IML S.B. 786 75(R)BILL ANALYSIS PUBLIC HEALTH S.B. 786 By: Madla (Van de Putte) 4-30-97 Committee Report (Unamended) BACKGROUND Currently, under the definition of "practice of pharmacy," a pharmacist is allowed to administer medications in certain situations. However, this authority does not include administration of immunizations or vaccinations. Each year, approximately 60,000 Americans die of vaccinepreventable infections, and Texas' immunization rate of 71% ranks the state 38th in the nation. By redefining "practice of pharmacy" to include the administration of immunizations and vaccinations under a physician's written protocol, Texas can boost its effort to make vaccinations and immunizations more easily-accessible and improve the current health care delivery system. PURPOSE SB 786 allows a pharmacist to administer a prescribed immunization or vaccination if the pharmacist meets standards established by the Texas Board of Pharmacy. RULEMAKING AUTHORITY It is the committee's opinion that rulemaking authority is granted to the Texas State Board of Pharmacy in SECTION 2 (Section 17(y), Article 4542a-1, V.T.C.S.), to the Texas State Board of Medical Examiners in SECTION 2 (Section 17(aa), Article 4542a-1, V.T.C.S.), and to the commissioner of health in SECTION 3 (Section 2, Article 21.53K, Chapter 21E, Insurance Code) of this bill. SECTION BY SECTION ANALYSIS SECTION 1. Amends Section 5(38), Texas Pharmacy Act (Article 4542a-1, V.T.C.S.), by adding Subsection (G), adding language to the definition of "practice of pharmacy" to include administration of immunizations and vaccinations under a physician's written protocol. SECTION 2. Amends Section 17, Texas Pharmacy Act (Article 4542a-1, V.T.C.S.), by amending Subsection (a), and adding Subsections (y), (z), and (aa), as follows: Subsection (a) adds language granting the Texas State Board of Pharmacy (board) the responsibility for the specifications of conditions under which a pharmacist is authorized to administer medications, including immunizations and vaccinations. Requires that these specifications include that the pharmacist possess the necessary skill, education, and certification as specified by the board, and that the pharmacist administer immunizations or vaccinations under a physician's written protocol and meets the standards established by the board. Subsection (y) requires the board, by rule, to require pharmacists to notify a physician who prescribes an immunization or vaccination within 24 hours of administering the immunization or vaccination. Requires the board to establish minimum education and continuing education standards for pharmacists who administer immunizations and vaccinations. Requires the standards to include certain training. Subsection (z) sets forth the terms under which physician supervision is considered to be adequate for the purposes of this section. Subsection (aa) requires the Texas State Board of Medical Examiners, by rule, to establish the minimum content of a written order or protocol. Prohibits the order or protocol from permitting the delegation of medical diagnosis. SECTION 3. Amends Subchapter E, Chapter 21, Insurance Code, by adding Article 21.53K, as follows: Art. 21.53K. PROVISION OF SERVICES RELATED TO IMMUNIZATIONS AND VACCINATIONS UNDER MANAGED CARE PLANS Sec. 1. PROHIBITION. Prohibits a managed care entity from requiring a physician participating in a managed care plan to issue an immunization or vaccination protocol for an immunization or vaccination to be administered to an enrollee in the plan. Prohibits a managed care entity from limiting certain benefits, providing financial incentives to physicians to issue a protocol, or imposing a financial or other penalty on a physician who refuses to issue a protocol. Sec. 2. RULES. Allows the commissioner of health to adopt rules to implement this article. SECTION 4. Effective date is September 1, 1997. SECTION 5. Article 21.53K, Insurance Code, as added by this Act, applies only to a managed care plan that is delivered, issued, or renewed on or after January 1, 1998. SECTION 6. Emergency clause.