SB251: Bill Text

LRB-2399/1

MED&TJD:jld&sac:ph

2013 - 2014 LEGISLATURE

2013 Senate BILL 251

August 16, 2013 - Introduced by Senators Gudex, Moulton and Lehman, cosponsored by Representatives Endsley, Czaja, Pridemore, A. Ott, Brooks, Spiros, Stone, Schraa, Kestell and Hulsey. Referred to Committee on Health and Human Services.

SB251,1,3 An Act to create 49.498 (2) (a) 3., 50.045, 450.01 (16) (hm) and 450.033 of the statutes; relating to: therapeutic alternate drug selections in nursing homes, performance of patient services by a pharmacist, and the practice of pharmacy.

Analysis by the Legislative Reference Bureau

This bill provides that a pharmacist who is licensed by the Pharmacy Examining Board (pharmacist) may perform any patient care service that is delegated to the pharmacist by a physician licensed by the Medical Examining Board (physician).

Under current law, a nursing facility, as defined under federal law, must maintain a quality assessment and assurance committee that must identify issues with respect to which quality assessment and assurance activities are necessary and must develop and implement appropriate plans of action to correct identified quality deficiencies. The committee must consist of the director of nursing services, a physician designated by the nursing facility, and at least three other members of the nursing facility staff.

This bill allows the quality assessment and assurance committee of a nursing facility to establish written guidelines or procedures for making therapeutic alternate drug selections for certain purposes if the committee members include a pharmacist. This bill also allows a nursing home, as defined under state law, that does not otherwise maintain a quality assessment and assurance committee under the federal law requirement for nursing facilities, to maintain a committee consisting of the director of nursing services, a physician, a pharmacist, and at least two other members of the nursing home staff. If the nursing home establishes a committee consisting of those members, the committee may establish written guidelines or procedures for making therapeutic alternate drug selections in accordance with the provisions created in the bill.

The bill also adds to the definition of the practice of pharmacy, allowing a pharmacist to make therapeutic alternate drug selections in accordance with written guidelines or procedures previously established by a committee of a nursing facility or nursing home that includes the required membership, as described above. Under the bill, the use of the therapeutic alternate drug selection must have also been approved for a patient during the period of the patient's stay within the nursing facility or nursing home by the patient's personal attending physician; the patient's physician assistant, if the physician assistant is under the supervision of the patient's personal attending physician; or the patient's advanced practice nurse prescriber, if the advanced practice nurse prescriber has entered into a written agreement to collaborate with the patient's personal attending physician.

The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:

SB251,1 Section 1. 49.498 (2) (a) 3. of the statutes is created to read:

SB251,2,5 49.498 (2) (a) 3. A quality assessment and assurance committee described under subd. 2. may establish written guidelines or procedures for making therapeutic alternate drug selections for the purposes of s. 450.01 (16) (hm) if the committee members include a pharmacist, as defined in s. 450.01 (15).

SB251,2 Section 2. 50.045 of the statutes is created to read:

SB251,2,11 50.045 Therapeutic alternate drug selections in nursing homes. (1) A nursing home that does not maintain a quality assessment and assurance committee under s. 49.498 (2) (a) 2. may maintain a committee that consists of the director of nursing services, a physician, as defined in s. 448.01 (5), a pharmacist, as defined in s. 450.01 (15), and at least 2 other members of the nursing home staff.

SB251,2,14 (2) A committee with the members specified under sub. (1) may establish written guidelines or procedures for making therapeutic alternate drug selections for the purposes of s. 450.01 (16) (hm).

SB251,3 Section 3. 450.01 (16) (hm) of the statutes is created to read:

SB251,3,8 450.01 (16) (hm) Making therapeutic alternate drug selections in accordance with written guidelines or procedures previously established by a quality assessment and assurance committee of a nursing facility under s. 49.498 (2) (a) 3. or by a committee established for a nursing home under s. 50.045 (2), if the use of the therapeutic alternate drug selection has been approved for a patient during the period of the patient's stay within the nursing facility or nursing home by any of the following:

SB251,3,9 1. The patient's personal attending physician.

SB251,3,12 2. The patient's advanced practice nurse prescriber, if the advanced practice nurse prescriber has entered into a written agreement to collaborate with the patient's personal attending physician.

SB251,3,14 3. The patient's physician assistant, if the physician assistant is under the supervision of the patient's personal attending physician.

SB251,4 Section 4. 450.033 of the statutes is created to read:

SB251,3,18 450.033 Services delegated by physician. A pharmacist may perform any patient care service delegated to the pharmacist by a physician, as defined in s. 448.01 (5).

SB251,3,19 (End)