•From the Executive Director• Penny Shelton, PharmD, BCGP, FASCP
The Association’s Assiduity
Okay, if the title caught your eye, well then step one has been achieved. Please read on! My column this issue is about NCAP’s ‘careful and unremitting attention’ to all the ongoing work behind the scenes to enact the different provisions, granted to pharmacists, in the passage of H.196, and H.96/S.575. These new laws expand scope for our profession, by allowing pharmacists to administer long-acting, and other injectable medications, pursuant to a prescription; and by allowing pharmacists to furnish certain medications, pursuant to statewide standing orders or protocols. The long-acting injectable authority went into effect October 1, 2021; and if all goes well, the other provisions will become effective, as early as, February 1, 2022. Soon, North Carolinians will be able to obtain nicotine replacement therapies, post-exposure prophylaxis for HIV, glucagon products, prenatal vitamins, oral and transdermal hormonal contraceptives, from their pharmacists, without a prescription. NCAP has spent numerous hours and resources advocating for these new authorities; howev-
er, our work, for the profession, did not stop with the passage of these bills. Instead, our efforts have shifted to three very important roles: • • Conversing with stakeholders, NC Medicaid and other payers regarding payment for services related to these new authorities; • • Coordinating teams to help with the drafting of statewide standing orders; and • • Creating training content and resource toolkits to equip pharmacists with what they need to legally, safely and efficiently provide these services for patients.
Conversing: North Carolina Medicaid has listened and worked diligently to create a means for pharmacists to bill an administration fee, when they give a long-acting injectable. We have also talked with them about how the 2022 statewide standing orders will have protocols that require screening, assessment, expanded patient education beyond just the medication counseling points, and time involved in required documentation and communication. If they want pharmacists to help address public health needs in our state, like unintentional pregnancies, smoking, and HIV, then the state needs to pay pharmacists for the patient care, as well as for the product. To date, our discussions have been very positive; and we are having similar discussions Page 4
with other health plans.
Coordinating: We are blessed to have amazing members and pharmacy practitioners in our state. NCAP moved quickly to organize small teams of individuals to help us draft standing orders. Why did we do this? In conversation with our Board of Pharmacy, we believed that our profession needed to be proactive; and that this was an opportunity to forge an even stronger relationship between NCAP and the Division of Public Health at NC DHHS. If we were to help on the frontend with the work that goes into issuing a standing order, let alone five different ones, we believed it would be more likely to reach stakeholder consensus in a timely manner. We knew that February 2022 would come around quickly, and this was our Association’s way to help Dr. Tilson and her staff. Currently, drafts have been written, reviewed by a Board of Pharmacy Committee, revised and submitted to NC DHHS, reviewed by their teams, and feedback provided to us on four of the five drafts. NCAP is currently working on incorporating DHHS feedback, and we are also awaiting input from the NC Medical Society. Next steps include recirculating the drafts to the Board of Pharmacy, DHHS, and including the NC Medical Board. Creating: The long-acting inject-
