The Official Publication Of The Florida Pharmacy Association SEP. 2015
October is American Pharmacists Month
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florida PHARMACY TODAY Departments 4 Calendar 4 Advertisers 5 President’s Viewpoint 7 Executive Insight 32 News & Notes 33 Buyer’s Guide
VOL. 78 | NO. 8 SEPT. 2015 THE OFFICIAL PUBLICATION OF THE FLORIDA PHARMACY ASSOCIATION
Features
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October is American Pharmacists Month More from the Florida Pharmacy Association’s 125th Annual Meeting and Convention Waiving Providers, Wavering Care: Managed Care Organizations Exclude Certain Pharmacy Providers
SEPTEMBER 2015
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Mission Statements:
FPA Calendar 2015-16
OCTOBER 5 - 7
Florida Board of Pharmacy Meetings Tampa
10-14 NCPA Annual Meeting Washington, D.C. 17-18 FPA Mid-year Clinical Conference Orlando 17-18 FPA Nuclear Conference Orlando 22
APhA Immunization Certificate Program Tampa NOVEMBER
of the Florida Pharmacy Today Journal DECEMBER
5-6
FPA Regulatory and Law Conference Sarasota
24-25 Christmas Holidays (FPA Office Closed) JANUARY 1
New Year’s Day (FPA Office Closed)
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2016 Legislative Session Begins
19-20 Health Fair and Legislative Day Event 23 - 24 FPA Law and Regulatory Conference
14-15 FPA Council and Committee Meetings Orlando 11
Veterans Day (FPA Office Closed)
26-27 Thanksgiving Holiday (FPA Office Closed)
For a complete calendar of events go to www.pharmview.com Events calendar subject to change CE CREDITS (CE cycle) The Florida Board of Pharmacy requires 10 hours’ LIVE Continuing Education as part of the required 30 hours’ general education needed every license renewal period. Pharmacists should have satisfied all continuing education requirements for this biennial period by September 30, 2015 or prior to licensure renewal. Consultant pharmacists and technicians will need to review their licenses and registrations by December 31, 2016. For Pharmacy Technician Certification Board Application, Exam Information and Study materials, please contact the FPA office. For more information on CE programs or events, please contact the Florida Pharmacy Association at (850) 222-2400 or visit our website at www.pharmview.com
The Florida Pharmacy Today Journal is a peer-reviewed journal which serves as a medium through which the Florida Pharmacy Association can communicate with the profession on advances in the sciences of pharmacy, socio-economic issues bearing on pharmacy and newsworthy items of interest to the profession. As a self-supported journal, it solicits and accepts advertising congruent with its expressed mission.
of the Florida Pharmacy Today Board of Directors
The mission of the Florida Pharmacy Today Board of Directors is to serve in an advisory capacity to the managing editor and executive editor of the Florida Pharmacy Today Journal in the establishment and interpretation of the Journal’s policies and the management of the Journal’s fiscal responsibilities. The Board of Directors also serves to motivate the Florida Pharmacy Association members to secure appropriate advertising to assist the Journal in its goal of self-support.
Advertisers THE HEALTH LAW FIRM............................... 27 KAHAN HEIMBERG, PLC................................. 9 PHARMACISTS MUTUAL.............................. 11 PPSC....................................................................... 9 Rx OWNERSHIP.................................................. 2
CONTACTS FPA — Michael Jackson (850) 222-2400 FSHP — Tamekia Bennett (850) 906-9333 U/F — Art Wharton (352) 273-6240 FAMU — Leola Cleveland (850) 599-3301 NSU — Carsten Evans (954) 262-1300 DISCLAIMER Articles in this publication are designed to provide accurate and authoritative information with respect to the subject matter covered. This information is provided with the understanding that neither Florida Pharmacy Today nor the Florida Pharmacy Association is engaged in rendering legal or other professional services through this publication. If expert assistance or legal advice is required, the services of a competent professional should be sought. The use of all medications or other pharmaceutical products should be used according to the recommendations of the manufacturers. Information provided by the maker of the product should always be consulted before use.
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E-MAIL YOUR SUGGESTIONS/IDEAS TO dave@fiorecommunications.com
The President’s Viewpoint TIM ROGERS, RPh, FPA PRESIDENT
O
Legislative Advocacy Efforts of the FPA
ne of the more important functions of the Florida Pharmacy Association is advocating to the Legislature on behalf of the practice of pharmacy. It is through these efforts that the FPA effects changes in existing laws and introduces new laws that impact how we practice our profession. For many years the FPA has been protecting pharmacy practitioners’ rights and the ability to deliver proper pharmaceutical care to our patients in the best way possible. Without the FPA’s advocacy, others (not in pharmacy), would dictate our functions and abilities. The practice of pharmacy is a continually evolving profession. Each year, our colleges expand their curriculum in order to supply us with pharmacists who have an increased knowledge of disease states and how we can better treat our patients. A new era of pharmacists is emerging. This movement is producing a pharmacist with enhanced training attained by working collaboratively with physicians and other medical professionals, and resulting in becoming a more integrated and essential part of the overall healthcare practice. I have heard the frustration expressed by new and seasoned practitioners who are unable to use the tools and training they have to reach the pinnacle of their abilities to treat their patients. They are being hindered and stopped by others who would not want an intrusion into their area of practice, or by those who would do so in order to retard the growth of our profession for errant fiscal reasons. However, we have proved time and time again that an increase in the pharmacist’s interaction with their patients and other
health professionals helps lower the overall cost of healthcare. Most recently, through legislative advocacy, we have started our efforts to obtain provider status for pharmacists. We were successful in getting our first fair Maximum Allowable Cost
We were successful in getting our first fair Maximum Allowable Cost (MAC) pricing bill passed, and greatly increased the immunization capabilities of Florida pharmacists. (MAC) pricing bill passed, and greatly increased the immunization capabilities of Florida pharmacists. Although we may still have a long way to go to satisfactorily put these issues to bed, we would not have made any strides in these areas without legislative advocacy. FPA’s Governmental Affairs Com-
Tim Rogers, RPh 2015-2016 FPA President
mittee, chaired by Dr. William Garst, has evaluated the current legislative issues facing the practice of pharmacy. From that evaluation, the committee has recommended to the Board of Directors that the following be given the highest level of priority to advocate for during the next session: 1. FPA should advocate for changes to F.S. 499.0121, which would help to provide relief for pharmacies that are struggling with getting adequate supplies of pain medications to treat their patients. 2. Advocate for changes to Florida laws that clarify enforcement and compliance with MAC pricing laws. 3. Consider recommended changes to the pharmacy practice act, as identified in the draft revisions to F.S. 465.0125, to help pharmacists with patient health and wellness issues and advocate for them if an opportunity is presented. SEPTEMBER 2015
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2015-16 FPA Board of Directors The Florida Pharmacy Association gratefully acknowledges the hard work and dedication of the following members of the FPA leadership who work diligently all year long on behalf of our members.
Suzanne Kelley..................................................................................................Board Chair Timothy Rogers..........................................................................................FPA President Alexander Pytlarz.................................................................................... FPA Treasurer Scott Tomerlin...........................................................................................President-Elect Jackie Donovan........................................................................Speaker of the House Carol Motycka................................................................Vice Speaker of the House Thomas Johns......................................................................................... FSHP President Jennifer Raquipo................................................................................. Region 1 Director Michael Hebb.........................................................................................Region 2 Director Tom Cuomo.............................................................................................Region 3 Director Linda Lazuka.........................................................................................Region 4 Director Robert Parrado...................................................................................Region 5 Director Luther Laite IV.....................................................................................Region 6 Director David Mackarey.................................................................................. Region 7 Director Humberto Martinez..........................................................................Region 8 Director Mitchell Fingerhut.............................................................................Region 9 Director
Florida Pharmacy Today Journal Board Chair.............................................................. Carol Motycka, motycka@cop.ufl.edu Vice Chair....................................................Cristina Medina, cmmedina@cvs.com Treasurer....................Stephen Grabowski, sgrabowski@seniormmc.com Secretary.............. Verender Gail Brown, brownvgrx4304@hotmail.com Member.................................................Joseph Koptowsky, docjik1215@aol.com Member.............................. Rebecca Poston, Rebecca.Poston@flhealth.gov Member.................................................Patricia Nguebo, notablep@hotmail.com Member................................................................Norman Tomaka, FLRX9@aol.com Member........................................................................Stuart Ulrich, Stuarx@aol.com Member............................................................. Don Bergemann, don@bceinfo.com Executive Editor................Michael Jackson, mjackson@pharmview.com Managing Editor...................Dave Fiore, dave@fiorecommunications.com Journal Reviewer....................... Dr. Melissa Ruble, mruble@health.usf.edu Journal Reviewer....................................Dr. Angela Hill, ahill2@health.usf.edu
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4. Continue with efforts to support the national provider status initiatives. 5. Advocate for modifications to the three-hour vaccine safety requirements in F.S. 465.009 to allow ACPE providers to deliver this program. 6. Advocate for changes in Florida laws to allow pharmacists to dispense a 30-day supply of maintenance medications, instead of the currently allowed three-day supply when the prescriber cannot be contacted. While these are our highest priorities for the upcoming legislative session, we will also advocate for instituting an expiration date for pharmacy intern registration, if the opportunity arises. Currently intern registrations do not expire after being issued. In addition, we will continue to monitor the development of Florida’s medical marijuana initiatives. The advocacy plan outlined above was reviewed by the FPA Board of Directors and approved at their August meeting. Changes that we make today will affect how you will practice your profession in the future. It’s time for the ostriches out there to get your head out of the sand. Stand up. Look around. Become more informed and ask the FPA what you can do to effect the change that you and we need for our profession. n Tim Rogers, RPh President Florida Pharmacy Association FPA OF THE PHARMACIST, BY THE PHARMACIST AND FOR THE PHARMACIST
Executive Insight BY MICHAEL JACKSON, RPH MICHAEL JACKSON, BPHARM, EVP & CEO, FLORIDA PHARMACY ASSOCIATION
A Plan for Pharmacist-Managers To Follow In Case Of A Natural Disaster
T
his year marks the 10th anniversary of one of the worst storms to ever hit the Gulf Coast. Hurricane Katrina devastated the New Orleans area, in addition to many communities in and around the southern Gulf states. Florida was the recipient of displaced citizens from affected areas, which caused many to reflect on Hurricane Andrew, which ravaged South Florida in August of 1992. We can never predict when the next disaster will be upon us, whether it be an act of God or manmade. In any case, pharmacies and pharmacy providers have to take on the role of first responders and demonstrate the provider status roles we have been preaching about over the years. The best way to get through a disaster is to have a comprehensive plan in place BEFORE the disaster strikes. That plan should be rehearsed and tested frequently to work through any glitches that may occur. Here are some tips you may want to consider for your pharmacy and your staff: Prepare Ahead of Time ■■ Assemble a list of all employees with contact information, including cell phone, home phone and email addresses. Consider turning your list into a call tree, where you contact several employees who will then be responsible for calling others within your organization. Make sure that the employee at the bot-
tom of the call tree contacts the originator of the message so that you can evaluate whether the messaging changed in the handoff from employee to employee. Assemble a broadcast fax or email
In any case, pharmacies and pharmacy providers have to take on the role of first responders and demonstrate the provider status roles we have been preaching about over the years.
Michael Jackson, B.Pharm
■■ Obtain waterproof covering materi-
al for later use.
list of local radio and television stations with their news phone numbers. ■■ Assemble a broadcast fax or email list of physicians’ offices and hospitals. ■■ Contact your county manager’s office to obtain a reliable contact at the County Emergency Management Headquarters. ■■ Make list of contact information for wholesalers and delivery services, such as UPS and FedEx.
■■ If controlled substances are lost in
a disaster, the pharmacist-manager needs to contact their regional DEA offices in Florida, at the following locations:
MIAMI DIVISION
2100 North Commerce Parkway Weston, FL 33326 Diversion Number: (954) 306-4650 Diversion Fax: (954) 306-5351 Diversion Program Manager Fax: (954) 306-5352 Diversion Program Manager: Susan C. Langston, (954) 306-4651 GS: Gayle W. Lane, (954) 306-4654 TDS ASAC: Kevin L. Stanfill, (954) 660-4611 TDS GS: Jeannette G. Moran, (954) 660-4654 SEPTEMBER 2015 |
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FPA STAFF Executive Vice President/CEO Michael Jackson (850) 222-2400, ext. 200
Director of Continuing Education Tian Merren-Owens, ext. 120 Controller Wanda Hall, ext. 211
Educational Services Office Assistant Stacey Brooks, ext. 210 Coordinator of Membership Christopher Heil, ext. 110
FLORIDA PHARMACY TODAY BOARD Chair..................................... Carol Motycka, St. Augustine Vice Chair................................Cristina Medina, Hollywood Treasurer...............................Stephen Grabowski, Tampa Secretary.........................Verender Gail Brown, Orlando Member..................................... Joseph Koptowsky, Miami Member..............................Rebecca Poston, Tallahassee Member.............................................. Patricia Nguebo, Ocala Member................................. Norman Tomaka, Melbourne Member..............................Stuart Ulrich, Boynton Beach Member.......................Don Bergemann, Tarpon Springs Executive Editor.........Michael Jackson, Tallahassee Managing Editor.........................Dave Fiore, Tallahassee
This is a peer-reviewed publication. ©2015, FLORIDA PHARMACY JOURNAL, INC. ARTICLE ACCEPTANCE: The Florida Pharmacy Today is a publication that welcomes articles that have a direct pertinence to the current practice of pharmacy. All articles are subject to review by the Publication Review Committee, editors and other outside referees. Submitted articles are received with the understanding that they are not being considered by another publication. All articles become the property of the Florida Pharmacy Today and may not be published without written permission from both the author and the Florida Pharmacy Today. The Florida Pharmacy Association assumes no responsibility for the statements and opinions made by the authors to the Florida Pharmacy Today. The Journal of the Florida Pharmacy Association does not accept for publication articles or letters concerning religion, politics or any other subject the editors/ publishers deem unsuitable for the readership of this journal. In addition, The Journal does not accept advertising material from persons who are running for office in the association. The editors reserve the right to edit all materials submitted for publication. Letters and materials submitted for consideration for publication may be subject to review by the Editorial Review Board. FLORIDA PHARMACY TODAY, Annual subscription - United States and foreign, Individual $36; Institution $70/year; $5.00 single copies. Florida residents add 7% sales tax. FLORIDA PHARMACY ASSOCIATION
610 N. Adams St. • Tallahassee, FL 32301 850/222-2400 • FAX 850/561-6758 Web 8 Address: | F L O Rhttp://www.pharmview.com IDA PHARMACY TODAY
Jurisdiction: Broward, Charlotte, Collier, Glades, Hendry, Lee, Miami-Dade and Monroe counties. JACKSONVILLE DISTRICT OFFICE
(reports to Tallahassee RO) 4077 Woodcock Drive, Suite 210 Jacksonville, FL 32207 Diversion Number: (904) 348-7415 Diversion Fax: (904) 348-7433 GS: Steve Utt, (850) 350-7355 Jurisdiction: Baker, Clay, Duval, Flager, Nassau, Putnam and Saint Johns counties. ORLANDO DISTRICT OFFICE
Heathrow Business Center 300 International Parkway, Suite 424 Heathrow, FL 32746 Diversion Number: (407) 333-7046 Diversion Fax: (407) 333-7056 GS: Linda A. Stocum, (407) 333-7006 TDS ASAC: Jeffrey T. Walsh, (407) 333-7096 TDS GS: Jae W. Chung, (407) 333-7007 Jurisdiction: Alachua, Bradford, Brevard, Columbia, Dixie, Gilchrist, Hamilton, Lafayette, Lake, Levy, Marion, Orange, Osceola, Seminole, Sumter, Suwannee, Union and Volusia counties. TALLAHASSEE RESIDENT OFFICE
1510 Commonwealth Business Drive Tallahassee, FL 32303-3170 Diversion Number: (850) 350-7350 Diversion Fax: (850) 575-0724 GS: Stephen L. Utt, (850) 350-7355 Jurisdiction: Bay, Calhoun, Escambia, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Okaloosa, Santa Rosa, Taylor, Wakulla, Walton and Washington counties. TAMPA DISTRICT OFFICE
4950 W. Kennedy Blvd, Suite 400 Tampa, FL 33609 Diversion Number: (813) 287-5160 Diversion Fax: (813) 287-4766 GS: Roberta E. Goralczyk, (813) 287-4767 TDS ASAC: James F. DiCaprio, (813) 287-4777 Acting TDS GS: Steven Genevish, (813) 282-4462 Jurisdiction: Citrus, DeSoto, Hardee,
Hernando, Hillsborough, Manatee, Pasco, Pinellas, Polk and Sarasota counties. WEST PALM BEACH RESIDENT OFFICE
444 West Railroad Avenue, Suite 500 West Palm Beach, FL 33401 Diversion Number: (561) 653-4050 Diversion Fax: (561) 832-9016 GS: Heather A. McMurry, (561) 656-5809 TDS Number: (561) 656-5842 TDS Fax: (561) 656-5802 TDS ASAC: John J. McKenna, (954) 489-1995 TDS GS: Thomas Redpath, (561) 656-5851 Jurisdiction: Highlands, Indian River, Martin, Okeechobee, Palm Beach and St. Lucie counties. It may be necessary to complete a loss form (DEA 106) and/or disposal form (DEA 41). Pharmacies are also required to report within one business day the theft or significant loss of controlled substances to the Board of Pharmacy, according to 465.022 (11)(b). Their mailing address is: Florida Board of Pharmacy 4052 Bald Cypress Way, Bin C-04 Tallahassee, FL 32399-3258 Their fax number is (850) 413-6982. It is recommended that anything sent to the Board include a confirmation of receipt. ■■ If the pharmacy is to be closed and/or evacuated, the appropriate supervisory personnel should be notified. ■■ Anticipate power outages; in some cases a portable generator may be advisable. ■■ Ice and coolers should be available to store refrigerated products. ■■ Store flammable materials appropriately. Check the Board’s website homepage at http://floridaspharmacy.gov/ or the Florida Pharmacy Association’s website at www.pharmview.com for guidance in the case of a hurricane. If the pharmacy computer is down, prescriptions can be dispensed manu-
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Florida Pharmacy Association
SEPTEMBER 2015
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ally. Labels can be typed or handwritten using a waterproof pen, if possible. Printed drug information may not be available, but patient counseling still needs to occur. Refill authorizations may be difficult or impossible to obtain. In such a case, pharmacists can utilize the Emergency Refill Statute 465.0275, which reads: 465.0275 Emergency prescription refill. In the event a pharmacist receives a request for a prescription refill and the pharmacist is unable to readily obtain refill authorization from the prescriber, the pharmacist may dispense a one-time emergency refill of up to a 72-hour supply of the prescribed medication, with the exception of those areas or counties included in an emergency order or proclamation of a state of emergency declared by the governor, in which the executive order may authorize the pharmacist to dispense up to a 30-day supply, providing that: (1) The prescription is not for a medicinal drug listed in Schedule II appearing in chapter 893. (2) The medication is essential to the maintenance of life or to the continuation of therapy in a chronic condition. (3) In the pharmacist’s professional judgment, the interruption of therapy might reasonably produce undesirable health consequences or may cause physical or mental discomfort. (4) The dispensing pharmacist creates a written order containing all of the prescription information required by this chapter and chapters 499 and 893 and signs that order. (5) The dispensing pharmacist notifies the prescriber of the emergency dispensing within a reasonable time after such dispensing. There is also similar language authorizing refills to be paid for by health plans when the governor declares a state of emergency. That statute reads: 252.358 Emergency-preparedness prescription medication refills.— All health insurers, managed care organizations, and other entities that are licensed by the Office of Insurance Regulation and provide prescription medication coverage as part of a policy or contract shall waive time restrictions on prescription medication refills, which include suspension of electronic “refill too soon” edits to pharmacies, to enable insureds or subscribers to refill prescriptions in advance, if there are authorized refills remaining, and shall authorize payment to pharmacies for at least a 30-day supply of any prescription medication, regardless of the date upon which the prescription had most recently been filled by a pharmacist, when the following conditions occur: (1) The person seeking the prescription medication refill resides in a county that: (a) Is under a hurricane warning issued by the National Weather Service; (b) Is declared to be under a state of emergency in an executive order issued by the Governor; or (c) Has activated its emergency operations center and its emergency management plan. (2) The prescription medication refill is requested within 30 days after the origination date of the conditions stated in this section or until such conditions are terminated by the issuing authority or no 10
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longer exist. The time period for the waiver of prescription medication refills may be extended in 15- or 30-day increments by emergency orders issued by the Office of Insurance Regulation. This section does not excuse or exempt an insured or subscriber from compliance with all other terms of the policy or contract providing prescription medication coverage. If the pharmacy is to be closed and evacuation is warranted, the pharmacist-manager should produce two sets of backup tapes or disks of all drug inventory and all prescription information. One set of information could be kept in a safe place and another kept off-site in the possession of the pharmacist-manager. Any media that contains confidential patient health information should be kept securely and accounted for to prevent any breach. Prior to evacuation, computers should be shut down and covered with waterproof material. If flooding is expected the computer should be disconnected from the terminals and moved to a safe area. Schedule II drugs should be moved to a locked, secure place. A safe may be used but is not required. Other products, such as prescription drugs, should be moved, if possible, above the floor level and covered with waterproof materials. Notify all store personnel if the store is to be closed. Notify local radio and television media if the store is to be closed. Notify local physicians and/or hospitals of store closing by broadcast fax or email, if necessary. Notify the emergency management contacts for the county in your affected area. County Emergency Management Contacts can be located as this link: http://www.floridadisaster. org/fl_county_em.asp When the pharmacy reopens, notify all store personnel, physicians and hospitals, local radio and television media, emergency management and emergency management contacts for your county. When the situation is stabilized, the pharmacy personnel should be notified to take steps to restore the integrity of the pharmacy setting. If prescriptions have been dispensed while the computer was disconnected please note that the code of federal regulations for controlled substances has a policy defined in CFR 1306.22, which states, in part: “In the event that a pharmacy which employs such a computerized application experiences system down-time, the pharmacy must have an auxiliary procedure which will be used for documentation of refills of Schedule III and IV controlled substance prescription orders. This auxiliary procedure must ensure that refills are authorized by the original prescription order, that the maximum number of refills has not been exceeded, and that all of the appropriate data are retained for online data entry as soon as the computer system is available for use again.” Pharmacies may want to apply this standard to all prescriptions and not just for controlled substances. n
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October is American Pharmacists Month (APhM) Every October, in conjunction with the American Pharmacists Association, Florida pharmacists join colleagues from across the country to celebrate American Pharmacists Month, otherwise known as APhM. The primary purpose of APhM is to promote pharmacists as medication experts, professionals directly involved in patient care and integral members of the national healthcare continuum. APhM is a well-orchestrated, monthlong effort designed to educate the public, policy makers and other healthcare professionals about the essential role pharmacists play in the reduction of overall healthcare costs and the safe and effective management of medications. While the movement emanates from the APA national headquarters, each pharmacist and pharmacy throughout Florida has a vital role in educating your patients, motivating your staff and inspiring your community to “Know Your Pharmacists, Know Your Medicine.� To help coordinate efforts nationwide and make it easier for everyone to participate, the APA has posted dozens of ideas and resources for APhM activities and events you can utilize during American Pharmacists Month and all year long.
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Get the Message to the People! It is important to send the right messages to the right people and generate buzz for your events. Below are dozens of tips to help you get the word out and give your audience the right impressions. Whenever you use or create any APhM materials, feel free to cut and paste from this information as much as you like. This will help ensure consistency in messaging and save you a lot of time. Here are some best practices to help you: Reach Your Community American Pharmacists Month is the time to take your message on the road. Don’t worry—you won’t have to go far. There are countless opportunities in your own community. Patients of all ages can benefit from discussions and information about how to use medications safely and effectively. ■■ Hit the malls: Ask management at a local mall about staging an exhibit or booth where pharmacists can answer shoppers’ questions about medications. ■■ Find the traffic: Create a medication education display for your local library, YMCA or other popular community site. ■■ Go back to school: Visit neighborhood schools for a “show-and-tell,” a science or math class or a career day to talk with students about medication safety, the dangers of prescription abuse and exciting careers in pharmacy. ■■ Reach out to seniors: Conduct “medication check-up” reviews or seminars at senior day-use centers. ■■ Go with groups: Civic, neighborhood, religious, even book groups—ranging from the Lions to the Junior League to Scouting groups—are all good places to target for an educational talk on medication safety or the role of the pharmacist. For more community outreach ideas, see the Ways to Celebrate APhM in Your Practice story in this section. Attract Media Coverage Attracting media attention requires a good story and good visual opportunities. Determine which media outlets you most want to reach and tailor your work to what they need in order to appeal to readers and viewers. STEP 1: TARGET YOUR MEDIA OUTLETS
■■ Find the right size: Local and personal stories appeal
more to small and local media. Issue-based stories can warrant regional or national coverage. ■■ Broaden your scope: There’s more to coverage than a
news story or feature in a particular show or section. Try letters to the editor, opinion pieces, radio talk shows and TV station editorial segments. ■■ Don’t limit yourself to health: You might discover your story is more appropriately suited for the metro, business or lifestyle sections of a newspaper. ■■ Know your reporters: Check for particular writers, columnists or broadcast journalists who have covered pharmacy-related issues, and take your stories to them first. Check the media outlet’s website for contact information.
It is important to send the right messages to the right people and generate buzz for your events. STEP 2: HAVE A GOOD STORY
What’s special about your American Pharmacists Month celebration? Are you trying to get as many seniors as possible to an event? Are you spotlighting a pharmacist with a strong relationship with patients? Are you looking at issues in the changing role or science in pharmacy? What are you most passionate about when it comes to pharmacy? What you care about is usually the seed for a story others will care about, too. Media outlets want stories that are timely, interesting and full of local and personal appeal. STEP 3: CULTIVATE MEDIA RELATIONSHIPS
Even in a short-term contact, a successful relationship with media outlets will go a long way toward accurate and compelling coverage. Here are some professional-caliber instructions to keep your work top quality: ■■ Send a pitch letter or email to your media list about 20 days in advance of an event. ■■ Prepare and send a media advisory the day before or the morning of an event. A follow-up phone call can help increase interest and attendance. ■■ Prepare a press release featuring greater detail; releases help reporters write full stories. ■■ Assemble media kits to distribute at the event. Include the press release and information about your practice and the services it provides. SEPTEMBER 2015
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■■ Immediately after the event, distribute the release to
members of the media unable to attend. ■■ Monitor the media for stories about your event. Send a thank-you to reporters who covered it. ■■ Keep copies of the press clippings to include in future media kits. See if you can get permission to post a video clip to social media. Get Official Recognition You can get official recognition for American Pharmacists Month in your municipality, city, county or state, which can lead to a ceremony with a wealth of promotional opportunities. It’s fairly simple to do, but the process can take up to a few months. Here’s the step-by-step guide to getting an official proclamation: Step 1: Find out if officials can issue proclamations without action from the city council or state legislature. If legislative approval is not required to issue a proclamation: Step 2: Call the mayor/governor’s office to find out how proclamations are issued. Step 3: Prepare your proclamation language. Under the APhM Month Resources and Promotional Materials section below is a sample template to get you started. Localize relevant facts about pharmacy and explain why American Pharmacists Month should be recognized by your city or state. Step 4: Try to elicit support from other pharmacy leaders in your area. Ask local pharmacy associations, health organizations, and academic and business leaders and groups to write a letter of support to the governor. Provide addresses and sample letters. Broad correspondence and support from state leaders reflects wide interest and gives your proclamation a better chance. If legislative action is required to issue a proclamation: Step 5: Contact your local senator’s or representative’s office to get instructions for the proclamation process. Step 6: Because resolutions typically must be sponsored by a member of the appropriate governmental body, find an official who supports pharmacy. An alternative is to focus on a government official who has not yet worked with you, whom you could educate. Is there a pharmacist among the legislators? Step 7: Ready your proclamation—use the sample template provided under APhM Month Resources and Promotional Materials below. Step 8: Work with your proclamation sponsor to find out how you can help get the proclamation approved. You will 14
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You can get official recognition for American Pharmacists Month in your municipality, city, county or state, which can lead to a ceremony with a wealth of promotional opportunities. probably need to lobby potential supporters and identify cosponsors. Start by writing your legislators about the proclamation and soliciting their support. Remember, a follow-up phone call might be necessary. The final steps come after the proclamation is issued. Be sure to invite those instrumental in getting it approved to any ceremonies planned. After APhM, send letters of thanks and appreciation. Use Social Media It’s the easiest, fastest, and probably your favorite way to promote American Pharmacists Month events. But with social media, your message could get lost in a flood of information. Here are some tips for standing out and getting leverage. And remember—stick with APhA messages for best results. ■■ Just the facts: For the whole month, post a daily pharmacy fact, tip, link or article to your Facebook wall or Twitter stream. ■■ Tag it: Use the Twitter hashtag #APhM2015 when tweeting about the profession, the month or your event. The more people who use a hashtag, the better chance it has of becoming a “trending” topic. This also increases the chances that other non-pharmacy users will run across the information. ■■ Let Facebook help: If you’re hosting a special event in honor of APhM, spread the word through Facebook. It makes it easy to send invites and for attendees to share the event with friends. It’s also a neat way for attendees to see the guest list of who’s going (which helps get them to the page!). ■■ Get visual: Get out your smart phone and start shooting and posting photos of events. Three things to remember: Ask permission, use captions and check before tagging. ■■ Document with video: Create a serious record of your events that others can learn from, or try a short, fun video with music or voice-overs. Once you’ve asked permission, post away. ■■ Pin it up: Pinterest and similar visual-based social media sites can be a good place to share tips and information.
Consider: ●● Recipes for people with diabetes, allergies or other chronic conditions ●● A poster showing flavors available for children’s medication ●● Ideas on storing or remembering medications ●● A calendar for medications or a tip-a-day ●● Photos of pharmacists providing patient care services ●● GIF videos or images of food and drugs that may interact ●● Don’t forget to fill in the description box with extra information ■■ Get personal with a blog: If you don’t have a blog already, APhM is a great time to start one. Or use a group blog where contributors rotate. Use this month to write about your work or what the profession means to you, or to share tips with students or professionals on continuing education or career advancement. A blog is an easy, relatable way to talk about the profession. Posts can be short and informal—the key is keeping the content fresh and consistent. ■■ Record a podcast: This is a great way to address an issue in pharmacy that’s important to you. A podcast is typically a short recorded audio session, and it’s easy to do through the microphone on your computer. Try talking about pharmacy, interviewing a patient or colleague, or describing how pharmacists can help someone with a certain condition, such as diabetes. ■■ Tell your friends: After people sign up for your event, take them to a “Tell Your Friends You’re Attending” page. With the click of a button, a customized tweet is created
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and posted for them. This makes it simple for attendees to share that they’re going—and gives a link for readers in their network to click. Add a Twitter widget: If people are already talking about the event, why not use that as proof to market to other potential attendees? The widget is a box that allows users to scroll through just the tweets relevant to your event (with your hashtag – #APhM2015). Build the excitement: Are you able to give away some free tickets to your upcoming event, or offer freebies or prizes? Social media is particularly conducive to building excitement around things like giveaways. It encourages people to share/retweet/repost—and it will enhance the awareness of your event. Capture the experts: Will your upcoming events feature interesting or popular speakers? Get your social media audience acquainted with them—and excited to hear more. Promote their appearance before the event, and be sure to get permission to post content, a report, or a video of their presentation or a Q&A. Invite leaders: Most senators and representatives now use social media tools. Contact your local legislators via social media and invite them publicly to attend your events. Provide Online Answers: Spend some time during APhM visiting a Q&A website such as WikiAnswers or YahooAnswers, and offer professional advice reminding people to contact their pharmacists with questions about issues such as potential drug interaction-related symptoms.
Source: American Pharmacists Association
Ways to Celebrate APhM in Your Practice Inform, Engage, Inspire There are more ways to celebrate American Pharmacists Month than there are days in October. You just need to figure out what works best for your pharmacy. Remember, you don’t need a big budget to make a big splash. The Florida Pharmacy Association or students from a nearby school of pharmacy may be willing to work with you to host educational events for your patients. Below is a list of great ideas to help inspire you; some work anywhere, while others are best suited for specific settings. Always be sure to pick quality over quantity, so that your events are memorable for everyone involved:
Ideas for Pharmacists in All Settings ■■ Make time for face time: Schedule special events where patients can meet and talk to their pharmacist. Use the time to promote vaccinations, flu shots, or host screenings for cholesterol, diabetes or osteoporosis. ■■ Check on medication: Invite patients to bring all the prescription and nonprescription medications they take, so pharmacists can answer any questions and conduct a medication checkup for potential interactions, unneeded or duplicate medications, adverse reactions and passed or upcoming expiration dates. ■■ Serve healthy lessons for lunch: Ask local businesses if you can come in during employee lunch hours and make presentations about safe medication usage and answer SEPTEMBER 2015
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medication-related questions. ■■ Clarify Medicare for seniors: Set aside time each day/ week to answer questions about Medicare drug coverage for local seniors. Use the questions and your knowledge for a local newspaper column or call-in radio show. You can also offer personalized counseling by contacting the Florida Department of Elder Affairs. ■■ Host local leaders: Provide your legislators with an invaluable view of the contemporary roles of pharmacists. Make sure they talk to a patient who has benefitted from interaction with his or her pharmacist and get to watch a pharmacist in your facility conduct patient care services, like MTM, immunizations, patient education and wellness screenings. ■■ Create a social media challenge: Establish a goal of organizing and understanding medications by the end of the month. Activities can include: ●● A daily tip delivered through social media ●● A drug disposal day a week, with reminders ●● Reminders to do a drug checkup (check expiration, interactions, etc.) ●● Lead discussions on how patients keep track of medication use or what gets in the way of consistent adherence ●● Links to articles and research ●● A blog for the month with articles, links and interviews about organization, using technology and smart phones, etc. Ideas for Community Pharmacies ■■ Conduct OTC aisle tours: Gear them to specific groups, like parents, older adults and athletes. Help each group understand how to pick the right products for the conditions most likely to affect them. Emphasize the importance of reading labels, knowing the active ingredients and asking the pharmacist questions. ■■ Join the race: People interested in fitness and health activities are a built-in audience for the pharmacy message. Marathons, 5Ks and walkathons are excellent settings to spread the word. Choose ones that align with your message and be on hand with giveaways, like water bottles,
People interested in fitness and health activities are a built-in audience for the pharmacy message. Marathons, 5Ks and walkathons are excellent settings to spread the word. 16
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T-shirts, bandanas and headbands. Or if you’re feeling adventurous, you could organize your own race. ■■ Get cooking: Check local cooking classes that give instruction in cooking and nutrition for health issues such as diabetes, heart-healthy or allergies, and ask the instructor for five minutes to make a presentation about the importance of talking to your pharmacist and knowing about food/medication interactions. ■■ Get down to business: Reach out to stores, restaurants and services in your block, mall or shopping center. Note: Chain stores may have restrictions about promotional activities, so start with independent, local businesses first: ●● Approach restaurants about having a pharmacy awareness day where they promote healthy choices or give out material with the check. ●● Work with local retail stores or dance and exercise studios to generate a month-long information or coupon promotion and exchange. ●● Create a “sidewalk sale” day where local businesses promote themselves outside their stores and you promote pharmacist-provided patient care services or offer mini-health screenings. Ideas for Hospital and Managed Care Pharmacies ■■ Join the class: Find out when diabetes, nutrition and prenatal classes are being held at your hospital or managed care setting throughout October. Check with the class organizers to see if they can give you time for a five-minute presentation on the importance of knowing their medications and talking to pharmacists. ■■ Give parting gifts: Patients and class attendees are often given “care packages” when they leave the hospital. See if you can add an information card or fun giveaway for APhM promoting the importance of talking to pharmacists, especially for diabetes patients, heart patients, new parents and chemotherapy/cancer patients. ■■ Make the rounds: Visit patients in their rooms. Introduce yourself and answer any questions they may have about pharmacy services, their current drug therapy or how to transition back to a normal medication routine when they leave the hospital. Give them patient education brochures and small APhM -themed giveaways like magnets, pens and tote bags. ■■ Set the stage: Create a lobby display to promote the pharmacy department. Include information about pharmacy services and photos of your staff. If your facility is large, consider changing the display weekly to focus on a different pharmacy activity or function. Make the display colorful and fun, with eye-catching elements like red and white streamers or APhM balloons and banners. ■■ Open your doors: Invite all hospital and managed care
setting employees to visit the pharmacy. Conduct brief tours that showcase daily pharmacy operations and describe how medications move from the initial physician order to the patient. ■■ Decorate ambulatory care pharmacies: Hanging APhM decorations like banners, posters and balloons is a great way to publicize your events and draw attention to your pharmacy. ■■ Offer curbside service: Encourage patients and caregivers to talk with pharmacists about medication therapy issues. Hold the sessions in a conference room or other relatively private area, and allot from 5 to 10 minutes per person. Ideas for Long-Term Care Settings ■■ Head to class: Visit the chair dance, stretch, or dance class with the message that patients can talk to their pharmacist about how their fitness and movement activities affect their medications, and vice-versa. ■■ Start a project: Engage in a month-long project with facility residents, meeting once or twice a week with a clear goal and outcome. Here are some ideas: ●● Create a cookbook with healthy recipes contributed by residents. ●● Create a short joke book with funny stories and jokes around the theme of “My Meds.” ●● Stage a talent show around the theme of “My Meds.” ■■ Share information: Hold a visitor information day once a week during APhM, complete with an information table and giveaways, where visitors and relatives can get information about how your pharmacy works, meet the pharmacists and become aware of the importance of the phar-
Hanging APhM decorations like banners, posters and balloons is a great way to publicize your events and draw attention to your pharmacy. ■■
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macists in their relatives’ health and well-being. Open your doors: Invite all long-term care center employees to visit the pharmacy. Conduct brief tours that showcase daily pharmacy operations, and describe how medications move from the initial physician order to the patient. Throw a party: Invite residents and their guests to a special APhM party. Maybe host an afternoon tea or other themed event. Decorate the designated areas with streamers and APhM balloons, banners and posters. Provide patient education brochures and small themed giveaways, like magnets and pens. Make the rounds: Visit patients in their rooms. Introduce yourself and answer any questions they may have about pharmacy services or drug therapy. Give them patient education brochures and small APhM-themed giveaways. Serve a side of advice: Develop lunch tray tent cards that explain the goals of the pharmacy and the services you offer residents. Encourage them to ask to speak with the pharmacist if they have any questions about their medication.
Source: American Pharmacists Association
Roles for Student Pharmacists and APhA-ASP Chapters Give your Campus a Crash Course on the Importance of Pharmacy Ok students, American Pharmacists Month is your time to educate. Cultivate your future in pharmacy by showing your campus and community the importance of talking to pharmacists and knowing their medications. You’ll raise awareness and help people at the same time. If you’re a student who works in a pharmacy, lots of the activities throughout this article could inspire you. You can also spread the word by:
■■ Sharing the daily #APhM2015 facts on the APhA-
ASP Facebook and Twitter pages on chapter and personal pages ■■ Writing an article or op-ed for a school-connected professional journal or your school paper presenting a point of view or issue of importance to pharmacy students ■■ Tweeting about community events and sharing relevant articles about pharmacy ■■ Incorporating American Pharmacists Month into your social media posts SEPTEMBER 2015
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Ideas for APhA-ASP Chapter Activities ■■ Hold a chapter fundraiser: Sell American Pharmacists Month T-shirts and/or other promotional items to student pharmacists and faculty. ”Know Your Pharmacist, Know Your Medicine” merchandise is available through the APhM store. ■■ Coordinating care: Get more attention and more mileage out of your work by collaborating and combining forces. Schedule Operation Immunization, Operation Diabetes and Operation Heart in October, and promote American Pharmacists Month during these events. Attract notice by decorating the event area with themed balloons, posters or banners. You can order materials through www.pharmacist.com/shop. ■■ Host a lunch: Celebrate American Pharmacists Month on campus by holding a celebratory lunch for all student pharmacists. Offer them a unique experience by inviting an honored local practitioner to discuss the importance of leadership and professionalism in pharmacy. ■■ Mobilize for better health: Partner with faculty members to conduct free health screenings, medication checkups and other community education events for area businesses and civic organizations. Check out collaboration opportunities with community service groups that do outreach to senior or low-income communities. ■■ Inspire future pharmacists: Visit a local high school to talk with students about careers in pharmacy. ■■ Host a healthy happy hour: Serve non-alcoholic smoothies or juices, along with pharmacy information. ■■ Serve info to go: Ask your local coffee shop or on-campus café if your group can host a pharmacy hour or pharmacy day, with giveaways, coupons or other promotional material about the profession and health. ■■ Be good sports: Establish a relationship with one or more of the school’s athletic teams. At games or competitions, sponsor shows, giveaways, put messages on the score-
Establish a relationship with one or more of the school’s athletic teams. At games or competitions, sponsor shows, giveaways, put messages on the scoreboard, or put a message in a program. Hold an APhM Day at a football game, soccer game or tennis match, for instance. 18
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Work with foreign language clubs or foreign exchange students for opportunities to learn about the cultural differences in pharmacies, the need for language skills and the importance of diversity training. board, or put a message in a program. Hold an APhM Day at a football game, soccer game or tennis match, for instance. Pharmacy students can also give presentations to the team or provide information to coaches—building awareness of the importance of student athletes talking to pharmacists and knowing their medications. ■■ Try something unique: Student pharmacists are unique in their ability to creatively describe how pharmacists benefit and enhance the patient experience. You are also uniquely positioned to produce content on the many new applications and mediums that exist. Showcase your talents: Produce a YouTube video about being a pharmacist; put together a pharmacy flash mob in your student union building; have the College of Pharmacy host a medicine and wellness-themed talent show; or put together an APhM photo or video journal about your monthly adventures as a pharmacist and display it in the college’s main building. ■■ Cross disciplines: Reach out to other departments at your school to engage different populations. For instance, work with visual and performing arts and literary groups. Consider sponsoring or collaborating with a performance or contest for creative work. (Artists, writers and performers are always looking for opportunities to create, and health and medicine is a powerful human theme for them to explore.) Buy or barter an ad in a theater program or student publication. ■■ Get some culture: Work with foreign language clubs or foreign exchange students for opportunities to learn about the cultural differences in pharmacies, the need for language skills and the importance of diversity training. Source: American Pharmacists Association
APhM Roles for Pharmacy Technicians Add Your Special Touch Team up with your fellow technicians and the pharmacists at your practice to help make your patients more aware of the important role you play in their healthcare. Here are a few simple ideas to try: ■■ Get decked out: Decorate your pharmacy with banners, posters and balloons that let everyone know it’s American Pharmacists Month. . You can order materials through www.pharmacist.com/shop. ■■ Coordinate special health events: Work with the pharmacy team to set up an event where they can conduct blood pressure screenings or other pharmacy-based patient care services. ■■ Host a party: Invite community members to come in for cake and other treats. Give them goodie bags stuffed with educational brochures and other freebies, like magnets, pill cases, tote bags and pens. Volunteer as a greeter and demonstrate the prescription-filling process. ■■ Change your bags: Encourage your pharmacists to put APhM stickers on pharmacy and prescription bags or oth-
er purchases.
■■ Customize your phone greeting: Change your automat-
ed voicemail greeting or answer your phones with something like, “Hello, this is Main Street Pharmacy, where we’re celebrating American Pharmacists Month.” ■■ Get social: Incorporate APhM messages and events into your Facebook posts, Tweets, blog posts and other social media activity. Find more social media tips in the “Use Social Media” section. Your Special Day Remind your team members that the fourth Tuesday of October is National Pharmacy Technician Day! This is a day dedicated to recognizing the invaluable contributions technicians like you make in all practice settings throughout the year. Go ahead and celebrate! Source: American Pharmacists Association
APhM Month Resources and Promotional Materials This article is full of great ideas to help you celebrate American Pharmacists Month and promote the extreme value of your career to your patients, the public and community leaders. To help you take full advantage of these helpful tips, here are some very useful resources and promotional materials you can include in your efforts: Brand Your APhM Materials The APhM “Know” logo was developed by the American Pharmacists Association to help pharmacists promote the “Know Your Pharmacist, Know Your Medicine” campaign, and celebrate the many ways pharmacists help their patients with medication usage every day. APhA retains the rights to the APhM “Know” logo but allows pharmacists, pharmacies and others to use it in their own celebrations. Useage of the logo is restricted in some cases. Without prior authorization from APhA, it cannot be used
on items that will be listed “for sale” or in the development of branded materials where the logo would appear to promote a company or product. Specific guidelines for use of the American Pharmacists Month logo are available in the APhM Brand Identity Guide. American Pharmacists Month Logos (Please send an email to aphm@aphanet.org if a specific file format is needed): ■■ APhM Facebook profile picture - PNG ■■ APhM Twitter icon - PNG ■■ APhM Know October - JPG ■■ APhM Know w/o month - JPG ■■ All Logos - zipped - EPS ■■ All Logos - zipped - JPG
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Sample American Pharmacists Month Proclamation Office of the [GOVERNOR/MAYOR] [STATE/CITY]
American Pharmacists Month Proclamation Whereas, Pharmacy is one of the oldest of the health professions concerned with the health and wellbeing of all people; and Whereas, Today, there are more than 300,000 pharmacists licensed in the United States providing services to ensure the safe and effective use of all medications; and Whereas, The safe and effective use of medication, as a cost-effective alternative and a mechanism to avoid more expensive medical procedures, is a major force in moderating overall health care costs; and Whereas, Today’s powerful and complex medications require greater attention to the manner in which they are used by different patient population groups—both clinically and demographically; and Whereas, It is important that all users of prescription and nonprescription medications, their families or their caregivers, be knowledgeable about and share responsibility for their own drug therapy; and Whereas, Pharmacists have extensive education and expertise on drugs and medication therapy, which makes them ideally suited to work collaboratively with patients and their health care team members to improve medication use and outcomes; and Whereas, Pharmacists provide patients with expertise, knowledge and accessibility, all crucial factors to support improvement in our nation’s public health; and Whereas, Pharmacists are best positioned to be the health care professionals to help patients improve their adherence to their medications, and provide patient care services that ensure optimal medication therapy outcomes; and Whereas, the American Pharmacists Association and the [STATE/LOCAL ASSOCIATION OR PHARMACY GROUP] have declared October as American Pharmacists Month with the theme “Know Your Pharmacist, Know Your Medicine.” IN WITNESS WHEREOF, I have hereunto set my hand this _______________, in the year of our Lord two thousand fifteen, and of the Independence of the United States of America the two hundred and forty. NOW, THEREFORE, I, [GOVERNOR’S/MAYOR’S NAME] [GOVERNOR/MAYOR of STATE/CITY], by virtue of the authority vested in me by the [CITY/STATE of CITY/STATE], do hereby proclaim October as American Pharmacists Month in the [STATE/CITY] of [NAME] and urge all our citizens to acknowledge the valuable services of pharmacists to provide safe, affordable and beneficial pharmaceutical care services and products to all citizens. [GOVERNOR’S/MAYOR’S SIGNATURE and SEAL]
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Brochures and More, Ready to Go! Make your promotions unique, informative and memorable with APhA’s wide selection of products and patient education brochures. Our brochures are ideal for individual patient counseling, displays, health fairs, screenings and presentations. Media Outreach Tools Media outlets want stories that are timely, interesting and full of local and personal appeal. APhA has tools such as pitch letters, news release samples, media advisories and media kits to help get your message out. Patient Outreach Tools These patient outreach and education tools will help you in your daily practice: ■■ Patient Outreach Tools ■■ APhM: 20 questions to talk over with patients ■■ Choosing the Right Over-the-Counter Treatment for You and Your Loved Ones ■■ Using Vitamins and Herbal Supplements Wisely Source: American Pharmacists Association
Proclamation for Official Recognition Here is a link to the sample proclamation template described on page 20. Source: American Pharmacists Association
(Note: This is the document online and linked into the page. I made a few comments in the doc stored under this folder, but it is uncertain as to whether they would be open to changing, if needed.)
Remembering Pharmacists Who Serve
Pharmacist organizations of each branch of the military can and do celebrate American Pharmacists Month. If you know pharmacists stationed overseas, send them a care package with APhM items. For pharmacists within the United States Public Health Service and the Department of Veterans Affairs, why not schedule a day to give flu shots to your civilian counterparts? Or conduct brown bag medication review consults or educational sessions. This will give you an opportunity to demonstrate the valuable role that pharmacists play on the healthcare team. Source: American Pharmacists Association
Celebrate National Pharmacy Technician Day
The third Tuesday of October is National Pharmacy Technician Day. Make an extra effort to thank technicians for their invaluable support and contributions throughout the year. Post pictures of your techs in the lobby. Give them a “thank you” lunch with a cake. Source: American Pharmacists Association
Keep Us in the Loop
As suggested above, we recommend you keep copies of all your outreach materials, press releases, web and social media posts, media kits, videos, etc., along with all press clippings, news stories and any other coverage you receive for APhM. This will not only help build your ongoing portfolio, it will also provide a nice historical record of your activities over the years – and make it easier to participate in the coming years.
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More from the Florida Pharmacy Association’s 125th Annual Meeting and Convention There were simply too many good images from this year’s convention to get them all in one journal. Enjoy the following gallery and feel free to share your own photos on our Facebook page.
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Waiving Providers, Wavering Care: Managed Care Organizations Exclude Certain Pharmacy Providers Article by Kala Kelly, attorney with the Lockwood Law Firm in Tallahassee. John Lockwood serves as the FPA's general counsel.
Generally speaking, health care spending accounts for approximately 33 percent of Florida’s budget.
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In Florida, the amount of Medicaid recipients is on the rise so it should come as no surprise that the state and federal government look for different strategies to curb these costs. Generally speaking, health care spending accounts for approximately 33 percent of Florida’s budget. One such route is through providing federal waivers to state agencies that allow private managed care organizations to service Medicaid recipients in Florida. Once a private managed care organization is permitted to service Medicaid recipients, the organization can limit the types of providers it will offer reimbursements to within its network. These waivers present a number of issues to providing quality care for Medicaid recipients in Florida. This article provides an overview of Medicaid waiver history, outlines current state and federal law, and addresses some concerns related to the waiver program. By way of background, Medicaid is “a joint state-federal funding program for medical assistance in which the federal government approves a state plan for the funding of medical services for the needy and then subsidizes a significant portion of the financial obligations the State has agreed to assume.” Alexander v. Choate, 469 U.S. 287, 289 n. 1 (1985). Under the federal Medicaid Act, each state is required to develop a State Plan and designate a state agency to administer the program. 42 U.S.C. § 1396a(a)(23). In Florida, the Agency for Health Care Administration (AHCA) is that designated agency. The Medicaid Act further requires states to administer state plans which include a “freedom of choice” provision requiring Medicaid recipients the right to choose services from a broad range of providers. 42 U.S.C. § 1396a(a)(23). The federal law permits states to provide up to twenty different services, but requires the state to provide at least nine services. 42 U.S.C. § 1396a(a)(10)(A), 139d(a)(1)-(29). Florida has a range of laws that expand on the ways in which the state will administer the “freedom of choice” provisions. For example, section 409.912(37)(a)4., Florida Statutes, states that AHCA “may limit the size of its pharmacy network based on need, competitive bidding, price negotiation, credentialing, or similar criteria.” The Medicaid Act also permits states certain waivers from providing “freedom of choice” programs if the state implements its own managed care program. The Centers for Medicare & Medicaid Services (CMS) is the federal agency charged with approving such waivers. 42 U.S.C. § 1915(b), 1396n(b). Florida first took advantage of this waiver program in 1989 when it required many Medicaid recipients to be enrolled in privately owned managed care organizations.
Since that time, CMS has continued to approve state waivers, including “freedom of choice” programs. Florida is currently operating pursuant to a CMS waiver that allows Florida to direct Medicaid recipients to its Managed Medical Assistance (MMA) plans. In Florida, the MMA plans are referred to as the Statewide Medicaid Managed Care (SMMC) program. Under the SMMC, the state is divided into 11 regions. Certain managed care organizations are permitted to cover each region. Further, chapter 409, Florida Statutes, is the state law that governs how these plans operate, including how certain Medicaid providers in the SMMC may provide that networks that exclude certain providers. Specifically, section 409.975(1), Florida Statutes, states, “managed care plans may limit the providers in their networks based on credentials, quality indicators, and price.” This means there are no state requirements governing how a managed care organization chooses to exclude providers from its network. At the federal level, federal law simply requires Medicaid managed care organizations to maintain “a sufficient number, mix, and geographic distribution of providers of services.” 42 U.S.C. § 1396u-2(b)(5)(B). Florida’s reliance upon managed care programs present a number of quality of care issues for Medicaid recipients. Specifically, relying on for-profit managed care organizations does not ensure that recipients will have access to the most comprehensive and personalized direct patient care possible. Instead, certain organizations may be more fiscally inclined to include large chain pharmacies, like CVS and Wal-Mart, for Medicaid claims as opposed to independent pharmacies in its provider network. Unsurprisingly, managed care organizations have taken advantage of the exclusion provision. In 2012, Amerigroup stated in its contract with AHCA to provide managed care that Amerigroup was permitted to control the pharmacy providers it chooses to utilize in its network. The contract went on to read that if Amerigroup “elects to use a more restrictive pharmacy network than the Medicaid fee-for-service network, [Amerigroup] shall provide at least one (1) licensed
Florida’s reliance upon managed care programs present a number of quality of care issues for Medicaid recipients. Specifically, relying on for-profit managed care organizations does not ensure that recipients will have access to the most comprehensive and personalized direct patient care possible.
pharmacy per 2,500 enrollees.” More recently, Humana began excluding pharmacy providers pursuant to their contract with AHCA. Humana’s contract allows for a closed pharmacy network provided that certain geographical criteria are met. Assuming Humana has a network provider within a certain distance or drive time, their contract purportedly allows for the exclusion of independent pharmacies – even if the patient has developed a pharmacist-patient relationship spanning many years. Still, these protections for managed care providers are codified into Florida’s law. This means that at this point, very little can be done at the executive or judicial level to remedy the situation. Instead, the Florida Legislature must amend the law to give added protections to individuals whose pharmacies are excluded from managed care plan networks.
Representing Health Care Professionals
• DOH Investigations • Licensure Discipline • Medicare/Medicaid Defense • Administrative Hearings • Contract Litigation George F. Indest III, J.D., M.P.A., LL.M.
1101 Douglas Avenue Altamonte Springs, FL 32714 Telephone: (407) 331-6620 www.TheHealthLawFirm.com
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Following are copies of the correspondence between FPA CEO Michael Jackson and AHCA Secretary Elizabeth Dudek concerning the “Closure of Medicaid Pharmacy Network.”
United to Advance Health Care and Pharmacy Practice
August 20, 2015 Elizabeth Dudek Secretary Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #1 Tallahassee, Florida 32308 Re: Closure of Medicaid Pharmacy Network Dear Secretary Dudek, The Florida Pharmacy Association (the “FPA”), as you know, has been a longstanding organization whose members are dedicated to serving our patients in the most effective and safe way. We are very concerned that recent actions by an HMO could jeopardize the safety and health of many Floridians who need medicine to sustain their health. It has come to our attention that Humana has issued notice stating that "Starting September 1, 2015 some pharmacies may not take your Humana Medicaid Plan." (Emphasis added). And included the following: "These are just some of the pharmacies where you can get your medicines from for free: CVS, Walmart, Walmart Express, Sam's Club, Walmart Neighborhood Market, Publix, PrescribeIT Rx, or Humana Pharmacy. There are other pharmacies that you can use to get your medicines at no cost to you. You can find the complete list online..." It appears there are no other pharmacies included in Humana’s approved list, other than a small amount of community health care centers. The FPA takes issue with the implication that any of our members had a choice as to whether we could accept Humana Medicaid patients. We did not. We are further concerned that the Humana notice was approved by AHCA prior to dissemination to patients. We believe the notice is misleading and implies that the pharmacies are making the choice not to accept Humana, instead of the reality that Humana made a business decision to close its network. Our main concern, however, is the lack of access to local pharmacies this closed network would create. Many of our members have had a close and long term relationship with our patients and the termination of this relationship will at the very least create confusion and has potential for jeopardizing pharmacy services that these patients have relied on for their health. We are particularly concerned for those patients in rural areas that may not have accessible transportation to these large chains and those patients who rely on home delivery that is not offered by these large chains. We would respectfully ask that AHCA provide more information to these patients or reiterate that Medicaid recipients can seek assistance from any source including a Florida Medicaid 610 North Adams Street, Tallahassee, FL 32301 www.PharmView.com (850) 222-2400
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Pharmacy provider as AHCA provided in a letter to the FPA dated 12/10/2012 related to similar network closure regarding another HMO. We would like to meet with you and/or your team at your earliest convenience to further discuss our concerns. Thank you in advance for your attention to this urgent matter. Sincerely,
Michael A. Jackson, BPharm Executive Vice President and CEO CC: FPA Board of Directors The Honorable Andy Gardiner, President of the Senate The Honorable Steve Crisafulli, Speaker of the House of Representatives
610 North Adams Street, Tallahassee, FL 32301 www.PharmView.com (850) 222-2400 Â
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FPA News & Notes
FPA Technician Member Recipient of National Award Florida Pharmacy Journal Board Member Verender Gail Brown of Orlando has received the 2015 Next-Generation Pharmacist Award for Technicians. Ms. Brown has a B.S. in Biology from Eckerd College and has also received the APhA Certificate of Achievement: Delivering Medication Therapy Management Services. She is a certified pharmacy technician and is the first recipient of the Florida Pharmacy Association Technician of the Year Award. She is also a member of the Florida Pharmacy Journal Board of Directors Co-founded by Parata and Pharmacy Times, this national awards program honors pharmacists, technicians, students and industry advocates who are defining the future of pharmacy. Since 2010, more than 140 pharmacy leaders have been named finalists or winners. Congratulations Ms. Brown from the staff and leadership of the Florida Pharmacy Association. Requirement to Report Significant Theft or Loss of Controlled Substances Members need to be aware that Florida laws require prescription department managers to report the significant theft or loss of controlled substances not only to the Drug Enforcement Administration but also to the Florida Board of Pharmacy. At this time we are not aware of what constitutes a significant theft or loss so this will depend on the judgment of the prescription department manager. This requirement is in Florida Statutes 465.022 (11) (b). This report needs to be filed within one business day after the discovery of that theft or loss. Of course, anything you send to the Board should be done with a return receipt or confirmation. The Board’s address is 4052 Bald Cypress Way, Bin C-04, Tallahassee, Florida, 323993258.
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FLORIDA PHARMACY TODAY
House Provider Status Legislation Gaining Cosponsors H.R. 592, titled the Pharmacy and Medically Under served Areas Enhancement Act, now has 206 co-spon sors. California has the most co-sponsors with 26 fol lowed by Illinois (15), Florida (14) and New York (11). Florida’s co-sponsors who have signed on in support of this bill include: ■■ Representative Alcee Hasting ■■ Representative David Jolly ■■ Representative Dennis Ross ■■ Representative Patrick Murphy ■■ Representative Gus Bilirakis ■■ Representative Carlos Curbelo ■■ Representative Ron DeSantis ■■ Representative Richard Nugent ■■ Representative Daniel Webster ■■ Representative Jeff Miller While there are 30 members of the Senate in Washington, D.C. listed as co-sponsors, neither Senator Bill Nelson nor Senator Marco Rubio has signed on. Both the House and Senate versions of the bills are identical. Continue to reach out to your member of Congress and ask for their support. Thank you to the many of our members that are actively engaged on this issue. You can make a difference and we have the tools to help you. This website link will tell you how. Revised Pharmacy Technician Rules In Effect On July 6, 2015, revisions to rule 64B16-27.410 (Registered Pharmacy Technician to Pharmacist Ratio) and rule 64B16-27.420 (Pharmacy Technician - Delegable and NonDelegable Tasks) took effect. While there were a number of technical changes with 27.410, the most significant one included the additional language clarifying the use of up to six technicians in a pharmacy that dispenses medications. That new language added is the following: Dispensing pharmacies. “A pharmacy which dispenses medicinal drugs may utilize a six to one (6:1) ratio in any physically separate area of the pharmacy from which medicinal drugs are not dispensed. A “physically separate area” is a part of the pharmacy which is separated by a permanent wall or other barrier which restricts access between the two areas.” In rule 64B16-27.420 language was removed related to allowable tasks that can be delegated to technicians. The older version of this rule allowed for technicians to assist in preparing parenteral and bulk solutions or assisting in any act involving sterile compounding must comply with the requirements of Rule 64B16-27.1001, F.A.C.
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
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
PHARMACEUTICAL WHOLESALER
FLORIDA BOARD OF PHARMACY 4052 Bald Cypress Way Bin #C04 Tallahassee, FL 32399-3254 (850) 245-4292 www.doh.state.fl.us/mqa
McKesson Drug Company Jim Springer (800) 804-4590 FAX: (863) 616-2953
FLORIDA POISON INFORMATION CENTER NETWORK (800) 222-1222 www.fpicn.org NATIONAL COMMUNITY PHARMACISTS ASSOCIATION 100 Daingerfield Road Alexandria, VA 22314 (703) 683-8200 (703) 683-3619 fax info@ncpanet.org
Advertising in Florida Pharmacy Today Display Advertising: please call (850) 264-5111 for a media kit and rate sheet. Buyers’ Guide: A signed insertion of at least 3X per year, 1/3 page or larger display ad, earns a placement in the Buyers’ Guide. A screened ad is furnished at additional cost to the advertiser. Professional Referral Ads: FPA Members: $50 per 50 words; Non‑members: $100 per 50 words; No discounts for advertising agencies. All Professional Referral ads must be paid in advance, at the time of ad receipt.
RECOVERING PHARMACISTS NETWORK OF FLORIDA (407) 257-6606 “Pharmacists Helping Pharmacists”