S.B. No. 659
AN ACT
1-1 relating to the ability of a pharmacist to perform a specific act
1-2 delegated to the pharmacist by a written order or protocol.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Section 5, Texas Pharmacy Act (Article 4542a-1,
1-5 Vernon's Texas Civil Statutes), is amended by amending Subdivision
1-6 (38) and by adding Subdivision (50) to read as follows:
1-7 (38) "Practice of pharmacy" means:
1-8 (A) provision of those acts or services
1-9 necessary to provide pharmaceutical care;
1-10 (B) interpretation and evaluation of
1-11 prescription drug orders or medication orders;
1-12 (C) participation in drug and device selection
1-13 as authorized by law, drug administration, drug regimen review, or
1-14 drug or drug-related research;
1-15 (D) provision of patient counseling; <and>
1-16 (E) responsibility for:
1-17 (i) dispensing of prescription drug orders
1-18 or distribution of medication orders;
1-19 (ii) compounding and labeling of drugs and
1-20 devices, except labeling by a manufacturer, repackager, or
1-21 distributor of nonprescription drugs and commercially packaged
1-22 prescription drugs and devices;
1-23 (iii) proper and safe storage of drugs and
1-24 devices; or
2-1 (iv) maintenance of proper records for
2-2 drugs and devices; and
2-3 (F) performance of a specific act of drug
2-4 therapy management for a patient delegated to a pharmacist by a
2-5 written protocol from a physician licensed in this state in
2-6 compliance with the Medical Practice Act (Article 4495b, Vernon's
2-7 Texas Civil Statutes).
2-8 (50) "Written protocol" means a physician's order,
2-9 standing medical order, standing delegation order, or other order
2-10 or protocol as defined by rule of the Texas State Board of Medical
2-11 Examiners under the Medical Practice Act (Article 4495b, Vernon's
2-12 Texas Civil Statutes).
2-13 SECTION 2. Section 17, Texas Pharmacy Act (Article 4542a-1,
2-14 Vernon's Texas Civil Statutes), is amended by adding Subsection (x)
2-15 to read as follows:
2-16 (x) The board shall adopt rules regarding records to be
2-17 maintained by a pharmacist performing a specific act under a
2-18 written protocol.
2-19 SECTION 3. Subchapter C, Medical Practice Act (Article
2-20 4495b, Vernon's Texas Civil Statutes), is amended by adding Section
2-21 3.061 to read as follows:
2-22 Sec. 3.061. DELEGATION OF CERTAIN FUNCTIONS. (a) A person
2-23 licensed to practice medicine may delegate to a properly qualified
2-24 and trained pharmacist acting under adequate physician supervision
2-25 the performance of specific acts of drug therapy management
2-26 authorized by the physician through the physician's order, standing
2-27 medical order, standing delegation order, or other order or
3-1 protocol as defined by board rule.
3-2 (b) The management of drug therapy permitted under this
3-3 section must comply with other applicable law, including Section
3-4 17(a)(5), Texas Pharmacy Act (Article 4542a-1, Vernon's Texas Civil
3-5 Statutes).
3-6 (c) Physician supervision is considered to be adequate for
3-7 the purposes of this section if a delegating physician:
3-8 (1) is responsible for the formulation or approval of
3-9 the physician's order, standing medical order, standing delegation
3-10 order, or other order or protocol and periodically reviews the
3-11 order or protocol and the services provided to a patient under the
3-12 order or protocol;
3-13 (2) has established a physician-patient relationship
3-14 with each patient provided drug therapy management by a delegated
3-15 pharmacist;
3-16 (3) is geographically located so as to be able to be
3-17 physically present daily to provide medical care and supervision;
3-18 (4) receives, as appropriate, a periodic status report
3-19 on the patient, including any problem or complication encountered;
3-20 and
3-21 (5) is available through direct telecommunication for
3-22 consultation, assistance, and direction.
3-23 (d) This section does not restrict the use of a
3-24 preestablished health care program or restrict a physician from
3-25 authorizing the provision of patient care by use of a
3-26 preestablished health care program if the patient is
3-27 institutionalized and the care is to be delivered in a licensed
4-1 hospital with an organized medical staff that has authorized
4-2 standing delegation orders, standing medical orders, or protocols.
4-3 (e) This section may not be construed to limit, expand, or
4-4 change any provision of law concerning or relating to therapeutic
4-5 drug substitution or administration of medication, including
4-6 Section 17(a)(5), Texas Pharmacy Act (Article 4542a-1, Vernon's
4-7 Texas Civil Statutes).
4-8 (f) The board by rule shall establish the minimum content of
4-9 a written order or protocol. The order or protocol may not permit
4-10 the delegation of medical diagnosis.
4-11 (g) In this section, "pharmacist" has the meaning assigned
4-12 by the Texas Pharmacy Act (Article 4542a-1, Vernon's Texas Civil
4-13 Statutes).
4-14 SECTION 4. This Act takes effect September 1, 1995.
4-15 SECTION 5. The importance of this legislation and the
4-16 crowded condition of the calendars in both houses create an
4-17 emergency and an imperative public necessity that the
4-18 constitutional rule requiring bills to be read on three several
4-19 days in each house be suspended, and this rule is hereby suspended.