ASHP InterSections ASHP InterSections

June 28, 2019

Advocacy in Action: Utah Pharmacists Make Contraceptive Provision a Reality

David C. Young, Pharm.D.

A NEW LAW THAT WILL CHANGE the way Utah pharmacists work began with a question that was part of a classroom assignment: “If you had one wish for a pharmacy dream bill, what would it be?” At the time, Wilson D. Pace, Pharm.D., was a University of Utah College of Pharmacy graduate student in the school’s leadership and advocacy class taught by David C. Young, Pharm.D. He immediately thought of the need for broader access to contraception and how pharmacists can fill that gap.

This issue hit home for Dr. Pace because his wife had experienced problems obtaining a prescription for a contraceptive from an obstetrician since a shortage of providers made her wait several months to get an appointment. As he further looked into the challenges women face getting contraception in a timely manner, he found that his wife’s experience was far from unique. As a result, Dr. Pace came to the conclusion that if there were a law that gave pharmacists the power to provide contraception without a new prescription, it would go a long way toward advancing women’s health in the state. This idea moved Dr. Pace to seek out other student pharmacists to form a working group. Together they started an advocacy campaign that would make this dream bill a reality.

Garnering Support from Medical Stakeholders

Wilson D. Pace, Pharm.D.

Dr. Pace and his working group began by reaching out to pharmacist mentors about their desire to take action on this idea in the hopes that the legislature would act on it. The pharmacists discussed how the advocacy process would work, and based on his prior experience, Dr. Young knew they first had to gain the support of various stakeholders in the state. Although groups such as Utah Board of Pharmacy, professional pharmacy organizations, the Utah Medical Association, and nursing organizations agreed that it was essential to address the issues women face while trying to obtain contraceptives, they had yet to agree on the exact role pharmacists should play in solving them. Specifically, whether or not pharmacists should be able to provide contraceptives without a prescription from a doctor.

As a result, Dr. Pace’s original vision of pharmacists having prescribing power was a point of contention during the discussions and ultimately something on which Drs. Pace and Young needed to compromise to get the groups’ support and move forward. In the end, the stakeholders all decided it was best for pharmacists not to have full prescribing power, but to be able to provide contraception without a prescription on a limited basis.

“We didn’t sit around the fire singing ‘Kumbaya,’” said Dr. Young. “We had very healthy, open, and honest discussions about what the idea for a new law meant, how we were going to accomplish it, and how we were going to work together.”

Hammering Out the Details

After completing discussions with all of the healthcare stakeholders and getting their support, it was time to work with the legislative research office to refine the language of the bill. This was a complicated and lengthy process because it required that every interested group sign off on each revision that was made to the draft.

“Any tiny change had to have buy-in from all of the different groups,” Dr. Pace said. “So the next big step was working out all the nuts and bolts and then coordinating to make sure everybody was on the same page.”

Legislative Support

Karen M. Gunning, Pharm.D., BCPS

Once the language of the bill was finalized, it was time to get legislative support. Finding the right sponsor was vital. Sen. Todd Weiler agreed to sponsor the bill, and Rep. Ray Ward, M.D., a family physician with a history of working on legislation related to improving public health, co-sponsored the bill. “We actually had no opposition. We were concerned that there might be different groups testifying against us or they would push back, but there was none of that,” said Dr. Pace.

The process went so smoothly that there were no opposing testimony delivered when the bill was in committee and no opposing votes in the Utah Legislature. In March, Gov. Gary Herbert signed S.B. 184.

Thanks to the efforts of Dr. Pace, the other student pharmacists involved, and guidance from their mentors, women in Utah can now get contraception from pharmacists for two years before being required to check in with a doctor for a new prescription.

“I believe this law will allow pharmacists in the state of Utah to demonstrate the value they bring to patient care, and also the team-based approach to care that pharmacists have,” said Karen M. Gunning, Pharm.D., BCPS, a Professor (Clinical) at the University of Utah College of Pharmacy, who provided expert knowledge and support to Drs. Pace and Young as they navigated the legislative process. “There is great potential for pharmacists to work with medical providers in their communities to improve access, and to ensure that patients who need contraceptive care from a non-pharmacist medical provider are referred promptly to one.”

A Future of Advocacy

With this significant advocacy win under his belt, Dr. Pace admits that he’s been bitten by the political bug and will continue working toward furthering the interests of the pharmacy profession. Drs. Pace and Young, now co-chairs in the legislative committee of the Utah ASHP state affiliate, have already begun exploring new issues to tackle in the current legislative session.

“Whatever job I end up being in, I can’t imagine not being involved in some way in the advocacy process,” Dr. Pace said.

Although at first blush many pharmacists may shy away from doing advocacy work, Dr. Young urges all pharmacy professionals to consider getting involved because of the tremendous impact it can have on the way they work in their state.

“If you’re not interested in advocating for your profession, other people may change the laws and rules on you, and you may not like it,” he said. “If you want to control your outcomes, you’ve got to get involved. The best way to control your destiny is to create it — and that’s what happened with this bill.”

 

By Kenya McCullum

 

March 1, 2017

Advocating for Pharmacists

Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP

KASEY THOMPSON, ASHP’s Chief Operating Officer and Senior Vice President for Policy, Planning and Communications, represented ASHP among leaders of the Patient Access to Pharmacists’ Care Coalition (PAPCC) this morning in a highly impactful fundraising breakfast for Congressman Michael C. Burgess, M.D. (R-TX). Dr. Burgess serves as the Chairman of the Subcommittee on Health of the highly influential House Energy and Commerce Committee, which is one of the House committees considering H.R. 592, the Pharmacists in Medically Underserved Areas Enhancement Act. As Chairman, Dr. Burgess plays a key role in setting the subcommittee’s agenda and ultimately determining whether legislation moves out to the full committee.

Dr. Thompson shared with Congressmen Burgess the many important clinical pharmacy services that pharmacists provide in various settings, including ambulatory clinics and throughout all care transitions. He emphasized the role that ASHP members play as direct patient care providers who optimize therapy as key members of interprofessional teams. Further, he stressed to Dr. Burgess how those vital pharmacist patient care services improve therapeutic outcomes and decrease healthcare costs.

The goal for this event was to advance efforts to pass provider status legislation in 2017. Although this is but one of many things ASHP and the PAPCC are doing to move this important legislation, we believe it was a great step in the right direction. Further, we are pleased to have had a productive discussion with such an influential member of Congress, and one who is a physician by training. Dr. Burgess did not express any opposition to our legislation and is eager to continue the discussion with members of the PAPCC about the benefits of H.R. 592. Rest assured that ASHP and the PAPCC will continue speaking with Dr. Burgess, other members of the Energy and Commerce Committee, and their colleagues in the Senate as we look to move H.R. 592 and S. 109 in 2017.

Thanks so much for everything you do for your patients and for being a member of ASHP.

Sincerely,

Paul

January 13, 2017

Provider Status Bill Reintroduced in Senate with Strong Bipartisan Support

Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP

IT IS WITH GREAT PLEASURE that I can announce that on Thursday evening, Senators Charles Grassley (R-Iowa), Robert Casey (D-Pa.), and Sherrod Brown (D-Ohio), along with 24 other original co-sponsors, reintroduced the Pharmacy and Medically Underserved Areas Enhancement Act (S. 109). This legislation is the same as last year’s provider status bill, with the exception of the new bill number, S. 109. This is significant not only because of the quick timing of the reintroduction, but also because of the high number of Senators who have signed on as original co-sponsors. The Patient Access to Pharmacists’ Care Coalition (PAPCC), in which ASHP serves on the steering committee, set a goal late last year of introducing the new bill in 2017 with 20 co-sponsors. We are pleased to see that this goal was not only met but exceeded.

On the House side we expect reintroduction soon. Our lead sponsor to the House bill, Rep. Brett Guthrie (R-Ky.), has been leading the charge and will reintroduce the bill with the same bill number as last Congress, H.R. 592. Again, the language will be same as last year. We expect the House bill to be reintroduced with approximately 90 co-sponsors.

We are greatly encouraged to see the momentum from last session carry over to the new 115th Congress, and we remain steadfast in our commitment to passing this important legislation. As a lead member of the PAPCC, ASHP will be working diligently to help facilitate passage of the legislation, most likely as part of a larger Medicare package later this year. In fact, early discussions between the PAPCC and key congressional staff are already occurring, as we seek to position the legislation to be a part of a larger Medicare bill.

I will continue to update you on the progress on provider status as new developments arise. Thank you so much for being a member of ASHP. It’s because of you that we are the premier organization in pharmacy.

Sincerely,

Paul

November 16, 2016

ASHP’s Role with the New Congress and Administration

Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP

Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP

AS ANOTHER ELECTION SEASON comes to a close and we look ahead to the new administration and the 115th Congress in 2017, ASHP is again positioning itself as a credible resource to policymakers on issues impacting the profession of pharmacy and public health. While elections create change among those in government, ASHP’s public policy priorities remain the same: advancing provider status legislation, protecting the 340B program, and working with both sides of the aisle and with the administration to address the growing problem of skyrocketing drug prices and their impact on our patients and the healthcare system.

Over the last few years ASHP has increased its presence in Washington by spearheading legislative efforts aimed at curbing drug shortages and ensuring safer compounding practices. These are issues that impact all Americans regardless of political affiliation, and ASHP input was instrumental in developing policy solutions.

The new landscape on Capitol Hill and at the White House is an opportunity for ASHP to forge new partnerships, educate new stakeholders, and highlight ASHP’s expertise in public health issues. Healthcare legislation will once again be back on the agenda, and issues related to Medicare and Medicaid are likely to be in play. As we look ahead to advancing provider status, 2017 may provide legislative vehicles that could include pharmacists as providers in the Medicare program.

ASHP remains committed to working with the new administration and the new Congress to address our public policy goals. Currently we are planning outreach efforts to the Trump transition team and will begin educating the freshman congressional class on how ASHP members improve the health and wellness of their patients by ensuring safe and effective medication use and advancing healthcare. Although change in Washington is inevitable, ASHP stands firm on its commitment to its members and the public at large.

We look forward to continuing to engage you and represent your professional interests in 2017 and beyond. Thanks so much for being a member of ASHP, and for everything you do for your patients.

Sincerely,
Paul

September 28, 2010

Health Care Reform: What’s Next For Pharmacists?

Henri R. Manasse, Jr., Ph.D., Sc.D.

Henri R. Manasse, Jr., Ph.D., Sc.D.

AS WE GO TO PRESS with the fall 2010 edition of InterSections, nearly 100 ASHP members have just finished an intensive day lobbying congressional representatives and their staff members on issues critical to our profession.

It has been a busy, but important, time for ASHP members and the patients they serve. With the passage of the Patient Protection and Affordable Care Act, as modified by the Health Care and Education Reconciliation Act, Congress showed its support for expanding access to affordable health care, improving quality, and reducing health care costs.

Health care reform offers pharmacists a number of great opportunities to expand patient-care services. It specifically addresses delivery systems reform, payment reform, and quality, comparative effective- ness research, work-force issues, and the 340B Drug Pricing Program.

When you look through the proposed delivery models, almost all of them mention the need to involve pharmacists in solving medication-related issues. That is an exciting change in perception on the national level and one that will help ensure that patients receive better, safer care. ASHP played a vital role for inclusion of pharmacists throughout the legislation.

At ASHP, our efforts to get the legislation passed have now evolved into a focus on working with the federal agencies responsible for developing the regulations to implement the law. We are keeping in close contact with members of Congress to encourage them to sufficiently fund the programs included in the law. We have nominated pharmacists to serve on the newly created Health Care Workforce Commission and other committees. And we are continuing our efforts to expand funding for postgraduate pharmacy residency training.

Although we don’t yet have a clear sense of how the entire process will play out, health-system pharmacists will have many opportunities over the next several years to influence how reform is implemented within their own institutions.

For example, begin a conversation with your institutional leaders and administrators about the importance of improved quality and reduced costs. What is your hospital doing or planning to do to implement reform-related changes, and what can you do to make those changes come to life?

Seek opportunities to include pharmacists in efforts by your organization to create accountable care organizations and “medical homes,” and to meet quality improvement requirements that align payment with quality.

Just as important is staying engaged in the public discourse surrounding health care reform. We all need to be more aware of and get more involved in the regulatory process. Although the new law is a complex document (nearly 2,000 pages with about 400,000 words), it is actually only a skeleton of what is to come. Regulators will flesh out the law, and we need to have a voice in that process to ensure that there are no negative consequences for patient care or for our profession.

Every ASHP member can be a player in this next phase of health care reform by participating in a number of ways:

  • Stay informed about the law’s progress both by connecting to your state affiliate and signing up for ASHP’s Grassroots Network,
  • Join ASHP’s Political Action Committee and help support members of Congress who understand pharmacists’ critical patient-care role,
  • Get to know your federal and state representatives, and invite them to your institution to demonstrate what you do each day to care for patients, and
  • Work within your own spheres of influence to ensure that your hospital or health system involves pharmacists in efforts to improve quality and reduce costs.

Please know that ASHP is behind you every step of the way, as a national advocate for the profession and as a resource for you to advocate for pharmacy within your own hospital or health system. Together, we really do make a great team!

April 9, 2010

How to Arrange a Congressional Site Visit

I DECIDED TO SCHEDULE A SITE VISIT after participating in ASHP’s Legislative Day in September. There I met with Representative Jerry Moran and his legislative aide for health care, and we discussed ASHP’s key advocacy issues, including health care reform, provider status, medication therapy management, loan forgiveness, and residency funding. I told the congressman that I’d like to show him how health-system pharmacists in his district are a critical element in health care.

Linda Radke, Pharm.D. (left) and Representative Jerry Moran (R-Kansas) (right)

I followed up with the health care aide, who gave me the contact information for Representative Moran’s scheduler in our home district. I spoke with her in September, at which point she warned me that his schedule can get tight. Then, in December, she called with three days notice for the visit! The congressman could only stay for 30 minutes, so it was important to keep the visit concise but meaningful.

Being well prepared helped. I had already met with my hospital’s administration about how to plan the visit and the marketing department regarding logistics and publicity. ASHP really helped me prepare, too. I received great information about key legislative issues that I could share, and I sent Representative Moran an e-mail highlighting those. He actually read it in advance, which helped us make the most of his visit.

Building a Lasting Relationship

My ultimate goal is to build an ongoing relationship with the congressman, so I looked for other ways to keep in touch. First, I signed up for his This Week in Congress electronic newsletter. When one of the newsletters included his reasons for voting against the health care bill, I e-mailed him and reminded him about the issues we had discussed during our Legislative Day visit.

%%SIDEBAR%%Because he had only 30 minutes, we had to make Representative Moran’s site visit as high impact as possible. As part of the pharmacy tour, we watched one of our technicians prepare her IV run, which allowed us to talk about technician training programs being developed in Kansas. A student from the University of Kansas was on rotation and talked about her plans to pursue a PGY1 and PGY2 administrative residency and master’s program. This presented a great opportunity to talk about my hospital’s plans to develop a residency program, as well as residency funding issues. We also went to a patient floor and met with a clinical pharmacist who described a typical day and his unique role in patient care.

Reaching Out to Media

My marketing department had helped reach out to the local media, but the congressman’s office had done so, as well. I was thrilled to see a notice in my local paper the day before the congressman visited us. The newspaper sent a reporter who met with the congressman at the end of the visit, which resulted in a short article with a picture. Our state affiliate featured an article in its newsletter, and my hospital is planning to include an article in our quarterly newsletter. I couldn’t resist putting pictures from the visit on my Facebook page!

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