76R15180 KEL-D
By Van de Putte, Rangel, Farabee, Telford H.B. No. 2528
Substitute the following for H.B. No. 2528:
By Morrison C.S.H.B. No. 2528
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the support of graduate pharmacy education and resident
1-3 pharmacists.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Chapter 61, Education Code, is amended by adding
1-6 Subchapter T to read as follows:
1-7 SUBCHAPTER T. ROBERTA HIGH MEMORIAL
1-8 PHARMACY RESIDENCY PROGRAM
1-9 Sec. 61.851. DEFINITIONS. In this subchapter:
1-10 (1) "College of pharmacy" means a college, school, or
1-11 university of pharmacy in this state that has an accredited
1-12 pharmacy degree program approved by the Texas State Board of
1-13 Pharmacy as provided by the Texas Pharmacy Act (Article 4542a-1,
1-14 Vernon's Texas Civil Statutes).
1-15 (2) "Community pharmacy" means a pharmacy that holds a
1-16 Class A pharmacy license or a community pharmacy license as those
1-17 terms are defined by Section 5, Texas Pharmacy Act (Article
1-18 4542a-1, Vernon's Texas Civil Statutes).
1-19 (3) "Compensation" includes a stipend, a payment for
1-20 services rendered, and a fringe benefit.
1-21 (4) "Institutional pharmacy" means a pharmacy that
1-22 holds a Class C pharmacy license or an institutional pharmacy
1-23 license as those terms are defined by Section 5, Texas Pharmacy Act
1-24 (Article 4542a-1, Vernon's Texas Civil Statutes).
2-1 (5) "Nuclear pharmacy" means a pharmacy that holds a
2-2 Class B pharmacy license or a nuclear pharmacy license as those
2-3 terms are defined by Section 5, Texas Pharmacy Act (Article
2-4 4542a-1, Vernon's Texas Civil Statutes).
2-5 (6) "Pharmacy residency program" means a postgraduate
2-6 residency program approved by the Texas State Board of Pharmacy as
2-7 provided by the Texas Pharmacy Act (Article 4542a-1, Vernon's Texas
2-8 Civil Statutes).
2-9 (7) "Primary teaching pharmacy" means a pharmacy that
2-10 holds a permit issued by the Texas State Board of Pharmacy at which
2-11 a college of pharmacy educates and trains both resident pharmacists
2-12 and undergraduate pharmacy students, pursuant to a resident
2-13 pharmacist affiliation agreement between the pharmacy and the
2-14 college.
2-15 (8) "Residency preceptor" means a licensed pharmacist
2-16 who:
2-17 (A) is affiliated with a college of pharmacy;
2-18 (B) meets the qualifications established by the
2-19 board to teach resident pharmacists; and
2-20 (C) has been designated as a preceptor by the
2-21 Texas State Board of Pharmacy.
2-22 (9) "Resident pharmacist" means a person who:
2-23 (A) has received a professional practice degree
2-24 from an accredited pharmacy degree program approved by the Texas
2-25 State Board of Pharmacy as provided by the Texas Pharmacy Act
2-26 (Article 4542a-1, Vernon's Texas Civil Statutes);
2-27 (B) is licensed to practice pharmacy by the
3-1 Texas State Board of Pharmacy; and
3-2 (C) is appointed to a resident pharmacist
3-3 position by a college of pharmacy.
3-4 Sec. 61.852. COMPENSATION OF RESIDENT PHARMACIST. A college
3-5 of pharmacy shall compensate each resident pharmacist being
3-6 educated, trained, developed, and prepared for a career in pharmacy
3-7 while the person is undergoing education, training, development,
3-8 and preparation at or under the direction and supervision of the
3-9 college.
3-10 Sec. 61.853. NUMBER OF AVAILABLE RESIDENT PHARMACIST
3-11 POSITIONS. (a) In each year, the total number of compensated
3-12 first-year resident pharmacists may not exceed the total number of
3-13 persons in the preceding year's combined graduating classes of all
3-14 colleges of pharmacy.
3-15 (b) At least 50 percent of the combined total number of
3-16 resident pharmacist positions must be in community pharmacy
3-17 practice.
3-18 Sec. 61.854. PREFERENCE TO APPLICANT FOR PRACTICE IN
3-19 MEDICALLY UNDERSERVED AREAS. Each college of pharmacy shall give
3-20 priority consideration to an applicant for a resident pharmacist
3-21 position who demonstrates a willingness to practice pharmacy in
3-22 medically underserved areas of this state, as defined by the Texas
3-23 Department of Health.
3-24 Sec. 61.855. DURATION OF PHARMACIST RESIDENCY. A person may
3-25 not hold a resident pharmacist position for more than two years, or
3-26 for a period longer than the period usually required for a resident
3-27 pharmacist to complete a graduate pharmacy education program
4-1 approved by the Texas State Board of Pharmacy for the specialty in
4-2 which the resident pharmacist seeks certification.
4-3 Sec. 61.856. PROGRAM FUNDING. (a) The legislature may
4-4 appropriate revenue to the board to fund the pharmacy residency
4-5 program.
4-6 (b) Funds appropriated and distributed under this subchapter
4-7 may not be transferred or diverted from the pharmacy residency
4-8 program.
4-9 (c) From program funds, the comptroller shall issue a
4-10 warrant to a college of pharmacy or other entity designated by the
4-11 board to receive funds under this subchapter.
4-12 (d) After August 31, 2001, general revenue funds may not be
4-13 used to fund pharmacy residencies other than in the manner
4-14 prescribed by this subchapter.
4-15 Sec. 61.857. STATE SUPPORT OF RESIDENT PHARMACIST
4-16 COMPENSATION. (a) To supplement the compensation of resident
4-17 pharmacists, the board may provide grants to colleges of pharmacy
4-18 in amounts not to exceed $10,000 in a fiscal year for each resident
4-19 pharmacist position approved by the board and filled by the
4-20 applicable college for that year.
4-21 (b) A college of pharmacy may receive funds under this
4-22 section for a resident pharmacist position in any year only if the
4-23 college and the primary teaching pharmacy each contribute at least
4-24 $10,000 toward the compensation of the resident pharmacist for that
4-25 year.
4-26 (c) If a resident pharmacist does not perform in that
4-27 capacity during an entire fiscal year, the college of pharmacy
5-1 shall reduce proportionately the compensation paid to the person to
5-2 cover only the part of the fiscal year during which the person
5-3 performed the person's duties as a resident pharmacist.
5-4 (d) If a person is compensated by an agency or institution
5-5 of the federal government or by any other agency or institution,
5-6 other than a primary teaching pharmacy, for the person's
5-7 performance of the person's duties as a resident pharmacist, the
5-8 college of pharmacy shall reduce the compensation that would
5-9 otherwise be paid to the person by an amount equal to the amount of
5-10 the compensation received by the person from the agency or
5-11 institution.
5-12 (e) If the college receives from an agency or institution of
5-13 the federal government or from any other agency or institution,
5-14 other than a primary teaching pharmacy, compensation for a person's
5-15 performance of the person's duties as a resident pharmacist to or
5-16 for the benefit of the agency or institution, the compensation that
5-17 may be paid to the resident pharmacist from funds awarded for that
5-18 position under this section is reduced by the amount received from
5-19 the other agency or institution.
5-20 (f) To qualify for supplemental compensation provided under
5-21 this section, a resident pharmacist must enroll for at least nine
5-22 semester credit hours each fall and spring semester and for at
5-23 least six semester credit hours each summer term in graduate
5-24 pharmacy education experiential courses. The resident pharmacist
5-25 is exempt from fees required for enrollment, other than tuition.
5-26 Sec. 61.858. PLACEMENT OF RESIDENT PHARMACISTS IF FULL
5-27 FUNDING NOT AVAILABLE. (a) If a college of pharmacy determines
6-1 that it does not have sufficient available funds from legislative
6-2 appropriations and other sources to support adequately the full
6-3 number of resident pharmacists that the college considers necessary
6-4 to carry out the purposes of the college, the college may assign
6-5 and place for education and training a resident pharmacist who
6-6 cannot be supported adequately with available funds in a primary
6-7 teaching pharmacy with which the college has a resident pharmacist
6-8 affiliation agreement.
6-9 (b) During the period for which a resident pharmacist is
6-10 assigned and placed in a primary teaching pharmacy under this
6-11 section, the resident pharmacist shall receive compensation
6-12 primarily from the pharmacy.
6-13 (c) A resident pharmacist affiliation agreement between the
6-14 college of pharmacy and the primary teaching pharmacy must describe
6-15 the exact method and manner of compensating the resident
6-16 pharmacist.
6-17 Sec. 61.859. ADDITIONAL FUNDING TO SUPPORT GRADUATE PHARMACY
6-18 EDUCATION PROGRAMS. (a) The board shall administer a program to
6-19 support graduate pharmacy education programs in this state
6-20 consistent with the needs of this state for graduate pharmacy
6-21 education and the training of resident pharmacists in appropriate
6-22 fields and specialties.
6-23 (b) From funds available to the program, the board may make
6-24 grants or formula distributions to a college of pharmacy or other
6-25 entity to:
6-26 (1) support appropriate graduate pharmacy education
6-27 programs or activities for which adequate funds are not otherwise
7-1 available; or
7-2 (2) foster new or expanded graduate pharmacy education
7-3 programs or activities that the board determines will address the
7-4 state's needs for graduate pharmacy education.
7-5 (c) To be eligible for a grant or distribution under this
7-6 section, a college of pharmacy or other entity must incur the costs
7-7 of faculty education or supervision in a graduate pharmacy
7-8 education program or the costs of compensating a resident
7-9 pharmacist in the program. The board shall take those incurred
7-10 costs into account in making grants or formula distributions under
7-11 this section.
7-12 (d) The program is funded by appropriations, by gifts,
7-13 grants, and donations made to support the program, and by any other
7-14 funds the board obtains for the program, including federal funds.
7-15 (e) An amount granted or distributed to a college of
7-16 pharmacy or other entity under the program may be used only to
7-17 cover expenses of training resident pharmacists participating in
7-18 the particular program or activity for which the grant or
7-19 distribution is made in accordance with any conditions imposed by
7-20 the board. The amount may not be spent for the general support of
7-21 the college or other entity.
7-22 Sec. 61.860. ADVISORY COMMITTEE. (a) The board shall
7-23 establish an advisory committee to advise the board regarding the
7-24 development and administration of the pharmacy residency program,
7-25 including evaluating requests for grants and establishing formulas
7-26 for distribution of funds under the program.
7-27 (b) The advisory committee consists of:
8-1 (1) the executive director of the Texas State Board of
8-2 Pharmacy or the executive director's designee;
8-3 (2) a physician serving as a program director of a
8-4 health-related residency program appointed by the Texas State Board
8-5 of Medical Examiners;
8-6 (3) the dean of each college of pharmacy, or the
8-7 dean's designee, who serve as nonvoting members; and
8-8 (4) the following members appointed by the board:
8-9 (A) four pharmacists in private practice, who
8-10 are recommended to the board by the Texas State Board of Pharmacy;
8-11 (B) one resident pharmacist, who serves as a
8-12 nonvoting member; and
8-13 (C) one pharmacy student, who serves as a
8-14 nonvoting member.
8-15 (c) Of the pharmacist members in private practice, two must
8-16 be active in community pharmacy practice, and two must be active in
8-17 hospital pharmacy practice.
8-18 (d) The appointed voting members of the advisory committee
8-19 serve staggered three-year terms. The Texas State Board of Medical
8-20 Examiners shall appoint the initial member appointed under
8-21 Subsection (b)(2) to a three-year term. The board shall appoint
8-22 the initial members appointed under Subsection (b)(4) to terms of
8-23 one, two, or three years as necessary so that one-third of the
8-24 appointed committee members' terms expire each year, as nearly as
8-25 practicable.
8-26 (e) The advisory committee shall elect one of its members as
8-27 presiding officer for a one-year term.
9-1 (f) The advisory committee shall meet at least once each
9-2 year and as often as requested by the board or called into meeting
9-3 by the committee's presiding officer.
9-4 (g) A member of the advisory committee may not receive
9-5 compensation for committee service but may receive reimbursement
9-6 for travel to official meetings according to policies established
9-7 by the board.
9-8 Sec. 61.861. DUTIES OF ADVISORY COMMITTEE. The advisory
9-9 committee shall:
9-10 (1) review applications for the funding of graduate
9-11 pharmacy education programs and make recommendations for approval
9-12 or disapproval of those applications;
9-13 (2) make recommendations relating to the standards and
9-14 criteria for approval of grants and for the development of formulas
9-15 for distribution of funds under the pharmacy residency program;
9-16 (3) recommend to the board an allocation of funds
9-17 among colleges of pharmacy;
9-18 (4) review applications for the funding of residency
9-19 preceptor positions, make recommendations for approval or
9-20 disapproval of those applications, make recommendations relating to
9-21 the standards and criteria for approval of those applications,
9-22 monitor compliance with the contractual conditions associated with
9-23 funding residency preceptor positions, and evaluate success in
9-24 increasing the number of those positions; and
9-25 (5) perform other duties assigned by the board.
9-26 Sec. 61.862. APPLICATION BY COLLEGE OF PHARMACY FOR FUNDING.
9-27 A college of pharmacy must include in an application for funds
10-1 under this subchapter:
10-2 (1) the names of the college and the dean of the
10-3 college, the mailing address of the college, and the accreditation
10-4 status for the undergraduate and graduate pharmacy programs of the
10-5 college;
10-6 (2) the number of resident pharmacist positions and
10-7 primary teaching pharmacies for which the college is requesting
10-8 funding;
10-9 (3) for each primary teaching pharmacy, the names of
10-10 the pharmacy, as recorded on its permit, and of the
10-11 pharmacist-in-charge, the mailing address of the pharmacy, and the
10-12 accreditation status of the pharmacy;
10-13 (4) a description of the learning objectives and
10-14 minimum competencies required of resident pharmacists at each
10-15 primary teaching pharmacy;
10-16 (5) a description of the learning activities and
10-17 resident pharmacists' duties at each primary teaching pharmacy, and
10-18 the time associated with each activity or duty;
10-19 (6) the name of the residency preceptor responsible
10-20 for the learning program at each primary teaching pharmacy, and a
10-21 description of the preceptor's credentials;
10-22 (7) the amount and form of compensation to be provided
10-23 to each resident pharmacist;
10-24 (8) a copy of the resident pharmacist affiliation
10-25 agreement between the college and the primary teaching pharmacy;
10-26 and
10-27 (9) other information required by the board.
11-1 Sec. 61.863. FUNDING OF RESIDENCY PRECEPTOR POSITIONS. (a)
11-2 A college of pharmacy may apply and receive a grant under this
11-3 section to support full-time faculty members who are residency
11-4 preceptors supervising accredited pharmacy residencies.
11-5 (b) The advisory committee shall recommend to the board an
11-6 allocation of residency preceptor positions that are to receive
11-7 funds under this section.
11-8 (c) An allocation of funds under this section must take into
11-9 account the following factors:
11-10 (1) the faculty-student ratio in community pharmacy
11-11 residencies at each applicant college of pharmacy;
11-12 (2) the length of time a budgeted residency preceptor
11-13 position has gone unfilled and whether the position is a new
11-14 residency preceptor position; and
11-15 (3) other factors determined by the board.
11-16 (d) Once funds are granted to support a residency preceptor
11-17 position affiliated with a college of pharmacy, the board shall
11-18 continue to grant funds to support that position for a period not
11-19 to exceed one additional calendar year. After that time, the
11-20 college shall provide an amount equal to the annualized amount of
11-21 the grant in its operating budget to maintain the level of
11-22 compensation for the position for two years after the grant period
11-23 has ended.
11-24 (e) The board may use not more than 10 percent of the total
11-25 amount appropriated for the pharmacy residency program under this
11-26 subchapter to fund residency preceptor positions under this
11-27 section.
12-1 (f) The board may solicit, receive, and spend grants, gifts,
12-2 and donations from public and private sources for purposes of this
12-3 section.
12-4 SECTION 2. Section 17(a), Texas Pharmacy Act (Article
12-5 4542a-1, Vernon's Texas Civil Statutes), is amended to read as
12-6 follows:
12-7 (a) The board is responsible for the regulation of the
12-8 practice of pharmacy in this state, including the following:
12-9 (1) the licensing by examination or by reciprocity of
12-10 applicants who are qualified to engage in the practice of pharmacy
12-11 and the licensing of pharmacies under this Act;
12-12 (2) the renewal of licenses to engage in the practice
12-13 of pharmacy and licenses to operate pharmacies;
12-14 (3) the determination and issuance of standards for
12-15 recognition and approval of degree requirements of colleges of
12-16 pharmacy whose graduates shall be eligible for licensing in this
12-17 state and the specification and enforcement of requirements for
12-18 practical training, including internship;
12-19 (4) the enforcement of those provisions of this Act
12-20 relating to the conduct or competence of pharmacists practicing in
12-21 this state and the conduct of pharmacies operating in this state
12-22 and the suspension, revocation, fining, reprimanding, cancellation,
12-23 or restriction of licenses to engage in the practice of pharmacy or
12-24 to operate a pharmacy;
12-25 (5) the specifications of conditions under which a
12-26 pharmacist may administer medications, including immunizations and
12-27 vaccinations, which at a minimum shall include the following:
13-1 (A) a licensed health care provider authorized
13-2 to administer the medication is not reasonably available to
13-3 administer the medication;
13-4 (B) failure to administer the medication, other
13-5 than an immunization or vaccination, might result in a significant
13-6 delay or interruption of a critical phase of drug therapy;
13-7 (C) the pharmacist possesses the necessary
13-8 skill, education, and certification to administer the medication as
13-9 specified by the board;
13-10 (D) the pharmacist notifies the appropriate
13-11 licensed health care provider responsible for the patient's care
13-12 within a reasonable time that the medication was administered;
13-13 (E) a pharmacist may not administer medications
13-14 to a patient where the patient resides, except in a licensed
13-15 nursing home or hospital;
13-16 (F) the pharmacist administers immunizations or
13-17 vaccinations under a physician's written protocol and meets the
13-18 standards established by the board;
13-19 (G) the authority of the pharmacist to
13-20 administer medications may not be delegated;
13-21 (H) nothing in this subdivision shall be
13-22 construed to prohibit a pharmacist from preparing or manipulating
13-23 biotechnological agents or devices; and
13-24 (I) nothing in this subdivision shall be
13-25 construed as prohibiting a pharmacist from performing an act
13-26 delegated by a physician in accordance with the provisions of
13-27 Subsection (d), Section 3.06, Medical Practice Act (Article 4495b,
14-1 Vernon's Texas Civil Statutes), and the pharmacist performing such
14-2 a delegated medical act shall be considered to be performing a
14-3 medical act and not as engaged in the practice of pharmacy;
14-4 (6) the regulation of the training, qualifications,
14-5 and employment of pharmacist-interns; [and]
14-6 (7) the determination and issuance of standards for
14-7 recognizing and approving a pharmacy residency program for purposes
14-8 of Subchapter T, Chapter 61, Education Code; and
14-9 (8) the enforcement of this Act and any rules adopted
14-10 under this Act.
14-11 SECTION 3. (a) On the effective date of this Act, the
14-12 comptroller shall transfer $850,000 from the Texas State Board of
14-13 Pharmacy fund account to the undedicated portion of the general
14-14 revenue fund.
14-15 (b) The legislature may appropriate funds transferred under
14-16 Subsection (a) of this section only for the pharmacy residency
14-17 program established under Subchapter T, Chapter 61, Education Code,
14-18 as added by this Act.
14-19 SECTION 4. This Act takes effect September 1, 1999.
14-20 SECTION 5. The importance of this legislation and the
14-21 crowded condition of the calendars in both houses create an
14-22 emergency and an imperative public necessity that the
14-23 constitutional rule requiring bills to be read on three several
14-24 days in each house be suspended, and this rule is hereby suspended.