North Carolina Pharmacist Volume 97 Number 1 by North Carolina Association of Pharmacists

North Carolina Pharmacist Volume 97 Number 1 Winter 2017 A d v a n c i n g P h a r m a c y. Im p r o v i n g H e a l t h .

Inside this issue: NCAP Leadership Updates From the NCAP Office 2016 Convention Hightlights NCAP Awards New Practitioner Network Education and Practice

Official Journal of the North Carolina Association of Pharmacists 1101 Slater Road, Suite 110 Durham, NC 27703 Phone: (984) 439-1646 Fax: (984) 439-1649 www.ncpharmacists.org Click Here to Follow us!

North Carolina Pharmacist Volume 97 Number 1

Winter 2017

Inside JOURNAL STAFF EXECUTIVE EDITOR Penny Shelton EDITOR/STAFF WRITER Ralph Raasch

• From the NCAP President............................................................................4 • From the Executive Director.....................................................................5-6 • The State of the Association.......................................................................8-9 • Chronic Care Practice Forum Meeting...................................................10-17

LAYOUT/DESIGN Rhonda Horner-Davis

• The Association Bylaws.......................................................................18-22

BOARD OF DIRECTORS

• NCAP Strategic Plan.................................................................................23

PRESIDENT Stephen Eckel

• The NC Immunization Coalition................................................................25

PRESIDENT-ELECT Stefanie Ferreri

• NCAP and The NC Prescription DrugAbuseAwareness Committee.......26-27

PAST PRESIDENT Ashley Branham TREASURER Thomas D’Andrea

BOARD MEMBERS Susan Bear Olivia Bently Jamie Brown Jennifer Burch David Catalano Lisa Dinkins Ouita Gatton Stephen Kearney Nikolaus Lawson Macary Marciniak Kim Nealy Dave Phillips Jennifer Wilson

NCAP STAFF Linda Goswick Sandie Holley Rhonda Horner-Davis Teressa Reavis Ron Williamson North Carolina Pharmacist (ISSN 0528-1725) is the official journal of the North Carolina Association of Pharmacists. An electronic version is published quarterly. The journal is provided to NCAP members through allocation of annual dues. Opinions expressed in North Carolina Pharmacist are not necessarily official positions or policies of the Association. Publication of an advertisement does not represent an endorsement. Nothing in this publication may be reproduced in any manner, either whole or in part, without specific written permission of the publisher.

• President’s Club........................................................................................28 • 2017 NCAP Leadership........................................................................30-33 • Pharmacy Legislative Day.........................................................................35 • 2016 NCAP Convention Awards...........................................................36-40 • Selected Convention Presentations and Research.......................................41 • New Practitioner Network Member Spotlights...........................................43 • Education and Practice..............................................................................44 • Financial Planning...............................................................................45-47

North Carolina Pharmacist is supported in part by: • Epic RX....................................................................................................................27 • Mutual Drug..............................................................................................................2

• NCAP Career Center...............................................................................................24

• Pharmacists Mutual Companies................................................................................7

• Pharmacy Quality Commitment...............................................................................29

• Pharmacy Technician Certification Board...............................................................34 • VIP Pharmacy Systems............................................................................................49 ADVERTISING

For rates and deadline information, please contact Rhonda Horner-Davis at rhonda@ncpharmacists.org

•From the NCAP President • Stephen F. Eckel, PharmD, MHA, BCPS

Ready, Aim, Fire: A Year of Action for NCAP As we embark on 2017, NCAP is ready for action. The past 2 years have been spent planning for this year. As a result, we believe our plan of action is deliberate, timely, strategic, comprehensive, and addresses our member needs. I think it is important to remind everyone what has been occurring over the past 2 years within NCAP. This will give perspective on how we arrived at this point. 1.

Creating stability – over the past 5 years, NCAP has had instability in the executive director position. While change is sometimes good, this continual turnover resulted in a lack of focus, poor communication, and limited membership engagement, to name a few issues. While there are successes that we can point to over this time period, we can also identify missed opportunities based upon this instability. We currently have an Executive Director, Penny Shelton, who is a pharmacist from North Carolina and a past president of NCAP. These were the desired characteristics that we identified when we started the search process. Penny has spent the first 6 months canvassing North Carolina, listening to members, and understanding the diversity of practice needs. She has also been active in working with the state legislature and other health care groups to identify opportunities and to develop relationships necessary for future success.

Enhancing structure – the structure of the organization was reviewed and modifications to the Bylaws were recently approved. The Bylaws revision was initiated because of a recognition that our leadership structure did not allow for decision-making in a timely manner and was not as conducive to board member input as it should be. We reduced our number of board seats and invested in the strengthening of our Practice Forums. We believe this will position us well into the future to take advantage of strategic opportunities and deliver value to our members. The new Bylaws can be accessed from the Table of Contents of this issue of North Carolina Pharmacist – look in the “From the NCAP Office section.”

Finalize our Strategic Plan – before hiring a permanent Executive Director, NCAP also revised its Strategic Plan. The revision was needed because the last one was dated, and we felt it would assist in identifying the desired characteristics of an Executive Director. We also left gaps, as we wanted the Executive Director to assist in its completion. The new Strategic Plan to help guide our leadership and resource allocation has been approved by the Board of Directors and is also accessible in this issue of North Carolina Pharmacist.

Significant preparation and reflection has occurred over the last 2 years. As a result, I feel like we have completed the steps of ‘ready’ and ‘aim.’ We all know that the next word is ‘fire’ and NCAP is now in a position to do so. While more information will be distributed over the next few months, all of our actions will be focused on advancing the role of the pharmacist in North Carolina. This concept guides all of our decisions and actions and is the thread that weaves our different practice groups and generations of pharmacists together. Here are a few areas of focus for the leadership team: 1. Advocacy – NCAP has played more of a passive and supportive role in the past and has been criticized for it. We are now much more active in this area. We have recently hired a lobbyist and are working with the State Legislation on numerous activities. We are actively discussing ways that pharmacists can assist in helping our opioid crisis as well as enhance our collaborative practice agreement laws. We are still in the early stages, but we need your help. Please plan to join our Pharmacy Legislative Day on March 22. We need as many people as possible to help us advocate for our profession. 2. Education – NCAP realizes that the education and competencies that pharmacists need to be successful in caring for their patients are varied and evolving as we transition to a health care that focuses on value and quality. NCAP recognizes this need and also hears from members that there is a gap in products and tools to meet these skills and competencies. NCAP realizes this need, which resulted in a changed conference/convention structure based upon member input. We are discussing further improvements and have plans for new offerings this year. Any ideas, thoughts, or interest in participating in this endeavor would be appreciated. 2017 has the opportunity to be a year of action for NCAP with many new activities focused on advancing the role of pharmacists in North Carolina. However, NCAP is made up of its members, and we can only do these activities with the involvement of you. Can we count on you to help us ‘pull the trigger’ as we head into 2017? This is the only way we can be successful. I would appreciate any insights and experiences you might have on this perspective. You can let me know what you think by e-mail at seckel@unc.edu. You can also follow me on Twitter at @stepheneckel.

•From the Executive Director• Penny Shelton, PharmD, CGP, FASCP

lina. Although part two of my road trip, over these next few months, will center on meetings with as many health systems and local pharmacy associations as possible, my time on the road Along this journey, when measured in days, there will be good will be spent speaking with, and listening to, pharmacists days when great strides are New Year, New Beginnings: made, such as the recent work and pharmacy technicians in all Recasting Our Brand practice settings. One of the with some of our volunteer leaders on our advocacy agenda messages that I am conveying Welcome to 2017! I hope that while on the road is that NCAP and the planning for our Pharyour new year is off to a great is a membership association, and macy Legislative Day. Other start. Perhaps you have even membership associations exist days, there will be some hits been fortunate enough to take to help their members. What that we absorb along the way, a break to reflect back on 2016 are you facing in your day-tosuch as this past Fall when a and reminisce a bit. Here with- Chicago Tribune article regardday work, business, service or in the NCAP office, I have found ing pharmacists got national practice for which the Associa1 or been confronted with various attention , and in the November tion can help? NCAP is underissues or concerns for which issue of JAMA, where an article going a transformation centered contemplating our past has been showed an increasing problem on rebuilding value - getting helpful for planning and anticiback to our roots for why we with outpatient adverse drug pating our future as an Associa- events resulting in emergency formed in the first place and tion. First and foremost, I want department visits.2 The probbuilding a modern service modyou to know that I am thorlems addressed in both of these el for today’s members’ needs. oughly enjoying my job servpublications are areas for which ing as your Executive Director. pharmacists can improve and I am an avid reader, but I do Every day in the office or on the can create positive impact. Our enjoy a good televised action road is different. The members, work nationally and locally on and drama series. However, in volunteer leaders, staff, and provider status designation and this era of streaming and onstakeholders are some of the demand shows, it is rare that I broadening of collaborative most passionate and amazing practice authority will hopefully catch many commercials. Yet, people. Serving and represent- lead to greater opportunities one that did catch my attention ing you is the rewarding part for pharmacists to generate this was the Lincoln MDK commerof the job. I will admit that the positive impact in patient care. cial in which you hear Matthew number of issues, the amount McConaughey say “sometimes However, it is still up to pharof work that needs to be done, you need to go back to actually macists to rise to the task. and the diversity of problems move forward.” The choice of and needs can be taxing, albeit This past week I kicked off part McConaughey and the use of a even a bit overwhelming from two of my #NCPharmacy road quote that examines one’s past time to time. These are times was an intentional partnership trip and headed out to several that I just remind myself to between an actor who had to places in western North Carotake a deep breath and that NCAP is, and therefore I am, on a journey best taken one step at a time.

rebuild his career and a car company that desperately needed a resurgence to totally reinvent their brand. Throughout this issue of the North Carolina Pharmacist, you will find information and signs that are indicative of a groundswell or resurgence for NCAP. In essence, NCAP needs to refine and recast our brand! We are examining everything that NCAP does. Even the Journal has undergone a change in formatting, as well as the amount and type of information included. In addition to practicebased types of articles, in this issue you will find information about our successful convention held in November and the

introduction of new committees for 2017. You will find revised Bylaws, our Strategic Plan, as well as articles pertaining to the state of our Association and new statewide initiatives for NCAP. Enjoy the issue and, if you would like for me to visit your practice, health system or pharmacy, please contact me at penny@ncpharmacists.org. If you would like to share your ideas on “how NCAP can help” as noted above, please send your comments to NCAP. For now, use the email address ncapatwork@gmail.com to send us your comments, your “sound off ” remarks, or any other items to which you would like NCAP to be attentive. The NCAP staff, Board of Directors

and other volunteer leaders are looking forward to 2017. Come be part of the resurgence! Pharmacy Proud, Penny 1http://www.chicagotribune.com/news/watchdog/ druginteractions/ct-drug-interactions-pharmacy-met20161214-story.html

The Chicago Tribune tested 255 pharmacies to see how often stores would dispense risky drug pairs without warning patients. Fifty-two percent of the tested pharmacies sold the medications without mentioning the potential interaction. Shehab N, Lovegrove MC, Geller AI, Rose KO, Weidle NJ, Budnitz DS. US Emergency Department Visits for Outpatient Adverse Drug Events, 20132014. JAMA. 2016;316(20):2115-2125. doi:10.1001/jama.2016.16201.

NCAP Sound Off ............ “There’s just never enough time. I would like to see NCAP find a way to provide help or resources to help with my pharmacy’s star ratings.” Do you agree with this pharmacist? Then sound off and click here to let us know at ncapatwork@gmail.com. Or maybe there’s something else for which you’d like to see NCAP help.

You have a Voice and we are listening! 6

The State of the Association Getting Healthier: A 2017 New Year’s Resolution for NCAP It is a new year and during this time, many of us think about our health and how to get healthier. At the NCAP Convention on November 5th, Executive Director Shelton provided a “State of the Association” address that was framed around the context of organizational health and just how healthy is our Association. Organizational health can be assessed by a variety of definitions and metrics, but overall is usually described as: the healthier an organization, the greater its agility and ability to function effectively. The more nimble an organization, the greater its ability to adapt and respond to internal needs and external pressures. McKinsey & Company, a global organizational consulting firm with decades of qualitative analysis on leadership structures and management decisions in both public and private sectors has found that healthy organizations, regardless of size or mission, are the ones that are both stable and dynamic. Stable, meaning the organization has processes built in to allow for resilience, reliability and efficiency; and dynamic, referring to the organization’s nimbleness and capacity for timely adaptation.

and finances. In Shelton’s convention address, she was transparent regarding areas of concern, what work has been devoted to these areas of concern and where ongoing improvement is needed. She shared with the audience that the NCAP BOD had been developing a sound Strategic Plan that would serve as the guiding document for the Association’s resurgence and transformation. There are five overarching goals within the Strategic Plan and each addresses an aspect essential to the sustainability and relevance of the Association. The Strategic Plan can be found in this issue of The North Carolina Pharmacist or online at the Association’s website at www.ncpharmacists.org. During the third and fourth quarters of 2016, the BOD examined closely NCAP’s governance, volunteer and operational structures. Considerable time was devoted to determining an optimal Board size, one for which the Board positions better facilitate performance and outcomes, as well as changes to various working groups to help improve organizational connectedness and effectiveness. Changes to the Bylaws were addressed, and are currently being enacted. Orientations for all leadership groups, including training for new Directors on the Board are in progress in an attempt to more clearly delineate roles and expectations. Regarding internal operations, Shelton shared with the membership that she had been updating many of the operational policies and procedures, as well as a number of contracts. The focus has been to ensure the Association is operating legally, ethically, efficiently and as cost effectively as possible.

In the world of non-profit membership associations, such as NCAP, the health of the organization is also based on relevance, as defined by the ability to: 1) align people around a clear vision, strategy and inclusive culture, 2) successfully execute initiatives, and 3) adapt overtime to new needs and changing trends. In essence, NCAP’s health is dependent upon our ability to engage, be effective and stay current. The effectiveness and success of membership associations, like NCAP, are often determined based on metrics examining governance, From a financial standpoint, Shelton portrayed confimembership, planning, operations, services, resources dence in the Association’s financial procedures, assuring

the membership that NCAP has excellent accounting principles, including a number of redundancies in place to serve as sound operational checks and balances. All financial statements, tax documents and budget information are shared with the BOD for timely review and approval. In 2016, significant funding was pulled down from the earnings of the Association’s investments, which are managed by a separate Endowment Board. Shelton reported that NCAP is in the middle of major transformation and, until we can improve membership and grow other non-dues revenue, the next couple of years are likely to continue to require infusions of cash from our investments to sustain operations and our rejuvenation efforts.

the Association’s advocacy agenda. The Association has hired Tony Adams to help us with our agenda as well as monitor pharmacy and healthcare related issues being addressed in the legislature. Mr. Adams has been described as one of the most effective lobbyists in our state. The Association has greatly improved advocacyrelated information being communicated to members via electronic newsletter and on the NCAP website. There were two messages that Executive Director Shelton conveyed during the advocacy portion of her presentation and those were: 1) “We need to take advantage of the fact that we are an umbrella organization for pharmacy in our state. We need to start supporting each other and thinking of ourselves as a ‘pharmacist’ first. Regardless of whether you are a hospital, longMembership, meeting and educational resource rev- term care, community or some other type of pharmaenues for the Association have all been trending down cist, you are a pharmacist first and a win for one sector over the past few years. Shelton indicated that specific of our profession is a win for all of us;” and 2) “Pharmastanding committees would be formed in 2017 to refo- cists are the most underutilized healthcare professional, cus on cultivation of these important Association needs. and pharmacies are a resource often overlooked when Services and resources are two key metrics for examin- thinking about healthcare-related solutions. The Asing the value and success of membership associations. sociation needs to do a better job. We all need to do a The greater NCAP’s ability to offer tangible and mean- better job of using our voice and highlighting this fact, ingful resources, products, and services the better our in order to bring about change.” potential to grow membership. NCAP has a number of existing resources for which we need to do a better job Shelton closed out her presentation with a simple slide promoting, and there are needs among our members for asking for help. “There’s a lot that we can accomplish which our Association can do a better job providing ac- together, but I need your help.” Call for volunteer cards cess to resources to help address these needs. were distributed to the audience, and an electronic call for volunteers went out to the membership shortly after In 2017, the Association will continue to work on im- the convention was over. Those calls to action are what provements to Association-related technologies. One led to the make-up of the standing committees found such improvement is to address deficiencies in the in this issue of the Journal. NCAP website, such as improved informational resources and better logic to content, which should help It’s a new year, and many of us make resolutions to imwith navigation. Early environmental scanning con- prove our health each year. Some of us are more sucducted by our new Executive Director found there is cessful than others. It has been said that most resogreat interest in the building of communities or net- lutions fail due to inadequate planning or lack of true works around common interests. The technology to commitment or perhaps too lofty of a goal. Consider support these communities will be explored in 2017. adding a professional New Year’s Resolution to your Since Shelton’s hiring, communication outreach to personal ones. Think about what you can do to help members has increased and the Association has also NCAP achieve a healthier profile. There will be other stepped up its social media presence. However, a new requests for help, campaigns for contributions and calls Communication and Outreach Committee will be to volunteer during the year. Resolve to do something launched in 2017 to help further enhance awareness of on behalf of YOUR pharmacy association. This is one the Association. resolution that will be simple to keep, simple to accomplish, because it’s a resolution we will do together. The number one NCAP benefit consistently identified by members is “advocacy.” Shelton reported that significant energy would be invested to develop and support 9

Chronic Care Practice Forum Meeting

2017 NCAP Chronic Care Practice Forum Meeting Sheraton Greensboro at Four Seasons Greensboro, North Carolina March 15-17, 2017 Developed with

UNC Eshelman School of Pharmacy Co-Sponsored by

Campbell University College of Pharmacy& Health Sciences Fred Wilson School of Pharmacy High Point University Wingate University School of Pharmacy

Wednesday, March 15 7:00-8:15 am

Registration/Breakfast

8:15-8:30

Welcome/Introductions

1.Identify what is a CASPER report and where the data originates 2.Describe quality measures and how data is collected 3.Discuss the different types of reports contained within the CASPER reports 4.Analyze a facility’s quality measures using Medicare.gov 5. Interpret 5 Star Ratings System and recognize strengths and weaknesses 6.Review changes to the 5 Star Rating System Lori Edwards, PharmD, BCGP, FASCP, CIC Consultant Pharmacist/Neil Medical Group 9:30-10:30 ACPE#: 0046-9999-17-049-L04-P (1.0 hr) ACPE#: 0046-9999-17-049-L04-T (1.0 hr) “Association Transformation: A Pinch of Magic and a Skoosh of Alchemy Tempered with a Dash of Reality” Learning objectives for Pharmacists/Technicians: At the completion of this knowledge-based activity, the participant will be able to: 1.Summarize key strategic initiatives for NCAP in 2017 2.List and describe important advocacy initiatives for NCAP in 2017 3.Describe important challenges association members will face 4.Apply a magical and alchemical analogy to the process of generating association value 5.Convey meaningful change and value of the association to non-members Penny S. Shelton, PharmD, CGP, FASCP Executive Director NC Association of Pharmacists 10:30-10:45 Break 10:45-12:15 ACPE#: 0046-9999-17-050-L04-P (1.5 hrs) ACPE#: 0046-9999-17-050-L04-T (1.5 hrs) “Controversies in Pharmacotherapy” Learning objectives for Pharmacists/Technicians: At the completion of this knowledge-based activity, the participant will be able to: A. “Clotting, Bleeding and Aging: Risky Business” 1.Compare and contrast the risk for thromboembolism vs. bleeding in older adults 11

2.Identify risk calculators that can be used to weigh risk vs. benefit of anticoagulation in a given patient (T) 3.Cite evidence regarding the use of anticoagulants in those at high risk for falls

Tasha Woodall, PharmD, BCGP, CPP Associate Director of Pharmacotherapy, Geriatrics Mountain Area Health Education Center Assistant Professor of Clinical Education UNC Eshelman School of Pharmacy B. “Taking a Break: Bisphosphonate Holidays” 1. Discuss the rationale for considering bisphosphonate holidays, including potential adverse events and medication pharmacology (T) 2.Evaluate clinical trials that examine therapeutic outcomes including fractures during bisphosphonate holidays 3.Develop a therapeutic plan for managing patients with osteoporosis during a bisphosphonate holiday Mollie Ashe Scott, PharmD, BCACP, FASHP, CPP Regional Associate Dean and Clinical Associate Professor UNC Eshelman School of Pharmacy 12:15-1:30 Lunch Symposium ACPE#: (1.0 hr) ACPE#: (1.0 hr) “Reducing Hospital Re-Admissions in Heart Failure: Pharmacy’s Pivotal Role” Learning objectives for Pharmacists/Technicians: At the completion of this knowledge-based activity, the participant will be able to: Michael B. Bottorff, PharmD, FCCP, FNLA, CLS Professor and Chair Department of Pharmacy Practice Manchester College of Pharmacy, Fort Wayne, IN Medical Learning Institute will provide ACPE CE instructions 1:30-3:00 ACPE#: (1.5 hrs) ACPE#: (1.5 hrs) “Post-Acute Care Industry Update” Learning objectives for Pharmacists/Technicians: At the completion of this knowledge-based activity, the participant will be able to: (Learning objectives to be sent at a later date) 12

Frank Grosso, RPh Executive Director and CEO American Society of Consultant Pharmacists

ASCP will provide ACPE CE instructions

3:00-3:15

Break

3:15-5:15 ACPE#: 0046-9999-17-051-L04-P (2.0 hrs) ACPE#: 0046-9999-17-051-L04-T (2.0 hrs) “Primary Care Medication Update 2016” Learning objectives for Pharmacists/Technicians: At the completion of this knowledge-based activity, the participant will be able to: 1. Identify new therapeutic agents recently introduced to the market and explain their appropriate uses (T) 2. Describe the indications and the most important adverse events and precautions of each new therapeutic agent 3. Compare and contrast new medications to others within similar therapeutic categories 4. Describe any important drug interactions and pharmacokinetic parameters that are clinically relevant 5. Discuss any evidence-based clinical trials that may be published about the medications to aid in therapeutic selection Kelly West Jones, PharmD, BCPS The Pharmacy Florence, South Carolina

Thursday, March 16 8:00-8:45 am Registration/Breakfast 8:45-9:00 Welcome/Introductions David C. Phillips, PharmD, BCPS Director of Clinical Services & Consultant Pharmacist Blue Ridge Pharmacy Chair, NCAP Chronic Care Practice Forum Penny Shelton, PharmD, CGP, FASCP Executive Director NC Association of Pharmacists 13

9:00-10:00

Annual Chronic Care Practice Forum Business Meeting to include introduction of Tony Adams, Adams & Associates, Government Relations (NO CE) Awards Presentation (NO CE) Chronic Care Pharmacist of the Year Excellence in Geriatrics – The Dales Jones Memorial Award

10:00-10:15 Break 10:15-12:15 ACPE#: 0046-9999-17-052-L04-P (2.0 hrs) ACPE#: 0046-9999-17-052-L04-T (2.0 hrs) “Evidence-Based Medicine Refresher: Getting the Most Out of a Study” Learning objectives for Pharmacists/Technicians: At the completion of this knowledge-based activity, the participant will be able to: 1. Define evidence-based medicine (T) 2. Describe the concepts of relative risk reduction, absolute risk reduction, number needed to treat (NNT) and number needed to harm (NNH), and how these statistical measures affect data interpretation 3. Define patient free of events and how this number can support medical decision-making 4. Discuss how evidence can be used in your long-term care practice to make outcome-oriented pharmacotherapy decisions that benefit the patient and reduce cost to the healthcare system 5. Discuss how to analyze and interpret a non-inferiority trial 6. Based on a specific provided case: (a) Discuss the specific case so learners can practice calculations and develop a conclusion Kelly West Jones, PharmD, BCPS THE Pharmacy Florence, South Carolina 12:15-2:00 Lunch & Exhibit Program 2:00-3:00 ACPE#: 0046-9999-17-053-L01-P (1.0 hr) ACPE#: 0046-9999-17-053-L01-T (1.0 hr) “Opioid Misuse and Addiction Treatment in Older Adults” Learning objectives for Pharmacists/Technicians: 14

At the completion of this knowledge-based activity, the participant will be able to: 1.Review epidemiology of opioid abuse in the older adult population 2.Discuss the stigma regarding addiction (T) 3.Discuss treatment options for opioid abuse Micah Sobota, PharmD, BCPS, CGP, FASCP Clinical Pharmacist Coleman Behavioral Health – AAH 3:00-3:15

Break

3:15-4:15 ACPE#: 0046-9999-17-054-L04-P (1.0 hr) ACPE#: 0046-9999-17-054-L04-T (1.0 hr) “Surveyor Findings/Common F-Tags” Learning objectives for Pharmacists/Technicians: At the completion of this knowledge-based activity, the participant will be able to: 1.Outline the updates for Unnecessary Drugs for the NH regulations that were implemented in November of 2016 2.Review an overview of the changes to the nursing home regulations that were implemented in November 2016 3.Discuss the intent of the regulations as they pertain to unnecessary drugs, behavior and person-centered care Cindy DePorter, MSSW State Agency Director Acting Assistant Section Chief Acute Home Care Section and Manager, NH Licensure and Certification Division of Health Service Regulation 4:15-5:00 Chronic Care PF Executive Committee Meeting

Friday, March 17 7:00-7:45 am Registration/Breakfast 7:45-8:00

Welcome/Introductions

David C. Phillips, PharmD, BCPS Director of Clinical Services & Consultant Pharmacist Blue Ridge Pharmacy Chair, NCAP Chronic Care Practice Forum Penny S. Shelton, PharmD, CGP, FASCP Executive Director NC Association of Pharmacists 8:00-9:00 ACPE#: 0046-9999-17-055-L04-P (1.0 hr) ACPE#: 0046-9999-17-055-L04-T (1.0 hr) “Transitions in Care: What’s Your Role?” Learning objectives for Pharmacists/Technicians: At the completion of this knowledge-based activity, the participant will be able to: 1. Describe the utility of transitional care management (TCM) codes 2. Evaluate existing transitions of care (TOC) programs 3. Apply principles of existing transitions’ models to create new TOC processes or enhance existing ones Irene Park, PharmD, BCACP, CPP Clinical Pharmacist, Mountain Area Health Education Center Assistant Professor of Clinical Education UNC Eshelman School of Pharmacy 9:00-10:00 ACPE#: 0046-9999-17-056-L01-P (1.0 hr) “Passing the Torch: The Emerging Role of Novel Pharmacotherapy in the Treatment of Systolic Heart Failure” Learning objectives for Pharmacists: At the completion of this knowledge-based activity, the participant will be able to: 1.Describe the pharmacotherapeutic principles of novel heart failure (HF) treatment modalities 2.Interpret primary literature associated with these novel (HF) therapies 3. Analyze patient-case scenarios and select the appropriate treatment regimen Robert Tunney, PharmD, BCPS Clinical Pharmacy Specialist, ECHI Heart Failure Program Vidant Medical Center, Greenville, NC Clinical Assistant Professor, Pharmacy Practice Campbell University College of Pharmacy & Health Sciences

10:00-10:15

Break

10:15-11:15 ACPE#: 0046-9999-17-057-L04-P (1.0 hr) ACPE#: 0046-9999-17-057-L04-T (1.0 hr) “Could I Be Liable? A Pharmacist’s Duties of Care to Patients” Learning objectives for Pharmacists/Technicians: At the completion of this knowledge-based activity, the participant will be able to: 1.Discuss the elements of a professional negligence claim. 2. Apply the elements of a professional negligence claim to pharmacy practice scenarios. 3. Discuss recent court cases applying the elements of a professional negligence claim to pharmacy practice. Jay Campbell, BS, JD Executive Director NC Board of Pharmacy 11:15-12:00 Closing Remarks from the Chronic Care Practice Forum Executive Committee

The Association Bylaws NORTH CAROLINA ASSOCIATION OF PHARMACISTS BYLAWS

(Effective Date November 14, 2016)

Article I – Name The Name of this organization shall be the North Carolina Association of Pharmacists (NCAP).

Article III – Government Section 1. Government: The Association shall be governed according to the Bylaws of the Association. 1.1 The Board of Directors is the governing body for the Association. 1.2 The Board of Directors, in collaboration with others as appropriate, is the policy- making body of the Association.

Article IV – Membership

Article II – Purpose and Objectives

Section 1. Membership: The Board of Directors may Section 1. Purpose: The North Carolina Association establish membership classifications as needed to of Pharmacists, hereinafter referred to as “Associa- help fulfill the mission and vision of the Association. tion”, is the state organization representing the pro- “Active Member” is a classification of membership fession of pharmacy, organized to unite, serve and open to any pharmacist licensed in a U.S. state or advance the profession of pharmacy for the benefit territory. Only “Active Members” are entitled to full of society. The organization was formed January 1, benefits and may vote in Board elections and hold 2000 as a unification of the North Carolina Pharma- office. ceutical Association (NCPhA), North Carolina Society of Health-System Pharmacists (NCSHP), North Section 2. Membership Dues: The Board of DirecCarolina Chapter of the American Society of Consul- tors shall set the dues of the various membership tant Pharmacists (NCASCP), and North Carolina Re- classifications. Each member of the Association shall be entitled to membership in one primary tail Pharmacy Association (NCRPA). Practice Forum with all rights and privileges. StuSection 2. Objectives: The objectives of the Associa- dent pharmacist members will be placed in the Student Pharmacist Network instead of a primary tion shall be: Practice Forum. Each Member may join additional 2.1 To present a unified voice for pharmacy secondary Practice Forums for an additional fee to be determined by the Board of Directors, but shall on social, political and financial issues. 2.2 To provide a forum for exchange of inno be entitled to hold office in only their primary Practice Forum. vative ideas among pharmacists and collaborate with other health care providers Article V – Board of Directors to establish progressive health systems. 2.3 To promote the optimization of drug Section 1. Composition: The Board of Directors for therapy for the people our members serve. 2.4 To anticipate future information and pro the Association shall consist of: fessional development needs for pharmacy 1.1 Officers practice. 2.5 To strengthen relationships among phar 1.2 Three at-large members. macy students, pharmacy practitioners 1.3 Chairs of the Practice Forums and other health professionals. 18

1.4 Chair of the New Practitioner Network

1.5 Chair of the Student Pharmacist Network 1.6 Executive Director

All officers and at-large members shall be elected by the Active membership of the Association. Except for the Executive Director and the Chairperson, all members of the Board of Directors shall be entitled to one (1) vote. The Chairperson (see Article VI Section 2.3) shall only cast a vote in the event of a tie. Other individuals may be appointed to the Board as non-voting members by approval of the Board.

Section 2. Responsibilities: The Board of Directors shall be vested with the authority and responsibility of conducting the business and administering the finances of the Association. The Board shall also be responsible for the following: 2.1 Approval of the annual Budget. 2.2 Approval of the time and place for the Annual Meeting and other business meet ings of the Association. 2.3 Employment of the Executive Director. 2.4 Approval of all appointments to comitees, task forces, project teams and advisory groups for the Association. 2.5 Establishment of Practice Forums or other component groups identified in accordance with a policy process adopted the Board of Directors. 2.6 Appointment of all vacancies of the Board of Directors. 2.7 Establishment and maintenance of affili ation agreements with national pharmacy organizations as appropriate. 2.8 Nomination and selection of all official Association award recipients.

Section 3. Quorum and Attendance at Board Meetings: A majority of the voting members of the Board of Directors, defined as one over one-half, shall constitute a quorum. Two (2) unexcused absences from meetings of the Board of Directors within one (1) year may result in termination from the Board. Article VI – Officers Section 1. Officers: The officers of the Association

shall be the immediate Past President, President, President-Elect, and Treasurer. Section 2. Responsibilities of Officers: The responsibilities of officers shall include:

2.1 President –The President shall be the chief elected officer and in addition to the Executive Director shall serve as the chief spokesperson for the Association. The President will appoint, with Board approval, all standing Committees for the Association. The President, in conjunction with the Executive Director, will appoint, with consent of the Board, all task forces, project teams, and advisory groups. The President will serve as an ex officio member of all committees, task forces, project teams and advisory groups, except for the Committee on Nominations. The President will be responsible, along with the Executive Director, for establishing and carrying out specific goals and objectives for the Annual Implementation Plan. 2.2 President-Elect – The President-Elect shall assume all powers and duties of the President in the absence of the President. The President-Elect shall assume the office of the President the next operational year of the Association. The President-Elect, in col laboration with the Executive Director, shall be responsible for the preparation of the Annual Implementation Plan to be approved by the Board for implemen tation during his(her) term as President of the Association. 2.3 Past President – The Past President shall be the immediate past president of the Association and shall serve as the Chairperson, presiding over meetings of the Board of Directors and the Executive Committee. The Past President shall also serve as Chair of the Committee on Nominations. In the event that the Past President can not fulfill the duties of the office, upon Board approval, the President and Executive Director will determine an appointee to assume

the Past President’s duties. 2.4 Treasurer – The Treasurer shall be the co-custodian of the Association’s funds in concert with the Executive Director and shall countersign disbursement of funds in accordance with written policies adopted and amended by the Board of Directors. The Treasurer shall present a financial report at all meetings of theBoard of Directors. The Treasurer and Executive Director shall prepare the Annual Budget and present it to the Board of Directors for approval. The Treasurer shall also advise the Executive Director and the Board of Directors on the proper management of the Association’s funds.

Section 3. Quorum: Three (3) voting members of the Executive Committee shall constitute a quorum of the Executive Committee. Article VIII – Nominations, Elections and Terms of Office

Section 1. Committee on Nominations: The President shall appoint a Committee on Nominations, consisting of no less than five (5) members. These members shall include but not be limited to the immediate Past Chairs of the Practice Forums. The Chair shall be the immediate Past President of the Association. It shall be the responsibility of the Committee on Nominations to select nominees for each elected position of the Association. The Committee Section 3. Responsibilities of the Executive Director: shall support the Association’s intent of representation of pharmacists from a variety of practice set3.1 Executive Director – The Executive Direc- tings in preparing a slate of candidates for approval tor shall be appointed by the Board of by the Board of Directors. Directors and serve as the chief executive officer and corporate secretary for Section 2. Nominations: A call for nominations the Association. The duties of the Execu- shall be published in the regular publication of the tive Director shall be outlined in a formal Association prior to the meeting of the Committee on Nominations. Nominations may be submitted in employment contract. writing to the Association prior to the deadline for such nominations. The Committee on Nominations shall submit, from the Active members, at least two Article VII – Executive Committee (2) nominees for elected office of the Association. In Section 1. Executive Committee of the Board of Di- the event only one candidate is available, the candirectors: The Executive Committee shall consist of date may run unopposed. the Association’s officers. The Executive Director shall be a non-voting member of the Executive Com- Section 3. Elections: The Executive Director shall distribute ballots to every member of the Associamittee. tion with voting privileges at least forty-five (45) Section 2. Responsibilities of the Executive Commit- days prior to the end of the Association’s operationtee: The responsibilities of the Executive Committee al year. The ballots returned shall be tallied according to procedures established by the Board of Direcare as follows: tors. Successful candidates must receive a plurality 2.1 To transact the business of the Associa- of votes cast. The results of the election shall be antion in the interim between meetings of nounced in the next regular publication of the Association. If, prior to the completion of a contested the Board of Directors. 2.2 To make recommendations to the Board election, the withdrawal of a candidate(s) reduces the field to one candidate, the remaining candidate of Directors relative to property, funds shall be declared to be duly elected. and finances of the Association. 2.3 To negotiate the employment contract and conduct performance evaluations Section 4. Terms of Office: No elected officer of the Association, except the Treasurer, shall hold the for the Executive Director. same officer position for more than one (1) elected

term, and no person shall hold more than one (1) elected office during the same operational year. Atlarge Board of Director positions shall be staggered in three (3)-year terms. The Treasurer shall be elected to a three (3)-year term and may serve no more than two (2) consecutive terms. Article IX –Committees, Task Forces, Project Teams and Advisory Groups Section 1. Committees: The Board of Directors will establish standing committees as is necessary for addressing ongoing Association business. Upon the establishment of these Committees, the President shall appoint members representative of each of the practice forums and networks to each Committee. The Annual Implementation Plan and Board of Directors, in collaboration with members, will determine the Committees’ agendas. The Committees’ recommendations will be reported to the Board of Directors for consideration for implementation and action.

Section 2. Task Forces, Project Teams and Advisory Groups: The President and Executive Director, with the consent of the Board of Directors, shall recommend the use of and appointment of members to other task forces, project teams, and advisory groups as deemed appropriate by the Board of Directors. A “task force” shall be established for an Association issue or need that is deemed as a finite need, but is likely to require multiple strategies to address. A “project team” shall be established to help meet a well-defined and specific need. An “advisory group” shall be established to provide non-binding strategic advice and support to the Association. Article X – Practice Forums, Networks and Special Interest Groups (SIG) Section 1. Practice Forums: Practice Forums shall exist within the Association to serve the educational and professional needs of distinct pharmacy practice disciplines. Practice Forums shall be statewide in scope and shall be open to any member of the Association, including technicians. Practice Forums may be created in accordance with procedures by

the Board of Directors. Each Practice Forum shall have a chair elected by its membership. The chair shall serve on the Board of Directors as a voting member. The Practice Forums will include: 1.1 Chronic Care Practice Forum

1.2 Community Care Practice Forum 1.3 Health-System Practice Forum

Section 2. Practice Forum Structure: In addition to the Chair, Past Chair and Chair-Elect, each Practice Forum will have a minimum of three (3) at-large members elected for two-year terms. The Chair shall appoint a technician member to the Executive Committee for a one-year term. This group will serve as the Practice Forum Executive Committee.

Section 3. Networks: The Board of Directors may establish networks of members who have common characteristics, but that cross boundaries of the practice forums (e.g., New Practitioner Network (NPN), available to any member who has been in practice for less than 7 years, and the Student Pharmacist Network (SPN) for all student members). The Board of Directors may also establish Networks, which foster communities intended to connect pharmacists with a common need (e.g., residency program directors and preceptors). The governance and leadership structures of each Network are to be established by the Board of Directors. Only the NPN and SPN have a representative member and voting privileges as part of the Board of Directors. Section 4. Special Interest Groups: The Board of Directors may establish Special Interest Groups that are composed of members of the same Practice Forum (eg., an ambulatory care or outpatient SIG within the Health-System Practice Forum). The governance and leadership structures of each SIG will be established by the Board of Directors. Article XI – General Operation Provisions Section 1. Official Meetings: The Association shall convene an Annual Business Meeting each year and other such special meetings as necessary to conduct the business of the Association. The membership

shall be notified at least thirty (30) calendar days in advance of an Annual Meeting and at least fifteen (15) calendar days in advance of a special meeting of the Association.

be submitted to the membership for a vote. The Bylaws amendment shall be adopted upon receipt of a majority vote of those voting for the Bylaws amendment. Prior to a membership vote, a draft of the amending language shall be shared with national affiliated organizations.

Section 2. Order of Business: The rules of order for the conduct of business at an official meeting of the Association shall be Robert’s Rules of Order, Newly Revised. The order of business for official meetings Article XIII – Dissolution of the Association shall be established by the presidIf for any reason the Association is dissolved, reing officer. maining assets of the corporation shall be transSection 3. Association Finances and Properties: All ferred by the Board of Directors to a nonprofit pharmoneys of the Association, except a petty cash al- macy-related organization. lowance, shall be deposited in financial institutions or invested in such manner as determined by the Board of Directors. Section 4. Personal Liability and Indemnification: A director, officer, employee, member or volunteer of the Association shall not be liable for its debts or obligations or be personally liable in that capacity for a claim based upon an act or omission of the person performed in the discharge of the person’s duties, except for a breach of duty of loyalty to the Association for acts or omissions not in good faith or which involve intentional misconduct or knowing violation of the law, or for a transaction from which the person derives an improper personal benefit.

Revised October 2006 Revised November 2016

Section 5. Operational Year: For accounting purposes the operational year of the Association shall be the calendar year. For other purposes the operational year shall be established by the Board of Directors. Article XII – Amendment Procedures

Section 1. Amendments: A proposal to amend the Bylaws shall be received in writing at the Association’s headquarters office at least ninety (90) days in advance of a meeting of the Executive Committee. Proposed Bylaws amendments shall be considered by the Board of Directors. In the event that further work is deemed necessary, the Board of Directors will work with the President to appoint a short-term Bylaws Task Force as allowed by Article IX Section 2. Upon receiving a two-thirds (2/3) vote of the Board of Directors, the proposed Bylaws amendment shall

The NCAP Strategic Plan

Strategic Plan

January 2017 - December 2018

VISION: NCAP will be recognized as the essential organization representing pharmacy in North Carolina, fostering the advancement of pharmacy practice to improve the health of the people we serve.

MISSION: NCAP exists to unite, serve and advance the profession of pharmacy for the benefit of society.

THE ASSOCIATION EXISTS TO: 1. Present a unified voice for pharmacy on social, political, and economic issues. 2. Provide a forum for exchange of innovative ideas among pharmacists, pharmacy technicians and student pharmacists. 3. Equip pharmacists, pharmacy technicians and student pharmacists with information, education and resources necessary for optimal patient care. 4. Anticipate future information and professional development needs for pharmacy practice. 5. Strengthen collaborative relationships among pharmacists, pharmacy technicians, student pharmacists, and other health professionals.

Click here to see a list of

Complete Strategic Goals 23

The North Carolina Immunization Coalition North Carolina Association of Pharmacists Tapped to Coordinate Statewide Immunization Coalition The North Carolina Immunization Coalition (NCIC) is a statewide, inter-professional network that organizes and supports efforts to reduce morbidity and mortality associated with vaccine-preventable diseases. Using a 1997 Kate B. Reynolds grant, NCIC was initially formed out of a partnership between a state health program and the NC Quality Improvement Organization. Over the years, the Coalition has grown and today includes representatives from an array of organizations and health professions. In October 2016 the Coalition underwent a coordination change, whereby the North Carolina Association of Pharmacists (NCAP) was selected to continue organizing this group’s important public health initiatives.

working together to improve immunization rates across our state, NCAP’s coordinating role helps better illuminate the pharmacist’s role in disease prevention. As an example, since NCAP began serving the Coalition, a pharmacist has now been added to the Coalition’s executive committee. Executive Director Shelton has been working with the NCAP Immunization Task Force to assume some of the logistical duties for future NCIC meetings and statewide communication efforts. Additional information about NCIC, including upcoming meetings, can be found at www.ncpharmcists.org.

This recognition is a significant accolade for our Association, as North Carolina is the first state, to our knowledge, to have its pharmacy association provide the coordination for the state’s Immunization Coalition. Although NCIC is an interprofessional group 25

NCAP and PDAAC NCAP Partnering to Elevate Awareness of Pharmacist-Provided Services as Part of the Solutions to Addiction and other Chronic Illness Since June 2016, NCAP has been a participant in the North Carolina Prescription Drug Abuse Awareness Committee (PDAAC). A legislative mandate led to the establishment of this Committee by Governor McCory, and the inter-disciplined representatives within this group have been meeting quarterly. Late last summer the Chronic Disease and Injury Section within the North Carolina Division of Public Health asked NCAP to take the lead on creating an on-demand webinar that would provide easy accessible education for pharmacists on the naloxone standing order and other important information regarding the opioid crisis. This was an excellent opportunity for our Association to partner with the Division of Public Health on such an important public health initiative. NCAP members Cathy Huie, Jerry McKee and Vera Reinstein took on this special project, and in November NCAP accredited and launched the on-demand webinar entitle “The Pharmacist and Naloxone: Opportunity to Save Lives.” Pharmacists who watch the webinar and complete the accompanying quiz may request one (1) hour of correspondence continuing education at no charge. To access, go to our website at www.ncpharmacists.org under the webinar tab or click the graphic below.

The plan moving forward is for NCAP to build off of the success of this webinar and to utilize another special project teams under the direction of the Education Committee to develop a series of additional educational webinars or live programming for other topics related to the opioid crisis. Currently we are exploring topics such as Screening, Brief Intervention and Referral for Treatment (SBIRT) training for pharmacists, how to use pain agreements or contracts with patients in your pharmacy, how to utilize the information within the CSRS to initiate intervention, as well as mental health first aid training. If you are a pharmacist who has experience working with patients in any of these areas and you are interested in helping NCAP develop these types of educational offerings, please contact us at 984-439-1646 or email Linda Goswick at linda@ncpharmacists.org. At the last PDAAC meeting in 2016, I had the opportunity to speak on behalf of NCAP and our profession. My presentation addressed the roles of the pharmacist in helping with the opioid crisis. I shared with the audience how the opioid crisis is a multifaceted problem for which there will be no one solution to the problem. Instead we need to begin thinking outside of the normal approaches, and we need to look at untapped resources. I spoke about how pharmacists have been an underutilized resource for far too long. I gave information on how there are over 12,000 licensed pharmacists actively working within our state; and there are 2026 community pharmacies across North Carolina. I gave examples of how pharmacists could help bridge the gap between primary care and behavioral health, and I shared examples of means by which pharmacists could help from education and needle exchange programs to screening and assessment to collaborating with physicians in the 26

provision of treatment programs for addiction to carryout pain management agreements with chronic pain patients. I had Drs. Courtenay Wilson (PharmD) and Blake Fagan (MD) shared their experience with their Asheville-based, collaborative practice, outpatient medication assisted treatment program for addiction.

this group have now volunteered to work with NCAP on a piece of legislation that would include broadening our collaborative practice authority in the interest of improving patient care for those with addiction as well as other chronic illnesses. Time will tell, but currently it is looking as though our March 22nd Pharmacy Legislative Day is going to be very engaging. Watch for more information to come soon! Penny Shelton

At this meeting we caught the attention of a number of groups, including, once again the Chronic Disease and Injury Section within the North Carolina Division of Public Health. A couple of representatives from

President’s Club

2016 NCAP PRESIDENT’S CLUB NCAP and The Endowment Fund wish to thank the following for their support in 2016. If you wish to make a tax-deductible contribution, you may do so on your membership renewal form, on the website or by mailing your contribution to the NCPhA Endowment Fund, 1101 Slater Road, Suite 110, Durham, NC 27703.

Gold

$100 - $999

Dina and Michael Adams Benson, NC Vestal Irving Boyles Statesville, NC David Catalano Wake Forest, NC Robert Cockman Whitsett, NC Mary Fischer Shallotte, NC Lisa Hampton Asheboro, NC David Line Charlotte, NC Harold Malion Fairmont, NC

Silver

Up to $99 Keith Ashby Montgomery Village, MD Robert Carr Rose Hill, NC Joseph Casacchia Greensboro, NC William Plyler Concord, NC William Rhodes III Lumberton, NC Janie Skertich Jamestown, NC Ronald Winstead Emerald Isle, NC

William Mixon Hickory, NC Penny Shelton Raleigh, NC Andy Willis Shelby, NC 28

2017 NCAP Leadership

Board of Directors........

Treasurer Thomas D’Andrea

President July-December Stefanie Ferreri

President Jan-June Stephen Eckel

Past President Ashley Branham

Chair-New Practitioner Network

Olivia Bently

Chair-Student Pharmacist Network

Nikolaus Lawson

Chair-Community Care Ouita Gatton

Advancing Pharmacy ....... 30

Chair-Health-System Kim Nealy

At-Large Lisa Dinkins

At-Large David Catalano

At-Large Jennifer Burch

At-Large Steve Kearney

At-Large Jennifer Wilson

Chair-Chronic Care Dave Phillips

At-Large Jamie Brown

At-Large Macary Marciniak

....... Improving Health 31

Leadership Groups........ CHRONIC CARE EXECUTIVE COMMITTEE David Phillips, Chair Keely Ray, Past Chair Jason Moss, Chair-Elect Rachel Benton Amanda Byrd Eric Hulin Jennifer Kim Andrea Leone Ann Marie Nye Robert K. Smith Elizabeth Wilson Tasha Woodall

COMMUNITY CARE EXECUTIVE COMMITTEE Ouita Gatton, Chair Jenn Wilson, Past Chair Cortney Mospan, Chair-Elect Ashley Abode Anna Armstrong Courtney Bradley Andria Eker Desiree Gaines Courtney Humphries Chelsea Renfro Megan Smith

HEALTH-SYSTEM EXECUTIVE COMMITTEE Kim Nealy, Chair Susan Bear, Past Chair Kira Harris, Chair-Elect Chris Barringer Kamaria Brown Evan Frasure

Adrienne Giddens Brock Harris Jennie Hewitt Tina Hipp Angela Livingood Kimberly Lewis

NEW PRACTITIONER NETWORK Olivia Bentley, Chair Jeff Reichard, Past Chair Kevin Helmlinger, Chair-Elect Janna Beavers, Secretary Irene Park, Secretary-Elect Cortney Mospan, Community Care Liaison Tyler Vest, Health-System Liaison Brittany Loy, Chronic Care Liaison Stacey Karl, At-large Brianna Luft, At-large Megan Coleman, At-large Emily Peedin, At-large Chelsea Renfro, At-large

STUDENT PHARMACIST NETWORK Mariam Dari (CU) – NPN Liaison Jerry Dyckman (CU) – Community Care Liaison Nikolaus Lawson (CU) – Chronic Care Liaison – Chair Alex Fleury (UNC) Ashlyn Norris (UNC) – HealthSystem Liaison Justin Reid (UNC) – Chair-Elect Sophia Deberry (WU) Ashley Ly (WU) Ece Okar (WU)

2017 STANDING COMMITTEES COMMUNICATION AND OUTREACH COMMITTEE Primary responsibility is to assist NCAP staff with improving our communications media to reach members and non-members as well as to help develop newsworthy content (e.g., blogs, videos, written articles or E-news) to share on our various platforms. This committee will also assist with identifying ways to improve NCAP’s website/ webpages. Lisa Dinkins, Co-Chair Debra Kemp, Co-Chair Megan Coleman Michelle Carrasquillo Desiree Gaines Wes Halton Brock Harris Courtney Humphries Andrea Leone Ashley Ly Emily Peedin Zafeira Sarrimanolis Brenda Zagar EDUCATION COMMITTEE Primary responsibility is to plan educational programming for live and virtual venues and help organize and oversee project teams to carry out program development.

Courtney Bradley, Co-Chair Jenn Wilson, Co-Chair Dawn Battise Janna Beavers Martha Boger Sophia DeBerry Steve Dedrick Robert Granko Alastain Hay Jennie Hewitt Amy Holmes Eric Hulin Justina Lipscomb Mary McClain Jacqueline Olin Irene Park Brian Romig Dustin Wilson Opioid/MH Project Team Cathy Huie, Chair Jacki Chorzempa Mary McClain Jerry McKee Vera Reinstein Shannon Rudolph MEMBERSHIP COMMITTEE Primary responsibility is to assist the Board of Directors in developing and implementing strategies that grow and retain membership for the Association. In addition, this committee will serve to help identify needs of members/potential members and help communicate and foster member participation in Association activities and initiatives. Justin Arnall, Chair Robert Bero II Dave Catalano Andria Eker Evan Frasure Brittany Loy Susan Miller

Jason Moss Justin Reid Laura Rhodes Tyler Vest Mary Vincent Nichole Wilson Technician Needs Project Team Nita Johnson, Chair Vishal Barnela Deborah Hewitt Brittany Stone Nichole Wilson POLICY & ADVOCACY COMMITTEE Primary responsibility is to help the Board of Directors with advancing statewide legislation and regulation to enhance pharmacy practice and health care. This group will work with various project teams to address various issues identified as part of the annual advocacy agenda for the Association. This group will be integral to the planning and implementation of an annual Pharmacy Legislative Day, as well as local grassroots advocacy initiatives. Cortney Mospan, Chair Ashley Abode Lauren Bode Jennifer Burch Cody Clifton Jerry Dyckman Stacey Karl Stephen Kearney Scott Larsen Mary-Haston Leary Angela Livingood Gavin Magaha Geoff Mospan Tarra Palyok Sarah Rhodes Wayne Sasser

Mollie Scott Robert Smith Ben Urick RESOURCE DEVELOPMENT COMMITTEE Primary responsibility is to work with project teams to identify or develop resources that members will find to be meaningful and useful in their practice. This committee will help identify the content and the organization of materials necessary to build out the resources tab on the NCAP website. Julie Cooper, Chair Jennifer Barrow Amy Brian Jamie Brown Kamaria Brown Casey Johnson Kimberly Lewis Brianna Luft Macary Marciniak Ashlyn Norris Chelsea Renfro Kathy Riley Jackie Roh Shannon Rudolph James Satterfield Tasha Woodall

Pharmacy Legislative Day March 22, 2017

Sponsored by Association of Community Pharmacists North Carolina Association of Pharmacists North Carolina Retail Merchants Association

8:00-9:00 am

Registration In Legislative Building, 1000 Court

9:00-12:30 pm

Demonstration of Pharmacist Services for Legislators and Staff, 1000 Court

9:00-10:00 am

General Session, 1300 Court Keynote TBD (1.0 hr. NC CE)

10:00-12:30 pm

Appointments with Legislators

12:30-2:00 pm

Lunch On Your Own

2:00-4:00 pm

Facilitated Discussion Groups (2.0 hrs. NC CE) (a) Pharmacists’ Role in Opioid Epidemic (b) CSEPN: Revising the Community Pharmacy Practice Model (c) Reimbursement for Pharmacy Services (d) Developing and Maintaining Transitions in Care Services (e) Specialty Pharmacy & Biosimilars (f) Naloxone Standing Order Implementation & Practice Challenges (g) Areas of Potential Community Pharmacists Expansion via Protocols/Standing Orders (h) Quality and Metrics Impact on Pharmacy Practice

4:00-5:30

Break for Business

5:30-7:00

Reception, NC Museum of History Lobby-All Legislators are Invited

Where: Legislative Building and North Carolina Museum of History in Raleigh, North Carolina What: A time to talk to your legislators about important pharmacy issues and earn 3.0 hours of North Carolina CE Who: Pharmacists, Residents, Technicians, and Student Pharmacists 35

2016 NCAP Annual Convention Awards NCAP President’s Award

Bowl of Hygeia

Presented by NCAP to the President in appreciation for service.

Stephen Eckel

Joseph Moose

Excellence in Innovation Award

Don Blanton Award

Presented to a pharmacist practicing in North Carolina who has demonstrated innovative pharmacy practice resulting in improved patient care. (Sponsored by Upsher-Smith Laboratories)

Trista Pfeiffenberger

Courtenay Wilson

Cardinal Health Generation Rx Champions Award

Presented to the pharmacist who has contributed the most to the advancement of pharmacy in North Carolina during the past year. (Established by Charles Blanton in honor of his father, Don Blanton, who served the North Carolina Pharmaceutical Association as President 1957-58)

Distinguished Young Pharmacists Award

This award recognizes a pharmacist for his/her work within the pharmacy community to raise awareness of the serious public health problem of prescription drug abuse. (Sponsored by Cardinal Health)

Davie Waggett

Presented to a pharmacist who has compiled an outstanding record of community service, which, apart from his or her specific identification as a pharmacist, reflects well on the profession. (Sponsored by AmericanPharmacists Association Foundation and National Alliance of State Pharmacy Associations) (accepting are Whit and Dot Moose)

Jennifer Wilson

Presented to a pharmacist practicing in North Carolina who received the entry degree in pharmacy less than ten years ago and participates in national pharmacy associations, professional programs, state associations and/or community service. (Sponsored by Pharmacists Mutual Companies) 36

National Community Pharmacists Association Leadership Award

McKesson Leadership Award Presented by McKesson to the President-Elect in recognition of leadership for the Association.

Presented by NCPA to the President-Elect in recognition of leadership for the Association.

Stefanie Ferreri

ASHP Leadership Award

Health-System Pharmacist of the Year Award Presented to a pharmacist in recognition of outstanding practice in health-system pharmacy.

Presented by ASHP to the Chair of the Health-System Practice Forum in recognition of leadership.

Jackie Roh

Susan Bear

Community Care Pharmacist of the Year Presented to a pharmacist in recognition of outstanding practice in community pharmacy.

Michael Scott Smith

President’s Service Award Presented by the NCAP President to recognize outstanding service to NCAP.

Keith Elmore Jimmy Jackson Mickey Watts 37

School Awards Preceptors of the Year Ian Hollis

Heath-System

Amy Sauls Community

Paoloni Health-System and Community Preceptor of the Year Awards Recipients of these awards are selected by the graduating class recognizing preceptors for outstanding contributions to the educational development of future pharmacists. This award is given by the Paoloni family in memory of their father, Claude Paoloni, in recognition of his many years of service to the UNC Eshelman School of Pharmacy. Mr. Paoloni was instrumental in the evolution of the clinical pharmacy program and is credited with initiating and leading the growth and development of the AHEC system for statewide pharmacy student education. Rebecca Chater

Brian Jenkins

Campbell Preceptor of the Year Awards Recognizes a Campbell University College of Pharmacy & Health Sciences pharmacy preceptor Qualifications • Outstanding contributions to the educational developments of future pharmacists • Demonstrates high standards of professionalism, ethics, and clinical practice • Nominations for the award are submitted annually by the College’s PharmD classes and reviewed by the Office of Pharmacy Experiential Education

Gene Merritt

Robert Smith

IPPE and APPE Preceptor of the Year Awards • This award is given annually to one IPPE preceptor who has demonstrated excellence in patient care, service, and precepting. • P1 and P2 students nominate deserving IPPE preceptors and provides a short narrative to support the nomination. • The Practice Experience Advisory Committee selects the APPE award recipient based on comments and student evaluations of nominated preceptors.

Community Partner of the Year Deep River Drug

During the development of the Fred Wilson School of Pharmacy, many area pharmacy partners have provided support to the University. During this important developmental stage, a community partner was selected due to their countless efforts in supporting our school. The pharmacists at this site have: • Provided faculty with practice opportunities • Provided their facility for media production purposes • Actively participated in our Preceptor events • Served on advisory boards • Served as an advocate of our new School • Served as a great friend to our University

Fifty Plus Club This honor (a certificate and pin) recognizes member pharmacists who celebrate fifty years as a licensed pharmacist. The following were inducted this year:

James Gordon Blount, Edenton Robert Lee Carr, Rose Hill Fred Allen Connelly, Black Mountain Roger Mahler Crane, Elizabeth City Joseph Arnold Creech, Selma Nancy Habrat Fagg, Charlotte Ronald Michael Geer, Charlotte Johnny Harold King, Greensboro Thomas Theophilous Lilly, Jr., Beaufort Ronald Hugh Small, Advance Marsha Barrow Tucker, Goldsboro

Rite of the Roses In Memory of NCAP members who have died since the previous Convention. JUSTIN ERIC BENFIELD CHARLES D. BLANTON, JR. NELSON ALLEN HIGGINS ROBERT SCOTT McCUNN CONNIE DAUGHTRY NANCE ROBERT JOSEPH SCHOLLARD JACK GLENN WATTS 40

Convention Presentations Links Selected Presentations from the 2016 NCAP Annual Convention • Opioid Epidemic Across North Carolina. Vera F. Reinstein and Andrew J. Muzyk. For further information from the CDC regarding opioid overdose, go to: www.cdc.gov/drugoverdose

• Mental Health First Aid as a Skill Set for Community Pharmacy. Jerry McKee.

• How to "LAFF" with Your Patients. Harskin Hayes, Jr.

• The Evolving Management of Hepatitis C Treatment for the Non-Specialist. Lisa Fletcher. • Hot Topics in Oncology for the Non-Oncology Practitioner. Jacqueline L. Olin.

• Hot Topics in HIV for the Non-HIV Practitioner. Olga Klibanov.

Research generated from posters presented at the Convention • Mospan G, DeGeeter M. Educating Student Pharmacists on Prescription Drug Monitoring Programs: A Pilot Activity, with Data Tables, and Sample Case 41

2016 NCAP Convention .......... You’ve Been Spotted!

NCAP ELECTION AND AWARDS FOR 2017 ELECTION

Deadline: May 1, 2017

NCAP members interested in serving on the NCAP Board and/or Practice Forum Executive Committees are invited to submit their bios by May 1. NCAP Board of Directors NCAP will elect a President-Elect (to serve as President in 2019), Treasurer and one At-large Board Member (3-year terms). Please send bio to Stephen Eckel (seckel@unch.unc.edu) Chronic Care Practice Forum The Practice Forum will elect a Chair-Elect (3-year term) and three Executive Committee members (3-year terms). Please send bio to Dave Phillips, Chair of the Practice Forum (dphillips@blueridgerx. com) Community Care Practice Forum The Practice Forum will elect a Chair-Elect (3-year term) and three Executive Committee members (3-year terms). Please send bio to Ouita Gatton, Chair of the Practice Forum (ouita.gatton@kroger. com) Health-System Practice Forum The Practice Forum will elect a Chair-Elect (3-year term), three Executive Committee members (3-year terms) and one Delegate to ASHP (3-year term). Please send bio to Kim Nealy, Chair of the Practice Forum (k.nealy@wingate.edu).

AWARDS

Deadline for Nominations: May 1, 2017

It is a privilege for the North Carolina Association of Pharmacists to recognize excellence within the profession. NCAP members are invited to nominate deserving members for the following awards to be presented at the Annual Convention. Nominations must be in writing (see nominations form is on the website www.ncpharmacists.org or you may request from Linda Goswick). Send nominations to the NCAP Awards Committee, c/o Linda Goswick, 1101 Slater Road, Suite 110, Durham, NC 27703; FAX 984-439-1649; or e-mail linda@ncpharmacists.org Bowl of Hygeia Award (sponsored by American Pharmacists Association Foundation and National Alliance of State Pharmacy Associations) Criteria for this award are: (1) Licensed to practice pharmacy in NC; (2) Has not previously received the Award; (3) Is not currently serving nor has he/she served within the immediate past two years on its awards committee or as an officer of the Association in other than an ex officio capacity; (4) Has compiled an outstanding record of community service, which, apart from his/her specific identification as a pharmacist, reflects well on the profession. Cardinal Health Foundation Rx Champions Award (sponsored by Cardinal Health) This award recognizes a pharmacist for his/her work within the pharmacy community to raise awareness of the serious public health problem of prescription drug abuse. Don Blanton Award Presented to the pharmacist who has contributed most to the advancement of pharmacy in North Carolina during the past year. This award was established by Charles Blanton in memory of his father, Don Blanton, who served the North Carolina Pharmaceutical Association as President 1957-58. Excellence in Innovation Award (sponsored by Upsher-Smith Laboratories) Presented to a pharmacist practicing in North Carolina who has demonstrated Innovative Pharmacy Practice resulting in improved patient care. Distinguished Young Pharmacist Award (sponsored by Pharmacists Mutual Companies) Criteria for this award are: (1) Entry degree in pharmacy received less than 10 years ago (2007 or later graduation date); (2) Licensed to practice pharmacy in NC; (3) Actively practices retail, institutional, managed care or consulting pharmacy; (4) Participates in national pharmacy associations, professional programs, state association activities and/or community service. Please send nominations for this award to Olivia Bentley, Chair of the New Practitioner Network (olivia@rxclinicpharmacy.com)

From the New Practitioner Network

Member Spotlight! Andrea Leone, PharmD, BCACP, has received the honor of being the final recipient for the 2016 New Practitioner

Spotlight. Dr. Leone graduated with highest honors from Chapel Hill in 2010. In graduate school, her research focused on pain and palliative care working with a general medicine pain service at the university. After graduating, she took a position as a community pharmacist for two years with CVS. In 2012, she relocated to Utah and worked as a specialist in poison information with the Utah Poison Control Center and then an independent hospice pharmacy. She currently works for Blue Ridge Pharmacy, an independent Long term care pharmacy in Asheville, NC, where she has spent time as both a staff and consultant pharmacist. Andrea is involved with implementing training policies and procedures for pharmacists at Blue Ridge Long-Term Care (LTC). Long term care pharmacy has some challenges since it’s not as well defined as retail or hospital. LTC merges elements from both which allows for many areas potential growth especially as the population ages. Andrea is also in the process of updating controlledsubstance policies for standing orders to reflect pain management guidelines. She hopes that obtaining a position with the NCAP Chronic Care Practice Forum will provide an opportunity to collaborate with others in LTC, geriatrics, and ambulatory care. Andrea became involved in the North Carolina Association of Pharmacists to network with others in her area of practice, stay current with guidelines, prescribing trends, and to advance the practice of pharmacy in the state of North Carolina.

Cindy Brasher, PharmD, MS, BCPS, is a pharmacy operations

manager at Mission Hospital in Asheville, North Carolina. She completed the Health Systems Pharmacy Administration PGY1 and PGY2 combined residency program at Mission Hospital and an MS in Pharmacy Administration through the University of North Carolina in 2016. She received her BS in Elementary Education from the University of Tennessee Martin and MA in Education from Cumberland University, and taught elementary education for 7 years. After making a career change to pharmacy, she received her PharmD from the University of Tennessee College of Pharmacy. After completing her residency program, Cindy joined the leadership team at Mission. In her current position, she supports the pediatric, oncology, and medication distribution service lines at her institution. Cindy enjoys working with these special populations because of the challenges that arise from meeting the needs of the patients through compounding, special dosage forms, medication access, and education. She is also passionate about staff development and has been working with her teams to develop staff training and education to better meet the needs of the department and patients. Promoting and developing the field of pharmacy is also very important to Cindy. She feels that organizational involvement at both the state level and national level are key to moving the profession of pharmacy forward. Currently, she serves on the NCAP Provider Status Task Force, ACCP Clinical Administration PRN Student and Resident Steering Committee, ACCP Publications Committee, and ASHP Section Advisory Group on Patient Care Quality. She appreciates being involved in NCAP due to their provision of continuing education for pharmacists and technicians and advocacy for key issues. The NCAP Provider Status Task Force is one example of local pharmacists collaborating with legislative members to improve access to care for our patients. 44

Education and Practice Links

Selected Education and Practice Click the Link of Choice Below

• Antimicrobial Stewardship: The Case for an Abridged Treatment Paradigm, Reid Gunn and Rebecca Chater • From the CDC, Core Elements of Outpatient Antibiotic Stewardship, November 2016 • Board of Pharmacy Specialties (BPS) receives petitions to recognize cardiology and infectious diseases as Pharmacy Specialties. Go to: http://www.bpsweb.org/wp-content/uploads/BPS-ReceivesPetitions-to-Recognize-Cardiology-and-Infectious-Diseases-asPharmacy-Specialties.pdf

Financial Planning Six Keys to More Successful Investing as a Pharmacist Todd Bailey As a Pharmacist, of course you work hard for your money, but is your money working hard enough for you? Your answer to that question may result in tens of thousands of dollars unintentionally being left on the table. If you’re like me, you want to be smarter with your money. Here’s a little help. Long-term compounding can help your nest egg grow It’s the “rolling snowball” effect. Put simply, compounding pays you earnings on your reinvested earnings. The longer you leave your money at work for you, the more exciting the numbers get. For example, imagine an investment of $10,000 at an annual rate of return of 8 percent. In 20 years, assuming no withdrawals, your $10,000 investment would grow to $46,610. In 25 years, it would grow to $68,485, a 47 percent gain over the 20-year figure. After 30 years, your account would total $100,627. (Of course, this is a hypothetical example

that does not reflect the performance of any specific investment.) This simple example also assumes that no taxes are paid along the way, so all money stays invested. That would be the case in a tax-deferred individual retirement account or qualified retirement plan. The compounded earnings of deferred tax dollars are the main reason experts recommend fully funding all tax-advantaged retirement accounts and plans available to you. While you should review your portfolio on a regular basis, the point is that money left alone in an investment offers the potential of a significant return over time. With time on your side, you don’t have to go for investment “home runs” in order to be successful. Endure short-term pain for long-term gain Riding out market volatility sounds simple, doesn’t it? But what if you’ve invested $10,000 in the stock market and the price of the stock drops like a stone one day? On paper, you’ve lost a bundle, offsetting the value of compounding you’re trying to achieve. It’s tough to stand pat. There’s no denying it--the financial marketplace can be volatile. Still, it’s important to

remember two things. First, the longer you stay with a diversified portfolio of investments, the more likely you are to reduce your risk and improve your opportunities for gain. Though past performance doesn’t guarantee future results, the long-term direction of the stock market has historically been up. Take your time horizon into account when establishing your investment game plan. For assets you’ll use soon, you may not have the time to wait out the market and should consider investments designed to protect your principal. Conversely, think long-term for goals that are many years away. Second, during any given period of market or economic turmoil, some asset categories and some individual investments historically have been less volatile than others. Bond price swings, for example, have generally been less dramatic than stock prices. Though diversification alone cannot guarantee a profit or ensure against the possibility of loss, you can minimize your risk somewhat by diversifying your holdings among various classes of assets, as well as different types of assets within each class.

Spread your wealth through asset allocation Asset allocation is the process by which you spread your dollars over several categories of investments, usually referred to as asset classes. These classes include stocks, bonds, cash (and cash alternatives), real estate, precious metals, collectibles, and in some cases, insurance products. You’ll also see the term “asset classes” used to refer to subcategories, such as aggressive growth stocks, long-term growth stocks, international stocks, government bonds (U.S., state, and local), highquality corporate bonds, lowquality corporate bonds, and tax-free municipal bonds. A basic asset allocation would likely include at least stocks, bonds (or mutual funds of stocks and bonds), and cash or cash alternatives. There are two main reasons why asset allocation is important. First, the mix of asset classes you own is a large factor--some say the biggest factor by far--in determining your overall investment portfolio performance. In other words, the basic decision about how to divide your money between stocks, bonds, and cash is probably more important than your subsequent decisions over exactly which companies to invest in, for example. Second, by dividing your investment dollars among asset classes that do not respond to the same market forces in the same way at the same time,

you can help minimize the effects of market volatility while maximizing your chances of return in the long term. Ideally, if your investments in one class are performing poorly, assets in another class may be doing better. Any gains in the latter can help offset the losses in the former and help minimize their overall impact on your portfolio. Consider liquidity in your investment choices Liquidity refers to how quickly you can convert an investment into cash without loss of principal (your initial investment). Generally speaking, the sooner you’ll need your money, the wiser it is to keep it in investments with comparatively less volatile price movements. You want to avoid a situation, for example, where you need to write a tuition check next Tuesday, but the money is tied up in an investment whose price is currently down. Therefore, your liquidity needs should affect your investment choices. If you’ll need the money within the next one to three years, you may want to consider certificates of deposit or a savings account, which are insured by the FDIC, or shortterm bonds or a money market account, which are neither insured or guaranteed by the FDIC or any other governmental agency. Your rate of return will likely be lower than that possible with more volatile investments such as stocks, but you’ll breathe easier knowing

that the principal you invested is relatively safe and quickly available, without concern over market conditions on a given day. Note: If you’re considering a mutual fund, consider its investment objectives, risks, charges, and expenses, all of which are outlined in the prospectus, available from the fund. Consider the information carefully before investing. Dollar cost averaging: investing consistently and often Dollar cost averaging is a method of accumulating shares of stock or a mutual fund by purchasing a fixed dollar amount of these securities at regularly scheduled intervals over an extended time. When the price is high, your fixeddollar investment buys less; when prices are low, the same dollar investment will buy more shares. A regular, fixed-dollar investment should result in a lower average price per share than you would get buying a fixed number of shares at each investment interval. Remember that, just as with any investment strategy, dollar cost averaging can’t guarantee you a profit or protect you against a loss if the market is declining. To maximize the potential effects of dollar cost averaging, you should also assess your ability to keep investing even when the market is down. An alternative to dollar cost averaging would be trying to 47

“time the market,” in an effort to predict how the price of the shares will fluctuate in the months ahead so you can make your full investment at the absolute lowest point. However, market timing is generally unprofitable guesswork. The discipline of regular investing is a much more manageable strategy, and it has the added benefit of automating the process. Buy and hold, don’t buy and forget Unless you plan to rely on luck, your portfolio’s long-term success will depend on periodically reviewing it. Maybe your uncle’s hot stock tip has frozen over. Maybe economic conditions have changed the prospects for a particular investment, or an entire asset class.

Even if nothing bad at all happens, your various investments will likely appreciate at different rates, which will alter your asset allocation without any action on your part. For example, if you initially decided on an 80 percent to 20 percent mix of stocks to bonds, you might find that after several years the total value of your portfolio has become divided 88 percent to 12 percent (conversely, if stocks haven’t done well, you might have a 70-30 ratio of stocks to bonds in this hypothetical example). You need to review your portfolio periodically to see if you need to return to your original allocation. To rebalance your portfolio, you would buy more of the asset class that’s lower than desired, possibly using some of the proceeds of the asset class that is now larger

than you intended. Another reason for periodic portfolio review: your circumstances change over time, and your asset allocation will need to reflect those changes. For example, as you get closer to retirement, you might decide to increase your allocation to less volatile investments, or those that can provide a steady stream of income. Todd Bailey is an Associate Member of NCAP and Owner & Independent Financial Advisor/Agent at KRB Financial, www.KRBfinancialNC.com, 919-518-7728.

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Click on the Event of your Choice for more Details or to Register Today! • Technician Review Seminar, Charlotte - March 5 • Chronic Care Practice Forum Meeting - March 15-17 • Technician Review Seminar, Raleigh - March 18 • Technician Review Seminar, Winston-Salem - March 19 • Pharmacy Legislative Day - March 22 • Residency Conference - July 14

North Carolina Pharmacist Volume 97 Number 1

Articles inside

Education and Practice

2016 NCAP Convention Awards

New Practitioner Network Member Spotlights

The Association Bylaws

The NC Immunization Coalition

NCAP and The NC Prescription Drug Abuse Awareness Committee

The State of the Association

2017 NCAP Leadership

President’s Club

From the NCAP President

From the Executive Director