Iowa Pharmacy News

Healthcare-Associated Infection & Antibiotic Resistance (HAI & AR) Advisory Group Convenes In January 1998, the Iowa Antibiotic Resistance Task Force was first convened by the Iowa Department of Public Health to address the development of bacterial resistance to antibiotics in Iowa. The purpose of this task force was threefold: to evaluate and monitor the prevalence of resistance in Iowa, to monitor the status of the problem, and to develop strategies to diminish the risk to the population of Iowa. The goals of the Iowa Antibiotic Resistance Task Force were to facilitate the appropriate use of antibiotics, discourage prescribing practices that promote the development of antibiotic resistance and decrease the spread of antibioticresistant organisms with appropriate prevention and control measures. This group met consistently for over a decade and authored a statewide report providing antibiotic resistance information and guidance.

In September 2009, a Healthcare-Associated Infections advisory committee was formed to develop a statewide plan to perform surveillance on healthcareassociated infections and to determine best practices to reduce and prevent HAIs in Iowa. Then the Council of State Territorial Epidemiologist issued a policy statement recommending that all state health departments evaluate and incorporate stewardship activities into their Healthcare-Associated Infection programs. This led to the Iowa Department of Public Health’s decision to combine the Iowa Healthcare Associated Infection Advisory Group and the Iowa Antimicrobial Resistance Task Force.

In late 2019, IPA was invited to participate in the newly formed Healthcare-Associated Infection & Antibiotic Resistance (HAI & AR) Advisory Group. Stakeholders throughout the healthcare, public health, and animal health fields were invited to participate in the HAI & AR Advisory Group. The goals of the HAI & AR Advisory Group are to: • Promote awareness of ongoing HAI & AR prevention and education efforts occurring throughout Iowa. • Identify additional HAI & AR gaps that public health and/or stakeholders can fill. • Serve as a forum of stakeholders that are doing work in the HAI & AR arena in Iowa that IDPH can share ideas with and consult as relevant issues arise.

The HAI & AR Advisory group met on January 28, 2020, and will plan to meet at least one additional time per year via teleconference. The group discussed many topics, including: Carbapenem-Resistant Enterobactoraceae investigation procedures and cases, Candida auris reporting mandate and screening recommendations, Infection Control Assessment and Response (ICAR) efforts in Iowa, and education for Iowa Infection Prevention Professionals in hospitals and long-term care facilities. IPA described mechanisms that pharmacists across the state identify accurate medication allergies to ensure appropriate antibiotic selection and treatment regimens. CMS Feedback on Scope of Practice In January, IPA submitted formal comments to the Centers for Medicare & Medicaid Services (CMS) on its request for feedback on scope of practice. The request by CMS was in response to President Trump’s Executive Order (EO) on Protecting and Improving Medicare for Our Nation’s Seniors, which required Medicare to examine regulatory barriers that are preventing healthcare practitioners from practicing at the top of their license. Many IPA members also submitted comments highlighting the important role that pharmacists play in patient care and outcomes when integrated into the health care team. IPA Staff Changes Welcome IPA’s new Director of Communications & Digital Engagement, Allison Hale!

Allison is a recent graduate of the University of Northern Iowa with a B.A. in Interactive Digital Studies. She is passionate about print design, social media marketing, and web development and is extremely excited to join the IPA team. For the previous two years, she worked in the communications field in the non-profit sector. In her free time, she enjoys photography, hiking, traveling, and spending time with friends and family.

As Director of Communications & Digital Engagement, Allison will be responsible for implementing a new marketing automation software for IPA, continuously updating IPA’s social media channels, and creating print material for IPA’s annual events. She has many great ideas to improve upon IPA’s current communications strategy. SCOTUS Set to Hear Arkansas PBM Case In January, the US Supreme Court announced it will hear a case in the coming months that could have a major impact on determining whether states have the right to regulate pharmacy benefit managers (PBMs). The case, Rutledge v. PCMA, concerns a challenge to an Arkansas law seeking to bring stricter regulatory control over PBM practices. As of now, the Supreme Court is still scheduled to hear oral arguments on April 27th. However, all hearings scheduled for March have been postponed, which could affect the rest of the Court calendar.

VAWD-Accredited Wholesalers in Iowa With the recent Iowa Board of Pharmacy regulations that took effect, requiring wholesalers to have VAWD accreditation through the National Association of Boards of Pharmacy (NABP), many hospitals and pharmacies are asking who are the VAWD Accredited Wholesalers.

You can search on NABP’s website for all VAWDaccredited wholesalers. This is a good practice to verify if your current primary and secondary wholesalers are in compliance. However, this NABP website doesn’t help you to know who is registered in Iowa as a wholesaler. The BOP’s website only allows you to verify if a specific wholesaler is currently licensed in Iowa.

The Iowa BOP is willing to assist pharmacies in locating wholesalers who are both licensed in Iowa and VAWD accredited by providing a list upon request. Please contact Amanda Woltz at amanda.woltz@iowa.gov to request this current list. Expedited Partner Therapy – Resources Available On March 18, 2020, new Board of Pharmacy regulations took effect that allow a pharmacist to dispense a non-patient-specific prescription for the purpose of expedited partner therapy (EPT) to treat sexually transmitted infections (STIs), chlamydia or gonorrhea, in an unnamed partner or partners. EPT is the clinical practice of treating the sex partners of patients diagnosed with STIs by providing medications to the patient to take to his/her partner without the healthcare provider first examining the partner.

While IPA offered a 2/2/2 webinar on February 11, 2020 regarding this rule change, IPA continues to work with the Iowa Department of Public Health to offer additional resources for your practice setting as you communicate with patients and other providers. A specific webpage of these resources s now available on IPA website. Visit www.iarx.org/EPT. Immunization Stakeholder Meeting On March 2, 2020, the Iowa Immunizes coalition convened at the IPA Headquarters. The coalition is supported by the Iowa Public Health Association and is comprised of multidisciplinary partners and stakeholders, including IPA, the colleges of pharmacy, Iowa Medical Society, American Academy of Pediatrics, Iowa School Nurse Organization, Iowa Hospital Association, Alliance for Patient Access, Telligen, UnityPoint Health, University of Iowa Health Care, Blank Children’s Hospital, Iowa Department of Public Health, and several others. The alliance discussed the goals and direction of the newly formed coalition, strategies to expand upon life course immunization advocacy efforts, and how county immunization rates provided by IDPH can assist with delivering targeted education in the areas that need it most. Mandatory Reporter Changes - Trainings Available With the newly effective (1/8/2020) Board of Pharmacy regulations that were updated on mandatory training for identifying and reporting abuse, pharmacists that determine themselves to qualify as mandatory reporters must use DHS-approved mandatory reporter trainings only. The Iowa Code defines this qualification for every health practitioner who, in the scope of professional practice, examines, attends, or treats a child and who reasonably believes the child has been abused.

To learn more and to access free mandatory reporter training from Iowa DHS, visit https://training.hs.iastate. edu/login/index.php. Medicaid Updated Q&A on Provider Status On February 20, 2020, Iowa Medicaid Enterprise (IME) released Informational Letter (IL) No. 2105-MC-FFS updating information on the process for pharmacists to be recognized and listed as a new provider in Medicaid, effective July 1, 2020. This recognition is in direct response to legislation that passed in 2018 creating pharmacist statewide protocols for immunizations, naloxone, and nicotine replacement therapy.

This IL provides additional details on the enrollment process and answers some questions that IPA members have asked. It includes a FAQ section answering general questions, managed care organization enrollment, pharmacist affiliation details, and continuing education requirements. IPA will continue to work with IME to ensure this is a smooth process for pharmacists. For more information on pharmacists enrolling as providers within Iowa Medicaid, you can review the recent feature within the 2020 Jan/Feb/March edition of The Journal of the IPA. RALI Lecture On March 4, 2020 in partnership with RALI Iowa, IPA presented on the pharmacists’ role in fighting the opioid crisis at the Iowa State Grange in Kellogg, Iowa. Among those in attendance were Representative Wes Breckenridge and Jasper County Lt. Aaron Groves. Attendees were informed of the importance of safe medication practices to help prevent misuse. IPA presented on how pharmacists in Iowa are helping prevent opioid misuse through patient counseling and education, utilization of the prescription drug monitoring program, ordering and dispensing naloxone pursuant to the statewide protocol, offering medication disposal receptacles, the electronic prescribing mandate, and dispensing limited quantities of controlled substances upon request pursuant to the federal CARA Act. ■