For California pharmacists, the dream of being recognized as health care providers by the state became a reality on October 1 when Gov. Jerry Brown signed SB 493 into law. State Sen. Ed Hernandez, OD, (D-24) wrote the legislation, which will go into effect January 1, 2014. Gaining provider status will expand roles for pharmacists and increase access to pharmacists’ patient care services for Californians.
The new law declares pharmacists are health care providers. It gives new authorities to all licensed pharmacists, establishes an Advanced Practice Pharmacist (APP) recognition, gives new authorities to APPs, and specifies requirements for pharmacists seeking recognition as APPs. It does not address payment. (See page 70 of October’s Pharmacy Today for more information on the new authorities.)
“We appreciate the Governor’s signature on this landmark legislation,” Jon R. Roth, CAE, CEO of the California Pharmacists Association, said in an October 1 statement. “With the implementation of the Affordable Care Act at a time when the number of primary care physicians continues to shrink, we believe this legislation will help ensure that the millions of new patients receiving insurance will be able to access health care services through their local pharmacist.”
Pharmacists from many areas of practice came together in support of this important piece of legislation. The success of these efforts brought a sense of unified pride.
APhA Trustee Nancy A. Alvarez, PharmD, BCPS, FAPhA, felt “pleased and proud of the efforts of the many pharmacists from various sectors of the profession in the state who worked tirelessly in support of the legislation.” Alvarez is Assistant Dean of Experiential Education and Continuing Professional Development at Chapman University’s new School of Pharmacy in Orange, CA.
“You have to give tremendous credit [to those] who showed incredible trust in pharmacists to help create the means by which the level of care available to patients will rise significantly,” said APhA Trustee Michael A. Pavlovich, PharmD, owner of Westcliff Compounding Pharmacy in Newport Beach, CA.
As pharmacists in California look forward to using their expanded roles, the state’s provider status legislation serves as a model for other states, as well as the nation.
The success in the state of California, Pavlovich predicted, “will eventually lead to the changes in federal statutes necessary to move us from a product-centered profession to a knowledge-centered profession.”
“APhA could not be more excited with the progress on provider status being made at the state level. These state successes are incredibly valuable to pharmacy’s pursuit of coverage of pharmacists’ patient care services across the country,” said Stacie Maass, BSPharm, JD, APhA Senior Vice President of Pharmacy Practice and Government Affairs. “California’s new law recognizes the services pharmacists are trained and qualified to provide and the importance of having pharmacists as part of the health care team.”
Maass continued to Today, “APhA is extremely appreciative of the California Pharmacists Association, California’s pharmacists, and the hard work being done by state associations and pharmacists around the country to advance our profession. You are making a difference to patients, to our health care system, and to our profession.”
In a time when health care is evolving rapidly, much remains to be done regarding the concurrent evolution of the roles of the pharmacist. Provider status in California serves as a stepping stone to future efforts. Each step along the way deserves celebration.
The profession’s effort to gain recognition of pharmacists as providers in the health care system is the Association’s number one strategic priority. A massive undertaking on many fronts, APhA’s provider status activities are under way in areas including the federal, state, and private pathways; work with a coalition of 14 pharmacy organizations; and communications.
A sampling of recent activities ranges from a fruitful meeting with executives from 11 state associations hosted at APhA headquarters on September 23, the approval of provider status principles by the pharmacy organizations, continued advocacy for provider status, and the ongoing publication of issue briefs on accountable care organizations (ACOs) for APhA members on pharmacist.com.
“This is just the beginning of the activities,” said APhA Senior Vice President of Pharmacy Practice and Government Affairs Stacie Maass, BSPharm, JD. “Although unified and coordinated involvement of the pharmacy organizations is critical for success, equally—if not more—important is the involvement at the grassroots level.”
Back in January, the Association first announced the launch of the provider status effort and then announced a $1.5-million allocation by the APhA Board of Trustees toward the multimillion-dollar, multifaceted, long-range effort.
APhA views provider status as a means to promote patient access to, and coverage of, pharmacists’ patient care services. The cornerstone of the effort includes recognition of the pharmacist’s critical role in providing patient care services in collaboration with other health care providers on the patient’s health care team, according to Maass.
Executives from 11 state pharmacy associations met with APhA on September 23 to talk about what their successes, opportunities, and challenges at the state level might mean for the national effort to pursue provider status.
APhA worked closely with the National Alliance of State Pharmacy Associations (NASPA) in organizing this year’s annual state meeting—a full day of information and idea sharing.
While most of the afternoon centered on a free-flowing discussion of state-level activities, successes, barriers, opportunities, and needs, the morning included Maass’s update on APhA provider status activities and three presentations by Leavitt Partners—a health care intelligence firm.
Leavitt Partners’ first two presentations were on health care system and policy changes at the federal and state levels. Leavitt Partners’ third presentation was on health care innovation and trends at the state level.
APhA has worked diligently with the other national pharmacy organizations on provider status since the beginning of 2013—first developing principles and now developing language for possible federal legislation or a legislative “ask.”
The Association also is working with other pharmacy organizations to highlight the current evidence supporting the value of pharmacists’ patient care services. Demonstrating the value of pharmacists and their patient care services is central to the work being done in the federal, state, and private pathways, according to Maass.
APhA is pursuing advocacy activities, including educating and lobbying regulators and Members of Congress. Each time APhA goes to Capitol Hill on pharmacy-related issues, provider status also is discussed. The Association is using the APhA Political Action Committee to support provider status activities.
APhA has worked closely with the House Community Pharmacy Caucus, co-chaired by Reps. Austin Scott (R-GA) and Peter Welch (D-VT). With other pharmacy organizations, the Association held a Hill briefing on provider status in June and is organizing a Hill health fair scheduled for November 19. With student pharmacist participation, the health fair is an opportunity to highlight pharmacists’ patient care services.
APhA is developing a series of eight issue briefs on ACOs for APhA members to assist members in identifying opportunities and implementing new services. The ACO briefs are being published at www.pharmacist.com/apha-accountable-care-organization-briefs.
In coordination with NASPA, APhA also helped develop data sheets on the pharmacy environment within each state to highlight innovation and successes at the state level and changes necessary to advance pharmacists as providers. A project supported by the Community Pharmacy Foundation, all 51 of these four-page resources are available at www.pharmacist.com/mtm-state-advocacy-fact-sheets.
For information on progress, news, a question-and-answer document, a one-pager to guide policy makers and payers, and ways to get involved, visit APhA’s special provider status section on its website at www.pharmacist.com/providerstatusrecognition. Sign up for APhA communications or send questions to firstname.lastname@example.org.