1-1 By: Madla S.B. No. 931
1-2 (In the Senate - Filed March 5, 1999; March 8, 1999, read
1-3 first time and referred to Committee on Health Services;
1-4 March 25, 1999, reported adversely, with favorable Committee
1-5 Substitute by the following vote: Yeas 5, Nays 0; March 25, 1999,
1-6 sent to printer.)
1-7 COMMITTEE SUBSTITUTE FOR S.B. No. 931 By: Madla
1-8 A BILL TO BE ENTITLED
1-9 AN ACT
1-10 relating to the support of graduate pharmacy education and resident
1-11 pharmacists.
1-12 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-13 SECTION 1. Chapter 61, Education Code, is amended by adding
1-14 Subchapter T to read as follows:
1-15 SUBCHAPTER T. ROBERTA HIGH MEMORIAL
1-16 PHARMACY RESIDENCY PROGRAM
1-17 Sec. 61.851. DEFINITIONS. In this subchapter:
1-18 (1) "College of pharmacy" means a college, school, or
1-19 university of pharmacy in this state that has an accredited
1-20 pharmacy degree program approved by the Texas State Board of
1-21 Pharmacy as provided by the Texas Pharmacy Act (Article 4542a-1,
1-22 Vernon's Texas Civil Statutes).
1-23 (2) "Community pharmacy" means a pharmacy that holds a
1-24 Class A pharmacy license or a community pharmacy license as those
1-25 terms are defined by Section 5, Texas Pharmacy Act (Article
1-26 4542a-1, Vernon's Texas Civil Statutes).
1-27 (3) "Compensation" includes a stipend, a payment for
1-28 services rendered, and a fringe benefit.
1-29 (4) "Institutional pharmacy" means a pharmacy that
1-30 holds a Class C pharmacy license or an institutional pharmacy
1-31 license as those terms are defined by Section 5, Texas Pharmacy Act
1-32 (Article 4542a-1, Vernon's Texas Civil Statutes).
1-33 (5) "Nuclear pharmacy" means a pharmacy that holds a
1-34 Class B pharmacy license or a nuclear pharmacy license as those
1-35 terms are defined by Section 5, Texas Pharmacy Act (Article
1-36 4542a-1, Vernon's Texas Civil Statutes).
1-37 (6) "Pharmacy residency program" means a postgraduate
1-38 residency program approved by the Texas State Board of Pharmacy as
1-39 provided by the Texas Pharmacy Act (Article 4542a-1, Vernon's Texas
1-40 Civil Statutes).
1-41 (7) "Primary teaching pharmacy" means a pharmacy that
1-42 holds a permit issued by the Texas State Board of Pharmacy at which
1-43 a college of pharmacy educates and trains both resident pharmacists
1-44 and undergraduate pharmacy students, pursuant to a resident
1-45 pharmacist affiliation agreement between the pharmacy and the
1-46 college.
1-47 (8) "Residency preceptor" means a licensed pharmacist
1-48 who:
1-49 (A) is affiliated with a college of pharmacy;
1-50 (B) meets the qualifications established by the
1-51 board to teach resident pharmacists; and
1-52 (C) has been designated as a preceptor by the
1-53 Texas State Board of Pharmacy.
1-54 (9) "Resident pharmacist" means a person who:
1-55 (A) has received a professional practice degree
1-56 from an accredited pharmacy degree program approved by the Texas
1-57 State Board of Pharmacy as provided by the Texas Pharmacy Act
1-58 (Article 4542a-1, Vernon's Texas Civil Statutes);
1-59 (B) is licensed to practice pharmacy by the
1-60 Texas State Board of Pharmacy; and
1-61 (C) is appointed to a resident pharmacist
1-62 position by a college of pharmacy.
1-63 Sec. 61.852. COMPENSATION OF RESIDENT PHARMACIST. A college
1-64 of pharmacy shall compensate each resident pharmacist being
2-1 educated, trained, developed, and prepared for a career in pharmacy
2-2 while the person is undergoing education, training, development,
2-3 and preparation at or under the direction and supervision of the
2-4 college.
2-5 Sec. 61.853. NUMBER OF AVAILABLE RESIDENT PHARMACIST
2-6 POSITIONS. (a) In each year, the total number of compensated
2-7 first-year resident pharmacists may not exceed the total number of
2-8 persons in the preceding year's combined graduating classes of all
2-9 colleges of pharmacy.
2-10 (b) At least 50 percent of the combined total number of
2-11 resident pharmacist positions must be in community pharmacy
2-12 practice.
2-13 Sec. 61.854. PREFERENCE TO APPLICANT FOR PRACTICE IN
2-14 MEDICALLY UNDERSERVED AREAS. Each college of pharmacy shall give
2-15 priority consideration to an applicant for a resident pharmacist
2-16 position who demonstrates a willingness to practice pharmacy in
2-17 medically underserved areas of this state, as defined by the Texas
2-18 Department of Health.
2-19 Sec. 61.855. DURATION OF PHARMACIST RESIDENCY. A person may
2-20 not hold a resident pharmacist position for more than two years, or
2-21 for a period longer than the period usually required for a resident
2-22 pharmacist to complete a graduate pharmacy education program
2-23 approved by the Texas State Board of Pharmacy for the specialty in
2-24 which the resident pharmacist seeks certification.
2-25 Sec. 61.856. PROGRAM FUNDING. (a) The legislature may
2-26 appropriate revenue to the board to fund the pharmacy residency
2-27 program.
2-28 (b) Funds appropriated and distributed under this subchapter
2-29 may not be transferred or diverted from the pharmacy residency
2-30 program.
2-31 (c) From program funds, the comptroller shall issue a
2-32 warrant to a college of pharmacy or other entity designated by the
2-33 board to receive funds under this subchapter.
2-34 Sec. 61.857. STATE SUPPORT OF RESIDENT PHARMACIST
2-35 COMPENSATION. (a) To supplement the compensation of resident
2-36 pharmacists, the board may provide grants to colleges of pharmacy
2-37 in amounts not to exceed $10,000 in a fiscal year for each resident
2-38 pharmacist position approved by the board and filled by the
2-39 applicable college for that year.
2-40 (b) A college of pharmacy may receive funds under this
2-41 section for a resident pharmacist position in any year only if the
2-42 college and the primary teaching pharmacy each contribute at least
2-43 $10,000 toward the compensation of the resident pharmacist for that
2-44 year.
2-45 (c) If a resident pharmacist does not perform in that
2-46 capacity during an entire fiscal year, the college of pharmacy
2-47 shall reduce proportionately the compensation paid to the person to
2-48 cover only the part of the fiscal year during which the person
2-49 performed the person's duties as a resident pharmacist.
2-50 (d) If a person is compensated by an agency or institution
2-51 of the federal government or by any other agency or institution,
2-52 other than a primary teaching pharmacy, for the person's
2-53 performance of the person's duties as a resident pharmacist, the
2-54 college of pharmacy shall reduce the compensation that would
2-55 otherwise be paid to the person by an amount equal to the amount of
2-56 the compensation received by the person from the agency or
2-57 institution.
2-58 (e) If the college receives from an agency or institution of
2-59 the federal government or from any other agency or institution,
2-60 other than a primary teaching pharmacy, compensation for a person's
2-61 performance of the person's duties as a resident pharmacist to or
2-62 for the benefit of the agency or institution, the compensation that
2-63 may be paid to the resident pharmacist from funds awarded for that
2-64 position under this section is reduced by the amount received from
2-65 the other agency or institution.
2-66 (f) To qualify for supplemental compensation provided under
2-67 this section, a resident pharmacist must enroll for at least nine
2-68 semester credit hours each fall and spring semester and for at
2-69 least six semester credit hours each summer term in graduate
3-1 pharmacy education experiential courses. The resident pharmacist
3-2 is exempt from fees required for enrollment, other than tuition.
3-3 Sec. 61.858. PLACEMENT OF RESIDENT PHARMACISTS IF FULL
3-4 FUNDING NOT AVAILABLE. (a) If a college of pharmacy determines
3-5 that it does not have sufficient available funds from legislative
3-6 appropriations and other sources to support adequately the full
3-7 number of resident pharmacists that the college considers necessary
3-8 to carry out the purposes of the college, the college may assign
3-9 and place for education and training a resident pharmacist who
3-10 cannot be supported adequately with available funds in a primary
3-11 teaching pharmacy with which the college has a resident pharmacist
3-12 affiliation agreement.
3-13 (b) During the period for which a resident pharmacist is
3-14 assigned and placed in a primary teaching pharmacy under this
3-15 section, the resident pharmacist shall receive compensation
3-16 primarily from the pharmacy.
3-17 (c) A resident pharmacist affiliation agreement between the
3-18 college of pharmacy and the primary teaching pharmacy must describe
3-19 the exact method and manner of compensating the resident
3-20 pharmacist.
3-21 Sec. 61.859. ADDITIONAL FUNDING TO SUPPORT GRADUATE PHARMACY
3-22 EDUCATION PROGRAMS. (a) The board shall administer a program to
3-23 support graduate pharmacy education programs in this state
3-24 consistent with the needs of this state for graduate pharmacy
3-25 education and the training of resident pharmacists in appropriate
3-26 fields and specialties.
3-27 (b) From funds available to the program, the board may make
3-28 grants or formula distributions to a college of pharmacy or other
3-29 entity to:
3-30 (1) support appropriate graduate pharmacy education
3-31 programs or activities for which adequate funds are not otherwise
3-32 available; or
3-33 (2) foster new or expanded graduate pharmacy education
3-34 programs or activities that the board determines will address the
3-35 state's needs for graduate pharmacy education.
3-36 (c) To be eligible for a grant or distribution under this
3-37 section, a college of pharmacy or other entity must incur the costs
3-38 of faculty education or supervision in a graduate pharmacy
3-39 education program or the costs of compensating a resident
3-40 pharmacist in the program. The board shall take those incurred
3-41 costs into account in making grants or formula distributions under
3-42 this section.
3-43 (d) The program is funded by appropriations, by gifts,
3-44 grants, and donations made to support the program, and by any other
3-45 funds the board obtains for the program, including federal funds.
3-46 (e) An amount granted or distributed to a college of
3-47 pharmacy or other entity under the program may be used only to
3-48 cover expenses of training resident pharmacists participating in
3-49 the particular program or activity for which the grant or
3-50 distribution is made in accordance with any conditions imposed by
3-51 the board. The amount may not be spent for the general support of
3-52 the college or other entity.
3-53 Sec. 61.860. ADVISORY COMMITTEE. (a) The board shall
3-54 establish an advisory committee to advise the board regarding the
3-55 development and administration of the pharmacy residency program,
3-56 including evaluating requests for grants and establishing formulas
3-57 for distribution of funds under the program.
3-58 (b) The advisory committee consists of:
3-59 (1) the executive director of the Texas State Board of
3-60 Pharmacy or the executive director's designee;
3-61 (2) a physician serving as a program director of a
3-62 health-related residency program appointed by the Texas State Board
3-63 of Medical Examiners;
3-64 (3) the dean of each college of pharmacy, or the
3-65 dean's designee, who serve as nonvoting members; and
3-66 (4) the following members appointed by the board:
3-67 (A) four pharmacists in private practice, who
3-68 are recommended to the board by the Texas State Board of Pharmacy;
3-69 (B) one resident pharmacist, who serves as a
4-1 nonvoting member; and
4-2 (C) one pharmacy student, who serves as a
4-3 nonvoting member.
4-4 (c) Of the pharmacist members in private practice, two must
4-5 be active in community pharmacy practice, and two must be active in
4-6 hospital pharmacy practice.
4-7 (d) The appointed voting members of the advisory committee
4-8 serve staggered three-year terms. The Texas State Board of Medical
4-9 Examiners shall appoint the initial member appointed under
4-10 Subsection (b)(2) to a three-year term. The board shall appoint the
4-11 initial members appointed under Subsection (b)(4) to terms of one,
4-12 two, or three years as necessary so that one-third of the appointed
4-13 committee members' terms expire each year, as nearly as
4-14 practicable.
4-15 (e) The advisory committee shall elect one of its members as
4-16 presiding officer for a one-year term.
4-17 (f) The advisory committee shall meet at least once each
4-18 year and as often as requested by the board or called into meeting
4-19 by the committee's presiding officer.
4-20 (g) A member of the advisory committee may not receive
4-21 compensation for committee service but may receive reimbursement
4-22 for travel to official meetings according to policies established
4-23 by the board.
4-24 Sec. 61.861. DUTIES OF ADVISORY COMMITTEE. The advisory
4-25 committee shall:
4-26 (1) review applications for the funding of graduate
4-27 pharmacy education programs and make recommendations for approval
4-28 or disapproval of those applications;
4-29 (2) make recommendations relating to the standards and
4-30 criteria for approval of grants and for the development of formulas
4-31 for distribution of funds under the pharmacy residency program;
4-32 (3) recommend to the board an allocation of funds
4-33 among colleges of pharmacy;
4-34 (4) review applications for the funding of residency
4-35 preceptor positions, make recommendations for approval or
4-36 disapproval of those applications, make recommendations relating to
4-37 the standards and criteria for approval of those applications,
4-38 monitor compliance with the contractual conditions associated with
4-39 funding residency preceptor positions, and evaluate success in
4-40 increasing the number of those positions; and
4-41 (5) perform other duties assigned by the board.
4-42 Sec. 61.862. APPLICATION BY COLLEGE OF PHARMACY FOR FUNDING.
4-43 A college of pharmacy must include in an application for funds
4-44 under this subchapter:
4-45 (1) the names of the college and the dean of the
4-46 college, the mailing address of the college, and the accreditation
4-47 status for the undergraduate and graduate pharmacy programs of the
4-48 college;
4-49 (2) the number of resident pharmacist positions and
4-50 primary teaching pharmacies for which the college is requesting
4-51 funding;
4-52 (3) for each primary teaching pharmacy, the names of
4-53 the pharmacy, as recorded on its permit, and of the
4-54 pharmacist-in-charge, the mailing address of the pharmacy, and the
4-55 accreditation status of the pharmacy;
4-56 (4) a description of the learning objectives and
4-57 minimum competencies required of resident pharmacists at each
4-58 primary teaching pharmacy;
4-59 (5) a description of the learning activities and
4-60 resident pharmacists' duties at each primary teaching pharmacy, and
4-61 the time associated with each activity or duty;
4-62 (6) the name of the residency preceptor responsible
4-63 for the learning program at each primary teaching pharmacy, and a
4-64 description of the preceptor's credentials;
4-65 (7) the amount and form of compensation to be provided
4-66 to each resident pharmacist;
4-67 (8) a copy of the resident pharmacist affiliation
4-68 agreement between the college and the primary teaching pharmacy;
4-69 and
5-1 (9) other information required by the board.
5-2 Sec. 61.863. FUNDING OF RESIDENCY PRECEPTOR POSITIONS.
5-3 (a) A college of pharmacy may apply and receive a grant under this
5-4 section to support full-time faculty members who are residency
5-5 preceptors supervising accredited pharmacy residencies.
5-6 (b) The advisory committee shall recommend to the board an
5-7 allocation of residency preceptor positions that are to receive
5-8 funds under this section.
5-9 (c) An allocation of funds under this section must take into
5-10 account the following factors:
5-11 (1) the faculty-student ratio in community pharmacy
5-12 residencies at each applicant college of pharmacy;
5-13 (2) the length of time a budgeted residency preceptor
5-14 position has gone unfilled and whether the position is a new
5-15 residency preceptor position; and
5-16 (3) other factors determined by the board.
5-17 (d) Once funds are granted to support a residency preceptor
5-18 position affiliated with a college of pharmacy, the board shall
5-19 continue to grant funds to support that position for a period not
5-20 to exceed one additional calendar year. After that time, the
5-21 college shall provide an amount equal to the annualized amount of
5-22 the grant in its operating budget to maintain the level of
5-23 compensation for the position for two years after the grant period
5-24 has ended.
5-25 (e) The board may use not more than 10 percent of the total
5-26 amount appropriated for the pharmacy residency program under this
5-27 subchapter to fund residency preceptor positions under this
5-28 section.
5-29 (f) The board may solicit, receive, and spend grants, gifts,
5-30 and donations from public and private sources for purposes of this
5-31 section.
5-32 SECTION 2. Subsection (a), Section 17, Texas Pharmacy Act
5-33 (Article 4542a-1, Vernon's Texas Civil Statutes), is amended to
5-34 read as follows:
5-35 (a) The board is responsible for the regulation of the
5-36 practice of pharmacy in this state, including the following:
5-37 (1) the licensing by examination or by reciprocity of
5-38 applicants who are qualified to engage in the practice of pharmacy
5-39 and the licensing of pharmacies under this Act;
5-40 (2) the renewal of licenses to engage in the practice
5-41 of pharmacy and licenses to operate pharmacies;
5-42 (3) the determination and issuance of standards for
5-43 recognition and approval of degree requirements of colleges of
5-44 pharmacy whose graduates shall be eligible for licensing in this
5-45 state and the specification and enforcement of requirements for
5-46 practical training, including internship;
5-47 (4) the enforcement of those provisions of this Act
5-48 relating to the conduct or competence of pharmacists practicing in
5-49 this state and the conduct of pharmacies operating in this state
5-50 and the suspension, revocation, fining, reprimanding, cancellation,
5-51 or restriction of licenses to engage in the practice of pharmacy or
5-52 to operate a pharmacy;
5-53 (5) the specifications of conditions under which a
5-54 pharmacist may administer medications, including immunizations and
5-55 vaccinations, which at a minimum shall include the following:
5-56 (A) a licensed health care provider authorized
5-57 to administer the medication is not reasonably available to
5-58 administer the medication;
5-59 (B) failure to administer the medication, other
5-60 than an immunization or vaccination, might result in a significant
5-61 delay or interruption of a critical phase of drug therapy;
5-62 (C) the pharmacist possesses the necessary
5-63 skill, education, and certification to administer the medication as
5-64 specified by the board;
5-65 (D) the pharmacist notifies the appropriate
5-66 licensed health care provider responsible for the patient's care
5-67 within a reasonable time that the medication was administered;
5-68 (E) a pharmacist may not administer medications
5-69 to a patient where the patient resides, except in a licensed
6-1 nursing home or hospital;
6-2 (F) the pharmacist administers immunizations or
6-3 vaccinations under a physician's written protocol and meets the
6-4 standards established by the board;
6-5 (G) the authority of the pharmacist to
6-6 administer medications may not be delegated;
6-7 (H) nothing in this subdivision shall be
6-8 construed to prohibit a pharmacist from preparing or manipulating
6-9 biotechnological agents or devices; and
6-10 (I) nothing in this subdivision shall be
6-11 construed as prohibiting a pharmacist from performing an act
6-12 delegated by a physician in accordance with the provisions of
6-13 Subsection (d), Section 3.06, Medical Practice Act (Article 4495b,
6-14 Vernon's Texas Civil Statutes), and the pharmacist performing such
6-15 a delegated medical act shall be considered to be performing a
6-16 medical act and not as engaged in the practice of pharmacy;
6-17 (6) the regulation of the training, qualifications,
6-18 and employment of pharmacist-interns; [and]
6-19 (7) the determination and issuance of standards for
6-20 recognizing and approving a pharmacy residency program for purposes
6-21 of Subchapter T, Chapter 61, Education Code; and
6-22 (8) the enforcement of this Act and any rules adopted
6-23 under this Act.
6-24 SECTION 3. (a) On the effective date of this Act, the
6-25 comptroller of public accounts shall transfer $850,000 from the
6-26 Texas State Board of Pharmacy account to the undedicated portion of
6-27 the general revenue fund.
6-28 (b) The legislature may appropriate funds transferred under
6-29 Subsection (a) of this section only for the pharmacy residency
6-30 program established under Subchapter T, Chapter 61, Education Code,
6-31 as added by this Act.
6-32 SECTION 4. This Act takes effect September 1, 1999.
6-33 SECTION 5. The importance of this legislation and the
6-34 crowded condition of the calendars in both houses create an
6-35 emergency and an imperative public necessity that the
6-36 constitutional rule requiring bills to be read on three several
6-37 days in each house be suspended, and this rule is hereby suspended.
6-38 * * * * *