File No. 323

House of Representatives, April 10, 2012

The Committee on Public Health reported through REP. RITTER, E. of the 38th Dist., Chairperson of the Committee on the part of the House, that the substitute bill ought to pass.

AN ACT CONCERNING PRESCRIPTION DRUG ADMINISTRATION IN NURSING HOME FACILITIES.

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

Section 1. (NEW) (Effective October 1, 2012) A medical director of a nursing home facility, as defined in section 19a-521 of the general statutes, may establish protocols for a prescription drug formulary system in accordance with guidelines established by the American Society of Health-System Pharmacists and any applicable collaborative drug therapy management agreement, as described in section 20-631 of the general statutes. The medical director of a nursing home facility that implements a prescription drug formulary system may make a substitution for a drug prescribed to a patient of the facility in accordance with the provisions of this section. Prior to making any substitution for a drug prescribed to a patient of the facility in accordance with the facility's protocols, the medical director, or the medical director's designee, shall notify the prescribing physician of the medical director's intention to make such substitution. If the prescribing physician does not authorize the medical director or the medical director's designee to make such substitution or objects to such substitution, the medical director, or the medical director's designee, shall not make the substitution. Notwithstanding the provisions of this section, the facility's administration of prescription drugs to a patient who receives benefits under a medical assistance program administered by the Department of Social Services shall be in accordance with the department's preferred drug lists, developed in accordance with section 17b-274d of the general statutes.

Statement of Legislative Commissioners:

In the third sentence of section 1, "medical director or the director's designee" was changed to "medical director or the medical director's designee" for consistency.

The following Fiscal Impact Statement and Bill Analysis are prepared for the benefit of the members of the General Assembly, solely for purposes of information, summarization and explanation and do not represent the intent of the General Assembly or either chamber thereof for any purpose. In general, fiscal impacts are based upon a variety of informational sources, including the analyst's professional knowledge. Whenever applicable, agency data is consulted as part of the analysis, however final products do not necessarily reflect an assessment from any specific department.

OFA Fiscal Note

State Impact: None

Municipal Impact: None

Explanation

The bill allows certain care facilities to establish protocols for a prescription drug formulary system. As the bill specifies that facilities must continue to use the Department of Social Services' preferred drug list for Medicaid clients, there is no fiscal impact to the state.

The Out Years

State Impact: None

Municipal Impact: None

OLR Bill Analysis

sHB 5516

AN ACT CONCERNING PRESCRIPTION DRUG ADMINISTRATION IN NURSING HOME FACILITIES.

SUMMARY:

This bill allows the medical director of a nursing home facility to establish protocols for a prescription drug formulary system. These protocols must comply with (1) American Society of Health-System Pharmacists guidelines and (2) any applicable collaborative drug therapy management agreement.

A medical director who implements such a system may make a substitution for a drug prescribed to a patient of the facility in accordance with the facility's protocols. Before making any substitution, the bill requires the medical director, or designee, to notify the prescribing physician. The bill prohibits the substitution if the prescribing physician objects or does not authorize it.

The bill specifies, notwithstanding it's provisions, that a facility must use the Department of Social Services' preferred drug lists when administering prescription drugs to Medicaid beneficiaries.

The bill applies to nursing homes, residential care homes, rest homes with nursing supervision, and chronic and convalescent nursing homes.

EFFECTIVE DATE: October 1, 2012

BACKGROUND

Collaborative Drug Therapy Management Agreements

The law permits physicians and pharmacists to enter collaborative agreements to manage the drug therapy of individual patients. These collaborative agreements must be governed by patient-specific written protocols established by the treating physician in consultation with the pharmacist. These agreements can authorize a pharmacist to implement, modify, or discontinue a drug therapy that the physician prescribes; order associated lab tests; and administer drugs (CGS § 20-631).

COMMITTEE ACTION

Public Health Committee

Joint Favorable