New Regulations on Pharmacy Staffing Leaves for Some Debate
The Florida Legislature is entertaining bills related to the number of registered pharmacy technicians that may be supervised by a licensed pharmacist. The House bill (HB671) passed the Florida House vote on Wednesday, April 17. The Senate version of HB671 (SB818) is currently in the Senate Regulated Industries Committee. With mere days remaining in the 2013 Session at the time this article is written that Senate committee does not appear to have any meetings scheduled where it could take action on SB818. The debate over the proposed legislation will likely be carried over into the next scheduled Session.
The two primary impacts of the bill have many in pharmacy circles talking about the balance between safety, money, and accountability.
Both versions of the bill raise the permissible ratio of registered pharmacy technicians to licensed pharmacists from the current 1:1 to a maximum of 6:1. Additionally, the bills remove the authority to set ratios, and also to grant exceptions, from the Florida Board of Pharmacy, a division of Medical Quality Assurance for the Florida Department of Health.
According to the House of Representatives Staff Analysis completed earlier in the Session, the majority of states either place no regulatory limit on the number of techs that can be supervised by a pharmacist, or require a limit of techs per pharmacist that is already higher than the 1:1 ratio set by the Board of Pharmacy. The Board does allow up to a 3:1 ratio via a written exception provision. Currently, about 15 percent of Florida pharmacists supervise the maximum of three techs. The majority— 83 percent— supervises only one tech.
Supporters of the bill claim that workflow routines allow for techs to competently handle duties, tasks, and functions that neither require a licensed pharmacist’s direct involvement, nor allow for the highest and best use of a pharmacist’s time. They also point to the apparent trend nationally for higher tech ratios, and the absence of health or safety issues in states that already allow higher ratios.
Opponents argue that many of those states that do permit higher ratios also require more training for techs to maintain high quality standards and accountability.
The Florida Pharmacy Association, who represents the interests of the pharmacy community and Florida’s 29,000 licensed pharmacists, is an opponent of the proposed legislation. Reports indicate that their position is closely split, originally coming out in support of the measure but reversing position in a later meeting.
Similarly, the Florida Society of Health Systems Pharmacists, who represents pharmacists and related professionals practicing in hospitals, health-systems and other organized healthcare settings, is also opposed to the bill. The two organizations released a joint letter citing mainly safety and accountability concerns with the advent of an increased ratio.
Pharmacists have doctoral degrees (Pharm.D.), while technicians are not required to complete college courses but are required to complete a training program and register with the Florida Department of Health.
Dr. Chris Tibbetts, a licensed pharmacist from Bartow, recognizes the debate within the medical community. “It’s definitely a major issue, and one that I’m not sure has a clear cut solution. Possible revenue increases, patient safety, and the very real need to responsibly meet the growing demand for prescription drugs … are all relevant considerations,” says Tibbetts. It’s a debate that will likely continue into the next Florida Legislative Session without an unexpected hearing in front of the Senate Committee before May 3.
story by MICHAEL JAMIE SELF, Ed.D.