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MSHP Public Policy, Practice Advancement Initiative & Strategic Planning Committees

17 Nov 2017 10:03 AM | Deleted user

MSHP Public Policy Committee

Author: Bert McClary, RPh (retired)

The Public Policy Committee met by telephone conference in its scheduled monthly meetings on October 5 and November 2.

During discussion of the practice advancement legislation proposal the committee was told that although MHA is very interested in supporting this and has agreed to help draft bill language, their regulatory staff is very busy at this time with DHSS rules and other legislation proposals. Discussion was held regarding possibly asking MPA again to write the bill language since the proposed changes were agreed on last spring, but this would be a decision to be made by the practice advancement group.

The technician legislation proposal has been facilitated with MHA by individual pharmacists, and MSHP has also expressed support. MHA has agreed to provide draft bill language for pharmacy groups to review, but has not had time to do so. The goal of the proposal is to provide open language regarding technician qualifications and scope of practice that can accommodate future changes in pharmacy practice. The scope of the legislation will be limited to hospitals and hospital facilities. Discussion included whether or not it would be advantageous to also develop a DHSS hospital licensing rule using similar criteria. PP Committee volunteers will develop draft language for promotional materials that provides evidence of both increased patient safety and economic advantages of advanced technician scope of practice.

Both of these proposals will need fast review and turnaround by interested pharmacy groups in order to select sponsors, file the bills and begin promotion by lobbying partners. Pre-filing of bills for the 2018 legislative session begins December 1, and lobbyists often begin promoting bills during November.

Other agenda discussion topics included:

  • BOP meeting summaries
  • Review of SB 501 and DHSS hospital licensing rules
  • CMS/MoHealthNet proposed reimbursement changes for 340B pharmacies
  • Opioid epidemic
  • Federal provider status legislation

Practice Advancement Legislation Group

This voluntary multidisciplinary practice group, which is described in the January and September Newsletters, is preparing a legislative proposal to grant authority for pharmacists to prescribe drugs and controlled substances through MTS protocol agreements with physicians. This will enable improved patient medication management by pharmacists who are allowed to practice not only at the top of their license but also at the top of their competency.

A core group of participants met by telephone conference on September 21 to review the current status of the proposal, make recommendations for finalizing the language, and make recommendations for promoting the bill to the legislature and to interested persons and organizations. Discussions included the following:

  • The colleges are preparing a summary of clinical practices in ambulatory care settings for use in promoting the bill.
  • The potential to include authority for ordering/performing/interpreting laboratory testing related to drug use. Also, the gray area of interpreting lab test results vs diagnosing, which is prohibited in the current statute. It was determined best to not make the bill too broad in scope, and that authority for testing should be determined based on current law and scope of practice standards.
  • Direct discussion of the proposal has been held with the Missouri Hospital Association. Additional contact will be made to request moving forward with preparation of bill language.
  • Additional efforts will be made to encourage participation by chain pharmacies and long term care pharmacies.
  • Members were encouraged to provide examples and ideas for promotional documents.
  • Promotion of the bill through MHA, MPA and health system lobbyists.
  • It is possible that MPA will want changes to current suggested language. Discussion also included the possibility of compromise during legislative hearings, and that compromise criteria should not be determined now, but the group should be aware of the possibility.

During later discussions about this proposal at the BOP Hospital Advisory Committee meeting and the BOP open session, it was stated that MHA is extremely busy with other regulatory issues, but hoped to have bill language ready in November. It was also noted that BOP has discussed this proposal with MHA.

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