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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, although the issue has been discussed in NARAL Pro-Choice Wyoming’s planning retreats . The Wyoming Health Council is working with NARAL Pro-Choice Wyoming on EC access issues and could take the lead on a pharmacy access initiative. The two organizations have surveyed (PDF-32K) most of the state’s 139 pharmacies in the state to see if they provide EC with a prescription. Results showed that 44% of the pharmacies that responded filled EC prescriptions. Mailings have been sent to physicians and hospitals encouraging them to sign up with the national 1-800-Not-2-Late hotline. Memos were sent to hospitals notifying them of where to refer patients, including sexual assault victims for EC. NARAL Pro-Choice Wyoming has an ad campaign promoting EC, specifically the Not-2-Late hotline; this includes newspaper, radio, and yellow-page advertising. NARAL Pro-Choice Wyoming has published a Report on Access to Emergency Contraception and Abortion in Wyoming. The Wyoming Health Council conducts EC trainings for family planning providers. Title X clinics currently provide EC.
CONTACTSSharon Breitweiser James T. Carder, R.Ph. Julie Lehman Kara Beech, BS, CHC Northwest Wyoming Family Planning
USEFUL LINKSWyoming Board of Pharmacy Wyoming Pharmacists Association Wyoming State Legislature Wyoming Health Council Planned Parenthood of the Rocky Mountains
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. WYOMING Pharmacists in any practice setting may implement collaborative practice agreements with patient-specific protocols approved by the Board and the Collaborative Practice Advisory Committee, a committee that advises the Board on protocol approval. Collaborative agreements shall be renewed annually. The physician and the pharmacist must maintain protocol and consent documents in the patient medical chart. The scope of practice is outlined in the protocol and may include “implementing, modifying or managing drug therapy,” as well as taking patient histories, checking vital signs, and ordering lab tests. The agreement must set forth:
There is no limitation to the scope of practice opportunities. Statutory authority for collaborative practice is granted the definition of collaborative practice. Regulatory authority is outlined in definition terms for “drug therapy management” and “pharmacist’s scope of practice.” There is a separate section on “collaborative pharmaceutical care” outlining agreement requirements. Statutory authority: Provided in sections defining “collaborative pharmaceutical care” and pharmacy practice, Wyo. Stat. Ann. § 33-24-101(d) and 124 Regulatory authority: Provided in section governing “collaborative pharmaceutical care” and related definitions, Wyo. Admin Code ch. 2 §§4 and 30
WYOMING STATUTE Pharmacy Laws CHAPTER 24 PHARMACY ARTICLE 1 33-24-101. Short title; definitions (d) “Collaborative pharmaceutical care” means a pharmacist working in collaboration with physicians and other medical providers authorized to prescribe medications. 33-24-124. Persons deemed practicing pharmacy. Any person shall be deemed to be practicing pharmacy within the meaning of this act who provides collaborative pharmaceutical care or prepares, or compounds, or processes, or packages, or repackages, or labels, or dispenses, or sells, or offers for sale, at retail or in connection with operation of a health-care facility, any dangerous drugs, medicines, poisons, chemicals, narcotics, or prescriptions, which are identified as such in accordance with this act.
WYOMING REGULATIONS Wyoming Board of Pharmacy CHAPTER 2 - GENERAL PRACTICE OF PHARMACY REGULATIONS Section 4. Definitions. (a) “Administer” means the direct application of a drug, whether by injection, inhalation, ingestion, or any other means, to the body of a patient or research subject by:
… (cc) “Agreement” means a voluntary agreement, written and signed, between a pharmacist and a prescribing physician that defines a collaborative practice for the purpose of drug therapy management of patients. (dd) “Collaborative pharmacy practice” means a practice in which a prescribing physician makes a diagnosis, maintains ongoing supervision of patient care and refers the patient to a pharmacist under a protocol allowing the pharmacist to perform patient care functions authorized by the physician under specified conditions or limitations. (ee) “Drug therapy management” means the review of drug therapy regimen(s) of patients by a pharmacist for the purpose of evaluating and rendering advice to the prescribing physician regarding adjustment of the regimen. Decisions involving drug therapy management shall be made in the best interest of the patient. “Drug therapy management” may include:
(ff) “Pharmacist’s collaborative scope of practice” means those duties and limitations of duties agreed upon by a pharmacist and the collaborating physician (subject to Board’s approval and applicable law), and includes the limitations implied by the specialty practiced by the collaborating physician. Section 30. Collaborative Pharmaceutical Care. (a) A pharmacist planning to engage in collaborative practice shall have on file at his place of practice a written signed agreement approved by the Board. The agreement allows the pharmacist, acting within the pharmacist’s collaborative scope of practice, to conduct drug therapy management approved by a prescribing physician acting within the scope of the physician’s current practice. (b) The agreement shall include:
(c) Drug therapy management shall occur only for a particular patient pursuant to a specific written order from the prescribing physician. The written order shall conform to the format established by the Board of Pharmacy and shall include the following as a minimum.
(d) A pharmacist providing drug therapy management for a patient, shall obtain written consent from the patient or the patient’s agent, parent or guardian prior to providing this service. Drug therapy management shall not be implemented for a particular patient, if the patient or the patient’s agent, parent or guardian, refuses to give written consent after being informed of the responsibility for payment. (e) At a minimum, the written agreement shall be reviewed/renewed annually. If necessary, the agreement may be revised. The Board of Pharmacy must approve all revisions, once signed by the pharmacist and the prescribing physician, prior to implementation. (f) The Board shall review and approve all agreements including revisions prior to implementation. This shall be accomplished as follows:
(g) A pharmacist and prescribing physician entering into an agreement must be currently licensed by their respective Board and authorized to practice in the State of Wyoming. (h) Nothing in this Section shall be interpreted to permit a pharmacist to accept delegation of a physician’s authority outside the limits included in W.S. §33-26-202 of the Medical Practice Act and the Board of Medicine’s regulations.
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