July 2021 Florida Pharmacy Today by Florida Pharmacy Today

The Official Publication Of The Florida Pharmacy Association JULY 2021

2021-22 FPA PRESIDENT

DANIEL E. BUFFINGTON

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florida PHARMACY TODAY Departments 4 Calendar 4 Advertisers

VOL. 84 | NO. 7 JULY 2021 THE OFFICIAL PUBLICATION OF THE FLORIDA PHARMACY ASSOCIATION

Features

Florida Pharmacists Can Boost Tobacco Cessation with a Dose of Knowledge

Palm Beach Atlantic University, Gregory School of Pharmacy

The Prescribing of Controlled Substances by Physician Assistants

5 Executive Insight 6 Call for Resolutions

FPA NEWS

William Garst Receives the Beal and Powers Pharmacist of the Year Award Alachua Pharmacist William Garst has been named Pharmacist of the Year. Bill is currently working as a part time pharmacist for the UF Health Psychiatric Hospital, Lake Butler Hospital and Best Drugs of Trenton. Since his retirement from the VA he has authored columns in The Pharmacy Newsletter for a local newspaper and has published several articles in Florida Pharmacy Today, a monthly publication of the Florida Pharmacy Association.

Sandra Barnes Named Technician of the Year Sandra Barnes holds a Bachelor of Science in biology and chemistry and has been a pharmacy technician for over 40 years. She served in the U.S. Army as a medical specialist/pharmacy specialist. Currently, she is a Medication Admission History Technician at Flagler Hospital and holds current PTCB Certification.

Look for complete Convention coverage in the August issue of Florida Pharmacy Today. JULY 2021

FPA Calendar 2021

Mission Statements: Florida Pharmacy Today Journal

AUGUST 1-4

38th Annual SE Gatherin, Henderson Beach Spa and Resort Destin

Budget and Finance Committee Conference Call

FPA/APhA Immunization Program via Zoom

FPA Board of Directors Meeting

25-26 Board of Pharmacy Meeting Tampa SEPTEMBER

11-12 FPA Regulatory and Law Conference via Zoom 23

FPA/APhA Immunization Program via Zoom

Florida pharmacist licensure renewals due OCTOBER

9 - 12 NCPA Annual Meeting Charlotte, NC 13 - 14 FL Board of Pharmacy Meeting 23

FPA Budget and Finance Committee

1 - Last day to submit nominations for FPA office 6

Labor Day FPA Office Closed

FOR A COMPLETE CALENDAR OF EVENTS GO TO WWW.FLORIDAPHARMACY.ORG

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 two-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 Sept. 30, 2021, or prior to licensure renewal. Consultant pharmacists and technicians will need to renew their licenses and registrations by Dec. 31, 2022. For the 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.floridapharmacy.org CONTACTS FPA — Michael Jackson (850) 222-2400

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

Note: The views of the authors do not necessarily represent the views or NSU — Carsten Evans (954) 262-1300 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. FAMU — Dr. Selika Sampson (850) 599-3301

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FLORIDA PHARMACY TODAY

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.

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Presidential Viewpoint BY MICHAEL JACKSON, DANIEL E. BUFFINGTON, PHARMD, RPH MBA, FAPHA

Striving for Practice and Healthcare Innovation

ne constant since the beginning of time is change. This is certainly true with regards to the field of healthcare. Changes in healthcare knowledge, pharmaceutical products, diagnostic testing, treatment

tate professional practice (i.e., National Provider Identification (NPI), Current Procedural Terminology (CPT) codes, and integration into electronic health records). At the same time, the profession has experienced negative chang-

Today’s pharmacists are poised to make true paradigm changes to how they are integrated into healthcare teams and to impact patient health outcomes. technologies, and electronic health information have created the need for pharmacists to commit to lifelong learning. This commitment is essential to ensure that they stay current and capable of providing the best care for their patients and practice at the top of their license. If a practitioner or profession rejects change, then there is no growth, no improvement, and no progress. Stagnation is a certain pathway to professional extinction. The profession has experienced evolution in clinical training curriculum, evolving scope of practice, expansion in practice roles across emerging health practice settings (i.e., ambulatory care, managed care, pharmacogenomics, and specialty pharmacy) and the development of essential tools that facili-

es as well, including the transition from independent practitioners who owned and controlled their practice settings, aggressive managed care contracts, restrictive PBM networks, and continually declining profit margins.

Daniel E. Buffington, PharmD, MBA, FAPhA

A famous Chinese proverb states that “crisis present choices.” During a crisis, a person can either dwell on the negative and decay over time or they can seize the moment to strive for improvements that can increase their value to society and ensure the future viability of the profession. Pharmacists are facing a critical crossroad. It is imperative to assess our personal practice set-

Table 1:

Examples of Successful Healthcare Innovations Pharmaceutical Research and Drug Development ■ Point-of-Care Diagnostic Testing ■ Immunizations ■ Radiologic Devices ■ Biotechnology ■ Genetic Sequencing ■ Electronic Health Records ■ Artificial Intelligence ■ Telehealth

JULY 2021

tings and the national status of the profession to identify specific crises, and to discern viable opportunities to innovate and evolve. A crisis may present as an acute epidemiologic challenge (i.e., HIV, Ebola, or COVID), limitations in treating a common disease (i.e., diabetes, cancer, or sepsis), or barriers to accessing healthcare services or healthcare coverage. Prior challenges or limitations in healthcare have produced multiple examples of successful healthcare innovations.

lenges and a crisis in the form of a healthcare pandemic of rare proportions and magnitude. During this period, the world was able to see first-hand the value and impact that pharmacists produced when engaged for more than managing product inventories and dispensing prescriptions. Pharmacist were prepared, innovative, responsive, and actively engaged in community-based COVID-19 testing centers and vaccination administration across communities (i.e., pharmacies, clinics, hospitals, retail, community health centers, and

Table 2:

Steps for Pharmacists to Stive for to Produce Innovation Changes Under st a nd i ng prac t ic e r ole s a nd how we i mpac t ot her healthcare practitioners ■ Embrace and be committed to change and evolution ■ Define the value we bring an interprofessional healthcare team model ■ Identify specific needs and the challenges to making change(s) ■ Collaborate and share the ideas and vision with other practitioners ■ Create a plan to implement the change(s) Each of these innovations evolved from mere concepts or visions by healthcare practitioners who were trying to improve a prevailing level of healthcare outcomes or to resolve unmet health system needs. Malcom Gladwell describes a “tipping point” as a magic moment or phenomenon where something obscure spreads rapidly to become routine and commonplace. Pharmacists are currently facing a critical tipping point with the need to expand the demand and utilization of our clinical services. Innovation is not a single practitioner’s aspiring idea. Ideas without a plan are just a wish or a dream. Today’s pharmacists are poised to make true paradigm changes to how they are integrated into healthcare teams and to impact patient health outcomes. Healthcare innovation is achieved when a concept converts to a plan, is implemented, and makes a positive and measurable impact on healthcare access and outcomes. There are several steps that are critical to pursuing innovation. In 2020, we experienced global chal6 |

FLORIDA PHARMACY TODAY

places of worship). Healthcare administrators, other practitioners, patients, insurers, and legislators have all acknowledged the important skills and services provided by pharmacists during the global pandemic. Time is of the essence to interface directly with other healthcare providers, payers, and patients to educate them on the differences between prescription management (products) and clinical care (patients) services that we provide. It is our responsibility to illustrate a clear path and articulate the value and impact that pharmacists’ patient care services produce across the entire care system. Albert Einstein stated that “if you can’t explain it simply, you don’t understand it well enough.” There lies our internal challenge and opportunity to strive for innovation. It is not sufficient that we understand these benefits among our own profession, but rather imperative that we illustrate the concepts to others to stimulate our own “tipping point.” The time is now for pharmacists to outline and develop clear plans that in-

clude defining the value statement (i.e., clinical, financial, patient safety, and system efficiencies) that are produced when pharmacists are utilized as a specialist, a clinical pharmacologist. The opportunity to demonstrate our value must be centered around optimizing a patient’s entire medication profile and assuming accountability for the impact on their health outcomes and reducing the preverbal “total cost of care.” I challenge every Florida pharmacist to conduct their own introspective assessment of how they can identify opportunities in their own practice setting as well as across the profession to engage with other healthcare providers to strive for practice and healthcare innovation. Both our profession and our patients’ futures depend upon us continually making positive steps forward. n

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

A Fantastic Conference in Ponte Vedra

ur annual meeting returned to our live format after experiencing the virtual world in 2020. It was amazing to see so many of our colleagues after being sequestered for the past 18 months due to the pandemic. Before we deployed this year’s convention, we experimented with our regional meetings to see what the best practices would be recovering from a global pandemic. Our staff spent many hours studying CDC guidelines and exploring efforts by various professional organizations that also elected to transition from virtual to in-person meetings. Obviously, the expectation of increased vaccination rates among our member participants provided comfort to our meeting attendees as well as the sizable inventory of educational programs and events at #FPA2021. Clearly we missed the ability to network with our state’s pharmacy students as many of Florida’s colleges of pharmacy are continuing their travel restrictions. We are cautiously optimistic that the plan for a fall return to campus will go well and set the groundwork for attendance at #FPA2022 in Ft. Lauderdale. Our summer convention just ended and we are now initiating discussions for next year. A special congratulation to Alachua County pharmacist William Garst for receiving the Beal and Powers Pharmacist of the Year Award. This is the highest honor that a member of our profession can receive within our state. Dr. Garst has done some amazing things during his career both in community and institutional pharmacy. He is actively involved with the Alachua County Association of Pharmacists and is also a Florida licensed consultant pharmacist. We also acknowledge Technician of the Year award winner Sandra Barnes.

This Jacksonville resident has been busy during her career in health care both as an educator and in pharmacy support services. She has been active both with the Florida Society of Health-System Pharmacists and the Florida Pharmacy Association. Nothing can be more exciting than

Before we deployed this year’s convention, we experimented with our regional meetings to see what the best practices would be recovering from a global pandemic. to witness the installation of new leadership for the FPA. Your Association will be guided under the steady hand of Tampa pharmacist Daniel Buffington. Together with his 2021-2022 leadership team, our profession will continue our efforts to re-energize and innovate our professional practices and provide value to our members. Dr. Buffington’s leadership tenure began earlier than most having taken on the role of interim president halfway through his term as President-Elect. Through his guiding hand, he worked us through a complicated governance issue and set us back on our path to success. We will provide full convention coverage in the August issue of Florida Pharmacy Today. If some of you reading this article and did not attend the convention, you missed a high-powered presentation by

Michael Jackson, B.Pharm

new APhA CEO Scott Knoer. Clearly this energetic health care provider hit the ground running with afterburners ablaze at 2215 Constitution Avenue NW, Washington, DC. If you have not been to an APhA meeting, mark your calendar for March 18-21, 2022 in San Antonio, Texas. Scott would love to meet you there. Finally, the members surprised me with an acknowledgement of my 25 years of service to the FPA. It’s hard to believe that together we have seen a quarter century of professional collaboration. They say that time flies when you are having fun and here at 610 North Adams Street we have seen a lot of new and interesting things. Looking forward to the 132nd Annual FPA Meeting and Convention at the Marriott Harbor Beach Resort in Ft. Lauderdale, July 6-10, 2022. n

JULY 2021 |

FPA Officer and Director Nominations FPA STAFF FPA Officer and Director Nominations FPA Officer and Director Nominations FPA OFFICER AND DIRECTOR NOMINATIONS FPA Candidate Nomination Form

Although we have just finished the election for a President-Elect and Directors for the odd-numbered regions who were installed the 2019 INFORMATION annual meeting, is totime to start about nomHANDBOOKat OF ASSOCIATION Information youitneed participate and takethinking advantage of your FPA membership. inees for the election, since the is September of this year As the Although we2020 have just finished thenomination election fordeadline a President-Elect and 1Directors for(9/1/19). the odd-numform indicates, this year weatwill needannual candidates for President-Elect, and Direcberedbelow regions who were installed the 2019 meeting, it is time to startTechnician thinking about nomExecutive Vice President/CEO tors for the even-numbered regions. Please note that you may nominate yourself. inees for the 2020Jackson election, since the nomination deadline is September 1 of this year (9/1/19). As the Michael Although we have just finished the election for a President-Elect and Directors for theand odd-num(850) 222-2400, ext. 200 form below indicates, this year we will need candidates for President-Elect, Technician Direcbered regions who were installed at the 2019 annual meeting, it is time to start thinking about nomDirector of Continuing Education CALL FOR FPA OFFICER AND tors for the even-numbered regions. Please note that you may nominate yourself. Tian Merren-Owens, ext. 120 DIRECTOR NOMINATIONS for inees for the 2020 since the is September of this year As the Although we haveelection, just finished thenomination election fordeadline a President-Elect and 1Directors for (9/1/19). the odd-numContinuing Education Coordinator 2020 Elections form below indicates, this year we needannual candidates for President-Elect, and Direcbered regions who were installed at will the 2019 meeting, it is time to startTechnician thinking about nomStacey Brooks , ext. 210 CALL FOR FPA OFFICER AND tors the even-numbered regions. Please notedeadline that youismay nominate yourself. DIRECTOR for inees for theNOMINATIONS 2020 election, since the September 1 of this year (9/1/19). As the Coordinator of Membership The for FPA bylaws specify that any subdivision or nomination Christopher Heil, ext. 110nominate one 2020 Elections any member in good standing may I AM PLEASED TO SUBMIT THE FOLLOWING form below indicates, this year we will need candidates for President-Elect, Technician and Direcperson for the office of President-Elect and one perI AM PLEASED TO SUBMIT THE FOLLOWING NOMINATION: NOMINATION: CALL FOR FPA OFFICER AND tors the even-numbered regions. Please note that you may nominate yourself. son forfor the office of Treasurer. A President-Elect shall FLORIDA PHARMACY TODAY BOARD The FPA bylaws specify that any subdivision or DIRECTOR NOMINATIONS for be elected every year and shall assume the duties of Chair............................... Carol Motycka, Augustine any member in good standing maySt.nominate one Vice Chair. ........................Cristina Hollywood the President on the of lastPresident-Elect day ofMedina, the annual meeting person for the office and one per2020 Elections Treasurer.................................... Eric Gainesville CALL FPA OFFICER AND shall of the following election as President-Elect. The son foryear theFOR office of Treasurer. A Jakab, President-Elect Secretary............................. Julie Burger, Pensacola Treasurer shall serve a two-year term and may sucDIRECTOR NOMINATIONS for be elected every year and shall assume the duties The FPA bylaws specify that anyJacksonville subdivision of or Member.........................Michael Finnick, ceed to oneElections consecutive term in thatmeeting capacithe President on the last day of office the annual 2020 any member in good standing may nominate Member.............David Mackarey, Boynton Beach one ty. Nominees must beelection Florida registered pharmacists of the year as Schneller, President-Elect. person forfollowing the office of President-Elect and one The perTampa Member....................................... Matt in good standing with the Florida Pharmacy AssociTreasurer shall serve a two-year term and may sucMember............................Teresa Tomerlin, Rockledge son for FPA the office of Treasurer. A President-Elect shall The bylaws specify that any subdivision or ation and the Florida ofofPharmacy. Nominees ceed to one consecutive term office that capaciGreta Pelegrin, Hialeah beMember...................................... elected every yearBoard and shall assume the duties of any member in good standing may in nominate one for President-Elect should have athe good understandty. Nominees be Florida registered pharmacists Member..........Julie Pensacola theTechnician President on the last day ofBurger, annual meeting person for themust office of President-Elect and one pering of how the Association functions and should be Executive Editor.......Michael Jackson, Tallahassee in standing with the Florida Pharmacy Associofgood the following election asPresident-Elect President-Elect. The son foryear the office of Treasurer. A shall Managing Editor. ..................Dave Fiore, Tallahassee current onthe the issues impacting pharmacy. Nominees ation and Florida Board of Pharmacy. Treasurer shall serve a two-year term and may sucbe Journal elected every year and shall Dr. assume theRuble duties of Reviewer........................... Melissa Treasurer should haveterm good skills and for President-Elect should have athe good ceed to one consecutive ofanalytical office inunderstandthat capacithe President on the last day of annual meeting Journal Reviewer....................................Dr. Angela Hilland experience and ability in financial management ing of how the Association functions and should be ty. Nominees must be Florida registered pharmacists of the year following election as President-Elect. The budget preparation. current on the issues impacting pharmacy. Nominees in good standing with the Florida Pharmacy AssociTreasurer shall serve a two-year term and may sucThisare is nine a peer-reviewed publication. There regional Board Directors. skills who shall for Treasurer should have good analytical and ation the Florida Board ofof Pharmacy. Nominees ceed toand one consecutive term office in INC. that capaci©2021 FLORIDA PHARMACY JOURNAL, serve two-year terms. A nominee must be a Florida experience and ability in financial management and for President-Elect should have a good understandty. ARTICLE Nominees must be Florida pharmacists ACCEPTANCE: Theregistered Florida Pharmacy registered pharmacist in good standing withshould the Florbudget preparation. ing of how Association functions and be in good standing with thethat Florida Pharmacy AssociToday is athe publication welcomes articles ida Pharmacy Association and the Floridawho Board of There are nine regional Board Directors shall current on the issues pharmacy. Nominees ation and the Board of Pharmacy. Nominees that have aFlorida directimpacting pertinence to the current Pharmacy. Additionally, each Board Director must serve two-year terms. A nominee must be a Florida forpractice Treasurer have good skills and of should pharmacy. Allhave articles areunderstandsubject for President-Elect should aanalytical good be a member of at least one the FPA Unit Associaregistered pharmacist in good standing with the Florexperience and ability in financial management and toofreview by the Publication Review Committee, ing how the Association functions and should be tions within their region. Board Directors’ terms ida Pharmacy Association and the Florida Boardare of budget preparation. editors and other outside referees. Submitted current on the issues impacting pharmacy. Nominees staggered such thatregional even-numbered regions shall be Pharmacy. Additionally, each Board Director must are received with the understanding There are nine Board Directors who shall forarticles Treasurer should have good analytical skills and elected in even-numbered years odd-numbered be a member ofability at least the and FPA Unit that they are not being considered by another serve two-year terms. Aone nominee must be Associaa Florida experience and in financial management and regions shall beAllelected in odd-numbered years. All tions within their region. Board Directors’ terms are publication. articles become the property registered pharmacist in good standing with the Florbudget preparation. newly elected Board of Directors Regional Directors staggered such that even-numbered regions shall be of the Florida Pharmacy Today and may not idaThere Pharmacy Association and the Floridawho Board of are nine regional Board Directors shall shall take office on the last day of the annual meeting, elected in even-numbered years and odd-numbered be published without written permission from Pharmacy. Additionally, each Board Director must serve two-year terms. A nominee must be a Florida and continue office until the lastPharmacy dayyears. of annuthe author and the Florida regions shall beofelected odd-numbered All beboth ashall member atinleast one the FPA Unit Associaregistered pharmacist in in good standing with the Floraltions meeting of the second ensuing year. Today. The Florida Pharmacy Association asnewly elected Board of Directors Regional Directors within their region. Board Directors’ ida Pharmacy Association and the Florida terms Boardare of sumes responsibility for statements and shall take no office on theeven-numbered last each daythe ofBoard the annual meeting, staggered such that regions shall be Pharmacy. Additionally, Director must opinions made by the authors tolast the Florida and office until day of annuelected incontinue even-numbered years and odd-numbered be ashall member of atinleast one thethe FPA Unit AssociaPharmacy Today. al meeting of their the year. regions shall be second elected inBoard odd-numbered years. are All tions within region.ensuing Directors’ terms The Journal of the Florida Pharmacy newly elected Board of Directors Regional Directors staggered such does that even-numbered shall be Association not accept forregions publication shall take office on the last day of and the annual meeting, elected in even-numbered years odd-numbered articles or letters concerning religion, politics and shall continue in officeodd-numbered until the last day of annuregions shall be elected years. All or any other subjectinthe editors/publishers al meeting of the second ensuing year. newly elected Board for of Directors RegionalofDirectors deem unsuitable the readership this shall take office on the last dayJournal of the annual journal. In addition, The does meeting, not and shall continue in office until the last day of annuaccept advertising material from persons al meeting the second ensuing year.association. who areof running for office in the 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 ASSOCIATION

610 N. Adams St. • Tallahassee, FL 32301 850/222-2400 • FAX 850/561-6758 Web address: www.floridapharmacy.org.

FPA Candidate Nomination Form FPA Candidate Nomination Form FPA Candidate Nomination Form I AM PLEASED TO SUBMIT THE FOLLOWING NOMINATION: NAME: I AM PLEASED ADDRESS: NAME:

NOMINATION:

TO SUBMIT THE FOLLOWING

I AM THE PLEASED TO SUBMIT THE FOLLOWING FOR FOLLOWING OFFICE: ADDRESS: (Nomination deadline: September 1, 2019) NOMINATION: NAME:

 President-Elect FOR THE FOLLOWING OFFICE: FOR THEDirector FOLLOWING OFFICE: ADDRESS: (Nomination deadline: September 1, 2019)  Board NAME: (Nomination  Region 2 deadline: Sept. 1, 2021)  President-Elect  Region 4FOLLOWING OFFICE: FOR THEDirector ADDRESS:  Board  President-Elect (Nomination  Region Region 26deadline: September 1, 2019)   Region 82   Region President-Elect  Region 4 FOR THE FOLLOWING OFFICE:  Technician Region 4  (Nomination  Region Board Director  6deadline: September 1, 2019)  Region 6  Region Region 82  President-Elect  Region 84 NOMINATED BY:  Technician RegionDirector  Board  Technician  Region Region 26  NAME:  Region RegionBY:48 NOMINATED   Region Technician  6 DATE SUBMITTED: NAME:  Region 8

NOMINATED BY:  Technician

SIGNATURE: DATE SUBMITTED: NAME: NOMINATED BY: SIGNATURE:

MAIL NOMINATIONS TO: Election Nominations, Florida Pharmacy Association, 610 N. Adams St., Tallahassee, FL 32301 (850) 222-2400 FAX (850) 561-6758 MAIL NOMINATIONS TO: Election Nominations, Florida Pharmacy SIGNATURE: DATE SUBMITTED: Association, 610 N. Adams St., Tallahassee, FL 32301 DEADLINE FOR NOMINATIONS IS SEPTEMBER 1, 2019 (850) 222-2400 FAX (850) 561-6758 DATE SUBMITTED: NAME:

SIGNATURE:

MAIL NOMINATIONS TO: Election Nominations, Florida Pharmacy DEADLINE FOR NOMINATIONS IS SEPTEMBER 1, 2019 Association, 610 N. Adams St., Tallahassee, FL 32301 (850) 222-2400 FAX (850) 561-6758 J U L Y 2 0 1 9 | 15 MAIL NOMINATIONS TO: Election Nominations, Florida Pharmacy Association, 610 N. Adams St., Tallahassee, FL 32301 DEADLINE FOR NOMINATIONS IS SEPTEMBER 1, 2019 (850) 222-2400 FAX (850) 561-6758 J U L Y 2 0 1 9 | 15 DEADLINE FOR NOMINATIONS IS SEPTEMBER 2019 DEADLINE FOR NOMINATIONS IS SEPT. 1,1,2021 JULY 2019

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Florida Pharmacists Can Boost Tobacco Cessation with a Dose of Knowledge

Tobacco is the leading preventable cause of death and disease in the country1, and it’s one of the many places a pharmacist can make a difference in a patient’s life. Whether it’s counseling on the effectiveness of nicotine replacement therapy, supporting patients who have struggled with repeated quit attempts, or even just discussing with colleagues the effects of nicotine addiction – there are many touchpoints where a pharmacist plays a key role in the efforts to curb tobacco’s massive public health impact It’s important to have the latest accurate information, including anticipating some of the most common myths and misconceptions from patients, as well as having the right information to respond effectively.

FLORIDA PHARMACY TODAY

Myth: “I would quit smoking, but I just have so much stress and smoking is a stress reliever.” Truth: Nicotine is the primary drug in tobacco that causes addiction. Nicotine, upon entering the lungs, quickly travels to the brain and causes the cells to release dopamine. Dopamine’s effects include heightened sense of alertness and contentment. However, as the brain adapts to the supply of extra dopamine, over time people who regularly use tobacco become dependent on this supply of stimulants. As such, in quit attempts or even just between exposure to cigarettes, the brain begins craving nicotine’s effects.2 What you can do: Your patients may feel calmer and less stressed after a cigarette. Far from reducing feelings of stress, smoking increases it. Help them understand smoking isn’t relieving their stress – it’s just relieving the craving it created

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for the addictive chemical, nicotine. In fact, the physiological impact is actually the opposite – smoking increases blood pressure and heart rate, tenses muscles, contracts blood vessels and reduces blood oxygen level.3 Consider advising that patients seek effective ways to take breaks that don’t involve smoking, get exercise to release endorphins, and try other stress reduction techniques. Myth: If someone has been a lifelong smoker, the damage is already done and not much can be accomplished by quitting later in life. Truth: While most cases of tobacco addiction start before the age of 18, even people who have suffered the health effects of tobacco and nicotine for extended periods can experience health benefits both immediately and over time through cessation. What you can do: Tell your patients about the benefits of quitting that they may not be aware of. As soon as 20 minutes after they stop smoking, their blood pressure and pulse has already begun decreasing.4 Within a few months, circulation can improve and lung function can increase.5 Within a year, the risk of heart attack drops dramatically.6 Within five years, most smokers cut their risk of stroke to nearly that of a non-smoker.7 And ten years after quitting smoking, the risk of lung cancer can drop by half.8 Myth: A pharmacist’s interactions with patients are too brief to make a significant impact in tobacco cessation. Truth: Even brief cessation conversations can improve quit attempts.9 Additionally, recent legislative changes in Florida have increased the opportunity for pharmacists in collaborative practice agreements to treat certain chronic conditions, and nicotine dependence is included in that defined list. What you can do: Understanding both the extreme time constraints on pharmacists and the importance of cessation interventions, the Florida Department of Health’s Tobacco Free Florida created a suite of ways to support healthcare providers through the “Ask, Advise, Refer” process. Additionally, pharmacists can now use the updated automatic referral system to connect patients directly with Tobacco Free Florida services. To learn about this referral process, as well as to see free materials to help guide you through easy conversations about nicotine addiction with your patients, visit https://tobaccofreeflorida.com/healthcare. Myth: Pharmacists are limited in supporting patients who want to quit because once they walk out the door, they’re pretty much on their own. Truth: Tobacco Free Florida provides Floridians free tools and services that can aid in a successful quit journey. These include Web Quit, Phone Quit, Group Quit classes both inperson and online, and more. Services are provided complete-

ly free of charge and regardless of insurance. Pharmacists can direct patients to www.tobaccofreeflorida.com or 1-877-UCAN-NOW. Continuing to make progress against tobacco addiction requires coordinated, concerted effort. Tobacco Free Florida and Florida pharmacists can team up to help people quit. Check www.tobaccofreeflorida.com/healthcare for free materials you can request today to help patients quit. REFERENCES

1. U.S. Department of Health and Human Services. Smoking Cessation. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2020. 2. U.S. Department of Health and Human Services. The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014. Printed with corrections, January 2014. 3. U.S. Department of Health and Human Services. How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2010. 4. U.S. Department of Health and Human Services. The Health Consequences of Smoking: What It Means to You. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2004 5. US Surgeon General’s Report, 1990, pp.193, 194,196, 285, 323 6. U.S. Department of Health and Human Services (USDHHS). (2014). Let's Make the Next Generation Tobacco-Free: Your Guide to the 50th Anniversary Surgeon General's Report on Smoking and Health (Consumer Booklet). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. 7. U.S. Department of Health and Human Services (USDHHS). (2014). Let's Make the Next Generation Tobacco-Free: Your Guide to the 50th Anniversary Surgeon General's Report on Smoking and Health (Consumer Booklet). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. 8. A Report of the Surgeon General: How Tobacco Smoke Causes Disease - The Biology and Behavioral Basis for Smoking-Attributable Disease Fact Sheet, 2010; and US Surgeon General’s Report, 1990, pp. vi, 155, 165 9. Okuyemi KS, Nollen NL, Ahluwalia JS. Interventions to facilitate smoking cessation. Am Fam Physician. 2006 Jul 15;74(2):262-71. PMID: 16883923. JULY 2021 |

F L O R I D A' S C O L L E G E S O F P H A R M A C Y

Palm Beach Atlantic University Gregory School of Pharmacy FROM THE OFFICE OF THE DEAN As Interim Dean, I am happy to share this annual update with our friends and colleagues in the state of Florida. As you read on, I trust you’ll see how we as an institution remained true to our mission of delivering “Pharmacy with Faith,” even during these most challenging days. In May 2021, Dean Jeff Lewis completed his tenure with the school. Interim Dean While at PBA, Dean Lewis made sigYolanda M. Hardy nificant achievements, including developing the Dean’s Award for Innovation, which is designed to acknowledge faculty research that is innovative, creative, and addresses challenging real-world problems. Dr. Lewis encouraged students and faculty to become involved in research and helped solidify the school as one that trains students to make an impact on the pharmacy profession and in the community served. We are grateful for the leadership and guidance of Dean Lewis during his tenure at the GSOP. If I could pick one word to describe the GSOP faculty, students, and staff for this year, I would pick the word “resilient.” Our students, faculty, staff, and alumni have answered the call to help the communities that they serve in a tremendous way during the pandemic. Our faculty and students have continued to shine even during a difficult year. You will read about two faculty who have demonstrated leadership to the profession over the past year. Dr. Elias Chahine, Professor of Pharmacy Practice, was named President-Elect of the Florida Society of HealthSystem Pharmacists. Dr. Laura Rhodes, Assistant Professor of Pharmacy Practice, has made an impact in the practice of pharmacy through the Community Pharmacy Enhanced Services Network of Florida (CPESN). Dr. Rhodes, in collaboration with the CPESN USA team, created and implemented a model and algorithm to determine how vaccine doses were distributed to eligible CPESN pharmacies. Her efforts with CPESN enabled in-

FLORIDA PHARMACY TODAY

dependent pharmacies to have access to COVID-19 vaccines, thus allowing greater access to vaccines for vulnerable populations.

AT ONE SITE, ATLANTIS PHARMACY, STUDENTS ASSISTED IN APPROXIMATELY 2,100 VACCINATIONS. Our students have been resilient and have not lost sight of serving the Palm Beach County community during the pandemic. Students have been assisting with COVID-19 vaccination efforts at many area community pharmacies. At one site, Atlantis Pharmacy, students assisted in approximately 2,100 vaccinations. Our alumni also answered the call to remain committed to service. You’ll read about the continued efforts of our alumni council to support and give back, even in the midst of the pandemic. Through continued virtual networking events and reunions, they have maintained communication with the school, our students, and fellow alumni. On a personal note: I am certainly looking forward to their first GSOP gala, which will be held November 13. I am so grateful to be blessed with the opportunity serve the GSOP community during this time of transition. In such a difficult year, I truly believe that our faculty, staff, students, and alumni demonstrated what we strive to develop in our students: “Pharmacy with Faith.” Continued blessings, Yolanda M. Hardy, Interim Dean

F L O R I D A' S C O L L E G E S O F P H A R M A C Y

INVESTMENT IN COMMUNITY PHARMACY As we reflect on the previous year’s achievements, one theme that rises to the forefront is our school’s dedication to the expansion of the field of community pharmacy. One key driving factor in this realm is our relationship with Community Pharmacy Enhanced Services Network (CPESN) and our own Dr. Laura Rhodes, a GSOP alumnaturned-faculty member, who was also recently appointed the Lead Network Facilitator for CPESN Florida. Doctor Laura Rhodes The Gregory School of Pharmacy is excited to have a representative/faculty member who is integrated within CPESN Florida as a component of service to the school and profession of pharmacy. Dr. Rhodes has facilitated administration of the network - including onboarding new members, coordinating network communications, and creating training materials for members. She led a team of nine pharmacies and three coaches through an additional year of the Flip the Pharmacy program – which included focuses on implementing workflow innovations related to immunizations (including, but not limited to, COVID-19) and diabetes/social determinants of health. And, answering the call of the times, Dr. Rhodes co-led the COVID-19 vaccination program for the network in Florida, which meant ensuring quality assurance and compliance with program requirements, creation and implementation of an algorithm to allocate vaccine doses to eligible pharmacies when resources were scarce, ordering of vaccine doses on behalf of network pharmacies and training on each vaccine’s storage and handling, administration, and documentation/reporting.

trepreneurial and business management activities, and gaining experience in teaching student pharmacists.

COMMUNITY PHARMACIES SPONSOR STUDENT FPA MEMBERSHIPS

Encouraging professional advocacy and engagement is a core component of our mission at GSOP. As such, through the office of our director of community engagement, Jeff Snow, we were proud to announce this year that each member of the P1 class received a 4-year student membership in the Florida Pharmacy Association. This generous sponsorship was made possible through support from seven independently-owned local pharmacies: Atlantis Pharmacy, Center City Pharmacy, Gardens Drugs, Linton Square Pharmacy, Pharmacia las Americas, Prescription Shoppe of Stuart, and Tequesta Drugs. We are extremely grateful to these community pharmacy partners for encouraging our students to become involved in the future of their chosen profession and for demonstrating to them the value they place on professional association engagement.

PGY2 IN AMBULATORY CARE RECEIVES FULL ACCREDITATION

UNIQUE FELLOWSHIP IN COMMUNITY PHARMACY ENHANCED SERVICES

As a further outgrowth of our collaborative work with CPESN-member pharmacies, the GSOP is proud to announce the creation of a unique one-year fellowship that partners our school with two community partners: Atlantis Pharmacy (Atlantis, FL) and the Prescription Shop of Stuart (Stuart, FL.) An overarching goal of the fellowship program is to build up service sets offered by our partner pharmacy sites and to create new opportunities for our graduates. By facilitating the expansion or refinement of clinical services at these pharmacy practice sites, they become excellent training sites for our student learners and increase opportunities in the job market for new graduates (i.e., fellowship positions, clinical pharmacist positions to support newly implemented/refined services.). The fellow begins in July 2021 and will focus on refinement of clinical practice skills, developing expertise in implementing clinical services and practice-based research, engaging in en-

Pictured here is Residency Director Dr. Jordan Sedlacek presenting our current PGY2, Dr. Lauren Roscizewski, with her certification of completion.]

We are excited to announce that GSOP’s PGY2 Ambulatory Care Residency Program was granted full accreditation. This unique program at PBA offers a variety of rotation sites, with the majority of rotations occurring at the West Palm VA Medical Center. Other rotation sites include Cleveland Clinic West Palm Beach, Caridad Center, and Elite Coastal Healthcare. It was a team effort to gain the accreditation, led by Dr. Amy Henneman (former Residency Director) and Dr. Jordan Sedlacek (current Residency Director).

JULY 2021

F L O R I D A' S C O L L E G E S O F P H A R M A C Y

DEAN’S AWARD FOR FACULTY INNOVATION The annual Dean’s Award for Faculty Innovation was established as a means of fostering, recognizing and celebrating the innovative spirit of the Lloyd L. Gregory School of Pharmacy faculty. This award is sponsored by Integra Connect, whose founder Raj Mantena pledged $550,000 to support faculty research and recognize innovation. The 2021 recipients of the award are: ■ Tarsis Brust - “Selective Adenylyl cyclase 1 inhibitors as a novel class of analgesic agents” ■ Laura Rhodes –”A Model for COVID-19 Vaccine Allocation within CPESN” ■ Amos Abioye –“Science-Practice Integration in Compounding Exercises and Core Competency Assessment”

CLEVELAND CLINIC SIGNS LETTER OF INTENT WITH PBA

Our school is excited by the news that Cleveland Clinic Florida and Palm Beach Atlantic University have signed a letter of intent to begin discussions on the development of a health sciences center on the university’s campus in West Palm Beach. The new facility would combine educational opportunities and resources for PBA students and faculty with convenient access to care for Cleveland Clinic Florida patients. Plans for the facility include basic and clinical science classrooms as well as clinical simulation laboratories for PBA students. The facility would also provide access to patient care, including offices and procedural areas for Cleveland Clinic Florida primary care doctors and physician specialists, diagnostic imaging and laboratories, chemotherapy, sports medicine, physical therapy and a clinic for PBA students.

GREGORY CENTER FOR MEDICAL MISSIONS

The Gregory Center for Medical Missions (GCMM) was launched in 2013 with a purpose to guide the school’s engagement in medical mission initiatives. During summer of 2020, the Center had five teams established to serve Costa Rica, Eswatini, Uganda, Ecuador, and El Salvador. The pandemic unfortunately resulted in the cancellation of these trips. The pandemic, however, did not stop the Center’s other ini14

FLORIDA PHARMACY TODAY

tiatives over the past year. The GCMM was able to virtually participate as an exhibitor in the Global Missions Health Conference in November 2020. In preparation for this conference, we prepared a new video to promote the Center’s work. The GCMM was also able to establish a local relationship, which fostered student engagement with health screenings at food drives in West Palm Beach. In 2020, the Center also launched the Missions Makers Society to raise scholarship support for student participation in medical missions. In March 2021, the GCMM hosted its annual form with speaker, Mrs. Rebecca McDonald, founder and president of Women At Risk, International. She provided a powerful, inspiring message that equipped participants with knowledge to recognize and respond to human trafficking within the healthcare setting. In April 2021, Mrs. McDonald visited the Palm Beach Atlantic University campus where she continued her dialogue on the topic with faculty and students. The GCMM will be returning to the medical missions field in Summer 2021 in a small but powerful way. Alumna Jocelyn Shrum (2017) and three PBA students will be joining a larger interdisciplinary team that will be serving the Dominican Republic from July 10-18. This trip is occurring in collaboration with Global Health Outreach as part of the Christian Medical and Dental Associations. We are excited to return to the missions field, and we look forward to seeing what opportunities lie ahead for us in the summer of 2022.

RESPONDING TO COMMUNITY NEEDS IN A CRISIS

At Palm Beach Atlantic University (PBA), the mission of Workship is a distinctive community service program that responds to human needs with Christ-like action in the community and the world. As the effects, both direct and indirect, of the COVID-19 pandemic affected our community, GSOP students and faculty put their ingenuity to work by finding innovative ways to serve those most in need. One of the positive outgrowths of these troubling times has been enhanced

GSOP students Sarah Bridges, Kiara Williams, and Nathan Czarnowski volunteer at the NorthEnd RISE Community Wellness Event.]

F L O R I D A' S C O L L E G E S O F P H A R M A C Y

and new partnerships with local organizations serving the good of the community. Beginning last November, our students joined staff and volunteers from the Tree of Life Resource Center to assist with a series of free food distribution events held in the parking lot of a local mall. Students provided health education and performed blood pressure and blood glucose screenings. The presence of our students at these recurring events increased the organization’s ability to help those in need while providing meaningful service-learning experiences for the students. PBA nursing and pharmacy students collaborated with a local, non-profit, community-restoration organization called NorthEnd RISE. Together, a community wellness event was held in April with nursing and pharmacy students serving the under-served community near our campus. Students provided education, personal protective equipment, and helped with food distribution for more than 150 residents during the community wellness event. Nursing and pharmacy students also worked with NorthEnd RISE to engage the community by going door-to-door and conducting important health surveys to better evaluate community needs.

RXPO 2020 RECAP

We referred to it as the “pandemic pivot.” The idea of cancelling the annual RxPO Careers and Experiential Education Expo was simply not an option. So, with a little bit of creativity and a great deal of technology, RxPO 2020 was conducted virtually on October 23. Utilizing the Handshake Virtual Fairs platform, our student body was able to engage in over 60 group sessions hosted by employer partners, residency programs, governmental agencies, and state associations. The event was a great success and a true testament to the adaptive spirit of both our school and our professional partners. We are pleased to announce that RxPO 2021 will be held in the Rubin Arena at PBA on Friday, October 22 and will feature both in-person and virtual opportunities for students and participating partners. For more info on RxPO 2021 please visit go.pba.edu/rxpo2021

ALUMNI ENGAGEMENT While we lamented the cancellation of in-person events, the necessary switch to virtual platforms brought a surprising and welcomed level of engagement with and from our alumni. Over the past 15 months, we’ve conducted Zoom reunions with our 2005, 2006, 2010, and 2011 classes. In each case, the technology allowed for alumni to conveniently Zoom in from all over the country and reconnect with fellow classmates and former professors. Dr. Jeremy McKelvey The GSOP Alumni Council appointed a new chairman in January. Dr. Jeremy McKelvey (’07) has brought an inspiring amount of energy and enthusiasm to the position. Key Council-led initiatives for the upcoming year include a first-ever GSOP Gala and Awards Dinner to be held November 12-13, a summertime family-friendly softball game, and social and networking events as well as increased mentorship and scholarship support. Additionally, the previously noted Missions Makers’ Society was founded by Alumni Council members who continue to support and raise awareness for this most mission-centric initiative. We are truly blessed to have such an invested and engaged alumni community. For more information on alumni events and init iat ives, please reac h out to Jef f_ Snow@ pba.edu

“PHARMACY WITH FAITH”

The GSOP faculty, staff, students and alumni have made it through a challenging year, yet they did not grow weary in doing good (2 Thessalonians 3:13). With God’s direction and grace, they were able to enlighten the minds of our students, prepare to enrich the souls of our global community, and extend hands to help the region combat COVID-19. We are looking forward to seeing what the future holds as we continue to practice “Pharmacy with Faith.”

JULY 2021

The Prescribing of Controlled Substances by Physician Assistants By T.J. Morton and Natalie Alonso According to the United States Bureau of Labor Statistics, the employment of physician assistants is expected to grow 31 percent between 2019 and 2029.10 As the demand for physician assistants continues to increase, T.J. Morton Natalie Alonso so does the need for state regulations that allow them to provide proper and efficient care for patients. This has resulted in recent changes to Florida’s laws governing physician assistants’ ability to issue prescriptions. Thus, it is important that pharmacists, who play a critical gatekeeper function in the healthcare industry, remain aware of this ever-changing regulatory landscape. This article aims to provide clarity regarding the rules and regulations that govern a physician assistant’s ability to prescribe controlled substances. During the 2021 legislative session, the Florida Legislature passed House Bill 431 (“HB 431”), which revised physician assistant prescribing requirements.11 HB 431 was signed into law by Governor DeSantis on June 29, 2021, and went into effect on July 1, 2021. To provide context to the changes made by HB 431, this article will briefly address the physician assistant prescribing requirements that were in effect prior to the passage of HB 431, and then discuss the changes implemented by HB 431. Prior to the passage of HB 431, Florida law required all prescriptions issued by physician assistants to include the name, address, and telephone number of the physician assistant’s supervising physician, the physician assistant’s prescriber number, and if applicable, the physician assistant’s DEA number.12 In addition, physician assistants were also required to comply with sections 456.0392(1) and 456.42(1), and chapter 499 of the Florida Statutes.13 The inclusion of the physician assistant’s prescriber number created a presumption that the physician assistant was authorized to prescribe the medicinal drug and that the prescription was valid.14 This presumption applied to all physician assistant prescriptions, including controlled substance prescriptions. The Florida Department of Health, however, did not actually issue prescriber numbers to physician assistants. Instead, it placed a modifier on the physician assistant’s license so that the physician assistant’s online license verification page indicated that they were an authorized pre16

FLORIDA PHARMACY TODAY

scriber.15 Pre-HB 431 regulations also imposed certain restrictions on a physician assistant’s authority to prescribe controlled substances. Physician assistants were not allowed to prescribe any medications included in a formulary established by the Council on Physician Assistants.16 In regards to controlled substances, the pre-HB 431 formulary prohibited physician assistants from prescribing psychiatric mental health-controlled substances for children younger than 18 years old.17 It also limited physician assistants to prescribing up to a 7-day supply of Schedule II controlled substances.18 In contrast, HB 431 alters prescribing requirements and broadens the scope of practice for physician assistants in the Sunshine State. HB 431 retains the requirement that the prescription comply with sections 456.0392(1) and 456.42(1), and chapter 499.19 Rather than require prescriptions issued by physician assistants to include the address and telephone number of the supervising physician, however, HB 431 now requires the prescription to include the physician assistant’s address and telephone number. In addition, the prescription must also include the name of each of the physician assistant’s supervising physicians.20 In addition, HB 431 expands the scope of a physician assistant’s prescribing authority by modifying the formulary of drugs to remove certain prohibitions on the prescribing of psychiatric mental health-controlled substances for children younger than 18.21 HB 431 allows physician assistants that work under the supervision of pediatricians, family practice physicians, internal medicine physicians, or physiatrists to prescribe up to a 14-day supply of Schedule II psychiatric controlled substances for patients under the age of 18.22 It removes the requirement that the formulary prohibit the prescribing of Schedule III, IV, and V psychiatric controlled substances for children under the age of 18.23 This is a significant change because, as mentioned above, physician assistants previously could not prescribe any psychiatric controlled substances to children under 18. Now, eligible physician assistants may prescribe up to a 14-day supply of Schedule II psychiatric controlled substances to patients under 18, and the Council on Physician Assistants has the authority to revise the formulary to allow all physician assistants to prescribe Schedule III, IV, and V psychiatric controlled substances for children under 18. It remains unclear, however, whether the Council will exercise this authority. HB 431 did not change the requirement that the formulary limit the prescribing of Schedule II controlled substances to a 7-day supply.24

Additionally, HB 431 removes the requirement to include the physician assistant’s prescriber number and the language indicating that that prescription was presumed to be valid if it included the physician assistant’s prescriber number.25 This was done to reflect the Florida Department of Health’s current practice of not issuing prescriber numbers to physician assistants. The Florida Department of Health will likely continue to indicate on the physician assistant’s license verification page if the physician assistant is an authorized prescriber. HB 431’s elimination of the presumed valid language is disappointing as it removes protections for pharmacists who fill physician assistant prescriptions. However, since the Department of Health never issued prescriber numbers to physician assistants, it could be argued that the presumption never actually applied. In any event, another provision in Florida law provides a similar, but narrower, protection for pharmacists. Section 456.0392(3) of the Florida Statutes, provides that a prescription, other than for a controlled substance, issued by a physician assistant is presumed to be valid and within a physician assistant’s prescriptive authority delegated by the supervising physician.26 This presumption provides the same protections as the presumed valid language that was removed by HB 431, except it does not cover prescriptions for controlled substances.

Pharmacists have an independent obligation to determine the validity of any prescription for a controlled substance and should never rely solely on a legal presumption. Rule 64B1627.831 of the Florida Administrative Code governs the filling of prescriptions for controlled substances and requires pharmacists to determine the validity of such prescriptions by exercising their professional judgment before filling such prescriptions.27 Thus, the removal of the presumption for controlled substance prescriptions should not affect how a pharmacist validates a prescription for a controlled substance issued by a physician assistant. As with other prescriptions, a physician assistant can only prescribe a controlled substance if his or her supervising physician delegates such authority to the physician assistant.28 A supervising physician can only prescribe controlled substances if he or she has a DEA registration number. Therefore, if the supervising physician is not registered with the DEA to prescribe controlled substances, then the physician cannot delegate such the ability to prescribe controlled substances to the physician assistant. A common question concerning controlled substance prescriptions issued by physician assistants is what information needs to be included on the prescription. As noted above, HB 431 still requires the prescription to comply with sections JULY 2021

456.0392(1) and 456.42(1) and chapter 499 and to contain the physician assistant’s name, address, telephone number, and the name of each of the physician assistant’s supervising physicians.29 Additionally, federal law requires that “[a]ll prescriptions for controlled substances shall be dated as of, and signed on, the day when issued and shall bear the full name and address of the patient, the drug name, strength, dosage form, quantity prescribed, directions for use, and the name, address and registration number of the practitioner.”30 A “practitioner” is defined as a physician, dentist, veterinarian, scientific investigator, pharmacy, hospital, or other person licensed, registered, or otherwise permitted, by the United States or the jurisdiction in which he practices or does research, to distribute, dispense, conduct research with respect to, administer, or use in teaching or chemical analysis, a controlled substance in the course of professional practice or research.31

AS WITH OTHER PRESCRIPTIONS, A PHYSICIAN ASSISTANT CAN ONLY PRESCRIBE A CONTROLLED SUBSTANCE IF HIS OR HER SUPERVISING PHYSICIAN DELEGATES SUCH AUTHORITY TO THE PHYSICIAN ASSISTANT. The term “dispense” includes prescribing a controlled substance.32 According to these definitions, a physician assistant who is authorized by Florida law to prescribe controlled substances is a practitioner. Thus, the controlled substance prescription must also contain the DEA registration number of the physician assistant. It should be noted that the supervising physician’s DEA registration number is not required on the controlled substance prescription.33 In conclusion, recent changes to Florida law revised the requirements for prescriptions issued by physician assistants and broadened the scope of a physician assistant’s authority to prescribe controlled substances. Physician assistant prescriptions no longer need to include the address and phone number of the supervising physician, but now must include the physician assistant’s address and telephone number, along with the name of each of the physician assistant’s supervising physicians. The law also removed language relating to the physician assistant’s prescriber number as the Department of Health never issued prescriber numbers to physician assistants. Finally, the law authorizes certain physician assistants to prescribe Schedule II psychiatric controlled substances to children under 18 and authorizes the Council on Physician Assistants to revise the formulary to allow physician assistants to prescribe Schedule III, IV, and V psychiatric controlled substances to children under 18. It is important that pharmacists remain aware of any changes to controlled substance prescribing requirements as pharmacists have a duty to validate such prescriptions before dispensing the medications. 18

FLORIDA PHARMACY TODAY

T.J. Morton serves as general counsel for the Florida Pharmacy Association. He is a partner at The Lockwood Law Firm in Tallahassee with significant experience representing individuals and businesses in highly regulated industries, specializing in gaming, medical marijuana, alcoholic beverage and health care. He graduated magna cum laude from the Florida State University College of Law and earned his Bachelor of Science in Cell and Molecular Biology from Missouri State University.

Natalie M. Alonso is a law clerk for The Lockwood Law firm and is entering her second year at FSU College of Law. Ms. Alonso received her undergraduate degree in Finance from Florida International University in 2019. REFERENCES

1. U.S. Bureau of Labor Statistics, Occupational Outlook Handbook, Physician Assistants (Apr. 9, 2021), https:// www.bls.gov/ooh/healthcare/physician-assistants. htm#:~:text=4%25-,Employment%20of%20physician%20 assistants%20is%20projected%20to%20grow%2031%20 percent,the%20average%20for%20all%20occupations.&text=PAs%20are%20expected%20to%20continue,trained%20 more%20quickly%20than%20physicians. 2. See Fla. HB 431 (2021). 3. Fla. Stat. §§ 458.347(4)(e)5, 459.022(4)(e)5 (2020). 4. Id. 5. Id. 6. Fla. H.R. Comm. on Health & Hum. Servs. Comm., HB 431 (2021) Final Staff Analysis (July 6, 2021) https://www. myfloridahouse.gov/Sections/Documents/loaddoc. aspx?FileName=h0431z1.PPH.DOCX&DocumentType=Analys is&BillNumber=0431&Session=2021. 7. See Fla. Stat. §§ 458.347(4)(f), 459.022(4)(e) (2020). The formulary is contained in Rule 64B8-30.008 of the Florida Administrative Code for allopathic physicians and Rule 64B156.0038 of the Florida Administrative Code for osteopathic physicians. 8. Id. 9. Id. 10. These provisions require prescriptions to include the prescribing practitioner’s name, the name and strength of the drug, the quantity of the drug, directions for use of the drug, the date, the prescribing practitioner’s signature, and in some cases, the prescribing practitioner’s license number. 11. Fla. HB 431, § 1, at 7, ll. 169–73; 538–42 (2021). 12. Fla. HB 431 § 1, at 8 (2021). 13. Id. 14. Fla. HB 431, § 1, at 7, ll. 184–95 (2021). 15. Fla. HB 431, § 1, at 7, ll. 188–90 (2021). 16. Fla. HB 431, § 1, at 7, ll. 173–81; 542–50 (2021). 17. Fla. Stat. § 456.0392(3) (2020). 18. Fla. Admin. Code Ann. r. 64B16-27.831 (2020). 19. See Fla. Admin. Code Ann. r. 64B8-30.008 (2020). 20. Fla. HB 431, § 1, at 7, ll. 169–74; 538–43 (2021). 21. 21 C.F.R. § 1306.05(a) (emphasis added). 22. 21 U.S.C. § 802(21). 23. 21 U.S.C. § 802(10). 24. However, the supervising physician must have a DEA registration number in order to delegate the authority to prescribe controlled substances to the physician assistant.

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JULY 2021

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

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