Senate committee substitute to the 1st edition makes the following changes. 

Eliminates the proposed changes to GS 90-12.7, adding an immunizing pharmacist and a clinical pharmacist practitioner to individuals who are authorized to prescribe an opioid antagonist.

Revises the additional authorities granted to immunizing pharmacists under GS 90-85.15B(c2) as follows. Replaces the ten categories of medications an immunizing pharmacist can prescribe and dispense, to now only list four: (1) FDA approved tobacco cessation medications; (2) oral hormonal contraceptives after the patient completes an assessment consistent with CDC eligibility criteria; (3) prenatal vitamins; and (4) controlled substances for the prevention of human immunodeficiency virus. Eliminates proposed subsection (e), which authorized an immunizing pharmacist to test or screen for and treat minor, nonchronic health conditions, with record requirements. Makes conforming organizational changes. 

Makes the provisions of proposed subsection (b1) of GS 90-18.4, providing clinical pharmacists' authority to prescribe and dispense the four identified categories of medications as those provided for immunizing pharmacists in new subsection (c1) of GS 90-85.15B, as enacted. 

Changes the directive to the NC Medical Board and the NC Board of Pharmacy joint subcommittee. Now directs the Boards' joint subcommittee to develop statewide written protocols and amend existing rules and protocols to provide and develop certification for clinical pharmacist practitioners and immunizing pharmacists that encompass the new authorized treatments and practices as authorized in the act (previously directed the joint subcommittee to (1) provide certification for clinical pharmacist practitioners and immunizing pharmacists that encompass the new authorized treatments and practices; (2) develop specified training related to minor, nonchronic health conditions; (3) create a list of minor, nonchronic health conditions eligible for screening, testing, and treatment by a clinical pharmacist practitioner or immunizing pharmacists; and (4) create a formulary of FDA approved medications to treat specific minor, nonchronic health conditions, excluding Schedule I-IV controlled substances identified by the NC Controlled Substances Act). 

Makes technical changes to the act's effective date provisions; maintains the effective date of October 1, 2021.