•From the Executive Director• Penny Shelton, PharmD, BCGP, FASCP start by dedicating this Executive Director column to the issue.
Our ‘State’ of Collaborative Care We tried something new at our Convention this past September. We held individual summits for different sectors of pharmacy to discuss the issues deemed to be most impactful, either because the issue gave great cause for concern or presented ample opportunity for the profession. One of the top issues to emerge was collaborative practice and provider status designation. The importance of this issue coincided with the unveiling of talking points and proposed draft language for a bill to be run by NCAP during the upcoming 2019 legislative session. The NCAP Board of Directors (BOD), various task force groups, the Policy and Advocacy Committee, staff, and NCAP lobbyist have been working on a bill for the past two years, which if passed, would update our collaborative practice authority. To date, the majority of feedback on the bill has been positive; however, there were some concerns raised during Convention regarding specific elements of the bill. At the October BOD meeting, these concerns were reviewed. The BOD determined there are misperceptions and confusion regarding the bill, as well as a general lack of awareness regarding the state of collaborative practice nationwide; therefore, NCAP plans to provide additional information on the bill using a variety media between now and the new legislative session. Furthermore, I have decided to
As healthcare needs, such as those associated with chronic disease, mental health and addiction continue to rise, there is a growing need in all practice settings for pharmacist-provided patient care services. This is particularly true given primary care and nursing shortages, as well as the increasing occurrence of provider burnout. Collaborative care has been shown to improve patient outcomes, increase access to care, raise patient satisfaction, and share the care burden with physicians, which helps with physician job satisfaction and burnout. The NCAP bill entitled “An Act to Improve Access to Patient Care Services via Collaboration between Physicians and Pharmacists” seeks to update our current collaborative practice authority statute, and thus the rules for implementation, making it easier for physicians and pharmacists to collaborate. Specifically, the bill calls for four key changes (elements): 1. Allow any licensed pharmacist and any licensed physician to collaborate versus a set of criteria that only allow certain pharmacists to be able to enter into a collaborative agreement. [Currently 29 states allow any licensed pharmacist, in any practice setting, to participate in a collaborative practice agreement.] 2. Move away from an approval process to a registry process. Currently a committee approves the application of the pharmacist as a CPP and approves
North Carolina Pharmacist
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the agreements (protocol). Under the new process, agreements are negotiated by the physician and the pharmacist and maintained by the practitioners. Any pharmacist participating in a collaborative agreement will first have to register with the Board of Pharmacy. The Board of Pharmacy will maintain the registry similar to how the immunization registry is handled. Practitioners engaged in collaborative agreements would be subject to abiding by the rules and could be audited. Physicians (or institutions such as with a hospital) establishing the agreement can require additional qualifications for their agreements if they wish. [Currently 26 states do not require approval of the pharmacist, review or submission of agreements. One state does not require any approval of the pharmacist, review or submission of agreements, but does maintain a registry of collaborating pharmacists. Eight other states do not have an approval process of the pharmacist or the agreement, but the agreement must be submitted to the BOP.] 3. Agreements allow for multiple physicians and multiple pharmacists on a single agreement. Institutions and large group practices could have institution-wide agreements. Individual pharmacists such as consultants or community pharmacists could have multiple physicians sign onto a single agreement. [Currently 29 states allow for multiple
Volume 99 Number 4 Fall 2018
