Why Your Voice and Vote Matters: The Student Pharmacist Perspective

by Ashley Builta, Pharm.D., MPA fellow of association management and business development

Are you registered to vote? I think our ability to vote is something that we all take for granted. We all know that every American citizen has the ability to vote, but can you say that you have exercised that right to vote?

Let’s go back to the summer of 1964. The 1960s produced many significant events in the civil rights movement, but there’s one event that doesn’t always get the attention it deserves. In Mississippi that summer thousands of volunteers, many of them students, came together to help register the African American population as voters. This campaign ventured into areas that were considered dangerous at that time, but the mission to register all of the newly-recognized voters couldn’t be deterred. This campaign was called Freedom Summer and 2014 marks the 50^th anniversary of that campaign. We can try to honor the sacrifices of those involved in Freedom Summer and the sacrifices of the civil rights movement by ensuring that all of us are registered and exercise our right to vote.

Now, you may be asking from a pharmacy standpoint, what does this have to do with me? Why does my voice as a student pharmacist matter? Consider this; in the state of Michigan, we have NO pharmacists in either the House or the Senate! So, who might we turn to when a pharmacy issue arises in the legislature? This is where the “friends of pharmacy” come into play. These are legislators with whom MPA has worked, who have a pharmacy-friendly ear, and who are willing to listen to us and our concerns about pharmacy-related bills. They can work with us to introduce pharmacy-friendly bills, and make sure our voice as pharmacists is heard in Michigan Legislature.

BUT none of this matters if they can’t win their elections. Did you know that in the last campaign cycle, some friends of pharmacy lost in their primary elections by 250 votes? 250 votes. Please think about that for a second. This is about one fifth of the student pharmacist population in Michigan. This is why every voice, your voice and your vote, matter! If we can’t get friends of pharmacy elected through their primary and general elections, then we greatly reduce the number of friends of pharmacy in the Michigan Legislature.

With primary elections coming up on Aug. 5, now is a great time to ensure that you’re registered to vote.

Important Dates to Consider for the 2014 Election
July 7, 2014	Last Day to Register for the Aug. 5, 2014, Primary Election
Aug. 5, 2014	Primary Election
Oct. 6, 2014	Last Day to Register for the Nov. 4, 2014, General Election
Nov. 4, 2014	General Election

The Michigan Secretary of State has a great step-by-step guide online about registering to vote. If you’re not sure if you’re registered to vote, you can go here to check! If you are living away from your legal address and can’t make it back to your district in time to vote on the day of elections, you can request an absentee ballot. You can do this only if you’re registered to vote AND have voted before! It’s a great way to ensure your vote is counted in elections. To obtain an absentee ballot, click here.

In addition, the Secretary of State Web site has some great resources to check out where to go to vote, what equipment your district will be using and generally what to expect. Be sure to remember your photo ID on the days of the primary and general elections, too (for a complete list of acceptable ID options, click here).

MPA is also happy to announce the launch of a new advocacy team and we’re looking for student pharmacists. If you’re interested in learning more about how you can get involved, join our Pharmacy Advocacy Response Team (PART) today! Do your PART by contacting Amanda Lick, MPA manager of advocacy, governmental and regulatory affairs at Amanda@MichiganPharmacists.org.

Get Involved in this Year’s Important Election and Make Your Voice Heard!

Every seat in the Michigan Legislature is up for grabs this year. It is important to note that none of these individuals are pharmacists, which is one reason why it is incredibly imperative that pharmacy professionals voice their opinion as to who they want to see advocating for patient safety and pharmacy issues. Do not let other health professions decide what is right for you! Get out and vote!

Candidate Information

Want to learn more about all the candidates? Get to know your state and federal legislator by visiting the MPA Web site.  Next, you can find out information related to all the candidates who are running in your district in every election. Click here to see a complete list that includes candidate name, district, party affiliation and a link to their Web site.

Election Information

Primary Election: The primary election, which takes place on Aug. 5, 2014, allows the opportunity for Michigan residents to vote for the candidate they want to see represent their chosen political party in the general election in November.

In order to vote in the primary election, you must be registered by July 7, 2014. Michigan residents only need to register to vote once unless they have moved or had a name change. If either of these has occurred, then you should verify your registration. To check if you are registered or if it is accurate, click here.  

The general election will take place on Nov. 4, 2014. Check out the table below to learn more.

Voting Information

Register to Vote: If you have never registered to vote, you can sign up now online.

Important Dates to Consider for the 2014 Election
July 7, 2014	Last Day to Register for the Aug. 5, 2014, Primary Election
Aug. 5, 2014	Primary Election
Oct. 6, 2014	Last Day to Register for the Nov. 4, 2014, General Election
Nov. 4, 2014	General Election

Absentee Ballots: Please note that if you will not be able to vote in person on the Election Day, you may request an absentee ballot. An absentee ballot allows you to submit a vote without having to go to the voting poll. To fill out an absentee ballot form, please click here.

Voting Tips:

• Register in advance
• Locate your polling site in advance (should be included on your voter registration card)
• Bring a photo ID (for a complete list of acceptable ID options, click here)
• Mark your ballot correctly. To learn more, please click here.

To get involved in advocating for pharmacy, join our new Pharmacy Advocacy Response Team (PART) today! Do your PART by contacting Amanda Lick, MPA manager of advocacy, governmental and regulatory affairs, at Amanda@MichiganPharmacists.org. She can also respond to any questions you may have regarding the election information provided.

Pseudoephedrine Bill Package and the Amendment to Keep Pharmacy Professionals Safe

Last week, the Michigan Legislature passed a bill package that creates new regulations and criminal provisions for those individuals with previous methamphetamine convictions who are trying to acquire over-the-counter pseudoephedrine. There are some additional changes to the Public Health Code, as outlined below. However, those changes do not relate to pharmacy. Keep in mind that the intent of this bill is to give law enforcement agencies additional tools to combat the methamphetamine problem and the misuse of ephedrine and pseudoephedrine products in Michigan.

Pseudoephedrine Bill Package Legislative Analysis

From the very beginning, MPA staff and the Executive Board took a supportive position on the bills that would keep patients and communities safe and, in addition, would not put additional burden on the role of the pharmacist. We wanted to make sure that the work flow of the pharmacy would not be impeded greatly and that all patients would get the safe, quality service that they have come to know and love in their community pharmacies. We were successful in making sure that our interests were heard and the bill package passed reflects that.

Background: Originally, two bill packages related to this issue were introduced. Typically, when similar bills are introduced in each legislative chamber, they are exactly the same. However, although these bills dealt with the same issue, the House and Senate versions tried to solve the problem in different ways. The drafted version introduced in the House denied access of pseudoephedrine to a patient with methamphetamine charges for the rest of their life. The Senate version requires a prescription for 10 years. Both had criminal penalties, the House version being stricter than the Senate version. In the end, the two groups worked together to come up with a complete bill package that all parties could come to a consensus on. To gain a greater understanding of the complete bill package, read the legislative analysis for the entire bill package.

Implications: When signed in to law, the bills will require linking criminal history to the National Precursor Log Exchange (NPLEx) system. The NPLEx system will then generate a stop-sale alert for those individuals who have been convicted of methamphetamine-related charges. The only way that the patient can attain the drug is by submitting a prescription written by their physician (note: this only applies to patients with methamphetamine convictions). Once convicted of a methamphetamine-related charge, patients will need a prescription for 10 years to receive pseudoephedrine.

To Keep Pharmacy Professionals Safe: An amendment made in the House Criminal Justice Committee includes an override function for those pharmacies that feel that they are in danger if they do not give the medication to the patient. This amendment was brought to the Committee by Rep. Margaret O’Brien (R-Portage).

A breakdown of each bill:

• SB 535: Creates the Methamphetamine Abuse Reporting Act, requiring Michigan State Police to notify the National Association of Drug Diversion Investigators of any methamphetamine-related convictions. Requires offenders to obtain a prescription for ephedrine or pseudoephedrine products for 10 years if convicted of a methamphetamine-related charge.
• SB 756: Prohibits the sale of ephedrine or pseudoephedrine products through a stop-sale alert through NPLEx. This bill is tie-barred to SB 535.
• HB 5089: Prohibits a person from soliciting another person to purchase ephedrine or pseudoephedrine products in any amount knowing it will be used for the purpose of manufacturing methamphetamine.
• HB 5090: Establishes sentencing guidelines

These bills are part of the package, but did not pass before the legislative session ended for the summer.

• HB 5363: Prohibits purchasing ephedrine or pseudoephedrine products of any amount knowing that the drug will be used to manufacture methamphetamine. Also includes penalties. This bill is tie-barred to SB 563, which has not passed yet.
• HB 5615: Includes the crimes associated with ephedrine and pseudoephedrine in the Public Health Code as racketeering crimes. This bill has not passed yet.

In an effort to acknowledge those individuals who work to keep our pharmacies safe, if you feel inclined, please send a thank you note to the following legislators who were instrumental in the development, introduction and passage of this bill.

• Rep. Amanda Price
• Rep. Bob Genetski
• Rep. Aric Nesbitt
• Rep. John Kivela
• Sen. John Proos
• Rep. Margaret O’Brien

Senate Bill 704: What it Means for Pharmacists

Bill: Senate Bill 704

Senate Bill (SB) 704 provides additional regulatory requirements for all pharmacies, but most notably for pharmacies compounding sterile pharmaceuticals. The bill was introduced by Sen. Joe Hune (R-Whitmore Lake), who has worked closely with the office of Michigan Attorney General Bill Schuette, the Michigan Department of Licensing and Regulatory Affairs and Michigan Pharmacists Association (MPA), to ensure that the bill holds pharmacists to fair and appropriate standards that increase patient safety. The bill has been described as introducing “accountability at the top,” and for the first time formally defines the role and responsibilities of the “pharmacist in charge” in the state of Michigan.

This week, the bill was voted out of the House of Representatives and now heads to Michigan Gov. Rick Snyder for his signature. The speed at which the bill is moving is a strong indication of the importance this issue holds in the minds of the stakeholders. SB 704 is the Michigan Legislature’s answer to the New England Compounding Center (NECC) tragedy that began in 2012.  

In 2013, Congress passed legislation related to the registration and inspection of outsourcing facilities. The Michigan bill takes the law one step further to tighten record keeping and accountability requirements for all practices that compound sterile pharmaceuticals. The bill also contains unique provisions for compounding of products for office use, which are geared toward facilities that do not ship across state lines and, therefore, do not wish to register as outsourcing facilities under FDA 503B. 

All facilities that compound sterile pharmaceuticals will be required to receive accreditation from an entity approved by the Michigan Board of Pharmacy. Additionally, sterile compounders who supply pharmaceuticals to patients outside of a hospital or health-system must adhere to more stringent record-keeping requirements that must be held in the same manner that prescription records are currently retained.

 

The bill also introduces criminal penalties for those who willfully and knowingly violate these regulations. Failure to meet appropriate accreditation and record-keeping requirements will result in a misdemeanor charge. This charge escalates to felony in the event that violation of the regulations directly results in the injury or death of a patient. Falsification of a prescription to compound a product in bulk is also considered a felony charge if it results in patient harm. It is important to note that these criminal penalties are all “willful and knowing” violations, which is different from the “willful or reckless” criminalities that currently exist in the Michigan Public Health Code (e.g., adulteration or misbranding of a prescription). These criminal penalties are not intended for individuals who may inadvertently breach the new regulations through activities such as clerical errors.

MPA and several member pharmacists testified in support of SB 704.  The bill will work to increase patient safety provisions in the state of Michigan and provides some much needed clarity as to what is expected of our compounding pharmacists.

.

Transparency Legislation Signed Into Law Today!

History was made in Michigan today!

Bill: Senate Bill 656

For the first time ever, pharmacy benefit managers (PBMs) contracted through Medicaid health plans will have to provide more information related to their Maximum Allowable Cost (MAC) pricing determinations. This was an important first step in the larger goal creating more transparency in the health insurance and PBM industries.

Senate Bill (SB) 656, introduced and championed by Sen. Bruce Caswell (R-Hillsdale), was signed into law today at 10:06 am. MPA staff Eric Roath, Heather Meyers and Amanda Lick joined Sen. Caswell and Annette Frosch and Casey Sullivan of Nash Drugs in Hillsdale in witnessing Michigan Gov. Rick Snyder sign the bill. It was an incredible opportunity to witness such a historical moment for community pharmacy in Michigan.

Specifically, SB 656 requires three things:

• PBMs must provide at least three National Drug Codes (NDCs), if available, that they used to determine their MAC price 
•  The drugs must be available and deliverable in the State of Michigan 
•  PBMs must respond in writing or electronically within 10 business days to an inquiry made by pharmacies 

Please note that the bill will likely go into effect 90 days after the legislative session ends. The estimated effective date is April 1, 2015. The bill was drafted with immediate effect, but that was waived due to the department needing more time to put the process in place. 

SB 656 is a landmark bill for many reasons, least of which is that the passage of this bill also represents the best that advocacy has to offer. It reminds us that pharmacists, technicians and students in Michigan can make a difference by advocating for their profession. Several MPA members, including pharmacists JoAnn Sanborn, Michael Sanborn and Annette Frosch, and pharmacy technician Casey Sullivan advocated for this cause and educated Sen. Caswell on the reimbursement discrepancies that exist in the pharmacy industry. In addition, MPA supported Sen. Caswell and our members by educating other legislators on the importance of this issue.

The passage of this bill is proof that when pharmacists in Michigan speak, they are heard. When an association works with its members to address their concerns, together they create a united message to communicate to policymakers, which can result in positive changes!

To learn more about advocacy at MPA, how we can help your voice be heard and to join our efforts, visit our Web site at www.MichiganPharmacists.org/advocacy/grassroots.

Welcome to MPA's The Advocate

Michigan Pharmacists Association is Proud to Introduce The Advocate!

The Advocate is an online blog publication open to pharmacy professionals who are interested in receiving up-to-date information on current pharmacy issues that affect the practice of pharmacy in Michigan.

The Advocate is a perfect opportunity for us to engage each other and to learn more about your thoughts on issues affecting the pharmacy profession. We care about your feedback and want you to feel like your voice is heard!

Our goal at MPA is to keep you up-to-date on all current pharmacy issues. It is also our goal to ensure that you have a safe place to express your opinions on how issues and bills will impact or are impacting your practice.

Before we get started, it is important to note the type of community we hope to create through this blog. This online forum is a perfect opportunity for us to unite all members of the pharmacy profession with different interests and experiences. The beauty of engaging pharmacists, pharmacy technicians and all other pharmacy professionals across all practicing disciplines is the vast array of opinions. It’s not often that experts in pharmacy across practice areas are provided with an opportunity to engage with each other, which is the beauty of a blog. In order to make sure that The Advocate is a productive forum for opinion, we must first outline the expectations of the community:

Our Community, Our Commitment

Please join us in maintaining a professional, safe and respectful community by limiting commentary pertaining to the focus of our united effort, which is to support policy that keeps the patients we serve and the communities we serve safe while improving health care for all residents in Michigan.

MPA’s commitment to you:

• All blog posts will be informative and respectful.
• Through frequent monitoring, we will ensure that the communication exchanged on the blog is also informative and respectful.
• We will post topics related to upcoming events, however, the focus of the content will be educational.

Please keep the content and comments posted within these guidelines:

• Reply to blog features with respectful and informative comments.
• Keep feedback appropriate, positive and open-minded.
• Respect copyright and fair use policies.
• Provide links to sources whenever necessary.
• Be aware of patient privacy and confidentiality laws (HIPAA).
• Avoid answering patient-specific questions publicly

Healthy discourse is important, as it helps us understand the motivations and intentions of others. However, we need to ensure that comments and posts are upstanding and preserve the distinguished profession of pharmacy. We reserve the right to remove any post or comment that violates any of the above guidelines, including:

• Any content that is crude, rude, offensive , disrespectful or unprofessional
• Any content that includes spam or sales information

We are so happy to have you join our online advocacy community. We hope that you find this opportunity as exciting and beneficial as we do. We look forward to advancing the profession through our advocacy efforts as united pharmacy professionals! Please let us know if you have any comments or concerns by contacting a member of our legislative team:

• Amanda Lick, MPA manager of advocacy, governmental and regulatory affairs, at Amanda@MichiganPharmacists.org or (517) 377-0254
• Eric Roath, MPA director of professional practice, at Eric@MichiganPharmacists.org or (517) 377-0224

By sharing comments on our blog posts, you agree to abide by the terms and conditions stated above.