Florida Pharmacy Today January 2019 by Florida Pharmacy Today

The Official Publication Of The Florida Pharmacy Association JAN. 2019

PREVENTING 1 MILLION HEART ATTACKS AND STROKES MIDDLE-AGED ADULTS ARE BEING HARD HIT

“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 2 |

FLORIDA PHARMACY TODAY

florida PHARMACY TODAY Departments 4 Calendar 4 Advertisers 5 Presidentâ&#x20AC;&#x2122;s Viewpoint

7 Executive Insight

25 License Renewal Deadlines 30 FPA Award Nominations

VOL. 81 | NO. 12 DECEMBER 2018 THE OFFICIAL PUBLICATION OF THE FLORIDA PHARMACY ASSOCIATION

Features

9 12 14 16 18 20 26

Preventing 1 Million Heart Attacks and Strokes Middle-aged adults are being hard hit

Recognizing the Impact of Grassroots Advocacy by Student Pharmacists - The Student Advocacy Outreach Teams OPINION How Lack of Drug Transparency in Rx Pricing is Hurting Patients at the End of Life in Hospice Care Association Involvement and Influence on my Journey into Managed Care Pharmacy Practice SMMC Transition Pharmacy Point of Sale Messaging from AHCA Local Unit Association Leadership Meeting FPA 129th Annual Meeting and Convention

JANUARY 2019

Mission Statements:

FPA Calendar 2019

Florida Pharmacy Today Journal

FEBRUARY 4-6

Florida Board of Pharmacy Meeting Tallahassee

23-24 FPA Council and Committee meetings Tampa 28

FPA Awards Nominations Due MARCH

Budget and Finance Committee Conference Call

Board of Directors Conference Call

First Day of the Legislative Session

12-13 FPA Legislative Days and Health Fair Tallahassee 22-25 APhA Annual Meeting Seattle, Wash.

APRIL 2-3

Board of Pharmacy Meeting Gainesville

6-7

Regulatory and Law Conference Tampa MAY

Last Day of Legislative Session

Last Day to Submit Resolutions for Consideration by the 2019 House of Delegates

House of Delegates Board of Directors meeting

18-19 FPA Clinical Conference Jacksonville 27

Memorial Day - 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. 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, 2019 or prior to licensure renewal. Consultant pharmacists and technicians will need to renew their licenses and registrations by December 31, 2020. 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 CONTACTS FPA — Michael Jackson (850) 222-2400

FSHP — Tamekia Bennett (850) 906-9333 UF — Emely McKitrick (352) 273-5169

FAMU — Leola Cleveland (850) 599-3301 NSU — Carsten Evans (954) 262-1300

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.

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 KAHAN & ASSOCIATES................................. 16 PQC...................................................................... 23 PHARMACISTS MUTUAL................................ 2 SHARP’S INC..................................................... 25

Note: The views of the authors do not necessarily represent the views or opinions of the Florida Pharmacy Association, Florida Pharmacy Today or any related entities.

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 |

FLORIDA PHARMACY TODAY

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

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

The Final Year of this Decade

e begin 2019 with an aggressive plan for our profession. Over the years we have learned of the tipping point for pharmacy. This is triggered by changes in reimbursement, practice rules and regulations and the growth of health care technology. We are now on the other side of the fence and have tremendous opportunities ahead of us. The key is to find a way to integrate traditional practices in the new pharmacy model. By now we should have transitioned our professional roles from that of the provider of prescription medications to provider of quality health care. Everything that we do should be about integrating the skills of a pharmacist as part of the modern contemporary practice of which prescription services is but one portion of the value that we deliver. There is a huge emphasis on preventative health care these days. Those who pay for health care services want it and would likely be willing to pay for it, provided that there is evidence of an effective delivery model that has the potential for tremendous cost savings. This year we will see a new administration stepping into the Governor’s Mansion. The conversations that we have been having suggest that members of the House and Senate would be open to new ideas on changing the current health care models that provide significant cost savings. This brings out an opportunity for two issues that we, as advocates, can make a difference in. The first issue is making changes to the Pharmacy Practice Act that utilizes the medication management skills of pharmacists. We have the ability to resolve patient medication problems, but we don’t have the authority under our practice act to execute changes without first gaining authorization from other

licensed providers. Legislation is being introduced during the 2019 legislative session to take advantage of the services that pharmacists can perform. Secondly, we all know that there is a tremendous lack of transparency in today’s prescription drug payment models. Costs for prescription medications continue to rise even though there are claims by the pharmacy benefit man-

By now we should have transitioned our professional roles from that of the provider of prescription medications to provider of quality health care.

Michael Jackson, B.Pharm

the veil of secrecy on the PBM industry so consumers can see once and for all what is going on. We all know what needs to be done, and that includes engagement by our members, awareness by those who are not member stakeholders and advocacy efforts before policy makers that can facilitate change. The FPA leadership team is committed to working hard to make a difference in our profession. You can be a part of this campaign to prepare us for the next decade of pharmacy practice. n

agement advocates of controlling those costs. This is because there are few transparent models out there where the payer of pharmacy services and the provider of pharmacy services know how the money is flowing. Secret and confidential contracts are in place to keep essential information away from those who may benefit from knowing what are in those agreements. It’s time to lift JANUARY 2019

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

Director of Continuing Education Tian Merren-Owens, ext. 120

Educational Services Office Assistant Stacey Brooks, ext. 210 Coordinator of Membership Christopher Heil, ext. 110 Accounting Coordinator Ashley Gandy ext. 211

FLORIDA PHARMACY TODAY BOARD Chair..................................... Carol Motycka, St. Augustine Vice Chair................................Cristina Medina, Hollywood Treasurer...........................................Eric Jakab, Gainesville Secretary.........................Stuart Ulrich, Boynton Beach Member............................... Michael Finnick, Jacksonville Member...............................................Matt Schneller, Tampa Member...................................Teresa Tomerlin, Rockledge Member..............................................Greta Pelegrin, Hialeah Technician Member.................Julie Burger, Pensacola Executive Editor.........Michael Jackson, Tallahassee Managing Editor.........................Dave Fiore, Tallahassee

This is a peer-reviewed publication. ©2019 FLORIDA PHARMACY JOURNAL, INC. ARTICLE ACCEPTANCE: The Florida Pharmacy Today is a publication that welcomes articles that have a direct pertinence to the current practice of pharmacy. All articles are subject to review by the Publication Review Committee, editors and other outside referees. Submitted articles are received with the understanding that they are not being considered by another publication. All articles become the property of the Florida Pharmacy Today and may not be published without written permission from both the author and the Florida Pharmacy Today. The Florida Pharmacy Association assumes no responsibility for the statements and opinions made by the authors to the Florida Pharmacy Today. The Journal of the Florida Pharmacy Association does not accept for publication articles or letters concerning religion, politics or any other subject the editors/publishers deem unsuitable for the readership of this journal. In addition, The Journal does not accept advertising material from persons who are running for office in the association. The editors reserve the right to edit all materials submitted for publication. Letters and materials submitted for consideration for publication may be subject to review by the Editorial Review Board. FLORIDA PHARMACY TODAY, Annual subscription - United States and foreign, Individual $36; Institution $70/year; $5.00 single copies. Florida residents add 7% sales tax. FLORIDA PHARMACY ASSOCIATION

610 N. Adams St. • Tallahassee, FL 32301 850/222-2400 • FAX 850/561-6758 Web Address: http://www.pharmview.com 6 |

FLORIDA PHARMACY TODAY

2018-19 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 Wise.....................................................................................................Board Chair Angela Garcia...............................................................................................FPA President Ashley Huff.................................................................................................... FPA Treasurer David Mackarey.......................................................................................President-Elect Jeanette Connelly...................................................................Speaker of the House Gary Koesten..................................................................Vice Speaker of the House Sandy Estrada......................................................................................... FSHP President Joyanna Wright................................................................................... Region 1 Director Neil Barnett............................................................................................Region 2 Director Dean Pedalino.......................................................................................Region 3 Director Cheryl Rouse.........................................................................................Region 4 Director Melissa Ruble........................................................................................Region 5 Director Barbara Beadle...................................................................................Region 6 Director Paul Delisser.......................................................................................... Region 7 Director Ramy Gabriel.........................................................................................Region 8 Director Mitchell Fingerhut.............................................................................Region 9 Director Julie Burger........................................................................................Technician Member

Florida Pharmacy Today Journal Board Chair.............................................................. Carol Motycka, motycka@cop.ufl.edu Vice Chair....................................................Cristina Medina, cmmedina@cvs.com Treasurer.........................................................Eric Jakab, ericjakab@hotmail.com Secretary................................................................... Stuart Ulrich, stuarx@aol.com Member.................................................. Michael Finnick, michaelfinnick@ufl.edu Member.......................................................Matt Schneller, schnem18@gmail.com Member..........................................Teresa Tomerlin, teresapharmd@cfl.rr.com Member............................................Greta Pelegrin, gretapelegrin@yahoo.com Technician Member........................Julie Burger, julieburger133@gmail.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

Florida Pharmacy Association Technician Education Update By Julie Burger MPH, CPhT

The new year has brought new changes for pharmacy technician education. There is now a delineation in national education requirements for both entry-level and advanced-level technicians. The industry leader responsible for education standards is the Pharmacy Technician Accreditation Commission (PTAC). PTAC is a collaboration of both the American Society of Health System Pharmacists (ASHP) and the Accreditation Council for Pharmacy Education (ACPE). PTAC and ASHP have collaborated on technician education since 2014 and they have collectively established these new standards as well. Historically, technician educators have used these guidelines in developing training programs and set the evaluation standard for entry-level pharmacy technicians. These new pharmacy technician educations standards are a critical step in the evolution of technician training. These new improvements are impor-

tant for the protection of the public. Entering the field of pharmacy can be accomplished in a variety of ways. This is a critical step to ensure consistency when training technicians for a complex set of tasks in a wide variety of pharmacy settings. Pharmac y tech n icians are t he only allied health profession without a mandatory national standard to support staff preparation. To address this, PTAC, ASHP, ACPE and the Pharmacy Technician Certification Board (PTCB) held a stakeholders conference in February 2017. There were 89 participants on site and more than 350 remote participants. Industry concerns addressed at this conference included: technician expanded scope of practice, greater expectations in the workplace and regulations governing technician entry into the workforce. An advisory group was formed from this conference and charged with drafting the updated standard. This group looked at information from the PTCB job analysis, ExCPT blue print review and incorporated stakeholder confer-

ence inputs. The advisory group faced two main issues: defining a national education standard and how to implement a national education standard. The final draft of the advisory groupâ&#x20AC;&#x2122;s proposal was approved by both the ASHP and ACPE boards in June 2018. The end result of this process defines two clear paths for pharmacy technician training programs. The entry-level training program meets standards designed to prepare technicians for a variety of contemporary settings. The advanced-level training program meets standards designed to prepare technicians for a broader set of roles (e.g. community, health systems, home care, mail order, compounding, etc). These changes reflect a strong marketplace need for a qualified and competent workforce to support pharmacists. Technicians can now be involved in patient care settings, compliance issues, medication therapy management, quality improvement planning and many other specialized areas depending upon the practice setting. The next step is to align state boards of pharmacy in an effort to require a national standard. I invite you to explore the new standards on the ASHP website: https:// www.ashp.org/Professional-Development/Technician-Program-Accreditation. There are tools to aid in accreditation including a model curriculum, guidance documents and a self-assessment checklist. I also encourage you to support ASHP/ACPE accredited programs in an effort to have a uniform standard for technician education and in an effort to attain a national standard and advanced roles for pharmacy technicians. Julie Burger MPH, CPhT, is Pharmacy Technician Program Director at Pensacola State College.

PREVENTING 1 MILLION HEART ATTACKS AND STROKES MIDDLE-AGED ADULTS ARE BEING HARD HIT Source: Centers for Disease Control and Prevention

About

16 MILLION

heart attacks, strokes, and related heartthreatening events* could happen by 2022.

8 |

FLORIDA PHARMACY TODAY

1 in 3

of these life-changing cardiovascular events happened in adults 35-64 years old in 2016.

80%

of premature heart disease and strokes are preventable.

Overview

Heart attacks and strokes can be catastrophic, life-changing events that are all too common. Heart disease and stroke are preventable, yet they remain leading causes of death, disability, and healthcare spending in the US. Alarmingly, many of these events happen to adults ages 35-64—over 800,000 in 2016. Million Hearts® is a national initiative with a network of partners focused on preventing one million heart attacks, strokes, and other cardiovascular events by 2022. Coordinated actions by public health and healthcare professionals, communities, and healthcare systems can and will keep people healthy, optimize care, and improve outcomes within priority populations. Healthcare professionals and systems can: ■■ Focus on the ABCS of heart health: Aspirin use when appropriate, Blood pressure control, Cholesterol management, and Smoking cessation. ■■ Take a team approach—use technology, standard processes, and the skills of everyone in the healthcare system to find and treat those at risk for heart disease and stroke. ■■ Make sure people who have had a heart attack or stroke get the care they need to recover well and reduce their risk of another event. ■■ Promote physical activity and healthy eating among their patients and employees.

* Deaths, hospitalizations, and emergency room visits due to heart attack, stroke, and other cardiovascular conditions like heart failure that could be prevented if Million Hearts

People not taking aspirin as recommended.

People with uncontrolled blood pressure.

Adults not using statins (cholesterollowering medecines) when indicated.

2022 actions are taken.

Heart attacks and strokes are common and preventable. ■■

■■

Adult smokers.

More than 1,000 Americans died each day in 2016 from heart attack, stroke, and other events Million Hearts® is trying to prevent. Many opportunities to find and treat risk factors are missed every day.

Adults who are physically inactive. JANUARY 2019

Populations more at risk. ■■

■■

■■ ■■

Americans aged 35-64 are less likely to use aspirin or statins (cholesterol-lowering medicines) when indicated, and only about half have their blood pressure under control. Blacks/African Americans are more likely than whites to develop high blood pressure—especially at earlier ages— and are less likely to have it under control. People with mental health and/or substance use disorders use tobacco more frequently. People who have already had one heart attack or stroke are at high risk for a second.

Million Hearts®: Everyone Can Make Small Changes that Matter.

The solution to this crisis is already in front of us. Small changes sustained over time will result in big improvements to the heart health of our nation. Everyone can take action. Million Hearts® is working with more than 120 partners, all 50 states and the District of Columbia, and 20 federal agencies to: Keep people healthy by making changes to environments in which people live, learn, work, and play to make it easier to make healthy choices.

Source: Million Hearts® At-A-Glance, 2017

Getting to One Million

Everyone can take small steps to improve their own health, the health of their families and loved ones, patients, communities, and the heart health of our nation. We have to act now. Small changes in every state will have a big impact (see map above). ■■ One million events could be prevented by 2022 if every state reduced these life-changing events by 6%. ■■ While rates are higher in the Southeast and Midwest, small changes to improve heart health are needed in all states. 10

FLORIDA PHARMACY TODAY

HOW: Achieve a 20% reduction in sodium intake, tobacco use, and physical inactivity.

What Can Be Done

Communities making physical activity easier by creating walking and biking trails.

People adding 10 minutes of physical activity a day—like walking or gardening. Optimize care so that those at risk for cardiovascular disease get services and skills needed to reduce the risk of having a heart attack or stroke. ■■ HOW: Achieve 80% performance in the ABCS, and 70%participation in cardiac rehabilitation. ■■ Insurers providing coverage for home blood pressure monitors. ■■ Clinicians using a standard treatment protocol for high blood pressure, cholesterol management, and tobacco cessation. Improve outcomes for priority populations who suffer more from cardiovascular disease and where we know we can make an impact. ■■ HOW: Employers providing places and time for employees to walk during the workday. ■■ Behavioral health providers receiving training in smoking cessation and using it in their practice.

We’ve already begun.

Keeping People Healthy. ■■ Eskenazi Health in Indiana lowered sodium content of foods in all vending machines and cafeterias by 37% with their Choose Health Initiative. Optimizing Care. ■■ Over 200 Federally Qualified Health Centers achieved more than 70% performance of the ABCS in 2016 earning a Million Hearts® badge. Improving Outcomes for Priority Populations— People who have had a heart attack or stroke. ■■ Dartmouth-Hitchcock Medical Center in New Hampshire achieved 80% cardiac rehab enrollment through liaisons who identified eligible patients and connected them to programs.

The Federal Government is: ■■ Co-leading the Million Hearts® initiative (CDC and the Centers for Medicare & Medicaid Services) to prevent 1 million heart attacks and strokes by 2022. millionhearts. hhs.gov ■■ Helping improve the heart health of millions of Americans by investing in improving delivery of care, including rewarding clinicians for providing care we know works. ■■ Providing funding and support to all 50 states, the District of Columbia, municipalities, and tribal communities to ensure clinical and public health agencies are working together to prevent heart disease and stroke. Healthcare Professionals & Systems can: ■■ Focus on the ABCS of heart health: Aspirin use when appropriate, Blood pressure control, Cholesterol management, and Smoking cessation. ■■ Take a team approach—use technology, standard processes, and the skills of everyone in the healthcare system to find and treat those at risk for heart disease and stroke. ■■ Make sure people who have had a heart attack or stroke get the care they need to recover well and reduce their risk of another event. ■■ Promote physical activity and healthy eating among their patients and employees. State and Local Health Departments can: ■■ Use their state’s heart disease and stroke events data to drive Million Hearts® actions locally. ■■ Promote tobacco control interventions, smoke-free environments, and programs to help tobacco users quit. ■■ Work to improve heart-healthy nutrition and physical activity by promoting the use of healthy food service guidelines and making communities more walkable. Employers can: ■■ Make it easier for employees to get needed medicines, blood pressure monitors, and services by providing insurance coverage with no or low out-of-pocket costs. ■■ Provide on-site blood pressure monitoring and physical activity programs. ■■ Ensure smoke-free spaces and access to healthy food and beverages in vending machines and facilities. Everyone Can: ■■ Start one heart healthy behavior today – eat a hearthealthy diet, get physically active, or quit smoking! Keep it going to keep your heart healthy now and later in life! ■■ Learn your heart age and take action to improve it. cdc. gov/heartdisease/heartage.htm ■■ If you don’t use tobacco, don’t start. If you do, seek help at 1-800-QUIT-NOW or www.smokefree.gov.

JANUARY 2019 |

Recognizing the Impact of Grassroots Advocacy by Student Pharmacists - The Student Advocacy Outreach Teams Doctor of Pharmacy Candidates 2021 Dustin Williams B.S., Trent Abel B.S., Andrew Zeigler, Morgan Turney B.S., Kathryn Albert B.S., USF College of Pharmacy,

Doctor of Pharmacy Candidates 2020 Blake Grogan B.S., Jay Patel B.S., USF College of Pharmacy Last year, much like any other firstyear student pharmacists, we were looking for ways to get involved in other things besides didactic coursework and naturally we began to join student professional organizations such as the American Pharmacists Association - Academy of Student Pharmacists (APhA-ASP). We looked up to our upperclassmen for guidance and examples of places to invest our time and efforts and identify with the profession. Through the University of South Florida (USF) APhAASP chapter, we met the advisor, Dr. Angela Garcia, and saw the passion she exuded about the profession of pharmacy and the students she teaches. One of our first large legislative-based events that we attended was Florida Pharmacists Legislative Days and Health Fair event, which was overwhelming, to say the least. In preparation for the event, much of our free time was spent researching legislative processes and identifying House and Senate Bills that FPA either supported or opposed. We learned together what it meant to contact legislators, put together our scripts for those calls and then coordinate our face-toface visits during the Legislative Days at the Capitol. We coordinated our travel with the support of our Student Affairs Department at our school and headed up nervous, excited and ready to defend our patients and our profession. After we returned from Tallahassee and the Legislative Days events, we watched remote dispensing legislation (SB848 and HB679) somehow speed through the

FLORIDA PHARMACY TODAY

process of potentially becoming legislation. As an Association we stood in opposition, which made it frustrating to see something we were so passionate about continue to progress. In the language of that legislation, we shared our concerns about patient safety, professional practice and impressions that were not completely accurate of the impacts that legislation would have in community pharmacy. We began looking forward in the legislative schedule to identify the committees that the legislation would go before to be heard and either passed, amended and passed or not passed. We started compiling a document with all of the legislators’ names, email addresses and phone numbers to send to the other students and pharmacists in our area, with the hopes of recruiting calls and emails with the legislators from our districts. We spent time concentrating our efforts to help share the information with patients, knowing their relationships with their pharmacists and pharmacies and their voices would help us send the message and reach legislators effectively. It was important that we shared our outreach through social media. As students, it was empowering for us to see local associations, pharmacists from several practice areas, and even patients and family members share in the advocacy. The outreach movement opened our eyes to the power of our voices when we came together for something we believed in - educating both the public and legislators about pharmacy-related issues. We had several meetings with students as a team, and continued to develop tools that we could share. We invested a great deal of energy in grassroots advocacy. At the time, we were in the midst of learning new terms, the process of advocacy and the legislative system, all while following the bills and maintaining our coursework. What we were able to accomplish as students reinforced how important it was to have an active voice. Using our voices to support the agenda for the FPA gave us an appreciation of the reasons we must be advocates for our pro-

fession, for strong legislation supporting patient safety and the highest levels of integrity in pharmacy practice. Although the remote dispensing legislation didn’t pass in the 2018 Session, we anticipated several issues would come back for the 2019 Legislative Session. We considered what helped educate our student colleagues and committed to formalizing this process and working diligently to reach out and ensure we had student advocacy teams at every school. For the 2019 Legislative Session, we would be a larger united front, fully prepared and working in unison with intention and unified voices.

cy and policy by learning from pharmacists who are leading the Association in our legislative efforts. We are excited to have the opportunity to strengthen our arguments and efforts by learning the importance of year-round advocacy and building relationships with legislators outside of the Legislative Session. We’re excited to disseminate our work to the other Student Advocacy Outreach Teams and continue to build resources and closely monitor progress of the advocacy efforts. Furthermore, we want to model a sustainable advocacy program and encourage members to reach out to legislators

WE HAVE SEEN THE ABSOLUTE NECESSITY OF BEING KNOWN BY, AND HAVING RELATIONSHIPS WITH, OUR LEGISLATORS TO ENSURE OUR MESSAGE REMAINS AT THE CENTER OF THEIR PRIORITIES AND ATTENTION. WE HAVE FACILITATED OPPORTUNITIES TO BRING IN SPEAKERS WHO ARE FPA MEMBERS, OFFICERS, FORMER OFFICERS AND OTHER HIGHLY ENGAGED MEMBERS IN GRASSROOTS ADVOCACY. This year we have a revised mission - to utilize the documents and tools we created for ourselves to instill change and organize the student voice across the state through education, concerted grassroots advocacy efforts and an organized approach. However, now, instead of remaining local we are forging stronger bonds with members of the pharmacy community by linking with the FPA Governmental Affairs Committee as an Ad Hoc sub-committee to represent the student voice and disseminate legislative updates and calls for action across all seven schools and Colleges of Pharmacy. To make sure we have a diverse and equally represented student advocacy team, we’re collaborating with some of the largest organizations from the pharmacy programs (APhA-ASP, NCPA, SNPhA and SSHP). With the unique opportunity to work hand-in-hand with FPA’s Governmental Affairs Committee (GAC), we know we’re going to gain additional mentorship regarding advoca-

in their districts and maintain communication before and after Legislative Days. We have seen the absolute necessity of being known by, and having relationships with, our legislators to ensure our message remains at the center of their priorities and attention. We have facilitated opportunities to bring in speakers who are FPA members, officers, former officers and other highly engaged members in grassroots advocacy. This introduces students to grassroots advocacy efforts, dispels insecurities about discussing bills, nervousness about interacting with legislators and helps partner students with experience to those who are just starting the process. We are striving to create a unified, and thereby, stronger voice to bring to our legislators to advocate for ourselves and our profession with the hopes of being able to positively impact the lives of our patients.

JANUARY 2019

OPINION How Lack of Drug Transparency in Rx Pricing is Hurting Patients at the End of Life in Hospice Care By Dawn Butterfield, RPh

Deeply embedded in Florida statues is one particular statute that makes the statement we as a society can all agree on: “The services of the hospice home care program shall be of the highest quality and shall be provided by the hospice care team.” Highest quality is a great term. What does that mean? If everything were equal and you had to choose between a generic Zofran or a generic Phenergan tablet for nausea in general - which drug would you chose? It’s a no brain14

FLORIDA PHARMACY TODAY

er that generic Zofran would be chosen due to lack of side effects and incredible efficacy. If it were for YOU or YOUR family member and you had the choice - which one? How about a patient who had cancer and their pain was being controlled (for months prior to hospice admission) with Morphine Sulfate SR 100mg and some immediate release morphine for breakthrough. Would you want them to continue this therapy when your family member got admitted to Hospice services or would you opt for the regimen to change from the SR of morphine

to another drug recommended. In this case, methadone? Why are drugs chosen or changed in hospice care? One reason - it’s about the money. We all understand and appreciate there aren’t unlimited healthcare resources. Even simvastatin isn’t a necessary drug for a hospice patient, and expensive COPD inhalers, while effective, may not be better for the patient than nebulizer treatments and oxygen as they are mostly (if not totally) homebound. What IS necessary (and apparently demanded by law) is that hospice care itself would assume drugs used for that care help make people “comfortable” and that patients get THE BEST CARE in their dying stage of this terminal illness we call life (as death is a certainty). The situation described above regarding nausea and pain medications happened in our area with patients we were serving as their pharmacy. When nurses call the pharmacy and tell us they can’t use generic Zofran as it’s “too expensive” or more than once we are told by hospice nurses that when we filled the prescription for omeprazole they were calling to be sure to use the OTC version of omeprazole as its “cheaper.” We scratch our heads wondering what they are talking about. Generic omeprazole is pennies compared to the over-the-counter version. Why were they telling us this and why were so insistent? As luck would have it, I had the very rare opportunity to see the charges a hospice received by their processing pharmacy benefits management company (PBM). It was then that I realized why the nurses were so convinced and were being pressured to insist on these things that didn’t make sense to us - it

was all about the billing. Someone said recently - it’s not the healthcare that’s expensive, it’s the charges. This was certainly the case with this hospice, and I imagine almost all hospices that don’t use a transparent PBM. A transparent PBM ONLY charges on a per-claim basis and some charge on a per-member per-month, or percensus per-month arrangement. If NOT

we looked back and voila, ondansetron and morphine sulfate SR, in particular, both had very high AWPs - while we were paid via MAC pricing. The PBM charged the hospice over $4 per pill and we were paid $1 a pill for the morphine, for example. The “spread” was worse for the generic Zofran as we are paid essentially pennies and the AWP for generic Zofran is over

SOMEONE SAID RECENTLY - IT’S NOT THE HEALTHCARE THAT’S EXPENSIVE, IT’S THE CHARGES. THIS WAS CERTAINLY THE CASE WITH THIS HOSPICE, AND I IMAGINE ALMOST ALL HOSPICES THAT DON’T USE A TRANSPARENT PBM. transparent, the PBM rolls all of their administrative fees into “spread pricing.” Spread pricing is the difference between what the PBM pays the pharmacy and what it charges the end payer. When we were able to see what was charged to the end payer (hospice entity) we could also look to see what we (the pharmacy) were paid and calculate the “spread” made by the PBM. That was another eye opener, not that we were surprised. Pharmacies are paid on a Maximum Allowable Cost (MAC) schedule - which is a “proprietary” list kept by the PBM. These lists are supposed to ensure the pharmacy shops for the best price, which can change daily. It’s interesting how quickly the changes are made for price decreases but are painfully slow when prices increase. What we have all thought this entire time is true regarding these lists, their formula calculations, etc. In reality, the PBMs just make up the prices, or if they don’t - they COULD as there is no way for anyone, any entity, to ensure that they don’t. From the payment the hospice made to the PBM it was obvious that the arrangement the PBM had with the hospice was a skewed pricing scheme particularly taking advantage of drugs that had a high AWP (Average Wholesale Price) being billed out at a high rate. So

$24/table. If there was transparency of billing – the hospice entity and the PBM was paid an administrative charge – the hospice would have paid one-third of what they had to pay under the “spread pricing” model for the morphine and wouldn’t keep their nurses from utilizing generic Zofran for nausea as the true (low) cost of generic Zofran would be reflected in the billing. The family was HIGHLY upset that methadone (due to perception of what methadone is used for) was suggested and the hospice nurses had to justify the switch - which they were uncomfortable in doing. Methadone, while being a great long-acting pain medication, isn’t necessarily an appropriate substitution for Morphine SR especially for a patient that HAS been stable (and happy) with their current regimen. The transition of life to death and having a family deal with all that encompasses shouldn’t include sketchy pricing schemes leaving their loved one with a lesser-quality medication. It’s truly the LAST thing they should be dealing with and is certainly NOT lawful as we can make the argument choosing drugs for this purpose runs counter to the government mandate in Florida statute that the services of the hospice home care program shall be of the highest quality and shall be provid-

ed by the hospice care team. There was another hospice in Florida that was charged over $3,700 (by their PBM) for a prescription for generic Zyvox and the pharmacy was paid $22.20. When considering generic Zyvox in the future, you know that this hospice would be nervous to consider even though it was the only drug to work for that patient - which is why it was selected. From $3,700 to $22.20 - that’s one whopper of a spread – on ONE prescription. Hospice entities are paid on a daily per-diem basis and not a fee-for-service basis. So the less the hospice entity has to pay for pharmaceuticals the more nursing staff (and other) support they can give the patient and family. It’s a tightrope to walk as in the end “comfort measures” beyond the comfort and personal attention given by nurses, other hospice workers and family, the true comfort the patient feels is enacted by pharmaceutical care. There’s probably not another segment of healthcare that is more reliant on pharmaceuticals for the BEST outcome (if considering comfort, pain control, etc.) for the patient. Due to this pricing scheme, are Floridians getting short-changed in their final days, all for the purposes of the middlemen to make money? Dawn Butterfield is the owner/pharmacy manager at West Cocoa Pharmacy and Compounding.

JANUARY 2019

Association Involvement and Influence on my Journey into Managed Care Pharmacy Practice By Indira Dupotey-Rubi, PharmD I know that my path in managed care pharmacy practice was greatly impacted by my involvement and networking through the FPA. I joined the Florida Pharmacy Association during my first year of pharmacy school and had a basic understanding of the importance of being involved in my state associations from very early on. For me, joining the Association was a no brainer. Literally, being involved in your state pharmacy association was just simply what you did if you were in leadership as a student or planned to be in some level of leadership out in practice. Some of my most memorable projects, mentors, and professional experiences during my years as a student were a direct result of my involvement with the Association. I remember attending the FPA Annual Convention for the first time and feeling so fortunate to have been sponsored as a student as part of the Adopt-A-Student Program. Keeping diligent with my goal to engage and grow in leadership within the FPA, I volunteered one summer at the FPA Office (in Tallahassee) and was an active member of various Student Seats on the FPA Leadership Councils. The most shaping of all experiences with the Association, was when a group of student leaders from Nova Southeastern University (myself included) decided to submit a Resolution to the House of Delegates to advocate for pharmacist intern involvement in the immunization process. I wasn’t aware of how loud my voice as s student could be for legislative change until then, but it is something that I know is critical in how I practice today. The need for pharmacists to be involved in advocacy and the legislative process is critical – whether I am focused on managed care specific issues or not, I recognize this as my duty as a pharmacist. I remember attending a conference event during school in of all places Washington, DC. Maybe it was sleep deprivation, maybe the nostalgia of DC – but regardless, there we were sitting up late one night filled with passion for our profession and the desire to impact patients’ lives. We were going to change history. We piled in a room and sat and drafted the resolution for student interns and immunization privilege. It was an exercise in passion, in will, in interest. The process opened our eyes into the spirit of pharmacy advocacy and it has never left those of us sitting around that circle. Shortly after graduation, I had the privilege of becoming a member of the Florida Pharmacist Political Committee (FPPC), an advocacy group within the Association with a key responsibility for raising financial support to help push our legislative agenda. These experiences increased my capacity in managed care leadership and I continue to grow year after year. 16

FLORIDA PHARMACY TODAY

This year, I had the honor to be a member of the FPA’s Professional Affairs Council and how to increase the accountability and expectations of the leadership. This leadership includes the staff, officers, regional directors and members of the councils and committees. My experiences as a student and in my post-student years within the FPA have allowed me to get a clear understanding of how the Association is structured, what is working and what needs improvements and change to be relevant and meet our current practice needs. I am aware of the impact that mentoring has on student pharmacists, technicians, and young practitioners. I have seen colleagues change practice areas, specialties, and innovate to create the care and services our patients need. I have seen successes, failures, changes in our approach and that’s given me a lot of perspective for what needs to improve in the Professional Affairs Council regarding our leadership, our members, and our Association as a whole. I have gained confidence in myself and in my colleagues to achieve our goals as members of the FPA Councils and as individuals in pharmacy practice. I have carried my growth in Association leadership into practice and leadership in managed care and health care teams. The Professional Affairs Council has opportunities to look at big picture landscapes for pharmacists as professionals and for the Association and where we need to grow our leadership, so we can provide the mentorship to the Association members. With these opportunities, I would like to see the Professional Affairs Council work toward elevating the profession of pharmacy through our Strategic Plan priorities and raise awareness of the impact of membership in our Association. There is such an opportunity to educate pharmacists, providers and patients about concepts and practices of managed care pharmacy. Networking within FPA provides a great platform for education and conversations about advocacy for managed care initiatives. For the past 6 years I have worked as a pharmacist in a managed care organization in South Florida. Consistently I have educated former classmates, physicians, and even students about what managed care pharmacy practice is, and the diversity in managed care for pharmacists in Florida. I spent time dispelling myths, educating about programs and services, as well as demonstrating the clinical services and impacts on patient care outcomes. I have held two different positions within the organization and built a significant amount of knowledge of how legislation and programming impacts what we do in managed care as a component of overall patient care. Furthermore, I have spent time really educating about how significant the role is for managed care in

the team-based concepts and approaches to evidenced-based practices that are changing patient quality of life, utilization of health services, and approaches to medical neighborhoods. I started out as a pharmacist clinician performing medication reviews and counseling our plan members about their medication adherence, treatment plans, personal goals, and progress in disease state management. I had a great deal of education and exposure to reimbursement issues and quality

BEING CONNECTED TO THE FPA ALLOWS ME THE OPPORTUNITY TO CONTINUE TO NETWORK, INTERACT WITH COLLEAGUES, EDUCATE, AND MENTOR OTHERS. measures, specifically learning the intricacies of quality initiatives in support of STAR measures, CMS regulatory requirements, and overall Quality of Care Initiatives for the patients under our care. Over time, I transition into a more administrative role serving as a Pharmacy Benefits Subject Matter Expert for Dual Special Needs Plans (DSNPs) and integrated (Medicare/Medicaid) plans for the organization. Pharmacists, student pharmacists and technicians, as well as other health care providers greatly benefit from the services of managed care pharmacy. I continue to educate others about the positive impacts on patient care outcomes, which is crucial in maintaining our role and creating additional opportunities in the face of the changing health care landscape. Being connected to the FPA allows me the opportunity to continue to network, interact with colleagues, educate, and mentor others. In addition, I am able to be an ambassador for our niche in pharmacy bringing issues from managed care to the forefront of the leadership. The importance of being active in legislation and advocacy is that it affords me the opportunity to voice my message, the message of my patients, the intentions of my health care team and where I want the profession to develop - first hand. It’s my responsibility to be active in my profession and I know that it is important not only for the sustainability of the pharmacy profession, but also in the success of companies like mine to provide the highest quality of care available to patients across the state through managed care approaches. A strong message that I think everyone in the profession of pharmacy needs to hear is that the involvement and work of the FPA Association Leadership (staff, officers, regionals and members of the councils and committees) is not going to be enough to make our Association flourish. It takes everyone in this profession to be active at some level. We need to be constantly thinking creatively about how we are going to increase involvement in the Association from pharmacists, student pharmacists, and technicians that are members, but only on paper (passive membership). We need our members to become very active in advocacy and patient outreach. Just as we use evidenced-based literature to support care and treatment in managed care pharmacy, we know we have

to be diligent in basing our decisions on what has worked best in organizational leadership. We need more members to recruit friends and colleagues and share issues and needs so the leadership can work to meet those and support our Strategic Plan Priorities. More importantly, we need to enhance our advocacy awareness efforts so that every pharmacist understands the legislative process and the importance of engaging with and supporting our political voice, the Governmental Affairs Committee and the FPPC. Our goals for the 2018-2023 Strategic Plan are ambitious, but they are reflecting the voice of the membership and we need continuous support to achieve our goals and objectives. The diversity, impact and responsibility of managed care practice on the health care system is very similar to our roles in the Association – we need to increase our clinical services, collect and disseminate strong data for the impacts we make, and strengthen our voice in efficient high-quality care to change the outcomes of patient health. By bringing some of these principles of managed care to the leadership and approaches of our leadership in advocacy efforts, it’s easy to see how my journey with the FPA and my journey in managed care have blended beautifully to create amazing opportunities in practice and leadership. I believe in the Power of WE – I have experienced it and know that it’s the right path for where we need to be as an Association. Indira Dupotey-Rubi, PharmD is a pharmacist in a managed care organization in South Florida.

A Pharmacist And A Lawyer Licensure Disciplinary Proceedings Insurance Company/PBM Audits and Appeals Purchase & Sales of Pharmacies Regulatory Compliance Consultants Business Operations Consultants KAHAN & ASSOCIATES, PLLC

Pharmacist Attorney Brian A. Kahan, R.Ph., J.D. Licensed Florida Pharmacist and Attorney

STATEWIDE REPRESENTATION 561-392-9000 bkahan@kahanlaw.com 2300 N.W. Corporate Blvd., Suite 123 Boca Raton, FL 33431 The hiring of a lawyer is an important decision that should not be based solely upon advertisements. Before you decide, ask us to send you free written information about our qualifications and experience.

JANUARY 2019

SMMC Transition Pharmacy Point of Sale Messaging from AHCA

On December 1, 2018, Florida Medicaid Managed Care enrollees began transitioning, by region, into the 2018-2023 Statewide Medicaid Managed Care Program health plans. Roll-out for phase three, the final phase, occurred Friday, February 1, 2019. The Statewide Medicaid Managed Care Health and Dental Plan Roll-out Schedule may be viewed at www. ahca.myflorida.com/smmc. Once on the page, click Program Changes, then the Health and Dental Plan Roll-out Schedule link. To ensure a smooth transition of enrollees from the fee-for-service delivery system or a health plan to another health plan, the Agency fiscal agent pharmacy system will support point of sale messaging to all pharmacies attempting to process claims during this transition period. Pharmacies will follow the process outlined below to receive reimbursement for services:

The pharmacy will receive a NCPDP Rejection Error of “M1: Patient not covered in this aid category” with a supplemental message directing the pharmacy to view the COB segment for guidance on how to process the claim to the enrollee’s new health plan. The COB segment will contain the new health plans billing information.

1. The pharmacy bills a claim to the current health plan pharmacy benefits manager (PBM);

To ensure no disruption in current services health plans will allow enrollees to continue to receive their prescriptions through their current provider, for up to 60 days after managed medical assistance starts in each region, until their prescriptions can be transferred to a provider in the plan’s network. Pharmacy providers may call the Florida Medicaid Support Call Center at 1-800-603-1714 for any questions or concerns.

2. The pharmacy receives a denied claim; 3. The pharmacy may ask the enrollee to provide their new membership card to obtain the health plan billing information (see example below) OR: The pharmacy may bill a claim to Medicaid fee-for-service: ■■ ■■ ■■

BIN (Bank Information Number): 013352 PCN (Processor Control Number): P035013352 Group ID: FLMEDICAID

FLORIDA PHARMACY TODAY

4. The pharmacy will bill the new health plan using the information provided in the messaging: ■■ ■■ ■■ ■■

BIN PCN Group ID (as applicable) Customer service phone number (the pharmacy may use this number to contact the new health plans PBM)

CALL FOR RESOLUTIONS TO THE 2019 HOUSE OF DELEGATES The House of Delegates Board of Directors will meet in May 2019 to review and approve resolutions for the Annual Meeting. The deadline for submitting resolutions is May 10, 2019! PLEASE NOTE THIS DEADLINE. The last day to submit items of new business is June 7, 2019. 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

JANUARY 2019

Local Unit Association Leadership Meeting By Joy Wright

On January 19, 2019, all of the local units across Florida were invited to participate in a meeting to improve communication and build bridges between the local associations and FPA. By building stronger local leader teams and improving individual leadership skills, there will be a greater pool of pharmacy leaders in the state of Florida to then serve in both state and national organizations. About 25 people came together representing about 7 different local units,

FLORIDA PHARMACY TODAY

as well as students from UF and USF came to discuss some hot topics affecting local units and pharmacy groups. Participants came from as far away as Miami, Pensacola, Tampa and Jacksonville. Joy Wright welcomed the participants on behalf of ACAP and FPA and brought a message from Angela Garcia, as she was unable to attend in person. Theresa Tolle gave an interactive presentation on Leadership and Worklife Balance – You Can Have It All! Her presentation kept everyone engaged and

gave us great things to think about like improving networking at our local and state meetings to get more pharmacists and technicians involved. We also discussed having time at our meetings to share common struggles and to help improve job satisfaction by being able to take ideas from others and implement them in our own work environments. Also focusing some meetings on mental health would be another way to help our profession deal with work-life balance in a more positive way. The second speaker was Nicole Howes, lawyer consultant, who presented on Board Liability. She made us think about what is the purpose of our organizations and what is doing our due diligence as a reasonable person. Are we upholding the bylaws of our organizations (do we even know where to find them?) Another message that we could apply in both our associations and worklife was about note-taking, slander and accuracy, and that once minutes are accepted by a board, that they cannot be “changed” or have any sections deleted, however you can make an addendum to them if need be. A board member should not vote to approve if they don’t agree with the minutes so be diligent in preparation to read them all beforehand!

Lunch was catered by Moe’s Southwest Grill and since each table had a mix of people from different associations and students, we encouraged networking by giving discussion questions on both fun and professional topics. At the end of lunch, Michael Jackson brought a message from FPA via Zoom software to all of the participants before we headed to our workshops. Participants could choose from several options in each time slot, in the first grouping, many participated in Michael

islative Efforts by William Garst and Charlie Brown, and CE Logistics led by Sandra Buck-Camp. In the wrap up session, participants seemed very positive about the relationships built and solutions to some of the issues that were discussed. Many expressed hope that this would not be a one-time event but an annual gathering, with more people being able to participate. Students expressed concern that it is not clear that APhA and FPA and the local units are seen as separate entities

increase student membership in FPA. What I am taking from this productive day were many great ideas as well as several new friends that I hope to keep in touch with for many years to come. I am grateful for the many students who participated, as well as assisted with set-up and tear down, registration, parking and wherever needed. Joy Wright is a clinical pharmacy specialist at UF Health Shands Hospital

MANY EXPRESSED HOPE THAT THIS WOULD NOT BE A ONE-TIME EVENT BUT AN ANNUAL GATHERING, WITH MORE PEOPLE BEING ABLE TO PARTICIPATE. Jackson’s Continuing Education Coordinator group with onsite facilitator Michael McKenzie, William Garst’s group for Treasurers and Secretaries and Joy Wright facilitated the President and Director’s group. In the second hour, there were groups discussing starting a new unit (led by Michael Jackson with Joy Wright facilitating the in-person group), Leg-

and not a cohesive group, participating in each other’s House of Delegates and lobbying for similar legislation, just at different levels (local, state and national). One idea was during orientation to have the student groups collect both APhA-ASP dues and the $20 one-time FPA membership together, as well as explanation of the ties between the organizations, their roles and benefits to JANUARY 2019

HELP SUPPORT THE ADOPT-A-STUDENT PROGRAM Florida Pharmacy Association (FPA) 129th Annual Meeting & Convention July 10-14, 2019 Marriott Harbor Beach Resort & Spa – Ft. Lauderdale, Florida

Again this year, students from Florida Colleges of Pharmacy will be “Adopted” for the FPA Annual Meeting and Convention. Pharmacy students will benefit from the interaction with practicing pharmacists, learn first hand how FPA actually operates and how they can become involved in their chosen profession. As you remember, college students are on a tight budget and most of them cannot afford to attend convention. Here is how you can help! Be a Bronze, Silver or Gold Sponsor! The donation amounts are Bronze ($150), Silver ($250), and Gold ($500) Level Mentor Sponsors and will help offset the costs of the AAS program. You also have the option to give any amount you prefer. The FPA offer Adopted students complimentary registration, which includes admission to the AAS Mentor Social, Exhibit Hall and Student Awards Event. FPA’s programs and services are keys to our success in advocating for our profession, supporting our pharmacy students and promoting quality patient care services. Thank you for giving back to your profession. Make a contribution yourself, ask your local unit association or get together with friends to Adopt-A-Student. Remember…..these are the future leaders of pharmacy! Mentor Program. Each of the adopted students will be assigned a pharmacist who may invite them to attend meetings, CE programs, and share their knowledge and pharmacy experience with them. If you plan to attend the convention and would like to be a mentor, please contact the FPA office. Please donate online at the Foundation’s website, www.flpharmfound.org, or complete the form below and fax or mail with your check to: Florida Pharmacy Foundation 610 North Adams Street Tallahassee, FL 32301 Fax: (850) 561-6758 Please make your check payable to the Florida Pharmacy Foundation Sponsor Name: _________________________________________________________________________ Address: ______________________________________________________________________________ City: _______________________________________ State: __________ Zip: _______________________ Phone: ____________________________________ Amount of Contribution: _______________________ Charge to the following:

! AMEX

! DISCOVER

! MASTERCARD

! VISA

Account #:_____________________________________Security Code: ________ Exp. Date: __________ Signature: _____________________________________________________________________________ ! Yes, I would like to serve as a Mentor. ! Contact me with more information on Mentoring. Contributions to the Florida Pharmacy Foundation are tax deductible as a charitable contribution for federal income tax purposes. Consult your CPA for complete details.

FLORIDA PHARMACY TODAY

Quick, Easy, and Secure REGISTER FOR OUR ONLINE SERVICES TODAY!

MEMBER PORTAL

RISK MANAGEMENT CENTER

PAPERLESS BILLING

! *Only Available for Commercial Accounts

*Not available in the state of Ohio

TO ACCESS YOUR ACCOUNT ONLINE VISIT: https://www.phmic.com/memberportal You will need your customer number and email address.

Pharmacists Mutual Insurance Company 808 Highway 18 W | PO Box 370 | Algona, Iowa 50511 P. 800.247.5930, ext. 4050 | F. 515.295.9306 | E. member.services@phmic.com

phmic.com

CALL FOR ABSTRACTS FOR POSTER PRESENTATIONS FLORIDA PHARMACY ASSOCIATION 129th ANNUAL MEETING AND CONVENTION

July 10-14, 2019 Marriott Harbor Beach Resort & Spa ♦ Ft. Lauderdale, Florida Poster Session: Friday, July 12, 2019 ♦ 11:00AM-1:00PM COST $25 PER POSTER The FPA Poster Presentations are open to PHARMACY STUDENTS ONLY. Complete and submit this COVERSHEET for each abstract submission. Submissions must be received no later than Friday, May 3, 2019. Abstracts will NOT be accepted after this date. Mail or E-mail this application along with the abstract submission to:

PLEASE TYPE

Tian Merren Owens, MS, PharmD, Director of Continuing Education Florida Pharmacy Association 610 N. Adams Street Tallahassee, FL 32301 tmerren@pharmview.com

Contact Information: Presenter's Name (MUST BE A STUDENT):________________________________________________________________

□Entry Level Pharm.D.

□ Post B.S. Pharm.D.

Address: ________________________________________________________________________________________ City, State, Zip: ___________________________________________________________________________________ Telephone No: _____________________E-Mail Address: _________________________________________________ College of Pharmacy: _____________________________________________________________________________ Abstract Title: ____________________________________________________________________________________ Poster Type:

□Clinical Research □Basic Science Research □Translational Research (Basic Science and Clinical Research)

Primary Author: __________________________________________________________________________________ (Students must be listed first to be considered for the Award. Presenter will be notified by mail of acceptance). Co-Author(s): _________________________________________________________ Student Awards:

□YES □NO

Posters will be eligible for 1 , 2 , and 3 place prizes to be presented at Convention. (Only one prize is given for each winning poster)

ABSTRACT FORMAT The abstract form submitted should be the equivalent of one page. The abstract should include: Title (Include authors’ names and name of College of Pharmacy), Purpose, Methods, Results, and Conclusions. Abstracts will not be accepted if it is not in this format. Do not include figures or graphs.

Please direct all questions and concerns to: Tian Merren Owens ♦ (850) 222-2400 ext. 120 ♦ tmerren@pharmview.com DEADLINE DATE: FRIDAY, MAY 3, 2019 24

FLORIDA PHARMACY TODAY

Licensure Renewal Deadlines Extended The Florida Pharmacy Association received notice from the Department of Health that the renewal deadlines for Florida licensed consultant pharmacists and registered pharmacy technicians has been extended to midnight of March 31, 2019. The Department is using authority granted to it under Governor Rick Scott’s October 2018 executive order declaring an emergency in Florida for Hurricane Michael that affected panhandle area pharmacies. According to the Department of Health, unless another extension is granted, any Florida consultant license or technician registration not renewed before March 31, 2019 will go into a delinquent status. Prescription department managers should review the registration status of your pharmacy technicians on staff. We will share with you any additional information that becomes available.

JANUARY 2019

129th Annual Meeting and Convention JULY 10â&#x20AC;&#x201C;14, 2019 Marriott Resort Harbor Beach Resort and Spa FORT LAUDERDALE, FL FOR MORE INFORMATION CALL (850) 222-2400

Accommodations

ROOM RATES: $189 plus tax based on single/double occupancy. The room reservation deadline is Friday, June 21, 2019 or

when room block is full. Thereafter, reservations may be taken on a space available or rate available basis. There is an optional resort fee. Self-parking is discounted to $12 per day. Please be sure to ask for the Florida Pharmacy Association group rate. All reservations must be accompanied by a first night room deposit or guaranteed with a major credit card. The check-in time is 4:00pm and the checkout time is 11:00 am. Room reservations can be made by calling (800) 222-6543 or (954) 525-4000.

Keynote Speaker Norman “Hoot” Hooten Dr. Hooten is a 20-year veteran of the U.S. Army. He has more than 20 years of experience training military special operations and law enforcement personnel and 14 years of experience in Counter-Terrorism operations while serving in the U.S. Army Delta Force. Dr. Hooten has a distinguished service history in joint, combined, interagency and international operations. He was a key contributor to the success of Operation Just Cause in Panama as well as operations in Lebanon, the Balkans, and Operation Restore Hope in Mogadishu, Somalia. As a DELTA Force Assault Team Leader in Somalia he and his teammates played a critical role in the rescue and recovery of the crew members of the Black Hawk helicopter that crashed on October 3rd, 1993. The incident was later the subject of the feature film known as Black Hawk Down. In August of 2001, Dr. Hooten retired from active duty. He briefly attended Pharmacy School at Campbell University in Buies Creek North Carolina. On September 11th, 2001, Dr. Hooten was recalled from pharmacy school to active service in the US Army. He subsequently played a critical role in the national effort to establish aviation security protocols and served as the National Supervisory Training Coordinator for the Federal Air Marshal Service Global Response Team. In February of 2009 he assumed duties as the Deputy Director of the King Abdullah Special Operations Training Center (KASOTC) in Amman, Jordan where he led an international team of subject matter experts in the design and development of protocols, tactics, techniques, and procedures for international counter terrorism operations. He served in this capacity for 3 years. During his Army career, Dr. Hooten realized the impact that pharmacists could have with active duty military and Veterans; he subsequently returned to pharmacy school at Palm Beach Atlantic University in West Palm Beach, Florida where he graduated in 2016. Upon graduation, he completed a Postgraduate Year One (PGY1) pharmacy residency at the Orlando Veterans Affairs Medical Center followed by a Postgraduate Year Two (PGY2) psychiatric pharmacy resident at the West Palm Beach Veterans Affairs Medical Center. Dr. Hooten has a passion for the role pharmacists can play in the management of pain and substance use disorders in Veterans and is committed to having a positive impact in this area of pharmacy practice. After completing his residency training, Dr. Hooten wished to continue to find ways to give back to the Veteran community that has given so much to our great nation. He currently practices at the Orlando Veterans Affairs Medical Center where his primary area of interest is working with Veterans who suffer with chronic service related pain and substance abuse.

General Education Track THURSDAY – SUNDAY The general education track will offer courses designed to educate pharmacists on a wide variety of important topics pertaining to the profession of pharmacy practice. Specific required Florida Board Approved courses being offered are Reducing Medication Errors, HIV/AIDS, and the Validation of Controlled Substances. There will also be courses on Collaborative Agreements, Appropriate Use of Metrics, Point of Care Services, Innovative Pharmacy Practice and the always popular, Legislative Update!

Consultant Education Track FRIDAY – SATURDAY The consultant education track will provide pharmacists with the most current information available on various topics that pharmacists encounter in the profession of pharmacy. The consultant track will focus on Infectious Diseases and Innovations in Pharmacy. The specific topics being offered include Clostridium difficile, Hepatitis, Immunizations, Antibiotic Stewardship, MACRA and MIPS, Diabetes, Oncology and Pharmacogenomics. There are 12 hours available for consultant pharmacists.

Student & Technician Education Track THURSDAY – SUNDAY Students and Technicians will benefit from interacting with practicing pharmacists and attending student and technician focused continuing education programs. The technician track offers several hours of continuing education on a variety of topics, including the required courses for Florida registration and PTCB renewal: Medication Errors, HIV/AIDS, and Law. The student track consists of several hours of fun and exciting continuing education, such as The Career Forum, the NASPA/ NMA Game Show and Leadership Courses. Students will also have an opportunity to participate in the Patient Counseling Competition and showcase their Poster Presentations.

Special Events FPPC RECEPTION: Attend this reception to support your Political Action Committee. HOUSE OF DELEGATES: Be a delegate or observer and see how important member participation is to the direction of the Association. RECOGNITION OF FPPC DONORS: Contribute to the FPPC and be invited to a private reception. EXHIBITS: Participate in the grand opening reception in the exhibit hall! Visit with exhibitors, introduce yourself, shake their hands, tell them you appreciate them and invite them back next year! The exhibitors are a very important part of FPA’s convention. Companies send their representatives to educate you about their products and services at great expense. Please show them your appreciation! POSTER PRESENTATIONS: Browse submissions from pharmacy students. Contact the FPA office for more information if you would like to submit a poster presentation. RECEPTIONS: Enjoy catching up with your colleagues as the Universities entertain their alumni and friends followed by a night of Karaoke Fun! STUDENT EVENTS: Participate in the Adopt-A-Student Mentor Social. Students will benefit from interacting with practicing pharmacists, attending student focused continuing education programs and learning firsthand about the FPA and how involvement can improve their chosen profession. Call the FPA office and offer to mentor or sponsor a student. FUN RUN WALK: Exercise is good for the soul. Incorporate health and fitness while at the FPA convention. Please register early to reserve your space. AWARDS EVENT: Honor outstanding practitioners during the awards presentation. INSTALLATION OF OFFICERS: Attend the installation of NEW officers on Sunday morning!

FPA 129th Annual Meeting and Convention July 10-14, 2019 Ft. Lauderdale, FL

55Daily Education Registration

Participant Information Participant Information

Daily registration does not include admittance to functions or handbooks. Handouts will be posted on our website July 10.

Name: Name _____________________________________________________ _______________________________________________ Address______________________________________________ Badge Name: _______________________________________________ City, State, Zip_________________________________________ Mailing Address: ____________________________________________ Phone___ ________________________ City, State, Zip: _____________________________________________ Email________________________________________________ Phone: (W) (H)_______________________ Practice Setting________________________________________ License: PS______________ PU _____________RPT_________ Fax: ______________________________________________________ NABP e-profile#__________________ Date of Birth___________ License: PS________________ PU_________ Other State________ Emergency Contact Name/Number_________________________

Before

June 21

Onsite

Amount

FPA Member

$165

$185

$_______

Non Member

$215

$235

$_______

Member Technician

$65

$85

$_______

Non Member Technician

$90

$110

$_______

Handbooks

$40

N/A

$_______

Please select the day(s) you will attend: Thursday

Full Package Registration

Full package registration includes Educational Programs Thursday-Sunday, House of Delegates on Thursday, Exhibit Hall Friday and Saturday, and Awards Event on Saturday. Handbooks are not included in full package registration. Handouts will be available the week of the convention on our website, www.pharmview.com. Before June 21 Onsite Amount_

2FPA Member

Friday

Saturday

Sunday

Additional Tickets

The following events are included in the Full Registration Package if requested. However, you must purchase additional tickets for guests who are NOT registered. Quantity

Price

Amount

Exhibit Hall

@ $30

$______

Awards Event

@ $80

$______

$345

$430

$_______

Non Member

$525

$610

$_______

Pharmacist BEST Value

$540

$625

$_______

Member Technician

$155

$185

$_______

Non Member Technician

$175

$210

$_______

Technician BEST Value

$185

$220

$_______

Student

$150

$170

$_______

FPPC Reception _________ @ N/C (Complimentary event, indicate if attending)

$_____

$145

$160

$_______

Christian Fellowship

$_____

3Guest (no CE) Guest Name_ Handbooks

_______ $40

__ N/A

$_______

(BEST Value includes Registration & Membership)

Please indicate below which functions you will attend. Tickets will be provided upon request during the pre-registration process and placed in your packet. If no boxes are selected, we will assume you will not attend any of the events listed below and tickets will not be available onsite. Please see box 6 for additional tickets.



House of Delegates (Friday)



Exhibit Hall (Friday and/or Saturday)



Awards Event (Saturday)



I will not attend any of these functions.

House of Delegates

House of Delegates (Non-convention registrants)

Special Events Registration

The events listed below must be purchased individually and are not included in any other registration packages. Quantity

Price

_________

@ N/C

Amount

(Complimentary event, indicate if attending) Poster Presenter

_________

@ $25

$_____

Student Awards Event

_________

@ $50

$_____

FPA Polo Shirt (Deadline is June 7, 2019) Quantity Price 

Yes

______ @ $35

Payment

M/F ______

Size ______

Amount $_______

Total Enclosed: $______

Check (To: FPA) AMEX Discover MasterCard Visa Account # ____________________________________________ Security Code _________________ Expiration Date __________

Before June 12

Amount

$165

______

Billing Address ________________________________________ Signature ____________________________________________

Four Ways to Register

Mail: FPA, 610 North Adams Street, Tallahassee, FL 32301 Phone: 850-222-2400 Fax: 850-561-6758 Web: www.pharmview.com

Schedule Subject to Change

C A L L

F O R

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 other than in 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.” 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. ■■ Candidate must have demonstrated

FLORIDA PHARMACY TODAY

N O M I N A T I O N S 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.

F P A

■■ Candidate must have been active-

ly involved in a project that has or could potentially be of benefit to members of the profession.

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.

A W A R D S

2 0 1 8 - 2 0 1 9

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. 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.

DEADLINE FOR NOMINATIONS: FEBRUARY 28, 2019 FPA AWARDS NOMINATION FORM I AM PLEASED TO SUBMIT THE FOLLOWING NOMINATION:

NOMINATED BY:

Name:

Address:

Date Submitted: Signature:

FOR THE FOLLOWING AWARD:  APhA Foundation and NASPA Bowl of Hygeia  James H. Beal Award  R.Q. Richards 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.)

 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

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, 2019

JANUARY 2019

florida PHARMACY TODAY

FREQUENTLY CALLED NUMBERS

BUYER’S GUIDE

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 & Associates, PLLC Brian A. Kahan, R.Ph., Attorney at Law (561) 392-9000

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

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. 32

FLORIDA PHARMACY TODAY

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