PioneerRx dives into three new laws that will change the future of pharmacy practice in the state of Iowa. Two Iowan pharmacists and PioneerRx users — Bill Drilling, co-owner and pharmacist-in-charge of Drilling Pharmacy, and Rick Dotzler, co-owner and pharmacist-in-charge of Pexton Pharmacy — weigh in on the logistics of the new laws and discuss how their pharmacies will be impacted. They also offer insight into where community pharmacy is headed.

Slowly but surely, lawmakers are beginning to grant community pharmacies the recognition they deserve.

Whether it be in day-to-day operations or times of crisis, like the COVID-19 pandemic, community pharmacies have demonstrated strong skill, efficacy, and adaptability; and lawmakers are finally starting to acknowledge it.

From making changes to national policies to updating state and city ordinances, legislators are giving pharmacies more responsibilities and providing them with the resources they need to do it.

More specifically, they are improving pharmacies’ scope of practice, increasing their patients’ access, and passing laws that can help facilitate better care — all of which equals a win for community pharmacy.

Right now, the important new wins are being seen in Iowa, where Governor Kim Reynolds recently passed new laws that will dramatically change the way that pharmacies are run.

Since April, Governor Reynolds has signed three pieces of legislation: HF 514, SF 296, and HF 891. Each of these laws offers unique opportunities for Iowan pharmacies to grow. In addition, they set an example for other states to follow and pave the way for important changes to be made.

Learn more about each piece of legislation and what it means for the future of pharmacy:

Win #1: HF 514

On April 30, 2021, Governor Reynolds passed the first of the three bills, HF 514, in a monumental victory for pharmacies across the state. The law does three main things:

  • It grants pharmacy technicians the ability to perform technical tasks, like dispensing prescriptions, under the supervision of a registered pharmacist
  • It grants pharmacy support personnel the ability to perform non-technical tasks, like administration and prep work, under the supervision of a registered pharmacist
  • It removes the one-year registration limitation for personnel in training to become pharmacist technicians — giving future techs more time to complete their training while still maintaining registration status

In effect, HF 514 increases pharmacy staff’s scope of practice and their ability to serve patients. It leverages the skills of techs and support personnel, increases their responsibilities in the pharmacy, and gives them more time to meet licensing requirements.

Bill Drilling understands the importance of giving staff more responsibilities and sees it as an important part of growing his pharmacy in Sioux City, Iowa.

He says, “If we want to move pharmacy forward, we’ve got to delegate the different tactical functions to our technicians. We’ve got to give them the training and support they need and help them to be successful and take over new roles.” 

In addition to giving staff more responsibilities, HF 514 frees up time for registered pharmacists to take on more specialized services.

Rick Dotzler has relied on technician-driven care at his pharmacy in Harlan, Iowa for years so that he and other pharmacists can focus on clinical care. He sees this new piece of legislation as an opportunity for other pharmacies to do the same.

He explains, “Anything that techs can do that free us up to do more patient care is good. As margins keep eroding on the dispensing side, we need to be able to expand our services to other areas to help patients with their health and help the business’s financial health as well.”

With more evenly delegated tasks, pharmacy staff will be able to provide higher standards of care to patients and will likely experience greater satisfaction in their practice. At the same time, they will have an opportunity to increase revenue and better their business.

Win #2: SF 296

The second piece of legislation, SF 296, was signed into law on May 19, 2021. Alongside HF 514, it further expands pharmacies’ scope of practice into clinical care. SF 296 includes 3 main provisions:

  • It allows pharmacies to order and administer COVID-19 vaccines, according to state protocols
  • It enables pharmacies to offer point-of-care testing for COVID-19, flu, and strep
  • It grants pharmacists the right to enter into collaborative practice agreements (CPAs) with other providers 

Visit these PioneerRx resources to learn how to get a CLIA-Waiver for POC testing and get certified to administer vaccinations.

As a whole, SF 296 increases pharmacies’ rights and responsibilities as healthcare providers. It grants them the ability to test, treat, and vaccinate against common illnesses. In addition, it allows them to expand their range of services and get reimbursed for it. 

Under the new law, both Bill Drilling and Rick Dotzler plan to expand their clinical services and take advantage of the “test and treat” model.

With this service, Bill explains, “A patient will come into the pharmacy and we’ll be able to give them a rapid test, and then in the same visit, we’ll be able to prescribe treatment for them, according to protocol. So in one single visit, we can take care of them.”

Services like test and treat grant patients more convenience and give pharmacies more opportunities to grow.

Bill goes on to say, “Pharmacies are extremely accessible healthcare providers, and laws like this will give us the opportunity to really step up and show what we can do.”

Win #3: HF 891

The third and most recent law, HF 891, was passed on June 16, 2021.

HF 891 outlines new funding requirements for the Department of Human Services, but it also has specific legislation relating to pharmacies, as detailed in Section 31.

In effect, HF 891 does 3 main things:

  • It raises dispensing fee reimbursements from $10.07 to $10.38 per prescription for all pharmacies in the state, regardless of size or location
  • It requires Medicaid managed care contracts to reflect the change in reimbursements
  • It prohibits Medicaid managed care contract organizations (MCOs) from negotiating different rates with national pharmacy chains — per a separate directive that Governor Reynolds issued after community pharmacies expressed concerns about unfair competitive advantages

HF 891 is a move in the right direction for the survival of independent pharmacy. Not only does it increase reimbursements for pharmacies across the state, but it places community pharmacies on an even playing field with larger competitors — by calling for consistent dispensing fees and reimbursement rates.

Considering HF 891’s MCO directive, Rick Dotzler feels relieved.

He says, “If MCOs would have been able to negotiate lower fees with chains, I’m afraid we might have seen some steering to those chains. And that’s not going to happen now.” Rick is optimistic about future legislation and says, “Maybe next year they can get something in the laws that says, ‘We’re not ever going to pay the chains less than independents.’”

With fair rules and regulations in place, community pharmacies are better able to compete with chains and focus on proving their unique advantage to patients: value-based care.

The Future of Pharmacy

Implementing these three pieces of legislation marks a significant step forward for independent pharmacies.

For those in Iowa, it represents a new opportunity to enhance the care that they already provide to patients.

Rick Dotzler commends the organizations involved in generating traction for these new laws, specifically the Iowa Board of Pharmacy.

He explains, “The Board likes to look ahead and see where the practice of pharmacy is going. It does a good job of removing some of the barriers that limit our progress while still maintaining the necessary safety elements.”

Without the collective work of individuals and organizations who support community pharmacy, these changes would not have been possible.

For other pharmacies throughout the country, this legislation represents a possibility for similar changes — which benefit both patients and pharmacies alike. Iowa sets the example, but other states can follow suit and expand their laws.

As far as the future goes, Bill Drilling is hopeful.

He remarks, “I see an extremely bright future for independent pharmacy, even brighter than that of chains. But I think that we have to be innovative, and we have to step up to the plate. We have to keep working and getting into new areas of treatment. Every move we make and every law we pass is a positive step forward.”

PioneerRx fully supports those who are working to improve community pharmacy through governmental efforts and legislation. We are committed to enhancing the value of community pharmacy and clinical services with our technology — and are constantly looking for ways to help enhance your practice with our pharmacy software.

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