Minnesota Legislature
HF 4009
as introduced - 92nd Legislature (2021 - 2022) Posted on 03/14/2022 04:34pm
Current Version - as introduced
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A bill for an act
relating to health occupations; expanding licensed pharmacist authority to initiate,
order, and administer vaccines and certain medical and laboratory tests; requiring
coverage under medical assistance; amending Minnesota Statutes 2020, sections
151.01, subdivision 27; 256B.0625, by adding a subdivision.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2020, section 151.01, subdivision 27, is amended to read:
Subd. 27.
Practice of pharmacy.
"Practice of pharmacy" means:
(1) interpretation and evaluation of prescription drug orders;
(2) compounding, labeling, and dispensing drugs and devices (except labeling by a
manufacturer or packager of nonprescription drugs or commercially packaged legend drugs
and devices);
(3) participation in clinical interpretations and monitoring of drug therapy for assurance
of safe and effective use of drugs, including deleted text begin the performance ofdeleted text end new text begin ordering and performingnew text end
laboratory tests that are waived under the federal Clinical Laboratory Improvement Act of
1988, United States Code, title 42, section 263a et seq.deleted text begin , provided that a pharmacist may
interpret the results of laboratory tests but may modifydeleted text end new text begin A pharmacist may collect specimens,
interpret results, notify the patient of results, and refer patients to other health care providers
for follow-up care and may initiate, modify, or discontinuenew text end drug therapy deleted text begin onlydeleted text end pursuant to
a protocol or collaborative practice agreementnew text begin . A pharmacist may delegate the authority to
administer tests under this clause to a pharmacy technician or pharmacy internnew text end ;
(4) participation in drug and therapeutic device selection; drug administration for first
dosage and medical emergencies; intramuscular and subcutaneous administration used for
the treatment of alcohol or opioid dependence; drug regimen reviews; and drug or
drug-related research;
(5) drug administration, through intramuscular and subcutaneous administration used
to treat mental illnesses as permitted under the following conditions:
(i) upon the order of a prescriber and the prescriber is notified after administration is
complete; or
(ii) pursuant to a protocol or collaborative practice agreement as defined by section
151.01, subdivisions 27b and 27c, and participation in the initiation, management,
modification, administration, and discontinuation of drug therapy is according to the protocol
or collaborative practice agreement between the pharmacist and a dentist, optometrist,
physician, podiatrist, or veterinarian, or an advanced practice registered nurse authorized
to prescribe, dispense, and administer under section 148.235. Any changes in drug therapy
or medication administration made pursuant to a protocol or collaborative practice agreement
must be documented by the pharmacist in the patient's medical record or reported by the
pharmacist to a practitioner responsible for the patient's care;
(6) deleted text begin participation in administration of influenza vaccines anddeleted text end new text begin initiating, ordering, and
administeringnew text end vaccines new text begin authorized or new text end approved by the United States Food and Drug
Administration deleted text begin related to COVID-19 or SARS-CoV-2deleted text end to all eligible individuals deleted text begin sixdeleted text end new text begin threenew text end
years of age and older deleted text begin and all other vaccines to patients 13 years of age and older by written
protocol with a physician licensed under chapter 147, a physician assistant authorized to
prescribe drugs under chapter 147A, or an advanced practice registered nurse authorized to
prescribe drugs under section 148.235, provided thatdeleted text end new text begin according to the federal Advisory
Committee on Immunization Practices schedules. A pharmacist may delegate the authority
to administer vaccines under this clause to a pharmacy technician or pharmacy intern who
has completed training in vaccine administration ifnew text end :
deleted text begin
(i) the protocol includes, at a minimum:
deleted text end
deleted text begin
(A) the name, dose, and route of each vaccine that may be given;
deleted text end
deleted text begin
(B) the patient population for whom the vaccine may be given;
deleted text end
deleted text begin
(C) contraindications and precautions to the vaccine;
deleted text end
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(D) the procedure for handling an adverse reaction;
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deleted text begin
(E) the name, signature, and address of the physician, physician assistant, or advanced
practice registered nurse;
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deleted text begin
(F) a telephone number at which the physician, physician assistant, or advanced practice
registered nurse can be contacted; and
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deleted text begin
(G) the date and time period for which the protocol is valid;
deleted text end
deleted text begin (ii)deleted text end new text begin (i)new text end the pharmacist deleted text begin hasdeleted text end new text begin and the pharmacy technician or pharmacy intern havenew text end
successfully completed a program approved by the Accreditation Council for Pharmacy
Education new text begin (ACPE) new text end specifically for the administration of immunizations or a program
approved by the board;
deleted text begin (iii)deleted text end new text begin (ii)new text end the pharmacist deleted text begin utilizesdeleted text end new text begin and the pharmacy technician or pharmacy intern utilizenew text end
the Minnesota Immunization Information Connection to assess the immunization status of
individuals prior to the administration of vaccines, except when administering influenza
vaccines to individuals age deleted text begin ninedeleted text end new text begin threenew text end and older;
deleted text begin (iv)deleted text end new text begin (iii)new text end the pharmacist reports the administration of the immunization to the Minnesota
Immunization Information Connection; deleted text begin and
deleted text end
deleted text begin
(v) the pharmacist complies with guidelines for vaccines and immunizations established
by the federal Advisory Committee on Immunization Practices, except that a pharmacist
does not need to comply with those portions of the guidelines that establish immunization
schedules when administering a vaccine pursuant to a valid, patient-specific order issued
by a physician licensed under chapter 147, a physician assistant authorized to prescribe
drugs under chapter 147A, or an advanced practice registered nurse authorized to prescribe
drugs under section 148.235, provided that the order is consistent with the United States
Food and Drug Administration approved labeling of the vaccine;
deleted text end
new text begin
(iv) if the patient is 18 years of age or younger, the pharmacist, pharmacy technician,
or pharmacy intern informs the patient and any adult caregiver accompanying the patient
of the importance of a well-child visit with a pediatrician or other licensed primary care
provider; and
new text end
new text begin
(v) in the case of a pharmacy technician administering vaccinations while being
supervised by a licensed pharmacist:
new text end
new text begin
(A) the pharmacist is readily and immediately available to the immunizing pharmacy
technician;
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new text begin
(B) the pharmacy technician has a current certificate in basic cardiopulmonary
resuscitation; and
new text end
new text begin
(C) the pharmacy technician has completed a minimum of two hours of ACPE-approved,
immunization-related continuing pharmacy education as part of the pharmacy technician's
two-year continuing education schedule;
new text end
(7) participation in the initiation, management, modification, and discontinuation of
drug therapy according to a written protocol or collaborative practice agreement between:
(i) one or more pharmacists and one or more dentists, optometrists, physicians, podiatrists,
or veterinarians; or (ii) one or more pharmacists and one or more physician assistants
authorized to prescribe, dispense, and administer under chapter 147A, or advanced practice
registered nurses authorized to prescribe, dispense, and administer under section 148.235.
Any changes in drug therapy made pursuant to a protocol or collaborative practice agreement
must be documented by the pharmacist in the patient's medical record or reported by the
pharmacist to a practitioner responsible for the patient's care;
(8) participation in the storage of drugs and the maintenance of records;
(9) patient counseling on therapeutic values, content, hazards, and uses of drugs and
devices;
(10) offering or performing those acts, services, operations, or transactions necessary
in the conduct, operation, management, and control of a pharmacy;
(11) participation in the initiation, management, modification, and discontinuation of
therapy with opiate antagonists, as defined in section 604A.04, subdivision 1, pursuant to:
(i) a written protocol as allowed under clause (7); or
(ii) a written protocol with a community health board medical consultant or a practitioner
designated by the commissioner of health, as allowed under section 151.37, subdivision 13;
and
(12) prescribing self-administered hormonal contraceptives; nicotine replacement
medications; and opiate antagonists for the treatment of an acute opiate overdose pursuant
to section 151.37, subdivision 14, 15, or 16.
Sec. 2.
Minnesota Statutes 2020, section 256B.0625, is amended by adding a subdivision
to read:
new text begin Subd. 13k. new text end
new text begin Vaccines and laboratory tests provided by pharmacists. new text end
new text begin
(a) Medical
assistance covers vaccines initiated, ordered, or administered by a licensed pharmacist,
according to the requirements of section 151.01, subdivision 27, clause (6), at no less than
the rate for which the same services are covered when provided by any other licensed
practitioner.
new text end
new text begin
(b) Medical assistance covers laboratory tests ordered and performed by a licensed
pharmacist, according to the requirements of section 151.01, subdivision 27, clause (3), at
no less than the rate for which the same services are covered when provided by any other
licensed practitioner.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2023, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end