11/4/2015. Objective. Detroit Medical Center Background

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1 Pharmacy Technician Licensure: A Hospital System Adventure Deborah A. Isopi, BS Pharm, MBA Pharmacy Manager & Director, PGY1 Pharmacy Residency Harper University Hospital, Detroit Medical Center 11/6/2015 Objective 1. Discuss the challenges that a health system must overcome to employ a licensed pharmacy technician. Detroit Medical Center Background Eight hospital system Five hospitals employ inpatient pharmacy technicians (techs) Children s Hospital of Michigan 26 techs Detroit Receiving Hospital 19 techs Harper University Hospital 51 techs Huron Valley-Sinai Hospital 15 techs Sinai-Grace Hospital 32 techs 1

2 Detroit Medical Center Background Ten outpatient pharmacy facilities Children s Hospital of Michigan (2 sites) 9 techs Detroit Receiving Hospital 7 techs Harper University Hospital (HUH) 12 techs Huron Valley-Sinai Hospital 4 techs Sinai-Grace Hospital (2 sites) 11 techs Cardiovascular Institute 6 techs Hutzel Hospital 3 techs Mail Order 2 techs Detroit Medical Center Background Pharmacy technician responsibilities Fill unit dose carts & automated dispensing cabinets Compound sterile products Controlled substance dispensing Medication reconciliation Pharmacy satellite duties Pharmacy unit inspections Deliveries Retail duties First fill program Lead technicians scheduling, compliance, managing work flow Licensure Timeline December 22,

3 Licensure Timeline September 30, 2014 Governor signed into law Public Act (PA) 285 of 2014 Key points Mandatory licensure for pharmacy technicians Outlined requirements for certification and licensure Public members on Michigan Board of Pharmacy to include one pharmacy technician Challenges No firm effective date No application available Cost Full licensure PTCB certification ($130) $25.00 application & $30.00 license fees Criminal background check - $62.75 Confusion between limited and temporary license 3

4 Challenges Limited License No Pharmacy Technician Certification Board (PTCB) certification Employed for 2 years & at least 1000 hours $25.00 application & $10.00 license fees Valid only for current employer Temporary License No PTCB certification Employed less than 2 years & 1000 hours $25.00 application & $15.00 license fees Valid for 210 days & cannot be renewed Licensure Timeline December 22, 2014 December 22, 2014 Effective Date of PA 285 of 2014 Key points Licensure date of June 30, 2015 On line application becomes available 18 pages Criminal Background Check with Fingerprints Proof of Certification Limited License includes High School Transcripts Verification of Employment 4

5 Challenges Expiration dating of license Paperwork burden for verification of employment including multiple locations High school transcripts Board of Pharmacy (BOP) workload Unpaid parking tickets no license Expiration Dating Pro licensure staff early completion HUH technicians completed in early January License expired on June 30, 2015 Renewal fee of $30.00 Challenges Expiration dating of license Paperwork burden for verification of employment including multiple locations High school transcripts Board of Pharmacy (BOP) workload Unpaid parking tickets no license 5

6 Paperwork Burden Multiple scenarios One site & PTCB certified easy Limited license multiple sites Limited license one site only 14 HUH technicians out of 51 were not certified Verification of employment High school transcripts electronically Criminal background check with fingerprints Paperwork Burden Paperwork Burden 6

7 Challenges Expiration dating of license Paperwork burden for verification of employment including multiple locations High school transcripts Board of Pharmacy (BOP) workload Unpaid parking tickets no license Technician Case AP is a pharmacy technician who has been employed in the HUH inpatient pharmacy department since October He has an active pharmacy technician license from the California Board of Pharmacy and successfully passed the PTCB examination at one time, but let the certification lapse. He began the application process in January Technician Case In March 2015, BOP was contacted and although CA license was active, it was not accepted. AP s application is delayed due to his lack of transcripts from Bangladesh. In April 2015, BOP was contacted to accept transcripts from CA licensure. 7

8 Technician Case Technician Case Asked to supply transcripts in English AP received limited license in May 2015 Challenges Expiration dating of license Paperwork burden for verification of employment including multiple locations High school transcripts Board of Pharmacy (BOP) workload Unpaid parking tickets no license 8

9 Board of Pharmacy Workload Number of initial applications Number of renewals, both technicians & pharmacists Errors in initial applications Board of Pharmacy Workload Board of Pharmacy Workload 9

10 Board of Pharmacy Workload Board of Pharmacy Workload Challenges Expiration dating of license Paperwork burden for verification of employment including multiple locations High school transcripts Board of Pharmacy (BOP) workload Unpaid parking tickets no license 10

11 Challenges On June 1, 2015 techs still needing licensure Children s Hospital of Michigan 12/26 techs Detroit Receiving Hospital 8/19 techs Harper University Hospital 8/51 techs Huron Valley-Sinai Hospital 3/15 techs Sinai-Grace Hospital 16/32 techs Outpatient 37/54 Licensure Timeline June 30, 2015 PA 91 of 2015 signed on June 25, 2015 Key points Amended effective date to October 1, 2015 Limited license includes multiple sites Temporary license expiration date 1 year Comprehensive FAQs available 11

12 Challenges DMC Management required submission by June 30, 2015 Renewals HUH 19 technicians Once licensed, DMC not requiring continuance of certification Licensure Timeline October 1, 2015 Final date that all technicians in State of Michigan had to be licensed DMC Update All DMC technicians have paperwork submitted HUH complete on September 17, 2015 Five temporary licenses in system Nine others still in process in system 12

13 Future Considerations Currently competitive job market Salary adjustment? Hiring full licensed technicians only DMC requiring full licensure by January 1, 2018 Encourage passing PTCB PGY1 residents involved in training sessions Training Pharmacy Billing and Reimbursement Breaking Down the Barriers: Licensing Pharmacy Technician s Annette V. Davis, CPhT Pharmacy Technician Coordinator University of Michigan Health Systems 13

14 Objective Discuss the barriers that Michigan pharmacy technician s faced when Public Act 285 was signed into law and how the University of Michigan Health Systems (UMHS) resolved these barriers. Facts about the University of Michigan Health Systems (UMHS) Three Hospitals: University Hospital C.S. Mott Children s Hospital Von Voightlander W omen s Hospital More facts about UMHS Six Specialty Centers U-M Comprehensive Cancer Center U-M Cardiovascular Center U-M Comprehensive Diabetes Center U-M Depression Center U-M Geriatrics Center W.K. Kellogg Eye Center (Ann Arbor, Brighton, Canton, Chelsea, Grand Blanc, Milford, Northville and Ypsilanti) 14

15 Our Technician Staff W e employ 190 pharmacy technician s We have many technician s employed in specialty or advanced roles These Include: 1. Pharmacy Technician Coordinators 2. Pharmacy Technician Trainer 3. Pharmacy Technician Recruiter 4. Transitions of Care Technician s Barriers technician s faced W hat were the barriers W hat UMHS did to resolve them Information Barriers Date the application would be available Understanding the application Changes in the date for applying What to do if you were licensed in another state Intern license versus pharmacy technician license 15

16 Understanding the various forms of licensing barriers Limited License Temporary License Full License Certification barriers for full licensure Must be Pharmacy Technician Certification Board (PTCB) or National Health Career Association (NHA) certified Financial barriers Certification fee Certification renewal fee License fee Fingerprinting and background check fee Mailing 16

17 Background check and fingerprinting barriers Confusion with the process Completing the process Time barriers: What happens if everything isn t quite right Failure to become certified Issues with background check Difficulties with being licensed in another state Licensing renewal issues In Conclusion: Breaking down the barriers Preplanning Support of the technician team Keeping on top of the situation 17

18 Questions? Eric Roath, Pharm.D. Director of Professional Practice Michigan Pharmacists Association Describe the specific requirements and implementation challenges of the pharmacy technician licensure law. 18

19 1. Licensure mandated as of October 1, Additional amendments made in SB 468: Removal of high school or GED requirement for limited licensed applicants Extension of the temporary license validity duration to one year Allows for limited license technicians working for a pharmacy with multiple locations to work at any of those locations 1. Completing requirements 2. Providing appropriate documentation 3. The question of reciprocation 1. What is the significance of the rules? 2. What does the rule making process look like? 3. Where are we now? 19

20 Request for Rulemaking (RFR) filed with the Office of Regulatory Reform (ORR) Rule Certified by the Legislative Services Bureau Rule Submitted & Certified by ORR RFR Approved by ORR Public Hearing Rule Filed with the Joint Commi8ttee on Administrative Rules (JCAR) Draft Rule Submitted to ORR Regulatory Impact Statement (RIS) submitted to ORR Rule Filed with the State Office and entered into the Admin. Code. 1. Proposed CE Requirements: 5 hours of live CE 1 hour of pain and symptom management 1 hour of patient safety 1 hour of pharmacy law 20 hour total to renew 2. Identifying victims of human trafficking 3. Maintenance of Certification? (Proposed) R Approved pharmacy technician programs. The following programs offer exemption from licensure while the technician is enrolled in the program: (a) A pharmacy technician program that is accredited by the accreditation council for pharmacy education (ACPE). (b) A pharmacy technician program that is offered by a pharmacist education program that is accredited by the accreditation council for pharmacy education (ACPE). (c) A comprehensive curriculum-based pharmacy technician education and training program conducted by a school that is licensed pursuant to the Proprietary Schools Act, 1943 PA 148, MCL to (d) A pharmacy technician training program utilized by a pharmacy or employer that includes specific training in the functions, specified in MCL (1), required to assist the pharmacist in the technical functions associated with the practice of pharmacy 20

21 What employer-based pharmacy technician program exams are approved by the board? Rite Aid Corporation Meijer Inc. Omnicare, Inc. CVS Health The Kroger Co. of Michigan Walgreen Company SpartanNash, Inc. Pharmacy Services Inc. (Program without exam) Target Pharmacy R Requirements for relicensure; pharmacy technician. R Licensure by endorsement. Rule 3. (1) An applicant for licensure by endorsement shall submit a completed application on a form provided by the department, together with the requisite fee. In addition to meeting the requirements of the code and administrative rules promulgated under the code, an applicant shall satisfy both of the following requirements: 21

22 R Licensure by endorsement. (a) Have met the [standard] requirements specified [in the public health code] (b) Meet 1 of the following requirements: (i) If licensed less than 5 years in another state, submit proof that the applicant passed 1 of the approved examinations specified in R (b). (ii) If licensed 5 or more years in another state, the applicant is presumed to meet the requirements of section 17739a(1)(d) of the code, MCL a(1)(d). 1. Appropriate supervision and Tech-check-Tech? 2. Specialty certifications? 3. Degree requirements? 22