H-1024.1  _______________________________________________

                          HOUSE BILL 1768

          _______________________________________________

State of Washington      55th Legislature     1997 Regular Session

By Representatives Dyer, Zellinsky, Sheldon and L. Thomas

Read first time 02/07/97.  Referred to Committee on Health Care.

Regulating pharmacy ancillary personnel.

    AN ACT Relating to pharmacy ancillary personnel; amending RCW 18.64A.010, 18.64A.020, 18.64A.030, 18.64A.040, 18.64A.050, 18.64A.060, 18.64A.070, and 18.64A.080; and adding a new section to chapter 18.64A RCW.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

    Sec. 1.  RCW 18.64A.010 and 1989 1st ex.s. c 9 s 422 are each amended to read as follows:

    Terms used in this chapter shall have the meaning set forth in this section unless the context clearly indicates otherwise:

    (1) "Board" means the state board of pharmacy;

    (2) "Department" means the department of health;

    (3) "Pharmacist" means a person duly licensed by the state board of pharmacy to engage in the practice of pharmacy;

    (4) "Pharmacy" means every place properly licensed by the board of pharmacy where the practice of pharmacy is conducted;

    (5) "Pharmacy ancillary personnel" means pharmacy technicians, pharmacy assistants, and any other personnel identified by the board;

(6) "Pharmacy ((assistant level A)) technician" means:

    (a) A person who is enrolled in, or who has satisfactorily completed, a board approved training program designed to prepare persons to perform nondiscretionary functions associated with the practice of pharmacy; or

    (b) A person who is a graduate with a degree in pharmacy or medicine of a foreign school, university, or college recognized by the board;

    (((6))) (7) "Pharmacy assistant ((level B))" means a person ((certified)) registered by the board to perform limited functions in the pharmacy;

    (((7))) (8) "Practice of pharmacy" means the definition given in RCW 18.64.011((, as now or hereafter amended));

    (((8))) (9) "Provision of pharmaceutical care" means that the pharmacist monitors patients' drug therapy, modifies drug therapy as necessary, documents the results, and assumes responsibility for the results;

(10) "Secretary" means the secretary of health or the secretary's designee.

    Sec. 2.  RCW 18.64A.020 and 1995 c 198 s 8 are each amended to read as follows:

    (1) The board shall adopt, in accordance with chapter 34.05 RCW, rules fixing the classification and qualifications and the educational and training requirements for persons who may be employed as pharmacy ((assistants)) technicians or who may be enrolled in any pharmacy ((assistant)) technician training program.  Such rules shall provide that:

    (a) Licensed pharmacists shall supervise the training of pharmacy ((assistants)) technicians; and

    (b) Training programs shall assure the competence of pharmacy ((assistants)) technicians to aid and assist pharmacy operations.  Training programs shall consist of instruction and/or practical training.

    Such rules may include successful completion of examinations for applicants for pharmacy ((assistant)) technician certificates.  If such examination rules are adopted, the board shall prepare or determine the nature of, and supervise the grading of the examinations.  The board may approve an examination prepared or administered by a private testing agency or association of licensing authorities.

    (2) The board may disapprove or revoke approval of any training program for failure to conform to board rules.  In the case of the disapproval or revocation of approval of a training program by the board, a hearing shall be conducted in accordance with RCW 18.64.160, and appeal may be taken in accordance with the Administrative Procedure Act, chapter 34.05 RCW.

    Sec. 3.  RCW 18.64A.030 and 1996 c 191 s 50 are each amended to read as follows:

    The board shall adopt, in accordance with chapter 34.05 RCW, rules ((and regulations)) governing the extent to which pharmacy ((assistants)) ancillary personnel may perform services associated with the practice of pharmacy ((during training and after successful completion of a training course.  Such regulations)).  These rules shall provide for the certification of pharmacy ((assistants)) technicians by the department at a fee determined by the secretary under RCW 43.70.250 ((and 43.70.280 according to the following levels of classification:

    (1) "Level A pharmacy assistants" may assist in performing, under the immediate supervision and control of a licensed pharmacist, manipulative, nondiscretionary functions associated with the practice of pharmacy.

    (2) "Level B pharmacy assistants" may perform, under the general supervision of a licensed pharmacist, duties including but not limited to, typing of prescription labels, filing, refiling, bookkeeping, pricing, stocking, delivery, nonprofessional phone inquiries, and documentation of third party reimbursements)).

    Sec. 4.  RCW 18.64A.040 and 1992 c 40 s 1 are each amended to read as follows:

    (((1) A pharmacy assistant)) Pharmacy ancillary personnel shall practice pharmacy in this state only after authorization by the board and only to the extent permitted by the board in accordance with this chapter.

    (((2) A pharmacist shall be assisted by a pharmacy assistant in the practice of pharmacy in this state only after authorization by the board and only to the extent permitted by the board in accordance with this chapter:  PROVIDED, That no pharmacist may supervise more than one person performing level A pharmacy assistant duties and functions:  PROVIDED FURTHER, That in pharmacies operating in connection with facilities licensed pursuant to chapter 70.41, 71.12, 71A.20, or 74.42 RCW, whether or not situated within the said facility which shall be physically separated from any area of a pharmacy where dispensing of prescriptions to the general public occurs, the ratio of pharmacists to persons performing level A pharmacy assistant duties and functions shall be as follows:  In the preparation of medicine or other materials used by patients within the facility, one pharmacist supervising no more than three persons performing level A pharmacy assistant duties and functions; in the preparation of medicine or other materials dispensed to persons not patients within the facility, one pharmacist supervising not more than one person performing level A pharmacy assistant duties and functions.))

NEW SECTION. Sec. 5.  A new section is added to chapter 18.64A RCW to read as follows:

    The board shall adopt rules governing the utilization of pharmacy ancillary personnel by pharmacies and pharmacists.  The board shall establish a standard ratio for the number of pharmacy ancillary personnel that one pharmacist may supervise.  Should a pharmacy desire to use more pharmacy ancillary personnel than the standard ratio, the pharmacy must submit to the board a pharmacy services plan for approval.

    (1) The pharmacy services plan shall include, at a minimum, the following information:  Pharmacy design and equipment, information systems, workflow, and quality assurance procedures.  In addition, the pharmacy services plan shall demonstrate how it facilitates the provision of pharmaceutical care services by the pharmacy.

    (2) Prior to approval of a pharmacy services plan, the board may require additional information to ensure appropriate oversight of pharmacy ancillary personnel.

    (3) The board may give conditional approval for pilot or demonstration projects.

    (4) Variance from the approved pharmacy services plan is grounds for disciplinary action under RCW 18.64A.050.

    Sec. 6.  RCW 18.64A.050 and 1993 c 367 s 15 are each amended to read as follows:

    In addition to the grounds under RCW 18.130.170 and 18.130.180, the board of pharmacy may take disciplinary action against the certificate of any pharmacy ((assistant)) technician upon proof that:

    (1) His or her certificate was procured through fraud, misrepresentation or deceit;

    (2) He or she has been found guilty of any offense in violation of the laws of this state relating to drugs, poisons, cosmetics or drug sundries by any court of competent jurisdiction.  Nothing herein shall be construed to affect or alter the provisions of RCW 9.96A.020;

    (3) He or she has exhibited gross incompetency in the performance of his or her duties;

    (4) He or she has willfully or repeatedly violated any of the rules and regulations of the board of pharmacy or of the department;

    (5) He or she has willfully or repeatedly performed duties beyond the scope of his or her certificate in violation of the provisions of this chapter; or

    (6) He or she has impersonated a licensed pharmacist.

    Sec. 7.  RCW 18.64A.060 and 1996 c 191 s 51 are each amended to read as follows:

    No pharmacy licensed in this state shall utilize the services of pharmacy ((assistants)) ancillary personnel without approval of the board.

    Any pharmacy licensed in this state may apply to the board for permission to use the services of pharmacy ((assistants)) ancillary personnel.  The application shall be accompanied by a fee and shall comply with administrative procedures and administrative requirements set pursuant to RCW 43.70.250 and 43.70.280, shall detail the manner and extent to which the pharmacy ((assistants)) ancillary personnel would be used and supervised, and shall provide other information in such form as the secretary may require.

    The board may approve or reject such applications.  In addition, the board may modify the proposed utilization of pharmacy ((assistants)) ancillary personnel and approve the application as modified.  Whenever it appears to the board that ((a)) pharmacy ((assistant is)) ancillary personnel are being utilized in a manner inconsistent with the approval granted, the board may withdraw such approval.  In the event a hearing is requested upon the rejection of an application, or upon the withdrawal of approval, a hearing shall be conducted in accordance with chapter 18.64 RCW, as now or hereafter amended, and appeal may be taken in accordance with the Administrative Procedure Act, chapter 34.05 RCW.

    Sec. 8.  RCW 18.64A.070 and 1977 ex.s. c 101 s 7 are each amended to read as follows:

    (1) Persons presently assisting a pharmacist by performing the functions of a pharmacy ((assistant)) technician may continue to do so under the supervision of a licensed pharmacist:  PROVIDED, That within eighteen months after May 28, 1977, such persons shall be in compliance with the provisions of this chapter.

    (2) Pharmacies presently employing persons to perform the functions of a pharmacy ((assistant)) technician may continue to do so while obtaining board approval for the use of certified pharmacy ((assistants)) technicians:  PROVIDED, That within eighteen months after May 28, 1977, such pharmacies shall be in compliance with the provisions of this chapter.

    Sec. 9.  RCW 18.64A.080 and 1977 ex.s. c 101 s 8 are each amended to read as follows:

    ((No)) A pharmacy or pharmacist which utilizes the services of ((a)) pharmacy ((assistant)) ancillary personnel with approval by the board, ((shall be considered as)) is not aiding and abetting an unlicensed person to practice pharmacy within the meaning of chapter 18.64 RCW((, as now or hereafter amended)):  PROVIDED, HOWEVER, That the pharmacy or pharmacist shall retain responsibility for any act performed by ((a)) pharmacy ((assistant)) ancillary personnel in the course of ((his or her)) employment.

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