California Governor Jerry Brown signed the state’s pharmacist provider status bill (Senate Bill 493) on October 1, the first day of American Pharmacists Month. The new law will go into effect January 1, 2014. Pharmacists will be recognized as health care providers in California, giving them various new authorizations to care for patients.
Pharmacists, as part of their new expanded role in healthcare, can provide consultation, training, and education about drug therapy, disease management, and disease prevention services. All licensed pharmacists will be allowed to administer drugs and biologics by injection when ordered by a prescriber. Pharmacists may also participate in a review of patient progress, access medical records, order and interpret tests to manage drug therapies in coordination with the patient’s prescriber. The law also authorizes all licensed pharmacists to “furnish” (specific statute language) self-administered hormonal contraceptives and prescription-level nicotine replacement drugs for smoking cessation without a physician’s prescription under a statewide protocol. Pharmacists may also furnish travel medications not requiring a diagnosis and administer immunizations to patients 3 years and older without a physician protocol.
Senate Bill 493 also authorizes Advanced Practice Pharmacist (APP) recognition, which enables pharmacists to perform additional healthcare tasks. An APP can perform patient assessments, refer patients to other health care providers, and participate in the complete process surrounding evaluation and management of diseases and health conditions in collaboration with other health care providers. In order to become recognized as an APP, pharmacists must complete two of the following three criteria: (1) certification in a relevant area of practice, (2) a postgraduate residency program, or (3) 1 year of experience providing clinical services to patients under a collaborative practice agreement or protocol with a physician, APP pharmacist, collaborative drug therapy management pharmacist, or health system.
The American Pharmacists Association (APhA) is working to support recognition of pharmacists as providers in health care. The Association is working with other pharmacy organizations to develop principles and language for possible federal legislation. Additionally, APhA is pursuing advocacy activities by educating and lobbying Members of Congress on pharmacist provider status. APhA and other pharmacy organizations continue to work together to highlight current evidence supporting the value of pharmacists’ patient care services. APhA is developing a series of briefs for APhA members to identify opportunities and implement new services in Accountable Care Organizations (ACOs). In September, APhA held a meeting with executives from 11 state pharmacy associations to discuss successes, opportunities, and challenges in each state to determine potential issues when pursuing pharmacist provider status. California’s new law recognizing pharmacists as healthcare providers in an important model for future state and federal statutes.