CSHP Advocates for Pharmacy Professionals in CT

CSHP represents you and your interests as a pharmacy professional. We work to create the best possible work environment for all. During the legislative session, our lobbyist and legislative committee track activity and use a service called Bill Book.

___________________________________________________________________________________

March 2019 - Get Involved! How to follow up on Pharmacy Day 2019

submitted by Thomas Buckley, RPh, MPH, Chairperson


 The Connecticut 2019 legislative session is in full swing, and CSHP has been actively monitoring hundreds of proposed bills and taking the legislative lead on two new pieces of legislation: HB 6543 “An Act Permitting Pharmacists to Prescribe Tobacco Cessation Products” and SB 921 “An Act Concerning the Scope of Practice of Advanced Practice Registered Nurses (Section 28)”. Both of these bills are currently in the Public Health Committee, the public hearing for these bills occurred on March 4th, and we give great thanks to Stephanie Luon and Fei Wang for appearing in person to testify. In addition to Steph and Fei’s testimony, we had 10 people submit written testimony supporting these bills, which will greatly assist us in getting the bills passed out of committee. We still have an uphill road to climb however, so this is NOW your opportunity to contact your Representative and/or Senator to advocate for these 2 bills. This is especially true if your legislator is on the Public Health Committee. Click here to see the list Public Health Committee members and the towns they represent.

You can view all the testimony submitted for both of these bills on the Connecticut General Assembly website. The testimony for HB 6543 can be found here: https://www.cga.ct.gov/asp/menu/CommDocTmyBillAllComm.asp?bill=HB-06543&doc_year=2019

The testimony for SB 921 can be found here: https://www.cga.ct.gov/asp/menu/CommDocTmyBillAllComm.asp?bill=SB-00921&doc_year=2019

On March 7th, a very successful Pharmacy Day at the Capitol occurred as a result of a highly effective collaboration between CSHP, CPA, the CT Association of Community Pharmacies, the Connecticut Chapter of the American Society of Consultant Pharmacists (CT ASCP), and the schools of pharmacy at the University of Connecticut and the University of Saint Joseph. Pharmacy students managed blood pressure screening tables during the day, Governor Ned Lamont issued an official Proclamation declaring March 7 as Pharmacists Day in Connecticut, and the day concluded with one of the largest receptions ever organized in the LOB lobby, as pharmacists and students engaged legislators on the practice of pharmacy in Connecticut.

This is an exciting and very active period in the legislative world of pharmacy. Legislators need to hear from you if these initiatives will be successful in expanding pharmacy practice in our state. We have developed the tools for you to help communicate with your legislator. Please feel free to put your own “spin” on the conversation.

In addition to viewing the testimony submitted for these 2 bills, click for the “talking points document we used at Pharmacy Day to discuss these bills with legislators. SB 921 is the overall scope of practice bill for APRNs, adding APRNs to our current collaborative practice law is in Section 28. Click here to view this language. HB 6543 would permit credentialed pharmacists (those that have completed relevant training) to prescribe tobacco cessation therapy. Click here to view the proposed language for this bill which is modeled after the current naloxone prescribing law.

We have two major points in our favor in advocating for these bills: (1) tobacco cessation is a very “hot” topic in Connecticut and the Public Health Committee this year; and (2) pharmacists have the ability to bridge the vast health disparities gap in this state because we are the most accessible health care provider. Prescribing tobacco cessation therapy and collaborating with APRNs to provide protocol-driven therapy are two major examples of how pharmacists can reach underserved patients in our state. These two initiatives will demonstrate yet another way pharmacists can provide cost-effective services in our state. Receiving reimbursement for these (and other) services is the next major step in the evolution of our profession – stay tuned for breakthrough efforts on this front in the months to come.

January 2019 - CSHP Legislative Update

Submitted by Thomas Buckley, RPh, MPH, CSHP Legislative Chair

The Connecticut General Assembly has begun with a new Governor, many new Commissioners, and many new legislators and legislative committee chairs. This represents an opportunity for pharmacists to make their voices heard to improve their professional workplace and their ability to serve patients.

CSHP has been working with Fred Knous and Knous Associates as their legislative lobbyist for the past 18 years, assisting us in shepherding new laws, such as collaborative practice authority and immunization administration, and monitoring all proposed bills related to our profession that may affect us in a positive or negative way. Over 3,000 new bills will be proposed this session, with perhaps 300 leading to a new or revised law by the time the legislative session ends in early June. Each week the bill monitoring service Fred provides releases a brief review of current bills of interest in the legislative pipeline (Click to read the first “bill book” for this session).

CSHP, working in collaboration with other interested pharmacy entities in the state such as CPA, will be working on three significant new legislative initiatives this session, in addition to closely monitoring other health care and pharmacy-related bills.

  1. We will work toward expanding collaborative practice authority (CDTM) legislation to include APRNs, in addition to physicians, with whom pharmacists can collaborate on protocol-driven prescriptive authority.
  2. We have proposed HB 6543, a bill that focuses on a major issue of the public health committee this legislative session, tobacco and e-cigarettes, by advocating for pharmacist prescriptive authority for tobacco cessation treatment. There are currently 8-10 states that have some form of pharmacist prescriptive authority for tobacco cessation treatment, and Connecticut will likely pursue legislation similar to Indiana and Idaho that have created state-wide protocols for pharmacist treatment management. This could result in a practice similar to our current immunization administration law, in which pharmacists provide treatment management per protocol upon patient request of services. Click for a good graphic summary of the pharmacist's role in tobacco cessation.
  3. The third area of focus for this session and beyond is pharmacist provider status recognition by Medicaid and commercial payers, thereby opening the door for potential reimbursement of pharmacist services from all payers in Connecticut. This initiative will likely require a coalition of pharmacy entities, such as the professional organizations, pharmacy schools, health-system administrators, and other policymakers that understand the cost-effective impact of pharmacists on patient health care outcomes. A law similar to what was recently passed in Ohio provides a potential roadmap of how this initiative could proceed, enabling pharmacists to be on the same playing field as any other provider rendering a service, creating a direct contractual payer/provider relationship.


All of these issues will require a coordinated, active engagement of our members. Please be receptive to reach out to your legislator, particularly if they are a member of a specific committee that oversees our legislative initiatives. CSHP may contact you to advocate directly to your legislator, or through collective advocacy in events such as Pharmacy Day at the Capitol on March 7th at the Legislative Office Building in Hartford. More information will be forthcoming on this event, and talking point documents will be produced for each active legislative initiative of interest to us. This event will be in collaboration with CPA, so we anticipate a large turnout of pharmacists from throughout the state, both at the evening reception from 4:30 – 7:00 p.m., and for one-on-one meetings with legislators from 9 a.m. to 4 p.m.

Pharmacy Advocacy: The Role of CSHP and You

by Thomas Buckley, CSHP Legislative Chair


Advocacy isn’t just about what happens in Washington, D.C. It’s about what you can do close to home as you build relationships with elected officials, policymakers and colleagues. The CSHP Legislative Committee works with the CSHP Board, the CSHP lobbyist and other interested parties around Connecticut to advocate for issues specifically relevant to pharmacy practice. Our lobbyist is Fred Knous, a veteran healthcare lobbyist in Hartford and a former state Senator from Portland, CT. He has tremendous relationships with all legislators and other key policymakers, and is more than willing to help any CSHP member work legislative chair of CSHP, Tom Buckley, was a hospital pharmacist for 18 years, then worked as a medical outcomes researcher with Pfizer, and has been a full-time UConn Pharmacy faculty member for the past 9 years, coordinating their public health curriculum.

 

CSHP works closely with other pharmacy entities in Connecticut, including CPA, CT-ASCP and other health care entities with interest in legislative or policy initiatives affecting pharmacy practice. CSHP was a leader in developing and passing collaborative drug therapy management (CDTM) legislation, starting with the publication of a White Paper in 1994, through the initial passing of the CDTM bill in 2002, and ultimately the current version of the law in 2012, enabling pharmacists in any practice setting to develop and manage collaborative practice protocols with physicians for any medication or medical condition. CSHP also was very active in immunization administration legislation, allowing pharmacists to provide any immunization on the CDC adult immunization schedule.

CSHP has been continually involved in provider recognition and reimbursement policies for pharmacy practice. This includes working with CT Medicaid and all commercial payers in the state, and with Medicare on the federal level, particularly with the current bill in Congress. Becoming a “provider” in the Social Security Act means that pharmacists can participate in Part B of the Medicare program and bill Medicare for services that are allowed under their state scope of practice. The Pharmacy and Medically Underserved Areas Enhancement Act (H.R. 592/ S. 109) is bipartisan legislation that will amend section 1861 (s) (2) of the Social Security Act to include pharmacists on the list of recognized healthcare providers. CSHP asks all members to discuss this legislation with their members of Congress (both House and Senate), and ask them to become co-sponsors. Currently in Connecticut, H.R. 592 has 3 co-sponsors (DeLauro, Larson, Courtney), while S. 109 has only Senator Blumenthal as a co-sponsor.

 

CSHP works closely with our lobbyist especially when the General Assembly is in session. Connecticut has a part-time legislature, meeting during odd years from January to June, while in even years from February to May. However, if CSHP is strongly advocating for new or current legislation that may be seeking a change, the advocacy work required to push legislation to a successful conclusion typically can be a year-round endeavor. This is where the CSHP legislative committee and the CSHP Board cannot possibly accomplish advocacy gains without the grassroots efforts of practicing pharmacists and the CSHP membership. When the word goes out through email alerts or other communication vehicles that an important initiative is occurring that may affect pharmacy practice, your voice, your action in clinical practice, your email, your phone call, or just your interactions with your neighbors play a critical role in advancing pharmacy practice initiatives in our state. Connecticut is blessed to have a very tight pharmacy community, meaning it is a small state with active practitioners and pharmacy leaders. Therefore, very simple actions can create major change.

 

Lobbying comes in all shapes and sizes, dispositions and attitudes. We lobby because we are the best representative of pharmacy. Legislators cannot possibly be informed of every issue, therefore a responsibility of our job of being a “good steward” of our profession, is to inform legislators about pharmacy. When told the President is a lobbyist for the people, Harry Truman responded: “God knows they need it!” Making an impact in a small state like Connecticut can come from a simple phone call, email, letter, and most effectively through a one-on-one visit – whether it’s at a legislative office, or at your practice site. The CSHP legislative committee and Board will guide you through the process, provide you with all the background information you will need for a specific issue, and set up appointments for you with influential policymakers. There is an old adage on how a legislator interprets communication from a constituent that is particularly relevant in Connecticut: one letter received is “a kook”, 2 letters received is “a kook with a friend”, 3 letters received means “someone had a meeting”, while 4 letters received is considered “a movement.”

 

Pharmacy advocacy means creating that movement – for your practice, your profession, and most importantly for your patients. The CSHP legislative committee has a long history of understanding health care issues and their relevance to pharmacy practice, and stands poised to work with you to open new doors for pharmacists to use your extensive clinical knowledge to care for your patients.

Legislative Update: 2018 Session

Submitted by Thomas Buckley, RPh, MPH; CSHP Legislative Chair

The Connecticut General Assembly ended their 2018 session on May 8th with a number of bills that included pharmacists and/or pharmacy practice. While there were at least 50 bills that we were actively monitoring that did not pass, the following bills did pass which may affect pharmacy practice, although in some cases not affecting hospital inpatient practice.

AN ACT CONCERNING PRESCRIPTION DRUG COSTS: HB 5384

This bill will impose additional disclosure and reporting requirements on pharmacy benefits managers, health carriers, pharmaceutical manufacturers, the Office of Health Strategy and the Insurance Department concerning prescription drug rebates and the cost of prescription drugs.

PHARMACY AND DRUG CONTROL STATUTES: SB 195

This bill will require pharmacists to maintain perpetual inventories of Schedule II controlled substances.

AN ACT CONCERNING BIOLOGICAL PRODUCTS: SB 197

This bill will add biological products to existing law regarding substitution of generic drugs. The pharmacist may dispense an interchangeable biological product, which is therapeutically equivalent – must notify patient and prescriber within 48 hours of change (exempts hospital inpatients)

AN ACT CONCERNING PHARMACIST AND PRACTITIONER COMPLIANCE RATES AND THE ELECTRONIC PRESCRIPTION DRUG MONITORING PROGRAM: HB 5241

This bill requires the Commissioner of Consumer Protection to review pharmacists’ compliance with PMP requirements.

AN ACT LIMITING AUTO REFILLS OF PRESCRIPTION DRUGS COVERED UNDER THE MEDICAID PROGRAM: SB 246

This bill is intended to prevent unnecessary costs and clinical outcomes associated with prescriptions that are unnecessarily automatically refilled.

AN ACT CONCERNING TELEHEALTH SERVICES: SB 302

This bill adds pharmacists as providers who can administer telehealth services and modifies and clarifies patient consent procedures.

In addition to state legislative activity, ASHP has released their analysis of the Administration’s “Drug Pricing Blueprint” which was announced on May 11th. An ASHP issue brief describes the Administration’s drug pricing policy proposals, includes their stance on the proposals (including what is promising and what is concerning), and their next steps in working with the Administration in addressing drug costs. HHS has released a site soliciting ideas for reducing drug costs: (https://www.gpo.gov/fdsys/pkg/FR-2018-05-16/pdf/2018-10435.pdf) ASHP will be submitting comments reinforcing the necessity of engaging pharmacists in these efforts and offering suggestions on how best to accomplish that aim.

January 2018

submitted by Tom Buckley, RPh, MPH, CSHP Legislative Chairperson

The Connecticut General Assembly is entering their "short session" year, meaning the regular session will run from February 7 through May 9; however, a special session is being held in January to tackle restoring funding for the Medicare Savings Program. Given that this is a short session year and the state's current fiscal situation, there will not be many, if any, opportunities to offer new legislation affecting pharmacy practice, unless there was a fairy tale promise of saving the state millions of dollars.

CSHP will continue to be active, however, in monitoring any legislation that has an impact on pharmacy practice through our "bill book" reviews done by our lobbyist Fred Knous. If you would like to see the bill book as it's produced (initially every few weeks, then weekly as the session produces proposed legislation), please notify the CSHP office.

 

Note: Our legislative chair, Tom Buckley, is on sabbatical in Cambodia until June 2018, organizing a grant project for patients with diabetes and mental health conditions. In his absence, Eric Tichy has graciously offered to be the local liaison with our lobbyist, Fred Knous, to coordinate any local responses should the need arise. Please contact Eric Tichy anytime with questions on either state or federal legislative activities.


~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
CSHP Joins PAPCC

CSHP has become a member of Patient Access to Pharmacists’ Care Coalition (PAPCC), a coalition spearheaded by ASHP that is working to obtain nationwide provider status for pharmacists in the Medicare program. For information about PAPCC, go to http://pharmacistscare.org   To see who are current members of the coalition (more being added each day), go to http://pharmacistscare.org/about-papcc/

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Resolve to Build Support for Provider Status

The Pharmacy and Medically Underserved Areas Enhancement Act received strong support in 2015, but there's still much work to do before this provider status legislation can be enacted into law. As the second half of the 114th Congress begins, invite your representative and senators to visit your practice site for an up-close look at the ways you care for patients. Use ASHP's toolkit for tips on how to extend an invitation and plan for the site visit. (source: ASHP NewsLink 12.22.15)

You can make a difference. Please read the May 2015 update, review the attached documents and contact your legislator to share the details of how Medication Therapy Management (MTM) can save money for the CT budget. Our goal is to have this language inserted into the final appropriations bill.

See the link below for members of the Appropriations Committee.

Map, Districts, Representatives with contact information
http://connecticut.hometownlocator.com/maps/congressional-districts.cfm
 
State Representatives and Senators
A resource to locate and contact your local CT representatives, visit http://www.cga.ct.gov/maps/townlist.asp