Missouri Regulations
Department of Commerce and Insurance/Board of Pharmacy
Code of State Regulations 2021-04-30
PUBLICATION DATE: 04/30/2021
ACTION DATE: 04/15/2021
EFFECTIVE DATE: 05/30/2021
PUBLICATION TYPE: Centralized Repository
REGISTER SOURCE: Vol. 46, No. 8, Missouri Register 2021-04-15 p.720
PUBLICATION DATE: 04/15/2021
ACTION DATE: 04/15/2021
EFFECTIVE DATE: 05/30/2021
PUBLICATION TYPE: Register
REGISTER SOURCE: Vol. 46, No. 1, Missouri Register 2021-01-04 pp.5-6
PUBLICATION DATE: 01/04/2021
ACTION DATE: 11/25/2020
EFFECTIVE DATE: 12/11/2020
EXPIRATION DATE: 06/08/2021
PUBLICATION TYPE: Register
REGISTER SOURCE: Vol. 46, No. 1, Missouri Register 2021-01-04 pp.12-13
PUBLICATION DATE: 01/04/2021
ACTION DATE: 11/25/2020
COMMENT DEADLINE: 02/03/2021
PUBLICATION TYPE: Register
REGISTER SOURCE: Office of the Secretary of State 2020-12-03
PUBLICATION DATE: 12/03/2020
ACTION DATE: 11/25/2020
EFFECTIVE DATE: 12/11/2020
EXPIRATION DATE: 06/08/2021
PUBLICATION TYPE: Agency

Title 20-DEPARTMENT OF COMMERCE AND INSURANCE

Division 2220-State Board of Pharmacy

Chapter 6-Pharmaceutical Care Standards

ORDER OF RULEMAKING

By the authority vested in the Missouri Board of Pharmacy under section 338.010, RSMo Supp. 2020, and section 338.280, RSMo 2016, the board amends a rule as follows:

20 CSR 2220-6.040 is amended.

A notice of proposed rulemaking containing the text of the proposed amendment was published in the Missouri Register on January 4, 2021 (46 MoReg 12-13). Those sections with changes are reprinted here. This proposed amendment becomes effective thirty (30) days after publication in the Code of State Regulations.

SUMMARY OF COMMENTS: The board received two (2) comments on the proposed amendment from Walgreens Pharmacy and Chief Inspector Tom Glenski.

COMMENT #1: Walgreens Pharmacy supported the board's expansion of pharmacist technician activities. However, Walgreens recommended that the board accept national pharmacy technician certification in lieu of requiring one (1) year of pharmacy technician work experience in Missouri. Alternatively, Walgreens recommended the board accept pharmacy technician work experience in another state as qualifying experience for administering vaccines.

RESPONSE AND EXPLANATION OF CHANGE: The board believes both pharmacy technician work experience and pharmacy technician certification are necessary to protect the public and to ensure pharmacy technicians are properly trained in vaccine administration. However, the board agrees that pharmacy technician work experience from another state meets the intent of the rule and has modified the rule accordingly.

COMMENT #2: Tom Glenski, Board Chief Inspector, recommended the board amend proposed section 20 CSR 2220-6.040(9) to be consistent with proposed changes to rule 20 CSR 2220-6.050 which has also been filed for public comment. Specifically, Mr. Glenski noted 20 CSR 2220-6.040(9) provides a pharmacist must be "physically present at the location" when a vaccination is administered by a pharmacy technician. However, the proposed amendment to 20 CSR 2220-6.050(8) governing immunizations by protocol provides a pharmacist must be "physically present on-site" when a pharmacy technician administers a vaccine.

RESPONSE AND EXPLANATION OF CHANGE: The board agrees with the recommendation and has amended the rule as suggested.

20 CSR 2220-6.040 Administration by Medical Prescription Order

(2) Except as otherwise provided by law, a pharmacist may not delegate medication administration to another person, except to an intern pharmacist or qualified pharmacy technician who has met the qualifications under subsections (3)(B)-(E) and is working under the direct supervision of a pharmacist who has met the qualifications to administer drugs pursuant to a medical order.

(A) For purposes of this rule, a "qualified pharmacy technician" is defined as a currently registered Missouri pharmacy technician who

1. Holds an active pharmacy technician certification issued by a certification entity accredited by the National Commission for Certifying Agencies;

2. Has an initial and, if applicable, annual documented assessment of competency in medication administration; and

3. Has assisted in the practice of pharmacy as a registered/licensed pharmacy technician in the state of Missouri or another U.S. state or territory for a minimum of one (1) year.

(9) A qualified pharmacy technician administering medication pursuant to this rule must be supervised by a Missouri-licensed pharmacist who is authorized to administer medication pursuant to this rule and who is physically present on-site when the medication is administered.