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Official Newsjournal of the Illinois Council of Health-System Pharmacists

Collaborative Pharmaceutical Task Force Report - July
More Recommendations Get a Vote!

by Scott A. Meyers, Executive Vice President

On Tuesday, July 9th the Collaborative Pharmaceutical Task Force met in Chicago and Springfield as usual. Following a trend begun at its June meeting, the Task Force voted on several recommendations that will be written up by the staff of the Illinois Department of Financial and Professional Regulation for presentation to the General Assembly this fall. The Task Force reviewed the list of tasks assigned to them by the General Assembly and noted that much of the work will be completed by the end of the July meeting. At this time the Task Force is scheduled to meet one more time in August and then their recommendations will be presented to the General Assembly in time for the fall veto session.

Here are the motions that were discussed and their votes:

Motion No. 1
Motion regarding “Pharmacy Technician Continuing Education and Duties”

So moved, that the Collaborative Pharmaceutical Task Force, intends to address the following directive contained in Section 4.5 of the Pharmacy Practice Act, which states that:

In developing standards related to its discussions, the Collaborative Pharmaceutical Task Force shall consider the extent to which Public Act 99473 (enhancing continuing education requirements for pharmacy technicians) may be relevant to the issues listed in Section 4.5 of the Pharmacy Practice Act.

by recommending amendments to sections of the Pharmacy Practice Act and Rules and the Controlled Substance Act, as shown on the document entitled “Proposed Changes Related to Duties of Pharmacy Technicians.” These amendments are intended to accomplish the following:

A. Require that pharmacy technicians be specifically trained for the tasks which they are assigned to accomplish, while retaining the exception that certain tasks cannot be delegated to pharmacy technicians;

B. Require that pharmacy technicians obtain documentation from a pharmacist-in-charge verifying that he or she has successfully completed a standardized nationally accredited education and training program with an objective assessment mechanism to be licensed, if they have not graduated from a pharmacy technician training program meeting the requirements of the Ac t;

C. Permit pharmacy technicians to administer vaccinations/immunizations to persons, as long as they successfully complete a course of training on the administration of vaccines approved by the Department and are directly supervised by a pharmacist; and

D. Permits student pharmacists and registered pharmacy technicians to transfer prescriptions between pharmacies for the purpose of original or refill dispensing, and to receive prescriptions for controlled substances from an employee or agent of the individual practitioner pursuant to the directions and order of that practitioner.

The Task Force voted 7-0-0 (in favor-opposed-abstain) on the motion. Brian Kramer representing the Illinois Long-term Care Pharmacy Providers Association was absent from the meeting. There was some discussion that pharmacy technicians should not be permitted to transfer controlled substance prescriptions but no conclusion was reached and the language of the motion was not revised in that regard.

Motion No. 2
Motion regarding “Pharmacy Prescription Systems Contain Mechanisms that Require Prescription Discontinuation Orders to be Forwarded to a Pharmacy”

So moved, that the Collaborative Pharmaceutical Task Force, intends to address the following directive contained in Section 4.5 of the Pharmacy Practice Act, which states that:

[T]he extent to which requiring the Department to adopt rules requiring pharmacy prescription systems contain mechanisms to require prescription discontinuation orders to be forwarded to a pharmacy.

by recommending amendments to sections of the Pharmacy Practice Act, or the Rules promulgated thereunder, which state the following:

A. Effective January 1, 2021, all pharmacies that use the SCRIPT standard for receiving electronic prescriptions must enable, activate, and maintain the ability to receive transmissions of electronic prescription cancellation and to transmit cancellation response transactions.

B. Within two (2) business days of receipt of a prescription cancellation transaction, pharmacy staff must either review the cancellation transaction for deactivation or provide that deactivation occurs automatically.

The Task Force voted 7-0-0 (in favor-opposed-abstain) on the motion. Brian Kramer representing the Illinois Long-term Care Pharmacy Providers Association was absent from the meeting. Task Force members believed that this was appropriate and were informed that any pharmacy using the SCRIPT standard for receiving e-prescriptions merely needs to turn on this function, train staff and develop pharmacy procedures to meet the intent of the changes.

Motion No. 3
Motion regarding “Pharmacy Employee Termination”

As the Pharmacy Practice Act currently requires that Pharmacies or pharmacists-incharge file a report with the Department’s Chief Pharmacy Coordinator in every instance where a pharmacist, registered certified pharmacy technician or a registered pharmacy technician “is terminated for actions which may have threatened patient safety,” it is moved, that the Collaborative Pharmaceutical Task Force recommends against the adoption of any additional language within the Pharmacy Practice Act, or the Rules thereunder, addressing the following directive listed in Section 4.5 of the Act:

In developing standards related to its discussions, the Collaborative Pharmaceutical Task Force shall consider the extent to which Public Act 99-863 (enhancing reporting requirements to the Department of pharmacy employee terminations) may be relevant to the issues listed in paragraphs (1) and (2).

The Task Force voted 7-0-0 (in favor-opposed-abstain) on the motion. Brian Kramer representing the Illinois Long-term Care Pharmacy Providers Association was absent from the meeting. Since very clear language already exists within the Pharmacy Practice Act, the Task Force members felt any additional language was unnecessary. However, the Task Force did urge the Department to re-establish its Board of Pharmacy newsletter and distribute this key information to all registrants. Representatives of several pharmacy associations indicated that they will inform their members of the existing language.

The voting concluded with the above three motions. The Task Force then considered requiring community pharmacies with auto-refill programs to use these programs only after the patient or the patient’s agent “opt in”. There was substantial debate on whether the patient or the patient’s agent should opt in for each new prescription or whether they could opt in for the system once for all prescriptions. Any decision was deferred to the August meeting.

The Task Force also deliberated on notifications provided by auto-refill systems and whether or not telephone or text notifications that a refill was ready should contain the medication name, strength and other important information within the notification. The Task Force believes that including these items of information in a text or voicemail message that could be recorded and found by other individuals would create a HIPAA violation. In addition, many pharmacy providers already have telephone apps that can provide this information in a password protected environment. The Task Force felt that this request did not make sense.

The Task Force will discuss and approve, at its next meeting, rationale for each vote taken by it. The rationale will include a majority and minority opinion when each exists.

Prior to the conclusion of the July Task Force meeting, Dr. Jerry Bauman, Dean Emeritus at the University of Illinois at Chicago College of Pharmacy, expressed the desire for the Task Force to consider and hopefully vote on one additional recommendation to the General Assembly at the August meeting. This recommendation would ask the General Assembly to convene a new Task Force to seriously consider the underlying cause of most of the issues this Task Force addressed during the past 18+ months. That underlying cause is the current mechanism of pharmacist and pharmacy reimbursement for services. The current mechanism revolves solely around the provision of a commodity (in pharmacy’s case, the medication). This mechanism does not provide any remuneration for patient care services and provides absolutely no incentive to ever discontinue a medication that is no longer needed or even contraindicated. Dr. Bauman and Garth Reynolds will work on a document to be considered at the August meeting. In the opinion of this author and member of the Task Force, it will truly be the most important recommendation we can make to our legislators in Springfield!

The next meeting of the Task Force will be held on Tuesday, August 13th at 1:30 pm in Chicago and Springfield. Exact locations for each site have not yet been announced but will eventually be posted on the Department website at www.idfpr.com. Pharmacists, pharmacy technicians and pharmacy students may and are encouraged to attend this meeting just as they have been for all previous meetings.