MED&TJD:jld&sac:rs
2013 - 2014 LEGISLATURE
August 20, 2013 - Introduced by Representatives Endsley, Brooks, Czaja,
Kestell, A. Ott, Pridemore, Schraa, Spiros, Stone and Hulsey, cosponsored
by Senators Gudex, Moulton and Lehman. Referred to Committee on Aging
and Long-Term Care.
AB292,1,3
1An Act to create 49.498 (2) (a) 3., 50.045, 450.01 (16) (hm) and 450.033 of the
2statutes;
relating to: therapeutic alternate drug selections in nursing homes,
3performance 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:
AB292,1
1Section
1. 49.498 (2) (a) 3. of the statutes is created to read:
AB292,2,52
49.498
(2) (a) 3. A quality assessment and assurance committee described
3under subd. 2. may establish written guidelines or procedures for making
4therapeutic alternate drug selections for the purposes of s. 450.01 (16) (hm) if the
5committee members include a pharmacist, as defined in s. 450.01 (15).
AB292,2
6Section
2. 50.045 of the statutes is created to read:
AB292,2,11
750.045 Therapeutic alternate drug selections in nursing homes. (1) A
8nursing home that does not maintain a quality assessment and assurance committee
9under s. 49.498 (2) (a) 2. may maintain a committee that consists of the director of
10nursing services, a physician, as defined in s. 448.01 (5), a pharmacist, as defined in
11s. 450.01 (15), and at least 2 other members of the nursing home staff.
AB292,2,14
12(2) A committee with the members specified under sub. (1) may establish
13written guidelines or procedures for making therapeutic alternate drug selections
14for the purposes of s. 450.01 (16) (hm).
AB292,3
1Section
3. 450.01 (16) (hm) of the statutes is created to read:
AB292,3,82
450.01
(16) (hm) Making therapeutic alternate drug selections in accordance
3with written guidelines or procedures previously established by a quality
4assessment and assurance committee of a nursing facility under s. 49.498 (2) (a) 3.
5or by a committee established for a nursing home under s. 50.045 (2), if the use of the
6therapeutic alternate drug selection has been approved for a patient during the
7period of the patient's stay within the nursing facility or nursing home by any of the
8following:
AB292,3,99
1. The patient's personal attending physician.
AB292,3,1210
2. The patient's advanced practice nurse prescriber, if the advanced practice
11nurse prescriber has entered into a written agreement to collaborate with the
12patient's personal attending physician.
AB292,3,1413
3. The patient's physician assistant, if the physician assistant is under the
14supervision of the patient's personal attending physician.
AB292,4
15Section
4. 450.033 of the statutes is created to read:
AB292,3,18
16450.033 Services delegated by physician. A pharmacist may perform any
17patient care service delegated to the pharmacist by a physician, as defined in s.
18448.01 (5).