SF 3940

1st Engrossment - 92nd Legislature (2021 - 2022) Posted on 03/30/2022 10:25am

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; proposing coding
for new law in Minnesota Statutes, chapter 151.

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 of deleted text end new text begin ordering and performing new 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 modify deleted 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 discontinue new text end drug therapy deleted text begin only deleted text end pursuant to
a protocol or collaborative practice agreement new text begin . A pharmacy technician or pharmacist intern
may perform tests authorized under this clause if the technician or intern is working under
the direct supervision of a pharmacist new 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) 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 new text begin the pharmacist new 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

deleted text begin (D) the procedure for handling an adverse reaction;
deleted text end

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

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

deleted text begin (G) the date and time period for which the protocol is valid;
deleted text end

deleted text begin (ii) the pharmacist deleted text end new text begin (i) new text end 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;

deleted text begin (iii) the pharmacist deleted text end new text begin (ii) new text end 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;

deleted text begin (iv) the pharmacist deleted text end new text begin (iii) new text end 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 deleted text end new text begin (iv) new text end 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 deleted text begin when deleted text end new text begin if the pharmacist is new text end 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; new text begin and
new text end

new text begin (v) if the patient is 18 years of age or younger, 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;
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.

new text begin [151.103] DELEGATION OF VACCINE ADMINISTRATION.
new text end

new text begin (a) A pharmacy technician or pharmacist intern may administer vaccines under section
151.01, subdivision 27, clause (6), if the technician or intern:
new text end

new text begin (1) is under the direct supervision of a pharmacist while administering the vaccine;
new text end

new text begin (2) has successfully completed a program approved by the Accreditation Council for
Pharmacy Education (ACPE) specifically for the administration of immunizations or a
program approved by the board;
new text end

new text begin (3) has a current certificate in basic cardiopulmonary resuscitation; and
new text end

new text begin (4) if delegated to a pharmacy technician, the technician has completed:
new text end

new text begin (i) one of the training programs listed under Minnesota Rules, part 6800.3850, subpart
1h, item B; and
new text end

new text begin (ii) 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

new text begin (b) Direct supervision under this section must be in-person and must not be done through
telehealth as defined under section 62A.673, subdivision 2.
new text end

Sec. 3.

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