On the plains of North Dakota, it is well known the amount of hard work and dedication it takes to harvest crops on frozen, unrelenting soil. Looking back at this past year, it is clear that North Dakota pharmacists not only know a thing or two about medication management, but also about sowing the seeds for future pharmacy practice.
Pharmacy practice in North Dakota has always had a unique presence in the country. The Pharmacy Ownership Law in North Dakota states that a pharmacy must be 51% owned by a pharmacist or group of pharmacists. This unique practice climate has thrust North Dakota pharmacy into the legislative spotlight numerous times. It is no surprise that during this past year, the profession has made great strides in implementing progressive laws.
Collaborative practice
North Dakota has had legislation supportive of collaborative practice agreements for pharmacists for almost 20 years. This past year, the state has made innovative steps to expand pharmacists’ role in patient care. A new bill allows pharmacists to enter into collaborative practice agreements with either nurse practitioners or physicians. The bill eliminates the institutional setting requirement and allows pharmacists to practice with collaborative practice agreements regardless of their setting as long as they have access to the medical records of the patient.
This bill sets the groundwork for North Dakota pharmacists to initiate patient assessments and administer point-of-care testing.
Provider status
Pharmacist provider status language is being integrated into multiple state bills thanks to strenuous efforts of pharmacy supporters such as the North Dakota Pharmacists Association (NDPhA). Three bills in particular specifically list pharmacists as health care providers.
The first bill grants pharmacists, as health care providers, limited authority to prescribe, distribute, and dispense naloxone rescue kits for opioid drug overdoses. The second names pharmacists as health care providers for services provided under North Dakota worker’s compensation. The third, which involves the creation of a medication therapy management (MTM) program for Medicaid-eligible patients, specifically names pharmacists as providers entitled for reimbursement for their in-person or telephone MTM services.
All three members of North Dakota’s representatives on Capitol Hill have signed on to their respective
national provider status bills.
Point-of-care testing
There has been a big push for the expansion of point-of-care testing for pharmacies within North Dakota. The state has allowed pharmacies more opportunities to provide these tests by removing previous language from legislation. These tests, waived under the Clinical Laboratory Improvement Amendments, provide an excellent opportunity for North Dakota community pharmacies to expand their patient care services while improving health at both the patient and population level.
Pharmacists are often the most accessible health professional in rural North Dakota communities. Considering the fact that the majority of the state is a rural environment, imagine how convenient it would be for a farmer to be screened and diagnosed for influenza instead of having to drive 1 hour to see the closest available physician. Point-of-care testing is also a great opportunity for North Dakota pharmacists to use collaborative practice agreements. That same farmer may now receive Tamiflu on the spot because of the new North Dakota legislation for collaborative practice agreements.
The ABCs
The strong relationship between the three main practice-influencing bodies in North Dakota is the main driver for advancing the profession. We call these bodies the “ABCs of Pharmacy”—the Association, the Board, and the College. They work together to promote the progression of pharmacy practice and continue to expand the role of pharmacists in health care.
It is evident by the NDPhA vision that provider status continues to be a priority in our state. “We envision a profession that is recognized as a primary health care provider capable of responding to society’s health care needs,” according to the visition statement on NDPhA’s
website.
The Board of Pharmacy is in place to impact patient care in a positive way; they provide support to pharmacists who continually improve the care they provide to the community they serve.
Finally, student pharmacists, the seeds still yet growing, are developing a passion to promote the progression of profession. Recently, our APhA–ASP Chapter brought more than 25 student pharmacists to Bismarck to educate local legislators on pharmacy issues.
From the ABCs and beyond, pharmacists in North Dakota are united in our commitment to the mutual goal of growing pharmacy practice into a prosperous field.