AN ACT TO AUTHORIZE IMMUNIZING PHARMACISTS TO DISPENSE, DELIVER, AND ADMINISTER CERTAIN TREATMENT AND MEDICATIONS AND TO REQUIRE PARENTAL CONSENT FOR ADMINISTRATION OF VACCINES UNDER AN EMERGENCY USE AUTHORIZATION TO A MINOR. SL 2021-110. Enacted Aug. 20, 2021. Section 1 is effective Feb. 1, 2022. Sections 2, 4, and 7 are effective Oct. 1, 2021. Section 3 is effective Sept. 1, 2021. Section 8 is effective March 31, 2022. The remainder is effective Aug. 20, 2021.
Summary date: Aug 23 2021 - View summary
Summary date: Jul 21 2021 - View summary
Senate committee substitute to the 3rd edition makes the following changes.
Revises the additional authorities granted to immunizing pharmacists under GS 90-85.15B as follows. No longer includes authority for an immunizing pharmacist to order the five specified medications; maintains the authorities granted for immunizing pharmacists to dispense, deliver, or administer the five specified medications. Now includes glucagon for the treatment of severe hypoglycemia in the listed medications (previously, included glucagon or other self-administered formulations for the management of hypoglycemia). Makes conforming changes throughout the remaining proposed changes to the statute. No longer requires an immunizing pharmacist that dispenses, delivers, or administers the listed medications to provide the immunizing pharmacist's name, business address, business phone, and business fax number on any communication with a prescriber; maintains the requirement for the immunizing pharmacist to provide the business contact information of the pharmacy with any communication with a prescriber. Effective March 31, 2022, adds that an immunizing pharmacist that dispenses, delivers, or administers the listed medications must provide the name of the immunizing pharmacist who dispenses, delivers, or administers the medication on any communication with the provider.
Adds the following required actions an immunizing pharmacist must take when administering a long-acting injectable medication pursuant to GS 90-85.15B. Requires: (1) notification of the prescriber within 48 hours of administering the medication if the injectable is in the class of psychotropic medications; and (2) notification of the prescriber if the medication prescribed in the class of psychotropic medications was not administered within 48 hours of receipt of the prescription.
Regarding the standing order the State Health Director is directed to issue authorizing immunizing pharmacists to dispense, deliver, and administer the medications described in the act, adds that the order must include protocols for the initiation, modification, and discontinuation of each therapeutic class of medication available pursuant to the standing order.
Deems any statewide standing order issued by the State Health Director pursuant to SL 2020-3 or SL 2021-3 (regarding COVID-19 vaccine administration) to expire on December 31, 2021, unless the State Health Director determines it is necessary for the order to be extended in order to protect the public safety, health, and welfare of citizens.
Adds to the disciplinary grounds of persons licensed to practice pharmacy or prospective licensees under GS 90-85.38 to include engaging in unprofessional conduct. Explicitly includes departing from or failing to comply with the requirements of GS 90-85.15B(c1) and (d1), when dispensing, delivering, or administering medication for patients.
Amends GS 90-21.5 to mandate health care providers to obtain written consent from a parent or legal guardian prior to administering any vaccine that has been granted emergency use authorization and is not yet fully approved by the FDA to an individual under 18 years of age.
Changes the act's long title.
Summary date: Jun 16 2021 - View summary
Senate committee substitute deletes the content of the 2nd edition and replaces it with the following.
Includes whereas clauses.
Adds to the authorities granted to immunizing pharmacists under GS 90-85.15B as follows. Authorizes the administration of vaccinations approved by the FDA in accordance with the protocols established by the Advisory Committee on Immunization Practices to persons at least six years old pursuant to a specific prescription order initiated by a prescriber following a physical exam of the patient by the prescriber (currently limited to administration of flu vaccines). Enacts new subsection (c2), listing five categories of medications an immunizing pharmacist can order, dispense, deliver, or administer, including FDA-approved nicotine replacement therapy, self-administered or transdermal contraceptives subject to specified requirements and limitations, and post-exposure prophylaxis medications for the prevention of human immunodeficiency virus. Enacts new subsection (c3), allowing an immunizing pharmacist to administer to a patient any described, self-administered injectable medication. Enacts new subsection (d1), establishing requirements for immunizing pharmacists who order, dispense, deliver, or administer a medication listed in new subsection (c2) to a patient, including maintaining a record of medication administered to the patient; notifying any PCP identified by the patient within 72 hours after administration, or if none identified, furnishing information regarding PCPs; furnishing patient records to the patient upon request; furnishing patient records to the PCP identified by the patient upon request by the PCP; and counseling the patient about preventative care if hormonal contraceptives were administered or dispensed. Enacts new subsection (e), conditioning the immunizing pharmacist's authority under new subsection (c2) upon the NC Medical Board and the NC Board of Pharmacy (Boards) having adopted jointly developed rules governing the approval of the individual immunizing pharmacist to order, dispense, deliver, or administer the mediations with limitations determined by the Boards to be in the best interest of patient health and safety; the immunizing pharmacist's current approval from both Boards; and the immunizing pharmacist's provision of contact information of the pharmacy and the pharmacist on any communication with a prescriber. Applies to immunizing pharmacists, pharmacy technicians, and pharmacy interns on or after February 1, 2022.
Further amends GS 90-85.15B, amending subsection (c1) to allow immunizing pharmacists to administer long-acting injectable medications, specifically including testosterone injections and vitamin B12, to persons 18 or older pursuant to a specific prescription order initiated by a prescriber following an exam of the patient that conforms to the standards of acceptable and prevailing medical practice by the prescriber (was, following a physical exam of the patient by the prescriber). Adds to the requirements of the immunizing pharmacist administering such medications the requirement to notify the prescriber of the medication if the medication was not administered to the patient within 72 hours of receipt of the specific prescription. Effective October 1, 2021.
Further amends GS 90-85.15B, enacting new subsection (b1) to allow immunizing pharmacists, and pharmacy interns and pharmacy technicians under the supervision of an immunizing pharmacist if related continuing pharmacy education requirements are met, to administer the flu vaccine, FDA-approved COVID-19 vaccines, and COVID-19 vaccines authorized under an emergency use authorization by the FDA to persons 10 or older. Also authorizes immunizing pharmacists to administer the flu vaccine, FDA-approved COVID-19 vaccines, and COVID-19 vaccines authorized under an emergency use authorization by the FDA to persons 6 or older pursuant to a specific prescription order initiated by a prescriber following a physical exam of the patient by the prescriber. Effective September 1, 2021.
Directs the Boards' joint subcommittee to develop statewide written protocols and amend existing rules and protocols to encompass the new authorized treatments and practices as authorized by the act and to develop a statement of ethics for immunizing pharmacists. Directs the Boards' joint subcommittee to adopt rules to govern the administration of vaccines by pharmacy technicians as authorized by the act. Effective October 1, 2021.
Directs the State Health Director to issue a standing order authorizing immunizing pharmacists to dispense, deliver, and administer medication described in GS 90-85.15B(c2), as enacted, which remains in effect until the later of the development of the statewide protocols or January 1, 2023.
Changes the act's long title.
Summary date: May 11 2021 - View summary
House committee substitute to the 1st edition makes the following changes.
Maintains the act's whereas clauses. Deletes the substantive content of the act and replaces it with the following.
Enacts new subsection (e) to GS 90-85.15B, authorizing immunizing pharmacists to administer FDA-approved drugs and biologicals via intramuscular or subcutaneous injection to human patients 18 years or older pursuant to a specific prescription order initiated by a prescriber following an exam of the individual patient that conforms to the standards of acceptable and prevailing medical practice in the State. Requires compliance with the rules jointly adopted by the NC Board of Pharmacy and the NC Medical Board. Provides that the new subsection does not limit the ability to administer vaccinations and immunizations in accordance with existing law. Effective July 1, 2022.
Directs the NC Board of Pharmacy and the NC Medical Board to, by April 1, 2022, to: (1) implement the act's provisions; (ii) establish and maintain a list of drugs and biologicals adopted pursuant to this act, including specific protocols for each drug or biological, that pharmacists may safely administer by injection; and (iii) develop record-keeping requirements, including a requirement that the pharmacist report administration of the drugs or biologicals authorized by this act to the prescriber within 72 hours. Requires drug- and biological-specific protocols to address the essential considerations and precautions the immunizing pharmacist must take before administering the drug or biological, as specified.
Bill H 96 (2021-2022)Summary date: Feb 16 2021 - View summary
Includes whereas clauses. Amends GS 90-85.3A to add that pharmacists may administer injectable drugs and to specify that immunizing pharmacists may administer injectable drugs (was, administer drugs). Applies to licensed pharmacists and immunizing pharmacists on or after October 1, 2021.
Requires the North Carolina Board of Pharmacy to adopt rules to implement this act by October 1, 2021. Allows for the adoption of temporary rules, which would remain in effect until permanent rules that replace the temporary rules become effective.