The 2016-2017 academic year has ended at St. Louis College of Pharmacy. On May 12-13, we celebrated our students’ accomplishments at our 149th Commencement, and we welcomed the doctoral class of 2017 into the profession of pharmacy. We also celebrated a milestone with our undergraduate students. For the first time, we awarded Bachelors of Science to students completing their undergraduate studies in the College’s new curriculum implemented in fall 2014.

The end of the year also provides an opportunity to reflect on all we have accomplished as a community. Nearly three years ago, we began the largest expansion project in the College’s history by breaking ground on the Academic and Research Building (ARB). Today, after adding more than 400,000 square feet of space to campus, we are preparing to open the Recreation and Student Center (RAS).

The RAS will be a hub of student activity, and the building has been thoughtfully designed to support student life. Students will benefit from one-stop access to study space, academic and personal support resources, dining, and fitness and recreation. The building is the new home to the College’s intercollegiate athletic programs and offers student-athletes a competition gymnasium and training facilities. Faculty and staff are beginning to move into offices and students are beginning to explore the building.

As these physical changes to our campus unfold, our faculty are taking steps forward through collaborative research.

The recently established Center for Health Outcomes Research and Education, led by inaugural Director Scott Micek, Pharm.D., associate professor of pharmacy practice, will bring together faculty across campus to focus on six key areas for improvement – nonadherence, delayed evidence-based treatment practice, antibiotic misuse, medication errors, suboptimal generic use and mismanaged polypharmacy. The effort was made possible by a generous contribution from Express Scripts Foundation, which in part, provided funds for the establishment of the center.

The Center for Clinical Pharmacology, led by Director Evan D. Kharasch, M.D., Ph.D., and Co-Director Karen Seibert, Ph.D., is continuing to make progress toward fulfilling its vision. On May 1, the center welcomed its first two faculty researchers, Ream Al-Hasani, Ph.D., and Jordan G. McCall, Ph.D. Recruitment is underway for three more researchers, who will hold academic appointments at both the College and Washington University School of Medicine in St. Louis.

This is an exciting time at St. Louis College of Pharmacy! I hope you will visit campus often and see our progress.

Sincerely,

Bruce R. Canaday, Pharm.D., FASHP, FAPhA
Dean of Pharmacy and Professor

P.S. The College is hosting the 2017 Reunion Celebration on Saturday, Nov. 11. Join us on campus for a family-friendly reception, Gold Alumni luncheon and a tour of the new buildings. More information is available online at stlcop.edu/reunion.

SB 501 was signed by the Governor on July 14 and will become effective on August 28 or other specific dates. Provisions include a statewide protocol for distributing an opioid antagonist; a procedure for prescribing, distributing and administering epinephrine injectors outside of usual prescription requirements; compliance with Medicare Conditions of Participation as the qualifying basis for a hospital license; clarifying a protocol relationship for pharmacists administering vaccines; allowing BOP to expend funds for a drug take-back program for CII and CIII controlled substances; and changes to physician assistant language related to dispensing drugs.

Click here to read the Senate Bill 501.

The PP and PAI Committees have continued to discuss and lead the effort on a possible legislative proposal to modify the scope of practice authorized through medication therapy services protocols with physicians.  A multidisciplinary group was convened in January, has held telephone discussions and met again in July.  The original focus was to revise the language to provide clear prescribing authority and controlled substance authority under MTS protocols.  Additional recommendations included removal of the separate prescription order requirement to implement a protocol, removal of the redundant term medication therapeutic plan and possible inclusion of provider status language.  Considerable discussion has been held between meetings by individual MSHP members at the Spring Meeting and through email communication.  Current reimbursement and provider status laws have been evaluated for both Missouri and other states to determine the best approach to codify pharmacist eligibility.  Since other Missouri professional practice acts do not include a provider status component, and this may dilute the significance of the scope of practice effort, it might be preferable to include provider status in a separate bill under another statute section such as Insurance.  While it is apparent that essentially all current MTS activity is occurring in hospitals and health system clinics, it is also clear that any scope of practice proposal must have the united support of all pharmacy practice settings.  The legislative expertise of both MPA and the Missouri Hospital Association will be sought, as well as lobbying support from individual health systems.  Final bill language will be developed soon and promotional information will be provided for use by groups and individuals when the next session of the General Assembly meets in January.

The Strategic Planning Committee met on June 24 and included scope of practice legislation and technician legislation proposals as its regulatory priorities for the coming year.  A third priority will be enhancing relationships with the Missouri Hospital Association.

 The HAC has not met since the last  Newsletter was published. The next meeting  in August will include a review of  the  committee’s progress and structure and  discussion of future activities.

The Board of Pharmacy held an additional open session on June 23 due to the additional  burden of reviewing all current rules, and also met on the scheduled date of July 12.

• A Governor’s task force is evaluating all current health boards and agencies. Outcomes could include reducing agency oversight or consolidating agencies.
  
• Extended discussions were held at both meetings regarding possible legislation that will define 3 categories of support and technician personnel. The June discussion included opposition by community pharmacists based on unnecessary training requirements, cost of training, unproven patient care benefit and displacement of pharmacists. Several hospital pharmacists provided supporting comments based on current practices and known patient care benefit. The Missouri Hospital Association is supportive and has discussed with Board staff a hospital-only option. All agree that a united proposal by all pharmacy practice areas is necessary for legislative success. At the July meeting the Board agreed to propose legislation for the 2017-2018 legislative session. A revised draft will be prepared to address age requirements, nuclear training, advanced technician requirements and other issues. Legislative proposals must be submitted to the Governor’s office by August 1st.
  
• A specific time was made available for public comment on any of the Board’s current rules as required by the Governor’s office. The rule review process continues to focus on eliminating unnecessary rules and language, and reducing the usage of “must, shall or may” by 33%.
• The Nuclear Pharmacy rule is very outdated and recommended changes will be made, but will probably be held until after implementation of a proposed USP 825 chapter on nuclear pharmacy.
• A draft new rule on supervision of technicians includes language on activities that may be performed when the pharmacist is temporarily absent. There continues to be confusion regarding technician supervision in hospital inpatient and Class B hospital shared space. Language regarding remote supervision of technicians may also be added.
• An extended discussion of remote technician supervision focused primarily on hospital and health system needs, including onsite remote supervision of sterile compounding and offsite supervision of techs in small rural hospitals. Current terms such as telepharmacy and telehealth need to be defined. It was agreed to continue a discussion focused on all aspects of final verification of prescriptions/medication orders, including tech-check-tech and supervision of a remote retail pharmacy staffed by a technician, considering technology, credentials and qualifications of the technician.
• It was agreed to remove CE requirements from the Administration by Prescription Order rule due to lack of available CE for routes of administration other than immunizations.
• A planned Opioid Conference with the Board of Healing Arts has been postponed and a Patient Safety Conference may be held later in the fall.
• A revised Practice Guide will be available soon, but the Class B Hospital Pharmacy Practice Guide will be delayed due to expected legislation that may affect certain hospital licensing rules, including the meaning of licensed premises.
• The Sterile Compounding Working Group received extensive written comments and in person comments at the June meeting on proposed rule changes related to garbing, environmental monitoring and expiration dating. They will continue to review these.
• MSHP is regularly represented at BOP meetings by several members who provide public comment, and their interest and expertise is recognized by the Board. Additional members are encouraged to attend. The next regularly scheduled open session will be October 25.