TheTransitionTimes. Welcoming a new healthcare profession. Understanding the pharmacy technician regulation process

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1 Working toward regulation since 2003 Technician scope of practice Steps to regulation Registering with ACP Next steps TheTransitionTies Spring 2010 HELPING YOU NAVIGATE CHANGE Things to keep in ind while reading: n When the ter pharacy technician or technician is used in this newsletter and in the practice standards, it refers to a regulated individual who will be registered with ACP. n The Pharacists Profession Regulation referred to is the legislation that defines professional roles for pharacists and pharacy technicians. It is currently being aended to accoodate regulated pharacy technicians. As part of the aendents, the nae Pharacists Profession Regulation will change to reflect that it applies to both professions. n The processes for technician regulation outlined here will coe into effect once the aended Pharacists Profession Regulation is enacted. That is expected to happen in late Welcoing a new healthcare profession Understanding the pharacy technician regulation process Alberta is looking forward to welcoing the new profession of regulated pharacy technicians. This new profession will provide benefits to patients, pharacy technicians, pharacists, and our health syste. The fraework and processes for regulating technicians has evolved over several years and has been shaped by the involveent of any individuals and groups. This newsletter outlines where we are today including what possibilities were considered and what decisions were arrived at and what the next steps will be. Patients, professions, and the province will benefit fro regulated pharacy technicians Regulated pharacy technicians will be directly responsible and accountable for the technical functions related to prescription preparation and processing. They will have to deonstrate key copetencies through nationally adinistered exas and will take on the responsibility, accountability, and any resulting legal liability for their work. They will then be authorized to continued on page 2 H e a l t h y A l b e r t a n s t h r o u g h e x c e l l e n c e i n p h a r a c y p r a c t i c e

2 Spring 2010 TheTransitionTies alberta college of pharacists FAQs fro technicians If I do not qualify to register will I lose y job? ACP does not expect that all individuals currently working as technicians will pursue registration. Pharacy licensees will not be required to hire a pharacy technician. In fact, we anticipate that the process will be gradual and that there will continue to be a variety of viable pharacy business odels with and without regulated technicians. Can I still use the title pharacy technician if I don t qualify for regulation? No. Only individuals who are registered on ACP s pharacy technician register will be able to be called a pharacy technician and only these regulated individuals will be peritted to practice unsupervised and conduct the final quality assurance check on dispensed prescriptions. Once the legislation has been enacted, will there be a pay scale that has to be followed? ACP is not legally authorized to set pay scales or negotiate reiburseent for pharacists or pharacy technicians, so will not be entering into any reiburseent discussions. ACP s andate is to protect the public by setting and enforcing high standards of copetence and ethical conduct. Welcoing a new healthcare profession continued fro page 1 work under the direction of a pharacist (i.e., unsupervised), rather than under supervision. This change will produce any benefits. Patients will benefit because pharacists, freed fro the technical aspects of the dispensing process, will be ore accessible to patients and will be able to focus on ore coprehensive patient care through edication anageent, prescription adaptation and initial prescribing, iunization, counseling and follow-up. Pharacists will benefit because the work in the areas of prescription processing and preparation can shift fro the pharacist to the technician, thereby allowing pharacists to ore appropriately use their skills and knowledge to deliver patient care. Pharacists will be able to let go of soe dispensing roles, knowing that pharacy technicians have et educational standards and deonstrated their copetency. Pharacy technicians will benefit because by having et defined and recognized standards for education and copetency, they will have the knowledge, skills, legal authority and confidence to practice ore independently and to take on ore authority. While pharacists will still be responsible for assessing the ACP CAPT AB CCAPP CPTEA NAPRA PEBC PTCB PTeB PTSA Acrony Key appropriateness of each prescription and counseling patients, pharacy technicians will be able to copound, dispense and sell drugs unsupervised. They will also be able to supervise other technicians, assistants and pharacy technician students in the pharacy. The health syste will benefit because health professionals skills will be used ore appropriately and patients will have increased access to care fro pharacists. The Alberta College of Pharacists will benefit because the regulation of pharacy technicians helps fulfill two of the college s priary goals: protecting the public and optiizing the use of pharacy professionals skills. Unlike a professional association or advocacy group which acts in the interest of its ebers, a professional college acts in the interest of the public. The andate of the Alberta College of Pharacists (ACP) is to protect the public s health and well-being. Therefore, ACP has a responsibility to ensure that only individuals who have the knowledge and who can deonstrate the required copetencies be registered. By regulating pharacy technicians, ACP can be assured and can assure the public - that these regulated individuals have et national and provincial entryto-practice standards and are copetent to take on ore responsibility within the copounding and dispensing functions. Alberta College of Pharacists Alberta branch of the Canadian Association of Pharacy Technicians Canadian Council on the Accreditation of Pharacy Progras Canadian Pharacy Technician Educators Association National Association of Pharacy Regulatory Authorities Pharacy Exaining Board of Canada Pharacy Technician Certification Board of Alberta (later known as PTeB) Pharacy Technician Board of Canada Pharacy Technician Society of Alberta 2

3 Spring 2010 TheTransitionTies alberta college of pharacists Working toward regulation since 2003 For alost a decade, pharacy technicians, pharacists, and ACP have worked together to develop the fraework for technician registration in Alberta A steering coittee coprised of pharacy technicians and pharacy technician educators was established by the Alberta branch of the Canadian Association of Pharacy Technicians (CAPT AB) and the Pharacy Technician Certification Board of Alberta (PTCB, later known as PTeB) to consider the erits of self-governance of pharacy technicians The CAPT AB/PTCB steering coittee ade a proposal for technician regulation to the provincial Minister of Health. At that tie, the Minister indicated support for the idea, but said no new professions would be recognized until all of the current professions said were recognized under the Health Professions Act Pharacy technicians fored the Pharacy Technician Regulatory Coittee of Alberta. This coittee was coprised of volunteers fro CAPT Alberta and PTeB and other interested individuals The Pharacy Technician Regulation Working Group was established to develop a plan to achieve technician regulation in Alberta. n 4 appointees fro ACP, 3 appointees fro the Pharacy Technician Regulatory Coittee of Alberta n This group recoended that pharacy technicians in Alberta be regulated within the Alberta College of Pharacists ACP began accepting applications for the voluntary Pharacy Technician Register. To date there are 975 pharacy technician ebers of ACP. While technician regulation is a provincial 5 4 A bridging progra (four courses) to assist in deterining the acadeic equivalence of individuals who have not graduated fro accredited progras was developed in Ontario through the leadership of the Ontario College of Pharacists and pharacy technician candidates. Exainations for entry to practice are being led by PEBC. 3 1 Educational outcoes to support the standardization of pharacy technician training progras were led by CPTEA. These outcoes outline the essential learning required by graduates at entry-to-practice and provide consistent standards for pharacy technician progras both interand intra-provincially. Cooperative national initiatives toward pharacy technician regulation The accreditation of technician training progras is being led by CCAPP at the request of technician, technician educator and pharacist groups. Accreditation standards are based on CPTEA s Educational Outcoes and NAPRA s Entry to Practice Copetencies. CCAPP began accepting applications for accreditation and accrediting progras in responsibility, there has been national coordination to ensure that processes are siilar and credentials are transferable across the country. The diagra below suarizes other key national initiatives in which pharacists and pharacy technicians have partnered to facilitate technician regulation. All provinces pursuing technician regulation are basing their progras on these initiatives. In all cases there has been direct participation or consultation with pharacy technicians or pharacy technician educators fro across Canada, including Alberta. Copetency Based Standards for Entry to Practice developent was led by NAPRA. They were developed by technicians, regulators and representatives fro national pharacy organizations and approved by NAPRA s Board of Directors in Noveber This docuent outlines the copetencies required for pharacy technicians to perfor their role in a regulated environent. 2

4 Spring 2010 TheTransitionTies alberta college of pharacists Technician observers appointed to ACP council in 2008 In 2008, the ACP council appointed two technician observers, Robin Burns and Teresa Hennessey, fro a list of noinations subitted by technicians. Robin and Teresa have participated in all council discussions, particularly those related to the regulation of pharacy technicians. They, and other ACP staff, have presented at any technician conferences and eetings. Robin and Teresa have also contributed input on the aendents to the Pharacists Profession Regulation and the developent of national fluency requireents for pharacy technicians at entry to practice. Technician scope of practice The biggest changes resulting fro the regulation of pharacy technicians will not only be in the scope of their practice, but in the fact that technicians will becoe legally responsible and accountable for their work. Although practitioners feel a personal responsibility for the work they undertake now, this is different than the legal accountability and liability conferred with regulation. Soe non-pharacists ay now be perforing at higher levels than others in pharacy settings, but there is currently no regulatory process which holds the directly responsible to the public for their practice. Having echaniss to ensure accountability is iportant to the public, the profession, and the college. The regulation of technicians will provide a greater degree of protection for the public as pharacy technicians ove to higher levels of responsibility (e.g., conducting restricted activities unsupervised and supervising others) and perit ore effective use of the skills of pharacists. What will a regulated pharacy technician be able to do? Schedule 19 of the Health Professions Act (as proposed in the Health Professions Aendent Act) provides the following role stateent for pharacy technicians: In their practice, pharacy technicians proote safe and effective drug distribution and, in relation to that, do one or ore of the following under the direction of a pharacist: Robin Burns a) receive, gather, enter and store prescription and patient inforation, b) store and repackage products, c) participate in the anageent of systes for drug distribution and inventory control, d) participate in the research, developent, ipleentation and evaluation of quality assurance and risk anageent policies, procedures and activities, e) provide restricted activities authorized by the regulations, f) instruct patients about the use of health aids and devices, and g) teach the practice of pharacy technicians. Subsection (e) refers to restricted activities. What are these? The aendents to the Pharacists Profession Regulation propose that, under the direction of a clinical or courtesy pharacist, a pharacy technician be authorized to: Teresa Hennessey a) dispense a Schedule 1 drug or Schedule 2 drug; b) copound, provide for selling or sell a Schedule 1 drug or a Schedule 2 drug; c) copound blood products. 4

5 Spring 2010 TheTransitionTies alberta college of pharacists A pharacy technician ay only perfor the restricted activity if: a) a pharacist has evaluated the prescription for the drug, b) a pharacist has assessed the patient, the patient s health history and edication record and has deterined that the drug therapy is appropriate for the patient, and c) a pharacist is available to counsel the patient and to onitor the patient s drug therapy. What does under the direction of ean? For the purpose of this section, under the direction of eans that the clinical pharacist or courtesy pharacist who is providing the direction ust a) practice at the sae pharacy* as the pharacy technician, unless otherwise authorized in writing by the Registrar, b) ensure there is a syste in place in the pharacy that coplies with the Standards of Practice under which i) a pharacist is available to consult with, provide guidance to and, if necessary, provide assistance to the pharacy technician, ii) the involveent of the pharacy technician in the restricted activities can be onitored and assessed, iii) the pharacy technician reports to the pharacist who is responsible for providing direction to the pharacy technician; and c) be authorized to perfor the restricted activities for which the pharacist is providing direction to the pharacy technician. * Note the difference between direction and supervision. Supervision is provided by the pharacist on shift that day and that pharacist ust be available to provide hands-on assistance, either iediately or within a reasonable period of tie. Direction is provided by a pharacist who works in the sae pharacy, but not necessarily on the sae shift as the technician. That pharacist is responsible for ensuring that there are appropriate policies and procedures in place to aintain the integrity of the dispensing and copounding processes and for aking sure that a pharacist is available to work with the technician as required in the regulations and the standards. Roles Responsibilities Role coparisons Pharacists will n assess patient n review patient history, edication history n ensure appropriate drug therapy n counsel patient n onitor ongoing therapy n provide direction to technician (Pharacists will continue to be authorized to conduct all pharacy technician roles.) n continue to be accountable for the overall supervision of pharacies and the systes that are in place to ensure the safe storage, copounding, packaging and distribution of drugs. n continue to be solely responsible and accountable for assessing the appropriateness of drug therapy (both new and continuing) and providing patient consultation. A prescription cannot be released to the patient without a pharacist having perfored these functions. Pharacy Technicians will (proposed) n prepare and distribute prescriptions n copound n sell n check to ensure correct drug is dispensed n copy prescriptions for authorized recipients n transfer prescriptions to, and receive prescriptions fro, other pharacies n receive and transcribe verbal prescriptions given by a prescriber n instruct patients re: health aids and devices n be authorized to check work of individuals eployed in a pharacy n Always practice in an environent where: procedures are in place to ensure the safety and integrity of the dispensing or copounding process (i.e., under the direction of a pharacist). a pharacist is available to ensure appropriateness of drug therapy and consult with patients. n Exercise professional judgeent at all ties and be able to recognize when the clinical expertise of the pharacist is required. 5

6 Expires 2015 Spring 2010 TheTransitionTies alberta college of pharacists Steps to regulation All provincial bodies pursuing technician regulation have agreed that requireents for pharacy technicians will parallel the process for pharacists where possible and will be in keeping with the Agreeent on Internal Trade. Adhering to the Agreeent eans technician qualifications will be recognized across the country. This will enable pharacy technicians to work anywhere in Canada without having to re-qualify. To becoe a regulated pharacy technician, individuals currently working in the field as well as those just entering the profession will need to successfully coplete the required steps outlined below. Technician Regulation Process Path 1: Transition Path 2: New entries Step hours worked in past 3 years OR Currently on ACP voluntary register Graduate fro CCAPP accredited progra (available now) Step 1 Step 2 PEBC Evaluating Exa (or PTCB-AB or OCP exa) Note: Must coplete by Jan. 1, 2013 Bridging Progra Copletion of all 4 courses OR Professional Practice course* and challenge exa in other 3 courses Coplete structured practical training (SPT) Jurisprudence/Ethics Exa (through ACP) Step 2 * includes jurisprudence/ethics exa Step 3 PEBC Qualifying Exa (written and practical) Step 3 Step 4 Registration with ACP Step 4 Although PEBC does not require individuals to have successfully copleted all four bridging courses (Path 1) or all three levels of SPT (Path 2) before sitting the Qualifying Exa, both PEBC and ACP strongly recoend this step. The extra knowledge and resource inforation attained will help candidates achieve success on the Qualifying Exa. 6

7 Expires 2015 Spring 2010 TheTransitionTies alberta college of pharacists Steps to Regulation Path 1: Transition Individuals already working in the field who did not graduate fro a CCAPPaccredited progra will have until Jan. 1, 2015 to register via Path 1. After that tie, anyone wishing to becoe regulated will have to take Path 2 and successfully coplete a pharacy technician progra offered through a CCAPP-accredited institution. STEP 1 Meet Miniu Criteria To enter the process, a current technician ust either be on ACP s voluntary register or have worked in pharacy practice for a iniu of 2000 hours in the past 3 years. Specific duties defined as pharacy practice are identified on the Pharacy Exaining Board of Canada (PEBC) website at (Note: if a current technician does not eet the iniu criteria, they would seek regulation through Path 2 by enrolling in an accredited pharacy technician progra.) STEP 2 PEBC Evaluating Exa and ACP Bridging Progra Contrary to soe other provinces that require candidates to coplete the PEBC Evaluating Exa prior to enrolling in bridging courses, ACP is letting candidates coplete these in any order. ACP s goal is to provide as uch flexibility as possible for each candidate to eet the requireents. The copletion of both the PEBC Evaluating Exa and the ACP Bridging Progra is required 1 by all individuals seeking regulation via Path 1. (Note: the only exception, as per PEBC s policy, is that those who successfully copleted the PTCB-AB (up to 2008) or OCP (up to 2008) exa do not need to sit the PEBC Evaluating Exa. They are still required to coplete the bridging progra.) The PEBC Evaluating Exa is a 3 hour, 150 ultiple choice question exa. The exa is offered by the PEBC two ties per year in Step 1 Step 2 Step 3 Step 4 key locations across Canada. More details on the Evaluating Exa, including the exa sitting schedule, are available at Note: Path 1 candidates ust coplete the PEBC Evaluating Exa by Jan. 1, The bridging progra is designed to prepare individuals for their role as regulated health professionals, including the additional responsibilities described in the entry-to-practice copetencies for a pharacy technician. One of the ost essential requireents for entry to practice is copletion of an Path 1: Transition 2000 hours worked in past 3 years OR Currently on ACP voluntary register PEBC Evaluating Exa (or PTCB-AB or OCP exa) Note: Must coplete by Jan. 1, 2013 Bridging Progra Copletion of all 4 courses OR Professional Practice course* and challenge exa in other 3 courses * includes jurisprudence/ethics exa PEBC Qualifying Exa (written and practical) Registration with ACP approved education progra. Until CCAPP accreditation in 2008, there was no syste to ensure consistency across education progras, and no standard requireent for an individual choosing to becoe a pharacy technician. As a result, there is a high degree of diversity aong those choosing to becoe regulated pharacy technicians. Their knowledge and skills, and roles and practice settings differ. This poses a challenge; as a regulatory body, ACP needs to ensure that individuals applying for registration have deonstrated the defined copetencies to continued on page 8 1 Where candidates have not graduated fro a CCAPP-accredited education progra, PEBC requires that candidates also successfully pass an Evaluating Exa. This is not an ACP policy, but rather a PEBC policy consistent for both pharacist and PT candidates. Although PEBC does not require individuals to have successfully copleted all four bridging courses before sitting the Qualifying Exa, both PEBC and ACP strongly recoend this step. 7

8 Spring 2010 TheTransitionTies alberta college of pharacists Path 1: Transition continued fro page 7 practice safely and effectively within the scope of their profession. Because of the diversity aongst individuals and the absence of previous educational standards and easures, the college is incorporating a bridging education progra that will prepare individuals to practice in the new regulated role. Building on the knowledge these individuals have gained through foral education or on-the-job training, this bridging progra will prepare the to eet the educational requireents and responsibilities of a regulated pharacy technician. The bridging progra is divided into four courses: Pharacology, Professional Practice, Manageent of Drug Distribution Systes, and Product Preparation. The content is being developed nationally and then odified as required for each province. Technicians who feel that they already have the necessary knowledge, skills, and abilities to challenge a particular bridging course ay do so through an exa process referred to as Prior Learning Assessent and Recognition (PLAR). The PLAR option was incorporated so technicians who are confident in their skills can fast track bridging. All bridging courses, with the exception of the Professional Practice odule which is andatory for everyone in Path 1, are PLAR-eligible. n Pharacology (33 hours) This course provides a practical, applied approach to pharacology. Through a variety of learning tools such as assignents, quizzes, case studies and group work, students will enhance their ability to practice copetently and contribute to a safe patient care setting. Participants will gain basic knowledge related to the pharacological uses of drugs within a variety of coonly encountered edical conditions. n Professional Practice (45 hours) andatory, no PLAR Students will be prepared for entry to practice in five ain areas of focus: legal requireents, scope of practice, ethical principles, professionalis and counication skills. Students will enhance their ability to practice copetently within the professional practice fraework. To iniize learners costs and tie, APC has incorporated the jurisprudence exa as part of this course, rather then a separate eleent. n Manageent of Drug Distribution (39 hours) This course will exaine various drug distribution systes in pharacy practice, and prepare learners to effectively anage operations in different practice settings to ensure safe and effective drug supply and distribution. Learners will explore distributive functions in institutional settings, as well as coon drug plans and their forularies, adjudication challenges, inventory anageent eleents and coon business practices. Accurate product release within the paraeters of the pharacy technician role receives special ephasis. n Product Preparation (33 hours) This course deals with the theoretical knowledge and practical skills essential for safe and accurate preparation of sterile and non-sterile pharaceutical products. For nonsterile preparation, students will focus on copounding practices for various internal and external preparations and specialty dosage fors, equipent and tools, professional guidelines, standards and legislation, pharaceutical calculations, and docuentation requireents. For sterile product preparation, areas of ephasis include infection control, aseptic technique, parenteral dosage fors, accurate calculations, appropriate use of equipent, and quality control. Best practices associated with the preparation of Total Parenteral Nutrition (TPN) and antineoplastics are also covered. ACP is working with three publicly funded colleges to offer the bridging progra. Each course will be offered online as well as in classroo. Each of continued on page 10 8

9 Spring 2010 TheTransitionTies alberta college of pharacists FAQs re: process for individuals who did not graduate fro a CCAPP-accredited progra Overall process Why was Jan. 1, 2015 picked as the end date for current technician transition? Is that still feasible given that bridging hasn t started yet? A deadline was required that allowed enough tie for individuals currently working in the field to coplete transition without a great deal of pressure, but that sent a clear essage that those entering the field today are expected to attend an accredited progra rather than attept to begin working in the field. This date is consistent with the date that other provinces are using. Availability of the bridging courses has been delayed, but is expected by fall That will still allow ore than four years to coplete the transition. If the deadline for transition is Jan. 1, 2015, why does the PEBC Evaluating Exa have to be copleted by Jan. 1, 2013? The transition pathway (Path 1) is intended for individuals who are now working in the field. The deadline to coplete the Evaluating Exa was set to clearly indicate to individuals who are entering the field now that they ust attend an accredited progra and qualify via Path 2. In addition, copletion of the Evaluating Exa by Jan. 1, 2013 ensures individuals working toward regulation via Path 1 will have tie to coplete all the requireents by Will individuals in other provinces be able to write the PEBC Qualifying Exa and becoe a regulated technician (in Alberta or elsewhere) without taking the bridging progra? All provinces currently pursing technician regulation require copletion of a bridging progra. At present that, includes Ontario, BC, Alberta, Saskatchewan and Nova Scotia. How do I know the bridging progra is of value? All four bridging courses have now been delivered twice in Ontario. Participant evaluations show that 81% of learners felt the courses et their learning needs. Furtherore, 83% of learners felt that the participant aterials provided with the course were useful. Why ust technicians be evaluated ore than once on the sae subject atter (e.g., through bridging and/or PLAR and PEBC exas)? Bridging is not an evaluation echanis, but a process to suppleent the knowledge gained through foral education and on-the-job training with the copetencies that will be required to take on the role and responsibilities of a regulated pharacy technician. The requireent to take both the Evaluating and Qualifying Exainations is a PEBC requireent, consistent with their requireent for pharacists. PEBC is aking one exception in their process: anyone who successfully copleted PTCB-AB (up to 2008) or OCP (up to 2008) exa is exept fro writing the Evaluating Exa. This will iniize tie and costs for candidates. 9

10 Spring 2010 TheTransitionTies alberta college of pharacists Path 1: Transition continued fro page 8 the four courses is in various stages of developent and odification and the anticipated rollout is Septeber Course inforation will be posted on the ACP website as it becoes available. Costs and grant inforation Final course costs will be deterined by the colleges delivering the. It is estiated that the cost to coplete all four courses of the progra will be approxiately $ The cost of the PLAR process is not yet known; however, it is expected to be approxiately half the cost of copleting the full odule. ACP has requested that Alberta Health and Wellness provide a grant to reiburse candidates for at least a portion of the registration costs for the bridging courses. STEP 3 PEBC Qualifying Exa The PEBC Qualifying Exa consists of two parts a written ultiple choice question exa (MCQ) and a perforance-based exa called an Objective Structured Perforance Exa (OSPE). PEBC is expected to offer the exa nationally at key locations twice a year. Note: Although PEBC does not require individuals to have successfully copleted all four bridging courses before sitting the Qualifying Exa, both PEBC and ACP strongly recoend this step. The extra knowledge and resource inforation attained fro the bridging courses will help candidates achieve success on the Qualifying Exa. STEP 4 Register with ACP Other requireents at entry to practice such as fluency, good character, professional liability insurance, product release proficiency, and registration and annual perit fees will be established by ACP council to coordinate with the aendents to the Pharacists Profession Regulation (see pages 14 and 15 for details). All registration requireents are consistent with those for pharacists and other regulated health professionals governed by the Health Professions Act. PEBC Exainations for technicians If I passed the PTCB exa several years ago but did not recertify with PTCB, will I have to write the PTCB exa again? No. Anyone who successfully copleted the PTCB exa is able to write the Qualifying Exa without writing the Evaluating Exa. (You will still be required to coplete the bridging progra.) What type of work counts toward the 2000 hours of work experience listed in Path 1? The PEBC website includes a list of duties that qualify for the 2000 hours of work experience. It does not atter what your job title is as long as you have been copleting duties that are included on the list for at least 2000 hours in the past 3 years. If I a currently voluntarily registered with ACP, do I still need to subit 2000 hours of work experience to be able to take the PEBC evaluating exa? Yes. PEBC will require inforation about your work experience when you register to write the Evaluating Exa. When will the exas be available? The next Evaluating Exa (which ust be copleted before the Qualifying Exa) will be offered on Sept. 18. The application deadline is June 28. The next Qualifying Exa will be offered on Aug. 28 and 29. The application deadline is June 4. See the PEBC website ( for the ost current exa schedule. What happens if I write the Qualifying Exa and do not pass? As with pharacists, pharacy technicians ay attept the PEBC Qualifying Exa three ties. The ACP Registrar has the option to perit a fourth attept, but ay require the applicant to coplete coursework, exainations and structured practical training before the fourth and final attept. 10

11 Spring 2010 TheTransitionTies alberta college of pharacists Why wouldn t grandfathering current pharacy technicians be wise? An accelerated regulation process for pharacy technicians sounds appealing at first. However, there are any reasons why ACP council decided against grandfathering current technicians. 1. To date there has been no standardized education, scope of practice, role definition, restricted title, or legal responsibility for individuals identified as pharacy technicians. The result is a very ixed population of technicians. ACP respects that, aongst these, soe individuals do perfor at higher levels than others as a result of their education and experience. However, without the proposed process, the college currently has no way to easure the copetence of pharacy technicians and thus cannot assure patients, technician peers, pharacists, other health professionals, and the public of their copetency. 2. Pharacy technicians have no history of being regulated, contrary to other professions that are becoing selfregulated under the Health Professions Act. Pharacy technicians will be a new regulated profession. 3. Pharacy technicians have had no requireent to aintain personal copetence, regardless of how they have gathered knowledge and skills to perfor their roles. Therefore, ACP has no eans of ascertaining the aintenance or growth of an individual s knowledge and skills during the period of their past practice. 4. Pharacy technicians have only been authorized to practice under supervision, and have held no legal responsibility, accountability, or shared in any potential liability when providing this assistance. The copetencies for entry to practice cannot be easured through a single exaination or by a single evaluation tool. Grandfathering alternatives are at the best subjective and introduce an unacceptable level of risk; it is not possible to objectively identify progras or cut-off dates that would provide confidence to ACP or fairness to all candidates. Throughout the planning, council has always sought to iniize tie and costs to participants while still protecting the public. This is deonstrated through: n the option for when candidates ay write the PEBC Evaluating Exa, n ACP s work to ensure the bridging courses will be offered in class and online fro ultiple colleges, n the incorporation of the jurisprudence exa into the Professional Practice course, n the PLAR option in bridging, and n ACP s pursuit of governent funding to offset bridging progra costs for technicians. ACP council believes that the proposed fraework for pharacy technician candidates to transition to regulated health professionals appropriately balances accountability, accessibility, and affordability. ACP s approach to evaluating pharacy technician candidates at entry to practice is consistent with that being pursued by other provinces and with the processes established under the Health Professions Act, as used in evaluating pharacists at entry to practice. What grandfathering alternatives were considered? Extending the recognition date for those graduating fro now-accredited progras Recognizing those who graduated fro a CCAPP-accredited progra for a set nuber of years before accreditation was considered by ACP council. For exaple, although Red Deer College s progra was only accredited in 2009, recognition could have been extended to those who graduated two, five, or eight years earlier. However, council realized that it was ipossible to know how educational progras had changed over the years, and thus to know how any years was enough or too any. A line had to be drawn at soe point; council decided that CCAPP accreditation was the best place to draw the line. Grandfathering those with foral education There was no standardization of education progras prior to the developent of CPTEA educational outcoes and the resulting CCAPP accreditation standards. Therefore, progras offered very different levels of knowledge and practical experience. It is ipossible to evaluate and copare progras that were delivered in the past, in soe cases any years ago, so a fair assessent can not be ade. Because there have been no requireents for continuing education, the college also can t know if individuals aintained all the knowledge and skills required of pharacy technicians. Additionally, graduates of each progra have different practice experiences since graduating, depending on their eployent. Applying conditions on the title or having two levels of technicians The Health Professions Act outlines one scope of practice for a pharacy technician and all national docuents, including entry to practice copetencies and educational outcoes, describe a single group of copetencies for a pharacy technician. Individuals who wish to qualify as a pharacy technician ust deonstrate all the required copetencies. Keep in ind that the regulation of pharacy technicians does not preclude pharacists fro hiring unregulated persons to work in the pharacy. A pharacist ay hire whoever they wish to assist the as long as the pharacist provides direct supervision and takes responsibility for the work copleted by the unregulated individuals. Grandfathering individuals already on the ACP voluntary register The voluntary register established in 2008 was always intended to be an interi step toward the regulation of pharacy technicians. All candidates were infored that registration on the voluntary register would not iply eligibility as a regulated technician because additional evaluation would be required. 11

12 Spring 2010 TheTransitionTies alberta college of pharacists Steps to Regulation Path 2: New entries STEP 1 CCAPP-Accredited Progra An accredited progra is a progra of study offered by either a public or private post-secondary institute that has et the accreditation standards for a pharacy technician progra established by the Canadian Council for Accreditation of Pharacy Progras (CCAPP). The CCAPP accreditation process ensures that accredited progras contain the necessary content to teach the copetencies (knowledge, skills and abilities) necessary for successful graduates to safely and effectively do the job of a regulated pharacy technician. In Alberta, four colleges began offering CCAPP-accredited Pharacy Technician progras: NorQuest College in 2008, and Red Deer College, Bow Valley College, and CDI (Edonton) in The CCAPP-accredited progras are a iniu duration of 34 weeks and consist of a iniu of 26 weeks instruction (25 hours/week in class or lab; 5 days/week), and 8 weeks of practicu experience (35 hours/week; 7 hours/day). The progra curriculu covers the sae broad content areas as found in the bridging progra required for current technicians: n Pharacology n Professional Practice n Manageent of Drug Distribution n Product Preparation STEP 2 Structured Practical Training (SPT) and Jurisprudence/Ethics Exa Once a student has graduated fro a CCAPP-accredited progra, they will be required to successfully coplete a Structured Practical Training (SPT) progra 2 ; a supervised copetencybased training period within a pharacy that includes regular assessent by a pharacist or another regulated technician. This training allows soon-to-be-regulated technicians the opportunity to practice their skills in a supervised practical environent before assuing sole responsibility. The Alberta College of Pharacists pharacy technician SPT progra is divided into three levels: Level 1 iniu 320 hours* Path 2: New entries Graduate fro CCAPP accredited progra (available now) Coplete structured practical training (SPT) Jurisprudence/Ethics Exa (through ACP) PEBC Qualifying Exa (written and practical) Registration with ACP n The learner is required to acquire and/or deonstrate copetencies at an acceptable level. The focus of this Step 1 Step 2 Step 3 Step 4 level is the provision of drug distribution. This level ay be copleted as part of an individual s progra practicu. Level II iniu 320 hours* n The learner is required to deonstrate copetencies proficiently. Expectations regarding the deonstration of professionalis and anageent knowledge and skills, and quality assurance are increased. Level III iniu 160 hours* n Level III is intended to confir proficiency. Learners are expected to 2 S3(1)(b) Pharacists Profession Regulation Although PEBC does not require individuals to have successfully copleted all three levels of SPT before sitting the Qualifying Exa, both PEBC and ACP strongly recoend this step. 12

13 Spring 2010 TheTransitionTies alberta college of pharacists work independently, acting as a pharacy technician, n Successful copletion of Level III requires deonstration of proficiency of product release, specifically ensuring the accuracy and quality of the final product. * The hours listed are inius. Successful copletion of each level requires deonstration of the required copetencies; additional tie ay be required to do so. Jurisprudence/Ethics Exa The requireent to successfully coplete a jurisprudence/ethics exa is consistent with the registration process for pharacists and is designed to test relevant provincial legislation and ethics which is not included on the national PEBC Qualifying Exa. STEP 3 PEBC Qualifying Exa The PEBC Qualifying Exa consists of two parts a written ultiple choice question exa (MCQ) and a perforance-based exa called an Objective Structured Perforance Exa (OSPE). PEBC is expected to offer the exa nationally at key locations twice a year. STEP 4 Register with ACP Other requireents at entry to practice such as fluency, good character, professional liability insurance, and registration and annual perit fees will be established by ACP council to coordinate with the aendents to the Pharacists Profession Regulation (see pages 14 and 15 for details). All registration requireents are consistent with those for pharacists and other regulated health professionals governed by the Health Professions Act. Education FAQs Who deterines which post-secondary progras are accredited? The Canadian Council for Accreditation of Pharacy Progras (CCAPP), which is the sae organization that accredits pharacy progras, is responsible for accrediting pharacy technician progras in Canada. A coittee with representatives fro pharacy technician, technician educator, and pharacist groups developed the accreditation standards. The accreditation process ensures that accredited progras contain the necessary content to teach the copetencies (knowledge, skills and abilities) necessary for successful graduates to safely and effectively do the job of a regulated pharacy technician. Which post-secondary institutions are currently offering a CCAPP-accredited Pharacy Technician progra? Please check the CCAPP website for the list of Accredited Pharacy Technician Progras: Will regulated pharacy technicians be required to coplete continuing education? Yes. Registrants on the pharacy technician register ust earn a iniu of 15 continuing education units (CEUs) per year (1 hour of learning is equivalent to 1 unit). These credits ay be earned either fro accredited pharacy continuing education or non-accredited learning or a cobination of the two. Continuing copetence progra requireents will be developed by the ACP Copetence Coittee and pharacy technician representatives. 13

14 Spring 2010 TheTransitionTies alberta college of pharacists Resources Note: The inclusion of a resource on this list does not iply any endorseent by ACP. Associations, Organizations and Licensing Boards n Alberta College of Pharacists pharacists.ab.ca n Aerican Association of Pharacy Technicians n Canadian Association of Pharacy Technicians n Canadian Council for Accreditation of Pharacy Progras n Canadian Pharacy Technician Educators Association n National Association of Pharacy Regulatory Authorities n Pharacy Exaining Board of Canada n Pharacy Technician Educators Council n Pharacy Technician Society of Alberta Useful Links n Moving Forward - Pharacy Huan Resources for the Future n Canadian Healthcare Network (forerly Pharacy Gateway) Docuents n Agreeent on Internal Trade eng/hoe n Educational Outcoes for Pharacy Technician Progras in Canada nal OutcoesMar2007.pdf n Professional Copetencies for Canadian Pharacy Technicians at Entry-to-Practice /Professional_Copetencies_for_ Canadian_Pharacy_Technicians 2007.pdf n Standards for Accreditation of Pharacy Technician Progras Registering with ACP Creation of new registers Upon approval of the regulation, ACP will create a provisional register for those working toward registration, a pharacy technician register for those who have et the registration requireents, and a courtesy register for individuals registered as pharacy technicians in good standing in another jurisdiction and who require registration in Alberta on a teporary basis for locu work or accredited CE provision. Registration on the provisional register will be open to: n graduates of CCAPP-accredited pharacy technician progras, or n candidates on the ACP voluntary register, or n candidates enrolled in bridging progras, or n candidates who successfully copleted the PEBC Evaluating Exa (or PTCB- AB or OCP exa), or n candidates who have 2000 hours worked in the last 3 years. Individuals currently on ACP s voluntary register will be eligible to ove iediately to the provisional register, but ust apply to do so. The application process will be introduced once the legislation is proclaied. Registration requireents for pharacy technicians In addition to copleting the steps to regulation already described, pharacy technicians will be required to provide the following: Proof of English fluency For Path 1: Candidates who have not graduated fro a high school, university, counity college, private vocational college or equivalent in Canada or the United States, ust provide evidence of fluency by subitting the results of a NAPRA-recognized English language fluency test copleted within the past two years. For Path 2: Candidates educated outside of North Aerica ust provide proof of English language fluency using any one of the tests approved by ACP council. (See resource.aspx?id=6744 for details.) Deonstration of good character For the purposes of deonstrating good character and reputation, applicants ust provide: n a statutory declaration indicating whether they are undergoing investigation or discipline or have been previously disciplined by a professional college, and whether they have pleaded guilty or been found guilty of a criinal offence for which they have not been pardoned n a criinal records check current within six onths of application. Proof of citizenship Applicants ust provide evidence in the for of a Canadian birth certificate or passport or a valid Canadian eployent visa that they are a Canadian citizen or are entitled to work in Canada. 14

15 Spring 2010 TheTransitionTies alberta college of pharacists Liability insurance Registrants on the pharacy technician register ust aintain a iniu of $1 illion of personal alpractice insurance (clais ade or occurrence). The policy ust be in the technician s nae. We anticipate that liability insurance for technicians will be available fro a variety of vendors. For exaple, PTSA is finalizing details for one option and will have progra specifics soon. Deonstrated product release proficiency Individuals with the practice experience required for Path 1 have been exepted fro the structured practical training portion that is included in Path 2, but ACP council felt it was iportant that there be a deonstrated proficiency in copleting the final check for product release. Therefore, council has directed that individuals applying for registration ust deonstrate this proficiency by copleting 100 final checks with 100% accuracy, with a iniu of 20 checks a day within three onths. Individuals who have successfully copleted the Alberta Health Services checking verification ay instead subit that as proof of proficiency. Path 2 candidates will deonstrate this proficiency in their structured practical training. Registration fees ACP will create and anage the register for pharacy technicians. In addition to anaging the registration process, ACP will also: n anage the continuing copetence process for technicians, n anage the coplaints resolution processes for technicians, n organize the election of pharacy technician ebers to ACP council, n aintain and ake available the jurisprudence exa for technician candidates, n ake college publications available to technicians, and n liaise with governent and other stakeholders concerned with practice and patient safety issues on behalf of pharacy technicians. ACP council has established the following 2011 fee schedule for pharacy technicians: Fee Nae Aount Forula used Rationale When it applies Technician registration fee $250 Sae as pharacist registration fee Sae work involved in registering regulated technician as a pharacist; therefore, should be equal. Voluntary technicians are currently paying $234 for registration. First tie registration with ACP. Those who have already paid to join the voluntary register will not be charged this fee when they are oved to the provisional register. Provisional Register perit fee $80 $78 (current voluntary technician perit fee) + 2% cost of living allowance (COLA) This equates to current voluntary register fee. When registering as a provisional technician until all conditions have been et to register as a regulated technician. Regulated technician practice perit fee 2011 Pro-rated regulated technician practice perit fee 2011 $450 $735 (pharacist perit fee) + 2% COLA x 60% $248 $450 annual fee x 50% + 10% for adin costs Non-copliance fee $77 $75 (current noncopliance fee for pharacists) + 2% COLA Reinstateent fee $250 $245 (current pharacist reinstateent fee) + 2% COLA Jurisprudence Exa fee (re-challenge or reinstateent) $139 $136 (current pharacist exa fee) + 2% COLA Calculated as 60% of the pharacist perit fee. This calculation is consistent with what is used for the pharacist pro-rated fee. There is the sae aount of work and costs involved for non-copliant technicians as for pharacists. There is the sae aount of work and costs involved for reinstating a technician as there is for a pharacist. The exa will cost ACP the sae whether it is a pharacist or technician writing. When registering on the pharacy technician register. When a provisional technician or locu technician is changing status to a regulated technician and is a firsttie registrant as a regulated technician is joining ACP between July 1, 2011 and Dec 31, Dec 1, Dec 31, 2011 for technicians who do not eet the payent or subission requireents prior to the end of the renewal period. If a cancelled (cancelled for non-renewal, discipline or other reasons) or suspended technician is reinstating to a regulated technician. If a provisional registrant fails the first attept of the exa, the fee will be charged for all subsequent attepts. If a reinstating regulated technician has been away fro practice for 2 years or ore, they ust pay to write the exa. Courtesy register/ locu perit $248 $450 x 50% + 10% adin Based on sae forula used for pharacist locu fee. When registering as a courtesy pharacy technician to practice teporarily in Alberta (locu) or to provide CE. 15

16 Spring 2010 TheTransitionTies alberta college of pharacists Next steps Aend the Pharacists Profession Regulation ACP and technicians have worked together with governent to draft the aendents necessary to the Pharacists Profession Regulation for technician regulation. A consultation on the aendents will be conducted by Alberta Health and Wellness this suer. Once the aendents are approved, an effective date for the Regulation will be set and technician regulation in Alberta can begin. Aend the Standards of Practice ACP, again with technician input, has drafted aended Standards of Practice to accoodate regulated technicians. ACP will conduct a consultation on these aendents this suer. Aend ACP by-laws ACP will be circulating a discussion docuent as a precursor to aending its by-laws to accoodate the election of voting pharacy technician ebers to the council. Read, listen, ponder, and participate ACP is looking forward to the consultations and to receiving your feedback. Only through the input and participation of all parties can we ensure we ve explored all the possibilities and ended up with the best process for creating this new profession. How do you participate in the consultations? Alberta Health and Wellness is conducting the consultation on the aendents to the Pharacists Profession Regulation. They will be using all channels available to the to solicit your feedback. For the consultations on the Standards of Practice and ACP s by-laws, ACP will circulate inforation via our website (pharacists.ab.ca), The Link (our e- newsletter), eails to registrants, and acpnews (our quarterly newsletter). We will also work with PTSA ( to distribute inforation to technicians. If you have questions or would like to coent on any of the inforation in this newsletter, please eail us at acpinfo@pharacists.ab.ca. Stay tuned Technician regulation is an evolving process. To keep up to date, look to the Pharacy Technician Inforation link in the Bulletin Board section of the ACP website and The Link, ACP s e-newsletter, delivered every two weeks. (Note that archived editions of The Link are available on the ACP website under News & Events/ACP newsletters.) Suite 1200, Jasper Ave NW Edonton, AB T5J 3N6 Telephone: Toll free: Fax: pharacists.ab.ca 16