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SF 1643

as introduced - 93rd Legislature (2023 - 2024) Posted on 02/17/2023 08:38am

KEY: stricken = removed, old language.
underscored = added, new language.

Current Version - as introduced

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A bill for an act
relating to health care; authorizing pharmacists to prescribe, dispense, and
administer hydroxychloroquine and ivermectin for preexposure prophylaxis use,
postexposure prophylaxis use, or the treatment of COVID-19; amending Minnesota
Statutes 2022, sections 151.01, subdivision 27; 151.37, by adding a subdivision.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2022, 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 the performance of laboratory tests that are
waived under the federal Clinical Laboratory Improvement Act of 1988, United States Code,
title 42, section 263a et seq., provided that a pharmacist may interpret the results of laboratory
tests but may modify drug therapy only pursuant to a protocol or collaborative practice
agreement;

(4) participation in drug and therapeutic device selection; drug administration for first
dosage and medical emergencies; intramuscular and subcutaneous drug administration under
a prescription drug order; 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, physician assistant, 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) participation in administration of influenza vaccines and vaccines approved by the
United States Food and Drug Administration related to COVID-19 or SARS-CoV-2 to all
eligible individuals six years of age and older 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 that:

(i) the protocol includes, at a minimum:

(A) the name, dose, and route of each vaccine that may be given;

(B) the patient population for whom the vaccine may be given;

(C) contraindications and precautions to the vaccine;

(D) the procedure for handling an adverse reaction;

(E) the name, signature, and address of the physician, physician assistant, or advanced
practice registered nurse;

(F) a telephone number at which the physician, physician assistant, or advanced practice
registered nurse can be contacted; and

(G) the date and time period for which the protocol is valid;

(ii) the pharmacist has successfully completed a program approved by the Accreditation
Council for Pharmacy Education specifically for the administration of immunizations or a
program approved by the board;

(iii) the pharmacist utilizes 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 nine and older;

(iv) the pharmacist reports the administration of the immunization to the Minnesota
Immunization Information Connection; and

(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;

(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, physician
assistants, 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;

(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; deleted text begin and
deleted text end

(13) participation in the placement of drug monitoring devices according to a prescription,
protocol, or collaborative practice agreementdeleted text begin .deleted text end new text begin ; and
new text end

new text begin (14) prescribing, dispensing, and administering hydroxychloroquine and ivermectin
pursuant to section 151.37, subdivision 17.
new text end

Sec. 2.

Minnesota Statutes 2022, section 151.37, is amended by adding a subdivision to
read:


new text begin Subd. 17. new text end

new text begin Hydroxychloroquine and ivermectin. new text end

new text begin (a) A pharmacist is authorized to
prescribe, dispense, and administer hydroxychloroquine and ivermectin to a patient if the
patient is 18 years of age or older and the protocols described in this subdivision are followed.
Hydroxychloroquine and ivermectin may be prescribed, if appropriate, for either preexposure
or postexposure prophylaxis purposes or for the treatment of COVID-19. A pharmacist
must not prescribe more than a 30-day supply of the drug at a time. Any prescription issued
under this subdivision is issued and dispensed for a legitimate medical purpose in the usual
course of professional practice.
new text end

new text begin (b) Before the pharmacist prescribes hydroxychloroquine or ivermectin, the patient must
complete a self-screening tool to identify possible patient risk factors and the pharmacist
must review the completed screening tool with the patient, including a discussion with the
patient on any possible risks in taking one of these drugs.
new text end

new text begin (c) If hydroxychloroquine or ivermectin is prescribed by the pharmacist, the pharmacist
must provide counseling to the patient before dispensing the drug. The counseling must
include the appropriate method for using the drug, contraindications, possible adverse effects
and the need to seek appropriate medical care, the importance of follow-up care, and any
additional information listed in Minnesota Rules, part 6800.0910, subpart 2, that is required
to be given to a patient during the counseling session. The pharmacist must also provide
the patient with an information sheet written in plain language that contains the information
provided during the counseling session. Nothing in the counseling or information sheet shall
discourage a patient from using hydroxychloroquine or ivermectin for the prevention or
treatment of COVID-19 unless specifically contraindicated.
new text end

new text begin (d) The pharmacist must provide the patient with a written record of the drug prescribed
and must document in the patient's record the drug prescribed, that the screening tool was
completed and reviewed with the patient, and that the patient received the required counseling
and information sheet.
new text end

new text begin (e) The Board of Pharmacy shall not deny, revoke, suspend, or otherwise take disciplinary
action against a pharmacist who prescribes or dispenses hydroxychloroquine or ivermectin
in accordance with this subdivision.
new text end

new text begin (f) If the United States Food and Drug Administration permits hydroxychloroquine or
ivermectin to be available over the counter, hydroxychloroquine or ivermectin must be
made available over the counter in this state without a prescription order or consultation
with a pharmacist or other health care professional.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end