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Key: (1) language to be deleted (2) new language

CHAPTER 166--S.F.No. 2173
An act
relating to health; allowing a licensed physician to dispense drugs in a
health care facility located in a designated health professional shortage area
under certain conditions; authorizing automated drug distribution systems;
amending Minnesota Statutes 2010, section 151.01, by adding subdivisions;
Minnesota Statutes 2011 Supplement, section 151.19, 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 2010, section 151.01, is amended by adding a
subdivision to read:
    Subd. 2a. Limited service pharmacy. "Limited service pharmacy" means a
pharmacy that has been issued a restricted license by the board to perform a limited range
of the activities that constitute the practice of pharmacy.

    Sec. 2. Minnesota Statutes 2010, section 151.01, is amended by adding a subdivision
to read:
    Subd. 34. Health professional shortage area. "Health professional shortage area"
means an area designated as such by the federal Secretary of Health and Human Services,
as provided under Code of Federal Regulations, title 42, part 5, and United States Code,
title 42, section 254E.

    Sec. 3. Minnesota Statutes 2011 Supplement, section 151.19, is amended by adding a
subdivision to read:
    Subd. 4. Licensing of physicians to dispense drugs; renewals. (a) The board may
grant a license to any physician licensed under chapter 147 who provides services in a
health care facility located in a designated health professional shortage area authorizing
the physician to dispense drugs to individuals for whom pharmaceutical care is not
reasonably available. The license may be renewed annually. Any physician licensed under
this subdivision shall be limited to dispensing drugs in a limited service pharmacy and
shall be governed by the rules adopted by the board when dispensing drugs.
(b) For the purposes of this subdivision, pharmaceutical care is not reasonably
available if the limited service pharmacy in which the physician is dispensing drugs is
located in a health professional shortage area, and no other licensed pharmacy is located
within 15 miles of the limited service pharmacy.
(c) For the purposes of this subdivision, section 151.15, subdivision 2, shall not
apply, and section 151.215 shall not apply provided that a physician granted a license
under this subdivision certifies each filled prescription in accordance with Minnesota
Rules, part 6800.3100, subpart 3.
(d) Notwithstanding section 151.102, a physician granted a license under this
subdivision may be assisted by a pharmacy technician if the technician holds a valid
certification from the Pharmacy Technician Certification Board or from another national
certification body for pharmacy technicians that requires passage of a nationally recognized
psychometrically valid certification examination for certification as determined by the
board. The physician may supervise the pharmacy technician as long as the physician
assumes responsibility for all functions performed by the technician. For purposes of this
subdivision, supervision does not require the physician to be physically present if the
physician or a licensed pharmacist is available, either electronically or by telephone.
(e) Nothing in this subdivision shall be construed to prohibit a physician from
dispensing drugs pursuant to section 151.37 and Minnesota Rules, parts 6800.9950
to 6800.9954.

    Sec. 4. [151.58] AUTOMATED DRUG DISTRIBUTION SYSTEMS.
    Subdivision 1. Scope. This section applies only to the use of automated drug
distribution systems located within the facilities specified in subdivision 2. Except as
provided in this section, all applicable provisions of this chapter, chapter 152, and
Minnesota Rules, chapter 6800, must be followed.
    Subd. 2. Definitions. For purposes of this section only, the terms defined in this
subdivision have the meanings given.
(a) "Automated drug distribution system" or "system" means a mechanical system
approved by the board that performs operations or activities, other than compounding or
administration, related to the storage, packaging, or dispensing of drugs, and collects,
controls, and maintains all required transaction information and records.
(b) "Health care facility" means a nursing home licensed under section 144A.02;
a housing with services establishment registered under section 144D.01, subdivision 4,
in which a home provider licensed under chapter 144A is providing centralized storage
of medications; or a community behavioral health hospital or Minnesota sex offender
program facility operated by the Department of Human Services.
(c) "Managing pharmacy" means a pharmacy licensed by the board that controls and
is responsible for the operation of an automated drug distribution system.
    Subd. 3. Authorization. A pharmacy may use an automated drug distribution
system to fill prescription drug orders for patients of a health care facility. The automated
drug distribution system may be located in a health care facility that is not at the same
location as the managing pharmacy. When located within a health care facility, the system
is considered to be an extension of the managing pharmacy.
    Subd. 4. Notification. (a) At least 60 days prior to the initial use of an automated
drug distribution system, the managing pharmacy must provide the board with written
notification of the address at which the automated drug distribution system will be
located, the manufacturer and model of the automated drug distribution system, and
written policies and procedures that govern the operation of the system. The policies
and procedures must address the requirements of subdivision 5 and the rules of the
board. If the managing pharmacy will be using a system identical to the one for which
it has previously provided notification to the board, and will be using identical policies
and procedures, it must notify the board of the address at which the automated drug
distribution system will be located and the manufacturer and model of the automated drug
distribution system at least seven days in advance of using the system.
(b) The managing pharmacy must notify the board whenever an automated drug
distribution system is taken permanently out of service.
(c) The managing pharmacy must notify the board whenever an automated drug
distribution system is replaced. It must also provide the board with new written policies
and procedures, unless an identical system is used as the replacement, 60 days prior to
the replacement of the system.
    Subd. 5. Operation of automated drug distribution systems. (a) The managing
pharmacy and the pharmacist in charge are responsible for the operation of an automated
drug distribution system.
(b) Access to an automated drug distribution system must be limited to pharmacy
and nonpharmacy personnel authorized to procure drugs from the system, except that field
service technicians may access a system located in a health care facility for the purposes of
servicing and maintaining it while being monitored either by the managing pharmacy, or a
licensed nurse within the health care facility. In the case of an automated drug distribution
system that is not physically located within a licensed pharmacy, access for the purpose
of procuring drugs shall be limited to licensed nurses. Each person authorized to access
the system must be assigned an individual specific access code. Alternatively, access to
the system may be controlled through the use of biometric identification procedures. A
policy specifying time access parameters, including time-outs, logoffs, and lockouts,
must be in place.
(c) For the purposes of this section only, the requirements of section 151.215 are met
if the following clauses are met:
(1) a pharmacist employed by and working at the managing pharmacy must review,
interpret, and approve all prescription drug orders before any drug is distributed from the
system to be administered to a patient. A pharmacy technician may perform data entry of
prescription drug orders provided that a pharmacist certifies the accuracy of the data entry
before the drug can be released from the automated drug distribution system. A pharmacist
must certify the accuracy of the filling of any cassettes, canisters, or other containers that
contain drugs that will be loaded into the automated drug distribution system; and
(2) when the automated drug dispensing system is located and used within the
managing pharmacy, a pharmacist must personally supervise and take responsibility for all
packaging and labeling associated with the use of an automated drug distribution system.
(d) Access to drugs when a pharmacist has not reviewed and approved the
prescription drug order is permitted only when a formal and written decision to allow such
access is issued by the pharmacy and the therapeutics committee or its equivalent. The
committee must specify the patient care circumstances in which such access is allowed,
the drugs that can be accessed, and the staff that are allowed to access the drugs.
(e) In the case of an automated drug distribution system that does not utilize bar
coding in the loading process, the loading of a system located in a health care facility may
be performed by a pharmacy technician, so long as the activity is continuously supervised,
through a two-way audiovisual system by a pharmacist on duty within the managing
pharmacy. In the case of an automated drug distribution system that utilizes bar coding
in the loading process, the loading of a system located in a health care facility may be
performed by a pharmacy technician or a licensed nurse, provided that the managing
pharmacy retains an electronic record of loading activities.
(f) The automated drug distribution system must be under the supervision of a
pharmacist. The pharmacist is not required to be physically present at the site of the
automated drug distribution system if the system is continuously monitored electronically
by the managing pharmacy. A pharmacist on duty within a pharmacy licensed by the
board must be continuously available to address any problems detected by the monitoring
or to answer questions from the staff of the health care facility. The licensed pharmacy
may be the managing pharmacy or a pharmacy which is acting as a central services
pharmacy, pursuant to Minnesota Rules, part 6800.4075, for the managing pharmacy.
Presented to the governor April 5, 2012
Signed by the governor April 9, 2012, 01:04 p.m.

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