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Substitute Senate Bill No. 1151

Public Act No. 03-164

AN ACT CONCERNING COLLABORATIVE PRACTICE BETWEEN PHYSICIANS AND PHARMACISTS.

Be it enacted by the Senate and House of Representatives in General Assembly convened:

Section 1. Section 20-631 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2003):

(a) (1) One or more pharmacists licensed under this chapter who are determined eligible in accordance with subsection (c) of this section, and employed by a hospital may enter into a written protocol-based collaborative drug therapy management agreement with one or more physicians licensed under chapter 370 to manage the drug therapy of individual patients receiving inpatient services in a hospital licensed under chapter 368v, in accordance with subsections (b) to (d), inclusive, of this section and subject to the approval of the hospital. Each patient's collaborative drug therapy management shall be governed by a written protocol specific to that patient established by the treating physician in consultation with the pharmacist.

(2) One or more pharmacists licensed under this chapter who are determined eligible in accordance with subsection (c) of this section and employed by or under contract with a nursing home facility, as defined in section 19a-521, may enter into a written protocol-based collaborative drug therapy management agreement with one or more physicians licensed under chapter 370 to manage the drug therapy of individual patients receiving services in a nursing home facility, in accordance with subsections (b) to (d), inclusive, of this section and subject to the approval of the nursing home facility. Each patient's collaborative drug therapy management shall be governed by a written protocol specific to that patient established by the treating physician in consultation with the pharmacist. Each such protocol shall be reviewed and approved by the active organized medical staff of the nursing home in accordance with the requirements of section 19-13-D8t(i) of the Public Health Code.

(b) A collaborative drug therapy management agreement may authorize a pharmacist to implement, modify or discontinue a drug therapy that has been prescribed for a patient, order associated laboratory tests and administer drugs, all in accordance with a patient-specific written protocol. In instances where drug therapy is discontinued, the pharmacist shall notify the treating physician of such discontinuance no later than twenty-four hours from the time of such discontinuance. Each protocol developed, pursuant to the collaborative drug therapy management agreement, shall contain detailed direction concerning the actions that the pharmacist may perform for that patient. The protocol shall include, but need not be limited to, (1) the specific drug or drugs to be managed by the pharmacist, (2) the terms and conditions under which drug therapy may be implemented, modified or discontinued, (3) the conditions and events upon which the pharmacist is required to notify the physician, and (4) the laboratory tests that may be ordered. All activities performed by the pharmacist in conjunction with the protocol shall be documented in the patient's medical record. The pharmacist shall report at least every thirty days to the physician regarding the patient's drug therapy management. The collaborative drug therapy management agreement and protocols shall be available for inspection by the Departments of Public Health and Consumer Protection. A copy of the protocol shall be filed in the patient's medical record.

(c) A pharmacist shall be responsible for demonstrating, in accordance with this subsection, the competence necessary for participation in each drug therapy management agreement into which such pharmacist enters. The pharmacist's competency shall be determined by the hospital or nursing home facility for which the pharmacist is employed. A copy of the criteria upon which the hospital or nursing home facility determines competency shall be filed with the Commission of Pharmacy.

(d) The Commissioner of Public Health, in consultation with the Commissioner of Consumer Protection, may adopt regulations, in accordance with chapter 54, concerning the minimum content of the collaborative drug therapy management agreement and the written protocol and as otherwise necessary to carry out the purpose of this section.

Sec. 2. Section 20-635 of the general statutes is amended by adding subsection (e) as follows (Effective October 1, 2003):

(NEW) (e) Records collected or maintained pursuant to this section shall not be required to be disclosed pursuant to subsection (a) of section 1-210 for a period of six months from the date such records were created pursuant to subsections (c) and (d) of this section and shall not be subject to subpoena or discovery or introduced into evidence in any judicial proceeding except as otherwise specifically provided by law.

Approved June 26, 2003