October 2016 Florida Pharmacy Journal by Florida Pharmacy Today

The Official Publication Of The Florida Pharmacy Association OCT. 2016

“I’M ALWAYS WATCHING OUT FOR MY PATIENTS, BUT WHO’S WATCHING OUT FOR ME?”

WE ARE. We are the Alliance for Patient Medication Safety (APMS), a federally listed Patient Safety Organization. Our Pharmacy Quality Commitment (PQC) program: • • • •

Helps you implement and maintain a continuous quality improvement program Offers federal protection for your patient safety data and your quality improvement work Assists with quality assurance requirements found in network contracts, Medicare Part D, and state regulations Provides tools, training and support to keep your pharmacy running efficiently and your patients safe

Call toll free (866) 365-7472 or visit www.pqc.net PQC IS BROUGHT TO YOU BY YOUR STATE PHARMACY ASSOCIATION

florida PHARMACY TODAY Departments 4 Calendar 4 Advertisers 5 President’s Viewpoint 7 Executive Insight 11 New FPA Members 21 News & Notes

VOL. 79 | NO. 10 OCTOBER 2016 THE OFFICIAL PUBLICATION OF THE FLORIDA PHARMACY ASSOCIATION

Features

9 12

Filling (and Refusing to Fill) Controlled Substance Prescriptions Under Rule 64B1627.831, Florida Administrative Code FPA Member Services and Value

28 Buyer’s Guide

16 25

Speaker of the House Delegates Report

Increasing Number of Compounding Errors Associated with Thyroid Prescriptions

OCTOBER 2016

Mission Statements:

FPA Calendar 2016-17

NOVEMBER 1

FPA Board of Directors Conference Call

Veterans Day - FPA Office Closed

FPA Board of Directors Conference Call

28-29 Clinical Conference Destin 31

24-25 Thanksgiving - FPA Office Closed DECEMBER 3-4

FPA Regulatory and Law Conference Sarasota

APhA Diabetes Certificate Program

23 - 26 Christmas Holiday FPA Office Closed 26-27 Florida Board of Pharmacy Meeting JANUARY 2

New Year Holiday FPA Office Closed (Corrected from previous journal)

Forward Your Profession Through Leadership Orlando

Last day to submit election ballots FEBRUARY

7-8

Florida Board Meeting Gainesville

Award Nominations Due MARCH

Legislative Session Begins

11-12 FPA Committee and Council Meetings Orlando 14-15 Health Fair and Legislative Days at the Capitol Tallahassee 24-27 APhA Meeting San Francisco, CA

For a complete calendar of events go to www.pharmview.com Events calendar subject to change CE CREDITS (CE cycle) The Florida Board of Pharmacy requires 10 hours’ LIVE Continuing Education as part of the required 30 hours’ general education needed every license renewal period. There is a new 2 hour CE requirement for pharmacists on the dispensing of controlled substances effective this biennial renewal period. Pharmacists should have satisfied all continuing education requirements for this biennial period by September 30, 2017 or prior to licensure renewal. Consultant pharmacists and technicians will need to renew their licenses and registrations by December 31, 2016. For Pharmacy Technician Certification Board Application, Exam Information and Study materials, please contact the FPA office. For more information on CE programs or events, please contact the Florida Pharmacy Association at (850) 222-2400 or visit our website at www.pharmview.com

of the Florida Pharmacy Today Journal

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

of the Florida Pharmacy Today Board of Directors

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

Advertisers THE HEALTH LAW FIRM............................... 18 KAHAN HEIMBERG, PLC............................... 17 PHARMACISTS MUTUAL.............................. 15 PHARMACY QUALITY COMMITMENT....... 2 EPIC..................................................................... 19

CONTACTS FPA — Michael Jackson (850) 222-2400 FSHP — Tamekia Bennett (850) 906-9333 UF — Kristin Weitzel (352) 273-5114 FAMU — Leola Cleveland (850) 599-3301 NSU — Carsten Evans (954) 262-1300 DISCLAIMER Articles in this publication are designed to provide accurate and authoritative information with respect to the subject matter covered. This information is provided with the understanding that neither Florida Pharmacy Today nor the Florida Pharmacy Association is engaged in rendering legal or other professional services through this publication. If expert assistance or legal advice is required, the services of a competent professional should be sought. The use of all medications or other pharmaceutical products should be used according to the recommendations of the manufacturers. Information provided by the maker of the product should always be consulted before use. 4 |

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

The President’s Viewpoint SCOTT TOMERLIN, FPA PRESIDENT

A Tribute to American Pharmacists Month

t is fitting, as October is American Pharmacists Month, that I reflect personally on my first experience with pharmacy. As a kid, each day I would ride the school bus. Behind the bus stop where I would get picked up in the morning and dropped off in the afternoon was a locally owned independent community pharmacy. This pharmacy wasn’t just any ordinary pharmacy; it had a full soda fountain counter with what seemed to be the most flavors of ice cream found anywhere. My favorite at the time (and it still is!) was the Superman flavor. I will always remember that pharmacy and the fond memories of going in there after school for a scoop. It was a warm, inviting connection, like one you might

experience from a friend or family member’s home. Many of you may remember your first experience in a pharmacy. Some of you might have been “cradle pharmacists,” as your family might have owned or operated their own pharmacy. I always love to hear these stories in particular, as some of my colleagues recall learning the ropes of the pharmacy business, from sweeping the floors to stocking shelves and pricing products. One thing I hear universally is being taught early on that your patients come first, and service is a priority. As times change, many other things change along the way. Certainly our profession is not the same today as it was yesterday and it will change to-

Scott Tomerlin 2016-2017 FPA President

Florida Pharmacists networking at the NCPA annual convention in New Orleans, Louisiana

OCTOBER 2016

2016-17 FPA Board of Directors The Florida Pharmacy Association gratefully acknowledges the hard work and dedication of the following members of the FPA leadership who work diligently all year long on behalf of our members.

Tim Rogers............................................................................................................Board Chair Scott Tomerlin..............................................................................................FPA President Alexander Pytlarz.................................................................................... FPA Treasurer Suzy Wise ...................................................................................................President-Elect Carol Motycka............................................................................Speaker of the House David Mackarey............................................................Vice Speaker of the House Kathy Baldwin.......................................................................................... FSHP President Jennifer Chen........................................................................................ Region 1 Director Neil Barnett............................................................................................Region 2 Director Tom Cuomo.............................................................................................Region 3 Director Linda Lazuka.........................................................................................Region 4 Director Robert Parrado...................................................................................Region 5 Director Luther Laite IV.....................................................................................Region 6 Director Paul Delisser.................................................................... Region 7 Director (Interim) Humberto Martinez..........................................................................Region 8 Director Mitchell Fingerhut.............................................................................Region 9 Director

Florida Pharmacy Today Journal Board Chair.............................................................. Carol Motycka, motycka@cop.ufl.edu Vice Chair....................................................Cristina Medina, cmmedina@cvs.com Treasurer...............................Don Bergemann, don.bergemann@verizon.net Secretary................................................................... Stuart Ulrich, stuarx@aol.com Member.............................. Rebecca Poston, Rebecca.Poston@flhealth.gov Member.................................................Patricia Nguebo, notablep@hotmail.com Member................................................................Norman Tomaka, FLRX9@aol.com Member............................................Greta Pelegrin, gretapelegrin@yahoo.com Executive Editor................Michael Jackson, mjackson@pharmview.com Managing Editor...................Dave Fiore, dave@fiorecommunications.com Journal Reviewer....................... Dr. Melissa Ruble, mruble@health.usf.edu Journal Reviewer....................................Dr. Angela Hill, ahill2@health.usf.edu

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morrow. I would argue that some things do not change along with the times, and that includes taking care of our patients. We can agree that the methods of delivery have changed, with the expanding services pharmacists are able to provide, including MTMs, immunization services and medication synchronization, just to name a few. But let’s take it even further. Let’s begin to think of the impact pharmacists can make in our communities by fully utilizing the superior training that we are all taught in pharmacy school. Imagine the implications such legislation as HR 592/SB 314 regarding Pharmacy Provider Status will hold for our profession if passed into law? The future is in the hands of us, as practitioners, student pharmacists and other interested parties. We all have our responsibility as stewards of this profession we all love. This is shared, no matter what our title may be. We are all united in our quest to advance our profession, to launch it forward. I would go so far as to say that health care professionals such as pharmacists are the “unsung heroes” in many settings, through disease prevention, detection of potentially life-threatening medication misadventures and many other outcomes-based interventions. As president of the Florida Pharmacy Association and its membership, I salute you, my fellow colleagues, for all you do in our communities to take care of our patients. Be strong and steadfast in your oath as a pharmacist and a lifetime of service to others through the profession of pharmacy. I consider myself fortunate and blessed to serve this profession. I hope you are able to say the same. n

Executive Insight BY MICHAEL JACKSON, RPH MICHAEL JACKSON, B.PHARM, EVP & CEO, FLORIDA PHARMACY ASSOCIATION

Pharmacist Services During Disaster Declarations

f you live in Florida, you know all too well that our state is in the gun sights of weather systems that migrate from the tropical areas of the Atlantic Ocean. Hurricane Andrew in 1992, with its winds peaking at 175 miles per hour, and Hurricane Katrina in 2005, with its devastating storm surge, are grim reminders of how nature can disrupt life as we know it. Just recently here in Tallahassee, we worked through the effects of a category 1 storm that left over 80 percent of this community without electricity for about a week. Hurricane Hermine left the area and within short order the community began its work to restore order. Our sincere thanks go out to those FPA members and pharmacy stakeholders who placed the health care needs of their patients as a priority. Just because you have power outages and disruption of infrastructure does not mean the provision of health care services takes a holiday. Many pharmacists found their way into local hospitals, facilities and pharmacies to help patients with their medical needs. Governor Scott declared a state of emergency for the affected counties, that the FPA communicated to our members. There are a few things that change how pharmacists can help patients in their community with such a declaration is issued. Under Florida Statutes 465.0275 pharmacists have the ability to dispense up to a 30-day supply of life sustaining medications when unable to get in touch with the prescribing practitioner. During natural or manmade disasters, communication infrastructure such as telephone service, email or fax services can be disrupted.

Existing laws allow for a pharmacist to provide up to a three-day supply when a patient’s refills have been exhausted, but during community emergencies three days is woefully inadequate. Take for example the devastation of Katrina on the city of New Orleans. There were some areas of that city that

Our sincere thanks go out to those FPA members and pharmacy stakeholders who placed the health care needs of their patients as a priority. Just because you have power outages and disruption of infrastructure does not mean the provision of health care services takes a holiday. did not get their “boil water” order lifted until a year later. While the city has for the most part fully recovered with a viable tourism industry now in place, you can still see evidence today of how that storm has changed that community. A number of its citizens left the area and evacuated to Florida. Orders were issued by Florida officials for pan-

Michael Jackson, B.Pharm

handle-area health care providers to assist patients from Louisiana through the granting of additional authority for pharmacists to assist those patients with their life-sustaining medications. Many patients received help who under normal circumstances, with the existing restrictions in the Florida Pharmacy Practice Act, would not have been able to get their maintenance medications. It was very common for those patients to have evacuated from certain areas around the Gulf Coast to not have contact with their prescribing physicians for many months at a time. My take-home message with this article is simply this. Why is it necessary for our state laws to require an executive order from its governor to allow a pharmacist to help a patient get lifesustaining drug therapy such as heart medications or blood thinner when the OCTOBER 2016 |

FPA STAFF Executive Vice President/CEO Michael Jackson (850) 222-2400, ext. 200

Director of Continuing Education Tian Merren-Owens, ext. 120 Controller Wanda Hall, ext. 211

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

FLORIDA PHARMACY TODAY BOARD Chair..................................... Carol Motycka, St. Augustine Vice Chair................................Cristina Medina, Hollywood Treasurer...................Don Bergemann, Tarpon Springs Secretary.........................Stuart Ulrich, Boynton Beach Member..............................Rebecca Poston, Tallahassee Member.............................................. Patricia Nguebo, Ocala Member................................. Norman Tomaka, Melbourne Member..............................................Greta Pelegrin, Hialeah Executive Editor.........Michael Jackson, Tallahassee Managing Editor.........................Dave Fiore, Tallahassee

This is a peer-reviewed publication. ©2016, 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.

prescriber cannot be contacted? When that authority is granted, there is no evidence that pharmacists abuse that privilege, and citizens benefit greatly from the removal of regulatory barriers and better access. Under the current plan for emergency refill services, pharmacists are granted temporary authority to provide a service that they are more than adequately trained for but then must suspend that service when the executive order expires. This can confuse patients who are not familiar with the intricacies of Florida laws and rules. It can also be disruptive to pharmacists because they have to be informed when to turn on a practice standard and then turn it off at some time in the future. It seems to make sense to us that the provision of at least a 30-day supply of life-sustaining medications should be a standard procedure for pharmacists and not just something granted when a governor declares an emergency.

After all, emergencies come in many forms. Just because there is no natural or manmade disaster in a particular community does not mean that a patient has not experienced a personal disaster beyond their control. During the 2016 legislative session there was recognition by the Florida House and Senate that installed a minor tweak to 465.0275. Added to the existing authority was a provision that allows a pharmacist to provide one vial of insulin to treat a patient with diabetes mellitus when the prescriber cannot be contacted. That fixes one problem, but what about patients needing rescue inhalers for asthmatic episodes or a patient who is being treated for seizures? What happens to them when the prescriber does not respond within the allotted 72 hours? Perhaps this is something the Legislature should revisit again in 2017. n

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Florida Pharmacy Association

Filling (and Refusing to Fill) Controlled Substance Prescriptions Under Rule 64B16-27.831, Florida Administrative Code By T.J. Morton, Office of FPA General Counsel, Lockwood Law Firm, Tallahassee, Florida

On Dec. 24, 2015, the Florida Board of Pharmacy revised its standards of practice for filling and refusing to fill controlled substance prescriptions by issuing its newest version of rule 64B1627.831, Florida Administrative Code. This rule, titled “Standards of Practice for the Filing of Controlled Substance Prescriptions; Electronic Prescribing; Mandatory Continuing Education,” represents the Board’s current stance on filling controlled substance prescriptions and is markedly different from the prior version of rule 64B16-27.831. This article will examine the key changes in the rule as it relates to refusing to fill a prescription for a controlled substance and address issues relating to when and how a pharmacist can refuse to fill a prescription for a controlled substance. The most notable change in rule 64B16-27.831 is the overall tone of the rule. The old rule began by warning that “the pharmacist knowingly filling [a prescription not issued for a legitimate medical purpose] shall be subject to penalties for violations of the law.” Compare that to the new rule, which provides, “Pharmacists should not fear disciplinary action from the Board or other regulatory or enforcement agencies for dispensing controlled substances for a legitimate medical purpose in the usual course of professional practice.” While this change has no effect on the substantive law, it signifies a marked change in the Board’s policy on filling controlled substance prescriptions from one founded on skepticism to one founded on trust. The rule also contains several significant substantive changes. The old rule contained criteria that, if present, required the pharmacist to question the legitimacy of the prescription. In essence, the rule replaced the

pharmacist’s independent professional judgment regarding the validity of a prescription with a mandate from the Board that required the pharmacist to question all prescriptions that met any of the rule’s criteria. The rule then laid out steps the pharmacist had to take in validating the prescription. Once again, the rule substituted bright-line requirements in place of allowing the pharmacist to exercise his or her professional judgment. The warnings and rigid validation requirements in the old rule suggested that controlled substance prescriptions should be presumed to be invalid until established otherwise. This made it difficult for some patients to fill valid pre-

scriptions for controlled substances. In recognizing these issues, the Board has eliminated the purported presumption of illegitimacy that permeated the old rule. As to the validation of prescriptions, the new rule provides, “Each prescription may require a different validation process and no singular process can fit each situation that may be presented to the pharmacist.” The rule goes on to state that “when a pharmacist is presented with a prescription for a controlled substance, the pharmacist shall attempt to determine the validity of the prescription and shall attempt to resolve any concerns about the validity of the prescription by exercising his or her independent professional judgment.” OCTOBER 2016

In addition to changing the standards for filling controlled substance prescriptions, the new rule now includes minimum standards a pharmacist must follow before refusing to fill a controlled substance prescription based solely upon a concern with the validity of the prescription. The new rule provides that, prior to refusing to fill a prescription, a pharmacist who has a concern about the validity of a controlled substance prescription must initiate communication with the patient and the prescriber to obtain information relevant to the pharmacist’s concern. In lieu of either communicating with the patient or the prescriber, but not both, the rule authorizes the pharmacist to access the Prescription Drug Monitoring Program’s (“PDMP”) database to acquire information relevant to the pharmacist’s concern. The rule further provides that, should the pharmacist be unable to communicate with the patient due to the patient’s refusal to cooperate, the pharmacist is not required to comply with the requirements of the rule. A pharmacist who is concerned with the validity of a controlled substance prescription cannot refuse to fill the prescription without first undertaking these steps. This is a significant change from the old rule and suggests a new focus on ensuring that patients receive the controlled substance medication they need. A pharmacist who is concerned with the validity of a controlled substance prescription and simply refuses to fill the prescription without following the minimum standards in the rule will have committed a violation of the rule and could be subject to disciplinary action from the Board. This means that a pharmacist who refuses to fill a controlled substance prescription should ensure that he or she complies with the minimum standards in the rule and, just as importantly, documents compliance with the rule. Documentation is vital because, in the event a pharmacist receives a complaint alleging that he or she failed to comply with the minimum requirements in the rule, the documentation will substantiate the pharmacist’s compliance with the rule and, in cases where the pharmacist does not 10

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recall the details of the interaction, may refresh the pharmacist’s memory as to what occurred on the date in question. The Board has not adopted a rule detailing what information, if any, must be recorded when refusing to fill a controlled substance prescription. However, the Board has adopted a rule setting forth the general requirements for patient records. Rule 64B-27.800(1), Florida Administrative Code, provides that pharmacies must create a patient record for each patient to whom medications are dispensed. The rule goes on to state what information must be maintained in the patient record, including general information about the patient and records of drugs dispensed to the patient. The rule does not require the pharmacist to document prescriptions not filled by the pharmacy or the pharmacists reasoning for not filling a prescription. Although the rule does not require the pharmacist to document this information, that does not mean it should not be done or is not the prevailing professional standard. The absence of any guidance from the Board on this issue leaves it up to the pharmacist’s professional judgment as to what information should be documented and where the information should be documented. The Board of Medicine’s rule 64B8-9.003, Florida Administrative Code, regarding the standards for adequacy of medical records, while not binding on pharmacists, is instructive as to what information should be recorded. That rule explains that medical records serve several purposes, including providing documentary evidence for the course of treatment, documenting communication between health care professionals and assisting in protecting the legal interests of the patient and health care professionals. In an effort to achieve these purposes, the rule requires that physician medical records contain sufficient detail to clearly demonstrate why the course of treatment was undertaken and that all entries made in a patient’s medical record be accurately dated and timed. Utilizing the Board of Medicine’s rule as guidance, a pharmacist who refuses to fill a controlled substance prescription should, at a minimum, document

the pharmacist’s concern with the validity of the controlled substance prescription, who the pharmacist talked to or attempted to talk to, the substance of the conversation, any relevant information relating to the pharmacist’s review of the PDMP database and any other steps the pharmacist took to attempt to validate the prescription. Each entry in the record should be timed and dated. Generally, this information will be sufficient to clearly demonstrate that the pharmacist complied with rule 64B1627.831, Florida Administrative Code, in refusing to fill a controlled substance prescription. Furthermore, this information will assist in protecting the pharmacist’s legal interests should the patient file a complaint against the pharmacist. This information should be documented in the patient record required by rule 64B16-27.800, Florida Administrative Code. If the individual is not an established patient of the pharmacy, a new patient record should be created even if the patient is not dispensed any medication. This will allow the pharmacy to maintain a historical record of its interactions with the patient. This historical record will contain important information that will assist the pharmacist in the event the individual returns as a patient in the future. The Board’s recent revision of rule 64B16-27.831 marks an important shift in the state’s policy towards controlled substance prescriptions and provides pharmacists with greater discretion when reviewing these prescriptions. While the standards have changed, pharmacists should ensure the legitimacy of these prescriptions and should rely on their training, experience, and judgment when reviewing these prescriptions. Finally, pharmacists should be well-versed in the Board’s new requirements before refusing to fill a controlled substance prescription based on concerns regarding the validity of the prescription and should ensure they document compliance with the rule requirements each time they refuse to fill a controlled substance prescription. T.J. Morton is an attorney with the Lockwood Law Firm in Tallahassee.

Welcome, New FPA Members The Florida Pharmacy Association would like to recognize the following members who joined the association between May 2016 and October 2016. Mariam Abaza Rua Abdelrahman Maroua Abouelhouda Teryn Acquaviva Adrrly Addison Aneal Ahmed Riham Aiad Anllel Alfonso Jayne Almodovar Bria Almonor Allen Anthony Iffat Anwar Sephora Aploan Samuel Assani Margarita Avellaneda Jeanette Baez Alyssa Barber Erin Barnard Don Baron Junelyn Bautista Hien Belkola Ariel Bell Anthony Benton Sheree Bett Robert Bicigo Najah Bilal Anna Blood Dorcas Boakye Herb Bobo John Bontros Dina Botros Deb Botta Monica Brady Treasure Bright Ava Brill Karen Brito Kathy Bruce Michelle Bunnage Bailey Burch Julie Burger Joannes Burgos Jamie Burnett Nino Buzzell Sandra Caballero Josefina Cabrera Maria Cagesso Erwin Callier Kathy Callier Timothy Cardile Catherine Carnivale Andrew Carothers Krystle Carrington Mimi Casci Juan Castellanos Wendy Cavanaugh Celestine

Chandler Ashley Chess Elizabeth Chiodo Adam Christian Nestle Ciftci Diana Cifuentes Kirste Steven Cindrio Michelle Claman Lauren Clark Virginia Cleaver Christopher Cobb Barbara Coleman Athena Colon Paul Conover Anthony Contento Sean Corgan Rosa Correa Jorge Correa Jr Amber Cox Richard Sprys Cph Casey Craig Manuel Crespo John Cunningham LaToya Cuyler Meseret Dabi Wanda A. Dagher Randy Dauzat Dakary Davis Arelys Del Pino Sagine Delva Heidi Deodath Jared Dickerson Edward Dillon Amy Dimauro Mbaye Diop Nicole Dixon Hanh (Sophia) Do Betsy Dodd Andrew Drnjevich Jason Duarte Chirag Dubal Lance Dugger Ryan Dunn Joann Dutt Nicole Dziewiatkowski Victor Edet Evna Eliacin Torri Elie Peter Enos Kedla Erysthee Saloumeh Esmaeili Ediverto Fagundo Larryn Farris Dave Fascia Bensley Faustin Stephanie Felton Solomon Ferguson

Daniela Fernandez Lydia Fernandez Anita Forrest Serge Francois Michele Frankenberg Amber Franklin Chelsea Frankoski Maria Franqui Garcia Crystal Fuco Allison Fuentes Kyra Fulcher Chante Fuller Marlon Fuller Katie Gainous Odisa Gamez Omjoy Ganesh Yoslayda Garcia Wellington Garcia Andreina Garcia Devon Ghee Alvin Gichinga Jessie Gil Samantha Gilchrist Sarah Gobrial Austin Golia Yoanna Gonzalez Suarez Albert Goodin Jamicia Gordon Wadell Gordon Megan Graham Cassandra Granberry Blake Grogan Jody Grossman Jessica Guerra Mariko Guest Betty Gunter Eduardo Gutzan Janae Guy Shauna Hair Keri Hames Terryann Harry Ashley Harvey Tracy Harvey Vincent Harville Alex Hatzileris Kristen Hay Katie Head Mario Hernandez Lisa Heslin Hunter Hill Charles Hines Prince Hinson John Hirschman Megan Holbrook Genarar Holladay

Honey Hong Amanda Hopkins Shari Hopwood Kathleen HrivnakMorello Miguel Huertas Julie Huyett Doreen Inman Amani Jadallah Sydney Jenners Porschia Jordan Ariel Jordan Lukose Joseph Flassorvia Joseph Briana Journee Joseph Jucha Michael Kamel Vujwala Kasaola Shelly Kearns Shawntia Kelly Negin Kenari Kiran Khan Leigh Kobelin Sandra Koerner Martin Kol Katlin Krakowiak Chris Kulak Natasha Kulkarni Serenna Lammers Maria-Elena Lauro Elkoda Lazarre Nhubg Le Emily Le Anh Le Mark Ledesma Seon Lee Joshua Lee Katherine Lewis Josefina llanos Jennie Long Willeta Luckett Sullivan Lynch Hani Malak Richard Malsom Ereka Manangan Neil Maniquis Paul Margolies Anna Martin Yanet Martinez Horta Kriscia Masey Mark Mason Danette Mason Grace Mathai Joanna Matheney Suzanne McCormick Christopher McCoy Victoria McCraw

Jason McDaniel Isaac McGee I Emily Medina Randall Mehlhop Paul Meola Veronica Mercado Briet Mier Armando Mieres Maria Minero Teala Mingoia Kenny Mitton Joseph Moarefi Erin Mohn Michael Montejo Terese Morgan Candace Morgan Danielle Morgan Gail Mulhearn Katherine Murphy Chetan Nager Negar Nasin Mark Nazareno Edouard Nerette Edwin Nerette Helen Nguyen Neda Nguyen Vivian Nguyen Arjun Nigam Youjian Nistorenko Denise NixonMarcelle Alice Nkembo Marie Noll Nick Novelli Felix Obasuyi Katia Ochoa Tomiwa Odnwole Uzo Amaka Oduh Rafael Olavarria Rodriguez Nicole Olympio Marlon Onias Julie Orellana Claudia Orozco Amoarah Ortiz Carlos Ortiz Nana Osei-Poku Lauren Owsinski Elizabeth Oyetoro Nicholas Palia Dahlia Palmer Melinda Palomino Maria de Lourdes Paredes Oliver Kaetlyn Parker Jennifer Parmar Jaydeep Patel Rajesh Patel Loretta Pechatsko Marco Perez

Glenda Perez Carlos Perez David Perez Christopher Perseo Cecilia Phan Veronica Phetprasith Janice Pickstock Kyra Pierre Manuel Pita Paige Price Donna Quach Khurrum Qureshi Meena Ragheb Waffa Rassam Dale Reynolds Thomas Richards Ariel Richardson Leticia Rivera John Rivera Mohamed Rizk Alexis Rodriguez Maria Rodriguez Azalia Rodriguez Willa Rogers Michael Rosenblatt Jared Roth Jenny Ruffin Jerzie Ruiz Keyshla Ruiz Kathleen Rull Elena Ryazhapova William Saelinger Paul Saia Frantz Saintilien Iyandris Salazar Alyssa Sanford Sayeh Sayar Jamey Schreck Brittany Schulte Robert Schwartzman Mary Scroggs Widnelia Seguinot Katelyn Shatz Annie Shields Boryana Simeonova Damian Sinclair Andrea Sinclair Lindsey Sinnett Keyosha Smart Jessica Smith Danilo Solis Gary Souders Joanne Sparcino Lisa Spence Anthony Spinelli Steffi Stephen

Nicole Stinner Sarah Strobel Nathawan Sudbanthad Charles Sultzman Frances Surles Nicole Tadros Mirza Tajic Lizette Taveras Jessica Taylor Alvaro Tejedor Donald Thibodeau Page Thomas Anjitha Thomas Samantha Thompson Julie Thurman Drew Timmons Winston Tinubu Andy Torres Amanda Traina Phuong Tran Michelle Tran Amanda Trifilla Mariela Tuero Orly Tyrkala Elona Unger Dela Vargas Yadira Velazquez Melissa Veulens Julie Voelschow Zhengying Wang Yvonne Weldon Danielle Wheeler Michael Whitaker Constance White McKay Whiting John Williams Cale Williams Janelle Wilson Jean Witter Judy Wood Naâ&#x20AC;&#x2122;Aysha Wood Katelyn Woodbury Jarah Yates Juliet Young Haleigh Young Sally Zakhari Jennifer Zambrano Angela Zarling Raymond Zelhof Zachary Ziner Jeffrey Zymblosky

OCTOBER 2016 |

The Real Value of FPA Membership Value Statement for Our Nonmember Stakeholders The FPA is the go-to source for current, reliable information on the legal and regulatory issues that affect YOU in your professional practice. We provide you with valuable educational tools and networking opportunities. We are your voice in protecting your profession at the state and national levels. JOIN TODAY and be a part of that voice.

THERE ARE MANY WHO VALUE OUR INFORMATION SERVICES AND OUR ADVOCACY; THERE ARE OTHERS WHO ARE LOOKING FOR SOMETHING DIFFERENT, UNIQUE AND NEW. The Florida Pharmacy Association is constantly working to maintain the support of the members and demonstrate to our other colleagues the advantages to being a part of the association team. This includes finding ways to create a diverse FPA experience. There are many who value our information services and our advocacy; there are others who are looking for something different, unique and new. Let’s open the FPA package and see what’s inside. Information Services This is the flagship benefit provided by your organization and is the most popular of our many programs and offerings. Information flows through the 12

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FPA publishing machine through various tools. This includes Florida Pharmacy Today, which has a board of directors working to ensure that you receive monthly updates on emerging issues related to the practice and business of pharmacy as well as important events of our member stakeholders. This is also an opportunity for our members to write articles that the Journal may consider for publication. We also have an electronic newsletter titled “Stat News” that informs members through email messaging of timely and relevant changes in the pharmacy landscape. The FPA website, www.pharmview.com, is teeming with information and practice tools including (but not

limited to) a section of pharmacy laws and rules, links to national and state governmental entities that regulate the profession of pharmacy, upcoming FPA educational programs and published newsletters and press releases. There is even a tool that launches fast-breaking news for members who set their emailenabled smart phones and devices to receive up-to-the-minute information. That tool is located on the FPA home page labeled “FPA Breaking News.” Social Media The use of social media has taken center stage in looking at what is going on in the pharmacy universe. It is probably a safe presumption that the majority of our members have, at some point in time, connected with Facebook or Twitter. The Florida Pharmacy Association has active accounts on both of those networks, and you are invited to visit with us in both of those areas. We also have Pharmacist Nation TV Network, a new tool launched last year. FPA member stakeholders in Florida now have their own television network with programming for pharmacists and the pharmacy profession all the time. We have included in that online TV network 15 specialty channels to meet the needs of all of our members. This includes everything from the stu-

FOR A SMALL FEE THAT CAN ONLY BE PAID BY OUR MEMBERS, YOU GAIN ACCESS TO THOUSANDS OF DISCOUNTS FROM A WIDE VARIETY OF COMPANIES SUCH AS MOVIE THEATERS, CELLULAR SERVICES, RESORTS, ATTRACTIONS, RESTAURANTS AND DEPARTMENT STORES. dent channel to the advanced practice channel. Members can use this tool to demonstrate the value of their services and to message their patients. Member Rewards You asked, and we got it for you. This a member service and value that returns your membership benefit and then some. For a small fee that can only be paid by our members, you gain access to thousands of discounts from a wide variety of companies such as movie theaters, cellular services, resorts, attractions, restaurants and department stores. These are places that you go to all the time, and with the use of your member rewards benefits, your savings will more than cover the dues you pay to the FPA. Remember that you must have an active membership in the FPA to take advantage of this benefit, and you must enroll as a Member Rewards beneficiary. When you sign into

your FPA member profile on pharmview.com, you will see an invitation to join the Member Rewards program at the top of your profile page. Select that to see a small sample of what is available. Continuing Education The Florida Pharmacy Association is one of Florida’s largest providers of continuing education for both pharmacists and technicians in all practice settings. The FPA is registered as a Florida Department of Health-approved continuing education provider and reports directly to CEBroker on behalf of those who complete our continuing education offerings. The FPA also has full accreditation through the Accreditation Council on Pharmacy Education and reports to the national database, CPE Monitor. In addition, you will have access to all of your continuing education records that you get from the FPA pub-

FPA Membership Cost: $195 (less employer contributions) What you get (direct benefits) What you get (indirect benefits) ■■ ■■ ■■ ■■ ■■ ■■ ■■ ■■ ■■ ■■ ■■ ■■

Subscription to Florida Pharmacy Today Free electronic newsletter via Stat News Access to members-only section of pharmview.com Free access to laws and rules Discount on car rentals Discount on hotel stays Discount on continuing education fees Discount on FPA publications General assistance with regulatory issues #1 Club Benefits Member Rewards Program Estimated value: $725

■■ ■■ ■■ ■■ ■■ ■■ ■■ ■■ ■■ ■■

Representation before Board of Pharmacy Representation before Florida Legislature Representation before AHCA Representation before the media Representation before National Pharmacy Societies and Associations Support for pharmacy education Support for demonstration projects Support for Recovering Pharmacists Network Support for Florida Pharmacist Political Committee (FPPC) Developing coalitions with other health care organizations

OCTOBER 2016

lished in your member profile on pharmview.com. The association, through a review committee of the Educational Affairs Council and a dedicated staff, works to bring to you the best in unbiased and relevant continuing education programs with a focus on helping our industry to navigate rough seas and expand services. The continuing education offerings are available at a greatly reduced cost for active FPA members. Member Connectivity Sometimes there is interest in members networking with other members. Believe it or not, there is a tool on pharmview.com that will facilitate that kind of interaction. This can have value, particularly if you are looking for an FPA member who is a graduate from the same pharmacy school, and you can

of incoming FPA presidents. Supporters are needed to help raise funds for the FPA’s political committee. Donations are needed for the Florida Pharmacy Foundation so that they can support the mission of helping students. If you have a leadership skill (or would like to develop one), the FPA has a long history of building health care industry titans. FPA Member Partners The association has a long list of relationship partners that can provide an array of services not available directly through the FPA. This includes insurance products such as professional and business liability through Pharmacists Mutual Insurance Company. Pharmacists Mutual is also a supporter of the FPA’s Distinguished Young Pharmacist Award. Our technician members have

DOES YOUR PHARMACY NEED A CONTINUOUS QUALITY IMPROVEMENT PROGRAM SOLUTION? THE FPA HAS PARTNERED WITH THE ALLIANCE FOR PATIENT MEDICATION SAFETY AND PHARMACY QUALITY COMMITMENT TO BRING OUR MEMBERS A SOLUTION TO MEDICATION ERRORS. use the advanced search features in our database to make your connection. After you sign into your profile, select the “Message” link and then select the “Message a Member” option. You will see a “Basic Search” tab and also an “Advanced Search” tab. With the advanced search option, you will be able to find FPA members who included in their member profile that they attended the same school you did.

a host of services, including certification through the FPA partner Pharmacy Technician Certification Board and training through our relationship with Passassured, which is providing the web-based portion of technician training utilized by pharmacies. We are also partnering with an agency that can assist with cost-effective loans for members who qualify. Watch future FPA messaging for more information.

Member Involvement The FPA has a unique problem in that we do not run out of opportunities for member involvement. We have more things that need to be done than people available in a volunteer pool. We need authors to write articles for our journal. We need candidates to step up and serve in an FPA office. Advocates are needed to storm the Florida Capitol on legislative day. Committee members are needed to serve on the leadership team

Pharmacy Resources Does your pharmacy need a continuous quality improvement program solution? The FPA has partnered with the Alliance for Patient Medication Safety and Pharmacy Quality Commitment to bring our members a solution to medication errors. Pharmacy Quality Commitment (PQC) is a continuous quality improvement program that helps you comply with quality assurance requirements found in network contracts,

FLORIDA PHARMACY TODAY

Medicare Part D and Florida regulations. The Alliance for Patient Medication Safety (APMS) is a federally listed Patient Safety Organization (PSO). Together, these tools can be used to share and study information about trends and best practices associated with dispensing errors and other medications errors with absolute confidentiality and insulation from discovery. The FPA also has included in the online store a host of other products, including (but not limited to) pharmacy signs, technician training manuals and workbooks, controlled substance inventory books and fraud waste and abuse compliance manuals. Nearly everything in our inventory is available at a reduced cost to FPA members. #1 Club Benefits Members may not be aware that they have access to our popular #1 Club member recruitment program. Those of you who are reading this article are supporting members, but how about your colleagues who are not on the “information superhighway”? The prestigious #1 Club, established in 1985, recognizes those members who demonstrate extraordinary commitment to increasing membership in the FPA. You are challenged to become one of the select few who achieve #1 Club membership. All you have to do is recruit 10 active regular members in the FPA and participate in one retention program. For your efforts, we will place on your shoulders a new blazer with the special #1 Club emblem, provide you with a plaque, and induct you into the #1 Club at the annual meeting. We will also cover the cost of your convention registration fee valued at $320. That more than covers your $195 membership dues.

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OCTOBER 2016

Speaker of the House Delegates Report Presented to the House of Delegates Greetings, Members of the Florida Pharmacy Association. Each year, organizations entitled to representation in the FPA House of Delegates send members to meet together to review and debate policy and advocacy statements for consideration as official FPA positions. This year marked Carol Motycka the 126th Annual Meeting, which took place at the Marriott Harbor Beach Resort in Ft. Lauderdale. We had 13 resolutions that were presented to the House of Delegates for consideration. Out of those resolutions, eight resolutions were adopted, with two of them passing without any objection. One resolution was referred for further review, one was withdrawn by the sponsor and three were not adopted. There were also four proposed bylaw changes for the House to consider. We also had one resolution submitted after the deadline; however, it was not introduced by the sponsor. In this report are the details of how each resolution and bylaw change was handled, including which FPA Committee or Council will review and take the appropriate action moving forward. The House also approved the updated policy manual that included adopted resolutions from the previous year. Congratulations to the winners of the FPAâ&#x20AC;&#x2122;s unit association recognition awards. Alachua County Pharmacy Association won the Association Involvement, Legislative Involvement, and Public Relations awards. Palm Beach County Pharmacy Association was recognized for winning the Community Service and Membership awards and the Duval County Pharmacy Association won the CE award. My spring report will provide an update on the 2016 resolutions, with a final report providing the outcome of each resolution to be submitted to the House of Delegates within three years as defined by association policy. I want to encourage you as individual pharmacists, and as local unit associations, to get more involved in the policy and advocacy process by submitting a resolution for our 2017 convention in Orlando. This is an opportunity for you to not only have input on how the Florida Pharmacy Association responds to issues, but also to help shape the future of our practice. The number of resolutions provided was an increase from last year and I am excited to see the growing interest in the pro-

FLORIDA PHARMACY TODAY

cess. We need to continue to work together to stimulate ideas that are ultimately patient-focused. I feel that unit associations are key here in helping make this happen. I challenge each reader to begin discussing this now in your unit association, well in advance of our next session, because it will be here before we know it! Please note that at least one of the resolution sponsors must be present at the House of Delegates session to introduce their resolution. The deadline for submission of resolutions is Friday, May 19, 2017. Additionally, if you need assistance with how to draft a resolution, please reach out to us via the FPA Office. A resolution form is included in this issue of Florida Pharmacy Today. The deadline for submission of new business items is June 16, 2017. I would like to introduce the 2016-2017 FPA House of Delegates Board of Directors: Chairman of the House Board of Directors.................. Jackie Donovan Vice Speaker..............................................David MacKarey Director.................................................. Matthew Schneller Director................................................................ David Pino Director.............................................................. Eric Alvarez Parliamentarian....................................... Michael A. MonĂŠ FPA President Elect and Ex Officio Member........................................Suzy Wise Secretary of the House............................. Michael Jackson Please begin considering members for nomination for the 2017-2018 Vice Speaker and Director positions. The responsibility of developing new leaders within our association lies with all of us. Recent graduates should be considered as we seek to further develop and grow the leaders in our profession. Future candidates should submit their intention to run for either of these positions by Friday, May 19, 2017. Lastly, Jackie Donovan appointed a committee to examine ways in which we can be more efficient during future House of Delegates sessions. This committee served our House well and provided some effective streamlining to improve the function of the House. Thank you for allowing me to serve as your 20162017 House of Delegates Speaker. Best wishes as we approach the upcoming holiday season. Warm regards, Carol Motycka

2016 ACTION ON FPA RESOLUTIONS 2016-1 Consultant Pharmacist Reviews Contact: Joseph Koptowsky, Docjik1215@aol.com Be it resolved, that the Florida Pharmacy Association pursue and support legislation that would require consultant pharmacist services at Adult Congregate Living Facilities; Urgent Care Centers; Endoscopy Centers; walk in clinics, urgent diagnostic care and treatment facilities as well as medical centers for plastic surgery, gastrointestinal care or any other facility developed for the delivery of health care that is staffed by physicians and/or other licensed or unlicensed practitioners where prescription drugs are stored, used and/or administered. ACTION ON RESOLUTION:

Resolution adopted This resolution was referred to the Governmental Affairs Committee who has placed this item on the legislative agenda as an item to monitor for opportunities that may present themselves. The Board of Directors has approved this policy statement. 2016-2 Increase in Regional Representatives Contact: Dean Pedalino daprx1@gmail.com and Thomas Cuomo tcrx0720@hotmail.com Be it resolved, be it resolved that the Pinellas County Pharmacy Association makes a motion that the number of regional representatives be increased to 18 and the this increase be done in 90 days. ACTION ON RESOLUTION:

Resolution not adopted

2016-3 Equality of Pharmacists Contact: Thomas Cuomo tcrx0720@hotmail.com Be it resolved, that the FPA or subdivisions of the FPA shall not support any discriminatory proposal due to a Florida Registered Pharmacist pharmacy school degree to say that all pharmacists are not all equal. ACTION ON RESOLUTION:

Resolution adopted This resolution was presented as an agenda item for the FPA Governmental Affairs Committee and will be monitored. The Board of Directors has approved this policy statement. 2016-4 Cost Analysis of Resolutions Contact: Elvis Kirsic elvischiresi16@yahoo.com Be it resolved, that the FPA or subdivisions of the FPA conduct a cost analysis for each and every resolution that passes the House of Delegates and be it disclosed to the members of FPA so if needed in the future, funds can be raised for the legislative process to cover the cost of lobbying and promoting the resolution. ACTION ON RESOLUTION:

Resolution not adopted

2016-5 Notice to members of the cost of passing a resolution Contact: Elvis Kirsic elvischiresi16@yahoo.com Be it resolved, that the FPA or subdivision of the FPA disclose the amount needed to act on each resolution and be it disclosed to all members within 60 days of passing so if needed the money can be raised by the interested members of the FPA for the legislative process. It also be resolved that FPA sets up restrictive accounts for each resolution so the donors can make sure that the money they are donating for a particular resolution is being used towards lobbying and administration for the propagation and progression of that specific resolution pertaining to their field of practice. ACTION ON RESOLUTION:

Withdrawn by sponsor

2016-6 PBM Enrollment (SUBSTITUTE RESOLUTION) Contact: Kaitav Shah ks1869@nova.edu Be it resolved, that the FPA seek legislation and/or regulation to make the process for a pharmacy to enroll in a health plan, through the PBM, uniform and more time sensitive/efficient. ACTION ON RESOLUTION:

Resolution adopted Resolution has been presented to the FPA Governmental Affairs Committee who has included its concepts in the overall advocacy of PBM transparency and regulations. This has been placed on the advocacy plan as a high priority and has been approved by the FPA Board of Directors.

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OCTOBER 2016

2016-7 Florida Pharmacists Dispense Oral Contraceptives Pills without Prescription Contact: David “Chachi” Mackarey; Palm Beach County Pharmacy Association Be it resolved, that the FPA supports Florida licensed Pharmacists to initiate hormone-based oral contraceptive medications. ACTION ON RESOLUTION:

Resolution adopted This resolution has been referred to the FPA Governmental Affairs Committee and recommended to the Board of Directors as an item to move forward if there is an opportunity to support filed legislation. The Board of Directors has approved the resolution. An article on this issue has been published in the September 2016 issue of Florida Pharmacy Today. 2016-8 Mandatory Half-Hour Break for Florida Pharmacists Contact: David “Chachi” Mackarey; Palm Beach County Pharmacy Association Be it resolved, that the FPA support legislation that gives authority for the Florida Board of Pharmacy to mandate all Florida licensed Pharmacists to take a minimum of a half-hour break if working longer than an 8 hour shift in any one day. ACTION ON RESOLUTION:

Resolution not adopted

2016-9 Transferring Prescriptions with Patient Consent Contact: David “Chachi” Mackarey; Palm Beach County Pharmacy Association Be it resolved, that the FPA support a requirement for patient’s informed consent and approval, either verbal or written, directly or indirectly or by a caregiver or guardian agreeing to the prescription transfer request before the transfer can legally be completed. ACTION ON RESOLUTION:

Motion to refer to the Professional Affairs Council adopted This resolution has been given to the Professional Affairs Council who will be charged with evaluating the policy intent and report back to the House during the 2017 FPA annual meeting. Two articles on this issue from pharmacists both “for” and “against” have been published in the September 2016 issue of Florida Pharmacy Today. 2016-10 Items of New Business Resolution Contact: Kathy Petsos, kpetsos@earthlink.net Be it resolved, an Item of New Business is a resolution submitted after the original call for resolutions which is 60 days prior to the scheduled date of the House of Delegates of the Annual Florida Pharmacy Association Conference, and Also be it resolved, that Items of New Business must be submitted to the Florida Pharmacy Association office at least 30 days prior to the scheduled date of the House of Delegates of the Annual Florida Pharmacy Association Conference. ACTION ON RESOLUTION:

Resolution adopted This resolution has been approved by the FPA Board of Directors and implemented as a policy statement.

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FLORIDA PHARMACY TODAY

2016-11 MAC Transparency Law Enforcement Contact: S. Mark Hobbs, hobbsrx@msn.com Be it resolved, that the FPA seek enforcement of FS 465.1862, which requires timely updating of MAC pricing, through the appropriate regulatory and/or legislative activity. ACTION ON RESOLUTION:

Resolution Adopted with no objection This resolution has been reviewed by the Governmental Affairs Council and recommended as a priority action item for the 2016-2017 legislative action plan. The resolution and legislative action plan has been approved by the FPA Board of Directors. 2016-12 PBM Transparency Contact: Kaitav Shah ks1869@nova.edu, NSU COP Student and Nicole Olympio no176@nova.edu, NSU COP Student Be it resolved, that the FPA seek and or develop legislation and/or regulation that bring PBMs under the joint jurisdiction of the Florida Board of Pharmacy and the Florida Insurance Commissioner for purposes of regulating and monitoring compliance with existing legislation. ACTION ON RESOLUTION:

Resolution Adopted with no objection This resolution has been reviewed by the FPA Governmen-

tal Affairs Committee and included as part of the overall regulation of pharmacy benefit managers. This resolution was approved by the FPA Board of Directors. The Board also approved the legislative action plan. 2016-13 Implementation of an Objective Structured Clinical Examination (OSCE) (SUBSTITUTE RESOLUTION) Contact: Anna Marsakova (anna.marsakova@rx.lecom.edu), LECOM SOP Student Be it resolved, that FPA declare support of the OSCE model, and encourage Florida Colleges of Pharmacy to adopt it as the better method of examination within their curriculum. ACTION ON RESOLUTION: Substitute Resolution Adopted This resolution was presented to the FPA Board of Directors who have approved it as a policy statement.

RESOLUTION SUBMITTED AFTER THE DEADLINE AND CONSIDERED AS NEW BUSINESS

out of pharmacy school and 75 percent the price for Regular Members the second year out of pharmacy school. The new bylaws state that membership rates will be 50 percent the rate for new members the first year out of pharmacy school and the Regular Members rate the second year out of school. Article V, Section 2 would have changed the potential number of delegates a Unit Association may send to the House of Delegates. Currently, each Unit Association was entitled to 2 delegates plus 1 additional delegate for each 50 members. New wording would have been added to state “in addition, for every 10 FPA members, each unit will be entitled to 1 additional delegate.” The proposed bylaw did not pass. Article XIII had a proposed title change with the addition of term limits being added to Section 4 as a proposed change. If passed, no member of the Board of Directors would be eligible to serve more than 7 consecutive years and would need to remain off at least 2 consecutive years to be able to return to the Board of Directors. The proposed bylaw did not pass.

2016-14 Pharmacy Technician Representation on the Florida Board of Pharmacy Contact: William Garst, wgarst1025@cox.net Be it resolved, that the FPA or a subdivision thereof support the inclusion of a Florida Registered Technician on the Florida Board of Pharmacy. ACTION ON RESOLUTION:

Not introduced by the sponsor

CHANGES TO THE FPA BYLAWS APPROVED BY THE HOUSE OF DELEGATES During the House of Delegates meeting in Ft. Lauderdale this summer, four sections of the FPA bylaws had proposed changes. There were proposed changes to Article III, Section 2 (D); Article III, Section 2 (G); Article V, Section 2; and Article XIII, Title and Section 4. Two proposed changes were adopted by the House of Delegates and two failed. A proposal to Article III, Section 2 (D), to change the wording regarding dues amounts to be more encompassing was proposed. Previously, the wording in D spelled out students to be Undergraduate Students and Full-Time Graduate students. By changing the wording to “student members,” this will allow a broader range for the definition in this section. Article III, Section 2 (G) bylaw proposal was also adopted and resulted in changing the rates for new practitioners following graduation. Previously, the bylaws stated that dues would be half the price for Regular Members the first year OCTOBER 2016

CALL FOR RESOLUTIONS TO THE 2017 HOUSE OF DELEGATES The House of Delegates Board of Directors will meet in May 2017 to review and approve resolutions for the Annual Meeting. The deadline for submitting resolutions is May 19, 2017! PLEASE NOTE THIS DEADLINE. The last day to submit items of new business is June 16, 2017. The following information will be needed when submitting resolutions: 1. Name of organization: The name of the organization submitting the resolutions(s); 2. Name and telephone number of individuals: A contact in the event clarification or further information is needed; 3. Problem: A statement of the problem addressed by the resolution; 4. Intent: A statement of what passage of the resolution will accomplish; 5. Resolution Format: Please type and use double spacing. TITLE OF RESOLUTION NAME OF ORGANIZATION WHEREAS , AND

WHEREAS :

THEREFORE BE IT RESOLVED (THAT THE FPA OR SUBDIVISION OF FPA)

CONTACT NAME AND PHONE #: PROBLEM: INTENT:

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

FLORIDA PHARMACY TODAY

FPA News & Notes Florida Board of Pharmacy Rules Under Revision The Florida Board of Pharmacy recently ordered the review and possible revision of several existing rules as well as some standard Board applications. Some of the rule changes were based upon comments from the Joint Administrative Procedures Council charged with the evaluation of state agency rules to make sure that they are compliant with state laws. The following are the recent rule actions of the Board: 64B16-26.204 Licensure by Endorsement – This rule revision under development is seeking to provide additional clarity on licensure by endorsement. Several modifications were recommended to address CE requirements as well as changes to the endorsement applications. 64B16-27.450 PDM Responsibilities – This is a new rule that was being proposed by the Board to further define what a prescription department manager’s responsibilities should be. The Board’s concern has been those pharmacists who are taking on those duties and may not be clear on what their obligations are. Included in the revised draft will be a change to the PDM application that will include a statement acknowledging an understanding of the laws and rules. There is also more clarity in the draft on fingerprinting requirement. 64B16-30.001 Addition of Disciplinary Guidelines – During the 2016 legislative session, Florida Statutes 456.072 was changed, which required discipline for providers who try to “balance bill” patients for their services. This new law was aimed primarily at providers who attempt to collect from the patient the difference between what is paid for by the insurance plan and what the provider’s usual and customary fees are. FPA testified before the Board that this new disciplinary authority should not apply to issues where the patient’s services are not covered by their plan. 64B16-28.605, 64B16-28.141, 64B16-28.607 and 64B1628.608 Automation Rules – There are pharmacy rules in the inventory that pertain to automation in various pharmacy settings. The Board has elected to open each of these rules to see what changes need to be made based upon emerging technology and or changes to pharmacy practice.

AHCA Medicaid Managed Care Meeting The Agency for Health Care Administration hosted regional meetings on the Medicaid managed care program (MMA) in the month of October. The purpose of these public meetings was to take comments in reparation for the extension of the waiver needed to keep the program operational through the year 2020. According to presentations made at these meetings: ■■ MMA HEDIS scores are the highest ever ■■ Dental score visits are up ■■ High satisfaction with MMA plans are between 73 and 93 percent ■■ Medicaid per member per year costs have gone down year after year Several pharmacy providers were there to provide comment on the network closure issues and also pharmacy compounding issues. New NAPLEX Retesting Policy The Board of Pharmacy at their meeting this month announced that the National Association of Boards of Pharmacy will be implementing a new retesting policy. This new policy, which takes effect on Nov. 1, 2016, limits attempts to take and pass the NAPLEX examination to three per year. After three attempts the candidate must wait one year. Lynn Haven Pharmacist Installed as NCPA President Deann Mullins, a pharmacist owner from Lynn Havenwas installed as president of the National Community Pharmacists Association at their annual meeting in New Orleans. Mullins is the owner of Mullins Pharmacy, providing a host of health and wellness services for citizens in Bay County. Mullins is a graduate of the Samford University McWhorter School of Pharmacy and also attended Florida State University. She is the recipient of the Innovative Pharmacy Practice Award from the Florida Pharmacy Association and is a diabetic educator. Mullins will be only the second Floridian to sit as president of NCPA. Her vision includes the collaboration of health care services with the inclusion of pharmacists as provider partners with all of the health disciplines.

OCTOBER 2016

Department of Health Online Services Webinars The Florida Department of Health, through the Division of Medical Quality Assurance (MQA), is facilitating a series of webinars to help licensed providers understand the new web portal for health professions. This includes licensed pharmacists, consultant pharmacists, nuclear pharmacists and registered technicians. These webinars include information on the department’s continuing education integration project and includes a demonstration of the CE tracking system. You will learn how to create a free basic account as well as how to register an account in the MQA’s new online services portal. If you have a consultant license or are a registered pharmacy technician and are renewing you will need to create this account. For more information, visit http://www.flhealthsource.gov/webinars. Required Telehealth Survey for Florida Licensees As published in the 2016 Legislative Session Report on Pharmview.com and the annual report of the FPA in the 2016 convention app, you will find information on HB7087, which was signed into law by Governor Scott. This legislation creates the Telehealth Advisory Council and also requires the Agency for Healthcare Administration (AHCA), the Department of Health (DOH) and the Office of Insurance Regulation (OIR) to survey health care facilities, health care practitioners, insurers and health maintenance organizations regarding the use of telehealth in Florida. Effective July 1, 2016, DOH will survey all health care providers upon and as a condition of licensure renewal. If you are a consultant pharmacist and are renewing your license, you will automatically be directed to the survey. An excellent article on telemedicine was published in the January 2016 issue of Florida Pharmacy Today, which is available online. FPA Advocacy Resource on Florida Health Issues The Florida Pharmacy Association has published a web resource that our members can use when discussing the services that a pharmacist can provide. This resource includes information provided to us from the National Alliance of State Pharmacy Associations and is specific to our state. It can help explain why changes are needed in the pharmacy practice act to take advantage of the training skills of today’s pharmacists. Click here to view that resource.

FLORIDA PHARMACY TODAY

Governor Scott Declares October APhM in Florida Governor Scott issued a proclamation declaring October as American Pharmacist Month in Florida. This acknowledgment recognizes our pharmacist colleagues for their services and the work that we do to improve health. Thank you Governor Scott for this recognition and honor. Registration Open for Annual Sarasota Law Conference It is now time for the FPA’s annual law conference at the Hyatt Regency in Sarasota. At this meeting we will be looking at a number of compliance issues, such as Medicaid, responding to inspections and audits, the latest information on Board of Pharmacy rulemaking and emerging concepts in telepharmacy and health information exchanges. We will also be analyzing adopted policy by the Florida House and Senate and project what may be coming for the 2017 legislative session. Register today to reserve your space at this event and join the hundreds of pharmacy stakeholders who plan to meet with us. Annual Pharmacist Day at the Capitol Plans are well underway for the 2017 Florida Pharmacists Legislative Days and Health Fair event. For the past several years, nearly 400 of our student and pharmacist colleagues have visited Tallahassee during the legislative session to participate in health screenings for the public and monitor legislative bills that the Florida House and Senate may be considering. FPA leadership is counting on this event, including a lot of participation by pharmacists, so set your calendar dates for March 14 – 15, 2017, and plan to be in Tallahassee.

Concerns Aired During Pharmacy Small Business Town Hall Meeting The Florida Pharmacy Association hosted a town hall meeting for pharmacy small businesses in Kissimmee on October 9. The turnout for this meeting was strong despite the disruptions caused by Hurricane Matthew. Participants had an opportunity to get current information on critical issues such as pharmacy network closure, MAC pricing, DIR fees and other related issues. A panel of advocates was assembled to discuss how these issues can be dealt with and what measures may be necessary to provide relief to small businesses. Copies of talking points were provided to attendees. Plans are to host similar town hall meetings in other parts of Florida. FDA Inspections on the Rise Members may need to be aware that inspections by the Food and Drug Administration are on the increase. If you are involved in sterile compounding or if your compounding is non-patient specific you may be visited by a representative from that agency. From our review the FDA can inspect, however there are certain limits and you have certain rights. This document that you can download from the International Academy of Compounding Pharmacists website may help answer some basic questions. Florida Board Executive Director Change Pending Allison Dudley, Florida Board of Pharmacy executive director, will be transitioning to prosecution services, leaving a vacancy in the Board office. Dudley has served as the Board’s executive director over the past several years, helping to marshal in a number of new rule revisions, including, but not limited to, sterile compounding and prescription drug validation. A new search is underway for a replacement. Participants Selected for Part D Enhanced MTM Model The Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (Innovation Center) is announcing the participants in the Part D Enhanced Medication Therapy Management (MTM) model. This enhanced MTM model offers an opportunity and financial incentives for basic stand-alone Part D prescription drug plans (PDPs) in selected regions to offer innovative MTM programs in lieu of the standard CMS MTM model, aimed at improving the quality of care while also reducing costs. As part of the “better care, smarter spending, healthier people” approach to improving health delivery, CMS will test changes to the

Part D program that aim to achieve better alignment of PDP sponsor and government financial interests, while also creating incentives for robust investment and innovation in MTM targeting and interventions. This program will begin Jan. 1, 2017, and run for five years. The enhanced MTM model named participants for 2017 for Florida include Blue Cross and Blue Shield of Florida, CVS Health, Humana, United Healthcare and WellCare. Florida Pharmacy Foundation Silent Auction The Florida Pharmacy Foundation will be hosting a silent auction online and also onsite during the 2017 FPA Annual Meeting and Convention, July 13 and 14, 2017. The annual conference will be at the J. W. Marriott Orlando Grande Lakes. To download a flier, click here. NASPA and PAPCC Issues Letter to Congressional Committees The National Alliance of State Pharmacy Associations (NASPA), which the Florida Pharmacy Association is a member, along with more than 30 organizations, sent a letter to the Senate Finance Committee, the House Energy and Commerce Committee and the House Ways and Means Committee requesting they take action on legislation that would allow pharmacists to be reimbursed under Medicare Part B for services provided in Medically Underserved Areas. The letter, spearheaded by the Patient Access to Pharmacists’ Care Coalition (PAPCC), highlights the need for provider status for pharmacists in that it will provide greater patient access to quality-based health care services. The legislation, which has over 290 cosponsors in the House of Representatives and nearly 50 in the Senate, has been stalled in the 114th Congress. PTCB Releases New Practice Exams The Pharmacy Technician Certification Board (PTCB) has released two new Pharmacy Technician Certification Examination (PTCE) practice tools: the updated Official PTCB Practice Exam and the Official PTCB Calculations Practice Questions app, a math practice tool PTCB is offering for the first time. The FPA highly recommends technicians consider becoming PTCB certified.

OCTOBER 2016

Save the Date

127th Annual Meeting and Convention

July 13 â&#x20AC;&#x201C; July 16, 2017 JW Marriot Orlando Grande Lakes 4040 Central Florida Parkway Orlando, Florida

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PHARMACISTS MUTUAL RISK MANAGEMENT ALERT:

Increasing Number of Compounding Errors Associated with Thyroid Prescriptions By Kristen Jones, Pharm.D. Pharmacy Risk Management Consultant Pharmacists Mutual

The ability to procure liothyronine in the diluted version has recently become much harder for compounding pharmacies across the country. Unfortunately, this has led to a significant upswing in patient errors and consequently pharmacy compounding claims. The concentrated form of the raw ingredient for the thyroid compound has led to compounding mistakes. One Kristen Jones such mistake resulted in an error of 53,000 times the intended dosage. Thyroid overdoses can result in symptoms including, but not limited to, heart palpitations, vomiting, lack of thermoregulation, nervousness and anxiety, but can even go as far as myopathy and death. Drug shortages are more and more common in the past few years, so pharmacies must be ready to adjust to new products and strengths. Use these tips to help your pharmacy prevent errors and claims when new medications and strengths are substituted by wholesalers: ■■ Look in to implementing barcoding and compounding software as an additional safety measure. The professional practice of the pharmacy industry is moving toward the use of barcode scanning as several studies have shown a reduction of medication errors with its use. Utilizing the technology properly is as important as purchasing it. Properly train pharmacists and technician on processes so work arounds are not created. ■■ Review every Certificate of Analysis (COA) for each lot of raw materials and update inventories and product formulas as necessary. ■■ Purchase and utilize products with proper labeling that includes entire product name, strength and concentration. This may require seeking out additional wholesalers. ■■ Verify changes in brands, strengths and concentrations upon receipt and document in pharmacy inventory system. Notify all compounding staff members of concentration changes in products commonly used. ■■ Separate concentrated and diluted versions on the shelves and consider special labeling of the concentrated version.

OCTOBER 2016

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

FLORIDA PHARMACY TODAY

N O M I N A T I O N S ■■ Candidate must have demonstrated

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

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

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

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

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

DEADLINE FOR NOMINATIONS: FEBRUARY 28, 2017 FPA AWARDS NOMINATION FORM I AM PLEASED TO SUBMIT THE FOLLOWING NOMINATION:

NOMINATED BY:

Name:

Address:

Date Submitted: Signature:

FOR THE FOLLOWING AWARD: (Nomination Deadline February 28, 2017)  APhA Foundation and NASPA Bowl of Hygeia  James H. Beal Award

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

 R.Q. Richards Award  Frank Toback/AZO Consultant Pharmacist Award  DCPA Sydney Simkowitz Award  Pharmacists Mutual Co. Distinguished Young Pharmacist Award  IPA Roman Maximo Corrons Inspiration & Motivation Award  The Jean Lamberti Mentorship Award  Upsher Smith Excellence in Innovation Award  Cardinal Generation Rx Award

MAIL NOMINATONS TO: Annual Awards, Florida Pharmacy Association, 610 N. Adams St., Tallahassee, FL 32301 (850) 222-2400 FAX (850) 561-6758 DEADLINE FOR NOMINATIONS IS FEBRUARY 28, 2017

OCTOBER 2016

florida BUYER’S GUIDE PHARMACY TODAY

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

PHARMACY RESOURCES PPSC Retail Pharmacy Purchasing Program (888) 778-9909

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

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

FREQUENTLY CALLED NUMBERS AHCA MEDICAID PHARMACY SERVICES 2727 Mahan Drive Tallahassee, FL 32308 (850) 412-4166 www.fdhc.state.fl.us/medicaid/ pharmacy AMERICAN PHARMACISTS ASSOCIATION (APhA) Washington, D.C. (800) 237-2742 www.pharmacist.com AMERICAN SOCIETY OF HEALTH SYSTEM PHARMACISTS Bethesda, MD (301) 657-3000 www.ashp.com/main.htm DRUG INFORMATION CENTER Palm Beach Atlantic University (561) 803-2728 druginfocenter@pba.edu FLORIDA BOARD OF PHARMACY 4052 Bald Cypress Way Bin #C04 Tallahassee, FL 32399-3254 (850) 245-4292 www.doh.state.fl.us/mqa FLORIDA POISON INFORMATION CENTER NETWORK (800) 222-1222 www.fpicn.org NATIONAL COMMUNITY PHARMACISTS ASSOCIATION 100 Daingerfield Road Alexandria, VA 22314 (703) 683-8200 (703) 683-3619 fax info@ncpanet.org

Advertising in Florida Pharmacy Today Display Advertising: please call (850) 264-5111 for a media kit and rate sheet. Buyers’ Guide: A signed insertion of at least 3X per year, 1/3 page or larger display ad, earns a placement in the Buyers’ Guide. A screened ad is furnished at additional cost to the advertiser. Professional Referral Ads: FPA Members: $50 per 50 words; Non‑members: $100 per 50 words; No discounts for advertising agencies. All Professional Referral ads must be paid in advance, at the time of ad receipt. 28

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