On March 23, 2016, new laws went into effect that will revolutionize pharmacist-provided care for patients in the state of Ohio!
Also, in August 2016, the Board of Pharmacy finalized rules on the law that can be accessed here.
In December, Governor John Kasich signed HB 188, dynamic legislation that greatly expanded pharmacist services within physician consult agreements and also expanded pharmacists' ability to dispense emergency supplies of medications when a patient has run out of refills.
Prior to Governor Kasich's signature, both the Ohio House of Representatives and Ohio Senate voted UNANIMOUSLY in favor of HB 188, and the governor quickly acted on the bill by signing it into law! OPA thanks Governor Kasich for his quick action on this important legislation, and for his support for enhanced pharmacist services in Ohio.
"This law is a game-changer for all Ohioans who suffer from chronic diseases. The Ohio Pharmacists Association applauds Governor Kasich for his leadership and forward-thinking approach to improving patient lives and outcomes through enhanced, expanded pharmacist services," said OPA Executive Director Ernest Boyd, "Furthermore, if it wasn't for the hard work of our members and some outstanding legislator advocates in Representative Stephen Huffman, Representative Nathan Manning, Senator Gayle Manning, and Senator Dave Burke, this legislation doesn't happen. It has been a long journey through the legislature to get this done, but now that it's in effect, Ohioans will see significant benefit."
HB 188 streamlines consult agreement paperwork so that multiple pharmacists can have an agreement with multiple physicians to manage drug therapy for multiple patients. Additionally, the law allows pharmacists acting under a physician consult agreement to order blood & urine tests, analyze the results of those tests, and then to remove, change, or add new medications to the patient's drug therapy regimen. The law also allows pharmacists to administer drugs when acting within a consult agreement. This is a huge milestone in OPA's efforts to better utilize pharmacist services to improve patient outcomes for Ohioans.
Aside from the consult agreement provisions of the law, HB 188 also allows pharmacists to give patients who are out of refills (and if the doctor can't be reached) up to an extra 30-day supply of medications (or the smallest unit of measurement possible), if the patient's life could be adversely affected by not having the prescription. This language is the result of the tragic loss of a diabetic patient in Northeast Ohio named Kevin Houdeshell. For more on Kevin's story, and the tireless efforts of his incredible family - who we have been fortunate to get to know over the last year - please click here.
This bill has been years in the making, and we thank all of the pharmacists, student pharmacists, the Ohio Society of Health System Pharmacists, the Ohio State Medical Association, the Ohio Osteopathic Association, the Houdeshell family of Northeast Ohio, and other industry supporters for assisting in its passage. We are thankful for the many OPA members who helped lead the charge to get this bill through the legislature despite the big odds against us. To say that we've come a long way would be an understatement.
Specifically, we'd like to thank OPA members Senator Dave Burke, Scott Knoer (Cleveland Clinic), Stu Beatty (Ohio State University College of Pharmacy), Cathy Kuhn (Kroger Pharmacy), and Giavanna Russo-Alvarez (Cleveland Clinic) for providing testimony in support of the bill in the House and Senate. Additionally, we would like to thank pharmacists Marla Samide, Craig Baker, Kevin Duvall, Melody Hartzler, Sue Fosnight, Ken Komorny, and Allen Nichol. We also would like to thank the OPA Medication Therapy Management Committee and the many other pharmacists and student pharmacists who helped secure letters of support, invited legislators to the pharmacy, wrote letters to legislators, and participated in the OPA Legislative Day & Student Legislative Day.
"Pharmacists are incredibly under-utilized in the health care system, and HB 188 takes a major philosophical step forward that emphasizes the services pharmacists can offer as key health care providers," said OPA President Jeff Bartone. "I am excited to see OPA successful in advancing this legislation past the finish line and now into law, and I am grateful to the legislature and to Governor Kasich for these important health care reforms."
Lastly, thanks to Representative Nathan Manning, Representative Stephen Huffman, Senator Gayle Manning, and Senator Dave Burke for leading the charge as the sponsors of the legislation. Further, thanks to Chairwoman Anne Gonzales, Chairwoman Shannon Jones, Senate President Keith Faber, Speaker of the House Cliff Rosenberger, and the rest of the members of the legislature for seeing the bill through and ultimately supporting its passage. And as stated above, thanks to Governor Kasich for signing the bill into law.
Now that HB 188 is in effect, it is also subject to rules from the Ohio State Board of Pharmacy, which were finalized in August 2016. Those rules can be accessed here.
In summer 2016, OPA ran special features in the Ohio Pharmacist journal that highlighted how several members from different practice settings plan to utilize the new law, and we continue to offer programming that will do a deeper dive into how pharmacies can integrate these new capabilities into their practices.
To view the testimonies and letters of support for HB 188, as well as its companion legislation SB 141, please click the links below:
Rep. Nathan Manning (R-North Ridgeville)
Rep. Stephen Huffman (R-Tipp City)
Sen. Dave Burke (R-Marysville)
Sen. Gayle Manning (R-North Ridgeville)
Dr. Anup Patel, Nationwide Children's Hospital
Dr. Dan Sullivan, Cleveland Clinic / Ohio American College of Physicians Health and Public Policy Committee
Scott Knoer, Cleveland Clinic
Lori Weinstein, Diabetes Partnership of Cleveland
Dr. Ron Jones, Summa Health Systems
Stu Beatty, Ohio State University College of Pharmacy
Dr. Michael Langan, Ohio State University Wexner Medical Center
Dr. Michael Rich, Summa Health System
Dr. Rex Wilford, Summa Health System
Dr. David Applegate, OhioHealth Physician Group
Dr. Rebecca deVillers, OhioHealth Physician Group
Dr. Robert Lorenz, Cleveland Clinic
Dr. Randy Jernejcic, OhioHealth Physician Group
Cathy Kuhn, Kroger Pharmacy / Ohio Pharmacists Association
Giavanna Russo-Alvarez, Cleveland Clinic
Dan, Judy, & Amy Houdeshell
Tim Maglione, Ohio State Medical Association
Dr. Ken Bertka, Mercy Health
Dr. Eugene Pfister, Akron General
Dr. John Petrus, Akron General
Dr. Gillian Myers, Akron General
Jon Wills, Ohio Osteopathic Association
For more information on the bill, please check out these news clips on the legislation:
Lessons learned in updating and improving a state collaborative practice act - American Journal of Health-System Pharmacy, 9/15/16
Polypharmacy and the Elderly Patient - Cleveland Clinic Consult QD, 6/29/16
Local story inspires change in Ohio and beyond - WKYC 3, 4/16/16
Ohio's HB 188 permits pharmacists broader authority in patient care - CoverMyMeds, 3/31/16
Restricting emergency refills of expired prescriptions can cost lives - Council of State Governments, 3/16
Ohio’s HB 188: Larger role for pharmacists in patients’ drug therapy management - Pharmacy Today, 3/16
Collaborative practice agreements open opportunities, liabilities for pharmacists - Pharmacy Times, 2/17/16
New Ohio law expands pharmacists’ care - APhA CEO Blog, 2/2/16
Ohio pharmacists gain ground with expanded CPAs - Drug Topics, 1/10/16
Death from diabetes sparks change, a new law - WKYC 3, 12/24/15
Ohio bill would expand pharmacists’ patient care services - APhA Pharmacy Today, 12/17/15
Ohio Senate weekly report - Ohio Senate Majority Caucus Blog, 12/13/15
Ohio bill to safeguard insulin access passes - Insulin Nation, 12/11/15
Bill to expand emergency medication passes - The Chronicle-Telegram, 12/10/15
Ohio House passes updated consult agreement legislation - Rep. Stephen Huffman, 6/30/15
Burke announces Senate passage of legislation to improve emergency access to life-saving medicine - Sen. Dave Burke, 6/25/15
Ohio State professor lends testimony to HB 188 - OSU College of Pharmacy, 6/22/15
Saving lives and improving the health care system with House Bill 188 - Rep. Nathan Manning, 6/19/15
OSMA testifies in support of pharmacist consult bill - Ohio State Medical Association, 6/10/15
Death by expired prescription - Insulin Nation, 4/30/15
Death of Avon Lake man inspires legislative action quickening prescription access - The Chronicle-Telegram, 4/16/15
Avon Lake family seeks small-dose insulin availability - The Chronicle-Telegram, 2/18/15
Emergency insulin could have saved man's life - WKYC-3, 2/12/15
Outside of the support of volunteers and members, and the work of OPA's legislative staff in building coalitions and meeting with legislators, supporting political campaigns is a huge part of the advocacy process. We need to support good legislators who support pharmacy and the patients we serve, and we need to build on these recent success by working towards even bigger goals. Please consider financial support of our legislative efforts by contributing to the OPA Pharmacy PAC. 100% of Pharmacy PAC money contributed by pharmacists goes to help candidates who support pharmacy in Ohio. Or if you'd like to make a corporate contribution to support OPA's investment in our advocacy program, please consider being a part of the OPA Legislative Defense Fund (LDF).