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NEWSLETTER OF THE NATIONAL ASSOCIATION OF BOARDS OF ®

Telepharmacy: The New Frontier of Care and Professional Practice

JUNE/JULY 2017 VOLUME 46 NUMBER 6 INNOVATIONS table of contents EXECUTIVE COMMITTEE 4 Legal Briefs 22 State Board News Perception Is Reality New Jersey Enacts Law Hal Wand Philip P. Burgess Imposing Restrictions Chairperson Member, District 4 Association News on Opioids and Other 9 Task Force Recommends Schedule II Jeanne D. Waggener Gary W. Dewhirst Expanding President Member, District 5 Regulations 23 Professional Affairs Update Susan Ksiazek Gay Dodson 13 Satisfaction Allows WHO Launches Global President-elect Member, District 6 Members to Share Opinions Challenge of NABP Programs, on Safety Jack W. “Jay” Mark D. Johnston Services Campbell Member, District 7 MPJE State-Specific Treasurer 19 Richard B. Mazzoni Review to Be Completed Via Secure Website; Timothy D. Fensky Member, District 8 Boards’ Participation Helps Member, District 1 NABP Executive Ensure Exam’s Validity Caroline D. Juran Committee elections Member, District 2 are held each year at the Association’s Annual Reginald “Reggie” Meeting. Dilliard Member, District 3

Innovations (ISSN 2472-6850 – print; ISSN 2472-6958 – online) is published 10 times a year by the National Association of Boards of Pharmacy® (NABP®) to educate, to inform, and to communicate the objectives and programs of the Association and its 67 member boards of pharmacy.

The opinions and views expressed in this publication do not necessarily reflect the official views, opinions, or policies of NABP or any board 10 unless expressly so stated. The subscription rate is $70 per year. Feature News Telepharmacy: The New Frontier of Patient Care and National Association of Boards of Pharmacy Professional Practice 1600 Feehanville Drive, Mount Prospect, IL 60056 • 847/391-4406 www.nabp.pharmacy • [email protected]

Carmen A. Catizone Executive Director/Secretary 2017 Special Issue

Amy Suhajda Coming Soon! Communications Manager The 2017 Innovations Special Issue © 2017 National Association of Boards of Pharmacy. All rights will be mailing soon. The newsletter reserved. No part of this publication may be reproduced in any will include an overview of NABP’s manner without the written permission of the executive director/ 113 th Annual Meeting in Orlando, secretary of the National Association of Boards of Pharmacy. FL; biographies of the 2017-2018 Executive Committee officers and members; resolutions approved by member board of pharmacy NABP Mission Statement delegates; and photos of the 2017 Annual Awards recipients. NABP is the independent, international, and impartial association The Special Issue will also be available in the Publications and that assists its member boards and jurisdictions for the purpose of Reports section of the NABP website at www.nabp.pharmacy. protecting the public .

June/July 2017 innovations | 2 Interview With a Board Executive Director

Gay Dodson, RPh, DPh Executive Director/Secretary, Texas State Board of Pharmacy

How long have you served as executive director/secretary of the Texas State Board of Pharmacy? What was your role prior to working with the Board? I’ve been executive director since June 1997. Following school in June 1969, I worked as a in the Dallas area, both at an independent and a chain pharmacy. In November 1982, I started to work for the Board as a field compliance in the Houston area, and in January 1985, I moved to the Austin office, Gay Dodson, RPh, DPh working as a senior compliance officer. I then held different positions until Executive Director/Secretary, November 1987, when I was promoted to director of the compliance program. I Texas State Board of Pharmacy held that position until I became executive director.

What is one of the most significant challenges or issues your board addressed in the past year or so? During the 2015 legislative session, the Texas Legislature moved our prescription monitoring program (PMP) from the Department of Public Safety to the Board of Pharmacy. This came about because of an interim study by both the House Committee on and the Senate Committee on Health and Services, which eventually led to a recommendation that the program be moved to the Board. They didn’t feel the Department was doing what it needed to do, and the medical greatly supported moving it to us. Our project for the last two years basically has been getting it up and running.

What actions were taken by the Board to address the issue? The Department of Public Safety originally had the program since 1983. Because of that department’s law enforcement focus, I believe they weren’t looking at it as a clinical tool that could assist in making good decisions when dispensing controlled substances, so we took that as our focus. It still has an enforcement piece, too, but mainly it’s trying to get the best care to the . Because the system had become stagnant under the Department of Public Safety, its usage had dropped dramatically during that time. So, we talked to other boards of pharmacy that were operating PMPs to learn what was available and what they thought was important, and then developed our bid specifications. In early 2016, we awarded the contract for the PMP software to Appriss, Inc. One of my directors, Allison Benz, took charge of the program, got it up and running, and we went live on September 1, 2016. Since we’ve taken it over, we have signed agreements with about nine states using NABP PMP InterConnect®. Previously, our PMP was not sharing data with other states, and I think that’s an important piece. During the first six months, we’ve increased the number of accounts — people who are signed up to use it — by more than a third. That sounds great, but we only have 44,000 people signed up to use it, and there are about 100,000 that can, so we’ve got some work to do. We’re in the process of trying to get the word out to everyone who hasn’t figured out what’s going on. Everyone using it seems to be very pleased with the product we have. continued on page 8

Texas State Board of Pharmacy Number of Board Members: 7 pharmacist members, 3 public members, 1 Number of Compliance Officers/Inspectors: 21 Rules and Regulators Established by: State Board of Pharmacy Number of Pharmacist Licensees: 32,680 Number of : 8,079 (in-state) Number of Wholesale Distributors: 381

June/July 2017 innovations | 3 Legal Briefs

Perception Is Reality

egulated professions and of board decisions. members occupations are under of the state boards of pharmacy must be heightened scrutiny from aware of and adhere to the principles of R various perspectives. government regulation for the benefit of Based upon numerous factors, the public health, safety, and welfare and not public protection component, upon allow professional promotion to unduly which regulating the professions influence decision-making. is premised, has been lost in an economic-freedom, free-market In part responsible for the legal approach to providing consumers and political movements regarding with choices of products and access professional regulation was the February to services. How state government 2015 Supreme Court chooses to regulate may be subject case of North Carolina State Board to fundamental changes that of Dental Examiners v. Federal Trade 1 contemplate consolidated boards Commission, 574 U.S. 1 (2015) . This Attorney Dale J. Atkinson, JD, or other regulatory structures that important legal opinion has emboldened outside counsel for NABP, “share” decision-making among plaintiffs to challenge decisions of state is a partner in the law firm professions. boards under antitrust theories, resulting of Atkinson & Atkinson. in numerous lawsuits challenging the The aforementioned perspectives actions of state boards in multiple include approaches from many professions. While many cases have different interests. From an economic been dismissed or resolved, several viewpoint, challenges to regulation are cases remain pending, especially in the propounded that promote competitive arena of regulating “telepractice” of a While some approaches over government control, , both intrastate and interstate. which ostensibly allow for consumer health professions, choice and, perhaps, more competitive More specifically, the Supreme Court pricing. From a legal perspective, this opinion has stimulated potential plaintiffs such as , competitive spirit appears to be fueling or disgruntled licensees to focus legal increased litigation challenging the arguments on the composition of state , and authority of state regulatory boards, boards. Based upon the fact that state using antitrust and other theories boards are comprised of active market pharmacy, may think related to anticompetitive behavior. participants, challenges to board And, from a political perspective, actions claim that professionals are they are ‘immune’ legislative movements permeate the protecting professionals under the guise from deregulation, landscape, arguing for less regulation, of government. Complainants allege consolidated boards, and, in some that state board members engage in the effects of the cases, deregulation of certain activities that promote the profession professions or occupations. in an anticompetitive manner. It is also regulatory climate argued that board members do not While some health professions, such or are unable to distinguish between will permeate all as medicine, nursing, and pharmacy, promoting the trade from public may think they are “immune” from protection. state boards. deregulation, the effects of the regulatory climate will permeate all Separation of trade from regulation is state boards. Such effects will include essential to the continued recognition added litigation as potential plaintiffs of effective and efficient government are emboldened to challenge the regulation of the professions. Yet, many regulatory structure and consequences governors and legislatively appointed

June/July 2017 innovations | 4 active market participants remain to board structures and composition cases.”2 The FTC has the authority to unable to distinguish between trade and will come in the form of legislative bring enforcement actions against state public protection and comingle the two. modifications to practice or, in some boards and is indicating its propensity State board members recognize and, at cases, executive orders from the to do so. times, are controlled by the interests of executive branch of government. the trade which promote the interests of Boards of pharmacy must continue to the profession. Professional promotion Legal challenges to boards of pharmacy train their members and staff on the perspectives that infiltrate a regulatory activities may surface from numerous separation of regulation from trade. board and its members contribute to sources. Disgruntled applicants, As state board members and staff are the “self-regulation” perception that licensees, or consumers can subject to change, training should be plagues the current regulatory system. legal arguments to challenge board ongoing. In fact, reminders of the state Real and perceived professional decisions related to denial, board’s mission should be referenced at promotion that permeate regulation disciplinary actions against licenses, the beginning of each board meeting and in the form of “turf battles,” scope rulemaking, cited for the record. Such small steps protections, and other self-serving interpretations, and other actions can assist in emphasizing the roles of the activities are stimulating change on that affect access to practice and/ board and board members and create a numerous fronts, including litigation. or products. Such potential plaintiffs record within the board meetings’ public will be more likely to challenge board minutes to illustrate, remind, and stress It is incumbent upon boards of decisions under the current legal and the public protection mission. When pharmacy to proactively and continually political climate focusing on these self- boards and board members do not address the potential for this comingling serving, self-regulation perspectives. adhere to these fundamental principles of the interests of government and separating regulation from trade, all trade and actively separate such roles. In addition to individual challenges of regulation is cast in a self-serving Failure to do so will result in increased to board actions, the Federal Trade light. To illustrate these perceptions legal and political challenges to the Commission (FTC) is exhibiting and realities of self-serving activities, current structure of how the practice of increased scrutiny of state boards consider the following. pharmacy is regulated. One potential and the potential for investigating result will be to populate boards of perceived anticompetitive behavior. The Multiple licensed physical therapists pharmacy with non-licensees to remove FTC recently launched an Economic along with ballet dancers who are the the perception (or reality) of self- Liberty Task Force to examine state recipients of physical services serving interests. Such a movement and local licensing requirements and (collectively referred to as the Plaintiffs) will likely impede the efficiencies and their potential to threaten economic initiated litigation (federal litigation) in effectiveness of using subject matter growth. The acting chairperson of the US District Court against the North experts in administrative decision- FTC recently stated, “The public health Carolina Acupuncture Licensing Board making capacities. Other potential and safety rationale for regulating many (Acupuncture Board), in the case of results may be to combine “related” of [these] occupations ranges from Henry v. North Carolina Acupuncture 2 boards in order to offset the argument dubious to ridiculous.” As emphasized Licensing Board, 2017 US LEXIS 12204 that active market participants of one by the acting FTC chairperson, (Dist Ct NC 2017). The Acupuncture profession have a controlling majority “When warranted, the FTC will bring Board is a state agency statutorily in the board. These potential changes enforcement actions in appropriate continued on page 6

1 In short, the North Carolina State Board of Dental Examiners (NCSBDE) case addressed the application of the state action immunity doctrine that historically insulates state boards from antitrust liability based upon enforcement of state statutes duly enacted by the legislature. The US Supreme Court held that state regulatory boards whose membership is comprised in whole or in part of “active market participants” (licensees) must meet the two-prong test that private actors are required to meet to avail themselves of the state action immunity doctrine. That two-prong test includes both a clearly articulated state policy to displace competition (likely found in the practice act) and active oversight by the state. Based upon the lack of oversight by the state of North Carolina, the findings of antitrust violations by the NCSBDE were upheld.

2 https://www.ftc.gov/system/files/documents/public_statements/1098513/ohlhausen_-_advancing_economic_liberty_2-23-17.pdf (accessed March 29, 2017)

June/July 2017 innovations | 5 Legal Briefs

Legal Briefs Attorney General also concluded that the page for dry needling to reflect their continued from page 5 Board had the authority contention that dry needling is a form of to determine that dry needling was acupuncture. The Acupuncture Board within the scope of practice of physical also instructed one of its individual created and delegated with the authority therapists. However, the Plaintiffs argue members to continue editing the to regulate the practice of acupuncture that the Acupuncture Board engaged in Wikipedia page to reflect the position in North Carolina. The Plaintiffs alleged conduct that used government power of the Acupuncture Board that dry that the Acupuncture Board engaged to suppress competition by physical needling is a form of acupuncture. in anticompetitive and unconstitutional therapists and for the exclusive benefit of conduct. The physical therapist plaintiffs acupuncturists. In September 2012, the Acupuncture perform dry needling on patients and Board posted a publication titled “Dry are under threat of sanctions from the Further disconcerting, the allegations Needling is Intramuscular Manual Acupuncture Board under what amounts state that the North Carolina Association Therapy is Acupuncture” (Acupuncture to a turf issue. The patient plaintiffs are of Acupuncture and Oriental Medicine Board publication) on its website and ballet dancers who receive dry needling (referred to as the Trade Association) on various social media platforms. treatment from physical therapists and pressured the Acupuncture Board into Further, the Acupuncture Board are concerned over access to such using such governmental authority instructed its individual members to services. The defendants include not to protect the scope of practice of post the Acupuncture Board publication only the Acupuncture Board, but also the acupuncturists and prohibit physical on other relevant websites and blogs individual Acupuncture Board members therapists from engaging in dry needling. that were under their personal control. who are licensed, actively practicing The Acupuncture Board also continued The outline below is the judicial opinion acupuncturists (collectively referred to as to edit the dry needling Wikipedia responding to various motions to stay the Defendants). page to reflect the Acupuncture and/or dismiss the litigation. The judicial Board’s conclusion that dry needling is According to the Plaintiffs, dry needling opinion and its notations to the facts in acupuncture and included a link to the is “[a] commonly used intervention for the complaint are worth emphasizing, Acupuncture Board publication. treating myofascial trigger point pain,” as the allegations illustrate the brazen whereby physical therapists insert nature of and legal consequences to The Acupuncture Board publication needles into trigger points to relieve comingling trade and regulation. What not only concluded that dry needling pain or dysfunction. Historically, the is alleged paints regulation of the is acupuncture, but also stated that North Carolina Physical Therapy Board professions in a self-preservation light physical therapists who perform dry determined that dry needling fell within and fuels the perception that content needling in North Carolina were: the scope of practice for physical or subject matter experts (licensees or • “engaging in a misrepresentation of therapists. Further, the North Carolina active market participants, as coined by the skill set included in the scope the US Supreme Court) are incapable of practice of physical therapists in of regulating the professions without North Carolina; engaging in self-promoting actions. • confusing the public as to who may Knowledge First, the Plaintiffs allege that the provide Acupuncture safely; Acupuncture Board and the Trade • undermining the General Assembly; is power, and well- Association formed a committee in June 2012 to create a position statement • subject to being legally enforced to trained state board regarding the Acupuncture Board’s discontinue these actions; and tentative stance on dry needling. The • endangering the public.” members will intent of the position statement was to distribute it online. At the same meeting The allegations also state that form the basis for where this committee was formed, the between October 2012 and August continued regulation Acupuncture Board noted that it had 2013, the Trade Association and not received any complaints regarding Acupuncture Board experienced a of the professions the practice of dry needling by physical number of disagreements regarding therapists. the appropriate manner of handling and occupations. “those who are guilty of dry needling.” During this committee formation period, Pursuant to the complaint, the Trade the Acupuncture Board members Association “persistently pressed individually began editing the Wikipedia the Acupuncture Board to take more

June/July 2017 innovations | 6 ‘vigorous’ action, while the Acupuncture North Carolina Physical Board stressed the fact that it only Therapy Board, seeking had jurisdiction over ‘licensed a declaration that “dry acupuncturists’ as well as the need needling by licensed for jurisdiction outside ‘professional physical therapists protectionism,’ citing the lack of constitutes the unlawful complaints from anyone other than practice of acupuncture.” licensed acupuncturists.” Eventually, The Acupuncture Board the Acupuncture Board “acceded” sought a permanent to the Trade Association and issued injunction requiring that numerous cease and desist letters to the Physical Therapy physical therapists who advertised Board advise its licensees dry needling. The physical therapist that dry needling is plaintiffs were recipients of such cease not within the scope of and desist letters. physical therapy practice and that the To be clear, the referenced judicial court authorize the Acupuncture Board opinion addresses various motions to The letters not only ordered the to issue cease and desist notices to stay and dismiss the case. There have recipients to cease and desist from noncomplying physical therapists. been no findings on the merits of the providing dry needling services, Such government versus government Plaintiffs’ allegations. However, the but also included a copy of the litigation is not only unusual, but also purpose of this article is to illustrate Acupuncture Board publication and fuels the notions that state entities are the critical point of separation of trade stated that dry needling may constitute acting in a manner under the guise from regulation. This point is not new, illegal billing that could subject of government to protect their own but is a fundamental concept that must recipients of the letter to action by the occupation and enhance benefits to be emphasized, understood, accepted, North Carolina Department of their profession. and respected. Knowledge is power, and that practicing acupuncture without and well-trained state board members a license is a Class 1 misdemeanor. With concurrent federal and state court will form the basis for continued cases pending involving the overlapping regulation of the professions and Astonishingly, the court-cited issues, the Acupuncture Board filed occupations. challenged conduct also notes that the relevant motions seeking to have the Trade Association’s executive director federal litigation “stayed” pending the It is incumbent on state boards “displeased with the delay in sending outcome of the state litigation. The of pharmacy and their individual the cease-and-desist letters, had two of Acupuncture Board also filed motions members to proactively embrace public the [Board] members replaced.” to have the federal litigation dismissed. protection perspectives, in spite of the Under complex procedural analyses, consequences to trade and commerce. In December 2014, the Acupuncture the court in the federal litigation found Checks and balances are essential, Board revised and republished that there is no basis to stay the and trade associations will continue the publication on its website and federal case in light of the state court to promote the professions and the disseminated it to third parties. proceedings. Thus, the federal litigation financial and economic benefits to In January 2015, a member of the will proceed. their individual members. However, Acupuncture Board emailed her comingling of trade and public contacts and “solicited them to call Addressing the motion to dismiss, the protection issues by licensees/active CBS headquarters in New York about a court in the federal litigation also denied market participants who serve on state television program featuring a physical the Acupuncture Board’s request, with boards of pharmacy will perpetuate therapist performing dry needling.” Also the exception of the Plaintiffs’ equal the stigma of “self-regulation” and in January 2015, the Trade Association protection claims. In short, the court stimulate change. Change is on the emailed all of its acupuncturist found well-pleaded facts that the horizon and may have far-reaching members in an attempt to raise $25,000 actions of the Acupuncture Board and consequences for all of regulation. Be for the stated goal of “[stopping] dry the Trade Association had a substantial prepared. Perception is reality. needling.” effect on interstate commerce and that the Plaintiffs’ complaint adequately Finally, in September 2015, the alleged injury in fact and antitrust injury Acupuncture Board filed a verified and adequately alleged a conspiracy complaint in Wake County Superior between the Acupuncture Board and Court (state litigation) against the the Trade Association.

June/July 2017 innovations | 7 Association News

Annual Report on Association Legal Affairs

Strong growth continues apace at international websites, Legal Affairs dismissal of his federal lawsuit against NABP in support of member boards of engages local counsel for guidance on NABP. The candidate claims, among pharmacy and international outreach. applicable laws and partners with the other things, that NABP conspired with The Legal Affairs department plays .Pharmacy Program’s team to evaluate another testing to invalidate an essential role in the Association’s international regulators for assistance a passing score on the Test of English development, with significant with .pharmacy application review. as a Foreign Language. The trial court achievements noted below. dismissed the case against NABP with Amicus Brief prejudice, meaning the candidate cannot refile the lawsuit. NABP awaits the Educational Support for Boards NABP recently filed an amicus brief federal appeals court decision. On July 19, 2016, NABP conducted a explaining the Verified-Accredited well-received, interactive, educational Wholesale Distributors® (VAWD®) webinar for board of pharmacy legal accreditation program and the Moving Forward counsel and compliance officers. A board decade-plus experience staff has in The Legal Affairs team is dedicated to investigator and attorney were featured surveying and evaluating wholesale serving and protecting the Association speakers, who instructed participants on distributors. A trade association and furthering NABP’s key services and techniques and processes to investigate for wholesale distributors is suing educational programming to optimize and prosecute board licensees who a pharmacy benefit management member board of pharmacy operations divert . Legal Affairs organization, which requires its network and public health protection endeavors. organized the educational seminar based pharmacies to acquire their medications upon feedback from board of pharmacy from VAWD-accredited distributors. On November 29-30, 2017, NABP will legal counsel. NABP is not a party to the lawsuit. host the biennial Interactive Compliance Officer and Legal Counsel Forum. .Pharmacy Verified Websites Litigation Topical cases, regulatory updates, and group discussions are currently slated Program A candidate for certification through the for the forum. As the .Pharmacy Verified Websites Foreign Pharmacy Graduate Examination Program continues to expand to verify Committee™ program is appealing the

Gay Dodson missions is to get out and visit programs as often as possible. continued from page 3 We charge our compliance staff and field inspectors who are pharmacists and pharmacy technicians to do that; a number of What other key issues has the Board been focusing on? staff members make presentations throughout the year to update Texas has a process called Sunset, and every agency is subject pharmacists. We also publish a newsletter. We were one of the to a Sunset review every 12 years. If you look at our law, every first states in the nation to have one. It’s online now, and we try section says, “Unless continued by the Legislature, this expires to educate through that. What I tell other executive directors who on September 1, 2017.” This means a bill was introduced to ask me what I do and how I figure out what’s going on when the Legislature this session in order to continue the Board of facing a challenge is that I generally pick up the phone and call Pharmacy and implement any recommendations that the Texas the executive directors who I know around the nation and ask Sunset Advisory Commission made for this agency. We were very what they did in this type of situation, if they faced it. Many times, pleased with our Sunset report. The commission indicated in the because we’re one of the bigger states, those issues hit us first. report that we are a well-run agency, and we are operating as we I always get good advice from my fellow executive directors and should. They focused on some suggestions for improvement of other board members. If I can’t find what I need from them, I call the PMP that we were already in the process of implementing. NABP. So, our Sunset bill is very favorable. It doesn’t have anything I’m retiring this fall, after spending half my life working at this controversial in it, and I have no doubt that the Board will be agency. Obviously, I’ve loved it, or I wouldn’t have stayed that continued. long. It’s been really wonderful to work with all the pharmacists What insights do you have for other states that may be facing around this state and our nation. They do an unbelievable service similar challenges? to the citizens that most people don’t even see because they’re behind the scenes. NABP does a good job of recognizing this. We try to do a lot of outreach to our licensees. The Board believes I just want to thank all the pharmacists, board members, and the great majority of pharmacists will comply with the laws and NABP members who have helped me out over the years. rules, if they know and understand them. One of our agency’s

June/July 2017 innovations | 8 Association News

Task Force Recommends Expanding Telepharmacy Regulations

Patients in both rural and urban settings can benefit from telepharmacy services, which can provide patients with quality that they may not otherwise receive or have difficulty accessing, concluded the Task Force on the Regulation of Telepharmacy Practice.

The task force met to discuss telepharmacy practice models and existing regulations definition of telepharmacy to recognize in response to Resolution 112-5-16, which of telepharmacy practices. The task force that it is the practice of pharmacy was approved by the NABP membership members made two recommendations, both within and across state lines. The at the Association’s 112th Annual Meeting including amending language in The Model members also recommended adding a in May 2016. Task force members included State Pharmacy Act and Model Rules definition for telepharmacy technologies Lee Ann F. Bundrick, RPh, chair; Freeda of the National Association of Boards that is broad and encompassing of future Cathcart; Kamlesh “Kam” Gandhi, of Pharmacy (Model Act), and further technological developments. PharmD, RPh; Patty Gollner, PharmD, collaborating with the boards of pharmacy RP; Mark J. Hardy, PharmD, RPh; Lisa regarding telepharmacy services between Further, the task force members also Hunt, RPh; Douglas Lang, RPh; Tamara pharmacies and medical or other recommended adding an exemption McCants, PharmD, RPh; Robert “Joey” facilities. to the requirement of a face-to-face McLaughlin, Jr, RPh; Bradley Miller, PhTR; examination in instances of third-party Penny Reher, RPh; Karen M. Ryle, MS, The task force members discussed the prescribing of certain drugs. The members RPh; and Philip P. Burgess, MBA, DPh, challenges presented by promulgating also agreed that the existing sections on RPh, Executive Committee liaison. telepharmacy regulations based on shared pharmacy services and automated geographical or distance-related pharmacy systems remain intact and that The task force met October 24-25, 2016, parameters. For instance, Wyoming had to a new section for telepharmacy be added and its report was approved by the reevaluate its current telepharmacy rules to the Model Act that specifies, among Executive Committee during its April 2017 to be less restrictive in order to provide the other things, general requirements for meeting. The task force’s recommended appropriate environment for the expansion licensure, staffing, supervision of delivery revisions to the Model Act were reviewed of telepharmacy practices. The task force and storage of drugs, and the security of and amended by the Committee on Law members agreed that from the practice drugs at a remote telepharmacy location. Enforcement/Legislation in January 2017 perspective, such requirements tend to and were reviewed by the NABP Executive create artificial barriers; at the same time, Members discussed technician Committee during its May 2017 meeting. from the regulatory perspective, monitoring and drug dispensing that and enforcement of such regulations may occurs under the supervision of a remote The approved task force report is posted become difficult. In addition, the members pharmacist in medical clinics and other in the Publications and Reports section of were informed that North Dakota has seen facilities not generally regulated by the the website. Additional information about an increase in telepharmacy permits with boards of pharmacy. The task force telepharmacy practices across various no decline in the number of traditional recommended that NABP collaborate states can be found on pages 10-11 of pharmacy locations. with boards of pharmacy to discuss the this issue. regulation of these types of practices. The members reviewed existing Model Act language and recommended amending the The Task Force on the Regulation of Telepharmacy Practice was established

1. Examine the need for the development and adoption of licensing processes that Task Force protect the public, retain board of pharmacy jurisdiction for such practices, and allow Charges for the development of practice models that are not unnecessarily restricted.

Task Force on the Regulation of 2. Review existing state laws and regulations addressing telepharmacy and relevant Telepharmacy Practice met on October Model State Pharmacy Act and Model Rules of the National Association of Boards of 24-25, 2016, and accepted the following Pharmacy (Model Act) language. charges: 3. Recommend revisions, if necessary, to the NABP Model Act addressing this issue.

June/July 2017 innovations | 9 Feature News Telepharmacy: The New Frontier of Patient Care and Professional Practice

With the increasing capability of pharmacists to securely access electronic patient health records and perform traditional pharmacy practice activities remotely via the , the implementation of telepharmacy systems has rapidly expanded to various states. Telepharmacy systems have facilitated medication order review, medication selection, and patient counseling in outpatient settings, as well as provided critical care pharmacists the opportunity to share their expertise across several ’ intensive care units and in inpatient settings.

Currently, the use of telepharmacy is authorized in 23 states, though requirements vary. North Dakota was the first state to enact telepharmacy regulations in 2001. By 2010, Idaho, Montana, South Dakota, and Texas also enacted laws and regulations authorizing the use of telepharmacy while Arkansas, Minnesota, Oklahoma, Utah, and Washington permitted the use of telepharmacy on a limited basis (eg, through board of pharmacy approval or pilot programs). Since that time, new state laws have been enacted and boards of pharmacy have been establishing rules and regulations regarding the practice. In general, Beginnings of Telepharmacy applications of In response to an increase in closures of rural pharmacies in 2001, the North Dakota State Board of Pharmacy established Pilot Telepharmacy Rules to explore the feasibility of using telepharmacy in the telepharmacy to restore and retain pharmacy services in the state’s medically underserved, remote, and rural communities. Almost 80,000 rural citizens had pharmacy services restored, setting involve a retained, or established through the project. Following the Pilot’s success, the Board established permanent rules in 2003 to allow telepharmacy to be practiced on a broader scale. licensed pharmacist who These permanent rules allow a retail pharmacy to open and operate in certain remote rural is at a central site and areas of the state without a licensed pharmacist being physically present in the store. Instead, a pharmacist in another location may supervise a certified pharmacy technician at the communicates through remote telepharmacy site using telepharmacy technology. Such arrangements are used for the purposes of dispensing prescriptions to patients, providing , and video conferencing providing patient counseling. in real time with a Telepharmacy Across States pharmacy technician From state to state, laws and boards of pharmacy rules differ in their definitions, geographic restrictions, facility limitations, and staffing and requirements for telepharmacy who is at a remote site operations. In general, applications of telepharmacy in the retail setting involve a licensed pharmacist who is at a central site and communicates through video conferencing in real where the prescription time with a pharmacy technician who is at a remote site where the prescription inventory inventory is stored. is stored. Another retail setting model is similar to a central fill pharmacy system in which a prescription is filled at a location where a pharmacist is present, and then the medicine is delivered to a remote site for patient pickup and counseling via telepharmacy technologies. The telepharmacy model in a hospital or institutional setting involves a registered technician who prepares the medication, which is checked by a pharmacist at a different location via audio and video computer links before it is dispensed to a patient.

June/July 2017 innovations | 10 Geographic Restrictions , etc), or Category III (closed classification of pharmacy permit that door, central fill, or other processing enables a telepharmacy dispensing site Certain states prohibit a telepharmacy site operations) permits. Hospitals holding a to be established. For a telepharmacy from being set up within a certain radius of Category II permit may operate site in Louisiana, the minimum existing pharmacies. locations within a reasonable distance of staffing requirement entails a Louisiana- the licensed area, as determined by the licensed certified pharmacy technician For example, in 2016, enacted legislation Board. The practice of telepharmacy in with at least two years of experience who that states a telepharmacy site cannot be set Indiana, whereby pharmacy technicians has demonstrated proficiency in operating up within 10 miles of an existing pharmacy. can process and dispense prescriptions to the telepharmacy system. Additionally, a patients following remote supervision and central pharmacy may supervise no more The Montana Board of Pharmacy has rules approval by a pharmacist using technology, than two telepharmacy dispensing sites for telepharmacy operations that indicate will be effective as of July 1, 2017, following located within the state. a site cannot be licensed as a remote the enactment of House Bill 1540. telepharmacy site if it is located within a The Idaho State Board of pharmacy 20-mile radius of an existing pharmacy. On the other hand, Texas restricts adopted updated and modernized rules This was a change from a previous rule that telepharmacy facilities to regarding the practice of telepharmacy set the limit at 10 miles from an existing clinics, health centers, or health care on October 31, 2016. For an outpatient pharmacy in 2010. facilities located in medically underserved telepharmacy with remote dispensing sites areas as defined by state or federal law. in Idaho, supervision does not require The 2017 Wyoming Legislature amended the the pharmacist to be physically present state’s telepharmacy statute by changing As of March 2017, the Idaho State Board at the remote dispensing site, but the the restriction of a 25-mile distance from a of Pharmacy removed the requirement pharmacist must supervise telepharmacy retail pharmacy to 10 miles, with no mileage that a remote dispensing site must be operations electronically from the restriction in two specific counties. located in a medical care facility. Similarly, supervising pharmacy. A pharmacist may beginning July 1, 2017, the Wyoming Applicants for a remote pharmacy site in neither be designated nor function as the Legislature removed the requirement for South Dakota must demonstrate to the pharmacist-in-charge of more than two a telepharmacy to be located in a medical Board of Pharmacy that there is limited or remote dispensing locations at one time. or . no access to pharmacy services in The Idaho Board rules state that a remote the community. dispensing site must be staffed by at least Staffing and Education one certified technician with at least 2,000 In contrast, other states are much less Requirements hours of experience. restrictive about geographic limitations on remote pharmacy locations. Illinois, for Several states have rules that impose As of December 30, 2016, the Minnesota example, does not have any geographic restrictions on the supervision of remote Board of Pharmacy’s Guidance restrictions in its statute regarding pharmacies. In addition, state regulations Concerning Approval of Telepharmacies telepharmacy. vary in terms of education requirements requires remote pharmacy staff to be for technicians in remote telepharmacy registered technicians certified through Facility Limitations locations. a Board-approved program; they must have a minimum of one year (2,080 hours) Some states impose limitations on the In 2014, the Colorado Governor signed into experience as a registered technician. types of facilities that may be used as a law the Telepharmacy Remote Pharmacy remote pharmacy location while others Outlet bill, which added the definition of In South Dakota, a pharmacy technician do not impose restrictions. For example, “other outlet” to enable the operation of working at a remote pharmacy must have a under limited circumstances, the practice a remotely located telepharmacy outlet. minimum of 2,000 hours of experience as a of telepharmacy has been allowed in In Colorado, an unlicensed pharmacy registered pharmacy technician and must Connecticut since July 2012. Electronic technician may perform tasks at a be certified through a Board-recognized technology or telepharmacy may be used registered telepharmacy outlet without a certification program. An intern working at at a licensed hospital and at the hospital’s licensed pharmacist physically present, a remote pharmacy must have a minimum satellite or remote locations to allow a as long as the licensed pharmacist is of 500 hours of experience as a registered clinical pharmacist to supervise pharmacy connected to the telepharmacy outlet via pharmacy intern. technicians in preparing intravenous computer link, video link, and audio link, or Under Illinois law, pharmacists may admixtures and dispensing sterile products. other telecommunication equipment, and is readily available to consult with and assist electronically supervise no more than Since 2012, Indiana Board of Pharmacy the pharmacy technician in performing three remote sites that are simultaneously approval is required for a permit to operate tasks. open. Additionally, Illinois’s statute a remote or mobile location. This applies indicates that the pharmacy technician The Louisiana Board of Pharmacy added to Category I (retail), Category II (institution continued on page 12 such as hospital, clinic, health care facility, new rules in 2015 by creating a new June/July 2017 innovations | 11 Association News

NABP Reappoints Michael A. Moné to ACPE Board

NABP is pleased to announce that president associate general counsel Michael A. Moné, BSPharm, JD, FAPhA, – regulatory for Cardinal Health. member of the State of Ohio Board of Prior to this position, Moné was the Pharmacy, has been reappointed by director of regulatory compliance the Association to the Accreditation at Medicine Shoppe International Council for Pharmacy Education (ACPE) and a staff attorney with United Board of Directors for a third six-year States Pharmacopeial Convention. term, beginning in 2018 and ending in In addition, he served as executive 2024. An active member of NABP, Moné director of the Kentucky Board of was a member of the NABP Executive Pharmacy from 1996 to 2004. Committee from 2002 to 2005. In addition, Moné has participated on multiple NABP Moné is active at several pharmacy committees and task forces, including and professional , serving on the Multistate Pharmacy including the American Society Jurisprudence Examination® Review for Pharmacy Law, the American Committee since 1998 and as chair for Pharmacists Association (APhA), and both the Committee on Constitution the Florida Pharmacy Association. director of the Arkansas State Board of and Bylaws and the Committee on Law Moné earned his bachelor of Pharmacy, whose term runs from 2014 Enforcement/Legislation. In May 2017, degree in pharmacy from the University to 2020; and LuGina Mendez-Harper, Moné was named Honorary President for of Florida College of Pharmacy and his PharmD, RPh, former member of the New his commitment to protecting the public juris degree from the University Mexico Board of Pharmacy, whose term health and his involvement with NABP. of Florida College of Law. runs from 2016 to 2022.

Moné has been a member of the State Moné serves on the ACPE Board NABP, the American Association of of Ohio Board of Pharmacy since of Directors with two other ACPE Colleges of Pharmacy, and APhA each 2010. Currently, Moné is the vice members appointed by NABP: John appoint three members to the ACPE Clay Kirtley, PharmD, RPh, executive Board of Directors.

Telepharmacy Act). The Model Act was recently participants an in-depth discussion continued from page 11 updated to include new and revised comparing the practice of with terms. the practice of telepharmacy. located at the remote dispensing site th must have one year of experience and In addition, NABP established the Task At the 112 Annual Meeting, experts be registered as a certified pharmacy Force on the Regulation of Telepharmacy presented the pre-meeting CPE session technician, or be a student pharmacist. Practice in response to Resolution “Telepractice – Smooth Sailing or Tsunami?” 112-5-16, which was approved by the Discussions included an overview of The Illinois Pharmacy Practice Act in NABP membership at the Association’s telepractice systems and standards in 2007 established a framework for remote 112 th Annual Meeting in May 2016. An Texas and Illinois and how medical boards pharmacy and telepharmacy, which overview of the Task Force report may are working with the benefits, challenges, was rewritten in 2010. Five years later, be found on page 9 of this issue. and barriers of telepractice. To learn amendments were adopted that adjusted about last year’s pre-meeting session, the accompanying regulations to the The Association continuously provides read the 2016 Innovations Special Issue reality of what technology was being members with information on emerging article, “Regulators, Stakeholders Discuss implemented and how it was being utilized. rules and regulations related to Telepractice in Pharmacy and Medicine telepharmacy practice. During NABP’s During Pre-Meeting Session,” (page 12) th Future of Telepharmacy 113 Annual Meeting, the Association which is available at www.nabp.pharmacy offered continuing pharmacy education under the Publications and Reports section. Although telepharmacy services are (CPE) on telehealth. The joint CPE expanding quickly, each state’s policies and titled, “Telehealth – Another Epcot NABP will continue to keep abreast regulations on telepharmacy vary. NABP Experiment?” provided pharmacists of emerging telepharmacy practices offers states both broad and specific model and technicians an overview of the and provide updates to its members language for regulating the practice of telepharmacy practices that are accordingly. Additionally, NABP telepharmacy in The Model State Pharmacy currently under review by many boards Government Affairs and Member Services Act and Model Rules of the National of pharmacy. In addition, regulators staff is available to state boards wishing Association of Boards of Pharmacy (Model of health care providers offered to incorporate new or revise existing telepharmacy regulations. June/July 2017 innovations | 12 Association News

Satisfaction Survey Allows Members to Share Opinions of NABP Programs, Services

NABP recently conducted a survey to collect the opinions of member boards of pharmacy on existing programs and CHART 1 services and to help NABP assess how Percent (%) of Total Respondents well those programs and services are 0102030405060708090 100 meeting the boards’ needs at a time 10+ Years 1 of rapid changes in technology and in the practice of pharmacy. While the 6-9 Years Association seeks and receives member 2 input through meetings and through the regular NABP-board of pharmacy 3-5 years 31 interactions that take place throughout the year, the survey provided a more 1-2 Years 2 formal mechanism for collecting input and understanding the responses. The results < 1 Year will help shape NABP’s efforts to assist < 1 Year 1-2 Years 3-5 years 6-9 Years 10+ Years its member boards and jurisdictions in Years Served protecting the public health.

An initiative announced by 2016-2017 Survey respondents included with a variety of experience levels (ie, number of NABP President Hal Wand, MBA, RPh, at years served on a board of pharmacy). the Association’s 112th Annual Meeting in May 2016, the member survey consisted of several sections. Members were asked on four dimensions: the respondent’s able to get a clear picture of how different to rate NABP’s programs and services familiarity with each program or service, programs and services support the needs frequency of utilization, perceived of different segments of its membership. importance, and the respondent’s satisfaction with the program or service. Survey Says . . . Respondents also rated their satisfaction Overall, most NABP programs received with the Association’s governance positive responses on all four metrics Another general and members’ ability to participate in in the ratings section of the survey governance and policy development. (familiarity, utilization, importance, and trend: Board staff Finally, respondents offered answers to satisfaction). Perhaps not unexpectedly, open-ended questions addressing what the four areas tended to track together; indicated a greater they like best about NABP and what for example, greater familiarity with areas they see for improvement. a program often corresponded with familiarity with and higher ratings on the other metrics as A broad cross section of NABP well. Another general trend: Board staff membership provided feedback via the utilization of almost indicated a greater familiarity with and survey. Responses came from boards utilization of almost all programs than all programs than board structured in a variety of ways, including board members, indicating that NABP autonomous boards (57%) and boards needs to work on making information members, indicating that are part of an umbrella organization more accessible to members as well as (38%). Respondents from these boards that NABP needs staff. included individuals who serve in a variety to work on making of board-related roles, including board of Well-established examination programs pharmacy staff (executive directors [25%] integral to most boards’ licensing information more and other staff [9%]) and members [64%]. decisions tended to receive higher Experience levels (ie, number of years ratings. For instance, the North American accessible to members as served on the board) and practice types Pharmacist Licensure Examination® likewise varied widely. (See Chart 1 above (NAPLEX®) and the Multistate Pharmacy well as staff. on this page.) With such a wide spectrum of respondents to the survey, NABP was continued on page 14

June/July 2017 innovations | 13 Association News

Satisfaction Survey continued from page 13 CHART 2 Percent (%) of Total Respondents Jurisprudence Examination® (MPJE®) 0102030405060708090 100 appear to be particularly valued, receiving 79% universally high ratings across all four 49% CPE Monitor 86% metrics among both board members 83% and board staff. (See Chart 2 on this 81% 80% page.) The Foreign Pharmacy Graduate NAPLEX 95% 91% Equivalency Examination® (FPGEE®) 70% and the Foreign Pharmacy Graduate 71% MPJE 89% Examination CommitteeTM (FPGEC®), CHART 2 76% while not garnering ratings as high as the Percent (%)38% of Total Respondents 21% NAPLEX or the MPJE, also seemed to be e-LTP 57% 0102030405060762% 08090 100 viewed positively overall. Among non- 79% exam programs – although still related Familiarity Utilization 49% Importance Satisfaction CPE Monitor 86% to boards’ licensure duties – the CPE 83% Monitor® service also stood out, with 81% 80% high ratings across all metrics among NABP programsNAPLEX receiving high ratings in all areas measured include CPE Monitor95%®, the ® ® 91% all responders groups. Interestingly, North American Pharmacist Licensure Examination (NAPLEX ), and the Multistate Pharmacy Jurisprudence Examination® (MPJE®)). TheCHART high ratings of 3 satisfaction70% for NAPLEX and MPJE CPE Monitor’s lowest ranking came in 71% are especiallyMPJE important in light of their importance to the board of pharmacy.89% Similarly, CPE Percent (%) of Total Respondents76% from board staff utilization. Though, this Monitor’s positive ratings in importance and satisfaction are encouraging as use among 38% is expected to change as audit tools boards continues01 to grow.02 The0321% lower04 ratings05 in the06 areas07 of familiarity0809 and utilization0 100 of the Electronic Licensuree-LTP Transfer Program® (e-LTP ®), a core57% NABP program, were impacted by for member boards are improved. The 50% 62% ® lower ratings from board members23% who may be less familiar with the operational aspects NABP PMP InterConnect program and VPP 65% of e-LTP. This insight providesFamiliarity a roadmapUtilization for NABP asImportance it59% plans memberSatisfaction outreach for the NABPLAW Online also came in with coming years. fairly-consistent, positive ratings. 36% 16% Blueprint 61% 46% Other programs’ ratings varied more notably among types of responder, with, Familiarity UtilizationCHARTImportance 3 Satisfaction as noted above, board members often assessing programs differently than Percent (%) of Total Respondents board staff. Indeed, this was true even 0102030405060708090 100 among some programs directly related to 50% 23% CHART 4 licensure. The NABP Clearinghouse, for VPP 65% example, had notably higher familiarity Percent (%) of Total Respondents59% and importance ratings with board staff 36% 010216%030405060708090 100 than with board members. The Electronic Blueprint 61% 42%46% ® ® 22% Licensure Transfer Program (e-LTP ), VAWD 65% 56% too, was more familiar to and utilized Familiarity Utilization Importance Satisfaction 49% more frequently by staff than by board 23% VIPPS 64% members, and staff members rated the 58% ® ® program very high in importance and Newer programs such as the Verified Pharmacy35% Program (VPP ) (launched 2013) and the 6% satisfaction. For the Verified Pharmacy Multistate.Pharmac Pharmacyy Inspection Blueprint Program40% (launched 2015) demonstrate the need CHART38% 4 Program® (VPP®), it too showed for information to be more accessible to NABP members, especially board of pharmacy members. Seeing high scores inPer importancecent (%) but of Tlowotal ratings Respondents in familiarity underscore that Familiarity Utilization Importance Satisfaction higher familiarity with board staff that it is essential for NABP to continue to build out the Member Services section of the NABP corresponded to higher ratings. website to provide01 information0203 about 04how these05 and06 other07 new programs0809 support0 100 the boards of pharmacy. 42% 22% Programs with lower ratings included VAWD 65% newer offerings that the membership 56% importance and satisfaction ratings. (See to49% protect the public health, may not has not had as much opportunity to use, 23% VIPPS 64% such as the recently launched Multistate Chart 3 on this page.) Other programs be as directly58% involved in the boards’ that received some lower ratings included day-to-day functions. Other low-rated Pharmacy Inspection Blueprint. The 35% 6% Blueprint showed low staff utilization those .Pharmacthat dealy less directly with board 40% programs were less board-oriented. The ratings – though higher familiarity scores licensure responsibilities and, while 38% Pre-FPGEE, aimed at foreign pharmacists for staff corresponded with higher they may support the Familiarityboards’ efforts Utilization preparingImportance for the FPGEE,Satisfaction also showed

June/July 2017 innovations | 14 CHART 2 Percent (%) of Total Respondents 0102030405060708090 100 79% 49% CPE Monitor 86% 83% 81% 80% NAPLEX 95% 91% 70% 71% MPJE 89% 76%

38% 21% e-LTP 57% 62%

Familiarity Utilization Importance Satisfaction

CHART 3 Percent (%) of Total Respondents 0102030405060708090 100

50% 23% VPP 65% 59%

36% 16% Blueprint 61% 46%

Familiarity Utilization Importance Satisfaction

low familiarity and utilization scores. The .Pharmacy Verified Websites Program CHART 4 and the Internet Drug Outlet Identification Percent (%) of Total Respondents Program – both more directed to the general public than exclusively to the 0102030405060708090 100 42% boards of pharmacy – received low 22% VAWD 65% utilization ratings; the e-Advertiser 56% CM Approval Program received the 49% 23% lowest ratings of all programs. The VIPPS 64% 58% durable medical equipment, prosthetics, 35% , and supplies (DMEPOS) 6% .Pharmacy 40% Accreditation program, available to 38% DMEPOS suppliers needing accreditation Familiarity Utilization Importance Satisfaction for maintaining Medicare billing privileges, received low ratings across most metrics, with the exception of its satisfaction Responses related to key accreditation programs were mainly positive. More established rating among board staff. (Chart 4 on programs had higher ratings of importance and satisfaction when compared to new programs, this page highlights responses from key such as the .Pharmacy Verified Websites Program. While utilization was ranked low, this is not accreditation programs.) unsurprising considering changes in board structure and the current regulatory climate. NABP is committed to working with the boards of pharmacy to help in their efforts to incorporate In terms of Association governance NABP accreditation programs into their rules or regulation for the protection of public health. and participation, about a third of And if this is not possible, NABP will continue to gather input from the boards of pharmacy as it continues to make these programs available. respondents indicated that they had served on an NABP committee or task force (about 7% of respondents had served on the Executive Committee), with the majority “extremely satisfied” 80% placed themselves somewhere between states and helping boards to with their participation. Respondents between satisfied (4 on a scale of 6) to become informed about programs in were somewhat less enthusiastic about extremely satisfied (6 on a scale of 6) on other states. Respondents also praised the overall opportunities for board of this metric. Respondents were even more NABP’s commitment to public safety pharmacy members and staff to become positive about the level of opportunity for and its role in providing leadership and involved in NABP’s governance, although board of pharmacy members and staff acting as a national spokesman for the to become involved with NABP’s policy boards of pharmacy, including working development process through resolutions for standardization, and heightening and task forces, with 88% considered professionalism within the practice of satisfied or above – and 72% in the very pharmacy. to extremely satisfied range (5 or 6 on a scale of 6). When asked which NABP services they find most valuable, some respondents When asked what Open-Ended Responses merely stated, “All.” But overall, Beyond rating NABP’s programs and respondents most frequently cited the attributes they liked best services, survey respondents answered Association’s examination services, several open-ended questions addressing particularly the NAPLEX and the MPJE. about the Association, what they liked most about NABP and In a further echo of the top-ranked its programs, and suggestions for programs from the ratings portion of the respondents lauded improvements. survey, many also listed CPE Monitor. PMP InterConnect and VPP also received NABP for its support of When asked what attributes they liked numerous mentions. A number of best about the Association, respondents respondents referenced NABP’s licensure the boards of pharmacy, lauded NABP for its support of the boards programs, including e-LTP. Other citing its accessibility of pharmacy, citing its accessibility and programs that received several mentions helpfulness, as well as professionalism included the NABP Clearinghouse, and helpfulness, as well and transparency. Many stated that they the Verified-Accredited Wholesale valued the communication that NABP Distributors® (VAWD®) program, the as professionalism and facilitates, not only between NABP Verified Internet Pharmacy Practice Sites® and the boards of pharmacy, but also transparency. by providing networking opportunities continued on page 16

June/July 2017 innovations | 15 Association News

Forty-One States, One Jurisdiction Now Live With PMP InterConnect; Steering Committee to Meet in July

The Maine Prescription Monitoring Ohio, Oklahoma, Rhode Island, South Program, the Montana Prescription Carolina, South Dakota, Tennessee, Drug Registry, and the Pennsylvania Texas, Utah, Vermont, Virginia, West Monitoring Virginia, and Wisconsin. Program have deployed NABP PMP InterConnect®, bringing the total NABP continues to work with other exclusively of representatives of PMPs number of live participating state states to facilitate their participation participating in the program, will meet prescription monitoring programs in the program. To date, one more July 19-20, 2017, at NABP headquarters in (PMPs) to 42. Maine, Montana, and state has executed a memorandum Mount Prospect, IL. Many new attendees Pennsylvania join PMPs in Alabama, of understanding (MOU) with the are expected at the annual event, where , , Arkansas, Colorado, Association and plans to be connected they will learn about the structure of PMP Connecticut, Delaware, District of to PMP InterConnect in 2017. Another InterConnect and how it functions. Columbia, Georgia, Idaho, Illinois, state has an MOU under review. In Additional information about PMP Indiana, Iowa, Kansas, Kentucky, all, approximately 45 states will either InterConnect is available in the Initiatives Louisiana, Maryland, Massachusetts, be connected to or working toward a section of the NABP website at www Michigan, Minnesota, Mississippi, connection to PMP InterConnect in 2017. .nabp.pharmacy. Nevada, New Hampshire, New Jersey, The PMP InterConnect Steering , New York, North Dakota, Committee, which is composed

Satisfaction Survey continued from page 15

(VIPPS®) program, and the .Pharmacy boards in protecting the public health, member survey results, and suggestions Program. Several respondents specified and for any other suggestions for NABP arising from that analysis have been and the networking and communication to better meet its members’ needs. While will continue to be acted upon. One action opportunities provided by NABP, and many respondents had no suggestions, already taken, for example, was to begin a few others mentioned the overall others called for public member and adding information to the Member Services resources the Association provides, pharmacy technician representation in section of www.nabp.pharmacy, to help including acting as an expert for the NABP leadership, for NABP engagement better familiarize board members with NABP boards, or offering policy guidance. in various pharmacy technician issues, programs and highlight their importance. and for increased information sharing The survey also asked the Association’s between states. Several respondents NABP thanks those boards of pharmacy membership what changes they would requested education on various issues members and staff that participated in suggest to improve NABP’s programs (notably on the medical marijuana issue). the survey, as the results have provided and services. While many respondents valuable insights for the NABP Executive stated “None,” the suggestions Finally, the survey asked members if they Committee and staff to learn from and with offered by others fell into a few broad would support NABP allowing active which to take action. NABP will continue categories, including more opportunities membership for international members. to use the survey results to consider ways for webinars and education on NABP’s Many (though not all) respondents were to best serve its member boards, and will programs, expanded consistency of open to the idea, while others expressed report further developments in future issues pharmacy inspections across states, interest in the idea while registering of Innovations. and interoperability between NABP concerns about differences in laws and databases and state databases. regulations.

Similar issues were raised in response As President Wand noted to attendees to the survey’s request to describe any during his address to the membership services or programs that could be at the 113th Annual Meeting in May 2017, developed for future assistance to the NABP has been busy analyzing the

June/July 2017 innovations | 16 Association News

Boards Report 1,523 Disciplinary Actions to NABP Clearinghouse in First Quarter 2017

During the first quarter of 2017, the state boards of pharmacy Ensuring Compliance for the Boards reported a total of 1,523 disciplinary actions to the NABP As stated in the NABP Constitution and Bylaws, Clearinghouse, including actions taken against pharmacists, participation in the NABP Clearinghouse is required as part pharmacies, pharmacy technicians, pharmacy interns, of a board of pharmacy’s membership to the Association. wholesalers, manufacturers, and other licensees. Of the Timely reporting to the NABP Clearinghouse is essential to 1,523 actions taken the first quarter of 2017: maintaining the integrity of the licensure transfer program.

• 628 (41.2%) were on pharmacists; In addition, NABP encourages all boards to designate • 436 (28.6%) were on pharmacies; NABP as their reporting agent to the National Practitioner Data Bank (NPDB). By doing so, boards are able to free up • 386 (25.3%) were on pharmacy technicians; valuable resources and staff time to focus on other board matters. To date, 33 boards of pharmacy have designated • 26 (1.7%) were on wholesalers and manufacturers; NABP as a reporting agent, allowing the Association to transmit all required records to NPDB, provide feedback • 15 (1%) were on other licensees; on NPDB rejected or accepted data, and assist the • 14 (0.9%) were on pharmacy interns; boards during compliance audits. In addition, monthly Clearinghouse reports are available for the boards in NABP • 11 (0.7%) were on mail-order pharmacies; and e-Profile Connect.

• 7 (0.4%) were on licensees. Additional information about the NABP Clearinghouse, including how to designate NABP as a reporting agent for For a full breakdown of the actions taken and the bases for NPDB, is available under the Member Services section on actions taken during the first quarter of 2017, see Figure A the NABP website at www.nabp.pharmacy. below and Figure B on page 18.

Figure A: Disciplinary Actions Reported During First Quarter 2017

0.8% 2% Publicly Available Fine/Monetary Penalty (37.6%) Miscellaneous* (17.4%) 5% 5.6% Reprimand or Censure (8.7%) Suspension of License or Certificate (8.2%) 7.3% Probation of License (7.5%) 37.6% Revocation of License or Certificate (7.3%) 7.5% License or Certificate Restored or Reinstated (Complete, Conditional, Partial, Denied) (5.6%)

8.2% Voluntary Limitation or Restriction on License (5%) Conditional, Provisional, or Probationary License or Certificate (2%)

8.7% Civil Money Penalty (0.8%) 17.4%

*The miscellaneous category includes cease and desist; denial of initial license or certificate; denial of license or certificate renewal; directed plan of correction; extension of previous licensure action; interim action – agreement to refrain from practice during investigation; limitation or restriction on license; modification of previous licensure action; other licensure action − not classified; publicly available negative action or finding; reduction of previous licensure action; summary or emergency limitation or restriction on license; summary or emergency suspension of license; and voluntary surrender of license or certificate.

June/July 2017 innovations | 17 Association News

Figure B: Bases for Disciplinary Actions Reported During First Quarter 2017

Violation of Federal or State Statutes, Regulations, or Rules (25.8%) 1.6% 1% Miscellaneous* (17%) 3.1% 2.9% Diversion of Controlled Substance (10%) Failure to Comply With Continuing Education or Competency Requirements (6.2%) 3.2% License Revocation, Suspension, or Other 25.8% Disciplinary Action (6%) 3.3% Failure to Maintain Records (4.6%) 3.3% Error in Prescribing, Dispensing, or Administering 3.4% Medication (4.4%) 17% Criminal Conviction (4.2%) 4.2% Fraud (3.4%) 4.4% Narcotics Violation or Other Violation of Drug Statutes (3.3%) 4.6% 10% Unable to Practice Safely by Reason of Alcohol or 6% 6.2% Other Substance Abuse (3.3%) Allowing or Aiding Unlicensed Practice (3.2%) Unauthorized Administering, Dispensing, or Prescribing of Medication (3.1%) Practicing or Operating Without a License, Without a Valid License, With an Expired License, or on a Lapsed License (2.9%) Violation of Federal or State Tax Code (1.6%) Failure to Meet Licensing Board Reporting Requirements (1%)

*The miscellaneous category includes breach of confidentiality; conduct evidencing ethical unfitness; conduct evidencing moral unfitness; default on loan or scholarship obligations; deferred adjudication; disruptive conduct; drug screening violation; expired drugs in inventory; failure to comply with patient consultation requirements; failure to cooperate with board investigation; failure to maintain supplies/missing or inadequate supplies; failure to obtain informed consent; failure to pay child support/delinquent child support; failure to take corrective action; immediate threat to health or safety; improper or abusive billing practices; improper or inadequate supervision or delegation; inadequate or improper control practices; inadequate security for controlled substances; lack of appropriately qualified professionals; misappropriation of patient property or other property; misbranding drug labels/lack of required labeling on drugs; nolo contendere plea; operating beyond scope of license; other disciplinary action − not classified; other unprofessional conduct; practicing without a valid license; unable to practice safely; unable to practice safely by reason of physical illness or impairment; unable to practice safely due to psychological impairment or mental disorder; and violation of or failure to comply with licensing board order.

June/July 2017 innovations | 18 Association News

MPJE State-Specific Review to Be Completed Via Secure Website; Boards’ Participation Helps Ensure Exam’s Validity

The annual Multistate Pharmacy of their exam item pool. State laws and Jurisprudence Examination® (MPJE®) regulations pertaining to the practice of State-Specific item pool review and pharmacy must be reviewed regularly, new item selection will take place as changes may impact the MPJE. Such from July 31, 2017 through August 31, regulatory changes that may impact the 2017. NABP requests that all MPJE- MPJE item pool include: participating jurisdictions schedule • Changes to the list of vaccines • Changes to requirements regarding resources and time to complete this prescription expiration dates; important set of tasks. The item pool pharmacists are permitted to review and new item selection process administer, or changes in the • Changes to pharmacist-to-technician will be set up through a remote, online, defined patient population to ratio requirements; secure access platform. which pharmacists may administer vaccines; • Changes to permissions for accessing During the MPJE State-Specific emergency kits; and Review, the responsibility of each • Changes to statute language, official board is to select new items to be titles, definitions, etc, that would • Changes to requirements for pre-tested for future pool and review render MPJE language invalid; dispensing syringes. operational (scored) item pool and • Changes to initial license, renewal, or previously approved items. The MPJE State-Specific Review continuing education requirements; provides each participating board State board participation in the annual the opportunity to select and review • Changes to collaborative practice review is critical to ensure that the MPJE questions applicable in their state or agreements; maintains the highest validity standards jurisdiction. To date, 50 boards use the with the most current questions on • Changes to state drug schedules; MPJE and are required to participate the examinations and that the items in at least one State-Specific Review on the MPJE are defensible. NABP will • Changes to pharmacists’ right to meeting each year to determine the work with states throughout the year to refuse prescriptions; appropriateness of items in the MPJE identify any shallow or incomplete parts for candidates seeking licensure.

Utah to Require VPP Inspections or Blueprint Program for Nonresident Compounding Pharmacies

During the 2017 General Session, the Utah Legislature Pharmacy Inspection Blueprint, a living document that amended the Pharmacy Practice Act to require Utah- provides a minimum set of inspection criteria for pharmacy licensed nonresident compounding pharmacies to submit inspections agreed upon by a majority of state boards. The an inspection report conducted by either NABP’s Verified Blueprint largely focuses on general areas of pharmacy Pharmacy Program® (VPP®) or a state licensing agency that is and references existing national compounding standards, in accordance with NABP’s Multistate Pharmacy Inspection such as United States Pharmacopeia Chapters <795> and Blueprint Program. This inspection report, which must be <797>. As more states implement the common requirements dated within the past two years, is a new prerequisite for included in the Blueprint, it is expected to assist boards by licensure or renewal of a class D pharmacy license that more easily identifying which resident state inspections meet engages in any type of compounding. their requirements as well as help them make nonresident licensure decisions. As part of NABP’s VPP program, NABP surveyors complete an inspection and the resulting report is accessible to boards Boards that participate in the Blueprint Program have two of pharmacy in the facility’s profile in the NABP e-Profile options for inspection forms. They may either utilize the Connect. Universal Inspection Form – Sterile Compounding Module or ask NABP to crosswalk the boards’ inspection form to the NABP established the Blueprint Program after working with Multistate Pharmacy Inspection Blueprint. the member boards of pharmacy to develop the Multistate

June/July 2017 innovations | 19 Association News

2017-2018 ACE Appointments Announced

NABP is pleased to announce that the or administrative officer of a board of • Neal F. , RPh • Hill City, MN following individuals have been appointed pharmacy, and non-affiliated individuals to serve on the 2017-2018 Advisory who are practicing pharmacists or • Anita Young, EdD, RPh • Boston, MA Committee on Examinations (ACE). This serving as faculty. • David Chikao Young, PharmD, RPh • standing committee, established by Members serve three-year terms and Salt Lake City, UT NABP in 1912, was created to safeguard ex officio members serve one-year the integrity and validity of NABP terms. The following members began • Mark T. Conradi, JD, RPh • Clanton, examinations. their terms on June 1, 2017. Reginald AL (Ex Officio Member, one-year term, “Reggie” Dilliard, DPh, Executive ACE oversees the development and Multistate Pharmacy Jurisprudence Committee member, is serving as the ® administration of all of the Association’s Examination program) Executive Committee liaison. examination and certification programs. • Benjamin L. Prewitt, PharmD, RPh • ACE also considers policy matters, 2017-2018 ACE Members Lebanon, OH (Ex Officio Member, one- evaluates long-range planning strategies, year term, North American Pharmacist and recommends appropriate action to the • Michael A. Burleson, BSPharm, Licensure Examination® program) NABP Executive Committee. RPh • Lexington, KY • Bruce Waldrop, PhD • Indian Springs, ACE typically convenes three to four • Mark Decerbo, PharmD, RPh, AL (Ex Officio Member, one-year term, times per year. The committee consists BCNSP, BCPS • Las Vegas, NV Foreign Pharmacy Graduate Equivalency of individuals who are affiliated members Examination®/Pharmacy Curriculum of NABP, including current active board • Debra Glass, BPharm, RPh • Outcomes Assessment® programs) of pharmacy members and administrative Tallahassee, FL officers, individuals who have served Orange color denotes new member within the last five years as a member • Theresa M. Talbott, BSPharm, RPh • Stroudsburg, PA

Newly Accredited VIPPS Facilities NABP Report Shows The following internet pharmacies were Link Between Rogue accredited through the NABP Verified Internet Internet Drug Outlets, Pharmacy Practice Sites® (VIPPS®) program: Resistance

DEGC Enterprises US, Inc, dba www.fredmeyer.com Released in March, NABP’s CCS Medical www.frysfood.com Internet Outlet Identification www.ccsmed.com Program Progress Report for www.gerbes.com State and Federal Regulators: Green Oaks Pharma, Inc, dba DFW www.jaycfoods.com March 2017 stresses how rogue Wellness Pharmacy internet drug outlets contribute www.kingsoopers.com www.dfwwellnesspharmacy.com to the rise of antibiotic www.kroger.com resistance by not requiring Long Prairie Pharmacy, LLC prescriptions to purchase www.longprairiepharmacy.com www.owensmarket.com medications. www.pay-less.com Senderra Rx Partners, LLC www.senderrarx.com www.qfc.com Read the full report by www.ralphs.com visiting the Program and The Kroger Co (14 domains) Committee Reports page in www.bakersplus.com www.smithsfoodanddrug.com the Publications and Reports section of www.nabp.pharmacy. www.citymarket.com Your Rx Pharmacy, Inc www.dillons.com www.yourrxpharmacy.com

A full listing of the accredited VIPPS pharmacy sites representing more than 12,000 pharmacies is available on the NABP website at www.nabp.pharmacy.

June/July 2017 innovations | 20 Association News Around the Association

Executive Officer Changes Board Member Appointments Awards and Honors

• Michael D. Bullek, RPh, has been • Emmanuel “Eddie” Bellegarde, BS, has • Gay Dodson, RPh, DPh, executive appointed board administrator/ been appointed a public member of the director/secretary, Texas State Board chief of compliance of the New District of Columbia Board of Pharmacy. of Pharmacy and member of the Hampshire Board of Pharmacy, Bellegarde’s appointment will expire NABP Executive Committee, received replacing Executive Director Michael March 12, 2018. the 2016 Legend of Pharmacy R. Dupuis. Bullek has served as Award from The University of Texas a member of the New Hampshire • Benjamin E. “Ben” Miles, PharmD, RPh, at Austin College of Pharmacy. The Board since September 2011, BCPS, has been appointed a member award is given to individuals whose including most recently as vice of the District of Columbia Board of contributions to the pharmacy president. He has been employed Pharmacy. Miles’ appointment will expire profession are considered above as a retail community pharmacist in March 12, 2018. and beyond, or “legendary;” who Plymouth, NH, for many years and have demonstrated a continuing is a recipient of the Bowl of Hygeia Board Member Reappointments commitment to The University of for community service. Bullek is also Texas College of Pharmacy by • Alan Friedman, RPh, has been an adjunct professor of health and volunteering, teaching, philanthropy, reappointed a member of the District of human performance/ or precepting; who are distinguished Columbia Board of Pharmacy. Friedman’s for undergraduate and graduate in their chosen business, profession, appointment will expire March 12, 2020. students at Plymouth State or work life; who have such integrity University. He graduated in 1979 • Tamara McCants, PharmD, RPh, has and ability that faculty, staff, from the Massachusetts College of been reappointed a member of the District students, and alumni of the college Pharmacy and Health . of Columbia Board of Pharmacy. McCants’ take pride in and are inspired by their appointment will expire March 12, 2020. recognition; and who manifest an attitude of respect and compassion for mankind. NABP Mourns Passing of Former President David R. Work

NABP is sad to throughout the years. In recognition of his announce that exemplary service in protecting the public David R. Work, health and significant involvement with the JD, RPh, passed Association, Work was awarded the NABP away on April Lester E. Hosto Distinguished Service Award 22, 2017. His in 1986. contributions ® to NABP, state Work taught pharmacy law and at the boards of pharmacy, and the protection University of North Carolina at Chapel Hill and of public health were significant. helped create programs to train pharmacists at Campbell University and Wingate University. Next FPGEE Work was executive director of the North Work was also a member of the International Administration Is Carolina Board of Pharmacy from 1976 Pharmaceutical Federation. to 2006. He was an active member October 10, 2017 of NABP and served as president of In 2004, Work was the recipient of the the NABP Executive Committee from Hubert Humphrey Award from the American Information about registering 1993-1994. Work also served as chair Pharmacists Association and the M. Keith for and scheduling the Foreign of the Task Force on the Development Fearing, Jr, Community Pharmacy Practice Pharmacy Graduate Equivalency of an Equitable Degree Upgrade Award from the College of Pharmacy & Health Examination® (FPGEE®) is Mechanism and the Task Force on Mail Sciences at Campbell University. Work was also available to candidates in the Delivery Prescriptions, and as Executive the recipient of the North Carolina Pharmacist Programs section of the NABP Committee liaison of the Task Force on of the Year Award in 1995 and the Order of the website at www.nabp Therapeutic Interchange. At NABP’s 97th Long Leaf Pine in 1981 for his service to the .pharmacy. Annual Meeting, Work was recognized state. Work earned a bachelor of science in in a resolution (No. 97-6-01) for creating pharmacy from the University of Iowa and a a historical pictorial of NABP meetings juris from the University of Denver.

June/July 2017 innovations | 21 State Board News

New Jersey Enacts Law Imposing Restrictions Dakota Department of Health to register with the South on Opioids and Other Schedule II Drugs Dakota Prescription Drug Monitoring Program (PDMP). It further requires pharmacies to submit dispensing data On May 16, 2017, P.L. 2017, c. 28, became effective, imposing every 24 hours. certain restrictions on how opioids and other Schedule II House Bill 1044 made changes affecting the wholesale controlled dangerous substances (CDS) may be prescribed. drug distributor chapter, SDCL 36-11A. The South Dakota In addition, the law established special requirements for the State Board of Pharmacy further amended the chapter management of acute and chronic pain, including, in cases to comply with the Drug Quality and Security Act. This of acute pain, prohibiting a practitioner from issuing an initial entailed adding a new category of licensure, the 503B prescription for an opioid drug in a quantity exceeding a five- facilities, as per the Compounding Quality Act, day supply and requiring the prescription to be for the lowest and also modeled the statute for the other drug distributors effective dose of an immediate-releasing opioid drug. to match the federal law in the Drug Supply Chain Security Although the new law and rules will primarily impose Act (DSCSA). The Board also eliminated its licensure of additional responsibilities on prescribers, the following third-party logistics providers and followed the DSCSA information may be useful for New Jersey pharmacists: by removing reference to pedigree and changing it to • The law and rules do not impose any additional transaction history, transaction information, and transaction requirements for pharmacists to confirm that a prescription statement. must be limited to a five-day supply of medication. However, pharmacists are required to perform their Washington Adopts Rules for Automated corresponding responsibility to ensure that all prescriptions Drug Dispensing Devices for CDS are being written for a valid medical purpose. The Washington State Pharmacy Quality Assurance • Beginning with the 2019 biennial renewal of pharmacist Commission adopted proposed language regarding the licenses, pharmacists must complete one credit of use of automated drug dispensing devices (ADDDs). The continuing education (CE) on programs or topics adopted rules outline the requirements for installation and concerning prescription opioid drugs, including alternatives use of ADDDs in various facilities identified in Chapter 246- to opioids for managing and treating pain and the risks and 874 of the Washington Administrative Code. Additionally, signs of opioid abuse, addiction, and diversion. This is not the adopted rules no longer require facilities to obtain an additional CE credit requirement and will be part of the approval from the Commission before using an ADDD. The existing 30-credit CE requirement for each renewal period. permanent rules were filed on March 7, 2017, and became • Insurance plans issued in New Jersey will charge co- effective on April 7, 2017. payments, coinsurance, or deductibles for an initial Washington pharmacies and nonresident pharmacies prescription of an opioid drug prescribed pursuant to the must submit a list of physical address locations where law that is either proportional between the cost sharing for they manage or service ADDDs on a form provided by a 30-day supply and the amount of drugs the patient was the Washington State Department of Health. This form is prescribed or equivalent to the cost sharing for a full 30-day available on the Commission’s website at www.doh.wa.gov. supply of the opioid drug, provided that no additional cost Pharmacies currently approved by the Commission to use sharing may be charged for any additional prescriptions ADDDs have one year from the effective date of the rule to for the remainder of the 30-day supply. Pharmacists may come into compliance with the new rule, which includes need to contact their insurance plans with any questions submitting the list of physical locations mentioned above. regarding how this component will be implemented. A copy of the law is available at www.njleg.state.nj.us/2016/ District of Columbia PDMP Requires Patient Bills/AL17/28_.PDF. Notification Before Running Query Prescribers and dispensers who plan to obtain prescription South Dakota 2017 Legislature Passes Bills monitoring information from the District of Columbia PDMP Related to PDMP, DSCSA shall provide notice to the patient that a request may be The South Dakota 2017 Legislative Session resulted in two made to obtain information on all covered substances bills amending laws affecting pharmacy practice. Both bills dispensed to that patient. The notice may be provided by were passed by the legislature and signed by Governor use of a conspicuous sign in an area that will be easily Dennis Daugaard. viewed and read by the patient. In lieu of posting a sign, the prescriber or dispenser may provide notice in written Senate Bill 1 amends South Dakota Codified Laws (SDCL) material given to the patient or may obtain written consent Chapter 34-20E with a requirement for all individuals who from the patient. hold a controlled substance registration through the South

June/July 2017 innovations | 22 Professional Affairs Update

WHO Launches Global Patient Safety CPE Training on Older Adult Fall Prevention Challenge on Medication Safety Available Online To reduce severe, avoidable medication-associated Developed in collaboration with the Centers for Disease harm in all countries by 50% over the next five Control and Prevention (CDC) and the American years, the World Health Organization (WHO) has Pharmacists Association, the Stopping Elderly Accidents, launched a worldwide initiative, the Global Patient , and Injuries (STEADI) initiative is offering Safety Challenge on Medication Safety. Medication continuing pharmacy education (CPE) training for errors cause at least one every day and injure pharmacists to prevent falls in adults 65 and older. The approximately 1.3 million people every year in the training will provide strategies to help pharmacists screen United States. In addition, low- and middle-income older adults for fall risk, conduct medication review and countries are estimated to have similar rates of management, and offer patient education. To participate medication-related adverse events as high-income in the free online training, “STEADI: The Pharmacist’s Role countries. in Older Adult Fall Prevention,” visit the CDC website at The Global Patient Safety Challenge on Medication www.cdc.gov/steadi/training.html for more information. Safety aims to make improvements in each stage of the medication use process including prescribing, FDA Presents Series of CE Webinars for dispensing, administering, monitoring, and use. WHO Students and Clinicians intends to provide guidance and develop strategies, Food and Drug Administration’s (FDA’s) Division of in addition to plans and tools to ensure that the Drug Information in the Center for Drug Evaluation medication process has the safety of patients at its and (CDER) presents a series of continuing core in all health care facilities. education (CE) webinars targeted toward students and Previous WHO Global Safety Challenges have health care providers who wish to learn more about FDA included the Clean Care is Safer Care challenge on and drug regulation. The webinars are presented by FDA hand hygiene in 2005 and the Safe Saves staff and allow participants to interact with staff. Previous Lives challenge in 2008. Additional information is webinar topics have included an overview of FDA’s role available in the WHO press release available at http:// in medication error prevention and prescription drug who.int/mediacentre/news/releases/2017/medication- labeling. The webinars and presentation slides can be related-errors/en/. accessed on FDA’s website at www.fda.gov/DDIWebinars. NCPDP Releases Guide to Ensure Patients New FDA Training Video Addresses the Get Their Medications During a Disaster Combat Methamphetamine Epidemic Act The National Council for Prescription Drug Drug Info Rounds, a series of online videos by FDA, Programs (NCPDP) released the NCPDP Emergency provides important and timely drug information to Preparedness Information guide to assist pharmacists practicing clinical and community pharmacists so they and other health care providers during a declared can help patients make better decisions. In the latest Drug emergency. Prepared by the NCPDP Emergency Info Rounds video, “Combat Methamphetamine Epidemic Preparedness Committee, the guide provides Act,” pharmacists discuss the legal requirements for resource information for eligibility and claims the sale of over-the-counter drug products that contain processing affecting displaced individuals. The guide pseudoephedrine. Drug Info Rounds was developed is available at www.ncpdp.org/NCPDP/media/pdf/ with contributions from pharmacists in FDA’s CDER, NCPDPEmergencyPreparednessInformation_v1_4. Office of Communications, Division of Drug Information. pdf. Additional information for pharmacists about All Drug Info Rounds videos can be viewed on the emergency preparedness is available on the NCPDP FDA website at www.fda.gov/Drugs/ResourcesForYou/ website at www.ncpdp.org/Resources/Emergency- HealthProfessionals/ucm211957.htm. Preparedness.

Health care providers and patients are encouraged to report adverse events or quality problems to FDA’s MedWatch Safety Information and Adverse Event Reporting Program at www.fda.gov/MedWatch.

June/July 2017 innovations | 23 First Class INNOVATIONS U.S. Postage PAID National Association of Boards of Pharmacy Permit #583 1600 Feehanville Drive Schaumburg, IL 60173 Mount Prospect, IL 60056

UPCOMING EVENTS

PMP InterConnect Steering NABP/AACP District 3 Meeting NABP/AACP Districts 6, 7, and 8 Committee Meeting August 6-9, 2017 Meeting July 19-20, 2017 Louisville, KY October 8-11, 2017 NABP Headquarters San Antonio, TX NABP/AACP Districts 1 & 2 Meeting 2017 Tri-Regulator Symposium September 14-16, 2017 NABP/AACP District 4 Meeting July 25-26, 2017 Groton, CT November 1-3, 2017 Chicago, IL Toledo, OH NABP Interactive Executive Officer NABP/AACP District 5 Meeting Forum August 3-5, 2017 October 3-4, 2017 Des Moines, IA NABP Headquarters