By Van de Putte                                       H.B. No. 1970
         76R5713 JMM-F                           
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to the licensing and regulation of pharmacists and
 1-3     pharmacies.
 1-5           SECTION 1.  Section 5(7), Texas Pharmacy Act (Article
 1-6     4542a-1, Vernon's Texas Civil Statutes), is amended to read as
 1-7     follows:
 1-8                 (7)  "Class C pharmacy license" or "institutional
 1-9     pharmacy license" means a license issued to a pharmacy located in:
1-10                       (A)  a hospital or other in-patient facility that
1-11     is licensed under Chapter 241 or 577, Health and Safety Code;[, or
1-12     Chapter 6,  Texas Mental Health Code (Article 5547-1 et seq.,
1-13     Vernon's Texas Civil Statutes),]
1-14                       (B) [to] a hospice in-patient facility that is
1-15     licensed under Chapter 142, Health and Safety Code; [, or]
1-16                       (C)  an ambulatory surgical center licensed under
1-17     Chapter 243, Health and Safety Code; or
1-18                       (D)  [to a pharmacy located in] a hospital
1-19     maintained or operated by the state.
1-20           SECTION 2.  Sections 17(a) and (b), Texas Pharmacy Act
1-21     (Article 4542a-1, Vernon's Texas Civil Statutes), are amended to
1-22     read as follows:
1-23           (a)  The board is responsible for the regulation of the
1-24     practice of pharmacy in this state, including the following:
 2-1                 (1)  the licensing by examination or by reciprocity of
 2-2     applicants who are qualified to engage in the practice of pharmacy
 2-3     and the licensing of pharmacies under this Act;
 2-4                 (2)  the renewal of licenses to engage in the practice
 2-5     of pharmacy and licenses to operate pharmacies;
 2-6                 (3)  the determination and issuance of standards for
 2-7     recognition and approval of degree requirements of colleges of
 2-8     pharmacy whose graduates shall be eligible for licensing in this
 2-9     state and the specification and enforcement of requirements for
2-10     practical training, including internship;
2-11                 (4)  the determination and issuance of standards for
2-12     recognition and approval of pharmacist certification programs,
2-13     including a requirement  that a pharmacist may not use the
2-14     designation "board certified" unless the pharmacist has attended a
2-15     certification program that meets board standards;
2-16                 (5)  the enforcement of those provisions of this Act
2-17     relating to the conduct or competence of pharmacists practicing in
2-18     this state and the  conduct of pharmacies operating in this state
2-19     and the suspension, revocation, fining, reprimanding, cancellation,
2-20     or restriction of licenses to engage in the practice of pharmacy or
2-21     to operate a pharmacy;
2-22                 (6) [(5)] the specifications of conditions under which
2-23     a pharmacist may administer medications, including immunizations
2-24     and vaccinations,  which at a minimum shall include the following:
2-25                       (A)  a licensed health care provider authorized
2-26     to administer the medication is not reasonably available to
2-27     administer the medication;
 3-1                       (B)  failure to administer the medication, other
 3-2     than an immunization or vaccination, might result in a significant
 3-3     delay or interruption of a critical phase of drug therapy;
 3-4                       (C)  the pharmacist possesses the necessary
 3-5     skill, education, and certification to administer the medication as
 3-6     specified by the board;
 3-7                       (D)  the pharmacist notifies the appropriate
 3-8     licensed health care provider responsible for the patient's care
 3-9     within a reasonable time that the medication was administered;
3-10                       (E)  a pharmacist may not administer medications
3-11     to a patient where the patient resides, except in a licensed
3-12     nursing home or hospital;
3-13                       (F)  the pharmacist administers immunizations or
3-14     vaccinations under a physician's written protocol and meets the
3-15     standards established by the board;
3-16                       (G)  the authority of the pharmacist to
3-17     administer medications may not be delegated;
3-18                       (H)  nothing in this subdivision shall be
3-19     construed to prohibit a pharmacist from preparing or manipulating
3-20     biotechnological agents or devices; and
3-21                       (I)  nothing in this subdivision shall be
3-22     construed as prohibiting a pharmacist from performing an act
3-23     delegated by a physician in accordance with the provisions of
3-24     Subsection (d), Section 3.06, Medical Practice Act (Article 4495b,
3-25     Vernon's Texas Civil Statutes), and the pharmacist performing such
3-26     a delegated medical act shall be considered to be performing a
3-27     medical act and not as engaged in the practice of pharmacy;
 4-1                 (7) [(6)]  the regulation of the training,
 4-2     qualifications, and employment of pharmacist-interns; and
 4-3                 (8) [(7)]  the enforcement of this Act and any rules
 4-4     adopted under this Act.
 4-5           (b)  The board has the following responsibilities relating to
 4-6     the practice of pharmacy and to prescription drugs and devices used
 4-7     in this state in the diagnosis, mitigation, and treatment or
 4-8     prevention of injury, illness, and disease:
 4-9                 (1)  regulation of the delivery or distribution of
4-10     prescription drugs and devices, including the right to seize, after
4-11     notice and hearing, any prescription drugs or devices posing a
4-12     hazard to the public health and welfare, but the board may not
4-13     regulate:
4-14                       (A)  manufacturers' representatives or employees
4-15     acting in the normal course of business;
4-16                       (B)  persons engaged in the wholesale drug
4-17     business and registered with the commissioner of health as provided
4-18     by Chapter 431, Health and Safety Code; or
4-19                       (C)  employees of persons engaged in the
4-20     wholesale drug business and registered with the commissioner of
4-21     health as provided by Chapter 431, Health and Safety Code, if the
4-22     employees are acting in the normal course of business;
4-23                 (2)  specification of minimum standards for
4-24     professional environment, technical equipment, and security in the
4-25     prescription dispensing area;
4-26                 (3)  specification of minimum standards for drug
4-27     storage, maintenance of prescription drug records, and procedures
 5-1     for the delivery, dispensing in a suitable container appropriately
 5-2     labeled, providing of prescription drugs or devices, monitoring of
 5-3     drug therapy, and counseling of patients on proper use of
 5-4     prescription drugs and devices within the practice of pharmacy;
 5-5                 (4)  adoption of rules regulating a prescription drug
 5-6     order or medication order transmitted by electronic means; and
 5-7                 (5)  [annual] registration of balances used for the
 5-8     compounding of drugs in pharmacies licensed in this state and the
 5-9     periodic inspection of such balances to verify accuracy.
5-10           SECTION 3.  Section 24A(d), Texas Pharmacy Act (Article
5-11     4542a-1, Vernon's Texas Civil Statutes), is amended to read as
5-12     follows:
5-13           (d)  An applicant who satisfies the continuing education
5-14     requirement through completion of approved programs must present
5-15     evidence satisfactory to the board of completion of not fewer than
5-16     24 [at least 12] hours of continuing education during the preceding
5-17     24  months of the applicant's license period.  [A licensee who
5-18     completes more than 12 hours during the preceding license period
5-19     may carry forward a maximum of 12 hours for the next license
5-20     period.]
5-21           SECTION 4.  Section 27A(g), Texas Pharmacy Act (Article
5-22     4542a-1, Vernon's Texas Civil Statutes), is amended to read as
5-23     follows:
5-24           (g)  The board  may add a surcharge of not more than $10 for
5-25     each 12 months in a license period to a license or license renewal
5-26     fee authorized under this Act  to fund the program to aid impaired
5-27     pharmacists or pharmacy students.
 6-1           SECTION 5.  Section 28(b), Texas Pharmacy Act (Article
 6-2     4542a-1, Vernon's Texas Civil Statutes), is amended to read as
 6-3     follows:
 6-4           (b)  A person  whose pharmacy license or license to practice
 6-5     pharmacy in this state has been canceled, revoked, or restricted
 6-6     under this Act, whether voluntarily or by action of the board, may,
 6-7     after 12 months from the effective date of the cancellation,
 6-8     revocation, or restriction, petition the board for reinstatement or
 6-9     removal of the restriction of the license.  The petition shall be
6-10     in writing and in the form prescribed by the board.  A person
6-11     petitioning for reinstatement has the burden of proof.  On
6-12     investigation and  review of the petition, the board may in its
6-13     discretion grant or deny the petition or it may modify its original
6-14     finding to reflect any circumstances that have changed sufficiently
6-15     to warrant the modification.  If such petition is denied by the
6-16     board, a subsequent petition may not be considered by the board
6-17     until 12 months from the date of denial of the previous petition.
6-18     The board in its discretion may require such person to pass an
6-19     examination or examinations for reentry into the practice of
6-20     pharmacy.
6-21           SECTION 6.  Sections 29(a) and (e), Texas Pharmacy Act
6-22     (Article 4542a-1, Vernon's Texas Civil Statutes), are amended to
6-23     read as follows:
6-24           (a)  A pharmacy shall be licensed by the board.  A pharmacy
6-25     license under this Act must be renewed annually or biennially as
6-26     determined by the board.
6-27           (e)  The board shall have the discretion to determine under
 7-1     which classifications a pharmacy applicant may be licensed.  With
 7-2     respect to Class C pharmacies, the board may:
 7-3                 (1)  establish rules for the use of pharmacy
 7-4     technicians and the duties of those technicians in Class C
 7-5     pharmacies licensed by the board, provided that these technicians
 7-6     are responsible to and directly supervised by a pharmacist licensed
 7-7     by the board;  provided, however, the board may not adopt any rule
 7-8     setting ratios with respect to pharmacists and pharmacy technicians
 7-9     or limiting the number of pharmacy technicians that may be
7-10     utilized; and
7-11                 (2)  issue a license to a pharmacy on certification by
7-12     the appropriate agency that the facility in which the pharmacy is
7-13     located has substantially completed the requirements for licensing.
7-14           SECTION 7.  Sections 31(d) and (f), Texas Pharmacy Act
7-15     (Article 4542a-1, Vernon's Texas Civil Statutes), are amended to
7-16     read as follows:  
7-17           (d)  The board shall remove the name from the register of
7-18     licensed pharmacies and suspend the license of a pharmacy that does
7-19     not file a completed application and pay the renewal fee before the
7-20     license expiration date [June 1 of each year].
7-21           (f)  The board may adopt a system in which licenses to
7-22     operate a pharmacy expire on various dates during the year or every
7-23     other year, as appropriate.
7-24           SECTION 8.  (a)  This Act takes effect September 1, 1999.
7-25           (b)  The change in law made by this Act to Sections 24A(d),
7-26     27A(g), and 31(d), Texas Pharmacy Act (Article 4542a-1, Vernon's
7-27     Texas Civil Statutes), applies only to an application for issuance
 8-1     of a  license or for renewal of a license that is filed on or after
 8-2     the effective date of this Act.  An application for issuance or
 8-3     renewal of a license filed before the effective date of this Act is
 8-4     governed by the law in effect on the date the application was
 8-5     filed, and the  former law is continued in effect for that purpose.
 8-6           (c)  The change in law made by this Act to Section 28(b),
 8-7     Texas Pharmacy Act (Article 4542a-1, Vernon's Texas Civil
 8-8     Statutes), applies only to a petition for reinstatement of a
 8-9     license filed on or after the effective date of this Act.  A
8-10     petition for reinstatement filed before the effective date of this
8-11     Act is governed by the law in effect on the date the petition was
8-12     filed, and the former law is continued in effect for that purpose.
8-13           SECTION 9.  The importance of this legislation and the
8-14     crowded condition of the calendars in both houses create an
8-15     emergency and an imperative public necessity that the
8-16     constitutional rule requiring bills to be read on three several
8-17     days in each house be suspended, and this rule is hereby suspended.