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| Helping pharmacy & health communities improve access to Emergency Contraception (EC) |
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EC PHARMACY UPDATEThere is currently no known activity promoting direct pharmacy access to EC. In April 2003 the Nevada Assembly approved (PDF-88K) an amendment (127) to measure AB144 (PDF-16K) that would prohibit pharmacists from refusing to fill prescriptions for certain drugs including EC. If a pharmacist receives an EC prescription and can’t fill it, he or she would be required to help the patient locate a place where she can get the prescription filled. The Nevada Senate tabled AB144 in May 2003. Nevada’s Maternal and Child Health (MCH) Coalition is less active than in some previous times. EC is available through Title X, but awareness is low. State contacts suggest that legislation would not be favorably received.
CONTACTSKeith Macdonald Khanh Pham Laura Cooper Fran Courtney
USEFUL LINKSNevada State Board of Pharmacy Nevada Legislature Planned Parenthood Mar Monte Planned Parenthood of the Rocky Mountains State of Nevada Health Division
PROTOCOL ENVIRONMENTPossible Environment: Revision to Existing Authority Required This state permits collaborative practice agreements or a similar agreement between physicians and pharmacists. However, some modification of existing statutes and/or regulations is required to allow pharmacists to initiate EC for the general community. Pharmacist initiation of EC would require:
PHARMACY PRACTICE ACTPharmacy Practice Act Regulatory and Statutory Authority Note: The text presented below has been prepared by the American Pharmacists Association for the Pharmacy Access Partnership and reflects legislation or regulation promulgated as of June 15, 2003. NEVADA Pharmacists practicing in a licensed medical facility or a community setting may implement or modify drug therapy pursuant to a patient-specific “protocol” or “written guideline” in collaboration with the physician. No external board review is required. There are no additional requirements relating to pharmacist training, no specifications on the time the protocol is valid, and no required reports or communications with the physician. The scope of practice for the collaborative agreement is outlined in the protocol or written guidelines and authorizes:
Statutory authority: Provided in the definitions for “administer,” “chart order” and “practice of pharmacy,” Nev. Rev. Stat. 454.191,213; 639.004, .0124 and .065
NEVADA STATUTE CHAPTER 454: POISONS, DANGEROUS DRUGS AND HYPODERMICS GENERAL PROVISIONS NRS 454.191 “Administer” means the direct application of a drug or medicine referred to in NRS 454.181 to 454.371, inclusive, whether by injection, inhalation, ingestion or any other means, to the body of a patient or research subject. (Added to NRS by 1973, 1196; A 1977, 672, 964; 1979, 593, 1676) NRS 454.213 Authority to possess and administer dangerous drug. A drug or medicine referred to in NRS 454.181 to 454.371, inclusive, may be possessed and administered by: 1. A practitioner. *** CHAPTER 639 PHARMACISTS AND PHARMACY GENERAL PROVISIONS NRS 639.001 Definitions. As used in this chapter, unless the context otherwise requires, the words and terms defined in NRS 639.0015 to 639.016 , inclusive, have the meanings ascribed to them in those sections. NRS 639.004 “Chart order” defined. “Chart order” means an order entered on the chart of a patient in a hospital, facility for intermediate care or facility for skilled nursing which is licensed as such by the health division of the department of human resources or on the chart of a patient under emergency treatment in a hospital by a practitioner or on the written or oral order of a practitioner authorizing the administration of a drug to the patient. (Added to NRS by 1967, 1651; A 1971, 683; 1973, 774; 1979, 1683; 1985, 1768) NRS 639.0124 “Practice of pharmacy” defined. “Practice of pharmacy” includes, but is not limited to, the: 1. Performance or supervision of activities associated with manufacturing, compounding, labeling, dispensing and distributing of a drug. 2. Interpretation and evaluation of prescriptions or orders for medicine. 3. Participation in drug evaluation and drug research. 4. Advising of the therapeutic value, reaction, drug interaction, hazard and use of a drug. 5. Selection of the source, storage and distribution of a drug. 6. Maintenance of proper documentation of the source, storage and distribution of a drug. 7. Interpretation of clinical data contained in a person’s record of medication. 8. Development of written guidelines and protocols in collaboration with a practitioner which are intended for a patient in a licensed medical facility and authorize the implementation, monitoring and modification of drug therapy. 9. Implementation and modification of drug therapy in accordance with the authorization of the prescribing practitioner for a patient in a pharmacy in which drugs, controlled substances, poisons, medicines or chemicals are sold at retail. The term does not include the changing of a prescription by a pharmacist or practitioner without the consent of the prescribing practitioner, except as otherwise provided in NRS 639.2583 . (Added to NRS by 1991, 367) NRS 639.0125 “Practitioner” defined. “Practitioner” means: 1. A physician, dentist, veterinarian or podiatric physician who holds a license to practice his profession in this state; 2. A hospital, pharmacy or other institution licensed, registered or otherwise permitted to distribute, dispense, conduct research with respect to or administer drugs in the course of professional practice or research in this state; 3. An advanced practitioner of nursing who has been authorized to prescribe controlled substances, poisons, dangerous drugs and devices; 4. A physician assistant who:
5. An osteopathic physician’s assistant who:
6. An optometrist who is certified by the Nevada state board of optometry to prescribe and administer therapeutic pharmaceutical agents pursuant to NRS 636.288, when he prescribes or administers therapeutic pharmaceutical agents within the scope of his certification. (Added to NRS by 1979, 1696; A 1985, 876; 1989, 1121; 1991, 791; 1993, 2224; 1995, 1711; 1997, 687; 2001, 408, 775, 1631, 1635) NRS 639.065 Annual report concerning immunizations administered by pharmacists. The board shall prepare an annual report concerning immunizations administered by pharmacists that includes, without limitation, the number of immunizations which were administered by pharmacists during the previous year, any problems or complaints reported to the board concerning immunizations administered by pharmacists and any other information that the board determines would be useful in determining whether pharmacists should continue to administer immunizations in this state. The report must be available for public inspection during regular business hours at the office of the board.
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