IPA Journal - Oct/Nov/Dec 2015 by Iowa Pharmacy Association

The Journal of the Iowa Pharmacy Association | A Peer-Reviewed Journal

New BPS Recertification Track highlights an enhanced 2016 Expo agenda! (pg. 10)

OCT.NOV.DEC 2015

RAGBRAI Recap Meet the Iowa Board of Pharmacyâ&#x20AC;&#x2122;s New Exec. Director Iowa Medicaid Modernization Questions Answered

OCT.NOV.DEC 2015 | Vol. LXXI, No. 4

TABLE OF CONTENTS 8515 Douglas Avenue, Suite 16, Des Moines, IA 50322 Phone: 515.270.0713 Fax: 515.270.2979 Email: ipa@iarx.org | www.iarx.org

PUBLICATION STAFF David Schaaf, Managing Editor dschaaf@iarx.org Kate Gainer, PharmD kgainer@iarx.org Anthony Pudlo, PharmD, MBA, BCACP apudlo@iarx.org Laura Miller lmiller@iarx.org

OFFICERS

Chairman John Swegle, PharmD, BCPS, Mason City 641.428.7182, john-swegle@uiowa.edu PRESIDENT Bob Greenwood, RPh, Waterloo 319.234.1589, bob@greenwoodpharmacy.com PRESIDENT-ELECT Rick Knudson, PharmD, BCPS, MS, MBA, Clear Lake 515.707.1174, raknudson@hotmail.com TREASURER Steve Firman, RPh, Cedar Falls 319.277.7540, steve@pmgrx.com SPEAKER OF THE HOUSE CoraLynn Trewet, MS, PharmD, BCPS, CDE, Ankeny 515.360.0065, coralynn.trewet@sanofi.com VICE SPEAKER OF THE HOUSE Susan Vos, PharmD, BCPS, FAPhA, Iowa City 319.335.8837, susan-vos@uiowa.edu

FEATURES

President’s Page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 CEO Editorial . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 2016 Leadership Agenda . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 2016 Midwest Pharmacy Expo . . . . . . . . . . . . . . . . . . . . . . 10 The IPA Foundation RAGBRAI Team Rides Again! . . . . . . . . 19 Making an Impact with IPPAC . . . . . . . . . . . . . . . . . . . . . . . 30 Ask Andrew . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 Iowa Residents Spotlight . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

IN EVERY ISSUE

Health Care Hot Topics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Iowa Pharmacy News . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Practice Advancement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 IPA Foundation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Public Affairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Member Section . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 Technician’s Corner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 College of Pharmacy News . . . . . . . . . . . . . . . . . . . . . . . . . . 44 Student Section . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 Calendar of Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

ONLINE FEATURES!

Where you see this banner, additional content is available for a story in our electronic Journal edition at www.iarx.org (Click on the Journal Cover).

TRUSTEES REGION 1 Kristin Meyer, PharmD, CGP, CACP, FASCP, Marshalltown 641.753.4580, kristin.meyer@drake.edu REGION 2 Ryan Jacobsen, PharmD, BCPS, Iowa City 319.321.4436, ryan-jacobsen@uiowa.edu REGION 3 Erik Maki, PharmD, BCPS, Johnston 515.326.0171, erik.maki@drake.edu REGION 4 Jerod Work, PharmD, Sioux Center 712.722.0845, jerodwork@gmail.com AT LARGE David Weetman, RPh, Iowa City 319.356.2577, david-weetman@uiowa.edu Laura Knockel, PharmD, North Liberty 319.354.7121, lauraknockel@gmail.com Brett Barker, PharmD, Nevada 515.382.4179, brett-barker@uiowa.edu Stevie Veach PharmD, BCACP, Tiffin 563.580.9662, stevie-veach@uiowa.edu HONORARY PRESIDENT Dennis Jorgensen, RPh, Panora 641.755.2520, dkjorgensen@netins.net PHARMACY TECHNICIAN G. Jean Gallogly, CPhT, Vincent crittersandstuff@yahoo.com STUDENT PHARMACISTS Christina Bravos, Drake University christina.bravos@drake.edu Robert Nichols, University of Iowa robert-nichols@uiowa.edu

ADVERTISERS

PharmServ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Inside Cover Pharmacists Mutual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Onnen Company . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 IPRN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 McKesson/RxOwnership . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Career Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 PTCB . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 OutcomesMTM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 PQC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 Buy-Sellapharmacy.com . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 PACE Alliance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 PBA Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Back Cover

The Journal of the Iowa Pharmacy Association is a peer reviewed publication. Authors are encouraged to submit manuscripts to be considered for publication in the Journal. For Author Guidelines, see www.iarx.org. “The Journal of the Iowa Pharmacy Association” (ISSN 1525-7894) is published 4 issues per year: January/ February/March issue; April/May/June issue; July/August/September issue; and October/November/ December issue by the Iowa Pharmacy Association, 8515 Douglas Avenue, Suite 16, Des Moines, Iowa 50322. Periodicals postage paid at Des Moines, Iowa and additional mailing offices. POSTMASTER: Send address changes to: The Journal of the Iowa Pharmacy Association, 8515 Douglas Ave., Suite 16, Des Moines, IA 50322. Published quarterly The Journal is distributed to members as a regular membership service paid for through allocation of membership dues. Subscription rates are $100 per year, single copies are $30. Printed by ColorFx; Graphic Design done by Iowa Pharmacy Association.

OCT.NOV.DEC 2015 |

President’s Page

Eye on the Finish Line Bob Greenwood RPh IPA President

ollowing a great Annual Meeting in Coralville, I look forward to the year ahead and to serve the IPA as your President. There are several key issues for which I will continue to pursue solutions on your behalf, the ground work for these issues has been put in place by our previous boards, and I will take up the baton and move these issues forward. Clearly to me, provider status remains the number one priority for our Association and for our pharmacist colleagues across the country. A couple thoughts circle through my head when I hear the term. One, I have been hearing the need for the recognition of pharmacists as providers under the Social Security Act since the very first steering committee that I participated in at NARD, now NCPA - a long time ago. Throughout my almost 40 years we have slowly changed pharmacy practice acts across the country, innovated pharmacy based healthcare solutions, and now stand at the threshold of our destination to becoming a recognized healthcare provider. Senate File 314, the Pharmacy and Medically Underserved Areas Enhancement Act, was introduced by our own Senator Chuck Grassley, and stands with 33 cosponsors as of October 21. The support we enjoy from Senator Grassley is the cumulative result of 30 years of work with Senator Grassley, whether in Washington or here in Iowa. We have the Joint Commission of Pharmacy Practitioners (JCPP) organizations in full support, so we need to stay laser focused to get this pushed across the finish line. The members of the Iowa House delegation are in full support, and we are working to gain the support from Senator Joni Ernst. We were able to host 4 of 6 members from the Iowa Congressional

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delegation in pharmacies across the state during the August recess. Most interesting to me was the visit to Iowa by Rodney Whitlock, the Senior Director of Health Policy for Senator Grassley. IPA’s CEO Kate Gainer and executive intern, Elizabeth Bald, spent a full day with Rodney and visited four unique pharmacy practice sites as well as meetings with the Iowa Medical Society and OutcomesMTM. The theme of IPA’s meetings was high tech/high touch – exposing members of Congress and Rodney to pharmacy practices that utilize technology for prescription dispensing and provide personalized care by a pharmacist. We appreciate Rodney being able to take the time to visit pharmacies on the ground here in Iowa. His message to us was to stay very focused on our most important issue, and to try to fix one problem at a time. Now, priority number two: Are we ready for provider status? The California State Assembly passed S.B. 493 in October of 2013, which was signed into law by Governor Jerry Brown and took effect in January of 2014. I won’t spell out the whole legislation here, however, I encourage you to read the bill and see if your practice is ready to perform the clinical service addressed in the legislation. Your association, along with CEI, Drake University, and University of Iowa are discussing how to best prepare for the duties and opportunities that will come with provider status. There are a lot of good things going on in pharmacy, especially in Iowa. I encourage all pharmacists and technicians to stay up to date, and stay tuned to the learning opportunities, 2/2/2 webinars, the IPA website, CEI’s website and think about attending the Midwest Pharmacy Expo in February to learn, network and be inspired with your colleagues. Until next journal we’ll call it a day. ■

ceo editorial

Iowa Pharmacists… the Will to Change the World

n the past four months, I’ve experienced a true highlight of my career. It was an event that opened my eyes to history, demonstrated leadership and generosity, created a mechanism to cultivate pharmacy innovation, and – quite honestly – made me very proud to be an Iowa pharmacist. I believe this event will be highlighted in the history books of Iowa Pharmacy and referenced for years and decades to come. This event was the creation of the IPA Foundation’s Outcomes Innovative Pharmacy Endowment. Following the sale of OutcomesMTM to Cardinal Health, many of the company’s investors donated a percentage of their proceeds to this endowment which was created by the former OutcomesMTM board members. The goal: to establish an endowment that supports the innovative spirit of Iowa Pharmacy by awarding grants for the financial support and encouragement of future innovative pharmacy practice within the State of Iowa. With the endowment balance over $726,000 to date, the IPA Foundation Board of Directors will have the opportunity to issue ‘Outcomes Grants’ to fund innovative pharmacy practice initiatives. Perhaps (one of) the coolest things, is the original investors in OutcomesMTM were not from any one region of the state, or just one type of pharmacy practice, but rather a cohort of Iowa pharmacists who decided to support fellow Iowa pharmacists with the launch of a novel business plan. While their backgrounds were unique, one similarity has shown through – these investors truly saw their initial ‘investment’ as a contribution to advancing the profession of pharmacy. What made me proud to be an Iowa pharmacist was learning that the desired ROI was not monetary in nature, but rather a vision of advancing pharmacy practice

by creating both the supply and demand for Medication Therapy Management services. This group of forward thinking pharmacists that invested in our profession back in 1999 has now created an opportunity to reinvest in our profession, and continue cultivating the spirit of innovation that our state is known for through the Outcomes Innovative Pharmacy Endowment. As with all great leaders, no one person has taken credit for the idea to create this endowment. Rather, members of the former OutcomesMTM Board refer to ‘… those who came before us and inspired generosity by their investments into the profession of pharmacy...and the opportunity to pay it forward.’ The list of donors (pg. 24) is long and diverse. I cannot thank these individuals enough for their generosity and ongoing investment in the profession of pharmacy.

Kate Gainer PharmD IPA Executive Vice President & CEO

In addition to the Founders Circle, there is an opportunity for anyone who believes in supporting innovation in Iowa pharmacy to contribute to the Outcomes Innovative Pharmacy Endowment. (see page 24 to learn more.) Stay tuned as the IPA Foundation Board develops and releases additional information related to the ‘Outcomes Grants’ and funding opportunities. Without question, innovative projects funded by these grants will help shape the future of pharmacy practice in Iowa.

“Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.” – Margaret Mead OCT.NOV.DEC 2015 |

board of trustees

IPA Board of Trustees’ 2015-2016 Leadership Agenda In July, IPA’s newly installed 20152016 Board of Trustees reviewed the association’s strategic plan and establish priority projects for the coming year. Each project is designed to advance IPA’s three strategic focus areas (SFA) – 1) patient care, safety and health outcomes; 2) membership; and 3) advocacy for the profession.

SFA #1: Patient Care, Safety and Health Outcomes

Goal 1: Quality patient care is provided through a multi-disciplinary team, which includes pharmacists. Goal 2: Pharmacists are actively involved in increasing patient safety through the appropriate use of medications. Goal 3: The public is aware of the expertise and value of pharmacy professionals. Priority Projects: 1. Identify and implement new opportunities for pharmacy integration in new and evolving healthcare models by partnering with outside organizations. 2. Promote and support ongoing pharmacy initiatives that include sustainable funding mechanisms, such as the Wellmark PQAC, IPA’s New Practice Model, Trinity Pioneer ACO project, and new Iowa Medicaid MCO’s. 3. Develop an online central repository to share information on current and future patient care initiatives. 4. Assess the opportunity to establish a new business model for an IPA consulting service to assist pharmacies with advancing their practice.

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5. Expand the use of measurement tools (e.g. Hospital SelfAssessment; EQUIPP; Ambulatory Care Self-Assessment) to showcase the value of pharmacy services focusing on safe and appropriate medication use.

SFA #2: Membership

Goal 1: IPA will have 1000 pharmacist members. Goal 2: IPA will have 400 technician members. Goal 3: IPA will have 900 student members from Iowa’s Colleges of Pharmacy Goal 4: IPA’s members are engaged and actively recommending IPA membership to pharmacy friends, colleagues, and students. Priority Projects: 1. Evaluate current membership data to identify actionable trends among member demographics and engagement. 2. Target key populations to increase membership and engagement through a member referral program, employer partnership packages and other specific strategies related to member engagement, recruitment and retention. 3. Develop a member loyalty program to recognize and reward pharmacists and technicians for milestone anniversaries and engagement.

SFA #3: Advocacy for the Pharmacy Profession

Goal 1: Pharmacy professionals are represented in all legislative and

regulatory issues that impact the profession. Goal 2: The role of pharmacists is understood and valued. Goal 3: IPA develops new and expanded pharmacy practice models. Goal 4: IPA develops new leaders who are involved in advancing the profession. Priority Projects: 1. Prepare for Medicare Part B provider status by establishing a legislative agenda to identify and update necessary state statutes and regulations. 2. Increase number of donors to IPPAC and LDF to 16% of the membership in 2016. 3. Maintain a positive relationship with the Board of Pharmacy that protects and improves the public health of Iowans. 4. Establish relationships with Iowa Managed Care Organizations and represent the profession to Iowa Medicaid and MCO’s. 5. Develop advocacy tools to promote the profession of pharmacy to the public. 6. Increase pharmacy professionals’ awareness and engagement in civic leadership through identifying open positions for service in the state. 7. Support proposed Provider Status bills in Congress and collaborate with supporting organizations locally and at the national level.

BEComE A mEmBEr of THE iowA PhArMAcy AssociAtion

Position yourself to lead and shape the future of your profession and join a network of pharmacists, pharmacy technicians and student pharmacists advocating the advancement of practice for the health and well-being of our patients.

AdvAntAges for You Equipping you for todayâ&#x20AC;&#x2122;s rapidly evolving health care system with free and convenient CPE and opportunities to connect with colleagues across the state.

AdvocAcy for Your ProfEssion Enabling you to confidently engage your elected officials while representing your interests with the Board of Pharmacy, state agencies, health care organizations, and provider groups.

of membership dues directly fund initiatives that advance the pharmacy profession

AdvAnceMent for Your PrACTiCE Creating opportunities for you and your colleagues to collaborate with healthcare teams and integrate pharmacy practice into emerging healthcare models.

iowA PhArMAcy needs your unique voice And exPerience!

leArn More & join todAy At

www.iArx.org FREE CPE!

iPA members receive ceiâ&#x20AC;&#x2122;s relicensure or recertification cPe Buckets for free!

All the required CPE for relicensure or recertification conveniently bundled by CEi and free for iPA members!

health care hot topics CMS Announces Enhanced MTM Model Initiatives

Beginning January 1, 2017, an enhanced MTM model will be implemented for Medicare Part D beneficiaries in 11 states, including Iowa. CMS announced in September that the model will be used to test strategies to improve medication use and achieve MTM program goals. These goals include: • Improving compliance • Reducing medication-related problems • Increasing patients’ knowledge of their medications to better achieve the goal of therapy • Improving communication between the health care team and the patient IPA is actively developing strategies for working with PDPs in our region on opportunities to enhance MTM services that meet the outlined program goals.

340B Mega-Guidance Released

On August 28, 2015, the Health Resources and Services Administration (HRSA) published guidance for the 340B drug pricing program. This program allows qualifying “covered entities” to purchase outpatient prescriptions at discounted prices. This omnibus guidance will clarify issues such as the types of outpatient facilities that are covered, the definition of patient, a modification to the prohibition against use of group purchasing organizations (GPOs), and reasonable cause standards for manufacturer audits of covered entities.

IHC Awarded Grants for HEN 2.0 and TCPI

On September 25, 2015, the Iowa Healthcare Collaborative (IHC) was selected by CMS as one of 17 national, regional, or state hospital associations

and health system organizations to receive a grant for hospital engagement networks (HEN). IHC will be participating in a second round of HEN to continue to improve patient care in the hospital setting. On September 29, IHC was one of 39 health care collaborative networks selected to receive the Transforming Clinical Practice Initiative Award (TCPI). IHC will receive up to $32.5 million from the U.S. Department of Health and Human Services (HHS) during this four year initiative to increase patients’ access to information, improve quality of care, and spend health care dollars more wisely.

CDC Introduces Antibiotic Resistance Tracking Tool

The National Antimicrobial Resistance Monitoring System for Enteric Bacteria (NARMS) was established in 1996 and is a collaboration of state and local health departments, CDC, FDA, and the USDA. In August 2015, the CDC created a tool NARMS Now: Human Data which is an interactive tool showing resistance data of four bacteria that are commonly transmitted through food. These bacteria are Campylobacter, E. coliO157, Salmonella, and Shigella. This tool makes it easy and quick to see the antibiotic resistance over the past 20 years and can be used to examine geographic distribution of resistance, monitor changes in resistance, and inform regulatory agency action.

Provider Status Bill Has Majority Support in the House

In October, The Pharmacy and Medically Underserved Areas Enhancement Act (H.R. 592/S. 314) reached a milestone as 219 of 435 members of the U.S. House of Representatives have signed on as sponsors or cosponsors of the bill, giving it majority support in the U.S. House. Known as the provider status bill, this legislation will allow

pharmacists to provide patient care services especially in areas that lack access to primary health care. All four of Iowa’s Representatives – Rod Blum, Dave Loebsack, David Young and Steve King – support H.R. 592. The Senate version, S. 314, was introducing by Iowa Senator Chuck Grassley and as of October 15, 2015 has 31 (of 100) senators co-sponsoring the bill, however, Iowa’s other senator, Joni Ernst is not one of them yet.

Wellmark Plans to Enter 2017 State Insurance Marketplace

After several years of withholding its participation in the state health insurance exchange, Wellmark, Iowa’s largest health insurer, announced that it will sell marketplace plans during the next open enrollment period. Coverage for beneficiaries would begin on January 1, 2017. Multiple reasons have been attributed to the delay in participation, including: Supreme Court rulings, potential problems with technology used in the marketplace, and the timeline needed to participate.

Strong Participation in 10th DEA Drug Take-Back Day

Over 702,365 pounds of unneeded, unwanted, or expired prescription medications were properly disposed of as part of Drug Enforcement Administration’s (DEA) National Prescription Drug Take-Back Day Initiative on Saturday, September 26, 2015. DEA and its law enforcement partners provided over 5,000 collection sites across the United States, DEA reports. The 10th Take-Back Day was scheduled after the DEA has seen limited pharmacy registrations as a permanent collection site of controlled substances. Since September 2010, the DEA has collected more than 5.5 million pounds of unwanted medication for safe and secure disposal through their Take-Back Days. ■

OCT.NOV.DEC 2015 |

February 12-14, 2016

Community Choice Credit Union Convention Center, Des Moines, Iowa

Learn, Connect & Be Inspired with Your Colleagues from Across the Midwest! The Midwest Pharmacy Expo brings together pharmacists, pharmacy technicians and student pharmacists from across the Midwest for one weekend of high quality live continuing education, engaging networking opportunities, and inspiring keynote speakers in a professional and relaxed Midwest atmosphere.

Featured Programming In addition to the high quality continuing education and uniquely Midwestern experience youâ&#x20AC;&#x2122;ve always enjoyed, the 2016 Expo will be enhanced with these programming options:

BPS Recertification Track | Fri., February 12

Expo has partnered with ASHP to host their Pharmacotherapy Intensive Studies Package of three, 2-hour intensive sessions for board certified pharmacists to earn recertification credit (BCPS, BCACP). CPE credit is also available. Expo is the first state-based regional meeting to host this level of programming.

Tech Forum | Sat., February 13

This one-day interactive conference features programming specifically tailored the needs of hospital and community pharmacy technicians, plus attendees can take advantage of Expoâ&#x20AC;&#x2122;s keynote, Sunday programming, exhibit hall and networking opportunities.

Heartland PRN | Sat.-Sun., February 13-14 The annual Heartland Pharmacist Recovery Network conference is a gathering of Midwest pharmacy professionals interested in addressing chemical dependency within the profession. Programming will provide the tools, motivation and networking opportunities for those in recovery or interested in supporting their peers.

For more information or to register, visit

www.MidwestPharmacyExpo.com 10

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FULL EXPO AGENDA Friday, February 12

BPS Recertification CPE Available: 6 Hours - Pharmacists 8:00 a.m. Registration 9:15 a.m. Welcome 9:30 a.m. Individualizing Therapy for Patients with Type 2 Diabetes 11:30 a.m. Lunch Break - on your own 12:30 p.m. Making Sense of Infectious Diseases Clinical Practice Guidelines 2:30 p.m. Break 3:00 p.m. Does Practice Need to a-DAPT? Considerations in Anti platelet Therapy after Drug-eluding Stent Implatation 5:00 p.m. Adjourn

Saturday, February 13

CPE Available: 6 Hours - Pharmacists & Technicians 6:30 a.m. Registration Opens 7:00 a.m. Political Leadership Breakfast (ticket req.)

Product Theater Breakfasts (free)

• Immunizations: Clinical Pearls • Medication Synchronization Overview • It Takes a Team: Technicians and Medication Reconciliation • Emerging Drugs of Abuse 3:00 p.m. Break 3:15 p.m. Session 4 (Expo, Tech Forum, Heartland PRN): • Incorporating Research into Practice • Worst “Case” Scenario: Managing Side Effects • Heart Failure: Pharmacotherapy Update • More Than Just a Number - A Review of Outpatient Labs • CBC’s, BMP’s, LFT’s - Oh My! • The Psychopharmacology and Neuroscience of Substance Use and Disorders 4:15 p.m. Break 4:30 p.m. Session 5 (Expo, Tech Forum, Heartland PRN): • Translational Care in Transitional Care • On the Case: Solving Conundrums in Pain Management • Pass the Salt! Managing Electrolyte Disorders • Tips to Reduce Med Errors in the Community Pharmacy • Tips to Reduce Med Errors in the Hospital Pharmacy • Medication Management of Persons in Recovery

8:30 a.m. Welcome

5:30 p.m. Adjourn

9:00 a.m. Keynote: Shine: Using Brain Power to Get the Best From People - Edward Hallowell, MD

5:45 p.m. Product Theater Dinner (Free)

10:00 a.m. Break 10:15 a.m. Session 1 (Expo, Tech Forum, Heartland PRN): • The Role of the Pharmacist in Emergency Medicine • Case Closed! Optimizing Treatment for Endocrinologic Disorders • Appropriate Prescribing in Older Adults: A Focus on the 2015 Update to the Beers Criteria • Communication Skills for Pharmacy Technicians • Navigating PRNs and the Workforce

7:00 p.m. PRN Recovery Support Meeting

Sunday, Februay 14

Expo CPE Available: 4.5 Hours - Pharmacists & Technicians 6:30 a.m. Registration & Continental Breakfast Begins 8:00 a.m. New Drug Update 9:30 a.m. Break 9:45 a.m. Gamechangers in Pharmacy

11:15 a.m. Break

11:45 a.m. Break

11:30 a.m. Session 2 (Expo, Tech Forum, Heartland PRN): • Medication Synchronization: Integration and Implementation • “Case” in Point: Dilemmas in Anticoagulation Management • Optimizing Inhaled Respiratory Medications: A Hands-on Approach • Compounding Pharmacy in the Community Setting • Compounding Pharmacy in the Hospital Setting • State PRNs Sharing Session

12:00 p.m. A Look Ahead/Specialty Pharmacy

12:30 p.m. Lunch and Exhibit Hall 2:00 p.m. Session 3 (Expo, Tech Forum, Heartland PRN): • Beyond Adherence: Expressing Value in the Era of Health Reform • Making the Case: Challenging Scenarios in Mental Health

1:00 p.m. Adjourn Heartland PRN CPE Available: 2.5 Hours - Pharmacists & Technicians 7:00 a.m. Non-Denominational Prayer Service (no CPE) 8:15 a.m. Issues Surrounding Addictive Disease in Pharmacists 9:45 a.m. Break 10:00 a.m. The Effects of Alcohol on Health 11:15 a.m. Break 11:15 a.m. Today Matters (no CPE) 12:15 p.m. Adjourn

OCT.NOV.DEC 2015 |

Thank You Joan! Congratulations to Joan Stover who is retiring from IPA at the end of 2015, after 34 years of dedicated service to Iowa pharmacy.

If you have ever attended Expo, Annual Meeting, the EgglestonGranberg Golf Classic or any other IPA event, you have been blessed by Joanâ&#x20AC;&#x2122;s hard work and passion for Iowa pharmacy. IPA and the Iowa pharmacy family would like to share our deepest appreciation to Joan and best wishes as she pursues the next chapter in her life.

iowa pharmacy news

2/2/2 is IPAâ&#x20AC;&#x2122;s free monthly webinar series designed to keep you engaged and informed on the hot issues impacting the pharmacy profession. When is it? 2nd Tuesday of every month at 2:00 p.m. CST. Upcoming Dates you wonâ&#x20AC;&#x2122;t want to miss: November 10, 2015

E-Prescribing of Controlled Substances

December 8, 2015

Equipping Pharmacists for Difficult Immunization Questions

January 12, 2016

Antimicrobial Stewardship in Iowa

February 9, 2016

Performance-Based Pharmacy Networks Take advantage of these virtual engagement opportunities by registering at www.iarx.org/222. Recordings of previous 2/2/2 programs are available at no charge at www.iarx.org/222. Previous subjects include 340b compliance, Incident-to Billing, Track-n-Trace, and more. Topics subject to change. Watch IPA communications for updates and registration instructions. 2/2/2 webinars are not accredited for CE.

OCT.NOV.DEC 2015 |

iowa pharmacy news

IPA Goes Local Wraps Successful 2015 Campaign “Collaborative practice and communication are important topics and Iowa pharmacists are doing good work in this area. The numbers to break down our successes were fantastic to see.” – Taylor Monson, Drake Student “It was nice to have a physician show their support and perspective of pharmacy in the health care setting.” - Anonymous “Very interesting. Important topic. Excellent speakers. Appreciate having IPA comes to us. Glad to see the different professions working more closely together.” – Anonymous

Going Local in 2016! The 2016 IPA Goes Local Program will feature a 1 hour patient safety CE presentation by pharmacists from advanced clinical practices sharing clinical pearls and team-based care practices to improve the health outcomes of patients with diabetes and hypertension.

With our final stop on October 6 in Spencer, Iowa, with the Northwest Iowa Pharmacy Association, IPA Goes Local wrapped for 2015. A total of 295 pharmacists, pharmacy technicians and other providers attended the 9 IPA Goes Local events hosted by each of Iowa’s 9 regional associations. This year, IPA partnered with the Iowa Healthcare Collaborative (IHC) to present the interprofessional CE program A Case for Change: Medication Safety and Effectiveness that sought to bring together Iowa’s healthcare professionals to collaborate on a medication safety and effectiveness plan for Iowans. Dr. Tom Evans, IHC President and CEO and Anthony Pudlo, IPA’s Vice-President of Professional Affairs, discussed strategies to improve safe and effective medication use in Iowa and shared case examples on ways to collaborate across practice settings.

In addition to the CE presentation, Andrew Funk, Executive Director of the Iowa Board of Pharmacy, will be available for a 30 minute informal meet and greet at each IPA Goes Local event. Watch IPA communications for the 2016 IPA Goes Local schedule announcement!

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Thank you to everyone who attended an IPA Goes Local event this year and the regional associations for their partnership and hospitality.

T.J. Johnsrud Receives IRHA Karbeling Award

T.J. Johnsrud, RPh, was the recipient of the 2015 Jerry Karbeling Award by the Iowa Rural Health Association (IRHA). T.J. was presented with the award at the IRHA Fall Conference on September 10, 2015. The award is named after the late Jerry Karbeling who served on the IRHA Board for 5 years and was president of the association. Jerry was on staff at IPA at the time of his death in 2005. IRHA presents the award each year to an Iowan who has demonstrated successful activism for improving rural and a commitment to community service exemplified by Jerry.

IPRN Supports Iowans at newly renamed APhA Institute on Alcoholism and Drug Dependencies

In 2014 due to scheduling conflicts with the University of Utah, the Utah School on Alcoholism and Other Drug Dependences was no longer going to be offered. However, APhA stepped up to offer their inaugural session of the APhA Institute on Alcoholism and Drug Dependencies in Salt Lake City, UT on June 5-8, 2015. The new APhA Institute continues to carry the message forward to provide pharmacists, student pharmacists, and the profession with resources, information, motivation, and guidance regarding the implementation or strengthening of state and campus-level programs

iowa pharmacy news to help pharmacists and student pharmacists whose competence to perform their responsibilities has become impaired due to chemical dependency or other causes. With support from the Iowa Pharmacy Recovery Network, 15 student pharmacists from Drake University and the University of Iowa plus one pharmacist attended the 2015 event. The Utah experience continues to be an opportunity unmatched by others. One 2015 attendee in Iowa commented, “I have been shown that compassion and education are integral to infiltrating the disease of addiction in the pharmacy profession. It seems as though there is so much more to be revealed on the horizon of addiction discovery and recovery. I am now aware that proactive care by pharmacists can have an impact on the outcomes of patients and colleagues affected by this disease.”

OutcomesMTM Recognizes Boone Hy-Vee Pharmacy as a Top Pharmacy

OutcomesMTM named Hy-Vee Pharmacy 1038 in Boone as the Top Pharmacy in the Central Region for finding a drug therapy problem in 100% of the CMRs delivered this year. They are one of four pharmacies OutcomesMTM has recognized across the country (one in each of their 4 regions) for demonstrating an exceptional dedication to medication therapy management and commitment to improving the health of their patients.

IPA Attends NACDS Total Store Expo

For the 3rd year, the National Alliance of State Pharmacy Associations (NASPA) hosted a meeting in conjunction with the NACDS Total Store Expo, held August 22-25, 2015, in Denver, CO. IPA staff was able to attend a unique meeting of chain executives as part of the NACDS-NASPA Institute on Expanding Pharmacy Care with a highlight of innovative models from the USA and abroad. In addition, meeting

attendees heard from TSE keynote speaker, television journalist and author Tom Brokaw. He highlighted the important role of pharmacy as the ‘new main street of America’ and encouraged attendees to be a voice for their patients pulling together the common needs of a community. Other Iowa highlights from NACDS TSE: • Randy Edeker, Chairman, CEO and President of Hy-Vee, Inc., offers his thoughts on the future of pharmacy practice as he serves as NACDS Chairman of the Board. • Katy Brown, PharmD, Clinical Pharmacy Specialist at Telligen, discussed how state pharmacy associations and other stakeholders can work with the QIN-QIOs to improve the health of Medicare beneficiaries

Iowa Pharmacists a Significant Presence at the 75th FIP World Congress

pharmacy services. Ryan Jacobsen, PharmD, BCPS (University of Iowa), shared the stage with pharmacists from Australia, the Philippines, Switzerland and the U.S. as he shared his experiences in interprofessional education and practice. Also in attendance were Donald Letendre, PharmD (Iowa City), Matt, BSPharm, FASCP, FAPhA, and Marilyn Osterhaus, RPh (Maquoketa), Gene, RPh, and Susan Lutz, RPh (Altoona), and Ben Urick, PharmD and Katie Owen, PharmD (Iowa City). Stephen Mullenix, RPh and Jenelle Sobotka, PharmD, part of the extended Iowa pharmacy family, were also in attendance. The 75th World Congress was an excellent opportunity for IPA members to showcase Iowa pharmacy and learn from our international colleagues. Look for members of the Iowa pharmacy family at the 76th World Congress, which will be held in Buenos Aires, Argentina, from Aug. 28-Sept. 1, 2016.

Iowa Reception at ASHP Midyear

Written By: Ben Urick, PharmD There is no other event like the International Pharmaceutical Federation (FIP) World Congress. The annual conference brings pharmacists from across the world together to share ideas across international borders and discuss the profession in a global context. The 75th World Congress was held this year in Dusseldorf, Germany on September 29-October 3, 2015. Pharmacists from Iowa made significant contributions to this year’s World Congress. Bill Doucette, PhD (University of Iowa), teamed with a pharmacist from the United Kingdom to deliver a master class on new

At this year’s ASHP Midyear Clinical Meeting, held December 6-10 in New Orleans, LA, IPA will once again be hosting an Iowa reception. December 7, 2015 5:30-9:00 p.m. New Orleans Downtown Marriott 859 Convention Center Blvd New Orleans, LA 70130 Join us to reconnect with colleagues and make new connections within the Iowa pharmacy family! ■ OCT.NOV.DEC 2015 |

PRACTICE ADVANCEMENT Trinity Pioneer ACO MTM Concludes; Publication Being Sought

Throughout the past two years, IPA in collaboration with the University of Iowa, OutcomesMTM, UnityPoint Health, and over 30 community pharmacies in north central Iowa conducted a research project on how a network of community pharmacies can contribute to the performance of the Trinity Pioneer ACO, part of UnityPoint Health, based in Fort Dodge. The purpose of this study was to implement and evaluate an integrated medication management (MTM) program in a Pioneer ACO in comparison to a similarly situated Medicare Shared Savings Plan (MSSP). Over an intervention period of almost 15 months, a total of 885 ACO patients were eligible for the MTM program and had Medicare claims data available. Of those, 450 (50.9%) unique people had at least one MTM claim filed for them. The integrated MTM program produced 1,573 MTM claims for 607 unique patients, including those referred from the hospital. A total of 66 community pharmacists worked with providers to manage drug therapy 249 times: changed dose (N=21), changed medication (N=35), stopped medication (N=52), started a new medication (N=59), and administered immunization (N=82). While the integrated MTM program in the Pioneer ACO was associated with significant decreases in hospitalization rates and Medicare costs in the intervention period relative to the baseline period, the rate of decrease was not significantly different than that seen in the MSSP comparison group. Though the integrated MTM plan was associated with improved outcomes, given the differences between the study groups in the baseline period, it is difficult to claim that the MTM program was the key driver of the improvements. The community pharmacists improved the coordination of medication therapy

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by administering immunizations, as well as recommending changes in dosing and medications for Medicare beneficiaries. The promising results of this integrated MTM model are planned to be published in national publications. Investigators from the University of Iowa include: William Doucette, Jane Pendergast, and Elizabeth Chrischilles.

University of Iowa & Mercy Family Pharmacy Focus on Care Transitions

As part of a grant from the Community Pharmacy Foundation, a research team from the University of Iowa College of Pharmacy and Mercy Family Pharmacy - Dubuque are currently investigating the effect of community pharmacist-managed transitions of care on 30-day hospital readmission rates for patients identified to be at high-risk for readmission over a 12-month period. Adult inpatients on the medical, surgical, cardiovascular and skilled units will be evaluated for inclusion in this study by nursing staff using the BOOST risk assessment tool, which assesses polypharmacy, highrisk medications, diagnoses of heart failure, acute myocardial infarction, or pneumonia and poor health literacy. Participating community pharmacists in the Dubuque area are notified daily of any high-risk patients from a pharmacist on the unit. The discharge summary with current medication list are shared with the patient’s primary pharmacy, and then the community pharmacists are charged with conducting 8-day and 25-day followup telephonic consultations focused on medication management. All Dubuque-area pharmacies have been invited to participate. Principle investigators for this project include: Matt Witry (University of Iowa), Beth Engel, Joshua Feldmann, Rachel Smith, and Craig Otting (Mercy Family Pharmacy).

Iowa Health Information Network (IHIN) Projects Kick Off

Throughout 2015, IPA has worked with Iowa Department of Public Health to conduct a pilot project to evaluate and expand the profession’s work within the Iowa Health Information Network (IHIN). Through pilot project approval by the Iowa Board of Health, this initiative provides chain, independent, and long-term care (LTC) pharmacies the opportunity to identify the benefits of IHIN use for pharmacy and address barriers to its use. As a six-month pilot project, specific goals for each pharmacy include: • Integrating Direct Secure Messaging (DSM) and Patient LookUp (PLU) access and functionality into current community & LTC pharmacy workflow, • Improving efficiency with medication list transitions in care and improve communication of laboratory data for MTM recommendations/ intervention, • Determining the value proposition for pharmacy’s involvement to effectively establish appropriate participation fees for IHIN and to develop testimonials to further gain involvement of the pharmacy profession in IHIN. To date, Greenwood Pharmacies, Martin Health Services, and Medicap GRX Holdings have been participating in regular conference calls to understand the struggles and other barriers to utilizing the health information collected and reported in the IHIN. In addition, Towncrest Pharmacy (Iowa City), as part of an Iowa City coalition of healthcare providers, has also been participating in the IHIN as part of a similar initiative. This important project will facilitate the electronic movement of pharmacyrelated information among healthcare providers and organizations within one statewide health information exchange according to nationally recognized data standards. Updates on the progress of

PRACTICE ADVANCEMENT this effort will be shared with the IHIN Advisory Council during their December 4th meeting in Des Moines. Primary pharmacy contacts for this initiative include: Anthony Pudlo (IPA) and Randy McDonough (Towncrest Pharmacy).

Performance Based Networks – Activity Underfoot in Iowa

IPA’s position related to narrow networks has been one to support pharmacy networks based on quality and performance. The IPA Board is discussing opportunities related to ‘high-performing-pharmacy’ or ‘performance-based’ networks for community pharmacy in Iowa. Several opportunities for network development and pharmacy payment based on value and outcomes are currently being developed and evaluated by public and private payers. Wellmark PQAC Wellmark has formed a Pharmacy Quality Advisory Committee (PQAC) to guide the development of a pharmacy network that provides an enhanced level of care to impact patient satisfaction and total cost of care focused on four target disease states: asthma, diabetes, hyperlipidemia and depression. To assist the pharmacies currently participating in the PQAC, IPA is hosting a ‘kick-off’ meeting on November 4th to share best practices related to care collaboration, documentation, targeting appropriate patients, data collection and sharing, along with patient and pharmacy staff engagement. IPA views the Wellmark opportunity as an important program for Iowa pharmacies to demonstrate the impact pharmacist care has on a targeted patient population. Enhanced MTM Medicare Part D stand-alone prescription drug plans (PDPs) are being asked to propose ‘enhanced MTM’ models for plan year beginning January 2017. Recognizing the current structure does not provide

an incentive for PDPs to invest in medication therapy management, CMS is requesting plans put forth proposals for enhanced MTM. Plans offering enhanced MTM services may receive data related to Medicare Part A and Part B claims, as well as a prospective per member per month payment to invest in MTM services. (See page 9 for more information) Iowa Health Link (Medicaid Managed Care) While not part of year 1 plans, MCOs contracted with the state of Iowa have expressed interest in evaluating value-based contracting for pharmacy providers. IPA is involved in these preliminary discussions related to value-based contracting in the future for Iowa Medicaid.

Drake & UnityPoint Health Work to Increase Vaccination Rates As part of a grant from Pfizer, a research team from Drake University College of Pharmacy & Health Sciences and UnityPoint Health are currently investigating a collaborative program to increase adult vaccination rates for a high-risk patient population who receive services at urgent care clinics. Through the implementation of a real-time, on-site vaccination reconciliation and patient education program, data will be collected at two urgent care clinics and compared to two similar clinics.

ONLINE FEATURE!

To learn more, read the Drake press release. With assistance from second and third year pharmacy students working on their Introductory Pharmacy Practice Experiences (IPPE), students will review walk-in patients for eligibility for the pneumococcal vaccine, checking both the clinic’s electronic medical record and the Iowa Immunization Registry Information System (IRIS) for records of current vaccinations and the patient’s electronic medical record for

indications for the vaccine. If eligible, the students discuss the importance of the vaccination, answer questions, and offer to have clinic staff administer it during their visit. Students utilize educational material derived from the CDC’s pneumococcal vaccination fact sheet. The students also record administered vaccinations, declined vaccinations and reason for refusal. If successful, the project’s model could be replicated at other UnityPoint Health urgent care clinics in Iowa. Principle investigators from Drake University include: Nic Lehman, Carrie Koenigsfeld, and Geoff Wall. As you learn about innovative pharmacy practice opportunities around the country, know that many IPA members are part of that innovation here in Iowa. IPA plans to continue to spotlight innovative service offerings and grant projects in this Practice Advancement section of the Journal of the IPA. If you have an innovative project that you are currently working on, please inform IPA at ipa@iarx.org.

Save the Date June 16, 2016 West Des Moines Sheraton

IPA will host the 2016 Practice Advancement Forum to strengthen opportunities for collaboration and practice advancement in Iowa. This year’s Forum will once again be held the day before IPA’s Annual Meeting at the same location. Watch for additional communications for the full Practice Advancement Forum agenda and registration!

OCT.NOV.DEC 2015 |

IOWA PHARMACY RECOVERY NETWORK

Assisting Impaired Pharmacists, Student Pharmacists, and Pharmacy Technicians

Where do you turn when you, a co-worker or someone you care about needs help with an addiction, physical illness or psychiatric disorder?

Providing support . . . through caring volunteers

HOPE FOR RECOVERY 1-877-890-IPRN

http://www.iowarecovery.org/

30 Riders 3 Mobile Pharmacies 462.2 miles 22 Pharmacies VISITEd Countless riders helped ! 1 Successful RAGBRAI Team

The IPA Foundation RAGBRAI Team Rides Again! For the second consecutive year, the IPA Foundation supported a team for the Register’s Annual Bike Ride Across Iowa (RAGBRAI) to serve as ambassadors for the association and our profession across the state. A team of 30 riders (tripled from last year’s team) rode 462.2 miles over seven days from Sioux City to Davenport. Along the way they visited 22 pharmacies, assisted in two health screening events, and provided first-aid and numerous over-the-counter medications to fellow riders from three mobile pharmacies.

Through this outreach opportunity, the team connected with pharmacists, listened to their concerns and discussed what IPA was doing for the profession. It also created high visibility for the profession with riders and the general public, showing the value of pharmacy professionals in a tangible way. The following pages feature several highlights from the team’s trip from Sioux City to Davenport.

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RAGBRAI

From Sioux City Pharmacies Visited: Daniel Pharmacy, Fort Dodge – John Daniel, PharmD Hy-Vee, Fort Dodge - Kristi Dodge, PharmD, Jill Shoopman, CPhT, and Theresa Doyle, Tech-in-Training Screening: Daniel Pharmacy, Fort Dodge – Blood Glucose, Blood Pressure, Sunscreen Education, Medication Disposal Education

Saturday, July 18: Sioux City

The team bonded and prepared for the first day of RAGBRAI with a social hosted by the Drillings and Wiedenfelds. Overnight Hosts: Sara and Terry Wiedenfeld Bill and Sharon Drilling Pharmacies Visited: Thompson Dean Drug, Sioux City – Darci Weakland, RPh and Lindsey McGinnis, CPhT

Sunday, July 19: Sioux City to Storm Lake Distance: 74.3 mi. | Climb: 4,110 ft.

Dressed in white coat jerseys, the team embarked on the long and hilly ride to Storm Lake after dipping their rear tires in the Missouri River. Overnight Hosts: Mike Porsch Ed McKenna Pharmacies Visited: Walgreens, Storm Lake – Jessi Rubin, PharmD

Monday, July 20: Storm Lake to Fort Dodge Distance: 68.4 mi. (82.9 w/ gravel loop) | Climb: 1,314 ft.

After some stretching and minor bike repairs, the team set out on day two. A few riders braved the extra 14.5 miles of the gravel loop. The team was warmly welcomed to Fort Dodge at Daniel Pharmacy, where the IPA rotation students helped promote the profession by assisting with a health screening event. Overnight Hosts: John and Vicky Daniel

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Tuesday, July 21: Fort Dodge to Eldora Distance: 71.5 mi. (98.8 w/ Karras Loop) | Climb: 1,490 ft.

After a wonderful sendoff by the Daniels, the team eagerly embarked on the famous ‘Century Ride’ in which half of our bikers chose to include the Karras Loop on their ride to reach a total of nearly 100 miles for the day. Both host families graciously provided delicious meals to help the team recover from the long day. Overnight Hosts: Bill and Mary Stonebraker Carol and Dave Hilsabeck Pharmacies Visited: Hy-Vee, Webster City - Matt Sommers, PharmD Thrifty White, Webster City - Michelle Terwilliger, PharmD, Cory Badura, PharmD, Nikol Krambeer, CPhT, and Ashley Mrla, CPhT

Wednesday, July 22: Eldora to Cedar Falls Distance: 56.3 mi. | Climb: 1,845 ft RAGBRAI Jersey Day gave the team a break with the shortest ride, allowing for four pharmacy visits. Medicap Pharmacy in Eldora hosted a health screening event during which the IPA rotation students performed bone density and blood pressure tests. The team celebrated reaching the halfway point rocking out to 80’s music at the Hairball concert. Overnight Hosts: Jim and Barb Hoehns Lisa Bennett

RAGBRAI

to Davenport Pharmacies Visited: NuCara, Ackley - Karla Cloby, CPhT, Connie Metzgar, CPhT, and Donna Roberts Medicap, Eldora - Vicki Paul, CPhT, Sue Colvin, CPhT, Tracy Peterson RPh, and Gaylord Victoria, RPh Siechs Pharmacy, Parkersburg - Thomas Reinhart, RPh and Joyce Bausman, CPhT CVS, Cedar Falls - Amber Kobliska, PharmD Screenings: Medicap, Eldora – Blood Pressure, Bone Density, First Aid Advice

Saturday, July 25: Coralville to Davenport Distance: 65.2 mi. | Climb: 1,920 ft.

Thursday, July 23: Cedar Falls to Hiawatha Distance: 69.6 mi. | Climb: 2,669 ft.

The team made numerous pharmacy stops along the ride from Cedar Falls to Hiawatha while proudly sporting their white coat jerseys. IPA Foundation Director Jay Currie and IPA President Bob Greenwood welcomed the team during The University of Iowa Pharmacy Mix and Mingle held at the home of Adriane and Mike Miller.

After making stops at the University of Iowa College of Pharmacy and the UIHC Discharge Pharmacy, the team eagerly set out on the final leg of their journey. They made two more pharmacy visits upon arriving in Davenport and then proudly dipped their front tires in the Mississippi, signifying that their ride had come to an end. Pharmacies Visited: UIHC Discharge Pharmacy - Sam Frances, PharmD and Jennifer Hansen, CPhT Hy-Vee, Davenport - Angie Danielson, PharmD and Hollie Giese, CPhT Walgreens, Davenport - Sarah Schmidt, PharmD

Overnight Hosts: Adriane and Mike Miller Pharmacies Visited: Clingman Pharmacy, Vinton: Chris Tuth, PharmD and Becky Stainbrook, CPhT La Grange Pharmacy, Vinton : Dan LaGrange, PharmD, Stacy Schulte, PharmD, Kelly Griffith, CPhT, and Ricki Hustead, CPhT Blair’s Ferry Family Pharmacy, Hiawatha – Doug Niedermann, PharmD

Friday, July 24: Hiawatha to Coralville Distance: 62.6 mi. | Climb: 2,600 ft.

A storm delayed the team in Mount Vernon on College Jersey Day. After the rain subsided, the team trekked on to Coralville where they were met with a red carpet welcome by the Vos and Mascardo families. Overnight Hosts: Lisa and Dom Mascardo Susan and Jeremy Vos Pharmacies Visited: CarePro Pharmacy, Mount Vernon - Jack Aldershof, RPh, Tricia Jones, PharmD, Jessica Jacobo, PharmD, Scott Kollasch, PharmD, Tina Burrus, CPhT, and Cindy Douglas, CPhT Towncrest Pharmacy, Solon – Denise Prybil, RPh and Robert Nichols, Iowa Student

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RAGBRAI

Thank You 2015 RAGBRAI Team! The IPA Foundation would like to thank all of the riders, overnight hosts and sponsors that comprised this yearâ&#x20AC;&#x2122;s RAGBRAI team in addition to the many pharmacists that donated supplies and met with us along the way! This was truly a team outreach effort for pharmacy across the state. Week Long Riders Mark Adams, Drake Student, Ankeny, IA Sharon Cashman, RPh, Waverly, IA Sarah Cashman, Waverly, IA Theresa Legg, Atlantic, IA Ann Moore, Des Moines, IA Bob Moore, Des Moines, IA Marshall Moyer, Burlington, IA Kate Pape, PharmD, Coralville, IA Anthony Pudlo, PharmD, MBA, Waukee, IA Daniel Ricci, PharmD, Madison, WI Bob Soltis, PhD, Des Moines, IA Denise Soltis, RPh, Des Moines, IA Abby Soltis, Des Moines, IA Emmy Soltis, Des Moines, IA Sarah Soltis, Des Moines, IA Ben Urick, PharmD, Iowa City, IA Daily Riders Theresa Chamberlain, Cedar Rapids, IA Melanie Furman, PharmD, Cedar Rapids, IA Katie Owen, PharmD, Iowa City, IA Ryan Pape, Coralville, IA Kelly Phan, PharmD, Marion, IA Ethan Sabers, Iowa Student, Iowa City, IA Angie Spannagel, PharmD, Maquoketa, IA Brian Spannagel, Maquoketa, IA Amanda Stefl, Iowa Student, Grundy Center, IA Pam Stierman, RPh, Dubuque, IA Emily Vyverberg, PharmD, Dubuque, IA

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Sara Wormley, PharmD, Oswego, IL Sara Wiedenfeld, PharmD, Sioux City, IA Terry Wiedenfeld, PharmD, Sioux City, IA Sponsors & Contributors CVSHealth H.D. Smith Hy-Vee Medicap Pharmacy Thompson Dean Drug Daniel Pharmacy NuCara Pharmacy GoMacro Bars

ipa foundation

IPA Foundation, Outcomes Establish Innovative Pharmacy Endowment The former board of directors and shareholders of OutcomesMTM have partnered with the Iowa Pharmacy Association (IPA) Foundation to establish an endowment to continue to support the innovative spirit of Iowa pharmacy that fueled the creation of the company. Stemming from OutcomesMTM’s purchase by Cardinal Health, the Outcomes Innovative Pharmacy Endowment was created to award grants and loans for the financial support and encouragement of future innovative pharmacy practice initiatives within the state of Iowa. “This is an incredible opportunity grown from the generosity of OutcomesMTM shareholders. The IPA Foundation will now have the opportunity to support pharmacists in the state and cultivate the spirit of innovation that Iowa pharmacy is known for,” stated Kate Gainer, IPA’s executive vice president and CEO. In 1999, IPA provided seed money to launch OutcomesMTM and support the innovative startup’s goal of developing both the demand for medication therapy management (MTM) services from healthcare payers and the supply of those services from pharmacists. The company has since become a national leader in MTM services and established pharmacists as essential members of the healthcare team. Understanding that there is still work to be done, the OutcomesMTM board thought it fitting to give back to IPA and asked shareholders to reinvest a portion of their proceeds from the OutcomesMTM sale to the endowment. The shareholders have responded generously at the opportunity to enable

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the next generation of pharmacy practice innovation. To date, $726,000 has been donated to the endowment. “We are proud of the achievements of OutcomesMTM and appreciate the opportunity to invest in the next generation of innovative pharmacists,” said Ray Buser, a co-founder and 16year board member of OutcomesMTM.

Contribute to the Endowment If you are interested in supporting innovative pharmacy initiatives, consider contributing to the IPAF Outcomes Innovative Pharmacy Endowment. Since the endowment

is managed by the Community Foundation of Greater Des Moines, all contributions to are eligible for a 25% Endow Iowa tax credit. The state sets aside a specific dollar amount each year ($6 million) to award the Endow Iowa tax credit and once that amount is awarded, the credit is no longer available until the next calendar year. Funds are still available, but limited, for 2015 on a first come, first serve basis. Contact Laura Miller (lmiller@iarx.org or 515-270-0713) to establish a donation.

IPAF Outcomes Innovative Pharmacy Endowment - Founders Circle Platinum Level ($100,000 and above) Ray and Sally Buser Michele and Michael Evink Russ and Lucile Johnson Jim and Pam Miller

Gold Level ($50,000 - $99,999) CarePro Health Services Matt and Marilyn Osterhaus

Silver Level ($10,000 - $49,999) Tom and Heather Halterman Greg and Diane Hoyman John and Cindy Forbes Brand Newland Sue and Kevin Purcell Brenda Thies

Bronze Level ($1,000 to $9,999) Gary and Diane Albers Michael and Krisanne Calhoun Jessica and Cody Frank Towncrest Pharmacy

IPA FOUNDATION

Another Successful Leadership Pharmacy Conference Features Changes & Traditions The 2015 Leadership Pharmacy Conference had a slightly different feel as this year marked the first time in 26 years without Harles Cone, who retired after last year’s conference. This year, Michael Frisina, PhD, CEO of The Frisina Group, provided participants focused discussion on influential leadership. He has extensive work with the American College of Healthcare Executives (ACHE) and most recently the American Hospital Association. While this year marked a change, much of conference stayed the same. Steve Rough, Director of Pharmacy, University of Wisconsin Hospital and Clinics, and Mike Brownlee, Chief Pharmacy Officer at University of Iowa Hospitals and Clinics, once again presented on effectively implementing change, which ended with the always interactive

(and sometimes) entertaining “shark tank” activity. This activity charges participants with implementing a new pharmacy service and presenting to a mock C-suite. In addition to classroom work, participants were able to practice their leadership and teamwork skills outside the classroom during the yard olympics and the murder mystery dinner. Held each fall, the Leadership Pharmacy Conference hosts 10 participants from each Iowa and Wisconsin in Galena, IL, and kick starts the 8-month Leadership Academy for the participants. To apply for the Leadership Pharmacy Conference/ Academy or nominate a colleague, go to www.iarx.org/LeadershipPharmacy.

LEADERSHIP PHARMACY 2015 Iowa Participants Jeanine Abrons, PharmD, MS The University of Iowa College of Pharmacy Emily Beckett, PharmD, BCPS Broadlawns Medical Center Randi Beranek, PharmD, BCPS University of Iowa Healthcare - Iowa River Landing Eliza Dy-Boarman, PharmD, BCPS Drake University College of Pharmacy & Health Sciences Dana McDougall, PharmD, BCPS Covenant Cancer Treatment Center Holly Randleman, PharmD UnityPoint Health - Des Moines Caitlin Reinking, PharmD NuCara Pharmacy - West Union Allie Schlicher, PharmD, BCPS UnityPoint Health - Des Moines Rachel Smith, PharmD Mercy Family Pharmacy Dubuque Ben Urick, PharmD The University of Iowa College of Pharmacy

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ipa foundation

Bill Burke Conference Celebrates 20 years of Training Future Pharmacists Thirty student pharmacists from Drake University and the University of Iowa participated in the 20th annual Bill Burke Student Pharmacist Leadership Conference on Friday – Saturday, September 11-12, 2015. For the second year in a row, the conference was held in conjunction with the Eggleston-Granberg Golf Classic. Friday’s events started following the Golf Classic at Otter Creek Golf Course in Ankeny, Iowa. Students heard from Michael Pursel, director of field medical and advocacy relations at Sanofi Biosurgery, who provided insight to the ever changing health care system and challenged students to take an active role during this change. Friday evening concluded with the students being challenged on a different level with bowling at Uncle Buck’s Fishbowl in Altoona, Iowa. Saturday featured a full day of programming at The Meadows Event & Conference Center in Altoona. Sarah Ennis, president of SparkPoint, Inc., led active discussion and activities to push students to be leaders and own the process in developing pharmacy’s culture helping them to understand the skill and practices to apply teambased care in practice. Students were also challenged to develop solutions to healthcare system issues. Once divided into teams, students worked together to solve a real-world problem as student leaders. The teams then presented their solution to a panel of students who provided their feedback. Held each fall, the Bill Burke Student Leadership Conference aims to help student pharmacists develop

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leadership skills and build lasting relationships with fellow students and practitioners that will serve them during their remaining years as students and as new practitioners. The conference is made possible through a partnership between IPA, Drake University, the University of Iowa, and grant support from Main at Locust Pharmacy in Davenport, Iowa.

2015 Participants

Drake University Christina Bravos, P3 Shane Kozlowski, P3 Laura Litwin, P3 Morgan McPherson, P3 Taylor Monson, P3 Mary Shea O’Brien, P3 Adati Tarfa, P3 Andrew Wagner, P3 Danielle Walla, P3 Jason Babcock, P2 Alexa DeVita, P2 Kayla Hughes, P2 Michelle Mages, P2 Jacob Schnackenberg, P2 Alexi Schrieber, P2 University of Iowa Michael Brunner, P4 Leslie Noty, P4 Monica Rauch, P4 Ashley Beckman, P3 Brandon Gerleman, P3 Logan Murry, P3 Laura Nesheim, P3 Jennifer Ross, P3 Daniel Widman, P3 Hayley Wittnebel, P3 Maxwell Anderegg, P2 Anh Ngo, P2 Casey O’Connell, P2 Claire Weidman, P2 Rochelle Yang, P2

IPA FOUNDATION

A Record-Breaking Golf Classic! A record 106 golfers took over Otter Creek Golf Course in Ankeny on September 11, 2015, for the 2015 Eggleston-Granberg Golf Classic. The event raised over $16,000, also a Golf Classic record, for the IPA Foundationâ&#x20AC;&#x2122;s initiatives to support student pharmacists. A special thank you to our 2015 sponsors. This event would not be possible without your commitment! Cart Sponsor NuCara Pharmacy Beverage Cart Sponsor Greenwood Drug Hole Sponsors Bellevue Pharmacy Chris Connolly/Wells Fargo Advisors Chuck & Janalyn Phillips Collaborative Education Institute Drake University College of Pharmacy Dubuque Area Pharmacy Association Greenwood Drug Hartig Drug Jay & Ann Currie Johnson County Pharmacy Association Manning Pharmacy McGowan, Hurst, Clark & Smith PC Miller-Purcell, Inc. North Iowa Pharmacy Association Osterhaus Pharmacy Pharmacists Mutual Pharmco Properties PharmServ Staffing Quad Cities Pharmacy Association The University of Iowa College of Pharmacy Towncrest Pharmacy Wasker, Dorr, Wimmer, Marcouiller

Student Support Tim Becker Frank Cable/South Sacramento Pharmacy Connie Connolly Nick Dahlke Dubuque Area Pharmacy Association Kate Gainer Bob Greenwood TJ Johnsrud Rick Knudson Nick Lund Steven Martens Kristin Meyer Jim Miller Leman Olson Lisa Ploehn Anthony Pudlo Mike Pursel Quad Cities Pharmacy Association Morgan Sayler Doug Schara Susan Shields A special thank you to UBS Financial Services/Alpha Wealth Consulting Group for their generous donation of golf products!

We would also like to recognize a few golfers for their achievements on the course: Closest to pin: M:Ray Buser F: Brittany Theleman Longest Drive: M: Mike Johnsrud F: Connie Connolly Longest Putt: M: Jon Greene F: Kayla Lalor Then, of course, there are the winners: 1st Flight 1. TJ Johnsrud, John Swegle, Jay Goeser, Mike Johnsrud 2. Jon Greene, Tom Greene, Doug Schara, Dale Dornbier 3. Bob Greenwood, Wes Pilkington, Dana McDougall, Chris Arp 2nd Flight 1. Mike Pursel, Tim Becker, Steve Firman 2. Allen Fann, Denny Jorgensen, Tom Goodrich 3. Anthony Pudlo, Kerianne Roder, Erik Maki, Zach Pape 3rd Flight 1. Ben Dagraedt, Scott Morrett, Jonathan Mueller, Shane Kozlowski 2. Connie Connolly, Chris Connolly, Tyler Sandahl, Shawn Sandahl 3. Al Shepley, Leman Olson, Jim Scott, Jim Miller

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ipa foundation

IPA Wins 2015 Battle of the Foundations What started as scrappy comeback turned into a rout as IPA defeated PSW $11,300 to $4,931.25 to claim its second consecutive Battle of the Foundation victory! After PSW took a strong lead in the early weeks of the challenge, Iowa pharmacist rallied generously to secure the win and a 2-1 series lead. In its third year, this is a friendly competition between IPA and the Pharmacy Society of Wisconsin to see who can raise the most money for the

towards the Leadership Endowment for the Leadership Pharmacy Conference and Academy in the four weeks (quarters) leading up to the Iowa-Wisconsin football game. After this year’s Battle, IPA has raised $350,510 of the $375,000 goal to complete our half of the endowment. While this is a fun, friendly competition between the associations, the real winner here is the future of the pharmacy profession. Leadership Pharmacy has graduated some of the profession’s top leaders and innovators from both states. This campaign was another big step forward towards completing the endowment and ensuring the future of the program. The additional bragging rights provided by the Hawkeyes this year was an added bonus!

Thank you to the follow members who contributed during this year’s Battle: Jeanine Abrons Bill Baer Bill Baker Tim Becker Carl Chalstrom Connie Connolly Jay Currie Ashley Dohrn Carmen Dunphy Alisha Eggers Kate Gainer Bob Greenwood Tyson Ketelsen Rick Knudson Julie Kuhle Lisa Lambi Nic Lehman Nick Lund Shane Madsen

Phyllis Olson Bob Osterhaus Wesley Pilkington Lisa Ploehn Anthony Pudlo Miller Purcell Mike Pursel Allie Schlicher Susan Shields Rachel Skoff Brenda Thies Farah Towfic CoraLynn Trewet Stevie Veach Patrick Verdun Brian Wall Jim Wallace Sara Wiedenfeld

IPA FOUNDATION

Supporting the Foundation of Pharmacy’s Future in Iowa The IPA Foundation was created in 1960 as a way to give back to the profession through scholarships, leadership programs, and professional education. Since then, pharmacy professionals who understand the importance of advancing pharmacy practice in Iowa have generously contributed to the Foundation. Those contributions have enabled the Foundation to carry out its mission to inspire generosity and fulfill the aspirations of the pharmacy profession through the support of education, practice based research, and practice development. In action, that mission looks like: • $19,000 in student scholarships awarded in 2015 • 20 years of leadership training for student pharmacists through the Bill Burke Student Leadership Conference • 27 years of continued support of the Leadership Pharmacy Conference • Supporting 16 sites in the New Practice Model pilot program • Creating the Outcomes Innovative Pharmacy Endowment to further the profession through grant funding As you consider your year-end giving, the Foundation has several ways that you can contribute to the advancement of pharmacy in Iowa. Choose the option that best fits your needs or aligns with your goals for the profession.

Foundation General Fund

This is the Foundation’s primary resource to award student scholarships, support pharmacy

leadership programs, and other initiatives and programs that fulfill its mission.

Foundation Institute

The Foundation Institute is a group of donor leaders who have made a commitment to sustained contributions though automatic monthly or annual donations. The annual tax deductible gifts by members of the Foundation Institute are recognized by various levels of giving: • Platinum Gifts - $1,000 or more • Gold Gifts - $500-$999 • Silver Gifts - $250-$499 • Bronze Gifts - $100-$249 • Sustaining Gifts - Up to $99

Thomas R. Temple Leadership Endowment

The Thomas R. Temple Leadership Endowment was organized to endow the Leadership Pharmacy Conference in recognition of its founder, Tom Temple, CEO Emeritus of the Iowa Pharmacy Association. With an original goal of $750,000, divided equally for each state, Iowa now has a goal of $375,000 to endow the conference into perpetuity.

Outcomes Innovative Pharmacy Endowment

Stemming from OutcomesMTM’s purchase by Cardinal Health in 2015, this endowment was created to award grants and loans for the financial support and encouragement of future innovative pharmacy practice initiatives within the state of Iowa. Since this fund is managed by the Community Foundation of Greater Des Moines, contact Laura Miller (lmiller@iarx.org or 515-270-0713) to establish donation.

All donations to this endowment are eligible for the Endow Iowa tax credits.

Memorial Contributions

Memorial contributions to the Foundation commemorate the legacy of a pharmacist or someone close to the pharmacy family. That legacy lives on through the Foundation’s programs and services for innovative projects and future pharmacy practitioners. A special thank you is sent to the families who designated the Foundation as a means for remembering our colleagues.

Legacy Society

The Foundation’s Legacy Society recognizes Iowa pharmacists and their families who have made provisions for a deferred gift to the Foundation through their will or trust. These gifts set a valuable example for generations to come while supporting Foundation programs that support the future of the profession.

Named Scholarship

Establishing a named scholarship, either by a one-time gift, annual gift, or differed gift, perpetuates your legacy while supporting future practitioners for years to come. Pharmacists and their families can establish an endowed fund to support annual student pharmacist scholarships in their names in a variety of denominations. Go to www.iarx.org/IPAFoundation for more information and to make a donation. However you choose to give, your generous and tax deductible contributions will keep Iowa a leader in pharmacy practice. The Foundation and its board of directors thank you for consideration and generosity. ■

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public affairs

Making an Impact with

Legislative involvement is the core of political advocacy. Since advocacy for the pharmacy profession is a strategic focus for IPA, participation in the political process is imperative to advance Iowa pharmacy’s agenda. By building relationships with legislators and encouraging members to do the same, opportunities are created to educate leaders on the issues that are important to Iowa’s pharmacists and patients. The Iowa Pharmacy Political Action Committee (IPPAC) is an important tool in sustaining IPA’s legislative involvement. It is a fund is used to directly and strategically strengthen relationships with legislators and candidates that are supportive of pharmacy interests. The IPPAC is funded through contributions from individual pharmacists, pharmacy technicians, or student pharmacists, as well as member PACs of other organizations. Since corporate contributions to candidates are illegal, IPPAC relies solely on these individual donors. These contributions aid in advocating for practice advancement, PBM regulation and other important issues facing our profession.

Why a PAC?

Since much of daily pharmacy practice is dictated by the actions of our elected officials, it is imperative that Iowa pharmacy maintains high visibility with as many legislators as possible. However, legislators have hundreds, if not thousands of constituents vying for their attention at any one time.

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Without an established relationship, it is very difficult for an individual to grab their legislator’s attention and hold it long enough to educate them on a pharmacy-related issue that they are unfamiliar with. The IPPAC is used to unify and amplify the voice of Iowa pharmacy professionals on a consistent basis. While many members are active and engaged in advocacy, gaps exist where a pharmacy-friendly legislator may not have an established relationship with a member. IPPAC contributions to legislators and candidates fill those support gaps. Whenever possible, an IPPAC donor will deliver the check, which helps establish the relationship. Contributions from the IPPAC to an elected official does not guarantee a favorable vote or outcome. They do however provide high visibility for Iowa pharmacy to educate these leaders on the importance of pharmacy in the health and well-being of Iowans. By establishing these important relationships, legislators know who to turn to with health care questions and are ready to listen to our concerns.

Who Gets What?

The IPPAC Advisory Committee works with IPA’s legislative counsel to identify legislators and candidates who are supportive of Iowa pharmacy to receive IPPAC contributions. Whenever possible, an IPPAC donor will hand deliver the check to the candidate or legislator to build that personal connection. Both the PAC and the candidate receiving the funds must report the contribution to the Iowa Ethics & Campaign Disclosure Board.

Your Support Matters

Contributions by individual pharmacy professionals to the IPPAC, large or small, allow IPA actively advocate on behalf of the pharmacy profession during the legislative session and throughout the interim. Consider making a contribution to keep Iowa pharmacy a viable, strong and active participant in the legislative process. Contributions can be made at www.iarx.org/ippac. ■

Additional Ways to Impact Advocacy

IPA’s Legislative Defense Fund (LDF) consists of donations from corporate sponsors. Since corporations are prohibited from contributing to candidates (and therefore, the IPPAC), these funds are used to pay for advocacy activities, which include IPA’s Legislative Day and Capitol Screenings, contracted lobbyists and external consultants, and IPPAC administration and fundraising costs. Support of this fund is critical to IPA’s advocacy efforts. IPA has established the Preserve Pharmacy Practice Fund (PPPF) as a restricted fund to ongoing efforts to regulate PBM practices in Iowa. This fund was instrumental in supporting the State of Iowa as it success sought the dismissal of PCMA’s lawsuit over Iowa’s MAC transparency law. While this victory is significant, more work will remain to assure that unfair PBM practices are reined in. Contributions to either of these funds can sent to IPA at: 8515 Douglas Ave., Suite 16, Des Moines, Iowa 50322.

public affairs

Board of Pharmacy: New Regulations, New Website, New Director

Pneumococcal Vaccines in Hospitals & LTC Facilities

The Iowa Board of Pharmacy has been busy over the past few months as they hired Andrew Funk, PharmD as the Executive Director and implemented a new website, pharmacy.iowa.gov. Here is a short summary of new regulations adopted by the Board of Pharmacy:

Disciplinary Action & Board Activities

Compounding Practice

Effective November 18, 2015, the Board of Pharmacy adopted new compounding regulations that combined previous chapters 13 and 20 under a single chapter, Chapter 20, that fully adopts national minimum practice standards for compounding found in General Chapters 795 and 797 of the United Sates Pharmacopeia (USP). This transition came from extensive conversations of a joint IPA/BOP task force on compounding as well as an open hearing on the proposed rules in early 2015. With these new regulations, the Board of Pharmacy also clarified that flavoring agents may be added to a medication at the discretion of the pharmacist or upon the request of the prescriber, the patients, or the patient’s agent. Despite flavoring falling under the context of USP’s definition of compounding, the Board of Pharmacy established separate rules that do not follow USP compounding standards as it relates to flavoring of medications.

The Board of Pharmacy updated regulations in Chapter 7, Section 8 and Chapter 23, Section 9 that previously held limitations for the type of pneumococcal vaccinations in hospital or long-term care facilities. Stemming from 2015 state legislation, these changes follow federal law that allow the administration of any influenza or pneumococcal vaccine to a hospital or long-term facility patient pursuant to a physician-approved hospital or facility policy after the patient has been assessed for contraindications. This rule change becomes effective on November 18, 2015.

As detailed in the June 2015 Board of Pharmacy newsletter, the Board has experienced a significant increase in its workload with continual rise in the number of disciplinary cases each decade. In the 1980s, the Board handled 11 cases per year (on average). In the 1990s, an average of 28 cases per year by the Board; and in 2000s, an average of 31 cases per year. The most recent 5-year period from 2010-2014 has seen the Board taking disciplinary action an average of 74 cases per year. Some of the most recent disciplinary cases have come from the Board’s inspection of all non-resident pharmacies as a response to the fungal meningitis outbreak stemming from the New England Compounding Center. Not all regulatory infractions come with discipline cases in front of the Board. The Board of Pharmacy may issue letters of education or administrative warnings to help guide pharmacies in correcting behaviors that could cause a disciplinary case to be heard.

PBM Update

Status on Rulemaking; PCMA lawsuit Following unanimous passage of Iowa’s PBM legislation in 2014 and 2015, IPA continues to work closely with the Iowa Insurance Division (IID) on rulemaking as well as the state Attorney General’s office related to the lawsuit filed by PCMA.

Rule Making by the IID

The question frequently asked of IPA, “Have PBM practices changes/ improved since the passage of PBM legislation and dismissal of the PCMA lawsuit?” The response: IID has authority to adopt rules that will implement the policies of legislation passed in 2014, as well clearly articulate their enforcement authority over PBMs that practice in Iowa. IID has informed IPA that draft rules will be circulated to all stakeholders in October, with feedback sought through November, and to appear on the agenda of the Administrative Rules Review Committee (ARRC) in December. The anticipated effect date of the new PBM rules is July 2017. It is the understanding of IPA that once updated rules take effect, IID will have enforcement authority to audit PBMs and ensure they comply with Iowa’s PBM statute and rules.

PCMA Litigation

On October 7, PCMA filed a notice to appeal following the September 8, 2015, dismissal of all six (6) claims in the PCMA lawsuit against the state of Iowa’s PBM legislation. IPA continues to serve as a resource to the state Attorney General’s office and IID related to the legislation and policy implications of this case. PCMA’s notice of appeal will focus on three issues including 1) ERISA preemption; 2) dormant commerce clause of US Constitution; and 3) due process clause of U.S. Constitution. ■ OCT.NOV.DEC 2015 |

public affairs

Ask Andrew

The New Executive Director of the Board of Pharmacy Answers Members’ questions. On September 11, 2015, Andrew Funk, PharmD, began his new role as executive director of the Iowa Board of Pharmacy (BOP). Andrew received his PharmD degree from Roseman University of Health and Sciences in Henderson, Nevada, in 2004. He moved to Iowa after graduation and work as a pharmacist for two years before accepting the role of pharmacist in charge at Medicap Pharmacy in Grimes, Iowa. After 7 years at Medicap, Andrew became a compliance officer for the BOP in November of 2013 and served in that capacity until being selected to serve as the executive director of the Iowa Board of Pharmacy. He also served as a pharmacy preceptor for both Drake University and the University of Iowa. Andrew and his wife of 11 years, Alicia, have two boys named Grayson and Dawson. In his spare time, he enjoys running, traveling, brewing beer and volunteering for high school ministries in West Des Moines. Andrew graciously and enthusiastically agreed to answer questions submitted by IPA members as he transitions into this important role. Do you anticipate the Board of Pharmacy having a system where technicians can renew their registration online? - Alyce Steig, CPhT, University of Iowa Hospitals and Clinics

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Andrew: The Board office is currently reviewing options for new software that will enable on-line renewals of technician and pharmacy support registration, controlled substance act registrations (CSAs), and all the various licenses the Board issues, including pharmacists and pharmacy licenses. It’s my hope that this software conversion will occur sometime in 2016. What changes do you think the profession of pharmacy will experience in the next ten years? Student at Drake University Andrew: I believe the profession of pharmacy will see drastic changes within the next ten years. I firmly believe that pharmacists will be identified at the federal level as healthcare providers. In doing so, the role of the pharmacist will continue to shift away from the current primary function of dispensing to a more extensive clinical role. The Board of Pharmacy will continue to navigate through these challenges and changes to ensure the safety and wellfare of all Iowans is maintained. What or who motivated you to join the pharmacy profession? If it is a person, does he or she know you are in the profession? - Lori Foster, CPhT, Springville Andrew: I remember as young child seeing the pharmacist in the pharmacy in my hometown of Wapakoneta, Ohio and thinking, “wow, that looks like fun!” I didn’t have a specific individual encouraging me to become a pharmacist. I’m also the first pharmacist in my family. However, I made my decision to pursue pharmacy immediately after I graduated high school. I had an essential love for math and science but I realized early on that I don’t do very well with the sight of blood. So I wrote off professions that would require me to be around that on a regular basis. Pharmacy seemed like the perfect fit. I also have a caring spirit and a love for people.

How do you see the Board’s primary function (protecting the public) as it relates to protecting the working conditions for pharmacists as it relates to employer and PBM practices? - Mike Schweitzer, Pharmacist/Owner Bedford, IA Andrew: This is a delicate balance between maintaining the well-being of the pharmacist while making sure the Board does not encroach up on the domain of the pharmacy owner. While Iowa does not mandate a technician to pharmacist ratio, it does require that a pharmacy be staffed appropriately in commensurate with its size and scope of practice. This requirement is now shared by both the pharmacy owner (or pharmacy license-holder) and the pharmacist-in-charge. Additionally, the Board understands that current PBM practices and the progressive nature of PBMs, as it relates to reimbursements, stretches margins extremely thin for pharmacies. This, in turn, has had an obvious negative effect on pharmacy as a whole. I am hopeful that the recent dismissal of the PCMA lawsuit over Iowa’s MAC transparency law will eventually lead to a positive impact on pharmacies. With all the issues presented to Iowa pharmacists from the closing of independent pharmacies to the proliferation of opioids, what is the number one focus for you and your staff during your first year of service? Michael Wolnerman, RPh, CCIM Andrew: There’s no doubt that the profession of pharmacy is facing a myriad of issues. It’s difficult to pinpoint a single focus or priority. However, the Board has recently adopted compounding rules that reference USP <795> and USP <797>. While these chapters have always been enforceable, our compliance officers have monitored compounding compliance in accordance with Board rules. Therefore, one of my priorities will be to ensure that the pharmacies across the state are aware of these rule changes and are educated on areas that may

public affairs currently be deficient. Additionally, I would like to focus on getting the Board’s legislative proposal passed so that rules can be created or updated to reflect current trends in the practice of pharmacy. Hello Andrew, the Board’s purpose is to protect the citizens of Iowa, in turn the board puts expectations on licensed pharmacists; however in today’s settings most pharmacists are employed by large corporations that are not healthcare minded and are more concerned about profits than their staff being able to meet these expectations. How do you plan to assure that these corporations are held accountable for creating an appropriate work environment to allow staff pharmacists to meet the expectations of the board and protect the citizens of Iowa from drug related issues? - retail staff pharmacist in Iowa Andrew: I appreciate this question, and realize that this is one of the ways that the landscape of pharmacy has continued to evolve. One step that the Board has already taken, quite recently I might add, is by re-writing 657--8.3 (155A) Responsible parties. Historically, the pharmacist-in-charge was held solely responsible for many, if not all, of the requirements outlined in 657--8.3. This included “ensuring that the pharmacy employs an adequate number of qualified personnel commensurate with the size and scope of services provided by the pharmacy.” The Board realized that many pharmacists-in-charge had no control over how their pharmacies were staffed. Therefore, these rules were reviewed and updated to include the pharmacy license holder as a responsible party for many of these areas in which the Board has traditionally held the PIC solely responsible. Where do you see Pharmacy in Iowa in 2025? What will your priorities be in keeping Iowa in the forefront of pharmacy innovation? - Michael Andreski, Assistant Professor, Drake University College of Pharmacy and Health Sciences

Andrew: I’d like to see pharmacists be recognized, at the federal level, as health care providers. Pharmacists and pharmacy students are equipped and are being equipped with the tools necessary to promote public health, reach and care for the medically underserved and reduce the over-all costs of health care. There’s no doubt that the role of the pharmacist will continue to evolve. Likewise, I envision the evolution of the parts that certified technicians play in the pharmacy. Technology and innovation will continue expand. Rather than resist these changes, I think it’s important that the Board cautiously embrace them, keeping in mind that their priority is to protect the health, safety and welfare of all Iowans. How do you see the practice of “telepharmacy” evolving? Have you had any contact/experience with implementing rules relating to this seemingly expanding area of pharmacy practice? - Mark McMullen, RPh, CGP, General Manager at Main Healthcare Extended Care Pharmacies in Bettendorf & North Liberty Andrew: I see telepharmacy as a tool to reach medically underserved communities in the state of Iowa. Currently, Iowa Code requires that telepharmacies be operated in conjunction with an automated medication dispensing system (AMDS). An amendment to this code will be presented to the legislature during the 2016 legislative session. I’ve had the opportunity to observe the telepharmacy task force that convened in 2014 as well as speak with other state boards of pharmacy and other stakeholders regarding this topic. What is a timeline for developing rules to allow collaborative practice agreements with nurse practitioners? - Heather Rickertsen, PharmD, Community Pharmacist with Mercy Family Pharmacy and Crescent Community Health Center in Dubuque Andrew: Right now, pharmacists may sign collaborative practice agreements with MDs and DOs. Conversations first

need to take place with the Iowa Nurses Association as well as the Iowa Board of Nursing. Board of Pharmacy rules pertaining to CPAs between ARNPs and RPhs would need to be developed concurrently with Board of Nursing rules. At the present, a definitive timeline has not been established as to when this process should begin. What have been the most rewarding and most challenging aspects of your pharmacy career, thus far? Andrew: The most rewarding aspect of my pharmacy career, thus far, has been my time spent in practice at Medicap Pharmacy in Grimes, IA. I got to know many of my patients and their families on a personal level. It was neat to see families return year after year to receive their flu shots because their kids insisted that “Andrew gives me my shot.” I also thoroughly enjoyed helping families with elderly parents or grandparents by setting up their medications in med paks and taking the time to explain each of them and the importance of adherence. Calling prescribers to review drug interactions or suggest alternative therapies so patients could afford or better tolerate their medications was also very rewarding. The most challenging aspect of my pharmacy career has been finding the proper work-life balance. What is your favorite thing about Iowa? Andrew: This is such a hard question! What’s NOT to love about Iowa? Ok, maybe the long, sometimes frigid, winters are a bit much. But otherwise, I love this state! Thank you Andrew for taking the time to answer these questions and thank you to those members who submitted them. Please note: Andrew’s responses to these questions are his own and do not necessarily reflect the views and the opinions of the Iowa Board of Pharmacy.

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public affairs AGENDA AT A GLANCE 7:30–8:30 a.m. Capitol Breakfast with Legislators (invitation only) 8:00–9:00 a.m. Registration at Embassy Suites

January 27, 2016

Embassy Suites, Des Moines • Iowa State Capitol Join IPA on January 27, 2016, for a day of advocacy at the Iowa State Capitol, highlighted by face-to-face meetings with legislators, at IPA’s 2016 Legislative Day and Capitol Screenings. Legislative Day is the key event in the association’s advocacy and public policy efforts. The morning is spent preparing pharmacists and student pharmacists to confidently engage their legislators. IPA’s legislative counsel will discuss procedures at the Capitol and the current issues to discuss with legislators. After that, it’s off to the Capitol to meet with legislators. Pharmacists and student pharmacists are encouraged to set an appointment with their legislators ahead of time. Students and first time participants have the opportunity to be paired up with pharmacist mentors in order to learn the ropes. These face-to-face meetings are important for building and maintain strong relationships with legislators that will be needed to pursue IPA’s legislative priorities. While pharmacists meet with legislators, student pharmacists from Drake University and The University of Iowa will provide screenings and education to legislators and Capitol staff on hypertension, high cholesterol, immunizations, osteoporosis, and pharmacists’ role in today’s health care system.

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9:00–10:00 a.m. Welcome & Legislative Briefing 10:00–10:20 a.m. Connecting Iowa to DC Speaker, TBD 10:00 a.m.-1:00 p.m. Student Screenings 10:30 a.m.–1:00 p.m. Capitol Visits & Lunch 1:15 p.m. IPA Group Photo on Rotunda Stairs

Following the Capitol visit, attendees will listen to presenters on important health care policy topics including IME director Mikki Stier on Iowa’s Medicaid Modernization and the Iowa Board of Pharmacy’s executive director Andrew Funk on the Board’s top regulatory issues. Pharmacists can earn up to 2.5 hours of CPE for these session, but must attend all sessions in order to receive credit.

DON’T FORGET YOUR WHITE COAT!

Immediately following meetings with legislators, all attendees will gather in the Capitol Rotunda for the “Paint it White” group photo. Also, it’s awesome to see all so many pharmacists, easily identified by their white coats, spread throughout the Capitol.

See the full agenda and register at www.iarx.org/IPALegDay

Pharmacy Law CPE Today’s Priorities, Tomorrow’s Opportunities *Must attend all CPE activities; no partial credit will be given. 1:45–2:30 p.m. Medicaid Modernization – Iowa’s Pathway to Managed Care Mikki Stier, IME Director 2:30–3:00 p.m. Meet Andrew Funk – Iowa Board of Pharmacy Executive Director 3:15–3:45 p.m. Legislator Panel: Top Priorities in 2016 Senator TBD Representative TBD 3:45–4:30 p.m. PBMs: Next Step – Enforcement

public affairs

Iowa Medicaid Modernization Questions Answered With the coming transition to managed care for the Iowa Medicaid program, IPA is working to educate the membership on how this transition impacts your pharmacy practice and patients. IPA has compiled a short (but growing) list of frequently asked questions on our website to assist you and your practice as this transition begins. The page will be updated regularly as new information becomes available. Here are few of the questions answered:

What’s the timeline of implementation? • Medicaid beneficiaries will receive enrollment packets in October 2015, which informs them of their “Default MCO,” as well as providing information on all four MCOs. • They will have a period of time during which they can switch their MCO prior to initiation of the program, similar to the Special Enrollment Period for Medicare Part D plans. • MCO coverage is scheduled to begin on January 1, 2016. • Beginning on January 1st, beneficiaries will have a 90 day period to switch their MCO for any reason. After this 90-day period passes, beneficiaries may switch MCOs for a good cause (including moving of residence, or a provider is no longer in network), or annually at eligible renewal times. • MCOs are currently working to sign agreements with providers. The

DHS must approve all MCO provider contract templates. All providers will be required to enroll with IME and will be able to choose which of the four MCOs to enroll with.

What are the most significant changes anticipated for pharmacy providers? What will not change? • Pharmacy benefits will remain the same for Medicaid beneficiaries. Pharmacy providers need to complete a contract with the MCOs for reimbursement through Medicaid. • MCOs will utilize the same Preferred Drug List (PDL) and Prior Authorization (PA) criteria that Medicaid is currently using today. • MCOs will honor existing prior authorizations for at least three months.

How will prescription medication reimbursement be calculated? • The current reimbursement rates will remain in place until June 30, 2016. At this time, MCOs and providers may negotiate networks and reimbursement rates. However, IPA advocated within the RFP process that MCOs must reimburse pharmacy providers at the rate comparable to the current Medicaid FFS reimbursement. Medication reimbursement will be calculated using the Iowa average Actual Acquisition Cost (AAC) calculation from Myers & Stauffer with a dispensing fee determined and approved by Medicaid through a biennial cost of dispensing (COD) survey of all Iowa pharmacies participating in the Medicaid program. The current dispensing fee has been set at $11.43.

Will the MCOs compensate for Pharmaceutical Case Management (PCM) or Medication Therapy Management (MTM) services? • MCOs may implement MTM programs, but are not required to do so. Participation and reimbursement rates for these services will be determined by the individual MCOs. No further information is known at this time about MTM programs for the four MCOs. It is the understanding of IPA that the pharmacy providers cannot bill for current PCM services after June 30, 2016.

ONLINE FEATURE!

Review the October 2/2/2 webinar with DHS.

When should pharmacy providers begin to see contracts to participate in these MCO networks? • Contracts for participation in MCO networks are expected to be negotiated and signed throughout the fall and winter of 2015. • Contracts between the DHS and the MCOs were finalized on October 9, 2015.

Will the enrollment process be uniform from plan to plan? • Yes, there will be one universal provider enrollment application to make sure the process is as streamlined as possible. • Each pharmacy will have to complete a contract with each individual MCO. ■

Read the full FAQ at www.iarx.org/medicaid_modernization (member login required)

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public affairs

IPA Meets with Iowa’s Congressional Leaders During Recess The Iowa Pharmacy Association took advantage of the August recess, meeting with many of Iowa’s congressional leaders to educate them about pharmacy and some of the important issues currently facing our profession. Members hosted visits in their pharmacies and had the opportunity to showcase the care that pharmacists provide to patients across the state.

Rep. Rod Blum, Iowa’s 1st District Hartig Drug, Dubuque, Iowa

Rep. Dave Loebsack, Iowa’s 2nd District Towncrest Pharmacy, Iowa City, Iowa

Towncrest Pharmacy hosted Representative Loebsack for a visit. The congressman was educated on the role of technology and reporting in pharmacy practice. Main topics of discussion included issues with PBM transparency and provider status.

Rep. David Young, Iowa’s 3rd District IPA members met with Representative Blum at Hartig Drug to educate him on the care that pharmacists provide and to discuss numerous topics including any willing pharmacy legislation.

District Office, Des Moines, Iowa

IPA and representatives from Managed Health Care Associates met with Congressman Young in his Des Moines Office to provide education on the differences in practice among pharmacy settings and to discuss issues in long term care pharmacy.

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public affairs Rodney Whitlock, Healthcare Policy Advisor for Senator Grassley Outcomes MTM, West Des Moines, Iowa Medicap Pharmacy, Urbandale Iowa Urbandale Family Physicians, Urbandale, Iowa Iowa Medical Society, Des Moines, Iowa Hy-Vee Central Fill Facility, Des Moines, Iowa Martin Health Services, Johnston, Iowa

Rodney Witlock visited numerous practice settings around the Des Moines Area with IPA, where members thanked him for all of his work with the Pharmacy and Medically Underserved Areas Enhancement Act. Other topics of discussion included 340B, issues in long term care pharmacies, and unfair practices of pharmacy benefit managers.

Rep. David Young Visits Oard-Ross Drug

Reprentative David Young visited Oard-Ross Drug in Council Bluffs, Iowa. There he met with owners Joe and Tony Beraldi and their staff.

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member section

MEMBER MILESTONES Professional Congratulations to Jerod Work, PharmD, (Sioux Center) who started a new job as Co-Founder and Chief Scientific Officer at Entegro. Natalie Roy (2016 PharmD Candidate, Drake University) was one of three finalists for the 2015 Next-Generation Pharmacist Award. Congratulations Natalie! Ben Urick, PharmD, (University of Iowa and Nucara) was named to APhAâ&#x20AC;&#x2122;s Legislative Committee. Congratulations Ben!

PERSONAL Dana McDougal, PharmD, BCPS, (Covenant Cancer Treatment Center, Waterloo) married Rachel Smith on June 6, 2015. Congratulations Dana and Rachel! Lydia Elizabeth Myers was born on October 7, 2015, to Megan, PharmD (IPA, New Practice Model Project Manager) and Ryan Myers. Congratulations Megan, Ryan and big sister Lucy! Andy Stessman (2016 PharmD Candidate, Drake University) married Jessica Krauel on September 26, 2015. Congratulations Andy and Jessica! Pamela (Wong) Wiltfang, PharmD, MPh, BA, CHES (Nucara) married Jason Wiltfang on June 27, 2015. Congratulations Pamela and Jason!

Congratulations to Cheri RockholdSchmit, RPh, (Ames) who expanded into a fulltime role as Clinical Coordinator for Medicap GRX. Osterhaus Pharmacy in Maquoketa is celebrating 50 years in business. Congratulations to Bob and Matt Osterhaus and their staff!

Welcome NEW IPA MEMBERS

Congratulations to Richard Michael, RPh, (Fort Dodge) was appointed to the National Coordinating Center Beneficiary Family Advisory Council. Jake Shell, PharmD, accepted a new Pharmacy Manager position with CVS/Pharmacy in Columbia, SC. Congratulations Jake!

In Memoriam Walter T. Williams, RPh, of Sioux City, passed away on March 18, 2015. Walter was a graduate of the University of Iowa and owned Williams Drug in Sioux City for 35 years until his retirement in 2005. Send your member milestones to ipa@iarx.org for inclusion in the next IPA Journal.

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Thank you for supporting IPA! July 1 - September 30:

Beth Diehl, West Des Moines Kristine Dodge, Fort Dodge Thomas Fisher, Coralville Marie Franzen, Iowa City Laura Halder ,North Liberty Kari Heitzman, Des Moines Amanda Latta, Springville Jack Lemanowicz, Ottumwa Alex Mersch, Iowa City Thuc Pham, Hanscom AFB, MA Casie Trimble, Marion Darlene Wegmann, Dyersville Joseph Weirather, Iowa City Ashley Wolfe, Cedar Rapids

member section

Nominate a colleague for A 2016 IPA Award Recognize a colleague for the outstanding work that they do to serve their patients and advance the pharmacy profession. IPA is seeking nominations for the following awards: • Robert G. Gibbs Distinguished Pharmacist • Honorary President • Excellence in Innovation • Distinguished Young Pharmacist of the Year • Health-System Pharmacist of the Year • Patient Care Partner Award • Appreciation Award: Individual & Corporate • Cardinal Health GenerationRx Award • Pharmacy Technician of the Year Awards will be given at the 2016 IPA Annual Meeting on June 17, 2016 in West Des Moines. For more information about each award and to nominate a colleague, visit www.iarx.org/ipaawards.

Save the Date!

Join your pharmacy colleagues from across the state to participate in the policy adoption process in the House of Delegates, Annual Award Presentations, afternoon educational sessions, and GREAT networking with pharmacy leaders! OCT.NOV.DEC 2015 |

technician’s corner

Iowa Pharmacy Association 101

H Lori Foster, CPhT Chair, IPA Pharmacy Technician Advisory Committee

ave you ever had any of your coworkers, or someone else, ask you why you are involved in the Iowa Pharmacy Association? Many of them may not understand what IPA does along with us, and for us. There may even be some confusion between what the Association does, and what the Iowa Board of Pharmacy (BOP) does. Here are some points to help clear that up. The BOP is involved with ensuring compliance of regulations from Iowa law, the Drug Enforcement Agency, the Food and Drug Administration, and more. They track the technician workforce in Iowa by requiring registration. Their inspections of pharmacies ensure that regulations are being followed, and that a pharmacy is placing patient safety and appropriate medication use above all else. The BOP will also take disciplinary action and work with law enforcement agencies as necessary. Currently, the BOP does not have a technician representative on the Board, but technicians may be invited to serve on a task force as necessary. The IPA works to support the profession of pharmacy by: • Advocating for legislative/policy changes determined by its members • Enabling certification of technicians by its work with those certifying bodies • Providing for accredited continuing education in conjunction with the American College of Pharmacy Education, include all required CPhT Recertification CE at no charge to technician members • Supporting research and innovation (i.e. poster presentations) • Assisting impaired professionals (including technicians) through the Iowa Pharmacist Recovery Network (also a volunteer opportunity)

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• Supporting members serving with the national organizations, like the American Pharmacists Association, the American Society of Health-System Pharmacists, etc. IPA does have a technician representative on its board, and any member can participate on its committees. These committees develop the policies of the association, many of which become legislative goals. IPA provides a platform for us to share these with our state legislators by hosting Legislative Day. They brief us on the previously-determined priorities and we meet with our legislators at the Capitol. Of course we can always contact our legislators on our own, as well as make written comments to proposed rules at both the state and federal level. An example of how the BOP and IPA might interact is through pilot projects. A pharmacy professional (yes techs, that includes you) or group develops an idea to improve their practice. If this idea pushes the boundaries of regulations, those involved may need to request permission from the BOP to try it. This is considered a pilot project. IPA may assist with preparations, by suggesting written procedures, summarizing outcomes, etc. If a pilot project greatly improves medication use or patient safety, the BOP may allow extension of the project, or even consider changing regulations. Even though their functions are separate, both the BOP and IPA have patient safety and effective medication use as their goal. Membership in IPA helps you promote these as well. Feel free to share this article with co-workers, who may wish to join us, once they realize all of these benefits. ■

technician’s corner Expo Tech Forum:

Earn up to 6 hours CPE and network with colleagues from across the Midwest! Join your colleagues from around the Midwest and earn up to 6 hours of CPE for this 1-day interactive conference. Programming is designed to help you understand the ever evolving role of pharmacy technicians in both community and hospital settings.

Sat., February 13, 2016

Attendees can also take advantage of the Midwest Pharmacy Expo’s keynotes, exhibit hall and networking opportunities!

Community Choice Credit Union Convention Center, Des Moines, Iowa

Attend Expo on Feb. 14 for up to

10.5 total hours of CPE!

Tech Forum is part of the Midwest Pharmacy Expo held on Feb. 12-14, 2016

Attend Expo’s Sunday (February 14) programming for up to an additional 4.5 hours of CPE credit! For more information or to register, visit

www.MidwestPharmacyExpo.com/TechForum

THE PTCB

ADVANTAGE • Improved employment opportunities • Demonstrated value to the pharmacy team • Validated achievement • Future career growth options • Prestige among coworkers • Potential for higher salary

Certification by PTCB is the gold standard for pharmacy technicians. Many employers now require their employees to be PTCB-Certified Pharmacy Technicians (CPhTs). PTCB has a new website, a streamlined application process, sponsorships, and free verifications. The Pharmacy Technician Certification Exam (PTCE) reflects current knowledge areas demanded across all practice settings. PTCB’s requirements to become a CPhT include a high school diploma and a passing score on the PTCE. Learn more and apply at www.ptcb.org.

Get the

PTCB ADVANTAGE SETTING THE STANDARD www.ptcb.org

CONNECT ONLINE:

Become a

PTCB CPhT TODAY OCT.NOV.DEC 2015 |

technicianâ&#x20AC;&#x2122;s corner

Newly PTCB Certified Iowa Technicians July 1, 2015 through September 30, 2015

Please join IPA in congratulating the following pharmacy technicians on becoming PTCB-certified! Tracey Abate Sarah Allen Tracy Armbruster Brandi Baber Samuel Beatty Rhonda Bellard Hailey Benson Deana Bergmann Khagendra Bhattarai Keisha Boles Matthew Bouska Sarah Brondyke Jacqueline Browne Sara Bryan Nichole Bryant Kari Burk Autumn Carter Ashley Cave Paul Choeun Erin Claussen Dakota Cline-Shaw Katina Conner Trang Dang Joshua Dees Caitlyn Deimerly Shaohan Deng Chelsey Dierks Karyn Downing

Delaney Dugger Suzanne Edahl Anna Evans Lucas Faley Summer Fedler Miranda Fistler Theresa Gnade Ross Gould Stephanie Graham Jordan Gran Emily Gudenkauf Megan Hanna Kaysi Heims Holly Hilton Sheryl Horner Austin Howe Chloe Huck Benjamin Jasper Jamie Jensen Kimberly Johnson Ralph Joseph Michelle Joubert Beau Kehoe Jennifer Kilcrease Haley Kirchner Kelsey Kiwala Julie Kleinman Crystal Koehler

Amanda Kristensen Paige Kruse Paige Kuennen Sonya Lanman-Lamb Stephanie Loudy Megan Lovan Christina Maas Derrick Markley Rebecca Martin Amber Mckay Chaise Mefferd Jacob Meyer Anthony Miller Rebecca Mills Elizabeth Miner Jane Moffitt Gail Moore Cari Moser Rebekah Muilenburg Elizabeth Mwaura-Johnson Kiley Nelson Madison Nissen Heather Nitz Kayla Orsini Wendy Paulson Megan Peterson Nicole Potter Christopher Powers

George Qi Jacey Redman LeeAnn Reichert Wendy Rogers Addyson Rosa Bethany Roth Kelsey Ruba Emily Ryan Inaam Salih Emily Sande Brittney Saunders Callan Schulte Candace Schulz Bailey Shaw Michael Siebels Lisa Sinclair Shannon Sojka Pablo Suarez Beltran Randall Treadway Marissa Varner Bethany Vogts Marc Wetrich Trevor White Michaela Wolter Karen Wood

IPA Technician Members Receive ALL Required CPE for CPhT Recertification for FREE! Looking for recertification CPE? Pharmacy technician members of IPA now receive the Recertification Bucket from CEI for FREE!

The Recertification Bucket includes Pharmacy Technician Certification CPE activities in categories consistent with the PTCB Domains, structured as 10 one-hour written modules that you can print and complete on the go. Also included are live and on demand webinars in the area of pharmacy law and patient safety.

Login at www.iarx.org/cei_buckets to take advantage of this new benefit for members and spread the word to your colleagues.

JOIN NOW & receive your free recertification bucket!

www.iarx.org/membership | 515.270.0713 | ipa@iarx.org

| OCT.NOV.DEC 2015

college of pharmacy news High Honors for Two Drake Pharmacy Fraternities

Two of Drake’s professional pharmacy fraternity chapters have been named among the best in the nation by their national organizations. Drake’s Phi Delta Chi and Kappa Psi chapters both earned third-place chapter awards—a reflection of members’ commitment to service, philanthropy and scholarship. Phi Delta Chi consists of 84 chapters nationwide. Drake’s chapter, comprised of about 80 active members, has been among the top 5 nationally for the organization’s top chapter award, the Emory W. Thurston Grand President’s Award for 14 of the past 15 years and has won the award 7 times during that time period. The chapter earned top distinction this year for scholarship among its participants. Kappa Psi is the oldest professional pharmaceutical fraternity in the world, with more than 6,000 collegiate members and 87,000 alumni members across 90 collegiate chapters and 65 graduate (alumni) chapters. Drake’s chapter, which has 90 active members, received the national organization’s W. Bruce Philip Certification of Commendation for recognition as the 3rd best collegiate chapter, the highest ranking that Drake’s chapter has received. The chapter has been in the top 10 ranked chapters for three of the last four years, earning 5th place honors in 2013 and 9th place in 2012.

CPHS Professors Granted Funding

June Johnson, Professor of Pharmacy Practice, received $31,000 from Janssen Pharmcueticals for her project titled Prescribing patterns for canaglifozin (Invokana) in a specialty endocrinology group practice: Patient characteristics and outcomes. Funds will be used

| OCT.NOV.DEC 2015

for research study to examine and describe actual canagliflozin (Invokana) prescribing patterns and patient outcomes in a specialty endocrinology group practice, the Iowa Diabetes and Endocrinology Center (IDEC). Brian Gentry, Assistant Professor of Pharmacology, received $20,000 from Iowa NASA EPCSoR for a project titled Infection Mitigation During Space Flight: Combination Pharmacotherapy to Combat Herpes Viral Infections, Curtail Drug Resistance, and Decrease Incidence Rates of Adverse Effects. He will be joined on the project by Pramod Mahajan, Ron Torry and Marc Busch.

Anna Shields Receives National Scholarship

The National Community of Pharmacists Association (NCPA) recognized Drake student Anna Shields, P4, with a national scholarship worth $2,500 that includes travel expenses for attending the national meeting in October. Shields received the Presidential Scholarship, which recognizes leadership qualities and academic achievement. “I am very grateful for the platform NCPA has provided me with as a student to lead, be involved, and actively learn about community pharmacy,” said Shields. Shields said her interest in independent community pharmacy grew while working on a team of students on the Pruitt-Schutte Business Plan Competition, and while visiting independent pharmacy ownwers across Iowa. “As president of Drake’s NCPA Student Chapter last year, I was able to challenge myself and achieve personal leadership goals,” Shields said. “The opportunities presented to me as a

part of NCPA are invaluable and I am honored to be a recipient of an NCPA Presidential Scholarship this year.

New Faculty Join CPHS

• Cassity Gutierrez, PhD - Preprofessional Programs Director and Associate Professor of Health Sciences. • Beth Diehl, PharmD - Assistant Professor of Pharmacy Practice • Lynn Kassel, PharmD - Assistant Professor of Pharmacy Practice • Nihal Mulla, PhD – Assistant Professor of Pharmaceutical Sciences Three faculty members joined the occupational therapy doctorate program in the College of Pharmacy and Health Sciences on July 1. They are preparing for the program’s inaugural class in May 2016. • Dr. Ann Burkhardt - Chair and Program Director of Occupational Therapy • Kathy Griner - Occupational Therapy Fieldwork Coordinator • Jayna Fischbach, Associate Professor of Occupational Therapy

New Staff Appointments

• Katie Shields – Interim Director of Student Programs

Promotions: • Chuck Phillips - Interim Associate Dean of Academic Affairs and Assessment • Jill Batten - Interim Assistant Dean of Student Affairs ■

college of pharmacy news Pharmacists Help Patients with Hypertension, UI Research Shows Studies conducted mainly at the University of Iowa have found that if you have hypertension, it pays to have a pharmacist on your medical care team.

Barry Carter, a professor in the College of Pharmacy, led the research teams on two studies, the most recent of which was published in print in the Journal of the American Society of Hypertension. Carter is the Patrick E. Keefe Professor in the Department of Pharmacy Practice and Science in the College of Pharmacy, and professor in the Department of Family Medicine in the Roy J. and Lucille A. Carver College of Medicine.

UI College of Pharmacy Launches Learning and Living Curriculum

The College of Pharmacy implemented its Learning and Living Curriculum, which will expand upon techniques that have been used successfully in the college for many years, in the Fall 2015 semester. It is transformative, patientfocused, and student-centered. Unique elements of the Learning and Living Curriculum include: • A two-week Professional Engagement Period. • Aligned Component Course series (ACCs): Classes are now organized by disease state and will be team-taught. Instead of having a stand-alone courses such as pathology (disease causes and their behaviors) and pharmacology (the uses, effects and modes of actions of drugs) with one instructor, a disease state will be used as the theme to tie former stand-alone subjects together. • Active learning strategies: Instructors will move away from a “sage on the stage” role into that of a “guide on the side”: Something that works better for a younger, more technologically-

savvy generation. Student preclass assignments will teach them concepts, while in class they will dive more deeply into the material, often in small groups. Students will apply, analyze and evaluate the material with the help of the teacher and other students. • Professional discovery: Across their years in the college, PharmD students in small groups will learn about the scientific process, develop a scientific project and present findings. • Interprofessional education: An essential piece of the Learning and Living Curriculum is having pharmacy students and other health sciences students collaborate. • Greater ability to specialize: There will be more flexibility for students seeking dual degrees and additional specialization.

UI Studies the Impact of Marijuana on Driving

A new study conducted at the University of Iowa’s National Advanced Driving Simulator (NADS) has found drivers who use alcohol and marijuana together weave more on a virtual roadway than drivers who use either substance independently. The study, which was published in Drug and Alcohol Dependence on June 23, was co-authored by Gary Milavetz, associate professor and head of the division of Applied Clinical Sciences, and Andrew Spurgin, postdoctoral research fellow.

Task Force for Pharmacy Technician Education Holds Meetings

The University of Iowa College of Pharmacy hosted the Iowa Task Force for Pharmacy Technician Education on June 9, 2015. The Task Force is composed of a group of Iowa community college presidents, deans for health sciences, vice presidents, department chairs, directors, and pharmacy technician program faculty, along with representatives from several

national organizations with interests in pharmacy technician education, who have volunteered to work to coordinate and enhance the pharmacy technician curricula available in Iowa. The inaugural meeting’s efforts were directed at the identification of best practices for current curricular offerings, avoiding unnecessary duplication of resource allocation, and working towards the development of a curriculum meeting the standards established by ASHP/ACPE, the collaborating group responsible for accrediting pharmacy technician education programs. The focus of the meeting was a discussion of the currently available programmatic offerings and the identification of areas where new curricular content will need to be developed to meet current accreditation standards. Subsequently, the Task Force met on Aug. 4, at the John and Mary Pappajohn Education in Des Moines. The discussion focused on currently available simulation activities and the identification of new activities, and the role of experiential training in meeting accreditation requirements and addressing the development of specific learning objectives for the required experiential component of an accredited program.

New Faculty Appointments

James B. Ray, PharmD, has been appointed to the James A. Otterbeck OnePoint Patient Care Professor in Hospice and Palliative Care. Mary E. Ray, PharmD, began her position as the Assistant Dean for Assessment and Curriculum on July 1, 2015. Ramprakash (Ram) Govindarajan has been appointed as a faculty member with the Division of Pharmaceutics and Translational Therapeutics and Director of Preformulation for University of Iowa Pharmaceuticals. OCT.NOV.DEC 2015 |

STUDENT SECTION

Ask not what IPA can do for you, but what you can do for IPA Elizabeth Bald 2015 IPA Max W. Eggleston Executive Intern 2017 PharmD Candidate Drake University College of Pharmacy and Health Sciences

“Ask not what pharmacy can do for you, but what you can do for pharmacy.” Those words spoken by Mike Pursel at the Bill Burke Leadership Conference in 2014 really resonated with me. After reflecting on the impact I could have on the pharmacy profession, I came to the realization that the way I had approached my involvement with the Iowa Pharmacy Association the past four years had been misguided. With every event or conference I attended, I had always asked myself, “What can IPA do for me?” Without fail the association delivered, offering networking opportunities, educational experiences, and countless resources. As I began the Max W. Eggleston Executive Internship in Association Management this summer, I realized the question I should have been asking myself all along was, “What can I do for IPA?” During my 12week internship, I learned that the answer to that question is different for every person. Throughout the summer, I had the opportunity to meet with IPA members of diverse pharmacy backgrounds that inspired me to give back to the association by educating, donating, and engaging.

Educate

Giving back to the association does not necessarily need to involve money or special skills. One of the most important missions of IPA is to provide education. It is important that we educate health care providers, legislators, and patients about the unique skills that pharmacy professionals possess and the value we add to the patient care team. It is equally important that we educate pharmacists, technicians, and students across the state on the work that the association does and the benefits of membership. Take the time to promote both the profession and the association by providing education to the people in your life.

| OCT.NOV.DEC 2015

Donate

Money is an important factor that drives the work the association does. This summer I had the opportunity to witness the impact of the numerous programs and initiatives that your donations support. I have also been fortunate to personally benefit from the generosity of IPA members as a recipient of an IPA Foundation scholarship and as an attendee of the Bill Burke Leadership Conference. It doesn’t matter if you are a student, new practitioner, technician, or retired pharmacist – every donation makes a difference no matter the amount. I encourage you to consider making a donation to the Thomas R. Temple Leadership Endowment, sponsoring a student at the Eggleston-Granberg Golf Classic, or donating an item to the Foundation’s Silent Auction at the IPA Annual Meeting.

Engage

Being a member of IPA comes with numerous perks; however, it is important to engage with the association in order to get the most benefit out of membership. The level and type of engagement can vary from year to year depending on your interests and amount of free time. The Eggleston-Granberg Golf Classic, IPAF RAGBRAI Team, and Annual Meeting provide unique opportunities to network with other members. If you are interested in learning more about important clinical or legislative issues related to the profession, consider attending one of the 2/2/2 webinars, Legislative Day, or the Midwest Pharmacy Expo. Leadership skills can be enhanced by applying for the Bill Burke Student Leadership Conference and the Leadership Pharmacy Academy, running for a Board of Trustees position, or serving on a committee. Find something that interests you and get engaged! The Max W. Eggleston Internship enabled me to answer the question I had asked myself at the beginning of the summer, and I discovered numerous ways to utilize my skills and talents to benefit IPA. I quickly learned that giving back to the association is a means of giving back to our profession, to our patients, and to our colleagues. I encourage you to spend some time reflecting on everything that the Iowa Pharmacy Association has done for you. I then challenge you to ask yourself, “What can I do for IPA?” ■

STUDENT SECTION University of Iowa College Night September 22, 2015

Students Choose Their Own Adventure at IPA College Nights

Drake University College Night September 24, 2015

IPA held its 6th annual College Nights for students of The University of Iowa and Drake University Colleges of Pharmacy. IPA College Night is an opportunity to introduce student pharmacists to the role IPA plays in the profession and the benefits of professional involvement. After a welcome from their respective Deans and IPA president Bob Greenwood, IPA president-elect Rick Knudson led the students in a “Choose your own adventure” presentation. Volunteers from the audience took turns recreating possible reactions to situations that students may find themselves in as they enter a professional environment. Example situations included how to handle pharmacy questions from non-pharmacist colleagues when your preceptor isn’t around, the appropriate amount of food to take at reception, and how to introduce yourself to professionals at networking events. After some entertaining stage work from the volunteers, students in the audience voted on which reaction they felt was most appropriate. This activity provided an opportunity to discuss how to respond and best take advantage of these scenarios. For the scenarios that didn’t have clear answers, Rick provided students with tips to decide when each reaction may be appropriate. IPA would like to thank all of the student pharmacists and faculty who attended their respective College Night.

OCT.NOV.DEC 2015 |

STUDENT SECTION

Congratulations Student Pharmacists Class of 2019! Drake University White Coat Ceremony | August 28, 2015

Anne Alley Chintan Barot Brittany Behrens Jessica Berei Lauren Blum Brandon Boelts Karli Borcherding Austin Brandes Anna Burns Samantha Campbell Scott Caslow Carter Chapman Andrea Chargo Da Won Choi William Cleveland Samantha Dao Christopher Dawson Andre Do Nicole Draker Colby Dunn Mary Elder Erin Engbring Maxx Enzmann Sara Faber Lisa Feldmann Kristin Fipps Abigail Fleischmann

| OCT.NOV.DEC 2015

Courtney Forschen Kee Gales Matthew Glasow Kyle Godwin Allison Golbach Kathryn Gray Spencer Gray Lucas Groeneveld Melissa Harvey Michael Harvey Claire Herbst Amanda Hoerres Meredith Hollman Marissa Holloway Olivia Hopton Brianna Hostert Shanell Hurst Lisa Huska Michelle Jacob Robert Jedlicka Hailey Jensen Yoon Young Jeong Jobin Joseph Matthew Kent Rachel Kiehne Anna Yea Ji Kim Nita Kumaran

Emily Lammers Gabrielle Landes Michael Lang Sara Lauterwasser Samantha Lee Davis Lockwood Zachary Lough Mercy Macharia Elena Maloletko Jenna Manatrey Kayla Manning Anna Marceau Kylie Markovich Andrew Mitchell-Bueso Benjamin Modrell Hannah Mortland Kelley Nguyen Ryan Nguyen Jacqueline Nordvall Katherine Oâ&#x20AC;&#x2122;Reilly Michael Ohman Jonathan Opheim Cassandra Owens Jacqueline Parmentier Avani Patel Kelsey Piech Rachel Purdy

Samantha Renfro Michaela Ruis Emily Ryan Christopher Sahli Tylan Schreiner Julie Schultz Shawna Seibel Allison Sekula Taylor Sheahan Emma Sheldon Kayla Spars Katarzyna Spyrka Alexander Stumphauzer Alyssa Sykuta Jess Thompson Brian Thoreson Jaclyn Tran-Nguyen Nichole VanDenEng Nicholas Vollmer Anna Wade Jacqueline Whitman Amanda Wiedemeier Amanda Wilken Andrew Winquist Anastasia Yablochkin

STUDENT SECTION

Congratulations Student Pharmacists Class of 2019! The University of Iowa White Coat Ceremony | August 29, 2015

Ahamed Ahamed Abbey Ahlrich Nicole Bahl Alyssa Berry Sarah Blackwell Chelsea Brandt Katarina Brown Benjamin Buffington Rebecca Burgett Thy Cao Jessica Coon Trang Dang Erin Day Zachary DeLanoit Huiwen Deng Shelby Dick Connor Dierks Sadie Donahue Theresa Doyle Adaeze Emecheta Brittany Faley Jonathan Fash Jacob Felckowski Bess Fevold Joshua Formanek Miranda Fullerton Benjamin Gardner

Paula Gawedzki Kristen Gerdesmeier Leah Granroth Alyssa Grycko Erik Gunderson Jinny Guo Fisher Herald Erika Hilleman Giang Ho Steven Hong Aron Hrubetz Sharon Huang Anthony Hunt Kyle Irland David Iverson Morgan Jacks Levi Jellison Grant Jerkovich Sophia Johnson Kaylee Kacmarynski Josh Kirchner Meagan Koepnick Chase Kooyman Liza Kramer Torey Kranau Kelby Kwok Jordan Langreck

Jisoo Lee Sarah Lothspeich Zachary Lynch Kyle Lyons Trevor Mace James Markham Breannah May Joshua McDonald Mackenzie Meade Darin Meinen Gavin Meyer Briana Midkiff Agassi Mila Asma Mumtaz Mitchell Myers Abigail Narayan Abigail Neese Anh Thu Ngo Jessica Ngo James Nguyen Tony Nguyen Corbin Nichol Tess Noeller Molly Oâ&#x20AC;&#x2122;Brien Corey Osborn Whitni Patterson Autumn Petersen

Abigayle Renner Suman Rijal Amna Rizvi-Toner Lauren Roberts Jillian Romanco Alison Russell Rebecca Serino Maureen Smith Jessica Streit Jared Szabo Lynn Tang Dien Tran Dayton Trent Jasmin Valentin Haley Ver Steeg Ashleigh Wallace Bradley Weis Andrea Weldon Daniel Wentworth Jaelyn Westfield Marianne Westrick Brittanie Wieland Samuel Williams Kate Zakrzewski

OCT.NOV.DEC 2015 |

Resident Spotlight

Welcome 2015-2016 Iowa Residents

Justin Bagby

University of Iowa PGY1 at Convenient Medical Center

Brianne Bakken IPA would like to introduce the 45 new residents to Iowa for 2015-2016. Join us in welcoming them to our state!

ONLINE FEATURE!

Read the full Iowa Resident Spotlight supplement online.

University of Iowa PGY1 at the University of Iowa Hospitals & Clinics

Lindsey Batz

University of Iowa PGY1 at Outcomes MTM

Jenna Bender

Drake University PGY2 at the University of Iowa Hospitals & Clinics

Tara Bergland

Residents Gather in Iowa City

On September 22, 2015, 43 of Iowaâ&#x20AC;&#x2122;s 45 pharmacy residents met in Iowa City for IPAâ&#x20AC;&#x2122;s annual Residents Meeting. The meeting is an opportunity for residents to network with each other, meet IPA staff and leadership and discuss key issues in the profession and their practice.

University of Nebraska PGY1 at the University of Iowa Hospitals & Clinics

John Beyer

Drake University PGY2 at University of Iowa Hospitals & Clinics

Brittany Bruch

University of Iowa PGY2 at the University of Iowa Hospitals & Clinics

Janice Bueter

University of Missouri- Kansas City PGY1 at UnityPoint Health- Allen Hospital After a morning of introductions - the residents, their projects and IPA, the afternoon included roundtable discussions with IPA staff and leadership on topics focusing on professional involvement, clinical practice and key initiatives in Iowa. The meeting wrapped with open dialogue on being a preceptor for students and an agent of change at their practice site.

| OCT.NOV.DEC 2015

Nupur Chopra

Drake University PGY1 at Unity Point- Allen Hospital

Resident Spotlight Ashley Clark

Megan Engel

Jason Cleppe

Erica Erixon

Jenna Dietrich

Meredith Ginn

Jessica Dizon

Ali Goodson

Rachel Duffield

Tracy Harlan

Elliot Duvall

Christie Hart

Rachel Dyke

Samuel Huber

Peter Elliot

Patrick Kinn

Beth Engel

Scott Kollasch

University of Kansas PGY1 at CarePro/A Ave

University of Iowa PGY2 at the University of Iowa Hospitals & Clinics

University of Iowa PGY1 at the University of Iowa Hospitals & Clinics

University of New England PGY1 at the University of Iowa Hospitals & Clinics

Drake University PGY1 at the Des Moines VA Health Care System

University of Iowa PGY1 at UnityPoint Health- St. Luke’s

University of Iowa PGY1 at the University of Iowa Hospitals & Clinics

Drake University PGY1 at Iowa Methodist

Drake University PGY1 at Mercy Family Pharmacy

Drake University PGY1 at Osterhaus Pharmacy

Creighton University PGY1 at Iowa Methodist

Auburn University PGY1 at the University of Iowa Hospitals & Clinics

University of Iowa Iowa City VA Health Care System

University of Missouri- Kansas City PGY2 at the University of Iowa Hospitals & Clinics

Wingate University PGY1 at the Iowa City VA Healthcare System

PGY1 at UnityPoint Health- St. Luke’s

University of Iowa PGY1 at the University of Iowa Hospitals & Clinics

University of Missouri- Kansas City PGY1 at CarePro Pharmacy

OCT.NOV.DEC 2015 |

| OCT.NOV.DEC 2015

Resident Spotlight Shelby Lang

Emily Prinz

Christer Lundblad

Danielle Rowan

Kathleen McNamara

Marie Sirek

Nicole McSweeney

Erica Tolle

Alex Mersch

Theresa Tranel

Corey Melroe

Caleb Warner

Hayley Meyer

Luke Watson

Nathan Peterson

Jarod Weidner

Blake Porter

Kirre Wold

University of Missouri- Kansas City PGY1 at the Des Moines VA Health Care System

University of Florida Mercy Medical Center - Des Moines

University of Iowa PGY1 at the NE/IA Medical Education Facility & Waverly Health Center

Drake University PGY1 at Iowa Methodist

Roosevelt University PGY1 at the University of Iowa Hospitals & Clinics

North Dakota State University PGY2 at the University of Iowa Hospitals & Clinics

University of Iowa PGY1 at the Iowa City VA Healthcare System

University of Iowa Residency: PGY2 at Mercy Medical Center

University of Iowa Mercy Medical Center - Des Moines

University of Nebraska PGY 1 at the University of Iowa Hospitals & Clinics

Drake University PGY1 at the Iowa City VA Healthcare System

North Dakota State University PGY1 at the University of Iowa Hospitals & Clinics

Ohio Northern University PGY1 at Towncrest Pharmacy

Drake University PGY1 at Hy-Vee Drugstore â&#x20AC;&#x201C; Iowa City

Drake University PGY1 at Covenant Medical Center

University of Iowa PGY2 at the Iowa City VA Healthcare System

University of Colorado PGY1 at Mercy Medical Center- North Iowa

South Dakota State University PGY1 at Mercy Medical Center- North Iowa

OCT.NOV.DEC 2015 |

Calendar of Events 2015-2016 Calendar of Events NOVEMBER 2015

January 2016

2/2/2 Webinar

Iowa Healthcare Collaborative Annual Conference - Altoona, IA

IPA Legislative Day and Capitol Screenings - Des Moines, IA

11 Hospital Engagement Network (HEN) 2.0 Learning Community - Altoona, IA 11

Log-in to Learn e-Journal club (CEI)

DECEMBER 2015 8

2/2/2 Webinar

6-10

ASHP Midyear Clinical Meetings and Exhibition - New Orleans, LA

FEBRUARY 2016 9

2/2/2 Webinar

12-14 Midwest Pharmacy Expo - Des Moines, IA

For the most up-to-date information on state and national events, visit www.iarx.org/events

need a relief pharmacist? Contact “Joseph in Relief” Joseph Thompson, RPh 9616 Quail Ridge Urbandale, IA 50322

1.888.278.0846 h. 515.278.0846 | c. 515.991.2684

Advertise in our publications Place your ad/classified ad with us. All ads, contracts, payments, reproduction material and all other related communication should be addressed to David at dschaaf@iarx.org or call the IPA office at 515.270.0713 for more information.

| OCT.NOV.DEC 2015

DO YOU HAVE SOME OF THESE SITTING AROUND? DO YOU WANT TO TURN THEM INTO CASH? Pharmacy looking to buy used 14–day OPUS cassettes. Specifically “Wednesday” start dates but also “Friday” as well as other days. Also interested in used bins, trays, and bags if in GREAT condition. Contact Mike at: Ph: (319) 936-6076 • Fax: (319) 337-8659 Email: mike@pharmacy-matters.com

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