Jody M. Curtis Event Program Coordinator Email: jody.curtis@austin.utexas.edu technicians working remotely must be supervised at all times by a pharmacist. These technicians must be taken into account when determining the technician-pharmacist ratio of the supplier pharmacy. This ratio cannot exceed 3 technicians per pharmacist.53 This training module discusses changes to the Texas State Board of Pharmacy (TSBP) rules that are part of the Texas Administrative Code (TAC) adopted from 2016 to 2019. Recent changes change pharmacy practice definitions, clarify pharmacy operating standards and update pharmacy registration requirements, and expand pharmacists` role in patient care and patient access to life-saving medications. Pharmacy rules and laws are found in the Texas Pharmacy Act, chapters 551 to 569 of the Texas Occupations Code, and in the Texas Pharmacy Rules, found in chapters 281 to 315 of the TAC.1 Telepharmacy is a major innovation in health care. About one-fifth of the U.S. population lives in rural areas, but independent rural pharmacies are closing and ceasing operations, limiting pharmacy services for these communities.54,55 Moreover, even rural hospitals have limited coverage from local pharmacists.56 Telecommunications platforms are used to provide pharmaceutical services such as drug screening and monitoring. medication dispensing, pharmacotherapy management and patient counselling can be used by patients in remote areas without physical access to a pharmacist.

Texas was one of the first states to pass laws and regulations specific to telepharmacy,54 and the continued safe expansion of telepharmacy services has the potential to improve quality of care and improve patient outcomes in rural communities. The University of Texas at Austin College of Pharmacy is a leading academic provider of pharmaceutical education. UT CIP works closely with presenters to ensure that all CE programs are of high quality, evidence-based and meet the needs of learners. The laws and regulations governing the practice of pharmacy in the State of Texas are continually reviewed by the TSBP and, as necessary or justified, are amended to reflect changes in training requirements, practice location conditions, or patient care needs. Some changes are significant and affect pharmacists` day-to-day activities in many situations, while others are little more than vocabulary clarifications or grammatical changes to existing laws and rules. However, the goal of the changes is to ensure the safest and best possible care for patients in Texas. Keeping abreast of changes, big and small, is a necessary part of pharmacy practice and ensures that pharmacists and pharmacy technicians work according to current standards of knowledge and practice. The current version of the Texas Pharmacy Act is available in www.pharmacy.texas.gov/Rules_Pharmacy_Act.asp and the Texas Pharmacy Rules in www.pharmacy.texas.gov/Rules_Pharmacy_Rules.asp. An amendment to Commission Rule 291.9 clarified the definitions of places where prescriptions are collected and delivered. A pharmacy may use an employee, courier, or U.S.

Postal Service (at the patient`s request) to pick up prescriptions at the office or home of a prescribing physician, at the home or workplace of the person for whom the prescription was issued, or at a hospital or medical care facility where the patient is being treated. A pharmacy may provide prescription drugs to the prescribing physician`s office if the prescription is for a dangerous drug or a single dose of a controlled substance to be administered to the patient in the prescribing physician`s office; the place of residence of the person for whom the order was issued; the place of work of the person to whom the order was issued, if that person is present to receive the delivery; or a hospital or medical facility where the patient is treated.49 These definitions are now consistent with the DEA`s requirements for prescription collection and issuance. Similarly, pharmacy technicians registered in the state of Texas must also meet continuing education requirements. Every 2 years, licensed technicians must receive 20 hours of training, and 1 of those hours must be related to the Texas Pharmacy Act.4 Every 2 years, licensed pharmacists in the State of Texas must complete at least 30 contact hours (3.0 continuing education units [CEU]) of continuing education to apply for license renewal. As of January 1, 2015, at least 1 of the hours (0.1 CEU) must be related to Texas pharmacy laws or rules. As of January 1, 2019, at least 1 of the hours (0.1 CFU) must be related to opioid abuse.1,3 The purpose of these requirements, according to Board Rule 295.8, is to enhance the professional competence of licensed pharmacists and protect the health and welfare of Texas citizens.1 In its current form, the PTSI Prescription Monitoring Program (PMP) collects information on all controlled substances listed in Schedules II to V. which are provided on an outpatient basis. Pharmacy in Texas or to a Texas resident through an out-of-state pharmacy. (Although many states allow some level of communication between PMP databases, not all PMPs are fully integrated yet. Therefore, prescriptions filled outside the state of Texas may not be eligible for the Texas PMP.) The objective of the PMP is to control the misuse of controlled substances by following them from the manufacturer to the end-user.

The PGP can be used by prescribing physicians and pharmacists to review records and assess patients` prescribing history. In addition, the PMP can generate data on trends in prescribing and dispensing of controlled substances that can inform prescribing practices.13 Registration requirements for pharmacy technicians were amended effective March 19, 2017. The amendments removed the requirement for a technician to pass a Pharmacy Technician Certification Board (PTCB) certification exam. Now, a technician can apply for registration after passing a TSBP-approved exam. Currently, the PTCB exam or the Pharmacy Technician Certification Examination (ExCPT) is approved and accepted by the TSBP.4,43 Texas pharmacists must understand the laws and regulations regarding the practice of pharmacy. This module examines recent updates to the Texas Pharmacy Act and Texas Board of Pharmacy rules impacting the pharmacy profession, interprofessional collaboration, and patient care. The Hospital Practice Seminar (HPS) provides a unique opportunity for pharmacists, pharmacy technicians and other hospital and health system practitioners to learn about treatment and practice updates that impact their particular patient population. Amendments have been made to Rule 291.121 to clarify the requirements for the remote supply of drugs using telepharmaceutical services.

Starting in 2018, a pharmacy will be authorized to offer telepharmacy services in up to 2 remote locations. A pharmacist must visit each dispensary at least once a month and the inventory of controlled substances must be checked monthly by a pharmacist at the supplying pharmacy. A pharmacist must be on site when services are provided that require the physical presence of a pharmacist, including vaccinations.53 Glen Baumgart, Ph.D. Director of Continuing Education in Pharmacy Email: gbaumgart@austin.utexas.edu In most states, an applicant for a pharmacist`s license must report prosecutions, convictions, illegal drug use, and sometimes arrests. State pharmacy boards evaluate applications and use these self-assessments to determine whether a pharmacist is of «good character.» A criminal record (or even an indictment and exoneration) does not automatically prevent an applicant from obtaining a license, but this information can be used by a pharmaceutical authority as evidence of indecency. Such record checks are in place to maintain the health, safety and welfare of the public.46 The language requiring «good character» remains in the laws of most other states governing the licensing of pharmacists, and it is unclear why this rule was changed in Texas. The patient or his representative must have the opportunity to use the system and must also have the opportunity to contact a pharmacist for any questions about the prescription, either in the pharmacy where the automatic storage and dispensing device is located or by telephone in the pharmacy directly connected to another pharmacy; 50 All pharmacists and pharmacy technicians, as well as other authorized health personnel involved in the use of automated delivery systems, must be well trained in the use of the system and demonstrate a thorough knowledge of the policies and procedures governing its use.33 PHARMACY Postgraduate Healthcare Education, LLC is accredited by the Accreditation Council for Pharmacy Education as a provider of pharmaceutical education.