IPA Journal Jan/Feb/Mar 2020 by Iowa Pharmacy Association

A Peer-Reviewed Journal | Vol. LXXVI, No. 1 | JAN.FEB.MAR 2020

READY, SET, GO! IOWA MEDICAID RECOGNIZES PHARMACISTS

INSIDE: 2020 IPA Board of Trustees Election IPAâ&#x20AC;&#x2122;s Legislative Priorities Updates from the Colleges

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

PUBLICATION STAFF PUBLICATION STAFF David Schaaf, Editor David Schaaf,Managing Managing Editor Kate Gainer, Kate Gainer, PharmD PharmD Anthony Pudlo, PharmD, Anthony Pudlo, PharmD, MBA, MBA BCACP Laura LauraMiller Miller Casey JD CaseyFicek, Ficek, JD Amanda PharmD MatthewAbdulbaki, Pitlick, PharmD, BCPS Amanda Abdulbaki, PharmD

COVER COVERSTORY

READY, SET, GO!

Iowa Medicaid Recognizes 2019 IPA Annual Meeting pg. 8 Pharmacists as Providers

See12 it all - the policy, awards, leadership and pies - from this year’s new-look IPA Annual pg. Meeting. Yes, it’s happening! But there is still work that needs to be done!

Figure 1: TOC Pharmacist Services

OFFICERS OFFICERS CHAIRMAN

Inpatient chart review

Cheryl Clarke, EdD, RPh, FAPhA - Waukee CHAIRMAN Cheryl Clarke,PRESIDENT EdD, RPh, FAPhA - Waukee

• Review of admission medication reconciliation • Daily chart review to identify and intervene on drug therapy problems • Begin discharge planning including identifying barriers to access

Connie Connolly, RPh, BCACP - DeWitt PRESIDENT ConniePRESIDENT-ELECT Connolly, RPh, BCACP - DeWitt

Discharge time out

Diane Reist,PRESIDENT-ELECT PharmD, RPh - Cedar Rapids Diane Reist, TREASURER PharmD, RPh - Cedar Rapids

• Review discharge medication reconciliation to identify and intervene on drug therapy problems

Tim Becker, RPh, FACP - Mason City TREASURER Tim Becker, RPh, Mason City SPEAKER OFFACP THE-HOUSE Ashley Dohrn, PharmD, SPEAKER OF THEBCGP HOUSE- Le Claire Ashley Dohrn, PharmD, - Le Claire VICE SPEAKER OF BCGP THE HOUSE Kristin Meyer, PharmD, CGP, OF CACP, FASCP - Marshalltown VICE SPEAKER THE HOUSE Kristin Meyer, PharmD, CGP, CACP, FASCP - Marshalltown

TRUSTEES TRUSTEES REGION 1

Sharon Cashman, REGIONRPh 1 - Waverly Sharon Cashman, RPh REGION 2 - Waverly

Discharge counseling

Legislative RecapELECTION BOARD OFSession TRUSTEES See8how pharmacy fared in the 2019 Iowa pg. Legislative Session. pg. 35

FEATURES FEATURES

Shane Madsen, PharmD, - North Liberty REGION BCPS 2 Shane Madsen, PharmD, REGIONBCPS 3 - North Liberty Sally Haack, PharmD, REGION 3BCPS - Norwalk Sally Haack,REGION PharmD, BCPS 4 - Norwalk Gary Maly, PharmD REGION 4 - Sioux City Gary Maly, - Sioux City ATPharmD LARGE Bill Baker, BS AT Pharm LARGE - Iowa City Craig Clark,BSRPh - Cedar Rapids Bill Baker, Pharm - Iowa City Bill Doucette, PhD, RPh- Rapids Iowa City Craig Clark, RPh - Cedar John Hamiel, PhD, PharmD Waterloo Bill Doucette, RPh- -Iowa City John Hamiel, PharmD - Waterloo HONORARY PRESIDENT Tony Beraldi, RPh - Council Bluffs HONORARY PRESIDENT Tony Beraldi, RPh - Council Bluffs PHARMACY TECHNICIAN Jessica Burge, CPhT - Des Moines PHARMACY TECHNICIAN Jessica Burge,PHARMACISTS CPhT - Des Moines STUDENT Joshua Hart PHARMACISTS - Drake University STUDENT Crissy Lawson University of Iowa Joshua Hart --Drake University Crissy Lawson - University of Iowa The Journal of the Iowa Pharmacy Association is is aapeer peer reviewed publication. Authors are encouraged to submit reviewed publication. Authors are encouraged manuscripts to be consideredtoforbe publication in thefor Journal. to submit manuscripts considered For author guidelines, www.iarx.org. publication in the see Journal. For author guidelines, see www.iarx.org. “The Journal of the Iowa Pharmacy Association” (ISSN 1525-7894) publishes issuesPharmacy per year: January/ “The Journal of the4Iowa Association” February/March issue;publishes April/May/June issue; per July/August/ (ISSN 1525-7894) 4 issues year: September issue; and October/November/December issue January/February/March issue; April/May/ by the Iowa Pharmacy Association, 8515 Douglas Avenue, June issue; July/August/September issue; and Suite 16, Des Moines, Iowa 50322. Periodicals October/November/December issuepostage by the Iowa paid at Des Moines, Iowa and8515 additional mailing offices. Suite Pharmacy Association, Douglas Avenue, POSTMASTER: Send address changes to: The Journal 16, Des Moines, Iowa 50322. Periodicals postage of the at Iowa Pharmacy Association, 8515 Douglas Ave., paid Des Moines, Iowa and additional mailing Suite 16, POSTMASTER: Des Moines, IA 50322. Published quarterly, The to: offices. Send address changes Journal is distributed members as a regular membership The Journal of thetoIowa Pharmacy Association, service paid for through allocation membership 8515 Douglas Ave., Suite 16, of Des Moines, dues. IA 50322. Subscription are $100 year, single copies are to Published rates quarterly, Theper Journal is distributed $30. Printed by Graphic design doneservice by the Iowa members as ColorFx; a regular membership paid Pharmacy Association. for through allocation of membership dues. Subscription rates are $100 per year, single copies are $30. Printed by ColorFx; Graphic design done by the Iowa Pharmacy Association.

Peer• Review: Development and medications 2020 LEGISLATIVE Face to face counseling on newPRIORITIES and changed Implementation of a Transitions of Care pg. 29 Transitions of care note Pharmacist Service. pg. 30 • Fax a note to the patient's preferred outpatient pharmacy noting the new, changed, and stopped medications

2020 ofMeeting TrusteesRecap Election . . . . . . . .call 2019Board Annual . . . . . . . . . . . . . . . .Follow-up . . . . . . . . . . .phone . . . . . . . . . . . . . . . . . . . .88 COVER STORY: Provider . . . . .new . . . .medications . . . . . .24-72 . . . . . .hours . . . . .post-discharge Speaker’s Address . . . .Status . . . . . .in . .Iowa . . . . • . Patient .obtain .contacted . . . . . .12 10 to ensure they were able to and to review potential side effects Updates FromAdopted the Colleges Policies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16 13 CPESN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23 IPAIowa . Awards . 16 2020 Legislative CPESN Iowa . . .Priorities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29 23 Ready for RAGBRAI New EPA Regulations2020 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38 27 Commencement 2019 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Peer Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 2019 Legislative Session Recap . . . . . . . . . . . . . . . . . . . . . . . . . . 35 EVERY ISSUE CBD in the Pharmacy? President’s Page . . . . . . . . Questions . . . . . . . . . Answered . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 4 CEO’s Column . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 14 Iowa CEO’sPharmacy Column .News . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18 . 5 Practice Advancement . President’s Page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22 . 6 Public . . . Topics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24 HealthAffairs . Care Hot 19 Technician Corner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33 Iowa Pharmacy News 20 IPA Foundation . . . . . . . .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .36 Practice Advancement 24 Members Section Public Affairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40 36 IPA in Action . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45 Technician Corner . 40 Calendar of Events . IPA Foundation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .46 44 Pharmacy Time Capsule . Members Section . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47 48 IPA in Action . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 Calendar of Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 Pharmacy Time Capsule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

Health Care Hot Topics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IN EVERY ISSUE

Mission MissionStatement Statement

TheIowa IowaPharmacy PharmacyAssociation Associationempowers empowersthe thepharmacy pharmacyprofession professionto toimprove improvehealth healthoutcomes. outcomes. The JUL.AUG.SEP2020 2019 || JAN.FEB.MAR

PRESIDENT’S PAGE

CHANGE THE CONVERSATION pharmacist did not know what she was doing. Connie Connolly, RPh, BCACP DeWitt IPA President

hile on Twitter in December, I came across a pharmacist who vented about how she caught an allergy interaction on a pediatric prescription. She waited for the mother to arrive to verify the allergy, called the prescriber to recommend and get an alternative, and completed the prescription. This is all pretty standard for most of us in our profession. The unfortunate circumstance surrounding this story is that the environment in which this pharmacist had to complete these tasks is also becoming standard. The pharmacist had to work with a staff shortened by illness, one of the technicians was at lunch and the other technician was new to the job and needed extra supervision and time to complete tasks. The pharmacy was bogged down with many other patients and prescription volume was high. The tweet began with a picture of the pharmacist’s lunch bag sitting unopened even though it was 7 p.m. and the pharmacist had arrived for her shift at 8 a.m. The lunch hour was “provided” by her employer, but the pharmacist continued to work so she would not be so far behind when her day was scheduled to end. The pharmacist explained that this is not unusual, but today was a breaking point because the mother of the patient proceeded to stand in the waiting room and loudly complain that the prescription was taking too long to be filled and that the

| The Journal of the Iowa Pharmacy Association

How did we get to this point? How do we fix it? I know this is a scenario that many of us have witnessed firsthand. I also know there are some in our profession who say, “get another position,” “refuse to work during your lunch hour,” and “you should never allow yourself to be treated that way.” As we learned from Tammy Rogers at our IPA Goes Local events this past year, when you are faced with this type of working environment day after day, you become blind to how wrong it is, until you break, as this pharmacist did by crying in front of her patients. Circumstances may also prevent you from getting another position — even more so now with the recent layoffs — so you continue working in the environment you are in to pay the bills. I am struck by the fact that we have been talking about telling our story, but many of us do our job without fanfare for our patients. We need to find a way to educate our patients and others in a way that engenders RESPECT for those of us in the profession. We are diligently trying to help our patients by performing a necessary task which often SAVES THEIR LIVES. How can we help patients change their view of pharmacy from one of a “fast-food” mentality to one of “safe and effective healthcare?” Many pharmacists work in a corporate or health system environment where they are throttled by policies that do not allow them to really talk with their patients and their interactions are often scripted by the business plan being put in place by those above them. How can they voice

their workflow concerns in a way that is non-punitive and productive? I am asking for pharmacists to begin by showing respect to each other, regardless of practice setting or position, and to lead the way in healthcare by doing the right thing to help our patients in every encounter. I am proud that we are using the pharmacist stories that have been sent to us at IPA to create awareness of the great patient interaction that occurs with pharmacists. Please continue to send these anecdotes so we can build on that platform and learn from each other.

“Let’s take time this year to look to our colleagues for innovative ideas and concrete steps we can take to educate those outside of pharmacy about our essential role as a safety officer in healthcare.” Innovation and improvements have cut down on the amount of time a patient has to wait to receive medications, but I think the focus on that singular part of the equation has led to some potentially disastrous circumstances. Let’s take time this year to look to our colleagues for innovative ideas and concrete steps we can take to educate those outside of pharmacy about our essential role as a safety officer in healthcare. I am looking forward to your suggestions for how we can help everyone by showing respect for others and earning it for ourselves. ■

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SAVE THE DATE

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Learn more at www.medicationsafety.org or call us at (866) 365-7472. The Alliance of Medication Safety (APMS) is a federally listed Patient Safety Organization (PSO).

IPA BOARD ELECTION

BOARD OF TRUSTEES ELECTION Vote for the 2020-2021 Iowa Pharmacy Association Board of Trustees! ELECTRONIC BALLOTS WILL BE SENT MONDAY, FEBRUARY 3, 2020. Each candidate’s personal statement and bio will be available online with the electronic ballots. All IPA pharmacist members vote for all elections. Ballots will close Tuesday, February 18 at 12:00 midnight. To request a paper ballot, contact the IPA office at 515270-0713. Bio’s edited for space, full bios available on ballot

FOR THE OFFICE OF PRESIDENT Diane Reist, BS Pharm, PharmD, RPh Cedar Rapids

Diane Reist is the clinical specialist in transitional care at the University of Iowa Hospitals and Clinics in Iowa City, Iowa. Through individualized care in a post-discharge ambulatory clinic; Diane helps to ease the transition of medically complex patients and facilitate communication among providers as the patient moves from the acute care hospital to their home or long term care (LTC) facility. Diane is also part of several integrated discipline research projects at UIHC and Carver College of Medicine in transitional and upstream care for rural Iowa patients and providers. Diane received her BS in pharmacy from the University Of Iowa College of Pharmacy and her Doctor of Pharmacy degree from the University of Florida. Diane practiced for 29 years at Mercy Medical Center in Cedar Rapids in various roles. Diane has worked in several community pharmacies, a corporate PPO pharmacy, manager of a closed-door LTC pharmacy and nursing home consultant at four LTC pharmacies. As adjunct assistant professor at the University of Iowa College of Pharmacy, Diane has precepted multiple student pharmacists and residents. She also serves on the University of Iowa Graduate College faculty and precepts for the University of Iowa College of Public Health. Diane has served in many capacities at IPA, including speaker of the house of delegates, vice speaker, delegate, chair of policy committees, board of trustees, and several task forces. She has been a member of the Johnson County Pharmacists Association, an officer of the Linn County Pharmacists Association and Iowa Society of Hospital Pharmacists, and an active member of ASHP, APhA, and ASCP.

About the Board The IPA Board of Trustees is the governing body responsible for advancing the goals and objectives of the association. The Board ensures clear communication between IPA and its members and maintains a strong awareness of our members’ needs, desires and attitudes. With that understanding, the Board shapes the association’s personality, defines its goals, sets its budget, and charts its future. Each year, IPA members have the opportunity to choose who will represent them on the Board. Candidates are selected by a nominations committee and are then ratified by the IPA House of Delegates at the Annual Meeting in June. The election is held the following February and those elected are inaugurated at the following Annual Meeting. Trustees are elected to serve a 2-year term. The Board meets for a retreat each summer and then meets in November, February and April at the IPA office in Des Moines, and again at the IPA Annual Meeting the following June.

| The Journal of the Iowa Pharmacy Association

The Nomination Process

Each year, the IPA president appoints a Nominations Committee, consisting of at least five members and chaired by the immediate past-chairman of the IPA Board of Trustees. The committee selects nominees for each elected position at IPA with the goal of filling a ballot with active IPA members that represent the diversity of practice settings that Iowa enjoys. The committee’s slate of candidates is presented for approval during the House of Delegates at the IPA Annual Meeting. Once approved, the ballot is sent to the membership at the beginning of the following year.

IPA BOARD ELECTION FOR THE OFFICE OF PRESIDENT-ELECT

Chris Clayton, PharmD, MBA Manchester

Chris Clayton, PharmD, MBA received his doctorate degree in Pharmacy from the University of Iowa in 2000 and his MBA from the University of Iowa in 2009. Chris is currently the Regional Director of Retail and Pharmacy Services for Unity Point Health Waterloo where he has practiced since graduation. He has direct oversight of inpatient pharmacies, retail pharmacies, outpatient MTM clinics, a hospital residency program, a community residency program, and the Occupational Health Clinic. He is also co-owner and the CFO of Clayton Drug in Strawberry Point, Sumner, and Elkader IA. Chris has also been the Director over other departments such as DME and Digestive Health, served as project leader for numerous projects (including the Epic implementation at Allen Hospital), has served on numerous committees and has assisted several other hospitals as Pharmacist in Charge during interim roles. He has participated in ongoing performance improvement initiatives and has a background in FMEA, Lean and Adaptive Design. He was recognized by IPA and was selected for the annual leadership conference in 2008. Chris is married to Jennifer Clayton, PharmD co-owner and CEO of Clayton Drug, and together they have 5 boys. Chris enjoys spending time with the family, listening to music, cars, motorcycles and most outdoor activities.

CoraLynn Trewet, MS, PharmD, BCPS, CDE Ankeny

CoraLynn Trewet attended Drake University graduating with her Doctor of Pharmacy degree and then completed a Practice Management Residency where she also obtained her Masters in Pharmacy Administration from the University of Kansas. Currently, she is a Senior Medical Science Liaison with Sanofi specializing in diabetes. Prior to this, she enjoyed several years as an Associate Clinical Professor of Family Medicine for The University of Iowa. Dr. Trewet is a Board-Certified Pharmacy Therapy Specialist (BCPS) and a Certified Diabetes Educator (CDE). She was named Iowa’s Distinguished Young Pharmacist of the Year in 2011 and is a fellow of the National Lipid Association and American Pharmacists Association. She has been an active volunteer with the Iowa Pharmacy Association and national associations working to advance the profession of pharmacy. She has served IPA in several capacities including participating in and leading committees and task forces, a trustee for the Board and Speaker of the House of Delegates. She has been known nationally as a clinical expert, in ways such as representing the American Pharmacists Association (APhA) as a member of a NHLBI/NIH committee for approval and dissemination of cardiovascular guidelines. She has been a speaker at various regional and national meetings in various clinical and adult learning topics. She has a passion for making things better. She lives in Ankeny, Iowa, with her husband and three children who motivate her to be her very best.

FOR TRUSTEE - REGION 1

Wes Pilkington, PharmD Waterloo

Wes Pilkington, PharmD, is a 2011 graduate of The University of Iowa. He currently manages Evans Crossing Pharmacy in Evansdale where he also serves as pharmacist in charge. Wes helped facilitate the purchase and rebranding of the pharmacy from previous ownership in 2018. Since this transition has taken place, he has implemented MTM services, vaccination services, clinical medication synchronization and started regularly logging eCare plans as part of the Flip The Pharmacy first cohort. In addition to his roles as a pharmacist, Wes manages the staff and all of the day to day operations at Evans Crossing Pharmacy. He was previously employed by Greenwood Drug in Waterloo where he oversaw all of the clinical services and served as the preceptor for the store’s first community pharmacy resident. Wes was honored by IPA as a Leadership Pharmacy participant in 2014, and as the recipient of the Distinguished Young Pharmacist of the Year award in 2019. Wes makes a point to volunteer on at least one IPA committee each year. He serves as a preceptor for The University of Iowa College of Pharmacy and Drake University College of Pharmacy. Wes has participated in youth mentorship in Waterloo and currently sits on the Black Hawk County Board of Health. Wes and his wife Sarah live in Waterloo with their sons, Jacob and Ryan. They welcomed a third child in December 2019.

Jess Purcell Smith, PharmD, MPH Dubuque

Jess Purcell Smith graduated from the University of Iowa College of Pharmacy and College of Public Health in 2006 and completed a Family Medicine Residency with Northeast Iowa Family Practice Center and the University of Iowa College of Pharmacy. After residency, she worked for Mercy Family Pharmacies in the Dubuque Area as community pharmacy residency preceptor, Adjunct Professor at the University of Iowa College of Pharmacy and manager of the Long-Term Care Pharmacy. Jess’ practice included long-term care consulting and dispensing, hospice consulting, MTM services, immunizations and collaborative care with other providers. In 2015 Jess became a partner in MPI Consulting, a pharmacy management company that served 6 retail pharmacies, 1 long-term care pharmacy, 3 hospital pharmacies as well as several consulting contracts. In 2019, Jess moved into her current role as the Outpatient Pharmacy Supervisor for MercyOne Dubuque and currently oversees the operations for 6 retail pharmacies, 1 long term care pharmacy and various consulting projects. Jess has served on the Iowa Medicaid Assistance Advisory Council Executive Committee and is a past member and current chair of the Iowa Pharmacy Association Medicaid & PBP Advisory Committee. Jess and her husband Jeff are the proud parents of 3 boys and 2 girls and enjoys running and spending time outdoors.

JAN.FEB.MAR 2020 |

IPA BOARD ELECTION FOR TRUSTEE - REGION 3 Candace Jordan, RPh, PharmD, BCPS Winterset

Candace Jordan received her Doctor of Pharmacy degree from Creighton University School of Pharmacy and Health Professions in 2009. She completed her post graduate pharmacy practice residency at Mercy Medical Center in Des Moines. She earned her Master in Business Administration-Healthcare Management in February 2018. Currently, she is the Manager of the Pharmacy Department at MercyOne West Des Moines Medical Center (formerly known as Mercy West Lakes) in West Des Moines and the Rural Pharmacy Manager for the Central Iowa Rural Affinity Hospitals to Mercy Medical Center. She is a preceptor for Mercy PGY1 and PGY2 Practice Management Rotation in addition to Drake and Creighton students. Prior to Mercy Medical Center West Des Moines, she was at VA of Central Iowa for 3 years, where she was a clinical pharmacist and developed the VA Central Iowa Residency Program and was subsequently the Residency Director. Locally, Candace is a member of the Health-System Liaison Board for IPA and an Iowa Delegate. She was a member of the Iowa Pharmacist Association Leadership Pharmacy Academy in 2014. She was on the Iowa Board of Pharmacy Continuing Professional Development (CPD) Task Force (2012), a Journal Article Peer Reviewer (2011-2013) and a member of the Policy Committee on Public Affairs (2009-2010).

DeeAnn Wedemeyer Oleson, PharmD, CPHQ Adair

DeeAnn Wedemeyer-Oleson received her PharmD degree from Drake University in 1999. She completed an ASHP-accredited residency in geriatric pharmacy practice at the VA Medical Center in Boise, ID. DeeAnn practices at Guthrie County Hospital (GCH) in Guthrie Center, IA, where she serves as the department director for both pharmacy and clinical safety, quality, and compliance, as well as the pharmacist educator on GCH?s diabetes education team. DeeAnn is the primary preceptor at GCH for Drake University introductory and advanced pharmacy practice experience students. She has also held adjunct faculty positions at Idaho State University, Des Moines Area Community College, and Des Moines University. DeeAnn was appointed to the Iowa Board of Pharmacy in 2007 and served two 3-year terms, retiring from the Board as vice chairperson in 2013. She is an active member of the Iowa Pharmacy Association and the American Society of Health-System Pharmacists. She will complete her master in healthcare administration (MHA) degree from Des Moines University in May 2019.

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FOR TRUSTEE AT LARGE

Emily Beckett, PharmD, BCPS Des Moines

Emily Beckett is an Ambulatory Care Clinical Pharmacist with the Broadlawns Family Medicine Residency Program in Des Moines and holds an Adjunct Clinical Faculty appointment with University of Iowa. She received her Doctor of Pharmacy degree from the University of Iowa College of Pharmacy, and completed an ASHP-accredited PGY1 residency at Mercy Medical Center Des Moines. She obtained her BCPS certification in 2013. She most recently held an appointment as an assistant clinical professor at the University of Iowa College of Pharmacy. Prior to that, Emily was a Patient Education Pharmacist at Unity Point Health Des Moines. Emily currently assists in the Broadlawns Family Medicine Anticoagulation clinic, and provides diabetes education and management to family medicine patients. She is developing a pharmacist-led Medicare Annual Wellness clinic, as well as a COPD inhaler clinic at Broadlawns. She works collaboratively with onsite medical residents on various research projects and precepts University of Iowa pharmacy students. She serves on the Broadlawns Pharmacy and Therapeutics Committee, as well as several other clinical committees. Emily is the past chair of the Iowa Pharmacy Association Education Advisory Board, has served as a member of the IPA House of Delegates since 2016 and is a member of the American College of Clinical Pharmacy. Her professional interests include anticoagulation, diabetes and chronic disease management, quality metric measurement, and professional education and nutrition. In her free time, she volunteers with her local Girl Scout troop and youth volleyball clinic. She also enjoys biking, traveling, and spending time with her husband and three children.

Nic Lehman, PharmD, BCACP Urbandale

Dr. Lehman is an Associate Professor of Pharmacy Practice at Drake University College of Pharmacy and Health Sciences. He also serves as a clinical pharmacist at the UnityPoint West Des Moines Internal Medicine and Family Medicine Clinics and as an Adjunct Clinical Professor at the University of Iowa Carver College of Medicine. Dr. Lehman received his Doctorate of Pharmacy from The University of Iowa in 2003. He completed a Primary Care Pharmacy Practice Residency at the Iowa City VA Medical Center in 2004, and joined the faculty at Drake in 2010. Dr. Lehman obtained Board Certification in Ambulatory Care Pharmacy in 2012, and is an active member of the American Pharmacists Association and the Iowa Pharmacy Association. He has served as the Chair of the Education Committee for the APhA Diabetes Management Special Interest Group for the past two years and is currently a member of the APhA-APPM Policy Standing Committee and House of Delegates. Dr. Lehman has also participated in a variety of roles within IPA, including serving as the Education Review Committee Chair from 2014-16. He has also been a member of the IPA Membership Task Force, the Policy Committee on Professional Affairs, and the Policy Committee on Public Affairs. Dr. Lehmanâ&#x20AC;&#x2122;s current practice and research interests include anticoagulation therapy, diabetes, transitions of care and immunizations.

IPA BOARD ELECTION FOR TRUSTEE AT LARGE

Nancy Bell, RPh, PharmD West Des Moines

Nancy Bell is a medical outcomes specialist for Pfizer in Iowa and Nebraska. She works with payers and large health care delivery systems to improve the quality of healthcare. Nancy has been active in several public health issues both for and with the association including a recent task force on opioid and heroine abuse. She has worked with various advocacy groups on smoking cessation policies and efforts in the state and served for a number of years on the State of Iowa Task Force for Antibiotic Resistance, for which she received the Director’s Award of Merit from the Iowa Department of Public Health. Prior to Pfizer, Nancy worked for the clinical services division of IPA, working most notably with the Iowa Medicaid drug utilization review and prior authorization programs. She has also worked as part of a team delivering quality care to patients in a staff model HMO setting with John Deere Health Care and has 5 years’ experience as a community pharmacist.

FOR PHARMACY TECHNICIAN

Macey Calderwood, CPhT Traer

Macey Calderwood has worked at NuCara Pharmacy in Traer since 1994. Currently, she is serving on the IPA Legislative Advisory Committee and the Technician Advisory Committee. She has been a part of the pilot program for Technician Product Verification and have been successfully practicing it for five years. Her site recently started practicing TelePharm one day per week. Macey has enjoyed serving four generations of families in her community and helping them with their healthcare needs. Recently, she has served as a Task Force member and Item Writer for PTCB developing questions for the TPV Exam Certification Program. Macey holds a Bachelor of Science degree in Educational Services from Iowa State University. She and her husband work and live on the family farm. They have two sons, both at Iowa State. She stays active in my community serving on various boards and organizations.

Nancy graduated from Drake University College of Pharmacy and Health Sciences with a Bachelor of Science in Pharmacy (90) and received her Doctor of Pharmacy at the University of Kansas College of Pharmacy (04). Nancy has served in various capacities with IPA including the payer subcommittee and regularly speaks with students about pharmacists’ roles in industry. She is a past participant of the Leadership Conference and has been very involved at Drake supporting the Curriculum Committee, the National Advisory Board to the College of Pharmacy, student interviews, student shadowing. Nancy was honored by the Pharmaceutical Manufacturers of America in 2016 with the We Work for Health Award for going beyond her role with Pfizer for her activities with IPA, Drake, and various initiatives.

Adam D. Boon, PharmD, MBA, BCPS Des Moines

Adam Boon is a 2003 graduate of Drake University. Upon graduation Adam held several positions in the state of Indiana as a staff pharmacist in community and hospital settings, including a stint as director of pharmacy at a critical access hospital. Adam returned to Iowa in 2007 and was the operations manager at Iowa Lutheran Hospital until 2012. In 2012 he joined Cardinal Health Innovative Delivery Solutions as a senior consultant in clinical operations dedicated to Indiana University Health, Indiana’s largest healthcare provider with 16 hospitals located throughout the state. Adam serves as a primary contact for several consultative programs relating to various aspects of acute care operations including inventory management, purchasing optimization, clinical operations, 340b, USP, and regulatory compliance. Adam is an active member of IPA and ASHP. Adam has participated in the IPA/PSW Leadership Pharmacy Conference, Bill Burke Student Pharmacist Leadership Conference, and has served as an IPA Delegate for IPA’s House of Delegates. Adam has previously served as a member of ASHP’s Section Advisory Group on Publications and is currently serving on the ASHP Foundation’s Donor Outreach Committee. Adam also has previously served on Drake University’s College of Pharmacy and Health Sciences Student Advisory Committee and is currently serving on Drake’s CPHS Assessment Committee.

Tammy Sharp-Becker, CPhT, CSPT Des Moines

Tammy Sharp-Becker is the 340B Pharmacy Technician Coordinator for the UnityPoint Health – Des Moines region. She has worked for the UnityPoint Health System for over 12 years. Prior to coming to UnityPoint Health – Des Moines, she worked at Mary Greeley Medical Center for 18 years where her pharmacy career started. She got her Pharmacy Technician diploma in 2001 from an at home study program and became certified the same year. Tammy served on the Certified Compounded Sterile Preparation Technician Standard Setting Committee and has been an item writer for PTCB. She is an active member with the Iowa Pharmacy Association and has been on the Technician Advisory Committee for several years and is currently the Chair. She previously sat on the Policy Committee on Public Affairs. Tammy has been a delegate for the House for over 5 years. She has also served on the Board of Pharmacy Compounding Task Force. In 2016, Tammy was named Iowa Pharmacy Associations Technician of the Year. In 2017, she completed a class on Breakthrough to Leadership through Dale Carnegie. Outside of the pharmacy realm, Tammy graduated in 2018 with her Associates of Arts after taking time off to raise her two boys.

JAN.FEB.MAR 2020 |

PROVIDER STATUS

IOWA MEDICAID RECOGNIZES PHARMACISTS AS PROVIDERS Yes, it’s happening! But there is still work that needs to be done!

n November 18, 2019, Iowa Department of Human Services (DHS) released Informational Letter No. 2048-MC-FFS. In this communication, DHS stated that Iowa Medicaid has added a new provider type for pharmacists, allowing pharmacists to enroll as a Medicaid provider immediately. As stated in the letter, enrollment will permit a pharmacist, pursuant to statewide protocols, to order and dispense naloxone and nicotine replacement therapy products, as well as to order and administer vaccines to Medicaid members. Approved services provided by pharmacists enrolled as providers will be eligible for payment effective July 1, 2020, but pharmacists are encouraged to begin the enrollment process now. This Informational Letter is a direct response to years of advocacy and successful passage of IPA’s legislation for statewide protocols in 2018. Once the Board of Pharmacy adopted regulations that effectively put these statewide protocols into action in 2019, IPA began seeing other third-party payers recognize pharmacists as prescribers under statewide protocols for immunizations, naloxone, and nicotine replacement therapy. Statewide Protocols – What Are They? The term “statewide protocol” refers to a framework that specifies the conditions

| The Journal of the Iowa Pharmacy Association

under which pharmacists are authorized to prescribe a specified medication or category of medications when providing a clinical service. Statewide protocols are issued by an authorized state agency pursuant to relevant state laws and regulations. Each protocol specifies the qualifications required for pharmacists to implement the protocol and the procedure(s) that must be followed. Generally, statewide protocols address identified public health problems and are used for patient care needs that do not require a new diagnosis or for which a documented diagnosis is known or readily available. The graphic showcases the scope of a statewide protocol as related to other forms of pharmacist prescribing mechanisms. As you refer to IPA’s 2020 legislative priorities, you will see a legislative agenda that continues

to pursue additional prescribing opportunities. IPA has provided a step-by-step approach to prepare your practice and yourself to participate in each statewide protocol on our webpage. How Is This Different from Pharmaceutical Case Management (PCM)? Iowa Medicaid Pharmaceutical Case Management (PCM) is an Iowa Medicaid service provided by physicians and pharmacists working together to closely manage the total medication regimens of their most complex patients. The services are provided to Medicaid members who are identified as being at high risk for medication-related problems. The innovative care delivered through this program is based on a model of care known to improve medication safety

Source: National Alliance of State Pharmacy Association (NASPA)

PROVIDER STATUS

in hospital and clinic settings where pharmacists and physicians practice under the same roof and have access to patient care records. The Iowa PCM program began in 2000 with funds appropriated by the Iowa legislature. With the transition to management of Medicaid by managed care organizations (MCOs), PCM is only eligible for patients still on Fee-forService (FFS) Medicaid, which is a small percentage of patients. PCM was not a mandated covered service when the state negotiated contracts with the MCOs. Provider Status: Success – With More to Be Done While this is a success for the profession, IPA is still advocating to Iowa Medicaid for coverage of services provided within the statewide protocols, not just the prescription itself. Once a pharmacist is enrolled as a provider within Iowa Medicaid, this will allow your pharmacy to bill under the pharmacist’s individual National Provider Identification (NPI) for the medications only. There is currently no payment tied to the service, except the standard dispensing fee (or vaccine administration fee). Next Steps with Iowa Medicaid IPA continues to work with Iowa Medicaid staff to ensure the enrollment and billing process are clearly established and communicated to pharmacists. While the enrollment process is underway, IPA expects to see information from Iowa Medicaid in the spring of 2020 on the billing process for pharmacists enrolled as providers. IPA will feature more information on this process in upcoming communications. What Do I Need to Do? To enroll under this new provider type, a pharmacist must: Complete the Iowa 1. Medicaid Universal Provider Enrollment Application Form 470-0254 (Section B) In box 16, enter type code 82. a. b. In boxes 31 a-c, enter the pharmacy NPI, Taxonomy Code, and

Location Zip Code. If employed at more than one location (pharmacy), you will have to submit a completed application for each location. • Include a copy of your Iowa Board of Pharmacy Pharmacist License. Obtain through the Board of Pharmacy’s new online portal. • Include a copy of the certificate from a college of pharmacy or an ACPE-accredited CE program on vaccine administration (if applicable). • Include a copy of current basic cardiac life support or CPR training certificate. • Include a copy of all applicable ACPE-approved CE certificates relative to vaccines, naloxone, and nicotine replacement therapy.

complete the credentialing process with the Council for Affordable Quality Healthcare (CAQH), a nationallyrecognized online credentialing service. a. Please note that Iowa Total Care does not require you to complete Section C or use CAQH. What About Other Third-Party Payers? At this point, IPA is aware that other third-party payers, such as Wellmark and Medicare Part D plans, already recognize pharmacists’ NPIs when billing for medications under the statewide protocols. Please contact IPA at IPA@iarx.org or 515-270-0173 for any ongoing questions or concerns. ■

2. To be recognized by AmeriGroup, complete Iowa Medicaid Universal Provider Enrollment Application Form 470-0254 (Section C). In lieu of completing Section C, you can

POINTS OF CONTACT Fee-For-Service (FFS)

Desiree Smith Provider Services Operations Manager Iowa Medicaid Enterprise Department of Human Services 515-974-3160 office Dsmith4@dhs.state.ia.us

Iowa Total Care

ITC’s RPh enrollment contact person varies depending on where the pharmacist is geographically located. There is a map with contact information located on our website at https://www.iowatotalcare.com/providers/resources.html

AmeriGroup AmeriGroup prefers Enrollment questions be directed to AmerigroupPSO@amerigroup.com. Yvonne Capraun (Yvonne.Capraun@anthem.com) can also be contacted for specific questions. Information in this section is subject to change as IPA advocates for an efficient process moving forward. IPA will post the most current information on our website.

HEALTHCARE HOT TOPICS

with suspected e-cigarette, or vaping, product use associated lung injury (EVALI). The guidance comes as the number of cases of lung injury and deaths associated with e-cigarette or vaping products continually increases.

Stephen Hahn Confirmed as FDA Commissioner

Oncologist Stephen Hahn of MD Anderson Cancer Center has been confirmed by the Senate as commissioner of the FDA. Hahn will enter the role as the FDA juggles serious health issues, including the surge in underage vaping over the past two years. Hahn succeeded Dr. Scott Gottlieb, who left the federal agency in April 2019.

Updated ACIP Recommendation for PCV13 Vaccine in Adults over 65 Years

13-Valent Pneumococcal Conjugate Vaccine (PCV13) is no longer routinely recommended for all adults aged greater than 65 years. The new recommendation includes shared clinical decision-making for PCV13 use in persons aged greater than 65 years who do not have an immunocompromising condition, CSF leak, or cochlear implant and who have not previously received PCV13 vaccine. Incidence of PCV13-type disease has been reduced to historically low levels among adults aged greater than 65 years through indirect effects from pediatric PCV13 use. Implementation of a PCV13 recommendation for all adults aged greater than 65 years in 2014 has had minimal impact on PCV13-type disease at the population level in this age group. ACIP continues to recommend PCV13 in series with PPSV23 for adults 19 years and older (including those aged greater than 65 years) with immunocompromising conditions, CSF leaks, or cochlear implants. The recommendations for the use of PPSV23 vaccine have not changed.

FDA Warns 15 Companies on Illegal CBD Products

The Food and Drug Administration (FDA) has distributed warnings to 15 companies for illegally adding cannabidiol (CBD) to their products. Additionally, the FDA said that it cannot certify CBD as generally

| The Journal of the Iowa Pharmacy Association

Forty-nine states, the District of Columbia, and one U.S. territory have reported 1,299 cases of lung injury associated with the use of electronic cigarette (e-cigarette), or vaping, products. Twenty-six deaths have been reported from 21 states.

Three STDs Reach New Highs in the U.S. FDA Commissioner Stephen Hahn, MD

recognized as safe (GRAS) for human or animal consumption due to the lack of scientific information surrounding it. The warnings and the general notice of non-GRAS status signal a renewed scrutiny of CBD products, an industry the FDA has struggled to regulate since the legalization of hemp in 2018. This appears to signal increased interest in CBD and marijuana research so scientists and clinicians can understand the drug better.

Invokana â&#x20AC;&#x201C; New Indication to Slow Diabetic Kidney Disease

Type 2 diabetes mellitus is the leading cause of kidney failure worldwide and accounts for a significant portion of patients who require dialysis. Invokana (canagliflozin), a sodium-glucose cotransporter 2 (SGLT2), was recently approved to slow diabetic kidney disease with albuminuria in adults with type 2 diabetes following the results of the CREDENCE trial, and is the first drug in over 20 years to receive that indication.

CDC Provides Interim Guidance for Patients with E-cigarette, or Vaping, Product Use Associated Lung Injury The CDC published interim guidance for health care providers of patients

According to CDC data, chlamydia, gonorrhea, and syphilis infections have risen in the United States for fifth year in a row. More than 1.7 million case of chlamydia were reported in 2018, increasing the infection rate by 3% from last year. The trend has been attributed to an increase in testing. About 580,000 cases of gonorrhea were reported, a 5% increase over the previous year and the highest number since 1991. Researchers are concerned that antibiotic resistance is a factor. The CDC report also saw a 15% increase in syphilis cases, with about 35,000 cases of the most contagious forms of the disease reported. The higher numbers of cases coincided with the closure of clinics and cuts to public health funding.

On a related note, the Iowa Board of Pharmacy has published a notice of intended action on expedited partner therapy, which would allow pharmacists to fill a non-patient specific prescription to treat sexually transmitted chlamydia or gonorrhea infection in an unnamed partner or partners. IPA policy supporting expedited partner therapy (18-U2) was passed during the 2018 IPA House of Delegates. â&#x2013;

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FROM THE DEAN

PARTNERSHIPS, PROGRAMS, AND HONORS

Renae Chesnut, RPh, EdD, MBA

Dean Drake University College of Pharmacy & Health Sciences

he Drake CPHS capped off the decade by continuing to provide excellent educational experiences and patient care, while also forming new partnerships, developing new programs, and celebrating several accomplishments and national recognitions. We are proud of our faculty who provide a stellar education along with outstanding students who will help transform the profession. A few of the new educational opportunities and partnerships include: • A new online certificate program in Evidence Based Healthcare specifically designed for health care professionals looking to expand their knowledge in evidence-based decision making. • A 30-credit hour, completely online Master’s in Health Informatics and Analytics that will begin in Fall 2020. This can be completed as a stand-alone program for practicing professionals or along with the PharmD for current students. • In collaboration with Vanadro Drug Development Consulting, a company providing clinical pharmacology expertise for cancer and other diseases, the college developed a new fellowship. Amanda Hoerres, PH’19, was selected as the first fellow. Our students continue to excel in obtaining residency and fellowship positions. Drake’s overall 87.5% match rate which far exceeded the national average of 64.38% percent,

| The Journal of the Iowa Pharmacy Association

was the #1 spot in the Midwest and #3 nationally. Several students were also selected for highly competitive fellowships and other post-graduate positions. Several students were the recipients of various honors: • Michael Harvey, P4, received the 2019 American Pharmacists Association (APhA) Good Government Student Pharmacist-ofthe-Year Award.

• Drake Reiter, P4, was the winner of the 2019 Parata Pharmacy Times Next Generation Future Pharmacist Award. • Emma Robasse, P3 is one of four dual-enrolled students nationwide to receive a 2019 Express Scripts Scholarship of $10,000. • Katie Vollmer, P2, received a Gateway to Research Award sponsored by the American Foundation for Pharmaceutical Education (AFPE).

• Kelli Jo Welter, P4, was installed as the President of the American Pharmacists Association – Academy of Students in Pharmacy during the APhA Annual Meeting.

Recent recognitions and awards for the faculty include the following: • Tim Welty was inducted as a Fellow into the American Epilepsy Society. • Kim Huey was inducted as a Fellow into the American Physiological Society. • Geoff Wall joins John Rovers as a John R. Ellis Endowed Professor. • Chuck Philips was named a Windsor Professor of Science. • Eliza Dy-Boarman received a 2019 Emerging Teaching Scholar Award from the American Association of Colleges of Pharmacy. • Several grants and contracts were received, including Brian Gentry, who along with Biology professor, Marc Busch, was awarded a multiyear $390,000 Merck Investigator Studies Program (MISP) grant to study letermovir. Congratulations as well to national pharmacy leaders, Eugene (Gene), PH’66, and Susan, PH’68, Lutz who received the 2019 Lawrence C. and Delores M. Weaver Medal of Honor, the highest honor given by the College. As a result of all of the work of our faculty, staff, preceptors, alumni, and students that led to these accomplishments and many others, the Drake University College of Pharmacy and Health Sciences continues to be recognized nationally for our excellence, commitment, and engagement. To all of the IPA members who support our college and assist us in these endeavors, thank you! ■

FROM THE DEAN

OUR NEW HOME

n late December we began the process of moving into the largest, most complex, pharmacydedicated educational facility in the nation. I like to say that: “We have gone from worst to first!”. Students will begin to grace our halls the day after Martin Luther King Holiday. This will be our home for many decades to come and given the manner in which it has been constructed, adapting to ongoing changes in educational delivery and scientific discovery will be made much, much easier. As a pharmacist, simply walking into the building prompts an immediate smile…it is that special! The number and type (formal and informal) of teaching space is extraordinary…large classrooms, small classrooms and everything in between including informal spaces where students can gather for peer exchange and mentoring. Now the cutting-edge curriculum that our faculty developed several years ago will no longer be hampered by cramped quarters, very limited break-out rooms, and inadequate technology. The full measure of curricular design will now be realized going forward. And the research space (with an entire shelved floor for future expansion) provides opportunities to pursue discovery that rival any cutting-edge research facility in academia or the industry. Moreover, our graduate students, who spend endless hours in the lab, will have cubicles of their own outside the laboratories rather than having a desk and personal belongings in the lab as has been done since our graduate program was first established many decades ago.

built in the USA that embraced ‘Universal Design’ since its inception. To the uninitiated, that means that any physically disabled student who has the intellectual capacity to pursue one of our rigorous programs of study can do so in an environment that makes it about as easy for them to utilize and traverse any segment of the facility as an abled bodied person. Adoption of this feature, despite the added cost, personally means a great deal to me! Also, the lower level…below grade…of the facility (24 feet from floor to ceiling!) will house the College’s University of Iowa Pharmaceuticals (UIP) sterile products manufacturing facility, another one-of-a-kind in the nation. Among other things, resources generated through UIP will help keep educational costs down and provide support to our program of discovery. And lastly, Alumni Hall. There is no space on the University’s campus that bears the name Alumni Hall. We will be the first. When you first walk into the building the observer is readily struck by the enormity of the open space on the first floor…that is now Alumni Hall. It is so important to me that EVERY UI College of Pharmacy alum, regardless of whether they graduated several decades ago or last May, feel that this is their home. Every effort will be made to help make that so including internal alumni created

Donald Letendre, PharmD Dean The University of Iowa College of Pharmacy

artworks and pictures that capture sentinel moments in our history. As the eldest of eight children and growing up in a small southeastern Massachusetts town in a home filled with love and a true sense of belonging, there was a small plaque in our living room that simply read “Home is not a place…it is a feeling”. Every time I visit the town I grew up in I get that feeling. Emotion wells-up inside of me…I know that I am home. My hope and prayer is that everyone ever associated with our College… past, present, and future…will feel the same way when they walk into their new home. ■

Other special features: It is the first health-sciences educational facility

JAN.FEB.MAR 2020 |

IOWA PHARMACY NEWS

Iowa Immunization Coalition Convenes IPA is part of a new coalition recently formed in Iowa to promote the benefits of immunizations and vaccines to the legislature and general public. Iowa Immunizes was formed primarily in response to several pieces of legislation introduced last year that would have weakened Iowaâ&#x20AC;&#x2122;s immunization laws. The coalition is composed of advocates, practitioners, and stakeholders from across the state and will help advance a pro-vaccine message during the 2020 Legislative Session.

Hospital Leaders Discuss Key Issues Across Iowa The IPA Hospital Leadership Team (HLT) is a group of hospital and health system pharmacy leaders across Iowa that meets on a bi-annual basis to discuss issues and opportunities for hospital pharmacy practice. During their December meeting, the group discussed the applicability of the electronic prescribing mandate to emergency departments and after-hours operations, best practice for handling patients in possession of authorized medical cannabis during their hospital stay, and success stories of technician product verification in hospital pharmacy departments. The group also discussed opportunities for health-system pharmacists to bill for services provided, how IPA can assist in managing critical drug shortages for Iowa hospitals, and shared ideas for the planning of an IPA Forum for hospital and health-system leadership. The HLT recommended that IPA address the non-reimbursable costs of manipulating intravenous specialty medications in hospitals, especially given the recent costs of USP 800 compliance, with key stakeholders in Iowa.

Iowa Pharmacy Stakeholders Convene; Prepares for 2020 The Iowa Pharmacy Stakeholder Group meets on a quarterly basis to discuss key issues influencing the profession of pharmacy and to foster a collaborative approach across key entities. The group is made of Iowa Board of Pharmacy

| The Journal of the Iowa Pharmacy Association

members and staff, Iowa Pharmacy Association presidential officers and staff, the deans of the two Iowa colleges of pharmacy, CEImpact representatives, and the Iowa pharmacist legislators. During their recent meeting in November, the stakeholders discussed the 2020 legislative priorities for pharmacy, including: expanding the collaborative practice language to allow pharmacists to enter into agreements with dentists and nurse practitioners, allowing pharmacist prescription adaptation to meet the intent of the prescriber, lowering the immunization age to 6 years and older for all vaccinations and immunizations, and increasing access to care through the establishment of two new statewide protocols. The stakeholders also discussed the newly achieved pharmacist provider status through Iowa Medicaid and strategies to advocate for broadening the rule language to include all pharmacist statewide protocols beyond the three that are currently in effect. Moreover, the next steps for the appointment process to the Iowa Pharmacy Practice Act Task Force were discussed. The group also touched on professional burnout, trends, and action steps their institutions have taken to help minimize the burden and promote resiliency.

E-Prescribing Goes Live

On January 1, 2020, the Iowa law and regulations mandating that prescribers transmit both non-controlled and controlled substance prescriptions to pharmacies electronically went into effect. Prescribers, medical groups, institutions and pharmacies who are unable to comply with the new standard by the go-live date have submitted petitions of specified duration to the Iowa Board of Pharmacy for consideration. There are a number of exemptions to the mandate outlined in Iowa Code Chapter 657-21.8(124,155A) which include prescriptions written for patients residing in nursing homes, longterm care facilities, correctional facilities or jail, prescriptions for compounded medications containing two or more components, prescriptions for an opioid use antagonist, and prescriptions issued in an emergency situation, among others. The Iowa Board of Pharmacy has advised

pharmacies that they are not responsible for verifying a prescriberâ&#x20AC;&#x2122;s exemption status in order to dispense a prescription. IPA will continue to provide clarification to pharmacies regarding the applicability of the electronic prescribing mandate to ensure that patients continue to receive timely care.

USP Chapter 800 Standards Now Effective

As of December 1, 2019, compliance with USP General Chapter <800>, as mandated by the Iowa Board of Pharmacy for pharmacies across all practice settings, took effect. Unless a pharmacy previously submitted a petition and was granted delayed compliance to the Board, all pharmacies dispensing and handling hazardous drugs are expected to have completed a risk assessment and made the appropriate modifications to their pharmacies and workflow.

Board compliance staff have begun assessing adherence to USP General Chapter <800> and will review required policies and procedures to determine if plans for compliance are sufficient, based on the type of hazardous drug handling that is being performed. The Board of Pharmacy encourages pharmacy licensees to have documentation ready for compliance staff to review and be prepared to explain how your pharmacy has addressed the requirements outlined by USP General Chapter <800>. IPA has provided its members a free USP 800 Template Guidance on USP <800>, which is available at www.iarx.org/USP. In addition, CEImpact is offering free continuing education on USP compliance.

IOWA PHARMACY NEWS Innovative Tele-Naloxone Program Provides Free Naloxone to Iowans

The Iowa Department of Public Health and the University of Iowa Health Care partnered to launch a new program called “Tele-Naloxone” that will now provide free naloxone by mail. Iowans who want to be prepared in the event they encounter someone experiencing an opioid overdose can now obtain Narcan nasal spray through this statewide TeleNaloxone Project. Funded by the federal State Opioid Response grant, individuals wanting to obtain naloxone participate in a brief consultation with a UIHC pharmacist using a mobile phone platform. Then, a free kit(s) is mailed to the individual anywhere in the state. “Cost should not be a barrier when it comes to saving someone’s life from an overdose. Through this effort our hope is it no longer will be,” said IDPH Opioid Initiatives Director Kevin Gabbert. IDPH encourages IPA’s members to spread the word and get this vital information out across Iowa. Printable posters and coordinated social media posts are also available. Please visit www. NaloxoneIowa.org/telenaloxone. In coordination with this project launch, the website includes instructional videos on the use of naloxone, naloxone directory and mapping tool and Tele-Naloxone appointment request forms.

IPA Member Benefits Expanded in 2020

RxAshlee Partnership for Career Development IPA has partnered with RxAshlee, a Career Pivot Expert and Interview Prep Coach, to offer unique coaching for pharmacy professionals looking to nail a job interview, finetune their resume, articulate their own unique brand, and level up their career! IPA members receive a 20% discount to the

RxAshlee Stand Out and Nail Your Interview course. This course will help you prepare yourself for deep dives into: 1. Solidifying your elevator pitch. 2. Answering the tough (but basic) question of: So, tell me about yourself. 3. Generating amazing examples of commonly asked, high stakes interview questions. 4. Gaining the confidence and strategy, you deserve. 5. Articulating your specific skills. 6. Learn how to research the company or facility you are interviewing with. 7. Learning how to ask the right questions and navigating tough discussions (i.e. salary, benefits). The course also emphasizes several game-changing, career-building skills, including: 1. Nailing your elevator pitch – Knowing who you are, why you are the best fit for this role, and the value you bring to the company is KEY in interviewing. 2. Crafting amazing answer – Pinning down why you want this job and practicing tough questions that may come your way. We will make sure you are ready with amazing answers PRIOR to your interview. 3. Confidence/mindset master – Confidence gets you jobs. This is a proven fact! Reflecting on your work experiences, your day to day duties in prior roles, and your life experiences (because this matters too!) will have you feeling REALLY awesome prior to your interview. LicenseTrak: Enhancing Your Compliance and Accreditation Programs IPA has partnered with LicenseTrak to help our members manage their regulatory compliance and accreditation requirements.

LicenseTrak includes three modules to record, track and manage at-risk items:

| The Journal of the Iowa Pharmacy Association

• LicenseTrak CTM: Record and track all regulatory items, including licenses, registrations, contracts, training programs and more. • LicenseTrak AMS: Manage tasks and documentation needed for major pharmacy accreditations, including specialty pharmacy, compounding and infusion. • LicenseTrak ECM: Record, manage and resolve errors, complaints and other incidents within your pharmacy operations. • LicenseTrak is priced to provide immediate value to your organization. IPA members get preferred pricing, including certain bundle discounts when using more than one module. Visit www.licensetrak.com for more information, or contact sales@licensetrak. com or 844-LICTRAK (542-8725) to schedule a demo. CEImpact: Critical Compliance Courses One of the most difficult things for pharmacies can be tracking and documenting compliance education and training. HIPAA; Medicare Fraud, Waste, and Abuse; and other compliance education is often required yearly and different courses are required by different accreditors and licensing bodies. It takes time to find the education and it can be an administrative nightmare to track it. CEImpact has Compliance Courses all in one place, that are easy to access, and meet requirements.

For Business Partner or Platinum Business Partner members of IPA, we have negotiated a discount with CEImpact for you to receive their Compliance Subscription for 5% or 15% off (respectively). The courses are ready to go so you can implement a turnkey solution quickly and start the year off right! ■

Assisting pharmacy professionals and student pharmacists in obtaining necessary help for a healthy recovery from substance abuse, mental and/or physical disabilities

Becky Carlson, LMHC, CADC IMP3 Case Manager Board of Pharmacyâ&#x20AC;&#x201D;IMP3 400 SW 8th Street, Suite E Des Moines, IA 50309-4688 Phone: (515) 725-3491 Fax: (515) 725-0642 E-mail: imp3@iowa.gov https://imp3.iowa.gov

The Iowa Monitoring Program for Pharmacy Professionals (IMP3) believes the skills and reputation of pharmacy professionals and student pharmacists can be maintained if monitoring and supportive services are put in place at an early stage. IMP3 can assist pharmacy professionals and student pharmacists in obtaining the necessary help for healthy recovery from substance abuse, mental and/or physical disabilities.

PRACTICE ADVANCEMENT HIV Screening & Linkage to Care Project Expands

In conjunction with the Iowa Department of Public Health’s Bureau of HIV, STD and Hepatitis, IPA is partnering with communitybased pharmacies across the state in offering HIV testing with plans to add Hepatitis C testing in 2020. The initial cohort of seven pharmacies, in areas of the state identified based on statistical data from the Iowa Department of Public Health’s epidemiology report, have been offering free HIV screenings since January of 2019. They have delivered a total of 75 tests in the first year. The second cohort of six pharmacies launched in the fall of 2019. With the goal of 40 sites providing HIV screenings, IPA is looking to gain more interest in the following counties: Palo Alto, Pocahontas, Calhoun, Webster, Humboldt, Kossuth, Clarke, Decatur, Wayne, Lucas, Monroe, Appanoose, Wapello. These are areas of the state that the Iowa Department of Public Health considers focus areas, based on their epidemiology reporting. To participate in the project or to learn more, please contact Kellie Staiert, IPA’s lead project manager at kstaiert@ iarx.org.

Iowa Healthcare Workforce Grant with IMS, IHA, and PCA

As part of an IDPH grant to address strategic planning and stakeholder engagement across the entire Iowa healthcare workforce, IPA is working collaboratively with the Iowa Medical Society, Iowa Hospital Association, and the Primary Care Association throughout 2019-2020. The goals of the grant, include: 1. Assess and evaluate the current landscape and future of rural healthcare workforce in Iowa. 2. Engage stakeholders from across Iowa’s rural workforce continuum to inform and participate in the strategic planning process. 3. Develop a comprehensive and action-oriented strategy to

| The Journal of the Iowa Pharmacy Association

address current rural healthcare workforce challenges, priorities, and opportunities in Iowa. 4. Execute a high quality, effective, and efficient project to support rural workforce development in Iowa. As part of this grant, IPA will assist in convening the conservation among IPA leadership and advisory committees throughout the spring of 2020. These discussions will occur live in-person or via webinar. In addition, IPA will collaborate with the other associations to convene open forums for the public and other stakeholders to discuss rural health workforce across all corners of the state. Watch IPA communications for ways to collaborate on this initiative!

Practice Advancement into 2020 and Beyond IPA has been actively pursuing various grant opportunities to help implement initiatives to advance pharmacist professional development, enhance interprofessional collaboration, increase patient access to care, and expand pharmacist-provided services through the established statewide protocols. While nothing is confirmed at this point, IPA has heard from our members that grant dollars greatly assist in your efforts to advance your practice.

IPA joined forces with the Iowa Medical Society and applied for a grant to promote patient education on smoking cessation in Iowa. IPA plans to use the funds to host Mental Health First Aid trainings as well as billing workshops across the state in order to provide pharmacists with education on motivational interviewing for smoking cessation, and to provide education on billing under the nicotine replacement statewide protocol. IPA also applied for a grant to implement a privileging service for pharmacists providing clinical services. Additionally, IPA sought grant funding to help establish a pharmacist recruitment and retention service to connect pharmacists in the process of succession planning with new practitioners seeking career

opportunities. This effort will ensure patients across Iowa will still have access to pharmacist services and that pharmacists continue to be an active member of the healthcare continuum in a time where remote order verification is becoming all too common. IPA is eagerly awaiting to receive notification regarding the proposals submitted!

Resources for Billing of Pharmacy Services

IPA will soon be releasing a resource for billing pharmacist provided services for its members to learn of opportunities available through some of the major payers in Iowa. While various resources were used to compile a comprehensive list of reimbursable services, IPA has worked to compile these tools and provide Iowa-specific payer information into the resource center. IPA will include guidance on chronic care management (CCM), diabetes prevention program (DPP), incident-to billing and many more billing types that pharmacists across various practice settings can engage in. ■

I O WA P H A R M A C I E S

Changing Community Pharmacy Practice Across America

Did You Know?

On average, a complex patient at risk for medication failures takes 10 meds a month, visits the emergency department three times a year, is hospitalized 20 times more than the average Medicaid enrollee. The care of these complex patients costs $30k each year. n

There is a network of over 100 local community pharmacies covering 95 percent of residences in the state that provide enhanced services for these complex patients Medication adherence for patients using these pharmacies is significantly higher across over 50 different medication classes used to treat chronic illness and behavioral health conditions.

This clinically integrated network of pharmacies is called CPESNÂŽ Iowa These community-based and locally-owned pharmacies offer patient-centered and locally-delivered care. They lower overall healthcare costs for the State of Iowa and its tax paying citizens.

To find a pharmacy near you or for more information about this network, contact Lindsey Ludwig at lludwig@cpesniowa.com or visit www.cpesn.com

PUBLIC AFFAIRS

IPA WORKING FOR YOU TO ADDRESS YOUR IOWA MEDICAID & MCO CONCERNS 2020 Medicaid PDL Changes – Amerigroup Claim Rejections for Brand Name Drugs IPA has been made aware of claim rejections for Brand Name Drugs that were preferred on the 2019 Preferred Drug List (PDL) for Amerigroup patients. We have been working closely with Amerigroup to resolve this issue as pharmacies have been reporting extremely long wait times when they call the Amerigroup Helpdesk.

The Amerigroup Helpdesk staff has been made aware of the PDL changes and the process allowed by Iowa Medicaid for pharmacies to use their remaining inventory of Brand Name Drugs. Amerigroup has loaded prior authorizations for their covered members who had prescriptions filled for Brand Name Drugs on the previous PDL at a 30day supply in either October, November, or December of 2019. Therefore, claims should not reject at point of sale for these patients. However, in the chance that a prior authorization was not loaded for a patient meeting the above criteria, or if a patient does not meet the above criteria, pharmacies will have to call the Amerigroup Helpdesk to obtain an override.

Amerigroup to Decrease Reimbursement Rates for DME Products

On December 13, 2019, Amerigroup sent

| The Journal of the Iowa Pharmacy Association

its contracted pharmacies notification that they will be decreasing the reimbursement rate for DME products. Pharmacies are in strong opposition to these drastic rate cuts and have voiced their concern to IPA and Amerigroup. IPA is working to address this issue with Amerigroup and Iowa Medicaid Enterprise as these changes pose a significant concern for patient access to diabetes testing and administration supplies and require pharmacies to make a business decision. Currently, the fee schedule changes will take effect on January 14, 2020. IPA is encouraging providers to reach out to Amerigroup if they object to the new fee schedule. All objections will be reviewed on a case by case basis and a written response will be sent following a thorough analysis. If providers and Amerigroup are unable to agree in writing on a resolution, providers may wish to consult their agreement regarding their other rights.

DHS Proposed Rule Changes - ARC 4763C

The Iowa Department of Human Services published proposed rule changes that would prohibit pharmacies from being paid more than one dispensing fee per thirty-day period for Medicaid patients. Iowa Medicaid claims that this change is due to an observed increase in multiple small fills per month, and thus multiple dispensing fees being paid to pharmacies. IPA has submitted clarification to DHS and IME explaining the scenarios in which pharmacies have to dispense

more than one prescription per thirty day period such as nursing home and long-term care facility prescriptions, compliance packaging for seniors and for patients with a high abuse potential risk, medication synchronization services, oral contraceptives, partial fills on opioid prescriptions, and more. IPA members have engaged in grassroots advocacy with the majority of the Administrative Rules Review Committee members to provide more education on the negative outcomes this rule would create on patients and pharmacies if it were to take effect.

Reminder: Iowa Medicaid’s AAC Rate Review Process

IPA members continue to have claims reimbursed below the State’s Average Actual Acquisition Cost List which is updated by Myers & Stauffer on a weekly basis. IPA wants to keep you informed about the process to submit rate review requests to Iowa Medicaid (IME) and Myers & Stauffer. First, a pharmacy should initially contact their claims processor to ensure the claim was billed correctly and verify the reimbursement methodology for that claim. In many cases, this will be through your pharmacy’s PSAO. Second, if reimbursement was below AAC, contact Myers & Stauffer through one of the multiple options listed on their communication plan, including online options.

PUBLIC AFFAIRS

This process has been in place since AAC was implemented. IPA encourages you to submit rate review requests to ensure that the current AAC calculated is accurate and appropriate. While AAC rates remain relatively stable, IME will make changes in published pricing based on these ongoing requests. ■

An Evening with the Jerry Karbeling Award Recipients

of the University of Iowa experienced an ‘Evening of Jerry’ as they heard stories about Jerry’s impact on legislative advocacy, leadership, and the future of the profession.

The Karbeling Leadership Award was established by the Iowa Pharmacy Association Foundation as a tribute to the leadership and service of the late Jerry Karbeling. The award reflects Jerry’s passion for involvement in professional organizations and the political process by recognizing one Drake University and Pictured L to R: Anthony Pudlo, Casey Ficek, Mohammed one University of Iowa student pharmacist Frederick, Bill Wimmer, Kelli Jo Welter, Tom Temple each year who demonstrate outstanding participation in these areas.

The 2019 recipients, Kelli Jo Welter of Drake University and Mohammed Fredericks

Building Resilience, One Episode at a Time! IPA’s ResilienceRx podcast on the Pharmacy Podcast Network is your prescription for resilience. Hear stories from pharmacy leaders and tips for personal growth and well-being. Subscribe to the Pharmacy Podcast Network at: • www.pharmacypodcast.com • Apple podcasts • Spotify

PUBLIC AFFAIRS

IPA Advocacy in Action Legislator Visits Building towards Session!

Throughout the year, IPA has focused on hosting legislators at pharmacies across the state. Allowing legislators to see first-hand the innovative ways pharmacists serve their patients is crucial in building support for IPA’s advocacy efforts. Thank you to everyone who hosted or met with their legislator over the fall. Although scheduling can be more difficult during session, there’s never a wrong time to reach out and set up a visit! Please contact IPA’s Director of Public Affairs, Casey Ficek, at cficek@iarx.org to get the ball rolling.

Speaker of the Iowa House Pat Grassley visiting Reinbeck Pharmacy

Once the 2020 session begins, make sure to utilize IPA’s tools to stay connected at iarx. org/legresources. Each week, we will keep you updated in the +1 section of the Top 5. You can also find a bill tracker listing all bills IPA is following. If you are interested in taking on a greater role in pharmacy advocacy this year, consider signing up for IPA’s Champion Advocate initiative or reaching out to your elected officials to serve as a resource on pharmacy issues. Finally, watch your inbox for Advocacy Alerts from IPA asking you to take part in grassroots outreach on pharmacy legislation. These alerts will tell you who to contact and what you need to tell them. You, and your relationship with your legislators, are the profession’s most important advocacy asset.

Senate Human Resources Chair Annette Sweeney and Rep. Dave Deyoe visiting Nucara Pharmacy in Nevada, IA.

Senator Joni Ernst and Jeff Olson at Montross Pharmacy in Winterset.

U.S. Senator Elizabeth Warren, Rep. John Forbes, and IPA Executive Fellow Amanda Abdulbaki at the Medicap in Urbandale.

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PUBLIC AFFAIRS

BOARD OF PHARMACY: REGULATORY UPDATE Board of Pharmacy: Regulatory Update

The Iowa Board of Pharmacy convened for open session on Nov. 5 and 6, 2019 to discuss multiple requests, reports and informational items, as well as several proposed rules.

Board of Pharmacy Legislation

The Board discussed and voted to adopt several pieces of legislation for the 2020 Iowa Legislative Session. Three pieces of legislation will be introduced, including: a controlled substance scheduling bill, legislation relating to the prescription drug monitoring program (PMP), and changes to the Iowa Pharmacy Practice Act. If passed, the Board’s PMP bill will require schedule V controlled substances, including when dispensed by a pharmacist without a prescription, to be reported to the PMP. Some of the recommended changes to the practice act included establishing broad statutory authority for collaborative practice in Iowa, allowing for prescription adaptation, expanding Iowa’s emergency dispensing laws, and changed to telepharmacy staffing requirements.

Vote of Adoption on New Regulations

Mandatory Reporter Training The Board approved adoption of rules that reflect the changes made to the Iowa Code during the 2019 Legislative Session relating to training of health care professionals who qualify as mandatory reporters. A licensed pharmacist who qualifies as a mandatory reporter must now complete abuse education solely through the Iowa department of human services’ program. These rules became effective January 8, 2020. Telepharmacy Practice The Board also approved amendments to the telepharmacy rules that include allowing the pharmacist in charge of a managing pharmacy to designate another pharmacist to serve as pharmacist in charge of a telepharmacy site. The changes also allow training of telepharmacy technicians at the managing pharmacy or at another pharmacy which uses the same audiovisual technology system. These changes also became effective January 8, 2020. ■

TUNE-IN TO IPA’S BOP: WHAT, WHY & HOW PODCAST following each Iowa Board of Pharmacy meeting to recap the board’s actions and EARN PHARMACY LAW CE! Each episode will focus on WHAT actions were taken by the Board of Pharmacy, WHY the BOP took the actions it did, and HOW BOP action will impact practice in Iowa.

WWW.IARX.ORG/BOP_PODCAST

JAN.FEB.MAR 2020 |

THANK YOU!

Thank you to all who contributed to the IPPAC or LDF in 2019!

The Iowa Pharmacy Political Action Committee (IPPAC) is a fund used to strategically strengthen relationships with legislators that are supportive of pharmacy interests. The IPPAC is funded by contributions from individual pharmacists, pharmacy technicians, or student pharmacists, as well as member PACs of other organizations.

IPAâ&#x20AC;&#x2122;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 IPAâ&#x20AC;&#x2122;s Legislative Day and Capitol Screenings, contracted lobbyists and external consultants, and IPPAC administration and fundraising costs.

2019 IPPAC Donors

2019 LDF Donors

Michael Andreski Bill Baker Brent Bovy Sharon Cashman Craig Clark Connie Connolly Kyra Corbett Ashley Dohrn Matthew Eide Casey Ficek Steve Firman Ryan Frerichs Robert Greenwood Jennifer James Thomas Johnsrud Candy Jordan Carson Klug Rick Knudson Shane Madsen Erik Maki Gary Maly Kristin Meyer Gary Milavetz Mary Milavetz Michaela Newell Marilyn Osterhaus Matthew Osterhaus

Robert Osterhaus Heather Ourth Wesley Pilkington Matthew Pitlick Shannon Rudolph Kayla Ruiter Susan Shields Angie Spannagel Sonya Thiessen CoraLynn Trewet Stevie Veach Kate Walton Kristin Williams Pat Wilsbacher

Anderson Pharmacy Kenneth Anderson Reinbeck Pharmacy Brent Bovy Daniel Pharmacy John Daniel III Meyer Pharmacy Ryan Frerichs Valley Drug Store Linda Grimm Thompson Dean Drug Gary Maly Evans Crossing Pharmacy Wes Pilkington Rashid Pharmacy, P.L.C. Joseph Rashid Bedford Drug Co. Michael Schweitzer Stangel Pharmacy Inc Aaron Stangel South Side Drug Inc David Voss

Your contributions to either the IPPAC or Legislative Defense Fund aid in advocating for practice advancement, PBM regulation, and other important issues facing our profession.

STRENGTHEN ADVOCACY. STRENGTHEN PHARMACY. For more information or to contribute, visit www.iarx.org/IPPAC

LEGISLATIVE PRIORITIES

2020 LEGISLATIVE PRIORITIES & POLICY POSITIONS The Iowa Pharmacy Association’s Legislative Committee and Board of Trustees have established the following legislative priorities for 2020.

State Legislative Priorities

Increasing Access to Patient Care Services IPA supports increasing access to patient care services through the expansion of pharmacist statewide protocols and collaborative practice agreements. Utilizing pharmacists to perform patient care services can be a valuable tool in addressing significant public health needs. IPA will support increasing access to patient care services through additional pharmacist statewide protocols, broader immunization authority, and expanding collaborative practice agreements. Recognizing Pharmacists as Providers Recognizing pharmacists as equal to other healthcare providers under state law can increase opportunities for pharmacists to receive payment for their services. Decades of research have proven the value of including pharmacists on healthcare teams. Improved health outcomes, lower costs, and increased access to care could be a reality for Iowa residents if pharmacists were fully recognized as patient care providers. While pharmacists already provide patient care services through collaborative practice agreements and statewide protocols, reducing barriers that prevent pharmacists from billing for those services is necessary to create sustainable access to care. Drug Pricing IPA supports oversight that ensures the protection of patients, sustainable reimbursement to pharmacies for pharmaceutical products and pharmacist’s professional services, and assurance that state dollars are being properly managed by pharmacy benefits managers.

IPA is committed to fair PBM practices for Iowans and pharmacy providers. This includes working to lower prescription drug costs and eliminating anti-competitive PBM practices that hurt patient choice and access. IPA will also advocate to ensure Iowa Medicaid continues reimbursing pharmacies in accordance with a sustainable and transparent methodology.

Policy Positions

Medical Cannabis IPA supports an active role for pharmacists in the medication management of cannabis used for legal medical purposes in the state of Iowa. IPA supports the role of pharmacists in educating patients and healthcare professionals on evidence-based use of cannabis-derived products. It is imperative that state law continues to adapt to this changing landscape to ensure standardized labelling, proper documentation in the patient’s medical profile, and oversight of dispensing and pharmacist consultation for patients receiving cannabis-derived products. Opioids IPA continues to support the efforts of lawmakers and stakeholders to address the opioid crisis and encourages the utilization of pharmacists and pharmacies to serve patients in treatment and recovery.

hypodermic needle exchange programs and safe disposal options as part of a comprehensive approach in preventing the spread of infectious diseases. Behavioral Health IPA supports the role of pharmacists in improving access to mental health care services by providing health screenings, triage, and referral. In addition, IPA advocates for the important role of pharmacists in providing comprehensive medication management for mental health conditions to optimize patient outcomes. An unacceptable portion of Iowa’s population suffers from often debilitating behavioral health conditions and complications. As healthcare transitions to a team-based care and value-based payment, pharmacists need to be included as a key provider on a patient’s healthcare team for their high accessibility and expertise in managing behavioral health drug therapy. Medication management, collaborative practice agreements, and statewide protocols provide an opportunity to help pharmacists address this growing problem.

IPA supports engaging pharmacists and their front-line expertise to help prevent the abuse and misuse of prescription opioids. IPA will continue to take every opportunity to offer solutions to the opioid crisis from the pharmacy perspective, including the prescription monitoring program, patient and provider education, and medication assisted treatment. IPA also supports

JAN.FEB.MAR 2020 |

PUBLIC AFFAIRS

RX AND THE LAW CONTROLLED SUBSTANCES

This series, Pharmacy and the Law, is presented by Pharmacists Mutual Insurance Company and your State Pharmacy Association through Pharmacy Marketing Group, Inc., a company dedicated to providing quality products and services to the pharmacy community.

he opioid crisis has brought a lot of attention to the prescribing and dispensing of opioids. This attention has also extended to the prescribing and dispensing of all controlled substances. I recently attended a seminar which contained a number of sessions on opioids and controlled substances. One of these sessions suggested that every pharmacist should read the DEA’s Pharmacist’s Manual. That suggestion caused me to ask myself when was the last time I had read it. One human trait is that we tend to forget details over time and our memory becomes a little less sharp. There have been a number of times when I was sure what a contract provision said, only to go back, read the document, and find that what it stated was slightly different from my memory. This same phenomenon applies to the Pharmacist’s Manual. The manual is about 80 pages, but it is much more readable than the actual statute and regulations.

The speaker at the seminar explained that many pharmacists feel their duty is to make sure that a controlled substance prescription isn’t forged or altered. While that is true, the duty is much broader. For a controlled substance prescription to be valid, it must be issued for a legitimate medical purpose in the usual course of the prescriber’s professional practice. The law does not require a pharmacist to dispense a questionable prescription. The DEA has provided some red flags that may indicate diversion. Those are discussed in 2018 decision and order. Corresponding Responsibility is a topic that requires its own forum so I won’t delve more deeply into it now. The Pharmacist’s Manual contains

| The Journal of the Iowa Pharmacy Association

information on a number of topics. Besides a basic introduction to the Schedules, there is a lot of practical information in the manual. There is a section on the transfer and disposal of controlled substances. This covers transfer to another pharmacy, the original manufacturer, or a reverse distributor. There are numerous reminders to use the triplicate DEA Form 222 to transfer Schedule II substances. Another reason to refresh our memories periodically is that requirements change and if we rely only on our memories, we may not be current. The DEA recently announced the phase out of the triplicate form over the next two years. The DEA Form 222 is also mentioned in the section of the manual on ordering of controlled substances. Topics here include how to order the Form 222, who is authorized to sign the forms, and what to do if the forms are lost or stolen. The manual also contains useful information on what to do when controlled substances are stolen or lost. The DEA must be notified, in writing, within one business day of the discovery of the theft or loss. Completion of the DEA Form 106 in this situation can be made easier by using the biennial inventory and prescription records because you can use these records to determine how much product was stolen or lost. There is also an entire section of recordkeeping requirements. While many pharmacies are using a perpetual inventory system today, that does not replace the required biennial inventories. Physical inventories are required for a new registrant (either opening a new pharmacy or taking over an existing one) and for products that are newly added to a schedule.

Don McGuire, RPh, JD General Counsel, Senior Vice President, Risk Management & Compliance Pharmacists Mutual Companies

The manual also contains helpful information for the review and dispensing of controlled substance prescriptions. It provides what information is required to be on the prescription itself and the information required to be on the prescription label. Partial fill situations are addressed as is the dispensing of controlled substances without a prescription. The record of over the counter sales of controlled substances is required to be kept in a bound record book. These types of sales must be made by a pharmacists and cannot be delegated to a nonpharmacist. While the manual contains a lot of practical information, there are some uncommon provisions also. Sometimes these less common situations are problem-prone because we aren’t as familiar with the situation. Suppose one of your patients has a valid prescription for a C-IV medication and requests that you send a refill to their vacation home in Bermuda. Can you send that refill to a foreign country? Not unless you are registered with the DEA as an exporter and have obtained the necessary permits or submitted the necessary declarations for export. The pharmacist might assume it is permissible to send the refill because there is a valid prescription on file. This is an example where a seemingly reasonable conclusion is incorrect. The periodic review of the DEA’s Pharmacist’s Manual is a good risk

PUBLIC AFFAIRS management tool. During my years of practice, none of my employers recommended or required that I review it. My working knowledge of the DEA regulations was what I drew from my pharmacy law class and any updates that I may have read and retained. Given the scrutiny that is currently being given to the dispensing of controlled substances, an annual review of the Pharmacist’s Manual is an excellent risk management tool to help the pharmacist and pharmacy avoid a potential problem brought on by foggy memory of the requirements. In addition, a review of your state statutes and regulations should also be done because your state may have more restrictive standards which you are required to follow.

This article discusses general principles of law and risk management. It is not intended as legal advice. Pharmacists should consult their own attorneys and insurance companies for specific advice. Pharmacists should be familiar with policies and procedures of their employers and insurance companies, and act accordingly.

PBM UPDATE

Landmark Developments in the Fight Against PBMs Recently, two major developments occurred bringing good news in the fight against detrimental PBM practices. Senate Finance Committee Chairman Chuck Grassley (R-Iowa) and Ranking Member Ron Wyden (D-Ore.) released an updated version of their bipartisan Prescription Drug Pricing Reduction Act of 2019. Included in the updated version is language to stop clawbacks and reform and fix DIR fees. This is a major victory in the fight against PBMs and a testament to all the work IPA members have done to contact Senator Grassley and urge him to include this language. This likely would not have occurred without the grassroots advocacy from IPA and our members. In December, the U.S. Solicitor General Noel Francisco recommended that the Supreme Court hear a case involving Arkansas’s PBM legislation passed in

2015. Francisco agreed with Arkansas Attorney General Leslie Rutledge’s assertion that Eighth Circuit was wrong to strike down the PBM regulations that Arkansas passed in 2015. This is a significant development for Iowa, as the PBM legislation that IPA worked to pass in 2014 was struck down by the Eighth Circuit on the same basis. In early January, the United States Supreme Court met in conference and decided to hear this case (Rutledge v. PCMA). A ruling in favor of Arkansas by the Supreme Court would have a major impact on the ability to regulate PBMs at the state level. The Court will likely hear oral arguments in early spring and could render a decision before the end of June, which marks the end of the Court’s current term. Soon after the time you read this, the Court may have already decided one of the biggest cases in decades for pharmacy.

Advance IPA’s Legislative Agenda by Becoming a Champion Advocate Are you interested in becoming an important partner in helping IPA advance its legislative and regulatory agenda throughout the year? IPA is looking for Champion Advocates across Iowa to build relationships with their elected officials. Help us achieve our goal of having a Champion Advocate in every House and Senate district! Our goal is to have pharmacists establish trust and familiarity with their legislators to keep them aware of the key issues facing pharmacy. As you work to educate our representatives and senators, we can help build their understanding of our concerns regarding patient care and the role of the pharmacist.

By volunteering as a Champion Advocate, you would be kept up to date on the latest information relating to IPA’s advocacy agenda and would be ready to answer the call when IPA needs to make a grassroots push with legislators.

Responsibilities would include:

• Building relationships outside of the legislative session by hosting pharmacy visits with legislators and delivering PAC contributions when needed • Contact legislators during session to explain how pending legislation would affect your pharmacy practice • Relaying your personal experiences to help legislators understand the important role that today’s pharmacists play in enhancing the health care of Iowans • Stay informed with bill tracking/ IPA legislative priorities and participate in bi-weekly update calls

If you are interested in becoming a Champion Advocate or have any questions, contact Casey Ficek, IPA’s director of public affairs, at cficek@ iarx.org or 515-270-0713. Casey can help you identify your senator and representative and get started with setting up a pharmacy visit.

TECHNICIAN CORNER

Technician Members!

To receive the Tech Tidbits newsletter each month, be sure that your email is up-to-date in your member profile on IPA’s website www.iarx.org.

PTCB in 2020 – Education, Training, or Work Experience to be Eligible

With the start of the new year, the Pharmacy Technician Certification Board® (PTCB®) has implemented new eligibility requirements and an updated Pharmacy Technician Certification Exam® (PTCE®) for its Certified Pharmacy Technician (CPhT) Program. The 2020 changes are based on data generated by PTCB’s most recent pharmacy Job Task Analysis, reflecting input from more than 40,000 technicians across practice settings, and guidance from the pharmacy community, including employers, educators, and organizations. Instead of the previous exam’s nine knowledge domains, the new PTCE categorizes knowledge into four domains: medications, federal requirements, patient safety and quality assurance, and order entry and processing.

The 2020 modifications now in effect require aspiring CPhTs to either complete a PTCB-Recognized Education/Training Program or have equivalent work experience before they take the PTCE. More than 1,400 PTCB-recognized programs are now available, including all pharmacy technician programs accredited by the American Society of Health-System Pharmacists/Accreditation Council for Pharmacy Education (ASHP/ ACPE) or by the Accrediting Bureau of Health Education Schools (ABHES), as well as non-accredited programs that comply with PTCB’s curriculum requirements.

The alternate work experience eligibility pathway is available to experienced technicians who are not in a position to enroll in education/training. They must complete at least 500 work hours and fulfill certain knowledge requirements before applying for certification.

Pseudoephedrine Dispensing (From IPA’s October 2019 Tech Tidbits newsletter) The Iowa Board of Pharmacy adopted and filed an amendment to Chapter 10, “Controlled Substances,” and Chapter 100, “Iowa Real-Time Electronic Pseudoephedrine Tracking System,” regarding the authorized dispensers of pseudoephedrine (PSE). Effective November 13, 2019, the new ruling includes pharmacy support persons as authorized dispensers of pseudoephedrine so long as they are under direct supervision by a pharmacist. This change would add to the previous list of pharmacy staff authorized to dispense products containing PSE without a prescription: a licensed Iowa pharmacist, a registered pharmacist-intern or a registered technician – both under the direct supervision of a pharmacist. The actual sale of the product, after the dispenser meets all requirements of dispensing, as described below, may still be delegated to non-pharmacy staff, such as a cashier. This ruling did not change the PSE dispensing requirements, including age and PSE quantity limits. Dispensers of PSE are responsible for verifying that purchasers are 18 years or older and present a valid, government-issued photo ID. A single purchaser is limited to 3,600 mg of PSE per calendar day, and 7,500 mg of PSE per thirty-day period.

• Date and time of purchase • Name and quantity of product purchased • Name or unique identifier of dispenser

OutcomesMTM Announces Top Pharmacy Technicians

This past September was Technician Involvement Month sponsored by OutcomesMTM. This program recognizes pharmacy technicians for their role in successful delivery of MTM services throughout the month. In conjunction with OutcomesMTM, IPA would like to recognize these ‘Top 5’ pharmacy technicians in the state of Iowa during Technician Involvement Month! 1. Jennnifer Luettjohann, CPhT from Bean’s Pharmacy 2. Madison Magedanz, CPhT from Walgreen’s Pharmacy (#11759) 3. Cate Unternahrer, CPhT from Hy-Vee Pharmacy (#1850) 4. Megan Matje, CPhT from Wagner Pharmacy 5. Jody Bockenfeld, CPhT from Hy-Vee Pharmacy (#1396)

IPA recognizes the importance of having highly engaged pharmacy technicians working alongside pharmacists in all practice settings. Thanks for all you do for our profession!

Review of Requirements for Reporting PSE Purchases Each OTC purchase must be reported to PSE tracking system (PTS) and must include: • Purchaser’s name & address • Current, government-issued photo ID number • Electronic signature of purchaser JAN.FEB.MAR 2020 |

TECHNICIAN CORNER

CPhT Recertification CPE for FREE! Join IPA for your FREE subscription to CEI’s Technician Catalog! CEI’s Technician Catalog is a web-based subscription that contains accessible and convenient continuing education courses for technicians to recertify and advance their career path.

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

JOIN NOW & Receive Your Free CPE! www.iarx.org/membership | 515.270.0713 | ipa@iarx.org

NEWLY CERTIFIED IOWA TECHNICIANS October 1, 2019 - December 31, 2019 Congratulations to the following pharmacy technicians on becoming PTCB-certified! Jordan Albert Imithaal Ali Blake Anderson Brooke Anderson Alisha Arendt Stephon Berry Ruth Black Jody Bockenfeld Madison Borden William Christopher Brooks Rachael Castle Megan Clowser Katherine Dencklau-Scheulle Austin Doughty Ahmed Elnour Anna Fleming Nicole Freeman Jill Gerot Salida Gilbert Lauren Gravert

| The Journal of the Iowa Pharmacy Association

Peyton Green Laura Gruenewald Jennifer Guevara Brittani Hickey Emily Hopkins Eva Houchins Ian Jones Samuel Juarez Marroquin Joseph Kaesbauer Theresa Lacina Andrea Malecek Courtney Martin Thomas McNamar Dalia Musa Britney Nguyen Imor Okwaramoi Sanny Ong Analy Phonephakdy Allison Purcell Isaac Ramos

Gina Rassel Ryan Rodriguez David Salas Emma Schaap Alixandra Sears Mena Sewiha Stacy Shellabarger Amber Smith Alyssa Staudt Amber Straw Dawn Teshak-Gimm Tessa Vagasky Leslie Waltz Kristin Willet Deborah Wood Lisa Woodrow Reem Yousif

Specializing in certifying pharmacy technicians because patient safety matters. Choose PTCB. Choose Excellence.

ptcb.org

IPA FOUNDATION

THANK YOU FOR SUPPORTING THE IPA FOUNDATION IN 2019!

The Iowa Pharmacy Foundation sincerely thanks those members who made a contribution to the future of the profession by supporting the efforts of the foundation…these contributions truly make a difference! The following list of contributors is for January 1, 2019 – December 31, 2019.

Platinum Level ($1,000+) Bryan Bailey Tim & Sherry Becker Ashley Branham Sharon Cashman Carl Chalstrom Renae Chesnut Connie & Chris Connolly Jay & Ann Currie Steve Firman Kate & Bob Gainer Bob & Chery Greenwood Tom Halterman Greg Hoyman TJ Johnsrud Rick Knudson Gary Milavetz & Mary Teresi Lisa & Andy Ploehn Anthony Pudlo Diane & Jeff Reist Al Shepley Bob Stessman Ben Urick Gold Level ($500-$999) Bill Baer Bill Baker Sarah Derr Brett Faine Sally Haack Christina Howe Donald E. Letendre Erik Maki Gary Maly Kevin Moores Bob & Ann Osterhaus Nathan Peterson Chuck & Janalyn Phillips Matt & Jamie Pitlick Doug Schara

Pamela Schweitzer Tom Temple CoraLynn Trewet Terry & Sara Wiedenfeld Silver Level ($250-$499) Carol Anderson Ginelle Bryant Cindy Buys Cheryl Clarke Dena Dillon Ashley Dohrn John Forbes Ben Fox Chris Fox Ryan Frerichs Brenda Gates Linda Grimm Manda Johnson Denny Jorgensen Tyson Ketelsen Carson Klug Julie Kuhle Craig Logemann Ed Maier Kristin Meyer Heather Ourth Charles Porter Barry Schneider Susan Shields Amanda West Bronze Level ($100-$249) John Amato Mike Andreski Bri Bakken Lupe Chavez Bill Doucette Colby Dunn Allen Fann Casey Ficek

| The Journal of the Iowa Pharmacy Association

Phil Greazel Tom Greene Daniel Hackett Jim Hoehns Ryan Jacobsen Terry Jacobsen Sandra Johnson Nic Lehman William Lindholm Susan & Gene Lutz Steven Martens Nicolle McClure Alex Mersch Jen Morris Jen Moulton Leman Olson Wes Pilkington Mike Pursel Justin Rash Drew Riesberg Rich Riesberg Karla Ruiter Kayla Sanders Michael Schnackenberg Kathy Stone Cassandra Streeter John Swegle Larry Thomas Tom Truong John Vallandingham Walt Wang JP Webb Pat Wilsbacher Susan Winckler Business Partner Contributors Broadlawns Medical Center Pharmacy Cardinal Health

Drake University College of Pharmacy & Health Sciences Dubuque Area Pharmacy Association Greenwood Pharmacy & Compounding Center GRx Holdings/Medicap Independent Pharmacy Cooperative Johnson County Pharmacy Association Main at Locust Pharmacy Manning Pharmacy McKesson Medicap Pharmacy, Norwalk Network for Good North Iowa Pharmacy Inc NuCara Pharmacies Osterhaus Pharmacy Pharmacy Times Quad Cities Area Pharmacy Association Taylor Pharmacy Towncrest Pharmacy UBS University of Iowa College of Pharmacy VA Central Iowa Pharmacy

SAVE THE DATE! THE EGGLESTONGRANBERG GOLF CLASSIC

New Day! New Month! New Location!

The Eggleston-Granberg Golf Classic provides support to student pharmacists. It brings together student pharmacists, alumni, and friends for a fun-filled day at the golf course with a purpose. All proceeds benefit the IPA Foundation’s support of student pharmacists at Drake University and the University of Iowa. This year it’s moving to the summer! Join us the day before Annual Meeting:

Wednesday, June 17, 2020 Copper Creek Golf Course, Pleasant Hill 9:30 am Shotgun Start

JAN.FEB.MAR 2020 |

READY FOR RAGBRAI 2020 Ride with the IPA Foundation RAGBRAI Team! July 19-25

The Register’s Annual Great Bicycle Ride Across Iowa (RAGBRAI) is scheduled for July19-25, 2020 and the IPA Foundation will be sponsoring a team of cycling pharmacy ambassadors! Now in its 7th year, the IPA Foundation RAGBRAI team connects with Iowa pharmacists and pharmacies along the RAGBRAI route, educates Iowans on the important role of pharmacy, and serves riders with OTC treatments. Any Iowa pharmacist, pharmacy technician or student pharmacist is welcome to ride one day, a few days, or the entire week and spread the word about pharmacy from river to river. Sign up early to guarantee a spot on the team! The team will be limited to 20 full week riders and an additional 10 riders per day. A wait list will be used for additional interested riders. The team will be divided into groups supported by a captain, who will have a list of pharmacies for their group to visit each day along the route.

Not a Cyclist? No Problem!

IPA Foundation RAGBRAI team is more than riders. We need volunteers to help get the team from the Missouri River to the Mississippi River, as well as help with outreach efforts along the RAGBRAI route with screenings and other pharmacy promotions. Donations to support individual riders are also welcomed!

Interested in participating and have questions? Contact Dawn Morse at dmorse@iarx.org or 515-270-0713. The IPA Foundation RAGBRAI team serves as a representative of the pharmacy profession and as such, all riders are expected to conduct themselves in a professional manner during their time with the team.

| The Journal of the Iowa Pharmacy Association

IPA Foundation Team Riders Receive... Full Week Riders receive all benefits of the daily rider, plus: • IPA Foundation Team Bike Jersey (free) • Transportation to the start and from the finish (meet at IPA’s office in Des Moines) • 2 days of laundry service • Indoor accommodation preference with host families (as available) Daily Riders (up to 3 days): • IPA Foundation Team Bike Jersey (discounted rate) • Transportation of gear and supplies • Official registration through RAGBRAI • Official RAGBRAI wristband • Camping with host families or on the RAGBRAI campgrounds (if needed); indoor accommodations when available • Bathroom facilities with host families • Shower access with host families or on the RAGBRAI campgrounds (if needed) • Snacks for each day • Water and coffee available each day • SAG service for half-day riders or tired riders if needed • Electrical charge stations

How to Join the IPA Foundation Team Go to www.iarx.org/RAGBRAI for instructions on how to join the IPA Foundation team.

Important Registration Deadlines: Weekly Riders: Early Bird - Feb. 28; Final - March 31 Daily Riders: Final - May 31

FEES Full Week Rider (20 max)

Early (by 2/28)

Late (by 3/31)

Pharmacist Member

$800

$1,000

Technician/Student Member $450

$600

Non-IPA Members (includes spouse & children)

$1,200

Daily Rider (max 3 days)

$1,000

(by 5/31) $125/day

STUDENT PHARMACISTS: APPLY TODAY!

Bill Burke Student Pharmacist Leadership Conference October 2-4, 2020 Application Deadline - May 1, 2020

The Bill Burke Student Pharmacist Leadership Conference is scheduled for October 2-4, 2020, in St. Charles, Iowa at the Wildwood Hills Ranch. The conference will provide student pharmacists with additional opportunities for networking and learning. The Bill Burke Student Leadership Conference aims to: • Instill quality organizational leadership skills

The Max W. Eggleston Executive Internship in Association Management Application Deadline – March 1, 2020

The Max W. Eggleston Executive Internship in Association Management is a 12-week program held each year during the summer months in the IPA offices in Des Moines. During the internship experience, the intern will receive educational instruction in each of the association’s divisions as follows: • Public Affairs and Business Development

• Increase awareness of issues impacting the profession of pharmacy

• Professional and Educational Affairs

• Encourage development of leadership skills and involvement in professional and community activities

• Membership Development

• Recognize pharmacy students who have displayed leadership potential • Improve communication and teamwork skills

To Apply

Current P1 through P3 student pharmacists from Drake University and the University of Iowa can go to www.iarx.org/BillBurke for for more information or to complete an application before May 1, 2020.

• Organizational and Administrative Affairs • Communications and Marketing • Foundation and Charitable Giving The ideal candidate is an IPA student pharmacist member currently in their second year of pharmacy school.

To Apply

Applicants should submit their online application at www.iarx.org/ExecIntern along with a current resume and writing sample to Anthony Pudlo at apudlo@iarx.org by March 1, 2020. For more information, please review the IPA website or contact IPA at 515-270-0713.

The Bill Burke Student Pharmacist Leadership Conference and the Max W. Eggleston Executive Internship in Association Management are supported by the Iowa Pharmacy Association Foundation as part of its mission to support student pharmacists and leadership development within the pharmacy profession in Iowa.

JAN.FEB.MAR 2020 |

MEMBERS SECTION

IPA MEMBER SPOTLIGHT:

Randi Beranek, PharmD Iowa River Landing Clinic

Written by:

Drew Dieckmann PharmD Candidate Class of 2020 St. Louis College of Pharmacy

ike many pharmacists, Randi Beranek’s path to pharmacy was not one without curves or turns. Interested in medicine since childhood, she believed that her calling in life was to be a pediatrician. However, this would change after she had the opportunity to shadow a pharmacist, Anne Sayre, at Long Drug in Monticello her junior year of high school. It was there where she discovered her passion for pharmacy and the merging of patient interactions with a focus on medications and their use. She attended the University of Iowa and graduated from the University of Iowa College of Pharmacy in 2010. During her summers, she worked as an intern at the independent pharmacy, Solon Drug, in Solon, Iowa. Following graduation, Randi completed a PGY1 Pharmacy Practice residency at the University of Iowa Hospitals and Clinics. Currently, Randi works for the University of Iowa Healthcare’s Iowa River Landing Clinic within the Internal Medicine Clinic, where she and her colleagues take part in three pharmacist-run services; Anticoagulation Clinic, Pharmacotherapy Clinic, and PreExposure Prophylaxis (PrEP) Clinic.

| The Journal of the Iowa Pharmacy Association

The majority of her time is spent between the Anticoagulation Clinic, which aims to provide education and continuity of care for individuals on warfarin, and the Pharmacotherapy Clinic, which involves the management of chronic disease states such as hypertension and diabetes. The Pharmacotherapy Clinic recently began educating patients on proper use and interpretation of continuous glucose monitoring systems and soon will expand its services to include the management of weight loss medications. Her role as pharmacist is very versatile, and, outside of the pharmacist-run services, also involves assisting medical residents in identifying high-risk patients who would benefit from a medication review, performing counseling on new medications, finding lower cost alternatives to expensive medications, and being a great resource of drug information to the providers in the clinic. Her role and expertise also allow her to spend one day every week working alongside a pediatric endocrinologist to see a variety of patients for evaluation of growth, adrenal disorders, hypo or hyperthyroidism, and other endocrinopathies. Randi loves the impact she is able to make in her patients’ daily lives and the interactions she is able to have with her patients. She says the most rewarding part of her position is through the relationships built with the patient, and “Getting to know my patients to the point that they are eager to share aspects of their lives with me, outside of our patient/ provider relationship.” Of course, these relationships are also what can make her position difficult at times, as it can make it very challenging to lose a patient she has worked so closely with over the years.

Professionally, Randi is an active member of the Iowa Pharmacy Association (IPA) and was a previous member and office holder in the Johnson County Pharmacy Association. She deeply stresses the importance of being involved. When asked how IPA members can prepare for, and be an instrument of change, Randi emphasizes, “being actively involved in IPA and attending meetings, webinars, and serving on committees to stay abreast of changes on the horizon.” Randi’s advice for upcoming students mirrors her advice to IPA members to get involved in organizations. We must be the advocates for our profession and the best way to do that is to get involved in organizations and dedicate your time and ideas working toward advancing pharmacy into its next stage. She also stresses the importance of taking advantage of as many opportunities as possible available to students, as this is one of the best ways to grow and learn more about different areas of the profession. She recommends that students “step outside of your comfort zone and experience areas of pharmacy that you aren’t familiar with.” It is only then that we can better understand our role as pharmacists and the potential we have to impact the healthcare system as a whole. Outside of pharmacy, Randi enjoys photography and taking photos of her friends and family, especially her kids Levi (5) and Evelyn (2). Although most of her photography is done digitally, she plans to explore film photography as well, and has even began attending photography conferences, including one this coming April in Phoenix. She is also involved in her community, volunteering in projects with the

MEMBERS SECTION

Johnson County Domestic Violence Intervention Program. Looking to the future, Randi’s goals for herself and her site are to better streamline time spent with the Internal Medicine resident team. Due to the large number of providers and only one available pharmacist, Randi and her colleagues hope to develop a process to integrate into the workflow that allows them to identify and prioritize patients to be seen by the pharmacists to maximize their efforts and impact. Long term, Randi states “our goal is to create a model that can be replicated in other provider clinics, allowing more pharmacists to practice as integral members of the healthcare teams, improving patient care overall.” Her advice to other pharmacy professionals as to how to they can “Make it Happen” at their sites is to seek out leadership roles in the development and generation of new clinical services. The landscape of community and outpatient pharmacy has undergone many changes in recent years and will continue to do so. Advancing technician roles and enhanced focus on clinical services rather than dispensing is freeing up more time for the pharmacist and we must take advantage of this. As pharmacists, we are in a unique position that allows us to offer insight into both the clinical and logistical opportunities and challenges that new services can create. Randi suggests that, “if we leverage that position to our advantage, and become the drivers for new clinical services, we can create opportunities for advancement for ourselves, our practice sites, and the profession.” ■

WELCOME NEW IPA MEMBERS! OCTOBER 1, 2019 - DECEMBER 31, 2019 Tahani Abdallah Afaf Abdulbaki Jyoti Adhikari Richarda Agyemang Abdullah Alhumood Kay Allen Ashgan Alshawy Asmaa Alzhrani Kelly Andersen Caitlin Anderson Jessica Anderson Mina Arnaut Keitasha Arnold Kayla Bennett Gloria Bernstein Maddy Berstler Elyass Bin Alsheikh Clarissa Blick Cara Braverman Keirstin Broadway Lynn Bui Tiffany Bui Cassie Burrs Collins Ellen Carlson Jordan Cervantes Alice Chang Elise Chang Michaela Chapman Connor Clark Riley Clark Hannah Clausen Susannah Cole Verna Conklin Reumina Cufurovic Katheryn Currie Nguyen Dang Sydney Day Jacob DeCleene James DeSchinckel Hoyt DeVolder Molly Dieujuste Lisa Ding Lucas Dinh Sondra Donald Will Dunscombe Kimberly Dykstra Hanna Ebel Courtney Engevold Emma Erner Lucy Ernst Kaitlin Ferguson Brock Fischer

Kelsey Floerchinger Allison Folin Tyler Forer Brenda Formanek Elena Foulke Fev Foxe Tanner Frey Emily Gajda Dylan Gao Nikko Garza Molly Gavin Erin Green Manar Habiballa Nicole Hanna Lakyn Hanson Sanya Hassan Keaton Higgins Taylor Hoefer Brandon Holdgrafer Michelle Holm Claire Holtz Jasmine Howell Trinh Huynh Shiela Jeppesen Caitlyn Jerkins Heather Johnson Travis Johnston Jennifer Johnston Melissa Kappelman Heather Ketcham Victoria Killian Chan Woo Kim Jeong Ah Kim Yury Kim Leah Kinney Kelsey Kiwala Amber Kobliska Morgan Koenen Laura LaFayette Travis Larson Alyssa Leavens Joshua Lechner Emily Leerar Lynndah Long MacKenzie Male Hilary Martinez Brooklyn McCuddin Justin McKee Dianna Meade Nathan Merten Ben Meyer Michels-Cordao Milagro

Madison Miller Michelle Moon Gabbie Morrow Trey Mueller Kaitlyn Mulder Steve Nguyen Thao Nguyen James Novak Sam Omen Kirstin Pacetti Ashlyn Paillon Jalak Patel Nadia Phouphommakhith Catherine Ponto Rebekka Rantanen Ramya Ravi Taylor Roder Jose Rodriguez Sandra Roozenboom Anna Ruby-Trzeciak Kimberly Salazar Morales Komel Shahid Michelle Slezak Esther Soh Kari Starbeck Emily Steimel Katy Stephens Mena Sweiha Ayah Taha Miah Thompson Audrey Tinkey Annie Tram Hailey Tweden Alison Urbanski Hannah Van Emily VanOtterloo Kamyla Vargas-Freytes Albert Vincent Jack Voller Tian Wang Serena Webb Alyssa Weber Nicole Wendel Julie White Ara Wiese Lake Williams Rony Wright Allyssa Yahnke Amanda Zehnle Muris Zenelji Infocus Pharmacy Services

JAN.FEB.MAR 2020 |

ITâ&#x20AC;&#x2122;S TIME TO... ENGAGE

CONNECT

ENERGIZE

ADVANCE

...RENEW! Renew your membership today and continue to receive important benefits like FREE CPE and join us as we build on our 2020 momentum to advance practice, including Provider Status in Iowa. Exciting things are happening in Iowa pharmacy! Renew your membership to be a part of it!

RENEW BY LOGGING IN AT WWW.IARX.ORG

IPA memberships expire on December 31, 2020

MEMBERS SECTION

MEMBER MILESTONES Congratulations to Micaela Maeyaert, PharmD, BCPS, BCGP on being selected as the new Director of Pharmacy at Spencer Hospital!

Congratulations to Amanda West, CPhT, CSPT as she begins in her role as 340B Compliance Analyst at Health Enterprises in Cedar Rapids!

Congratulations to Nick Lund, PharmD as he becomes the new Pharmacy Manager at NuCara Pharmacy in Nevada!

Congratulations to Brandon Gerleman, PharmD, GxRPh as he starts in his new role as Clinical Pharmacist at OutcomesMTM!

Congratulations to Renae Chesnut, EdD, MBA, RPh for her election to chair-elect of the American Association of Colleges of Pharmacy (AACP) Council of Deans!

Congratulations to Sharon Cashman, RPh on her retirement from Waverly Health Center in Waverly! Congratulations to Gary Christensen, PharmD on his election to the Saydel school board!

IPA MEMBER BENEFIT Have You Accessed Your FREE Continuing Education Beneﬁts Yet? WWW.IARX.ORG/ACCESSCPE

You know life-long learning is important to being the best pharmacist you can be. But you’re so busy with work and life that fitting it in is hard. CEImpact Subscriptions bring the learning to you and help you make learning a habit. Personalize your subscription to our regularly scheduled releases, engage in our learning community, and before you know you it, you’re connecting learning to your practice, meeting your re-licensure or re-certification requirements, and being the best IPA member, you can be! Follow the instructions provided via email to Activate your CEImpact subscription! Pharmacist Subscription This subscription meets all state re-licensure requirements for CPE on a yearly basis including an annual immunization update, pharmacy law and patient safety topics, clinical and professional discussions, & more! • New On-Demand Course released every month • Live Journal Club discussion the 2nd Wednesday of every month • In addition, best practices, resources, faculty Q&A, podcasts, and a learning network provide additional discussion & learning on the monthly topics

Pharmacy Technician Subscription This subscription meets re-certification requirements for both PTCB and ExCPT on a yearly basis including pharmacy law and patient safety topics, immunization update, clinical and professional discussions, & more! • New On-Demand Course released every month • In addition, best practices, resources, faculty Q&A, podcasts, and a learning network provide additional discussion & learning on the monthly topics

JAN.FEB.MAR 2020 |

IPA IN ACTION APhA-ASP Midyear Regional Meeting Comes to Coralville The University of Iowa APhA-ASP Chapter hosted the Midyear Regional Meeting (MRM) for Region 5 in Coralville on November 1-3. This year MRM brought together nearly 200 student pharmacists from across the midwest. The programming of this year’s meeting included professional education on contemporary issues, career information, leadership development, and networking opportunities. In addition to participating in the exhibit hall, IPA staff provided insight to the attendees on the value of advocacy and the policy making process.

ASHP Midyear Clinical Meeting

IPA attended the ASHP Midyear Clinical Meeting from December 8-12 in Las Vegas. For the opening session, former Secretary of State Condoleezza Rice was the keynote speaker and shared some of her lessons in leadership and critical decision making, which are skills that pharmacy professionals engage in regularly as healthcare providers. IPA attended meetings with other state association executives and discussed how ASHP can help its state affiliates meet their goals through resource sharing in the areas of practice advancement, advocacy, and association management. IPA met with students, alumni and practitioners from Iowa at the residency showcase, poster sessions, and throughout the conference. The Iowa Reception held on Monday evening was sponsored by Drake University, The University of Iowa, and IPA, had an amazing turnout with over 250 attendees!

Updating the Diabetes Statewide Strategy

As part of an ongoing effort to address the rising incidence of diabetes in the state, key public health stakeholders, including representatives from IPA, convened on October 9, 2019 to update the current statewide strategy on diabetes. With a mission to improve diabetes care and outcomes in Iowa, the statewide strategy will continue to address issues related to primary prevention, detection, management and treatment, and data collection. The role of the pharmacist has been highlighted in numerous areas of the currently drafted strategy. As the strategy is finalized, IPA will work to inform the membership about mechanisms to insert your practice into the strategy.

of HIV, STD and Hepatitis. This two-day technical assistance meeting was a great opportunity for partners around the state to gather, share and receive updates about HIV, STDs and Hepatitis in Iowa. After a full day of information sharing, various small groups, including a pharmacy affinity group were provided an opportunity to dive further into important topics. Topics of discussions included: education around nPEP, PrEP and U=U, better utilization of pharmacy staff in carrying out vaccines and sexual health education, statewide protocols for PrEP, and how pharmacists can incorporation mental health education when treating patients living with HIV. The final day of the conference provided an opportunity for various skills building, including a Mental Health First Aid training delivered by IPA staff.

Iowa Hospital Association Annual Meeting

This year the Iowa Hospital Association (IHA) held its Annual Meeting on October 8-10 in Des Moines. With collaboration from IPA, IHA hosted a pharmacy-specific track with pharmacist CPE credit available on the first day of this 3-day meeting. There were 75+ attendees in the pharmacy track that heard topics that ranged from the prescription drug monitoring program (PDMP) to the e-prescribing mandate to pain management services. IPA will continue to work with IHA to continue to collaborate on programming to meet the needs of each association.

IPA Attends IPHA Legislative Forum

On December 6, Casey Ficek and Amanda Abdulbaki from the IPA staff attended the Iowa Public Health Association’s Legislative Forum on behalf of IPA. The forum brought together interested stakeholders and legislators to discuss Iowa’s pressing public health issues prior to the 2020 legislative session. Major topics of discussion included improving behavioral health access and educating legislators and the public on the benefits of vaccination. The forum was capped off by a legislative panel that included Senator Joe Bolkcom, Representative Mike Bergan, and Representative John Forbes.

NAMI of Iowa: Annual Conference Highlights Integrated Care Models

The Iowa chapter for the National Alliance on Mental Illness (NAMI) held their Annual Conference on November 15, 2019. IPA represented the profession at this year’s meeting to spotlight the valuable behavioral health services that pharmacists provide across practice settings in Iowa. Attendees heard presentations on avoiding burnout to remain effective in our effects to address mental health inadequacies in the state. The attendees were able to have active dialogue with a panel of law enforcement officials on how to work together to address people suffering from mental illness.

Pharmacist Roles in STD Prevention Discussed at IDPH Meeting

On October 15-16, IPA attended the Iowa Department of Public Health’s Technological Assistance Meeting hosted by the Bureau JAN.FEB.MAR 2020 |

IPA IN ACTION Reframe, Refocus, and Rebuild – Rural Health Conference

IPA attended the joint conference of the Iowa Rural Health Association and Midwest Rural Agricultural Safety and Health in Marshalltown on November 13-14. This year’s conference highlighted the importance of community preparedness when dealing with emergencies and natural disasters.

CALENDAR OF EVENTS

Find additional details to these events and more at www.iarx. org. Click on the “Calender of Events” link under the Events tab.

A keynote panel gave great insights about challenges faced by farmers and rural communities when responding to disasters. Elayne Saejung, Director of Emergency Management for the University of Nebraska Medical Center (UNMC), discussed the impact the flood of 2019 on their organization and shared how their emergency plan was implemented across the entire state. The panelists reminded the audience that the impact of a natural disaster is often measured by numbers of buildings destroyed or the cost of clean-up, but the mental health impact of these events is something that is often overlooked.

MARCH 2020

One the breakout sessions focused on the current state of telehealth. As telehealth continues to grow and is becoming an expected aspect of healthcare services, the session discussed how a focus on chronic care management using remote patient monitoring in rural communities in Iowa can have a positive impact on health outcomes.

25-28 NACDS Annual Meeting Scottsdale, AZ

The Sun Shines on NCPA Annual Convention

The NCPA Annual Convention was held in San Diego from October 26-29. The theme of this convention was ‘Changing the Pharmacy Payment Model.’ Programming included business education for pharmacy owners and leaders to optimize critical performance indicators for their business with guidance related to contracting, cash flow management, marketing strategies, and audit mitigation. Attendees also benefited from topics on streamlining workflow and expanding opportunities such as pharmacogenomics services, care planning, medication synchronization targeting strategies, employer group partnerships, medical care for home-bound patients, medical billing and credentialing, merchandising tips, updates on hempbased product laws and regulations, and team culture and staff utilization. Iowa pharmacists and student pharmacists were on full display as they were honored with such awards as the NARD Ownership Award (to Randy McDonough of Towncrest Pharmacy) and the Next Generation/Pharmacy Times “Future Pharmacist” of the Year (to Drake Reiter, P4 from Drake University).

| The Journal of the Iowa Pharmacy Association

20-23 APhA Annual Meeting Washington, DC

APRIL 2020 7-8

Iowa Governor’s Conference on Public Health Des Moines, IA

CEImpact Immunization Training

Des Moines, IA

APhA’s Pharmacy-Based Immunization Delivery Kansas City, MO

RALI Iowa Luncheon Showcases the Role of Pharmacy in the Opioid Crisis On December 3, 2019, IPA attended and presented at the Rx Abuse Leadership Institute (RALI) Iowa Luncheon in Clive. The event was sponsored by the Clive Community Health and Wellness Initiative in order to bring together local, state and national organizations to take steps to address the opioid epidemic in Iowa. The luncheon programming featured the CEO of UCS Healthcare Jennifer Pearson, City of Clive Mayor Scott Cirksena, RALI National Policy Director Candace S. DeMatteis, and Iowa Senator Charles Schneider. IPA’s VP of Professional Affairs, Anthony Pudlo, presented on pharmacists’ role in combating the opioid crisis and highlighted some of IPA’s efforts and partnerships in this initiative. Olivia Welter, student pharmacist at Drake University and past IPA Executive Intern, also presented on the Drake APhA-ASP Chapter’s efforts through GenerationRx to promote safe medication use awareness to children and teens. IPA will continue to work along with RALI Iowa and other stakeholders to help promote safe medication use to address the opioid crisis.

IPA Presents on TPV at McKesson Event

On October 23, 2019, IPA and CEImpact provided a presentation to an engaging crowd of McKesson technology and implementation stakeholders in Pittsburgh, PA. The presentation focused on the 10+ years of work of the IPA New Practice Model Task Force as technician product verification was tested and researched across 17 community-based pharmacies. The attendees discussed the benefits of evolving the role of the pharmacy technician to be an operations leader through ongoing professional development.

PHARMACY TIME CAPSULE

19 99 97

Issues&&events eventsthat thathave haveshaped shapedIowa Iowa Issues pharmacy(or (orare arefun funto toremember!) remember!) pharmacy

JANUARY:

JANUARY: The Iowa Board of Pharmacy approved the first guidelines for collaborative The Iowa Board of (CPA) Pharmacy announces “secret shoppers” program to enforce patient counseling and pro-DUR regulations . practice agreements among pharmacists with a prescribing practitioner or a group of prescribing practitioners for the purpose of drug The formal establishment of theCPA’s new professional organization for pharmacy in Iowa occurred . On January 1st, Iowa Society therapy management of patients. gave pharmacists the authority of of Health-System Pharmacists and the Iowa Pharmacy Association were unified to represent all pharmacists, pharmacy medication implementation, modification, and management of therapy students, and pharmacy technicians in Iowa . via agreement terms, evaluating patient drug histories, conducting clinical assessments, ordering and evaluating lab results, and many more! This The Healthy andto Well Kids in Iowaa(HAWK-I) program began on January 1st which provided coverage for children age 18 and allowed for duties be done within pharmacist’s scope of practice as GlaxoWel younger who did not qualify for Medicaid but were at 185% of the federal poverty level . agreed upon with the prescribing physician(s). lcome MARCH: MARCH:

Jordan as the newDay deanwas of the Iowa College The 19th Cohen annual began Iowa Legislative heldUniversity on Marchof5th, 1997, and of Pharmacy on March 1st succeeding Gilbert Banker . Cohen was previously dean of the University of Kentucky College of addressed key issues such as seeking the enactment of legislation that Pharmacy . would establish a pharmaceutical assistance program for the elderly, Governor Tom Vilsack thepharmacy keynote speaker at IPA Legislative Day on March 3rd . His speech focused on the importance of establishing a program towas assist personnel whose competence quality health care to attract future Iowans . might be impaired due to chemical abuse/dependence, and modifying the requirements of a prescription to include information regarding the The Remington Medal was awarded in to order Carl Franklin Emswiller, Jr . ofdrug Leesburg, Virginia during APhA annual meeting in San purpose of the prescribed medication to facilitate pharmacist Antonio, Texas on March 7th . utilization review. Also, Dr. Linda Strand from the University of Minnesota Max W. Eggleston received the Remington Medal from APhA for her lecture titled, “ReRepresentative and Iowa visioning the profession. ” Pharmacist, Robert Osterhaus, received the Hubert H . Humphrey Award from APhA on March 8th which recognizes a pharmacist for distinguished public service as an elected or appointment government official .

MAY:

conference is designed to provide an unequaled opportunity APRIL: Glaxo Wellcome provided the Iowa Pharmacists Association for speakers pharmacists theiron first ten years of practice to develop IPhA held its educational 93rd annualgrant convention . Thisa convention hosted several whoinspoke topics ranging from “Better with a $30,000 to support two-year series leadership skills which will enable both personal and between chain and independent pharmacy to “Legal and Public Health Aspects of Rx Price ofPharmacy leadershipCommunication” conferences for the Association’s governing professional growth. Posting and Discount Advertising Practices” . boards. This allowed IPA to bring together a variety of speakers to enhance the level of awareness of key issues SEPTEMBER: affecting MAY: the profession of pharmacy. The Public Health Training Network hosted a live interactive Certification in Geriatric Pharmacy established by CCGP satellite broadcast to provide healthcare workers with the JUNE: most current information available in the constantly and changing IPA hosted a conference foraward Iowa Hospital System Pharmacy Directors to discuss issues facing practitioners Dr. Max D. Ray was the 1997 recipientand for Health the Harvey field of immunizations. developLecture. ways toDr. advance pharmacy practice . A.consequently K. Whitney Award Ray was a professor of Pharmacy Practice and Director of the Center for Pharmacy The FDA added and “pharmacist” to Over-the-Counter Medication labeling as in “Ask your doctor or pharmacist .” NOVEMBER: Practice Research Development at the Western University Max W. Eggleston passes away after a long battle with cancer. of Health Sciences in Pomona, California. His lecture On November 10, of a pharmacy stamp wasbasis issued Ohio to honor the 120th anniversary the American Eggleston was a past president of IPA andof a founding director consisted of a series letters andpostage responses on the ofin Cincinnati, Pharmaceutical Association . The stamp pictured a Bowl of Hygeia, that was associated with the American Pharmaceutical of the Iowa Pharmacy Foundation and Pharmacy Network of pharmacy practice ideals. Association, and a Mortar and Pestle, associated with the National Association of Retail Iowa (PNI, Inc.). He Druggists . was a strong supporter of the University of Iowa and the University of Iowa College of Pharmacy, JULY: where he held many leadership titles. He also served as a past Thirty pharmacists from Iowa, Illinois, and Wisconsin were president of the American Pharmaceutical Association from selected to attend Leadership Pharmacy 1997, a Tri-State 1968 – 1969. Young Pharmacists Leadership Conference. This The Iowa Pharmacy Association Foundation is committed to the preservation of the rich heritage of pharmacy practice in Iowa. By honoring andisremembering we are reminded of the strongoftradition The Iowa Pharmacy Association Foundation committed tothe thepast, preservation of the rich heritage we have topractice build upon for aBy prosperous for the profession. pharmacy in Iowa . honoringfuture and remembering the past, we are reminded of the strong tradition we have to build upon for a prosperous future for the profession .

JAN.FEB.MAR 2020 | JUL.AUG.SEP 2019 |

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