager, I am happy to say that our work is being recognized by our membership as important. It is exciting to hear our card-carrying members acknowledge their appreciation for what we have been doing. With over 3,500 members, most are advocate believers. Some are even activists themselves and give their time and talent to fight against

ship (especially our independent colleagues) overwhelmingly supported our fight and helped us to raise over $80,000, which we placed into a restricted fund account to use exclusively for this effort. The petition filed on behalf of the FPA and one of our members from Northwest Florida resulted in the state suspending efforts to implement the mail-order program. During the 2011 legislative session, members of the House and Sen-

With over 3,500 members, most are advocate believers. Some are even activists themselves and give their time and talent to fight against efforts to make poor health care policy. efforts to make poor health care policy. Others have been vocal proponents of FPA-facilitated policy designed to improve pharmacy services and advance our profession and business. Consider the following issues and the response from our membership: Mandatory Mail Order Issues During the 2010 legislative session, health care policymakers inserted into the state budget a program that would have moved a significant number of chronically diseased Medicaid recipients into a mail-order program. On your behalf, FPA leadership quickly moved into an offensive posture and ordered the FPA to file a petition against the state to prevent this program from moving forward. The FPA moved forward with this petition, even though it did not have a defense fund account to offset litigation costs. Association leadership traveled throughout the state describing the Medicaid bid protest effort and asked for support from membership to help with the expenses. The member-

ate revisited this issue and revised the language making it optional for the mail-order program to move forward. This change resulted in this particular mail-order program being indefinitely suspended and is considered an achieved objective of the FPA on behalf of our membership. Our combined litigation and public policymaking advocacy efforts and the inability to take the case to court on the basis of our complaint has resulted in a reserve amount balance remaining in the restricted defense fund account. Your FPA Board of Directors has elected to leave these funds in the restricted account to address future legal pharmacy services defense issues. As you are aware, the Medicaid program is moving entirely to managed care organizations. Florida state employees are also required to get their prescriptions filled through the mail. We will be considering our offensive options as these programs move forward. There is a cost to managing a comprehensive advocacy program. Mem-

bers may ask where their dues and support for the PACCE are going in support of our advocacy efforts. Well, you may be interested in knowing that dues paid to the FPA cover only about 25 percent of FPA’s operating expenses. Nearly half of the dues that you pay are used to offset our comprehensive lobbying effort. The FPA has been resourceful in finding other revenue to support our educational programs and member services. Over 91 percent of the PACCE support received by the FPA from the membership goes to political candidates who are supportive of pharmacy issues. The other 9 percent is used for PACCE printing, publishing and other direct fundraising expenses. The vast majority of these political campaigns supported by the PACCE were either retained or elected to office. While the member support of the PACCE, our legal defense fund and the FPA in general during recent months has been phenomenal, additional resources are needed. Over 50 percent of the services provided by pharmacists

are paid for by the federal government. The FPA does not only have to monitor what our state legislators are doing, but we also have to help support our national associations. All of you reading this article are advocates in some way. There are thousands of pharmacist and pharmacy technicians who have skin in this advocacy game that are not reading this journal and are not aware of the things that we take for granted as common knowledge. The sheer scope of questions that we receive in the FPA office from nonmember pharmacists overwhelmingly suggests that many within our industry do not understand what is happening to them. They come to realize how important being an advocate is after the deed is done and you have adapted while they have not. With the next pharmacist or pharmacy technician you talk to today, ask if they hold active membership in the FPA and if they are an advocate for their profession or their business. Statistically, it is very possible that who you talk to is not an

Increase Profits Independent…But Not Alone. PPSC is Your Partner for Success

active member and is not at the advocacy table. October is American Pharmacists Month. Let’s use this campaign to help others become advocates. If we all do not become involved, the cost of advocacy will only increase with the veracity of the issues growing in front of us. n

Florida Pharmacy Association Law and Regulatory Conference December 3 - 4, 2011 Hyatt Regency Sarasota 1000 Blvd of the Arts Sarasota, Florida 34236 For more information visit www.pharmview.com NOTE: Room reservation cutoff date is November 11, 2011

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About American Pharmacists Month Source: APhA “We need to promote the pharmacy profession! No one understands what pharmacists do.” How many times have you heard these comments… or even made them yourself? No matter when you first heard the comments, it was not a new idea. Pharmacists have been calling for recognition of pharmacists since the profession was established. William Procter, Jr., a founding member of the then-American Pharmaceutical Association (APhA) observed in 1867, that “public opinion is in America a forceful agent of reforms, and has been the main source of progress in pharmacy.” But it wasn’t until Asheville, N.C. pharmacist Robert J. Ruth introduced the idea of highlighting the profession through an annual celebration that the event took shape. At the 1924 annual meeting, Ruth unveiled his plan of “A National Pharmaceutical Week” and with that the first National Pharmacy Week was born. The first celebration was held on October 11-17, 1925. During this inaugural effort, radio stations across the country broadcast special programs which emphasized the professional side of pharmacy. A 1959 National Pharmacy Week press kit, found in the APhA Newsroom during a move to our temporary headquarters, highlighted many of the same issues we talk about today: pharmacy careers, medication costs, and standards for training. Offering practicing pharmacists displays, posters, radio and television material, newspaper articles and even speeches (a complete kit cost $2.00) to ‘promote’ the profession, much like the promotions available on pharmacist.com today. In fact, a current APhA consultant, George B. Griffenhagen, was on the public relations committee at that time. After celebrating National Pharmacy Week for nearly eight decades, 2004 marked the launch of American Pharmacists Month. The expansion to a month responded to APhA member comments that a week was not enough 10

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During this inaugural effort, radio stations across the country broadcast special programs which emphasized the professional side of pharmacy time to fully promote the expanding role of the pharmacist. And while the length of time was changed, the goal of the event has remained the same: to highlight the importance of the pharmacists’ value to the healthcare system and their role as medication experts. Since then, American Pharmacists

Month has continued to grow. In 2005, U.S. President George W. Bush acknowledged the important role pharmacy professionals play in the lives of Americans. An increasing number of state pharmacy associations, pharmacists and pharmacy practices participate in the annual celebration.

The Florida Pharmacy Association 2011 Resolutions Presented to the House of Delegates Greetings members of the Florida Pharmacy Association The Florida Pharmacy Association is an advocacy organization whose mission includes the representation of stakeholder members from various professional practice and business interests. We gather at our regional and annual conferences to network and exchange ideas that help to facilitate quality patient care and sound business practices. Each year our affiliated and invited organizations identify and send to the annual meeting representatives to review draft policy statements and shape the initial advocacy plan for our professional organization. This is the opportunity for each of you to have input in how the FPA responds to issues. This summer we met at the Turnberry Isle Resort and debated seven resolutions on various pharmacy issues. Three of the seven were submitted after the deadline and required special handling by the House of Delegates. I have included in this report the results of those deliberations and which of FPA's Committees and Councils are tasked with planning for execution of these policy statements. Some of the resolutions may see immediate action while other issues may require resources and time to achieve its objectives. In either case a final report of the outcome of each of this year's resolutions will be reported back to the House of Delegates within three years as defined by Association policy. Watch for my final report next spring on the status of the 2011 resolutions. If there is an interest in discussing an issue, consider working with one of your local associations and plan to submit a resolution at next year's convention in Marco Island. The deadline for the submission of resolutions is March 15, 2012. A resolutions form is included in this issue of Florida Pharmacy Today. I am also pleased to report the following members of the 2011 - 2012 FPA House of Delegates Board of Directors Chairman of the House Board of Directors . ........................................................................................................... William Riffee Vice Speaker........................................................................................................................................................................ Eric Alvarez Director........................................................................................................................................................................ David Mackarey Director.......................................................................................................................................................................Kimberly Murray Director........................................................................................................................................................................... Caridad Ferree Parlimentarian.....................................................................................................................................................................Lori Weems FPA President Elect and Ex Officio Member of the Board of Directors................................................................ Goar Alvarez Secretary of the House............................................................................................................................................... Michael Jackson I thank you for allowing me the honor of serving our grassroots organizations on the FPA Board of Directors. Please let me know if I may be of service. With kindest regards, Suzanne Wise 2011 - 2012 Speaker of the House of Delegates

2011 List of Resolutions 1. Medical Marijuana Broward County Pharmacy Association 2. Florida licensed consultant pharmacist to inspect pain management clinics for compliance. Broward County Pharmacy Association 3. Information on the Face of the Prescription Interamerican Pharmacists Association 4. Electronically Signed Prescriptions FS 456.42 Interamerican Pharmacists Association Resolutions submitted late: 5. Pharmacist to Intern Ratio Palm Beach County Pharmacy Association 6. Encouraging the use of NPI number Professional Affairs Council Chair 7. Third Party Prescription Signature Requirements Dade County Pharmacy Association 1 Medical Marijuana Broward County Pharmacy Association WHEREAS it has been documented and approved for use in California and neighboring states the medical use of marijuana. There are similar laws under consideration in the Northeastern States. WHEREAS referencing California SB 420 the following conditions are deemed appropriate for the use of Medical Marijuana: Acquired 12

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immune deficiency syndrome (AIDS), Anorexia, Arthritis, Cachexia, Cancer, Chronic pain, Glaucoma, Migraine, Persistent muscle spasms, including, but not limited to, spasms associated with multiple sclerosis, Seizures, including, but not limited to, seizures associated with epilepsy and Severe nausea. Therefore BE it RESOLVED: That any Florida legislation related to the legal use of medical marijuana shall include provisions that dispensing and monitoring of such legal use of medical marijuana be managed by Pharmacies, Pharmacists, and Consultant Pharmacists. Contact: David Andrews PD CPh Chairman of the Board, BCPA 954-328-4320 Problem: Marijuana has been shown to be effective in treating multiple medical conditions. Unfortunately because of its misuse has been classified as a Schedule I Controlled Substance. This carries in the State of Florida a Felony charge. Intent: To follow in the regards of other states and decriminalize the use of medical marijuana and make it available on prescription at the pharmacy level. Motion to amend Resolution amended Division of the House Called on final Vote Resolution fails on standing vote Fiscal Impact Statement: $$

enacted, and WHEREAS a provision of this law (458.3265 (3)) calls for routine inspections of pain management clinics by inspectors from the Florida Department of Health (DOH), and WHEREAS inspectors from the DOH are also charged with other functions including, but not limited to, inspecting pharmacies and dispensing physicians offices THEREFORE BE IT RESOLVED that FPA, through the FPA Legislative Committee, seek legislation requiring Florida licensed consultant pharmacists to conduct monthly reviews of all registered pain management clinics to ensure compliance with applicable law, regulation and any applicable clinic policy and procedures Contact: Gary Koesten, M. S., C.Ph. President Elect, BCPA 954-979-5995 x 8510 Problem: Manpower issues related to inspecting permit premises do not allow for timely inspections. Intent: To utilize Florida licensed consultant pharmacists in the inspection process as pertains to registered pain management clinics only Substitute resolution accepted by sponsor Resolution adopted Referred to Professional Affairs

2 Florida licensed consultant pharmacist to inspect pain management clinics for compliance. Broward County Pharmacy Association

Fiscal Impact Statement: $$$$$

WHEREAS SB 2272 regulating pain management clinics registered with the Agency for Health Care Administration (AHCA) has been

Whereas, FS 893.04 states that certain information must appear on the face of the prescription.

3 Information on the Prescription Interamerican Pharmacists Association

Whereas, third party payors are using this FS to deny payment when this information does not appear on the face of the prescription. Whereas, BOP inspectors are using this FS to cite pharmacies for not having this information on the face of the prescription. Let it be resolved, that the FPA pursue the change of this FS to remove the wording “on the Face of the Prescription”. Problem: Several pharmacies are being charged back for thousands of dollars for not having the required information on the face of the prescription. Also, new BOP inspectors are following the letter of the law and citing pharmacies for not having the required information on the face of the prescription. Intent: To alleviate citations from the BOP from new inspectors for this obscure law. And to stop predatory

audits from third party payors using this FS. Contact: For more information: Raul Gallo- President IPA rigrph@aol.com Substitute resolution presented by sponsor Resolution adopted with no objection Referred to Governmental Affairs Fiscal Impact Statement: $$ 4 Electronically Signed Prescriptions FS 456.42 Interamerican Pharmacists Association Whereas, several prescribers are now using new computer programs that generate electronic signature prescriptions.

Whereas, prescribers are not aware that they must transmit these electronically generated signature prescriptions to the pharmacy and not give them to the patient. Whereas, pharmacists are not aware that these electronically generated signature prescriptions must be transmitted to the pharmacy and not given to the patient. Whereas, third party payors are denying payment for these electronically signed prescriptions that are not transmitted to the pharmacy and given to the patient. Let it be resolved, that the FPA educate both the prescriber and the pharmacist that electronically generated and signed prescriptions must be transmitted to the pharmacy or hand signed by the prescriber, for them to be valid. Problem: More prescribers are using these new programs with

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Florida Pharmacy Association OC T O B E R 2 0 1 1

The Florida Pharmacy Association and the Cardinal Health Foundation congratulate Robert S. Miller as the recipient of the 2011 Cardinal Health Generation Rx Champions Award!

This award recognizes a pharmacist who has demonstrated excellence in community-based prescription drug abuse prevention. We celebrate Robert’s outstanding efforts and commitment to raising awareness of the dangers of prescription drug abuse among the general public and among the pharmacy community. For more information about the award, visit cardinalhealth.com/GenerationRx

© 2010 Cardinal Health. All rights reserved. CARDINAL HEALTH, the Cardinal Health LOGO, and Essential to care are trademarks or registered trademarks of Cardinal Health. All other marks are the property of their respective owners. Lit. No. 5CR7308 (09/2011) – FL

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cardinalhealth.com/GenerationRx

electronically signed prescriptions and giving them to the patient without transmitting them to the pharmacy and or not hand signing them.

Whereas, the current rules of the Board of Pharmacy require a preceptor to intern ratio of one to one. And

Intent: To avoid charge backs from third party payor plans for not following this letter of the law.

Whereas, there are situations when a preceptor takes both IPPE (Introductory Pharmacy Practice Experience) and APPE (Advanced Pharmacy Practice Experience) and due to the nature of the scheduling there schedules overlap and there is only one pharmacist on duty. And

Contact: Raul Gallo- President-IPA rigrph@aol.com Resolution adopted with no objection Referred to Public Affairs Fiscal Impact Statement: $$ RESOLUTIONS SUBMITTED LATE 5 *Late Resolution* Pharmacist to Intern Ratio Palm Beach County Pharmacy Association

Whereas, this puts the preceptor in violation of Board Rules. Therefore be it resolved, that the Florida Pharmacy Association work with the Florida Board of Pharmacy to change the rule to remove a preceptor to intern ratio Problem: Because an APPE student is required to attend a 40 hour week they generally are on 8 hour cycles

and the IPPE student depending on the college is required to attend either a 4 of 6 hour shift once a week. The pharmacists in a schedule generally only have a one or two hour overlap. This leaves a number of hours where there is a potential for a pharmacist to be in violation of this rule. Furthermore, I have found it to be very beneficial for the students to interact with each other and we all learn more. And isn’t that the purpose of internships. Contact: Paul Ackerman packerman@prodigy.net Rules of the House suspended to consider this item of new business Motion to table until the afternoon session Second session of the House convenes Motion to amend Motion to refer to the Professional Affairs Council

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Motion to refer adopted Fiscal Impact Statement: $ 6 *Late Resolution Encouraging the use of NPI number Professional Affairs Council Chair Whereas, the National Provider Identification number (NPI) is to be used for identification of professional services, and Whereas, pharmacists can have NPI numbers to bill for professional services, and Whereas, most pharmacy professional fees are usually bundled into the price of medications, Be it resolved that the FPA seek legislation that payment for medications be composed of three components: professional fee, dispensing fee and cost of the medication and, Be it further resolved, that the FPA seek legislation that adds a professional fee for prescription medications dispensed and, Be it further resolved, that the professional fee be associated with and payable to the pharmacist’s NPI number. Problem: The typical method of billing for prescription medications bundles all professional fees into one dispensing fee. This method of payment for health care professional services is not consistent with other health professionals’. Pharmacists’ professional services should be clearly billed for, separate and distinct from the price of drugs and their associated carrying costs. NPI numbers for pharmacists are currently not widely held by individual pharmacists and are not used in the health care billing system to identify the services provided by these pharmacists. 16

Florida Pharmacy TodaY

Intent: Separating out the professional pharmacy services fee from the dispensing fee and then linking that fee to the pharmacist’s NPI number brings the billing of these services in line with other health professionals providing care to Florida residents. Eventually, NPI numbers and fees will be built to address pharmacy services not linked to a product (such as MTM, OTC recommendations, etc.). Contact: Eric Alvarez 305-965-7886 Chairman- Professional Affairs Council Motion to suspend the rules of the House Rules of the House suspended Resolution adopted Referred to the Governmental Affairs Committee

otherwise educating pharmacists as to the alternatives available to convert invalid prescriptions into valid prescriptions, Further be it resolved that the Florida Pharmacy Association generate educational letters regarding the legal requirements of a prescription to physicians and that these letters be made available to members of the Florida Pharmacy Association. Motion to suspend the rules of the House Rules of the House suspended Question called to end debate Resolution adopted Referred to the Public Affairs Council Fiscal Impact Statement: $

Fiscal Impact Statement: $$$$ 7 *Late Resolution Third Party Prescription Signature Requirements Dade County Pharmacy Association Whereas there are laws in the State if Florida that explicitly state the requirements of a prescription for controlled and non-controlled drugs, and, Whereas third party payers are using these prescription requirements to audit pharmacies to reverse payments and Whereas pharmacies who have been audited have been subject to substantial fees and paybacks to third party payers, Be it resolved that the Florida Pharmacy Association mount an educational campaign aimed at reinforcing the legal requirements of a prescription, sharing anecdotal events from those who have been subject to a third party audit, and

Fiscal Impact Statement Key: Should address the anticipated costs and benefits that will be derived should the resolution be passed $ - Minimal to low Impact (Example: Publishing position statements) $$ - Low to Moderate Impact (Example: FPA preparing letters and op-ed papers to policy makers) $$$ - Moderate to Considerable (Example: FPA having to support comprehensive legislative campaign) $$$$ - Considerable to substantial (Example: FPA having to fund consultant assistance, support comprehensive legislative campaign) $$$$$ - Substantial Impact (Consist of FPA spending considerable resources on consultant assistance, funding comprehensive legislative campaigns, and invest in market outreach)

New Law Impacts Treatment of Chronic Nonmalignant Pain In the May 2011 issue of FPA’s Stat News and also the June 2011 issue of Florida Pharmacy Today we briefly reported how House bill 7095 affected the prescribing of controlled substances used to treat pain. This new Florida law was created under F.S. 456.44 affecting the regulation of professions in general. Of interest to FPA members is a section of the law that creates a standard of practice for the treatment of “chronic nonmalignant pain” by prescribing practitioners who do not hold certain credentials. Chronic Nonmalignant pain is defined in F.S. 456.44 as pain unrelated to cancer or rheumatoid arthritis which persists beyond the usual course of disease of the injury that is the cause of the pain or more than 90 days after surgery. These standards include (but are not limited to): ■■ Having to complete a medical history and physical prior to beginning treatment ■■ Requiring the patient to be seen at least every 3 months prior to continuation or modification of therapy. This section of Florida law does not apply to prescribing practitioners who are: ■■ board certified anesthesiologists ■■ physiatrists (spelling to be corrected to “certified psychiatrist” during the 2012 session) ■■ neurologists ■■ board certified physician with surgical privileges at a hospital or ambulatory surgery center and primarily providing surgical services ■■ board certified medical specialist who has also completed a fellowship in pain medicine approved by the Accreditation Council for Graduate Medical Education or the American Osteopathic Association or ■■ board certified in pain medicine by a board approved by the American Board of Medical Specialties or the American Osteopathic Association and performs interventional pain of the the type routinely billed using surgical codes

So what does all this have to do with the practice of pharmacy? In this new law there are conditions that must be met when patients are being treated for pain with controlled substances by prescribers who do not hold the credentials listed above. The FPA questions whether it is possible for pharmacists to be aware of or know that those conditions have been met when presented with a prescription for pain medication. In some cases the prescribing practitioner’s credentials may not be readily available. We are also not sure how PBM auditors will rule on prescriptions that are not issued by prescribing practitioners under these new standards. When will this requirement take effect? F.S. 456.44 requires registration and designation of the physician as a controlled substance practitioner on their practitioner profile by January 1, 2012. You can view the physician’s profile by using the “Professional License Lookup” link on the home page of the FPA web site. What about controlled substance prescriptions written by practitioners from other states? We do not believe that the provisions of this law are applicable to out of state prescriptions as a physician licensed outside of Florida are not subject to Florida laws. Florida laws do however allow pharmacists to fill controlled substance prescriptions from other states provided that the pharmacist called upon to fill such an order determines, in the exercise of his or her professional judgment, that the order was issued pursuant to a valid patient-physician relationship, that it is authentic, and that the drugs or medicinal supplies so ordered are considered necessary for the continuation of treatment of a chronic or recurrent illness.

So what should a dispensing pharmacist do? When a pharmacist receives a prescription and believes that it is for the treatment of chronic nonmalignant pain (CNP) and the pharmacist does not if the prescribing practitioner has been exempted from this new law then is recommended to circle back with the physician if the prescription and or its refills may last longer than 90 days. An inquiry should be made as to whether or not the patient has been seen within the last 3 months. This inquiry probably should be documented in the patient record somewhere. Does this mean that a physician can no longer write for more than a 90-day supply of medications used to treat pain? This change in Florida statutes 456 does not have language that specifically mentions any prescribing limitations rather it places an obligation on physicians to evaluate a patient’s progress “before” continuing treatment. It would appear to be prudent for the prescribing practitioner to order only a 90 day supply to ensure that patients whose prescriptions for chronic nonmalignant pain has run out actually return to the office for a follow up visit and assessment if more medication is needed. Editor’s note: Articles in this publication are designed to provide general information to FPA members. This information is provided with the understanding that the Florida Pharmacy Association is not engaged in rendering legal or other related professional services. If expert assistance or legal advice is required, the services of a competent professional should be sought.

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APhA Foundation and NASPA Bowl of Hygeia Awarded to a pharmacist for outstanding community service above and beyond professional duties. The use of the following selection criteria is required: ■■ The recipient must be a Florida licensed pharmacist and a member of FPA. ■■           ■■ T recipient has not previously received the award. ■■                 on its award committee or an officer of the association in other than an ex officio capacity. ■■   has compiled an outstanding record of community service, which, apart from his/her specific identification as a pharmacist, reflects well on the profession. James H. Beal Award Awarded to the "Pharmacist of the Year." The criteria established for this award is that the recipient be a Florida registered pharmacist and a member of FPA, who has rendered outstanding service to pharmacy within the past five years. Criteria: ■■   must be a Florida registered pharmacist and a member of the FPA. ■■   has rendered outstanding service to pharmacy within the past five years. Technician of the Year Award Awarded annually to a Florida pharmacy technician who is recognized for his/her outstanding performance and achievement during his/her career. Criteria: ■■ Candidate must be a member of the Florida Pharmacy Association for at least 2 years. ■■ Candidate must have demonstrated contributions and dedication to the advancement of pharmacy technician practice.

Florida Pharmacy TodaY

N o m i n a t i o n s ■■ Candidate must have demonstrated

contributions to the Florida Pharmacy Association and/or other pharmacy organizations. ■■ Candidate must have demonstrated commitment to community service. ■■ Candidate is not a past recipient of this award. R.Q. Richards Award This award is based on outstanding achievement in the field of pharmaceutical public relations in Florida. Criteria: ■■  recipient must be a Florida registered pharmacist and a member of the FPA. ■■   has displayed outstanding achievement in the field of pharmaceutical public relations in Florida. Frank Toback/AZO Consultant Pharmacist Award Criteria: ■■ Candidate must be an FPA member, registered with the Florida Board of Pharmacy as a consultant pharmacist in good standing. ■■ Candidate should be selected based on their outstanding achievements in the field of consultant pharmacy. DCPA Sidney Simkowitz Pharmacy Involvement Award Presented annually to a Florida pharmacist who has been active at the local and state pharmacy association level in advancement of the profession of pharmacy in Florida. Criteria: ■■ A minimum of five years of active involvement in and contributions to the local association and FPA. ■■ Candidate must have held office at local level pharmacy association. ■■ Member in good standing for a period of at least five years in the FPA and must have served as a member or chairman of a committee of the association. ■■ Candidate must have been actively involved in a project that has or could potentially be of benefit to members of the profession.

F P A

Pharmacists Mutual Companies Distinguished Young Pharmacist Award Awarded to a young pharmacist for their involvement and dedication to the practice of pharmacy. Criteria: ■■ Licensed to practice for nine (9) years or less. ■■ Licensed to practice in the state in which selected. ■■ Participation in national pharmacy association, professional programs, and/or community service. IPA Roman Maximo Corrons Inspiration & Motivation Award Interamerican Pharmacists Association created this award to honor the memory of Roman M. Corrons who inspired and motivated countless pharmacists to participate actively and aspire to take on leadership roles in their profession. Roman was always there with guidance and support that motivated pharmacists and encouraged visionary leadership, approachable active membership and succession planning. This award recognizes the motivators among us who inspire others to continue to advance the profession. Criteria: ■■ The recipient must be a Florida Licensed Pharmacist and a member of the FPA. ■■ Candidate should motivate others to excel within the profession by encouraging them to be leaders. ■■ Candidate is not necessarily an association officer, but guides, supports and/or inspires others. A brief description on the candidate’s motivational/inspirational skills must accompany the nomination. The Jean Lamberti Mentorship Award The Jean Lamberti Mentorship Award was established in 1998 to honor those pharmacists who have taken time to share their knowledge and experience with pharmacist candidates. The award is named in honor of long time FPA member Jean Lamberti for her effort in working with pharmacy stu-

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dents. Criteria ■■ The recipient must be an FPA member. ■■ The recipient must serve as a role model for the profession of pharmacy. Upsher Smith Excellence in Innovation Award Awarded to honor practicing pharmacists who have demonstrated innovation in pharmacy practice that has resulted in improved patient care. Criteria: ■■ The recipient has demonstrated innovative pharmacy practice resulting in improved patient care. ■■ The recipient should be a practicing pharmacist within the geographic area represented by the presenting Association. Qualified Nominee: A pharmacist prac-

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

following criteria: ■■ Commitment to community-based educational prevention efforts aimed at prescription drug abuse ■■ Involvement of other community groups in the planning and implementation of prevention programs ■■ Innovation and creativity in the creation and implementation of prevention activities ■■ Scope/magnitude of prescription drug abuse efforts Demonstrated impact of prescription drug abuse prevention efforts

Deadline FOR NOMINATIONS: February 28, 2012 F P A A W ARDS N O MINA T I O N F O RM I am pleased to submit the following nomination:

Nominated by:

Name:

Address:

Date Submitted: Signature:

For the following Award: (Nomination Deadline February 28, 2012)  APhA Foundation and NASPA Bowl of Hygeia  James H. Beal Award

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

 R.Q. Richards Award  Frank Toback/AZO Consultant Pharmacist Award  DCPA Sydney Simkowitz Award  Pharmacists Mutual Co. Distinguished Young Pharmacist Award  Academy of Pharmacy Practice Practitioner Merit Award  The Jean Lamberti Mentorship Award  IPA Roman Maximo Corrons Inspiration & Motivation Award  Upsher Smith Excellence in Innovation Award  Technician of the Year Award  Cardinal Generation Rx Award Mail nominatons to: Annual Awards, Florida Pharmacy Association, 610 N. Adams St., Tallahassee, FL 32301 (850) 222-2400 FAX (850) 561-6758 DEADLINE FOR NOMINATIONS IS FEBRUARY 28, 2012

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Pharmacy Time Capsule 2011 ■■

■■

■■ ■■ ■■

1986

1936

Twenty-five years ago:

Seventy-five year ago

Food and Drug Administration approval of the first monoclonal antibody drug, Muronomab-CD3 (also known as Orthoclone OKT3), for treatment of transplant rejection Total health care expenses for a population of approximately 244 million were approximately $477 billion. Average prescription price was $14.36 and the average number of new and refill prescriptions filled per year was 29,100 according to the Lilly Digest.

■■

Johnstown, PA was hit with a devastating flood on St. Patrick’s Day. Initial reports were that 27 out of 34 drug stores were destroyed. Pharmacists and manufacturers rushed aid to the city to assure that essential medicines were available.

1961

1886

Fifty years ago

One hundred twenty-five years ago

Pharmacist Donald Hedgpeth and the Northern California Pharmaceutical Association indicted for violation of the Sherman Anti-trust Act for the development of a pricing schedule that incorporated a professional fee. Amitriptyline HCl (Elavil) was introduced in the US by Merck Sharp & Dohme Total health care expenses for a population of approximately 189 million were approximately $29 billion. Average prescription price was $3.25 and the average number of new and refill prescriptions filled per year was 15,100 according to the Lilly Digest.

■■

The Brooklyn College of Pharmacy was formed in 1886. Renamed, it is now the Arnold and Marie Schwartz College of Pharmacy and Health Sciences of Long Island University.

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

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CALL FOR RESOLUTIONS TO THE 2012 HOUSE OF DELEGATES The House of Delegates Board of Directors will meet in March 2012 to review and approve resolutions for the Annual Meeting. The deadline for submitting resolutions is March 15, 2012! PLEASE NOTE THIS DEADLINE. The following information will be needed when submitting resolutions: 1. Name of organization: The name of the organization submitting the resolutions(s); 2. Name and telephone number of individuals: A contact in the event clarification Or further information is needed; 3. Problem: A statement of the problem addressed by the resolution; 4. Intent: A statement of what passage of the resolution will accomplish; 5. Resolution Format: (please type and use double spacing) Title of Resolution Name of Organization Whereas

, and

Whereas

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

Contact name and phone #: Problem: Intent:

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

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Buyer’s Guide florida PHARMACY TODAY

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

PHARMACY RESOURCES Abbott Diabetes Care Michael J. Forker (239) 839-3313 Cerner Etreby Pharmacy Management Systems (800) 292-5590 PPSC Retail Pharmacy Purchasing Program (888) 778-9909

PHARMACY CONSULTANTS HCC Pharmacy Business Solutions Dean Pedalino (800) 642-1652 Mobile: (727) 460-1855 Empire Pharmacy Consultants Michael Chen PharmD., CPh President/CEO (786) 556-7825 Mobile (305) 374-1029 Office

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

TEMPORARY PHARMACISTs – STAFFING HealthCare Consultants Pharmacy Staffing Bob Miller (800) 642-1652 Empire Pharmacy Consultants Michael Chen PharmD., CPh President/CEO (305) 374-1029 Office Rx Relief (800) RXRELIEF

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

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

Florida Pharmacy TodaY

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 (800) 222-1222 www.fpicn.org National Community Pharmacists Association 100 Daingerfield Road Alexandria, VA 22314 703.683.8200 703.683.3619 fax info@ncpanet.org Recovering Pharmacists Network of Florida (407) 257-6606 “Pharmacists Helping Pharmacists”