89R27007 DNC-F     By: Harless, Howard, Darby H.B. No. 3540       A BILL TO BE ENTITLED   AN ACT   relating to the regulation of pharmacists and the practice of   pharmacy, including the administration of a medication and the   ordering and administration of an immunization or vaccination by a   pharmacist.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Section 551.003(33), Occupations Code, is   amended to read as follows:                (33)  "Practice of pharmacy" means:                      (A)  providing an act or service necessary to   provide pharmaceutical care;                      (B)  interpreting or evaluating a prescription   drug order or medication order;                      (C)  participating in drug or device selection as   authorized by law, and participating in drug administration, drug   regimen review, or drug or drug-related research;                      (D)  providing patient counseling;                      (E)  being responsible for:                            (i)  dispensing a prescription drug order or   distributing a medication order;                            (ii)  compounding or labeling a drug or   device, other than labeling by a manufacturer, repackager, or   distributor of a nonprescription drug or commercially packaged   prescription drug or device;                            (iii)  properly and safely storing a drug or   device; or                            (iv)  maintaining proper records for a drug   or device;                      (F)  performing for a patient a specific act of   drug therapy management delegated to a pharmacist by a written   protocol from a physician licensed in this state in compliance with   Subtitle B; [or]                      (G)  ordering or administering an immunization or   vaccination subject to Section 554.052(c-1); or                      (H)  administering an immunization or   vaccination, other than an immunization or vaccination as   authorized under Section 554.052(c-1), to a patient under a   protocol or prescription from a licensed health care provider   [under a physician's written protocol].          SECTION 2.  The heading to Section 554.004, Occupations   Code, is amended to read as follows:          Sec. 554.004.  ADMINISTRATION OF MEDICATION; ORDERING AND   ADMINISTRATION OF IMMUNIZATION OR VACCINATION.          SECTION 3.  Section 554.004, Occupations Code, is amended by   amending Subsection (a) and adding Subsections (a-1) and (a-2) to   read as follows:          (a)  The board shall specify conditions under which a   pharmacist may administer medication and order or administer [,   including] an immunization or [and] vaccination. The conditions   for ordering or administering an immunization or vaccination must   ensure that:                (1)  [a licensed health care provider authorized to   administer the medication is not reasonably available to administer   the medication;                [(2)  failure to administer the medication, other than   an immunization or vaccination, might result in a significant delay   or interruption of a critical phase of drug therapy;                [(3)]  the pharmacist possesses the necessary skill,   education, and certification as specified by the board to order or   administer the immunization or vaccination [medication];                (2)  not later than the third business day [(4)  within   a reasonable time] after administering an immunization or   vaccination [medication], the pharmacist notifies the licensed   health care provider responsible for the patient's care that the   immunization or vaccination [medication] was administered;                [(5)  the pharmacist may not administer medication to a   patient at the patient's residence, except at a licensed nursing   home or hospital;                [(6)  the pharmacist administers an immunization or   vaccination under a physician's written protocol and meets the   standards established by the board;] and                (3) [(7)]  the authority of a pharmacist to administer   an immunization or vaccination [medication] may [not] be delegated   to a certified pharmacy technician who possesses the necessary   skill, education, and certification as specified by the board to   administer the immunization or vaccination.          (a-1)  A pharmacist satisfies the notice requirement of   Subsection (a)(2) if the immunization or vaccination administered   by the pharmacist is recorded in the immunization registry   maintained by the state.          (a-2)  A pharmacist shall inform the child receiving an   immunization or vaccination and the adult caregiver accompanying   the child of the importance of an annual well-child visit with a   pediatrician or other licensed primary health care provider.          SECTION 4.  Sections 554.052(a), (b), (c), and (c-1),   Occupations Code, are amended to read as follows:          (a)  The board by rule shall require a pharmacist to notify a   physician who prescribes an immunization or vaccination not later   than the third business day [within 24 hours] after the date the   pharmacist administers the immunization or vaccination.  A rule   adopted under this subsection must provide that a pharmacist   satisfies the notice requirement if the immunization or vaccination   is recorded in the immunization registry maintained by the state.          (b)  The board shall establish minimum education and   continuing education standards for a pharmacist who orders or   administers an immunization or vaccination. The standards must   include federal Centers for Disease Control and Prevention   training, basic life support training, and hands-on training in   techniques for administering immunizations and vaccinations.          (c)  Supervision by a physician is adequate if the delegating   physician:                (1)  is responsible for formulating or approving an   order or protocol, including the physician's order, standing   medical order, or standing delegation order, and periodically   reviews the order or protocol and the services provided to a patient   under the order or protocol;                (2)  [except as provided by Subsection (c-1), has   established a physician-patient relationship with each patient   under 14 years of age and referred the patient to the pharmacist;                [(3)]  is geographically located to be easily   accessible to the pharmacy where an immunization or vaccination is   administered;                (3) [(4)]  receives, as appropriate, a periodic status   report on the patient, including any problem or complication   encountered; and                (4) [(5)]  is available through direct   telecommunication for consultation, assistance, and direction.          (c-1)  A pharmacist may order or administer [an influenza   vaccination] to a patient who is at least:                (1)  three years of age an influenza immunization or   vaccination and SARS-CoV-2 immunization or vaccination; and                (2)  five years of age an immunization or vaccination   if the immunization or vaccination is:                      (A)  authorized or approved by the United States   Food and Drug Administration or listed in the routine immunization   schedule recommended by the federal Advisory Committee on   Immunization Practices published by the federal Centers for Disease   Control and Prevention; and                      (B)  ordered or administered in accordance with   the federal Advisory Committee on Immunization Practices   vaccine-specific recommendations [over seven years of age without   an established physician-patient relationship].          SECTION 5.  This Act takes effect immediately if it receives   a vote of two-thirds of all the members elected to each house, as   provided by Section 39, Article III, Texas Constitution. If this   Act does not receive the vote necessary for immediate effect, this   Act takes effect September 1, 2025.