PA Pharmacist July/August 2016

Pennsylvania

PERMIT NO. 533

PAID

HARRISBURG PA

PRSRT STD

U.S. POSTAGE

July/August 2016 z Volume 97 z Issue 4

The official publication of the Pennsylvania Pharmacists Association

Inside PPA Educational Foundation Grant — Final Report

Meet the 2016–2017 PPA Board of Directors Pennsylvania’s New & Improved Prescription Drug Monitoring Program is Here!

http://www.thepharmacyconsultants.com/pharmacogenetics

PPA Board of Directors PPA Officers: President: Eric Pusey, RPh President Elect: Nicholas Leon, PharmD, BCPS, BCACP Vice President: Lauren Simko, PharmD Immediate Past President: Donna Hazel, RPh

Our Vision

Pennsylvania pharmacists will be recognized, engaged, and fairly compensated as health-care providers.

Regional Directors: Central Region: Robert Killoran, RPh Northeast Region: Thomas Franko, PharmD, BCACP Northwest Region: Nickolas Kernich, PharmD Southeast Region: Mark Lawson, PharmD, MBA Southwest Region: Cory Krebs, RPh Practice Directors: Academia: Roshni Patel, PharmD Community-Independent/LTC: Stephanie Smith Cooney, PharmD Community Independent/LTC: Chuck Kray, RPh Chain Pharmacists: Stephen Pfeiffer PharmD, MBA Health System Pharmacists: Richard Demers, RPh, MS, FASHP Managed Care/Government/Industry and Other: Julene Vidic, RPh Associates: Greg Drew, RPh Student Directors: East, Rachel Von Vital West, Marissa Badzik PPA Office Staff: CEO: Patricia A. Epple, CAE pepple@papharmacists.com Program Manager: Sara Powers spowers@papharmacists.com Government Relations Manager: Donald L. Smith, III dsmith@papharmacists.com Communications Coordinator: Danielle Adams dadams@papharmacists.com Membership Coordinator: Ashley Robbins arobbins@papharmacists.com Bookkeeper: Michele Dibble mdibble@papharmacists.com PPCN Executive Manager: Mindy Kozminski, PharmD, BCACP mkozminski@papharmacists.com PPCN Trainer: Brandon Antinopoulos, PharmD ppcntrainer@papharmacists.com

Ext. 3 Ext. 2 Ext. 6 Ext. 1 Ext. 5 Ext. 4

Pennsylvania Pharmacists Association (PPA) 508 North Third Street, Harrisburg, PA 17101 (717) 234-6151 Fax: (717) 236-1618 www.papharmacists.com ppa@papharmacists.com Pennsylvania Pharmacist (ISSN 0031-4633) is the official publication of the Pennsylvania Pharmaceutical Association d/b/a Pennsylvania Pharmacists Association and is published every other month, six times per year. Annual subscription is $100 for nonmembers; for members it is included in the annual dues.

Editorial information should be addressed to the PPA address listed above. Peer reviewed articles accepted according to the stated guidelines available from PPA. Editorial Board: Olufunmilola Abraham, PhD, MS, BPharm Hershey S. Bell, MD, MS, FAAFP Kim Coley , FCCP, PharmD, RPh Bernard Graham, PhD Stephanie Smith Cooney, PharmD Associate Editor: Danielle Adams Editor/Manager: Pat Epple Designed and Published by: Graphtech Publications Manager: Sarah DiCello (717) 238-5751 x118, sarah@thinkgraphtech.com

Board of Pharmacy Meeting Dates: July 19, 2016 August 16, 2016 September 20, 2016 October 18, 2016 On the Cover: Save The Date for PPA’s 2016 Annual Conference!

Disclaimer — The opinions of the authors reflected in this publication do not necessarily reflect PPA’s official position on an issue.

The Pennsylvania Pharmacists Association, as the leading voice of pharmacy, promotes the profession through advocacy, education, and communication to enhance patient care and public health.

Pennsylvania MAGAZINE

Departments President’s Message................................................................................................................3 Calendar of Events..................................................................................................................5 Campus Checkup...................................................................................................................6 New Members.......................................................................................................................44

Features Pharmacy Spotlight: Williams Apothecary................................................................................9 Member Profile: Kyle McCormick, PharmD............................................................................11 Student Profile: Ryan Bolden.................................................................................................12 Student Profile: Demi Rissmiller.............................................................................................12 PPA Educational Foundation Final Report..............................................................................14 What I Learned from the Pennsylvania Pharmacists Association............................................16

Association News Meet the 2016–2017 PPA Board of Directors........................................................................18 Affiliated County Board of Directors.......................................................................................19 Meet the 2016–2017 Student Advisory Board.......................................................................20 BMPA Meeting June 2, 2016.................................................................................................22 Congratulations to the 2016 Recipients of the PPA Outstanding Student Award....................23 2015 Outstanding Students: Where Are They Now?..............................................................26 Call for 2017 PPA Educational Foundation Grant Applications...............................................27 PPA’s Student Interns: Where Are They Now?.......................................................................28 We Need Your Support of PharmPAC....................................................................................30 Honoring the Memory of Pauline R. Montgomery...................................................................31 2016 Graduating Students....................................................................................................33

Industry News Pennsylvania’s New and Improved Prescription Drug Monitoring Program is Here!................35 We Asked ... You Told Us......................................................................................................36 Preserving Your Pharmacy License: Part 1.............................................................................39 Pharmacists Mutual Risk Management Alert: Increasing Number of Compounding Errors Associated with Thyroid Prescriptions.....................................................................41 Pharmacists Mutual Pursues Case to Establish Compounding Pharmacists as Health Care Providers in Texas..........................................................................................42 Pharmacists’ Role Under Pennsylvania’s New Medical Marijuana Law...................................43

For Advertising Information: Account Manager: Alexis Kierce (717) 238-5751 x119, alexis@thinkgraphtech.com Pharmacist State Board of Pharmacy Members: Institutional: A. Cotchen, PharmD., MBA Independent Community: Rob Frankil Chain Community: Janet Hart Chain Community: Theresa M. Talbott, RPh Independent Community: Mark J. Zilner, RPh

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Departments

Message from the President I am so proud to have the honor and privilege of serving as the President of the Pennsylvania Pharmacists Association for the 2016–2017 year. The world of pharmacy is exciting and rewarding, but also challenging and ever changing. The past year was no exception. Our immediate past-president, Donna Hazel, has done a wonderful job during her tenure and I would like to personally thank her guidance, advice and advocacy for our profession.

We are obviously in the midst of a Presidential Election cycle and we hear many different views on the state of the economy, the state of health care and the role of Pharmacy in improving the lives of our residents. A primary focus during my term will be on the many legislative issues facing us here in Pennsylvania, as well as finally attaining Provider Status on the national level. In Pennsylvania our main focus will be on PBM Registration/ MAC transparency and Fair Audit Bills which have already been introduced in the state legislature.

A key part of our success will be improving communication with our Representatives and Senators, but also improving communication within Pharmacy. We are a diverse group of professionals including Community Independent and Chain pharmacies, Hospital pharmacies, Long Term Care

Consultants, Pharmacy Sales, Mail Order pharmacies, Academia, Research, Nuclear and I apologize for those specialties I missed. Like our Presidential hopefuls I hope to better “unite” our profession so that we can work together for a common goal and that is to “Keep Pharmacy Great!”

The opioid/heroin epidemic in our state and country has reached critical mass. PPA is taking the lead in developing strategies to combat this scourge on our society. This, combined with new Medical Marijuana Law, which the regulations are still be written needs our immediate attention.

PPA, thanks to Tom Franko and his committee have already developed Opioid Guidelines, which are available on our website by the way, to assist Pharmacists on best practices concerning opioids. We are working together with the Pennsylvania Medical Society, the Pennsylvania Department of Health, the DEA, the Governor’s office and the State Board of Pharmacy in ensure that Pharmacy is not only at the table but is instrumental in developing propharmacy, pro-patient policies. We need your help, your expertise and your viewpoints. We appreciate your membership and I personally look forward to working for you and most importantly with you. z

“A primary focus during my term will be on the many legislative issues facing us here in Pennsylvania, as well as finally attaining Provider Status on the national level. In Pennsylvania our main focus will be on PBM Registration/MAC transparency and Fair Audit Bills which have already been introduced in the state legislature. A key part of our success will be improving communication with our Representatives and Senators, but also improving communication within Pharmacy.”

Eric M. Pusey R.Ph, CDE PPA President 2016-2017

Pennsylvania Pharmacist I July/August 2016 I 3

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Departments

Calendar of Events

Thank You to Our Corporate Partners These companies support PPA activities throughout the year.

DIAMOND LEVEL

July 12–13

23–27

PPA Board of Directors Orientation/ Leadership Retreat/ Meeting AACP Annual Meeting Anaheim, CA

August

GOLD LEVEL

September 22 22–25 25 25–27

PLATINUM LEVEL

PPA’s Annual Golf Outing Limerick, PA Annual Conference King of Prussia, PA

SILVER LEVEL

PPA Board of Directors Meeting ACCP Annual Meeting Bethesda, MD

BRONZE LEVEL

October 3–6 15–19

AMCP Educational Conference National Harbor, MD NCPA Annual Conference New Orleans, LA

November 4–6

ASCP Annual Meeting Dallas, TX

December 1

PPA Board of Directors Meeting

4–8

ASHP Mid Year Clinical Meeting Las Vegas, NV

For additional events including webinars, CE opportunities, and PPA committee meetings, be sure to see our Calendar of Events on the PPA website!

Correction

In our May/ June issue, we published Gateway Pharmacy: It’s All In The Family but incorrectly listed the author of the article. The article was actually written

by Jamie Shepherd, LECOM PharmD Candidate 2016, who was on rotation with PPA.

Tony Hayslip, ABR/AREP 713-829-7570 Tony@RxBrokerage.com

Ernie Zost, RPH 727-415-3659 Ernie@RxBrokerage.com

Pennsylvania Pharmacist I July/August 2016 I 5

Departments

Campus Checkup LECOM Contributed by: Emily Petrak, Director The past few months have been a busy time for LECOM students as we wrapped up another term in April and began our summer term in early May. Even though finals can be stressful, PPA/APhA still found time to give back to our community and fellow healthcare professionals through various events. A blood drive was hosted by the Erie LECOM PPA/APhA student chapter at the local LECOM Fitness & Wellness Center on February 27th. Members of the community could come donate their blood to the American Red Cross.

On April 4th, members of the PPA/APhA chapter participated in a Consumer Health Fair at the local mall. At this event, student pharmacists and student doctors went to the Millcreek Mall to help with the Nurse Educator from the Erie County Diabetes Association, teaching people about diabetes prevention, proper diet and exercise, conducting diabetes risk assessments provided by the American

6 I Pennsylvania Pharmacist I July/August 2016

Diabetes Association, promoting medication adherence, and providing blood pressure screenings.

This was a Script Your Future event promoting people to take their medications exactly as prescribed. Script Your Future is a national campaign that involves both pharmacy and medical school students going out into the community to educate the public on medication adherence. LECOM is a finalist in the Script Your Future competition this year!

Members of the PPA/APhA student chapter also traveled to Harrisburg on April 6th to take part in Legislative Day! LECOM held educational tables and talked to people in the Capitol about Asthma and Collaborative Practice Agreements between Physicians and Pharmacists. Students took part in advocating for pharmacists by talking to their local representatives and senators about the importance of PBM Transparency and PBM Registration. z

Departments

Temple University Contributed By: Jennifer Nguyen, Communications Ambassador As the spring progresses into the summer, the Areas Enhancement Act. In honor of Patient Safety Temple PPA student chapter continues to keep busy.

Awareness Week, OTC posters were presented to In collaboration with APhA and SNPhA, a Letter patients to increase their knowledge on the possible Writing Campaign supporting Provider Status for harm of OTCs if misused. As the spring semester Pharmacists was organized where letters to PA Senator wrapped up, a community health fair took place to Pat Toomey were sent, urging him to support H.R. provide more patient education. z 592/ S. 314, The Pharmacy and Medically Underserved

University of Pittsburgh Contributed by: Nicolette Diehl, Communications Ambassador

University of Pittsburgh PPA Chapter Members at Legislative Day — April 13, 2016

The University of Pittsburgh PPA chapter had an exciting end to the Spring 2016 term with the transition of new officers for the upcoming school year and the planning and execution of Legislative Day. On April 13th, the chapter brought the P2 class to Harrisburg through the Community Practice Course as well as many P1 and P3 students. While at Legislative Day, each student met with a state representative and state senator to discuss upcoming bills in addition to tabling about Script Your Future, Operation Immunization, and Get Smart Initiatives at our school. To prepare for the day, many of our chapter members completed the GRASP program, where they were able to learn about how to

effectively communicate with our legislators and about the content of the bills. Legislative Day was a huge success and our chapter looks forward to returning to Harrisburg with the upcoming P2 class next year.

In July, many of our chapter members will be attending the annual statewide leadership retreat.

In addition to our returning e-board, our chapter welcomes Ally Seitz as our new Government Relations Ambassador. The chapters also congratulates our members elected to the 2016–2017 Student Advisory Board, specifically, Marissa Badzik — Director-West, Rebecca Wytiaz — Foundation Director, Jennifer Fever — Vice Chair, Olivia Marchionda — Corresponding Secretary, and Nicolette Diehl — Recording Secretary.

Pennsylvania Pharmacist I July/August 2016 I 7

Departments CAMPUS CHECKUP continued We are all excited to see the great work that they will do over the upcoming academic year!

The remainder of the summer will be used to plan for the upcoming academic year. Every year our APhA-ASP chapter establishes a “Dean’s Theme” which will be Operation Diabetes for the 2016–2017 school year. Plans for our involvement in the annual Dean’s

Theme Project are in motion and Katy’s Kids will be returning for its second year. Additionally, our chapter will be participating in our annual back-to-school picnic in September where our e-board will welcome the incoming P1 class. We look forward to working with our school’s organizations to promote diabetes education and welcome new members this fall. z

Wilkes University Contributed By: Kristen Lopatofsky, Communications Ambassador To celebrate the end of the year, the Wilkes Wilkes University PPA chapter also has an exciting University PPA chapter held a BBQ on the summer planned. Members will be presenting the Greenway as our annual spring social. Many Katy’s Kids program at local daycares throughout the members braved the rain and joined in on the summer. In addition, late this summer, they will also food and fun! At this time, we introduced our be presenting the proper use of EpiPens and allergy new officers who will be starting soon! precautions at the local daycare’s teachers in-service. z

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Features

Williams Apothecary: Where Pharmacy is a Service By: Raymond Snyder, Duquesne University PharmD Candidate 2016

R

ichard Williams, President of Williams Apothecary, started his journey in pharmacy at The Philadelphia College of Pharmacy, graduating in the class of 1968. His career began in West Chester before moving to Lancaster and purchasing Williams Apothecary in 1970.

Williams wanted his pharmacy to be unique and he will be the first to tell you, Williams Apothecary is not a store, it’s a pharmacy. He believes even small recognitions like that can give the profession the respect it deserves. A store sells a variety of products, where a customer goes to make a purchase.

A pharmacy is a healthcare facility, where a patient goes to have their healthcare needs addressed by a professional. That is why he wanted Williams Apothecary to be strictly an apothecary style pharmacy, with an ultimate focus on medications and the health of patients. He has always believed that pharmacy was not so much about the product we dispense, but the intellectual property we are able to share with patients.

Williams has adopted a positive, “always say yes” attitude. Whether it is a patient or a community member, he always says yes regardless of the request. He will then take the request and figure out how he and his team can actually accommodate it. Williams has always stressed the importance of the service that pharmacy can provide the community.

Pharmacy goes beyond just filling prescriptions.

The business model for pharmacy is always evolving, and Williams always tries to stay one step ahead. He has long been an advocate to recognize pharmacists as providers. He believes we have to get pharmacists out into the community to utilize their skills as clinicians and educate patients within the community.

He pursued pharmacy ownership because he wanted to determine

his own course; he wanted to be able to provide a high level of professional service and truly help people. When asked what his niche was, he replied, “service.”

Williams Apothecary services about 7,500 patients per month.

The company focuses on six major areas of business; community,

Pennsylvania Pharmacist I July/August 2016 I 9

Features compounding, hospice care, long-term care, community education, and medication information services. They are also extensively involved in providing MTM services. They have two community pharmacy locations, the original in Lancaster, and an additional in Lititz. Across the street from the apothecary in Lancaster is the long-term care pharmacy, a closed door operation serving a large part of Lancaster County.

They also have four satellite pharmacies that service long-term care communities. The company has 90 employees, including 18 full and part-time pharmacists, 30 delivery drivers, technicians and others.

The pharmacy takes community education very seriously. Coleen Kayden serves as their consultant pharmacist. She deals almost exclusively with long-term care consultation and is a contracted provider for Hospice and Community Care. One of her responsibilities is to help perform thirty day chart reviews of every patient’s medications. Kayden

10 I Pennsylvania Pharmacist I July/August 2016

started at Williams Apothecary in 1986 and began as a consultant in the late 90’s. Kayden stresses the importance of being part of the interdisciplinary healthcare team. She believes we need to be open and effective when working with other healthcare professionals to demonstrate the benefits pharmacists can offer towards patient care. Kayden firmly believes in community involvement. She states it is very important for pharmacists to be able to go out the public and see

patients to provide education about their medications.

Both Williams and Kayden are long-time supporters of professional organizations, such as PPA. They believe it is an obligation to the profession to be involved at the legislative level and the community level. Kayden, a past president of PPA, says that organizations like PPA provide a great opportunity to network and build friendships with other pharmacists that you might have otherwise never had the chance to meet.

She also believes PPA has helped bring the profession together saying, “PPA does a great service bringing all of the practice settings together making sure that pharmacists are part of the solution.” z

Features

Member Profile Kyle McCormick, PharmD Contributed By: Daniel Brust, Duquesne University, PharmD Candidate 2016 What are your major interests in pharmacy?

I love independent pharmacy because it allows for the freedom and capability to engage in whatever interests you personally, and the potential for financial success is present. I have always been fascinated by the way technology has advanced and infiltrated every industry, and how healthcare has incorporated it. Another interest is in education, whether it’s presenting, giving talks, precepting, or continuing my own education, I have always been excited by learning and the education process.

What initially drew you to PPA membership? A group of friends and I began to attend PPA events in the Pittsburgh area. I remember going to a picnic where we talked and networked with new students

and pharmacists. I loved the idea of networking with other people who shared the same interests as I did, and the close-knit feel of the PPA community. I immediately saw the value of a professional organization.

In what ways have you been involved professionally with PPA? My passion for and interest in technology has compelled me to remain active with the public relations (PR) committee; I enjoy fielding technology questions about blogs and websites from members. I’ve been part of the education foundation board, and I am also on the ACPA board as well as vice president – I mainly take care of ACPA scholarship process. I recently gave a CE presentation about technology in pharmacy at the PPA conference.

How do you envision the pharmacy profession changing in 5–10 years?

Currently there is a huge push for

pharmacists to provide direct patient care services, such as point of care testing, pharmacogenetics services, MTM, etc. I believe tapping into technology that patients are using to manage their health, and assessing data to help them make changes in the way they manage lifestyle and medications will help improve health outcomes.

What is something that all pharmacists should do to be better practitioners? I may be preaching to the choir, but honestly staying involved with PPA or another professional organization and keeping up to date and prepared is essential.

PPA has some great resources available to educate you on legislative issues and other current events in the profession. Picking an organization that most resonates or aligns with your career path can help you to become a better practitioner. z

Pennsylvania Pharmacist I July/August 2016 I 11

Features

Student Profile

Ryan Bolden Hometown: Indiana, PA School: Mylan School of Pharmacy – Duquesne University; PharmD Candidate 2016 What was your biggest challenge in pharmacy school and how did you overcome it? My biggest challenge in pharmacy school was translating the information that I learned in the classroom to actual patient care in the field. When you begin to rotate between practice sites, you quickly learn that optimal care for patients is not often black and white.

Instead, you have to compile all of the relevant information to make accurate, informed decisions in reallife scenarios. Applying the clinical information I had learned to solve patient-specific cases was the most difficult challenge I have faced to date.

Where do you envision yourself in five years? In five years I envision myself in a clinical role in the acute care setting. I have grown to enjoy the collaboration with other members of the healthcare team and the increased responsibility placed upon pharmacists in the hospital. The advancement of our profession lies upon the increasing responsibility placed upon us as clinicians and I have found the hospital environment to present these opportunities.

12 I Pennsylvania Pharmacist I July/August 2016

What advice would you give to younger pharmacy students? To younger students: It is never too early to start thinking about life after graduation. Terms like “residency” and “fellowship” didn’t mean much to me early on in school, but you can create a more appealing and wellrounded CV/application by compiling extra-curriculars as early as possible.

Researching these opportunities as early as possible will get you ahead of the curve.

What do you believe is the most important issue facing the pharmacy profession today? MONEY. A majority of patients with which I come into contact, cost comes into the equation on some level. Cost of new, novel medications and the specifics of insurance coverage are topics that patients often do not understand and are a common source of frustration.

More education on these things in pharmacy school and more transparency for the public will do much benefit to patient care.

Demi Rissmiller School: Wilkes University, PharmD Candidate 2018 What has been your favorite part about being a member of PPA? My favorite part about being a PPA member is attending the conferences.

They are such great networking opportunities. You have the time to chat with professionals in the field and potentially form some mentor, mentee relationships. Not only do you get to talk to pharmacists it also is a great weekend to bond with PPA student members!

What are some of your hobbies besides school and work? When I’m not studying for PT I like to play with my puppies, go hiking, play the piano and ukulele and just relax with my friends!

What area of pharmacy can you see yourself practicing in the future?

Currently, I have my sights set on pursuing an academia residency and then becoming a part-time clinical practice professor while having a site in the community. My main interest is with clinical community practice such as MTM, immunization clinics, glucose screenings, blood pressure screenings and much more. With the current push for provider status I really see this field getting much larger and hope to have more clinical opportunities in the community in the near future!

Have you had a co-worker or professor who has been influential to you during pharmacy school? Besides my mom who is also a pharmacist and my biggest role model, I have really grown to look up to many of my pharmacy professors at Wilkes.

Two professors in particular who are involved with PPA are Dr. Kimberly Ference and Dr. Nicole Pezzino.

They are such great advocates for the profession and have inspired me to be an advocate as well. They have both encouraged me to step outside my comfort zone and try new things in the pharmacy world and I am thankful for that because it has opened many doors for me! z

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Features

PPA Educational Foundation Grant —

Final Report

Pharmacist-­led Improvements to Care Coordination for Patients on Long-­acting Injectable Antipsychotics Transitioning from Hospital to Home Michelle N. Myers, PharmD Candidate; Olufunmilola K. Odukoya, BPharm, PhD; Tanya Fabian, PharmD, PhD; Jamie Montgomery, RPh; Bryan A. Norman, PhD This study and report was made possible in part through a grant provided by the PPA Educational Foundation grant in 2015.

This report was not submitted through the peer review process and is presented as a report only. The full report may be found under the Foundation section Grants — 2015 Grants

http://www.papharmacists.com/page/FBOD_Grants15 Introduction Care coordination for individuals with serious and persistent mental illness is multifaceted and complex.1 Serious mental illness (SMI), pri­mar­­ily schizophrenia and bipolar disorder, is chronic and progressive. Frequent relapse is a known contributing factor of disease progression and mental deterioration. Antipsychotic medi­ cations are an effective treatment modality for preventing relapse and further progression of SMI.2 Despite antipsychotic treatment, high relapse rates persist among patients with SMI. This is attributed in part to poor adherence to antipsychotic therapy. A multitude of individual patient variables, illness characteristics and environmental factors have been identified as determinants of partial adherence and nonadherence in this patient population. Medication-­related factors present an additional

14 I Pennsylvania Pharmacist I July/August 2016

barrier to appropriate medication use; which include side effects, regimen complexity, frequency of administration and cost.3 Over five decades ago, long-­ acting depot formulations of two available antipsychotics were developed in an attempt to simplify medication administration and improve adherence for patients with SMI.1 Since that time, eight long-­acting injectable (LAI) antipsychotic agents have been approved by the FDA. These LAI agents reduce antipsychotic administration from daily to as infrequently as four times per year. In practice, LAI agents have become an essential component of recovery for patients with SMI4 and are now a mainstay of therapy for those with known nonadherence to oral formulations.5 Although the true impact of LAI agents on medication adherence is controversial, several studies

have reported reductions in both relapse rate (10–30%) and hospitalizations.6 The growing use of LAI antipsychotics presents new treatment challenges for healthcare professionals caring for patients with SMI. Effective treatment with an LAI agent requires continuous care coordination. For patients beginning therapy during hospitalization, the continuum of care begins with the inpatient healthcare provider’s decision to initiate an LAI and extends to the outpatient setting where therapy is maintained after discharge.

High medication costs, patient perceptions of treatment7 and access to healthcare personnel trained to administer injections may lead to discontinuation of LAI agents across all levels of care. Partial adherence and nonadherence due to inadequate transitions in care processes,

Features incomplete outpatient care plans, and lack of adequate patient education6 continue to result in relapse and re-­hospitalization,8–13 thus imposing a significant financial burden on the healthcare system4 and reducing patient quality of life.

The key to optimizing antipsychotic treatment, including LAI agents, is to ensure long-­ term medication continuation.14 The challenges surrounding care coordination for patients on LAI antipsychotic therapy present pharmacists with an opportunity to

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assume new roles in patient care.5 Pharmacists are well positioned to assess the appropriateness of LAI therapy, provide medication education to patients, caregivers and providers, participate in routine monitoring, and facilitate continuity of care for patients with chronic mental illness.

Further investigation is needed to understand factors that contribute to long-­term adherence to LAI antipsychotic treatment.1 The purpose of this quality improvement project was to observe the current process for

providing care to patients who are initiated on LAI agents during hospitalization and subsequently transitioned from hospital to home. Using an interdisciplinary approach that incorporated both pharmacy and system engineering perspectives, we aimed to identify and resolve gaps in care that lead to nonadherence to LAI antipsychotics agents.

Please see the rest of this report online at http://www. papharmacists.com/page/FBOD_ Grants15 z

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Pennsylvania Pharmacist I July/August 2016 I 15

Features

What I Learned from the Pennsylvania Pharmacists Association By: Daniel Brust, PharmD Candidate 2016

M

ost students who do a rotation with PPA agree that they knew relatively little about the organization prior to the start, but by the end, they felt that they thoroughly enjoyed their time here. While this is certainly true in my case as well, I feel that this general summary of the rotation does not adequately do justice to the beneficial experience I got here at PPA. I had been involved with PPA during my time as a student at Duquesne, so while choosing our elective rotations, PPA’s APPE rotation caught my eye.

During a conversation with my boss and preceptor, he suggested strongly that I do complete the rotation with PPA; he is highly involved with PPA, and he believed it would be an unparalleled opportunity for growth and development as a pharmacy student and future pharmacist. Due to the fact that the rotation was non-patient based, I was slightly apprehensive. I was unsure of which skills I could contribute in a setting as the only pharmacy student. Upon the initiation of the rotation, however, it is safe to say that these worries and apprehensions disappeared, as I felt like part of the team from day one.

My preceptor, Pat Epple, helped me to get acclimated to all of the staff members and their respective duties within the organization during the first week of rotation. The office has distinct duties assigned to each staff member to ensure quality and efficiency, which is important to keep a large organization such as PPA operating and running smoothly. I felt overwhelmed at first after learning about each respective staff

16 I Pennsylvania Pharmacist I July/August 2016

member’s daily responsibilities. There is a plethora of work that goes on behind the scenes at PPA which most people are unaware of. I was able to put into perspective just how difficult it can be to keep operations in order, and the staff really did an excellent job staying current and up to date with priority issues.

Because of the timing of my rotation in March-April, one main focus was PPA’s annual Legislative Day, which is a gathering of student pharmacists and pharmacists to promote and advocate for legislative issues impacting the pharmacy profession. Legislative Day 2016 was an incredible opportunity to network with other students and pharmacists, as well as legislators in the Capitol building.

I attended meetings with my local representatives and senators to discuss PBM registration/MAC transparency, and fair pharmacy audit bills. I was surprised to see how many legislators truly cared about pharmacy, and it was refreshing to get a new perspective and support from those outside of the pharmacy world.

I believe that one of the most beneficial components of the rotation was the ability to expand my network of pharmacists and other professionals who I have contact with. Through various meetings, meet and greets, interviews, and conference calls, I got the opportunity to increase my network of contacts significantly. I met so many people who were passionate about advancing the profession of pharmacy in Pennsylvania.

Through its various collaborative groups, I received insight on just how involved and intertwined PPA is with legislative

and medical issues affecting the whole state. PPA’s network extends from north to south, east to west, and its formidable presence undoubtedly plays a huge role in advocating for our profession.

I would recommend PPA’s rotation for any student who is interested in learning more about professional organizations and for those interested in advancing our profession. You will learn about the legislative process, you will learn about the branches of the state organization, and you will get firsthand experience while helping each staff member contribute to his or her specific functions. The people I met here have been kind and welcoming, and they helped me to see how much value there is by being involved in PPA. You often hear that in pharmacy, like other professions, who you know matters.

I am proud to say that I know those involved with the PPA rotation, and I am thankful for the opportunities I received to extend my web of professional ties. z

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Association News

Meet the 2016– 2017 PPA Board of Directors

Eric Pusey, President

E

lections for the 2016 Board of Directors were held in the spring of 2016, and new Officers and Directors will assume their position on July 1, 2016. Officers and Directors will be formally installed during the Annual Business Meeting on Saturday, September 24th at the 2016 Annual Conference. PPA would also like to thank the 2015–2016 Officers and Directors for their hard work and dedication over the past year! z

Officers:

Nick Leon, President Elect

Lauren Simko, Vice President

Donna Hazel, Immediate Past Pres.

Stephanie Smith Cooney

Greg Drew

Rick Demers

President, Eric Pusey, RPh President Elect, Nicholas Leon, PharmD, BCPS, BCACP Vice President, Lauren Simko, PharmD Immediate Past President, Donna Hazel, RPh

Directors: Academia, Roshni Patel, PharmD Community Independent/LTC, Stephanie Smith Cooney, PharmD Community Independent/LTC, Chuck Kray, RPh Chain Pharmacists, Stephen Pfeiffer, PharmD, MBA Health System Pharmacists, Richard Demers, RPh, MS, FASHP Managed Care/Government/Industry and Other, Julene Vidic, RPh Associates, Greg Drew, RPh Central Region, Robert Killoran, RPh Northeast Region, Thomas Franko, PharmD, BCACP Northwest Region, Nickolas Kernich, PharmD Southeast Region, Mark Lawson, PharmD, MBA Southwest Region, Cory Krebs, RPh

Student Directors: East, Rachel Von Vital West, Marissa Badzik

18 I Pennsylvania Pharmacist I July/August 2016

Association News Affiliated County Board of Directors Allegheny County Pharmacists Association 2016–2017 Board of Directors

Tom Franko

Nickolas Kernich

Bob Killoran

President, Brandon Antinopoulos, PharmD President-Elect, Kyle McCormick, PharmD Vice President, Nicholas Wytiaz, PharmD Secretary, Christine Jordan, PharmD Treasurer, Ashley Firm, PharmD Director, Michele Hebda, PharmD, TTS Director, Ravi Patel, PharmD

BucksMont Pharmacists Association 2016–2017 Board of Directors

Chuck Kray

Cory Krebs

Mark Lawson

Roshni Patel

Stephen Pfeiffer

Julene Vidic

Student Directors:

Rachel Von Vital

Marissa Badzik

President, Scott Himler, RPh Vice-President, David Cunningham, RPh Treasurer, John Gatto, RPh Secretary, Stephen Pfeiffer, PharmD, MBA Event Manager, Jan Kitzen, RPh, PhD Past President, Bruce Sigman, RPh Montgomery County Director, Melinda Williams, RPh Montgomery County Director, Robert Frankil, RPh Montgomery County Director, John Barrett, RPh, MBA Bucks County Director, Charlie Palilonis, RPh Bucks County Director, Michael Brown, RPh Bucks County Director, Vaishali Rawani, PharmD Bucks County Director, Charlie Palilonis, RPh

Lehigh Valley Pharmacists Association 2016–2017 Board of Directors President, Edward Bechtel, RPh President-Elect, Howard Cook, RPh, BCNSP, FASHP Treasurer, Gary Fields, RPh Secretary, Kristen Hartzell, PharmD, BCACP Director, Erin Fitzgerald, PharmD Director, Leslie Johnson, PharmD Director, Pauline Vargo, RPh Director, Nicole Pezzino, PharmD

Pennsylvania Pharmacist I July/August 2016 I 19

Association News

Meet the 2016–2017 Student Advisory Board The Student Advisory Board (SAB) regularly holds brief business meetings at each of PPA’s two conferences and provides students with a manner in which to have a voice in PPA policy and activities. PPA wants to thank the 2015–2016 Student Advisory Board for their time and commitment!

Director – East, Rachel Von Vital, Temple University Director – West, Marissa Badzik, University of Pittsburgh

Each Pennsylvania College of Pharmacy is also entitled to have one student representative and one student alternate serve on the Student Advisory Board. Additionally, each school has a Membership Ambassador, Government Relations Ambassador, and Communications Ambassador which work to promote and plan events in their area. *Please note, the missing candidates will be filled over the summer or when school starts. z

Foundation Director, Rebecca Wytiaz, University of Pittsburgh Chair, Rachel Richter, Duquesne University Vice Chair, Jennifer Fever, University of Pittsburgh Corresponding Secretary, Olivia Marchionda, University of Pittsburgh Recording Secretary, Nicolette Diehl, University of Pittsburgh

PPA wants to thank the 2015– 2016 Student Advisory Board for their time and commitment!

Marissa Badzik

Nicolette Diehl

Jennifer Fever

Rachel Richter

Rachel Von Vital

Rebecca Wytiaz

20 I Pennsylvania Pharmacist I July/August 2016

Olivia Marchionda

Association News 2016–2016 Student Advisory Board

continued

School Director Alternate Duquesne

Olivia Erickson

Jamie Celento

Jefferson

Matthew McGuire

*

LECOM

Sally Habusta

*

Ohio Northern

Allison Fye

Kaitlyn Bova

PCP

*

*

Pitt

Brandon Barry

Phil Kappes

Temple

Lin Tran

Ali Shahbaz

Wilkes

Anthony Fanucci

Allie Grudeski

School

Communications

Government Relations

Membership

Duquesne

Courtney Hager

Brittany Carney

Alyssa Gosnell

Jefferson LECOM

Gianna Girone Ashley Freeman

Jose Fernanzez Kaitlin Fairlamb

Thomas Kelly Rebecca Goetz

Ohio Northern

*

*

*

PCP *

*

*

Pitt

Nicolette Diehl

Allyson Seitz

Marissa Badzik

Temple

Harris Nguyen

Ali Shahbaz

Lin Tran

Wilkes

Kayla Bardzel

Felicia Snyder

Keri Diehl

Students Interested in Pharmacy Ownership –

Attend NCPA this fall on us!

Sponsored by PPA’s Special Interest Group (SIG) for Independent Pharmacy Receive an expense paid trip to attend the NCPA (National Community Pharmacists Association) Annual Convention • October 15-19, 2016 • New Orleans, LA The Pennsylvania Pharmacists Association SIG will present up to four students with grants covering the related expenses for attending the NCPA Convention: (provided certain requirements are met!)

Qualifications:

3 One roundtrip plane ticket

• Pennsylvania resident

3 Up to 4 nights hotel accommodations (room and tax)

• PPA Student Member

3 Student registration at student member rate

• Must not have previously received this grant

3 Up to $200 in meals and incidentals such as tolls and parking at the hotel, (receipts and an itemization must be submitted). These must be in accordance with the expense reimbursement policy. *Expenses are reimbursed subject to the completion of several criteria and attendance at the meeting.

• Interest in Community Pharmacy particularly Independent Pharmacy

• 5th or 6th year* pharmacy student enrolled at a Pennsylvania School of Pharmacy

*or equivalent of last two professional years

More information and the application may be found at: http://www.papharmacists.com/?page=SIGNCPA

Pennsylvania Pharmacist I July/August 2016 I 21

Association News

BMPA Meeting June 2, 2016 On Thursday evening, June 2, 2016, BMPA hosted its third annual CE dinner meeting at the Spring House Tavern. This event was open to members and nonmembers free of charge. The purpose of this open meeting, which included networking opportunities, a generous dinner, a CE presentation and more, is designed to enhance awareness and stimulate new membership in PPA/BMPA. Over 40 people attended the meeting including eight students from Temple and USP/PCP. Handouts describing the benefits of membership were made available to all attendees.

David Ezdon, PharmD, clinical pharmacist at Einstein Medical Center Montgomery in East Norriton, PA presented a 1 hour CE program titled “Back to the Future of Antimicrobial Stewardship.”

This is an important topic of growing concern to many healthcare professionals since it fosters the judicious use of antibiotic therapy at a time of everincreasing antimicrobial resistance. Dr. Ezdon cleverly incorporated scenes from the 1985 movie “Back to the Future” into his slides to maintain interest as well as to emphasize his points.

After the CE program, meeting attendees were able to reap the benefits of a presentation by PA state pharmacy board inspector, John Schiavo. John’s topic on “Helpful suggestions on how to prepare for a State Board of Pharmacy inspection” was filled with much useful information as he reviewed the details of an actual Pharmacy Inspection Report form that generated a lot of questions which he answered very effectively.

Following these presentations an open business meeting was held. The status of the student scholarship program, which currently has several applicants, was discussed. These will be evaluated over the summer and the scholarships will be presented at PPA’s Annual Conference in September. BMPA will be hosting one more dinner meeting in 2016, tentatively scheduled for late October. This will be sponsored by DaiichiSankyo and will include an informational presentation on the topic of “Hospital readmissions: Impact of the coordination of care continuum.” Details of the date and location will be made available on the BMPA web page when available. z

22 I Pennsylvania Pharmacist I July/August 2016

PA State Pharmacy Board inspector John Schiavo providing advice on how to prepare for a state inspection.

CE speaker David Ezdon pictured (l to r) with former mentor Dr. Tom O’Connor, Emily Ezdon and Olivia Johnson.

Association News

Congratulations to the 2016 Recipients of the PPA Outstanding Student Award This award honors and recognizes one graduating student at each school of pharmacy in Pennsylvania who has been most active in PPA during his/her academic years.

Wilkes University: Trina Patel

LECOM: Jamie Shepherd

My involvement in the Pennsylvania Pharmacists Association has taught me a lot about pharmacy, leadership, and advocacy. In the four years that I have been a member I have grown both personally and professionally and am very honored to be an Outstanding Student for the class of 2016. By attending multiple conferences, I was able to network with students, pharmacists, and teachers at Wilkes University. I am the leader that I am today because of my involvement in PPA at a local and state level. I am very thankful that I was able to be part of such a great organization as a student and cannot wait to see what opportunities I will have as a pharmacist in PPA!

I can’t even begin to express how honored I am to be named the PPA Outstanding student of the year of 2016 from LECOM. PPA has provided me with incredible opportunities including networking with pharmacists and students at conferences, providing educational programs, and advocating for our profession.

After completing the GRASP program with PPA, I realized the importance of advocating for our profession and how to understand the law-making process so we can effectively deliver our message to representatives of our state. To say I’m grateful to be part of this organization is an understatement. I have no doubts that my future career will include PPA. After graduation, I plan to work with Holy Spirit Hospital in Camp Hill, PA as a pharmacist, right across the river from PPA headquarters. I look forward to seeing what PPA will have to offer throughout my growing career.

Duquesne University: Mariah Deibert I feel very honored to have been awarded Pennsylvania Pharmacist Association’s Outstanding Student Award for the Class of 2016! I have experienced many memorable events and have met many great friends through PPA that I look forward to continuing to work with in the future. My participation in this organization has helped me grow personally and professionally. I had the pleasure of being able to participate in multiple Legislative Days and advocate for the profession of pharmacy. I plan to continue to be a part of PPA throughout my pharmacy career. I have been proud to be a part of this wonderful organization, and it is very humbling to be recognized with this award.

“I am the leader that I am today because of my involvement in PPA at a local and state level.”

— Trina Patel, Wilkes University

Pennsylvania Pharmacist I July/August 2016 I 23

Association News University of Pittsburgh: Kelsey Moss

Temple University: Nissa Tasnim

I am humbled and honored to receive this recognition by PPA. PPA has provided me with many mentors and networking opportunities throughout my time as a student pharmacist at the University of Pittsburgh. My participation in PPA has been rewarding and I am looking forward to the future opportunities as a new practitioner. PPA has made such an impact on my education and has set the foundation for me to excel in my career – I will be beginning my pharmacist career as an Ambulatory CareFocused PGY1 Resident at Allegheny General Hospital while working part-time as a Pharmacist for Rite Aid in the Pittsburgh area. Again, thank you to everyone at PPA!

I was thrilled to learn, during graduation, about being honored with the Pennsylvania Pharmacist Association Outstanding Student from Class of 2016. During my pharmacy school career at Temple, PPA has provided me with lots of learning opportunities and experiences, which allowed me to grow as a person and as a student pharmacist. The opportunity to serve as the President of the organization at the school level, while serving as a liaison between the state and local chapter has afforded me a lot of wonderful chances to be involved with the association. I was fortunate enough to attend the different conferences, legislative day and the GRASP program. I have had the pleasure to take part in the self-care competition and advocate for my profession, where I was able to meet my legislator and discuss key legislature issues, involving the profession of pharmacy. The association has served to provide excellent networking opportunities, where I was able to meet wonderful people and establish lifelong friendships. I hope to work with these wonderful individuals in the future.

As I move from being a student to a professional, I will be completing my PGY1 residency at Reading Hospital starting in July. PPA has served me well by providing exceptional opportunities and I plan to stay connected, advocate and give back to my profession through my involvement with PPA. I am so humbled to have won this award and I would like to thank PPA for choosing me for this award. z

Philadelphia College of Pharmacy: Breanna Kester It is with great gratitude that I accept PPA’s outstanding student award, what an honor! My involvement with this wonderful association has only benefitted me as a person and as a future pharmacist. Now that I am a PCP graduate (finally!) I plan to con­ tinue my career with Walmart pharmacy. I started working there as an intern during my first year of pharmacy school and have continued to learn and grow with the company. Recently, the pharmacy started incorporating medication therapy management into the business, of which I am a full supporter. I think this is a great way to connect with patients and make sure that they are getting the most appropriate and affordable medi­­cations. As for the Pennsylvania Pharmacists Association, I could not be more excited to continue attending conferences to learn, network, and advocate for the profession. PPA has always provided its mem­ bers with the most up to date information regarding state policies and recently approved laws that affect our everyday practice, and continuing to receive that information will be of great use during my first year as a pharmacist.

24 I Pennsylvania Pharmacist I July/August 2016

“PPA has made such an impact on my education and has set the foundation for me to excel in my career.”

— Kelsey Moss, University of Pittsburgh

Association News

Pennsylvania Pharmacists Association

2016 Annual Conference AMERICA’S HEALTHCARE REVOLUTION

BE THE CHANGE Medical Marijuana Forum Opening Session featuring Physician General Rachel Levine and Dept. of Drug & Alcohol Programs Secretary Gary Tennis Continuing Education Cardiac Exams

Digital Health

Spirometry

Managing Pain Management Deprescribing

Adherence

Star Ratings

Substance Abuse

Golf Outing Leadership & Awards Dinner

Panel Discussions with Expert Pharmacists Community Pharmacy Role in Accountable Care Organizations and Patient Centered Medical Homes Transitions of Care and Medication Reconciliation

Get your questions answered

Annual Business Meeting

Residency Showcase

Achieving Independence Competition

Exhibit Hall

September 22 to 25, 2016 Crowne Plaza Philadelphia-Valley Forge

http://www.papharmacists.com/Annual2016 Pennsylvania Pharmacist I July/August 2016 I 25

Association News

2015 Outstanding Students: Where Are They Now? Kyle McGrath PharmD, University of Pittsburgh This past year has been a whirlwind of excitement being involved on the national stage of pharmacy. As the Executive Fellow at the National Association of Chain Drug Stores Foundation, I have been able to take my association related experiences and bring them to a new platform. During my time as the fellow, I have been heavily involved in developing, managing and launching various initiatives that focus on public health and surround topics such as transitions of care, novel models of care delivery for minor ailments, and closing gaps in care for patients with diabetes. I constantly am using skills and abilities that were developed through my involvement with PPA and would not be where I am today had I not been a member during my education.

Benjamin Andrick PharmD, Duquesne University This past year has been an incredible experience as a PGY1 Pharmacy Resident at Augusta University Medical Center and University of Georgia College of Pharmacy. I have grown immensely in my ability to provide direct patient care and work as a member of the multidisciplinary team. Though my experiences on multiple services lines, I have gained invaluable experience which has allowed me to provide my patients with quality pharmacy care. In addition, I have been involved in teaching activities through the college of pharmacy from both an academic as well as preceptor perspective. As my research project, I designed and am conducting a prospective cohort study to evaluate anti-pneumococcal antibody titer response

26 I Pennsylvania Pharmacist I July/August 2016

for patient with CLL administered the pneumococcal conjugated 13 valent vaccine. I will be staying on for a second year as the PGY2 in Hematology/Oncology.

Alysha Lopez PharmD, RPh, Wilkes University My first job in the hospital setting and I love it! Since graduation in May 2015 I have almost completed a year as a Clinical Pharmacist at Geisinger Lewistown Hospital in Lewistown, PA. I came at a great time of growth for Geisinger and my hospital has been hugely expanding the roles of pharmacists and I cannot be happier to be involved in the change! Since I began in July 2015 my clinical skills have greatly improved. Lewistown is a moderate sized hospital with 123 acute care beds, including intensive care, cardiology, oncology and surgical floors. We also have an outpatient intravenous infusion center. With the plethora of specialties and only six pharmacist positions at Lewistown, it gives me great opportunity to get my hands dirty in many fields. Even so, I still have a passion for diabetes management, IV and compounding, and internal medicine/transitions of care. I greatly enjoy working with my colleagues and couldn’t ask for a better team. The pharmacy department has gone through many changes to help improve patient care and it wouldn’t happen without my wonderful co-workers. I look forward to what the next year has in store!

Note: PPA did not hear back from 2015 Outstanding Students: Alicia Shontz, PharmD, and Michael Bellano, PharmD. We wish them well!

Association News Antonella S. Frattarelli, PharmD, University of the Sciences After graduation, I was hired on at CVS Health as a pharmacist.

Not only am I currently staffing in a pharmacy, but I am also an immunizer for my district that spans across parts of Delaware County and into Delaware.

Throughout flu season, I immunize employees of various businesses in the area and educate them on the importance of these vaccinations, which is sometimes misconstrued in our society. CVS and PPA allowed me to have a smooth transition from student pharmacist to pharmacist and I am very thankful to my mentors and organization!

Marcell Martinez, PharmD I am currently a community pharmacist at Walgreens in Cherry Hill, NJ. While the position can be challenging at times, it is rewarding when I am able to help patients understand complicated treatment regimens. I also assist in precepting pharmacy students from the University of the Sciences in Philadelphia. During my free time, I am the proud mother of baby girl, Camille Isabella, born on February 9th, 2016. z

Call for 2017 PPA Educational Foundation Grant Applications The PPA Educational Foundation will award up to four grants in 2017 with a maximum amount of $1,000 per awarded grant. Grants may be used for projects which are targeted towards patient care by pharmacists and innovative activity around pharmacy practice. The purpose of the grants is to encourage exploration of innovative and best pharmacy practices, especially those which focus on patient-centered services or which offer some patient benefit.

For 2017: The PPA Educational Foundation encourages the submission of grants that investigate, demonstrate, document, measure or otherwise explore the value of pharmacist involvement in the Patient Centered Medical Home (PCMH), Accountable Care Organizations(ACOs)or other innovative models of collaboration. Of particular interest to the Foundation, are the following aspects related to the business model of embedding a pharmacist in the PCMH/ACO: productivity, ROI, payment, and/or quality outcomes/ measures. This focus does not preclude applications of another topic or project.

The Foundation has available on its website a short recorded webinar (about 15 minutes) on

the Foundation, the grant program, its goals and objectives, and the application and decision process.

Watching the webinar is not required but may be helpful in providing any applicant with a greater chance of success by a full understanding of the process and expectations. Participation will also not be considered in the grant evaluation process and therefore is not a requirement or guarantee of success.

If you are interested you must register in advance by sending an email to Foundation@papharmacists.com.

You will be sent specifics about login/call-in a few days in advance.

We encourage residents, new practitioners, seasoned practitioners, students, and academia members to apply! It can be a simple, easy way to support a new or ongoing venture of provision of patient care!

Information about Grant Opportunities, the 2017 Grant Announcement, and the Grant Application can be found on the PPA website under Foundation, Grant Programs. z

Pennsylvania Pharmacist I July/August 2016 I 27

Association News

PPA’s Student Interns: Where Are They Now? This past year, PPA was honored to have seven students on rotation with them. Here is an update on what they plan to after graduation!

Matthew Veli

Daniel Brust

Shaina Kulp

Jamie Shepherd

Christine Trusky

Llindsey Wenger

Matthew Veli, Duquesne University Upon graduation from Duquesne University Matt will be staying in Central Pennsylvania as a full time floater pharmacist with Walmart. He hopes to connect with his patients and educate them on their medica­ tions in order to achieve the best care possible.

He wants to continue to grow as a leader and move up within the company as opportunities present themselves.

Daniel Brust, Duquesne University After graduating from Duquesne University at the end of May 2016, Daniel will briefly move back to Scranton before beginning a PGY1 residency at the Erie VA Medical Center in Erie, Pennsylvania. He is currently undecided where his journey will take him after completing residency, but he would eventually like to return to his roots in independent community pharmacy, where he can incorporate clinical knowledge and components of ambulatory care into a hybrid model for improved patient outcomes.

Shaina Kulp, Philadelphia College of Pharmacy Upon graduation from the Philadelphia College of Pharmacy in May 2016, Shaina Kulp will be working as a pharmacist at Williams Apothecary in Lancaster. She is excited to be a part of a wonderful group of people and is looking forward to learning more about longterm care and independent community pharmacy. She believes Williams Apothecary will help her grow as a new pharmacist and is enthusiastic to see what the future holds.

Jamie Shepherd, LECOM Upon graduating from LECOM, Jamie Shepherd will reside in her hometown of Mechanicsburg, PA. She has a job lined up with Holy Spirit Hospital as a night shift 28 I Pennsylvania Pharmacist I July/August 2016

pharmacist. She looks forward to her future career and doing what she loves.

Christine Trusky, Wilkes University Upon graduating from Wilkes University, Christine will be working as a pharmacist at the Lebanon VA Medical Center completing her PGY-1 pharmacy residency.

This residency focuses mainly on ambulatory care, which she hopes will prepare her to reach her goal of working as a clinical pharmacist in a VA outpatient clinic after residency. She would like to sincerely thank everyone who has supported her through her journey to become a pharmacist, and looks forward to starting the next adventure of her life with her fiancé Ryan!

Lindsey Wenger, Philadelphia College of Pharmacy After graduating from the Philadelphia College of Pharmacy, Lindsey will continue to work for CVS, where she has worked for about 2 ½ years. Lindsey will be extremely busy in the upcoming months as she is expecting her first child, a baby boy, with her husband on July 4th! z Note: PPA did not hear back from Raymond Snyder, Duquesne University. We wish him well!

Pennsylvania Pharmacist I July/August 2016 I 29

Association News

We need your support of By simply completing this form and sending in your contribution — you are providing PPA with the resources it needs to advance our legislative efforts. We need your support to help us stay in front of lawmakers on many key issues that are important to you! Need a few reasons why you should contribute? For the remainder of 2016, PPA is making a strong push to: • Provide for the registration of PBMs and MAC/Generic Drug Pricing Transparency to pharmacies (House Bill 947 & Senate Bill 669) • Set uniform and standard practices in the auditing of pharmacy claims (House Bill 946 & Senate Bill 668) • Make various changes to the PACE statute; including moving to NADAC plus a professional dispensing fee, adding Med Sync and MTM components, changes to the Pharmaceutical Assistance Review Board (PARB) and increasing income limits (House Bill 2069) • Protect pharmacists’ right to substitute interchangeable biological products when they come on the market without artificial or unnecessary barriers (Senate Bill 514) You can make recurring credit card payment contributions, a single credit card contribution, or a one-time check contribution. Please note we accept MasterCard, Visa, or Discover. o Monthly Contribution

Please charge my credit card every month in the amount of

$______________

o Single Contribution

Please charge my credit card one time in the amount of

$______________

Name as it appears on card: Credit Card Number :

Exp. Date: /

CC Billing Address: Security Code:

(on back of card)

BY SIGNING BELOW, I PERMIT PPA TO DEDUCT THE IDENTIFIED AMOUNT FROM THE INDICATED CREDIT CARD: (Signature)

(Date)

Credit card contributions may be faxed to PPA at 717-236-1618. Check contributions are to be made payable to PharmPAC and mailed to PA Pharmacists Assn, 508 North Third Street, Harrisburg, PA 17101-1199.

Special Medical Marijuana Briefing and Education Session Will provide the Pennsylvania pharmacist community with a detailed overview of the requirements and opportunities to participate in the Commonwealth’s upcoming medical marijuana program.

Friday, September 23rd at Annual Conference 9:00 AM - 12:00 PM Presented by the Center for Medical Cannabis Education & Research at Thomas Jefferson University and the Jefferson College of Pharmacy *additional fee applies, advanced registration required

30 I Pennsylvania Pharmacist I July/August 2016

Association News

Honoring the Memory of Pauline R. Montgomery PPA’s First Woman President in 1981–82 A

lifelong pioneer and leader, Pauline graduated from the Temple School of Pharmacy in 1950, as one of only six female students.

After working in several local pharmacies, getting married, and while having three kids, Pauline opened Montgomery’s Pharmacy on Main Street, Hughesville in 1959. Later relocating it to TJ’s Market, the family grocery store that features Mama Paulini’s

Left — 1999: Ike, Terry, and Pauline – first three PPA women Presidents

Kitchen, which includes many of her favorite recipes.

Pauline was very passionate about her career as a Pharmacist and enjoyed helping those in need. In addition to serving as the first female President of the Pennsylvania Pharmacist Association, she received several national pharmacy awards for her community service. She also served pharmacy through as a member of the Board of Value Drug, and as an appointee to the State Board of Pharmacy for 19 years, two separate terms.

An avid Democrat, Pauline was very active in state and local politics. She was one of the first two women to be elected to the Hughesville Borough Council and served as Mayor until she was appointed as a Lycoming County Commissioner. In 1984, Pauline ran for the

State House of Representatives.

She also was named one of Pennsylvania’s Top 50 Business Women. She served as a trustee for the Hughesville Area Public Library for 34 years and as a director with Muncy Bank and Trust for many years.

Pauline enjoyed cooking, traveling, and spending time with her friends and family. She also loved attending social gatherings and cocktail parties, often being one of the last individuals to leave the event. She will be keenly missed by her family, friends, business colleagues, many patients she served, and the pharmacy community. z

Pauline front and center during a Value Drug excursion trip!

Pennsylvania Pharmacist I July/August 2016 I 31

Association News

Recollections by other PPA past presidents and friends May the Force Be With Us Always Force (noun)-power to influence, affect, or control.

The first female President of PPA, Pauline R. Montgomery was first and foremost a force. In every aspect of her life—family, community and professional—her unwavering commitment to serve has and will continue to shape the future. This service was freely given by Pauline with dignity, integrity and grace. She never ceased striving to attain the highest level in any of her endeavors, and she never ceased her quest to expand her knowledge and horizons. There was never any doubt about Pauline’s thoughts or opinions. More concerned with being forthright than with being popular, she always expressed her true beliefs. Pauline had no “hidden agenda.”

the Lycoming Democratic Party and as long–term mayor of Hughesville. She and George are members of the Pennsylvania’s Voters Hall of Fame.

The name plate in front of Pauline at certain meetings stated “Queen.” This could not have been more appropriate, since a true queen’s highest priority is the welfare of her subjects. It was my very great privilege to recruit and promote Pauline for office in PPA. During her term as PPA’s President, she also served on the search committee that selected me to assume the position of Executive Director. The ensuing decades of working together for both our shared profession of pharmacy and for political action yielded an indestructible friendship that was precious to me.

Farewell to a steadfast and loyal friend, an eternal source of inspiration. Thank you, Queen Pauline, for serving pharmacy, Carmen A. DiCello, R.Ph.

Much has been said about Pauline being a role model for women in pharmacy, and rightfully so; but, she was so much more than that. She was a tireless advocate for her profession, for independent community pharmacy in particular, and for the community and patients she served. Pauline and my father traveled in the same circles, not just in pharmacy. Both were on the Board of Directors for their local banks and crossed paths at bank conventions. Because of the relationship with my dad, when I got involved with PPA, Pauline took me under her wing. She was always generous with encouragement and advice.

The Pennsylvania pharmacy community and the world of pharmacy suffered a great loss with Pauline’s death. Pauline truly embodied the word “trailblazer” in every sense of the word. She was one of the first women to graduate from pharmacy school at Temple and would go onto become PPA’s first female president and one of the Board of Pharmacy’s first female members. Pauline took me under wing when I was a student at Duquesne, encouraging my involvement at PPA. She reminded me to “not take any crap because you’re a woman. You can do it better than they can anyways.” She taught by example and demonstrated to me that it was acceptable to be vocal about issues about which you are passionate. In her opinion, all politics were local and if you weren’t going to be involved in the process, then you were not doing your job as an advocate for the profession and our patients. She is one of the reasons I became so involved in PPA and she was so excited to have me join her and Ida May Englehart in the “girls club” of the PPA presidency. She offered much support and advice during my presidency, and we always had fun sitting together in the “has been” (past president) area of the House of Delegates. Serving with her on the Board of Pharmacy was an added bonus as it allowed me to spend more time with her doing something we both loved.

“Mama” Pauline also loved life and was a joy to be around. Never a “shrinking violet,” she often reminded me that well behaved women rarely made history!

Pauline possessed seemingly unending energy which she channeled into everything she did. Whether it was taking care of her patients at the pharmacy, serving the town of Hughesville as mayor, presenting awards at PPA’s annual meetings, or taste-testing offerings at “Mama Paulini’s” kitchen in her supermarket, Pauline always brought her “A” game and gave 100%, making sure others had everything THEY needed. A devoted wife, mother, and “dog-mom” to her Boston terriers, Pauline’s heart was pure gold. My life, and those of countless others, have been richly blessed by her influence and I am hopeful that I will continue to “channel my inner Pauline” throughout my own journey. Terry Talbott, R.Ph. In May 2013, Pauline Montgomery was awarded the Doctor of Humane Letters by Wilkes University. The night before Dr. Montgomery gave the keynote address at the hooding ceremony for the PharmD class of 2013. As she spoke, the graduates and the 500 attendees knew this was someone very special. This was a pharmacist who had done it all. She and George raised a family of three successful professionals.

She started and ran successful businesses; she gave back to her profession by service to the Pennsylvania Pharmacists Association and the State Board of Pharmacy. She also served her community through her work with the Library,

32 I Pennsylvania Pharmacist I July/August 2016

Dr. Pauline Montgomery was a personal friend and a strong believer in the Wilkes University Pharmacy program. She twice served on the accreditation team for the startup of our program. She consistently offered council and support. She even posted a picture of my bulldog on her prescription counter of her store.

Although Pauline was an Outstanding Alumna of Temple University we at Wilkes are proud of her membership in the Wilkes family. Pauline will be long remembered at Wilkes for her friendship, her contributions and her role modeling. Bernard W. Graham, Ph.D.

I had the honor of being appointed to succeed Pauline on the State Board of Pharmacy. Six years later, I had the pleasure and privilege of serving alongside her when she was appointed to an unprecedented third term on the Board. During one of my first Board meetings, I don’t remember the issue was, but I made a comment and the Chair, Mike Podgurski, turned to me and said “Mr. Bechtel, you’ll make a motion to that effect. It’s what Pauline would do.” I knew I was on the right track.

We all have heroes in our lives. People we look up to and try to emulate. Pauline was, is, and will always be one of mine. Ed Bechtel, RPh. In 1994, Pauline Montgomery was appointed to the Value Drug Board of Director’s. She was our first female Director and a real game changer for the company. I was ecstatic to have her on our team and the years we worked together were over the top fun!

Pauline was the first woman of many held positions. She was a great leader, mentor, and a lady who could enjoy life while accomplishing many tasks at the same time. She was my mentor and beyond our company events and conventions, we coordinated many CE Excursions for our Value Drug members and friends in pharmacy. Our excursions took us to the Caribbean, Mediterranean, Mexico, the Rhine River and no matter where our travels lead she knew the cruise ships of choice and the land based hotels that would be favorable to the group. We scheduled 12 hours of CE and this travel cade remains to be a special group of business partners and friends. Pauline will always hold a special place in my heart and is missed by so many at Value Drug. Karla Moschella Pauline and I worked together on many projects initiated by PPA for over 20 years in various leadership positions. She supported my goals during my 1979–1980 term as President of PPA, and I reciprocated during her PPA Presidential term.

Pauline was part of the “greatest generation” of pharmacists who worked for the best interests of her patients and our profession following World War II. She embodied the essence of the “old time” community pharmacist serving as a leader in her town, as well as the larger Pennsylvania community during her years as a member of the State Board of Pharmacy. Pauline was always a Pharmacist patient advocate. Of course, all of her efforts on behalf of Pharmacy are well documented.

Pauline cherished her family, especially George, her constant companion and best friend. Pauline’s common sense approach to life, along with her good cheer endeared her to all who had the opportunity to interact with this extraordinary woman. Alan J. Vogenberg, BSPharm, RPh, FASCP

Association News

2016 Graduating Students PPA wishes the 2016 PPA graduating students all of the best as they embark on their pharmacy careers! Remember to remain a committed member of our state pharmacy association no matter where you reside! For those staying in Pennsylvania, we invite and encourage you to update your membership as either a resident or New Practitioner! This can be done online or by contacting Ashley Robbins, arobbins@papharmacists.com.

Albany College Rajneel Chohan

Chicago State University Thanh Ngo

Duquesne University – Mylan School of Pharmacy Heidi Pigott Matthew Veli Sydney Kehr Alex Wright Aubrey Goertel Michael Dovidio Brianna Dombrosky Kristen Kotsenas Daniel Brust Regis Bender Alana Grabigel Laura Brickett Catherine Hobart Mariah Deibert Joanna Fitzer Ryan Bolden Adam Dashner Rose Brown Raymond Snyder Richard Chubirka Katie Stollar

Jefferson School of Pharmacy Kenneth O’Donnell Kyle Massey Julie Savelloni John Pitsakis Amanda Gibson Oludamilola Olugbile Andrea Lordan Chelsea Wampole

LECOM School of Pharmacy David Marchewka Lindsay Gasper Rakesh Patel Britny Appel Megan Barringer Zachary Bowser Alex Gragg Annie Livit Julia Livit

Jamie Shepherd Brandon Sing Jonathan Thompson Jason Walker Lyndsie Delprato Jaxson Burkins Taylor Warmbrodt Amanda Chronister Breanne DeMarco April Elling Curtis Segur Ian Hatlee Ashley Sanders Jennifer Wisen Honore Yonti Ryan Fitzmaurice Joshua Harold Tersea Still Emily Windoft Corinn Floyd Kortney Wiant Jennifer Barlekoff Tracey Nicks

Ohio Northern University Megan Bookser Rachel Edeburn

Temple University School of Pharmacy Matthew Marianski Monica Mark Gregory Shertzer James Sperry Stephani Strasburger Wa Him To Steven Cheng Kevin Dunn JJ Gaughan Tyler Salovin Peymon Tavangar Joel Musser Gina DeCarolis June Lu Johnson Manoharan Duy Nguyen Edward Avanessians Joyce Chong Matthew Hoctor Jin Leung Randy Meng Larissa Woloszczuk Nissa Tasnim Kim-anh Tran Arya George

Philadelphia College of Pharmacy

Nansie Khalil James Krusling Kelly Gough

University of Charleston Channing Thacker

University of Findlay Brittany Topolnak

University of Maryland Eastern Shore Richard Yim

University of Pittsburgh School of Pharmacy Kelsey Moss Michelle Myers Samantha Adams Emily Smith Meicheng Wang Mackenzie Boring Amanda Antosz Brendan Homanick Chelsea Zavilla Lucetta Pontiff Anthony Chiappelli Karen Hoang Jack Mao Zachariah Hicks Chelsea Henderson Aaron Devanathan Alexandra Ellis Valerie Nolt Georgina Waldman Katelyn DelGrande Brittney Knass Carrie Recker Megan Waser Shea Liput Emily Linville Daniel Nelson Neil Turco Kyle Hejmanowski Neal Sprissler Anthony Albert Megan Frazer Brianna Thompson Alyssa Kunkel Kelly Yelenic Jennifer Baird Christina Goldaine Brent Milovac

James Levanduski Terry Pak Lindsey Wenger Yuting Jiang Kimmy Nguyen Sarah Goldsborough Shaina Kulp Bradley Inman Matthew Forman Breanna Kester Fidelia Bernice Annie Tien Chelsea Evry Rachael Oyewole Nicholas Peng Ivan Puskovic Hayley Conner Asla Ehtesham Matthew Gogoj Justin Mathew Sabina Bukowska

Wilkes University — Nesbitt School Of Pharmacy Geoffrey Arentz Tyler Young Jeffrey Kinney Omar Richardson Catherine Knapp Gregory Hood Stephanie Horger Alyssa Jones Casey Anzulavich Holland Kunkel Jaclyn Werkheiser Elizabeth Walters Kelsey Noss Lauren Para Erika Green David Swanger Ryan Bowersox Rachel Quinn Shantha Venugopal Brittany Wills Danielle Koch Kerrie Beggs Corey Haupt Rachel Sprock Christine Trusky Trina Patel Tori Sallo z

Pennsylvania Pharmacist I July/August 2016 I 33

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Industry News

Pennsylvania’s New and Improved Prescription Drug Monitoring Program is Here!

This is to inform you of a Pennsylvania Prescription Drug Monitoring Program (PA PDMP) system change that will be taking place on June 24, 2016.

As per Act 191, control of the PA PDMP (formerly PENNscript) will be transferring from the Pennsylvania Office of the Attorney General to the Pennsylvania Department of Health. As part of this transition, access to the PA PDMP will be provided through the Appriss software, PMP AWARxE (http:// www.appriss.com/pmpaware.html) Data collection for PMP AWARxE is facilitated via PMP Clearinghouse. (https://pmpclearinghouse. net/users/sign_in)

PLEASE MAKE NOTE OF THE FOLLOWING CHANGES TO SUBMISSION REQUIREMENTS: • Beginning June 24, 2016, all prescription files must be submitted to PMP Clearinghouse in the ASAP 2011 version 4.2 format.

• All Schedule II-V dispensed prescriptions must be reported

to the system within 72 hours of being dispensed.

Your pharmacy software vendor or corporate office may have already been notified several times. Nonetheless, if you have not already, we recommend contacting your pharmacy software vendor or corporate office immediately to ensure all necessary changes are complete prior to June 24, 2016. The Pennsylvania Data Submission Dispenser Guide explains the process of how to register and transmit data to the PMP Clearinghouse. The most up to date version of the guide can be found online at www.doh.pa.gov/PDMP. Registration to submit data is now open and you must begin reporting to the new system as of June 24, 2016. Your request to submit to the new PA PDMP will remain in a pending status until June 24, 2016. Please refer

to page 7 of the Data Submission Dispenser Guide for instructions regarding access to PMP Clearinghouse.

If you have any technical questions or concerns regarding how to make these changes, please contact Appriss support directly at 855-572-4767 (855-5PA-4PMP). Technical assistance is currently available Monday through Friday 8 AM to 8 PM EST. Should you have any policy questions regarding the transition to the Pennsylvania Department of Health, please contact the Pennsylvania Prescription Drug Monitoring Program (PDMP) Office at 844-377-7367 (844-377-PDMP) from Monday through Friday 9 AM to 5 PM EST or by e-mailing at RA-DH PDMP@pa.gov. z

Pennsylvania Pharmacist I July/August 2016 I 35

Industry News

We Asked ... You Told Us Why do you feel other pharmacists do not belong to PPA?

Don’t see the value or benefit 0.35%

Already a member of a national pharmacy organization 0.06%

Don’t care / lazy / apathetic 0.19%

Not aware of PPA — never asked to join 0.05%

Too busy with work and personal life 0.11%

Feeling that their employer takes care of them 0.04%

Costs too much to join 0.08%

Typically not a “joiner” or volunteer 0.03%

Pharmacy profession is not unified 0.08%

Employer will not pay their membership 0.02%

36 I Pennsylvania Pharmacist I July/August 2016

Which of the following PPA Benefits do you feel are of most value to you?

Advocacy on State Legislative Issues 0.37%

Idea sharing 0.03%

Networking with pharmacy colleagues 0.18%

Pennsylvania Pharmacist magazine and journal 0.02%

Conferences 0.16%

Weekly bulletin information 0.02%

Professional opportunities — practice advancement 0.08%

Webinars 0.01%

Continuing Education opportunities 0.08%

Website information 0.01%

Monitoring of state agencies and programs 0.04%

Assistance with general pharmacy questions and information 0.01%

PPA’s Last Chance to Meet Act 31 Requirements Child Abuse Awareness Training Live Webinar Tuesday, August 16, 2016 — 6 to 8 PM Register at: http://www.papharmacists.com/event/childabuse816

You can not renew your license without this requirement!

Pennsylvania Pharmacist I July/August 2016 I 37

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Industry News

Preserving Your Pharmacy License: Part I By: Steven E. Grubb, Esq., Goldberg Katzman P.C.1 Learning about the potential loss of your license may not be at the top of your reading list so feel free to skip over this article, BUT KEEP IT TUCKED AWAY IN A SAFE PLACE, just in case. Unfortunately, investigations which may threaten your license do happen. Sometimes they are justified, sometimes not. What is important for you, and the point of this article, is to give you a general idea of what happens and what you need to do if you find your license in peril.

How it Starts The Pharmacy Act (the Act), together with the Rules and Regulations of the State Board of Pharmacy (the “Pharmacy Regulations”) will generally govern the process by which your license can be reviewed and potentially revoked or suspended. The Act speaks of two ways the process can begin: (1) Upon the State Board of Pharmacy’s (the “Board”) own motion; or (2) by the filing of a verified complaint.

The Board’s Own Motion The Board has wide discretion as to the bases upon which it can investigate the suspension or revocation of your license.2 The Board may review your license based on internal records it keeps, such as a failure to submit renewal forms and fees or your not staying current on continuing education credits. The Board may also become aware of a criminal charge or conviction (often criminal conduct is reported directly to the Board by the District Attorney’s office which has filed charges); hear about a situation involving a pharmacy or pharmacist through media outlets, including social media and newspapers; may have become aware of a civil lawsuit that has been filed and which raises a pharmacist’s fitness to practice; or may simply have heard it through the grapevine that something is amiss at a certain pharmacy warranting an investigation.

Verified Complaint An individual may file a complaint against a pharmacist on a form made available by the Department of State, Professional Compliance Office.

Complaints are handled by the Commonwealth Department of State, Bureau of Professional and Occupational Affairs (the “BPOA”). Individuals may file the form themselves or with the assistance of an attorney. Anyone with a concern over the fitness

of a pharmacist (ethics, moral, incompetence, etc.) can file a complaint. This may run the gamut from a disgruntled customer to another pharmacist.

Once the Complaint is Filed According to the Department of State website, when the Complaint is filed, the BPOA opens a file and reviews the Complaint for technical compliance and whether the Complaint is within its jurisdiction. Some Complaints will have all of the necessary information for the BPOA to determine if a violation of the licensing law has occurred. Most, however require further investigation, in which case they are forwarded to the Bureau of Enforcement and Investigation.

The Investigation The Bureau of Enforcement and Investigation (the “Bureau”) will send out one of its investigators to collect additional information to gain a full understanding of the allegations of the Complaint.

This is usually a visit to your pharmacy by a clearly identified investigator, although, occasionally, the Bureau will conduct undercover operations. While cooperation with the investigation is important, it should also be handled carefully. Think of the investigators as police officers, thus, honesty and candor are important. “Anything you say can and will be used against you.” Since this is not a criminal investigation, the investigators are not obligated to tell you this, but keep this in mind when you answer questions.

When the investigator shows up at your door, you will likely not know the specifics of the complaint lodged against you. Investigators usually read the allegations of the complaint to you, but if they do not, be sure to ask the investigator why you are being investigated.

Pennsylvania Pharmacist I July/August 2016 I 39

Industry News Investigators have the power to subpoena records, or they may ask you to turn over records voluntarily.

Before turning over any records make sure your release of the records does not violate HIPAA. Also be sure you retain the originals and keep record of exactly what you produced.

Do I Need an Attorney?

When the investigator makes contact with you, it is time to consider legal representation. Much of the case against you is developed in this investigatory stage.

A careless, incomplete response or vague answer to an investigator’s question can either unnecessarily prolong the process or create new issues for you.

The investigation phase is certainly a logical time to consider an attorney.

Where Do I Find An Attorney?

If time permits, your first call should be to your professional liability insurance carrier. Many policies cover not only claims for professional negligence, but also defense of your license. While you may have coverage for the costs associated with the defense of your license, read your policy closely as to whether the coverage applies to paying any fines associated with the disciplinary action. Most types of fines do not fit within a covered incident or expense under your policy.

Even if you have decided to go forward without an attorney, contacting your carrier may be in your best interests. Typically, your carrier will want to be involved in the matter from the start. If you do not immediately alert your carrier, it may be a basis for your carrier to deny coverage which might otherwise be applicable.

If you maintain coverage, your insurer may appoint an attorney to represent your interests. Many policies also allow you to choose your own attorney with the insurer paying for your attorney’s reasonable costs and fees that the carrier has approved. If you have this option, you should look for an attorney with experience before Pennsylvania’s licensing boards. If you do not know one or cannot easily find an attorney with this experience, check with the Pennsylvania Pharmacists Association, or your local bar association. Additionally, the attorney who

40 I Pennsylvania Pharmacist I July/August 2016

handles your general legal work may be able to handle the matter or suggest someone who can.

There may be occasions when you wish to hire an attorney and alert your carrier, but you do not immediately hear back from your carrier. In this case, it may be worthwhile to hire the attorney and pay the attorney. If your carrier later informs you that you have coverage for the attorney’s costs, you can always seek reimbursement.

What Should I Discuss With My Attorney?

With regards to the investigation, get your attorney up to speed with where things stand. Provide him or her with the materials you may have previously provided to the investigator and convey what you know about the investigation. Your attorney will help you gain an understanding of what is at issue, what the likely lines of inquiry will be, and how you should best respond to the investigator.

The Interview Assuming the meeting with the investigator was delayed pending your retention of counsel3, you and your attorney should now be prepared to meet with the investigator. As referenced above, start the meeting with the investigator telling you the allegations of the complaint. They will then typically ask for your version of the events. Following the meeting, you will be provided an opportunity to supply a written response within 7 to 10 days. Take advantage of this opportunity so as to clearly set forth your position and perhaps clear up any confusion created during the oral interview. Work with your attorney to draft the written response so as to preserve all legal rights available to you.

What Happens Next?

Once the investigator completes the investigation, he or she will prepare a report to be sent to the reviewing prosecuting attorney. The report will include any written response provided on your behalf, notes of the investigator’s interviews with witnesses, and any documents obtained. Based on this information, the prosecuting attorney determines whether to proceed with a formal disciplinary action.

Continued on next page

Industry News

Pharmacists Mutual Risk Management Alert: Increasing Number of Compounding Errors Associated with Thyroid Prescriptions The ability to procure liothyronine in the diluted version has recently become much harder for compounding pharmacies across the country.

Unfortunately, this has led to a significant upswing in patient errors and consequently pharmacy compounding claims. The concentrated form of the raw ingredient for the thyroid compound has led to compounding mistakes. One such mistake resulted in an error of 53,000 times the intended dosage.

Thyroid overdoses can result in symptoms including, but not limited to, heart palpitations, vomiting, lack of thermoregulation, nervousness, and anxiety but can even go as far as myopathy and death.

Drug shortages are more and more common in the past few years so pharmacies must be ready to adjust to new products and strengths. Use these tips to help your pharmacy prevent errors and claims when new medications and strengths are substituted by wholesalers: • Look into implementing barcoding and compounding software as an additional safety measure. The professional practice of the pharmacy industry is moving toward the use of barcode scanning as several studies have shown a reduction

of medication errors with its use. Utilizing the technology properly is as important as purchasing it. Properly train pharmacists and technician on processes so work arounds are not created.

• Review every Certificate of Analysis (COA) for each lot of raw materials and update inventories and product formulas as necessary.

• Purchase and utilize products with proper labeling which includes entire product name, strength and concentration. This may require seeking out additional wholesalers.

• Verify changes in brands, strengths, and concentrations upon receipt and document in pharmacy inventory system. Notify all compounding staff members of concentration changes in products commonly used.

• Separate concentrated and diluted versions on the shelves and consider special labeling of the concentrated version.

For additional information contact Pharmacist Mutual Risk Management Department at RiskMgmt@phmic.com. z

Preserving Your Pharmacy License continued If the prosecuting attorney determines he or she will not prosecute, they will send you a letter to that effect. This essentially ends the complaint process against you. If the evidence supports disciplinary charges, the prosecuting attorney initiates a formal action against you.

In Part II of this Article, (which will be in the September-October issue), we will discuss what happens if the prosecution continues, including the administrative hearing, ability to settle the dispute and appeals. z

RESOURCES 1 Goldberg Katzman P.C. is general counsel to the Pennsylvania Pharmacists Association and practices in the area of professional licensure. Thomas J. Weber, Esq. is the lead attorney at Goldberg Katzman in this area of practice and was a resource for this article. Mr. Weber has written on general disciplinary procedures applicable to professionals. See The State Board of Dentistry and You, Pennsylvania Dental Journal, March/April 2006 Issue.

2 The Board has a wide range of penalties in addition to a suspension or revocation of your license. These include a reprimand, probation, requirement to take additional continuing education credits or civil penalties up to $10,000 per count.

3 Although the investigator typically shows up unannounced, they tend to be accommodating in rescheduling the interview at a mutually convenient time.

Pennsylvania Pharmacist I July/August 2016 I 41

Industry News

Pharmacists Mutual Pursues Case to Establish Compounding Pharmacists as Health Care Providers in Texas

By Don McGuire, R.Ph., J.D., General Counsel Pharmacists Mutual Companies Pharmacists Mutual Insurance Company defended a case against our insured pharmacy that had important implications for the pharmacy profession. In this case, the patient received an infusion of Lipoic Acid in her physician’s office in 2011. She suffered adverse reactions which resulted in weeks of hospitalization and permanent blindness. The patient blamed her injuries on the compounded Lipoic Acid and filed suit against her physician, the pharmacy, and six of its pharmacists. The allegations against the pharmacy and pharmacists included assertions that the Lipoic Acid was negligently prepared and was of an unsafe design.

Cases filed in Texas against physicians and other health care providers fall under the Texas Medical Liability Act. The Act requires that the plaintiff file an expert report within 120 days of the suit being filed.

Failure to file the required expert report will result in dismissal with prejudice of the case upon the motion of a health care provider. The patient here did not file an expert report against the pharmacy or the pharmacists. The pharmacy and pharmacists moved for dismissal. The trial court denied the defendants’ motion concluding that the patient’s claims were not health care liability claims as defined in the Act and the pharmacists were not health care providers as defined in the Act. The pharmacy and pharmacists appealed the ruling.

The Texas Court of Appeals affirmed the trial court’s decision and distinguished between pharmacists dispensing compounded medications directly to patients (covered by the Act) and those pharmacists providing compounded medications to physicians for office use (not covered by the Act). Following this ruling, the pharmacy and pharmacists appealed to the Texas Supreme Court.

The Texas Supreme Court reversed the previous rulings and ordered that the case be dismissed pursuant to the Texas Medical Liability Act for the failure to provide the expert report.1 The Supreme Court

42 I Pennsylvania Pharmacist I July/August 2016

concluded that the patient’s claims were health care liability claims as defined under the Act and that the pharmacists in this case were health care providers as defined under the Act. Analyzing the Act, the Texas Pharmacy Act, and the Board of Pharmacy regulations, the Court concluded that compounding pharmacists providing office use compounds to physicians were indeed health care providers and that the patient’s claims constituted a health care liability claim.

Other insurance carriers may not have recognized how detrimental the trial court and court of appeals decisions were to the practice of pharmacy. From a purely economic perspective, other insurers may have settled the case following the trial court’s ruling to end defense costs and avoid a potentially large judgment.

However, Pharmacists Mutual not only provides insurance protection for the pharmacy profession, but is an active promoter of the profession of pharmacy and the value that it can provide to the health care system in this country. The decision to push the case forward resulted in compounding pharmacists providing office use compounded medications being considered as health care providers under the Texas Medical Liability Act. This respect for, and promotion of, the pharmacy profession is what sets Pharmacists Mutual Insurance Company apart from other pharmacy insurers. z RESOURCES 1 Randol Mill Pharmacy, et al. v. Stacey Miller and Randy Miller, 465 S.W.3d. 612, (Tex., April 24, 2015).

Industry News

Pharmacists’ Role Under Pennsylvania’s New Medical Marijuana Law By: Steven E. Grubb, Esq., Goldberg Katzman, P.C. (attorney for PPA) Pennsylvania’s new medical marijuana law, while controversial, offers the mitigation of pain and suffering which could enhance the quality of life of many Pennsylvanians with serious medical issues. Important for pharmacists is that the new law will allow employment opportunities and potential business development. This article will address opportunities for pharmacists under Pennsylvania’s new medical marijuana law.

Note: This article is available online at http:// www.papharmacists.com/?page=LawsRegs and covers information related to each heading at right: 1. The Pharmacists’ Role at a Dispensary 2. Can a Pharmacy be a Medical Marijuana Dispensary?

3. Pharmacies Participating in a Medical Marijuana Research Program 4. The Elephant in the Room 5. Conclusions Additionally, PPA is working on special programming around medical cannabis for the Annual Conference – watch for more information. z

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Departments

Welcome! New Members PPA Welcomes the following New Members who joined the association on March 30, 2016 – May 23, 2016. Please make these new members feel welcome and part of Pennsylvania pharmacy!

Pharmacists

ASSOCIATEs

Leslie Johnson, Macungie, St. Luke’s University Health Network

Jeffrey Liberati, Monaca, Express Med Pharmacy Services

Alexandra Shannon, Mount Holly Springs, Alert Pharmacy Services, Inc.

Michael Durso, Cheshire, Cardinal Health

Robert Matza, Bensalem, Total Home Health Care Inc. Emily Lohr, Allison Park, Duquesne University Mylan School of Pharmacy

Kristen Robinson, Greensburg, Abbvie

StudentS Duquesne University – Mylan School of

Iakshmi Kandula, Hockessin, Good Health Pharmacy

Pharmacy

Terri Kroh, Carnegie, Self Employed

Meghan Cunningham, Eighty Four

Kristen Gawronski, Erie, LECOM School of Pharmacy

Jefferson School of Pharmacy

Jay Rhodes, Conestoga, Diamond Pharmacy

Brooke Barlow, Huntingdon Valley

Evan Lessa, Philadelphia, Gold’s Pharmacy

Jennifer Kmetich, Philadelphia

Theresa McCarthy, Greensburg, Uniontown Hospital

LECOM School of Pharmacy

Thomas Viola, Philadelphia College of Pharmacy Natalie McComb, South Park, Giant Eagle Benjamin Vrooman, Pleasantville, LECOM School of Pharmacy Kourtney Chichilitti, Chalfont, Professional Pharmacy of Pennsburg

Heather Whitmer, Etters

Ashley Barlow, Huntingdon Valley

Megan McCoy, Irwin Taylor Penpek, Erie Ohio Northern University Foud Bahamdain, Ada Nicholas Blaise Bileck, Pittsburgh Samantha Blake, Gibsonia

Yuan Chang, King of Prussia Michelle Mark, Philadelphia Mia Ro, Philadelphia Erik Berkheiser, Churchville Michelle Cottino, Basking Ridge Ali Shahbaz, Bensalem Emily Harkins, Ardmore Veronika Lagutina, Newtown Alyssa Nguyen, Philadelphia Veronika Tereshko Pulsifer, Elkins Park Tony Tran, Philadelphia Alenoush Vertanian, Philadelphia Jennifer Taing, Narberth Thanh Truong, Philadelphia University of Maryland Eastern Shore Richard Yim, Bel Aire University of Pittsburgh Danielle Shovel, Murrysville Andrea Evankovich, Wexford Zherui Guo, Pittsburgh Erica Wilson, Pittsburgh David Rose, Pittsburgh University of Rhode Island

Susan Lenhart-Herman, Sewickley, Sanofi

Megan Bookser, Pittsburgh

Sue Skledar, University of Pittsburgh School of Pharmacy

Sarah Bova, Erie

Wilkes University — Nesbitt College of Pharmacy

Debra Mekosh, Elysburg, Belski Community Pharmacy

Rachel Edeburn, Pittsburgh

Gabrielle Hayward, Sandy Ridge

Allison Fye, Reynoldsville

Jordan Borger, Kunkletown z

Rebecca Pulk, Bloomsburg, Geisinger Health System

Aliya Hutman-Zahler Conneaut Lake

Inmaculada Hernandez, Pittsburgh, University of Pittsburgh School of Pharmacy

Danielle Odette Johnson, Gibsonia

pharmacy technicians

Kaitlyn Bova, Erie

Mary Komandt, Delmont Shannon Nicole Kraus, Pittsburgh Elizabeth Anne Matthews, Allison Park Joseph Muscarella, Erie

Christine Heavey, Bensalem

Connor Rowan, Grove City

Luis Torres-Hernandez, Lancaster, Community Pharmacy

Philadelphia College of Pharmacy

Rebekah Zimmerman, Mohnton, Stauffers Drug Store

Sara Coulter, Philadelphia

Heather Rodgers, Indiana, CV

Emily Beardsley, Havertown

44 I Pennsylvania Pharmacist I July/August 2016

Soonyip Huang, Edison Temple University

James Levanduski, New Egypt

GENERIC PRICES MATTER!

RDC/Quality Care members receive the lowest everyday prices on generics across the board, and save even more with GIA, a first-of-its-kind automated monthly price protection program on new and existing generics!

GIA

GENERIC INTRODUCTION ADVANTAGE

• Automated Monthly Price Protection Credits on new generics (based on historical purchases)

• Fast auto-ship on popular new generic launches

• Price Increase protection for existing generics

• Extended Dating

• Manufacturer Exclusivity Expiration Notifications

• Guaranteed Sale

Over $1.17 million credited to RDC stores in the last year!

See your Territory Representative for more details!

INDEPENDENT PHARMACY IS OUR BUSINESS

www.rdcdrug.com

1.800.333.0538

ELEMENTS of Success Re

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Reputation

Affiliation

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Connections

Location

Jefferson College of Pharmacy is recognized as an emerging force in the future of Pharmacy education. We prepare students to be leaders, as demonstrated by victories in ASHP, APhA and ACCP student pharmacy competitions. Our grads have an above-average pass rate among all who take national boards. And, it’s happening just steps from the best Center City Philly has to offer. These are contributing elements to our success.

Jefferson.edu/PharmacyJournal