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Event Details

Date 2018/09/20
Time 10:30 AM
Recurring
Event status
Handicap access, ADA Contact info: Lee Ann Teshima, 808-586-2695
Title Board of Pharmacy Working Group
Location Queen Liliuokalani Conference Room, King Kalakaua Building, 335 Merchant St, 1st Floor, Honolulu, HI 96813
This event was posted on 09/13/2018 04:22 PM
This event was last updated on 09/13/2018 04:23 PM
BOARD OF PHARMACY
Professional and Vocational Licensing Division
Department of Commerce and Consumer Affairs
State of Hawaii
WORKING GROUP MEETING AGENDA 
 
Date: Thursday, September 20, 2018
Time: Immediately following the Board meeting (approx. time 10:30 a.m.)
Place: Queen Liliuokalani Conference Room, First Floor
King Kalakaua Building
335 Merchant Street
Honolulu, Hawaii 96813 
 
1. Call to Order, Public Notice – HRS §92-3 Open Meetings and HAR §16-89-70 Oral Testimony
2. Report from August 16, 2018 meeting.

 
Members of the “working group” are attending voluntarily so we would like to keep the meeting as efficient as possible, so due to the number of agenda items up for discussion, any presentation/discussion will be limited to 5 minutes so that the working group can address all the agenda items. 
 
3. Update on 2018 Legislation
a. SB 2247, SD1, HD2, CD1 Relating to Opioid Antagonists – Authorizes pharmacists to prescribe, dispense, and provide related education on opioid antagonists to individuals at risk of opioid overdose and to family members and caregivers of individuals at risk of opioid overdose without the need for a written, approved collaborative agreement; subject to certain conditions. (CD1) – Approved by the Governor on 7/9/2019, Act 154, SLH 2018
Draft of Bill That Includes Recommendations Discussed at August 16, 2018 Meeting
b. HB 2739, HD1 – Relating to Health - Establishes a regulated process under which an adult resident of the State with a medically confirmed terminal disease and less than six months to live may choose to obtain a prescription for medication to end the patient's life. Imposes criminal sanctions for tampering with a patient's request for a prescription or coercing a patient to request a prescription. (HB2739 HD1) – Act 2, SLH 2018
Lorrin Kim, Department of Health 
 
4. Discussion of Topics Raised at August Meeting – Updates/Additional Information
a. Definition of “Practice of pharmacy”
i. Lab Test
• CLIA Waived Test
• Glucose
• AIC
• Flu
• Hepatitis
• Pharmacologic PGX Testing (DNA)
• TB
• Strep Throat
• Conjunctivitis
• UTI
b. Return for Disposal
c. Chronic Care Management by Pharmacists – Pharmacists Filling Gaps in the Provision of Healthcare
d. EMR Update to PCP
e. Providership Status 
 
5. New Business
a. Board Approved Pilot and Demonstration Research Projects for Safe and Innovative Application in Pharmacy Practice
6. Next Meeting: October 18, 2018
Immediately following the Board of Pharmacy meeting
Queen Liliuokalani Conference Room, First Floor
King Kalakaua Building
335 Merchant Street
Honolulu, Hawaii 96813
7. Adjournment
 
Individuals who require special needs accommodations are invited to call Lee Ann Teshima, Executive Officer, at (808) 586-2695 at least 4 working days in advance of the meeting. 
 
9/13/18 
 
 
Report on August 16, 2018 Pharmacy Working Group Meeting 
 
Start: 9:48 a.m.
 
Present:
Paul Smith, Walgreens
Jared Redulla, Narcotics Enforcement Division
Tanya Demattis, CVS/Longs
Jonathan Ching, Kaiser
Kellie Noguchi, Kaiser
Tiffany Yajima, Ashford & Wriston/Walgreens
Lori Walmsley, Walgreens
Stacy Pi, Kaiser
Ashok Kota, Foodland
Lindsey Reinholz, UHH DKICOP
Veronica Morales, UHH DKICOP
Jacce Mikulanec, HMSA
Patrick Uyemoto, HPhA and Times
Dr. Glenn Wasserman, DOH
Fred Cruz, CVS Caremark
Reece Uyeno, Pharmacare
Mary Jo Keefe, Pharmerica
Alanna Isobe, Safeway
Mihoko Ito, Walgreens
Pono Chong, HMSA
Lee Ann Teshima, Executive Officer (“EO”), Board of Pharmacy
 
Issues Discussed:
Act 154, SLH 2018 Relating to Opioids
Recommendation to submit legislation to amend the new section in HRS 461 entitled “Opioid antagonist; authority to prescribe and dispense; requirements.”, as follows:
On page 4 of the proposed bill, lines 12 – 15 is amended to read as follows:
(3) Dispense the opioid antagonist to the individual who is at risk for an opioid overdose, family member, or individual requesting the opioid antagonist as soon as practicable after the pharmacist issues the prescription. (Walgreens)
New language is underscored.
HPhA As part of Workgroup 5 of the Statewide Opioid Task Force, Mr. Uyemoto asked about pharmacists/pharmacy reimbursement for prescribing and dispensing opioid antagonist.
August 16, 2018
Working Group Meeting
EO The EO reported that at the next meeting, she will share a draft of proposed legislation to allow pharmacists and other healthcare providers to be reimbursed for practicing within their scope of practice. She stated that the language was taken exactly out of a bill from the 2018 Legislative Session, SB 2774, Relating to Insurance.
Walgreens Ms. Walmsley asked if a pharmacy can transfer a prescription for an opioid antagonist to another pharmacy if the pharmacy does not have the opioid antagonist to be dispensed.
DOH Dr. Wasserman asked the EO for the Board of Pharmacy (“Board”) if a pharmacist had to “prescribe and dispense” or could the pharmacist “prescribe” but not dispense the opioid antagonist.
EO The EO reported that the Board discussed the “prescribing and dispensing” of opioid antagonist and the intent of the legislature was not to give pharmacists “prescriptive authority” but to give the pharmacist the authority to “prescribe and dispense” opioid antagonists, like women’s contraceptives.
Walgreens Ms. Walmsley stated that pharmacies cannot “force” a patient to fill their prescriptions from their pharmacy.
EO The EO stated that if the pharmacist prescribes the opioid antagonist, the law specifically states that the pharmacist shall “Dispense the opioid antagonist to the individual who is at risk for an opioid overdose, family member, or caregiver as soon as practicable after the pharmacist issues the prescription.”
So if the pharmacy does not have the opioid antagonist available, perhaps they should not prescribe it. She stated that pharmacists should be careful in going beyond what the intent of the law is and that perhaps, the working group can discuss recommendations to clarify this further.
Pharmacy Scope of Practice
DOH Dr. Wasserman asked about the scope of pharmacy practice and if consideration should be given to allow pharmacists to perform “lab tests” for the following:
• CLIA Waived test;
• Glucose;
August 16, 2018
Working Group Meeting
• AIC; Flu;
• Hepatitis;
• Pharmacologic PGX Testing (DNA);
• TB;
• Strep Throat;
• Conjunctivitis; and
• UTI
Safeway Ms. Isobe recommended that a specific list be considered for the types of test a pharmacist could administer and also what kind of training is available for pharmacists to conduct such tests.
HMSA Mr. Chong was concerned for keeping the patient’s physician informed, including updates to the “EMR” for the PCP.
KTA Ms. Okamura stated that pharmacists, especially in the rural areas where there is a shortage of PCPs, can provide these “gaps” in services, including but not limited to chronic care management.
EO She recommended that members bring forward language from other states that allow pharmacists to provide “testing” or other pharmacy practices for the working group’s consideration.
Drug Take Back Program
HMSA Mr. Chong asked who would be authorized to take back drugs?
NED Mr. Redulla reported that federally registered entities, with permission from NED, and licensed to collect may be able to take back drugs for disposal purposes, however, the concern is diversion of the returned drugs, the cost of a license for reverse distributors and amendments to the pharmacy scope of practice.
HMSA Mr. Chong was concerned with the cost of disposal being passed on to the consumer.
EO She asked that someone provide language from other states who allow pharmacies to take back drugs for disposal.
End: 10:45 a.m.
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