87R12691 KKR-F

By: Cortez, Clardy, Price, et al. H.B. No. 678

Substitute the following for H.B. No. 678:

By: Klick C.S.H.B. No. 678

A BILL TO BE ENTITLED

AN ACT

relating to the administration of a medication and the ordering and administration of an immunization or vaccination by a pharmacist.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Section 551.003(33), Occupations Code, is amended to read as follows:

(33) "Practice of pharmacy" means:

(A) providing an act or service necessary to provide pharmaceutical care;

(B) interpreting or evaluating a prescription drug order or medication order;

(C) participating in drug or device selection as authorized by law, and participating in drug administration, drug regimen review, or drug or drug-related research;

(D) providing patient counseling;

(E) being responsible for:

(i) dispensing a prescription drug order or distributing a medication order;

(ii) compounding or labeling a drug or device, other than labeling by a manufacturer, repackager, or distributor of a nonprescription drug or commercially packaged prescription drug or device;

(iii) properly and safely storing a drug or device; or

(iv) maintaining proper records for a drug or device;

(F) performing for a patient a specific act of drug therapy management delegated to a pharmacist by a written protocol from a physician licensed in this state in compliance with Subtitle B; [or]

(G) subject to Section 554.052(c-1), ordering or administering an immunization or vaccination to a patient who is at least three years of age; or

(H) if the patient is younger than three years of age and is referred to a pharmacist by a physician, administering an immunization or vaccination to a patient under a physician's written protocol.

SECTION 2. The heading to Section 554.004, Occupations Code, is amended to read as follows:

Sec. 554.004. ADMINISTRATION OF MEDICATION; ORDERING AND ADMINISTRATION OF IMMUNIZATION OR VACCINATION.

SECTION 3. Section 554.004(a), Occupations Code, is amended to read as follows:

(a) The board shall specify conditions under which a pharmacist may administer medication and order or administer [, including] an immunization or [and] vaccination. The conditions for ordering or administering an immunization or vaccination must ensure that:

(1) [a licensed health care provider authorized to administer the medication is not reasonably available to administer the medication;

[(2) failure to administer the medication, other than an immunization or vaccination, might result in a significant delay or interruption of a critical phase of drug therapy;

[(3)] the pharmacist possesses the necessary skill, education, and certification as specified by the board to order or administer the immunization or vaccination [medication];

(2) [(4)] within a reasonable time after administering an immunization or vaccination that is prescribed by a licensed health care provider [medication], the pharmacist notifies the licensed health care provider responsible for the patient's care that the immunization or vaccination [medication] was administered;

[(5) the pharmacist may not administer medication to a patient at the patient's residence, except at a licensed nursing home or hospital;

[(6) the pharmacist administers an immunization or vaccination under a physician's written protocol and meets the standards established by the board;] and

(3) [(7)] the authority of a pharmacist to administer an immunization or vaccination [medication] may [not] be delegated to a certified pharmacy technician.

SECTION 4. Sections 554.052(a), (b), (c), and (c-1), Occupations Code, are amended to read as follows:

(a) The board by rule shall require a pharmacist to notify a physician who prescribes an immunization or vaccination not later than the 14th day [within 24 hours] after the date the pharmacist administers the immunization or vaccination.

(b) The board shall establish minimum education and continuing education standards for a pharmacist who orders or administers an immunization or vaccination. The standards must include Centers for Disease Control and Prevention training, basic life support training, and hands-on training in techniques for administering immunizations and vaccinations.

(c) Supervision by a physician is adequate if the delegating physician:

(1) is responsible for formulating or approving an order or protocol, including the physician's order, standing medical order, or standing delegation order, and periodically reviews the order or protocol and the services provided to a patient under the order or protocol;

(2) [except as provided by Subsection (c-1),] has established a physician-patient relationship with each patient who is younger than three [under 14] years of age and referred the patient to the pharmacist;

(3) is geographically located to be easily accessible to the pharmacy where an immunization or vaccination is administered;

(4) receives, as appropriate, a periodic status report on the patient, including any problem or complication encountered; and

(5) is available through direct telecommunication for consultation, assistance, and direction.

(c-1) A pharmacist may order or administer an immunization or [influenza] vaccination to a patient who is at least three [over seven] years of age without an established physician-patient relationship if the immunization or vaccination is:

(1) authorized or approved by the United States Food and Drug Administration or listed in the routine immunization schedule recommended by the federal Advisory Committee on Immunization Practices published by the federal Centers for Disease Control and Prevention; and

(2) ordered or administered in accordance with the federal Advisory Committee on Immunization Practices vaccine-specific recommendations.

SECTION 5. This Act takes effect September 1, 2021.