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Missouri Board of Pharmacy News

17 Nov 2017 9:23 AM | Deleted user

Author: Bert McClary, RPh (retired)

The Board of Pharmacy held an additional public session on September 13 in Jefferson City, and the regularly scheduled meeting on October 25 at St. Louis College of Pharmacy.

According to the Governor’s Executive Order 17-03, all Missouri administrative rules are being reviewed and the additional session was necessary in order to keep the BOP rule review on schedule. The following rules were among those considered for the first time, and a recommendation was made to open them for further discussion by the Board for possible revisions:

  • PRN Refills 20 CSR 2220-2.110
    o Quantities remaining on refills
  • Transfer of Prescription Information 20 CSR 2220-2.120
    o Consider current technology, special types of transfers
  • Drug Repackaging 20 CSR 2220-2.130
  • Automated Filling Systems 20 CSR 2220-2.950
    o Compare language with other automated system rules
  • Patient Counseling 20 CSR 2220-2.190
    o Use of remote technology for counseling, other language considerations

Continuing discussion was held on the following rules from previous meetings:

  • Pharmacy Standards of Operation 20 CSR 2220-2.010
    o Mandatory name tags for pharmacy staff
    o Print or electronic versions of required reference materials
    o Technician pictures allowed in binder vs posted publicly
    o Humidity control requirements
    o Use of the term medication vs drug
    o Content and retrievability of records for all legend drugs received and distributed
    o Possession of steroids by a home health agency
    o Security requirements
  • Pharmacy Supervision 20 CSR 2220-2.012
    o Technician activities during pharmacist’s temporary absence
    o Technician activities when pharmacist is not on site, including accepting prescriptions and compounding
    o Who is responsible for negative events when pharmacist is not present
    o Differentiate between security issues and oversight of duties
    o Define discretionary vs non-discretionary work
    o Clear definition of permit area
    o Subcommittee will prepare recommendations for discussion
  • Administration by Medical Prescription Order 20 CSR 2220-6.040
    o Qualification requirements
    o Board approval of training programs
    o Requirement for patient to remain in pharmacy after vaccine administration
    o Vaccine information statements
    o Reporting to DHSS ShowMeVax system
    o Mileage requirements
    o Will file for rulemaking
  • Administration of Vaccines per Protocol 20 CSR 2220-6.050
    o Requirement for obtaining or creating a prescription to document dispensing
    o Will refer to BOHA for approval, then file for rulemaking
  • Pharmacist-In-Charge 20 CSR 2220-2.090
    o Necessity of PIC requirement
    o Division of responsibility between PIC and permit holder
  • Electronic Prescriptions 20 CSR 2220-2.085
    o Digital signatures
    o Controlled substances in accordance with state and federal law
    o Will proceed with final rulemaking
  • Shared Services 20 CSR 2220-2.650
    o No additional changes suggested
    o Will file for rulemaking

The BOP proposed legislation for technician registration changes is not a high priority for the Governor’s office as it does not reduce regulatory burden. An alternate proposal that would apply only to hospital pharmacy and hospital clinic sites is being considered by a hospital based group.

The Governor’s Task Force on Boards and Commissions has recommended combining certain health profession boards, but has not recommended combining BOP with any other board. There was discussion of adding a technician member.

The Governor is concerned that rule review meetings are not being held in all parts of the state by all agencies. The Board considered the utility of meeting in other areas of the state for rule review as well as for regularly scheduled meetings to provide more opportunity for public comment. The rule review requirements are causing a significant increase in workload for both Board members and staff, and this is expected to continue for the next couple of years. The Board will also focus on the Governor’s emphasis on timely clearing of investigation cases. The Board currently meets quarterly for open sessions and at least monthly in email and telephone conference meetings. Recommendations for adding an additional open meeting and the meeting schedule for the coming calendar year were discussed.

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