December 2013 Florida Pharmacy Journal

The Official Publication Of The Florida Pharmacy Association DEC. 2013

THE CDC’S

TOP

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A look at the top five health concerns from 2013 and the top five threats for 2014

Pharmacy Time Capsule 2013 1989

1964

Twenty-five years ago ■■

The second Pharmacy in the 21st Century (P21) conference was held in Williamsburg. The concept of pharmaceutical care was formally introduced by Hepler and Strand and enthusiastically accepted.

1939 Western Massachusetts School of Pharmacy opened in Willimansett, MA, although it was never accredited.

■■

The survey, Mirror to Hospital Pharmacy, was published. Data included that less than 40 percent of all hospitals employed approximately 2,000 fulltime pharmacists.

1914 1889

Seventy-five years ago ■■

Fifty years ago

One hundred years ago ■■

The federal Harrison Narcotic Act passed to regulate and tax the importation, production and distribution of narcotics.

One hundred twenty-five years ago ■■

Walden University (Meharry Pharmaceutical College) opened in Nashville.

By: Dennis B. Worthen Lloyd Scholar, Lloyd Library and Museum, Cincinnati, OH One of a series contributed by the American Institute of the History of Pharmacy, a unique non-profit society dedicated to assuring that the contributions of your profession endure as a part of America’s history. Membership offers the satisfaction of helping continue this work on behalf of pharmacy, and brings five or more historical publications to your door each year. To learn more, check out: www.aihp.org

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FLORIDA PHARMACY TODAY

florida PHARMACY TODAY Departments 2 Time Capsule 4 Calendar 4 Advertisers 5 President’s Viewpoint 7 Executive Insight 20 Buyer’s Guide

VOL. 76 | NO. 12 DECEMBER 2013 THE OFFICIAL PUBLICATION OF THE FLORIDA PHARMACY ASSOCIATION

Features

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Adherence — It Only Takes a Minute to Be Heart Healthy CDC’s Top Ten A Look at The Top Five Health Concerns From 2013 and The Top Five Threats For 2014

Alligator Management

DECEMBER 2013

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FPA Calendar 2013 - 2014

DECEMBER 25-26 Holidays - FPA Office Closed JANUARY 1

FPA Office Closed

11

Young Pharmacist Leadership Conference Orlando

12

FPA Strategic Planning Retreat Orlando

20

Martin Luther King Day FPA Office Closed

25

FPA Law and Regulatory Conference Sandestin

31

Last day to submit election ballots FEBRUARY

4-5

28

Florida Board of Pharmacy meeting Orlando

MARCH 4

Legislative Session Begins

10-11 Florida Pharmacy Health Fair and Legislative Days Tallahassee 15

Deadline to Submit Resolutions

22-23 FPA Council and Committee meetings/Board of Directors meeting 28-31 APhA Annual Meeting Orlando APRIL 1-2

Florida Board of Pharmacy meeting Tampa

5-6

FPA Clinical Conference Tampa

18

Good Friday, FPA Office Closed

20 Easter

Awards Nomination Deadline

For a complete calendar of events go to www.pharmview.com Events calendar subject to change CE CREDITS (CE cycle) The Florida Board of Pharmacy requires 10 hours LIVE Continuing Education as part of the required 30 hours general education needed every license renewal period.

Pharmacists should have satisfied all continuing education requirements for this biennial period by September 30, 2015 or prior to licensure renewal. Consultant pharmacists and technicians will need to review their licenses and registrations by December 31, 2014.

For Pharmacy Technician Certification Board Application, Exam Information and Study materials, please contact the FPA office.

For More Information on CE Programs or Events: Contact the Florida Pharmacy Association at (850) 222-2400 or visit our Web site at www.pharmview.com

Mission Statements: of the Florida Pharmacy Today Journal

The Florida Pharmacy Today Journal is a peer reviewed journal which serves as a medium through which the Florida Pharmacy Association can communicate with the profession on advances in the sciences of pharmacy, socio-economic issues bearing on pharmacy and newsworthy items of interest to the profession. As a self-supported journal, it solicits and accepts advertising congruent with its expressed mission.

of the Florida Pharmacy Today Board of Directors

The mission of the Florida Pharmacy Today Board of Directors is to serve in an advisory capacity to the managing editor and executive editor of the Florida Pharmacy Today Journal in the establishment and interpretation of the Journal’s policies and the management of the Journal’s fiscal responsibilities.

The Board of Directors also serves to motivate the Florida Pharmacy Association members to secure appropriate advertising to assist the

Journal in its goal of self-support.

Advertisers EPC...................................................................... 15 HCC...................................................................... 3 KAHAN HEIMBERG, PLC............................. 15 PPSC.................................................................... 15

CONTACTS FPA — Michael Jackson (850) 222-2400 FSHP — (850) 906-9333 U/F — Dan Robinson (352) 273-6240 FAMU — Leola Cleveland (850) 599-3301 NSU — Carsten Evans (954) 262-1300 DISCLAIMER Articles in this publication are designed to provide accurate and authoritative information with respect to the subject matter covered. This information is provided with the understanding that neither Florida Pharmacy Today nor the Florida Pharmacy Association are engaged in rendering legal or other professional services through this publication.

If expert assistance or legal advice is required, the services of a competent professional should be sought. The use of all medications or other pharmaceutical products should be used according to the recommendations of the manufacturers. Information provided by the maker of the product should always be consulted before use.

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FLORIDA PHARMACY TODAY

E-MAIL YOUR SUGGESTIONS/IDEAS TO dave@fiorecommunications.com

The President’s Viewpoint TERRY GUBBINS , FPA PRESIDENT

W

“And the Winner Is...”

e have completed our first annual student membership drive, and the numbers are impressive! I want to thank all of the FPA members (pharmacists and students), who made this event successful.

To remind you of the specifics, the pharmacy school with the highest percentage of students as members of FPA will receive a $1,000 check from us. This was also the first year of our $20 one-time membership fee to cover the student’s FPA membership during their entire school career. No need to renew every year!

I am proud to say that we now have over 1,300 student members in FPA! And, just like football in the Sunshine State, our schools were very competitive and made a real race out of the membership drive. Our Top Three schools all have over 40 percent of their students as members of FPA. The No. 1 pharmacy school in the state, with the highest percentage of its students as members of FPA, is the

University of South Florida, at 48 percent. Congratulations, Bulls! Following close behind the Bulls, only 2 percentage points away, is the University of Florida, at 46 percent. Great job, Gators!

Rounding out our Top Three schools is Florida A&M, with 41 percent. Over 250 Rattlers are members of FPA! Now, with over 1,300 student members in FPA, we need to keep you engaged and active in FPA. Please join us January 11 in Orlando for our first annual Young Pharmacist Leadership Conference. You can register on our website in advance or at the door on January 11. Whatever you do, please join us. And don’t forget to join us for Legislative Days, March 10 and 11, in Tallahassee. We had 400 students attend last year. How many of our 1,300 student members will be able to join us this year? You will also be able to register for this on our website as we get closer to March.

Again, thanks to everybody who made this student membership drive a

Terry Gubbins 2013-2014 FPA President

success. Congratulations to the University of South Florida for winning the contest. And WELCOME to the over 1,300 student members! n

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2013 FPA Board of Directors The Florida Pharmacy Association gratefully acknowledges the hard work and dedication of the following members of the FPA leadership who work diligently all year long on behalf of our members.

Goar Alvarez............................................................................. Chairman of the Board Terry Gubbins...............................................................................................FPA President Suzanne Kelley......................................................................................... President Elect Alexander Pytlarz................................................................................................Treasurer Gary Koesten.............................................Speaker of the House of Delegates Bob Parrado....................................Vice Speaker of the House of Delegates Tim Rodgers, Director........................................................................................... Region 1 Michael Hebb, Director ......................................................................................Region 2 Stephen Grabowski, Director .......................................................................Region 3 Raul N. Correa, Director ...................................................................................Region 4 Jason Beattie, Director ....................................................................................Region 5 Scott Tomerlin, Director.....................................................................................Region 6 Kimberly Jones, Interim Director................................................................ Region 7 Raul Gallo, Director.................................................................................................Region 8 Nadine Seabest, Interim Director...............................................................Region 9 Richard Kessler...................................................................................... President FSHP Michael Jackson........................................Executive Vice President and CEO

Florida Pharmacy Today Journal Board Chair......................................................Jennifer Pytlarz, jlc_rxdoc@hotmail.com Vice Chair......................................................... Don Bergemann, don@bceinfo.com Treasurer....................Stephen Grabowski, sgrabowski@seniormmc.com Secretary...................................................................Stuart Ulrich, Stuarx@aol.com Member.................................................Joseph Koptowsky, docjik1215@aol.com Member........................Rebecca Poston, rebecca_poston@doh.state.fl.us Member....................................................... Carol Motycka, motycka@cop.ufl.edu Member........................................................Cristina Medina, cmmedina@cvs.com Member................................................................Norman Tomaka, FLRX9@aol.com Member................... Verender Gail Brown, brownvgrx4304@hotmail.com Executive Editor................Michael Jackson, mjackson@pharmview.com Managing Editor...................Dave Fiore, dave@fiorecommunications.com

PHARMACY BRIEFS Compounding Bill Passes Senate In Washington, D.C., the Senate passed H.R. 3204 related to compounding and track and trace of prescription drugs. According to the International Academy of Compounding Pharmacists, if H.R. 3204 were signed into law

by President Obama, traditional compounding would continue to be exempt from the act’s manufacturing requirements. Mass producing compounders will have to register with the Food and Drug Administration as outsourcing facilities and subject to laws required of prescription drug manufacturers.

Also included in the legislation is language designed to create a nationwide tracking system for prescription drugs to keep counterfeit and stolen drugs out of the distribution system.

This is very similar to the pedigree program that has been in place here in Florida for a number of years. Prescription drug wholesaling and manufacture licensing in this state is within the Bureau of Drugs, Devices and Cosmetics of the Department of Business and Professional Regulation.

New Online Board of Pharmacy Applications Available The Florida Department of Health Division of Medical Quality Assurance See Briefs, continued on page 8

JOIN TODAY! See "Viewpoint", continued on page 6 6 |

FLORIDA PHARMACY TODAY

Florida Pharmacy Association

Executive Insight

BY MICHAEL JACKSON, RPH MICHAEL JACKSON, BPHARM, EVP & CEO, FLORIDA PHARMACY ASSOCIATION

I

The Price is Right. Or is it?

t seems that there is always a controversy surrounding prescription drug pricing. This has been a mystery and puzzle that the passage of time never seems to address. Consumers have become so frustrated over the years with prescription drug pricing that the government has been asked to intervene to provide more clarity.

Websites have been developed over the years to help consumers make provider choices based on prescription drug pricing. Florida has such a resource with a partnership between the Florida Attorney General’s Office and the Agency for Health Care Administration. Members should take a peek at the state-managed website. The prices in this site are presumably updated monthly.

So what are the latest trends in prescription drug pricing?

The Florida Pharmacy Association receives a host of calls each day on various pharmacy issues from our membership. A large number of calls are related to sudden and significant increases in the cost of certain prescribed medications with no real reason for the increase. It has been suggested that some of the increases are related to the implementation of the Affordable Care Act provisions that may limit price increases at some point in the future. If this is the case, then manufacturers may have some uncomfortable explaining to do.

Generally, the prices of commodities increase and decrease with economic factors such as supply, demand and the cost to produce and distribute. None of these issues seem to be the case for certain products that have been on the market for many years and may have multiple suppliers. If our readers are looking for an answer to this question, it is disappointing that the answer

cannot be found in this article. The Florida Pharmacy Association does not collect pricing information for prescription drugs.

What we can share with you is that these pricing adjustments are creating significant issues for pharmacy businesses that need to be addressed. For example, we are aware that prices may change each time a prescription drug is purchased by a pharmacy. We are also aware that the typical pharmacy has a

The Florida Pharmacy Association does not collect pricing information for prescription drugs. large percentage of their business processed though third-party programs and that payment for these pharmacy services are determined by contract.

Many of these contracts may include a maximum allowable cost list or MAC list. What our members are telling us is that the cost of certain prescription drugs are changing at an alarming rate; however the cost basis in MAC pricing programs has not keep pace with the changes. This may result in a pharmacy dispensing medications at or below the cost of acquisition.

So what can be done about this issue?

The pricing of prescription drugs cannot be influenced by the Florida

Michael Jackson, B.Pharm

Pharmacy Association. Any efforts to do so could create serious legal issues.

Members are encouraged to discuss pricing-related issues in your pharmacy with state policy makers such as your state representative and senator or congressman.

The current system of reimbursement for pharmacy businesses and the way MACs are being used today is harmful to both small and large businesses. It could have an effect on patient access to certain medications as pharmacies begin reviewing the types of services they are able to provide. The FPA has already been interviewed by a south Florida news station and discussed with key members of the Florida Legislature on this issue.

Questions should be raised by purchasers of prescription drug services clarifying MAC pricing. Perhaps a policy statement by the Florida House and Senate on the transparency of MAC pricing should be considered. n

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FPA STAFF

Executive Vice President/CEO Michael Jackson (850) 222-2400, ext. 200

Director of Continuing Education Tian Merren-Owens, ext. 120 Controller Wanda Hall, ext. 211

Educational Services Office Assistant Stacey Brooks, ext. 210 Coordinator of Membership Christopher Heil, ext. 110

FLORIDA PHARMACY TODAY BOARD Chair............................................. Jennifer Pytlarz, Brandon Vice Chair...................Don Bergemann, Tarpon Springs Treasurer...............................Stephen Grabowski, Tampa Secretary.........................Stuart Ulrich, Boynton Beach Member..................................... Joseph Koptowsky, Miami Member..............................Rebecca Poston, Tallahassee Member.............................. Carol Motycka, St. Augustine Member....................................Cristina Medina, Hollywood Member................................. Norman Tomaka, Melbourne Member..............................Verender Gail Brown, Orlando Executive Editor.........Michael Jackson, Tallahassee Managing Editor.........................Dave Fiore, Tallahassee

This is a peer reviewed publication. ©2013, FLORIDA PHARMACY JOURNAL, INC. ARTICLE ACCEPTANCE: The Florida Pharmacy Today is a publication that welcomes articles that have a direct pertinence to the current practice of pharmacy. All articles are subject to review by the Publication Review Committee, editors and other outside referees. Submitted articles are received with the understanding that they are not being considered by another publication. All articles become the property of the Florida Pharmacy Today and may not be published without written permission from both the author and the Florida Pharmacy Today.

The Florida Pharmacy Association assumes no responsibility for the statements and opinions made by the authors to the Florida Pharmacy Today.

The Journal of the Florida Pharmacy Association does not accept for publication articles or letters concerning religion, politics or any other subject the editors/ publishers deem unsuitable for the readership of this journal. In addition, The Journal does not accept advertising material from persons who are running for office in the association. The editors reserve the right to edit all materials submitted for publication. Letters and materials submitted for consideration for publication may be subject to review by the Editorial Review Board.

FLORIDA PHARMACY TODAY, Annual subscription - United States and foreign, Individual $36; Institution $70/year; $5.00 single copies. Florida residents add 7% sales tax.

Pharmacy Briefs, continued from page 6

announces that some pharmacy professions may now apply online. This process will eliminate mailing time and expedite your application. Apply online, using your user ID and password, and receive a response within 10-13 business days.

Once applicants create an account in the Online Licensure Application using an email address and password, they will have up to a year to complete the application and pay the application fee. The online tool is dynamic and keeps the applicant informed of any deficiencies and the current status of their application. It can be used by the following applicants who wish to apply and pay using a credit or debit card: ■■ Pharmacy interns, both U.S. and foreign graduates ■■ Registered Pharmacy Technicians ■■ Consultant Pharmacists ■■ Nuclear Pharmacists ■■ Registered Pharmacy Technician training programs To access the Online Licensure Application, go to: ■■ www.FLHealthSource.com ■■ Select the Apply for a License - the Practitioner Services page is displayed ■■ Click on Create an Account ■■ Choose Board of Pharmacy from the Board/Council dropdown menu.

■■ Choose your profession ■■ Enter email address ■■ Create a password FPA Leadership Election Tool Now Available The 2014 election of Florida Pharmacy Association (FPA) officers is now underway. Members should have received a postcard with ballot instructions on how to select your next FPA president and regional director. We are using an electronic balloting system to

make it easy to make your selection of candidates. All you will need to do is to log into www.pharmview.com with your username and password. The polls will be kept open until midnight, January 31, 2014. A committee of election canvassers will be assembled to certify the election and the winners will be announced in February. Watch your mailbox for your ballot post card.

FPA Meets with Florida’s Attorney General Staff FPA visited with Rob Johnson, Director Legislative and Cabinet Affairs and Matthew Dunagan, Chief Policy Analyst, Prescription Drug and Special Projects Section of the Office of the Attorney General (AG) to discuss our interest in sustainable funding of the Prescription Drug Monitoring Program (PDMP). Attending on behalf of the FPA, in addition to FPA’s CEO Michael Jackson, were Robert Beck and Claudia Davant of Adams Street Advocates and John Lockwood, General Counsel of the FPA. Our goal for this meeting was to share the FPA’s interest in PDMP and

FLORIDA PHARMACY ASSOCIATION

610 N. Adams St. • Tallahassee, FL 32301 850/222-2400 • FAX 850/561-6758 Web 8 Address: | F L O Rhttp://www.pharmview.com IDA PHARMACY TODAY

See Briefs, continued on page 14

Adherence — It Only Takes a Minute to Be Heart Healthy Take a minute, save a life. The statistics on cardiovascular health in this nation are sobering. Not only is heart disease, including stroke, the leading cause of death in the United States, but every 25 seconds an American will have a coronary event, and about every minute someone will die from one. Heart disease isn’t known as “the silent killer” without a reason. The importance of adherence is especially heightened with cardiovascular medications, which can pose a greater risk of adverse events if doses are missed or suddenly stopped, even if the patient is “feeling fine” while their blood pressure skyrockets.

In his presidential address, Dr. Ralph Sacco, MD, FAHA, president of the American Heart Association, said that “we are facing a global crisis, and must work together to improve the health of our patients, the public, and ourselves.”

To that end, his association has set an ambitious, 10- year goal to improve the cardiovascular health of all Americans, by reducing the occurrence of cardiovascular diseases and stroke deaths by 20 percent by the year 2020. The AHA has identified seven factors and behaviors for ideal cardiovascular health, something we at NCPA believe every community pharmacist can have a hand in promoting, both through improving medication adherence and patient education.

They are called “Life’s Simple Seven,” core elements to building healthier lives. Sacco noted that these factors are not new, but the approach to addressing them is. By making the distinction

of referring to them as ‘health factors’ as opposed to ‘risk factors’, the AHA believes that this will help patients to “understand and embrace the benefits of healthy living.” What are they? A combination of ideal levels (blood pressure, blood sugar, and cholesterol), and lifestyle choices (diet, physical exercise, appropriate weight, and non-smoking), something community pharmacists counsel their patients on every day. Reinforcing adherence can be a simple act; taking a minute to discuss diet or check blood pressure, done consistently can make a real difference. There’s a good chance many of your patients are not meeting their goals, so don’t pass up the opportunity to talk with them about their health factors whenever they are picking up a new prescription, or you’ve noticed a dosage increase in their medications.

The AHA acknowledges that they will not be able to improve the cardiovascular health of the country alone, and that what’s needed is more collaboration and interdisciplinary partnerships. NCPA sees their goal as being synergistic with what we are trying to achieve with medication adherence and can’t wait to see what community pharmacists can do to improve the heart health of their patients.

Take a minute to talk to your patients about the ABCs of heart disease: A, as in hemoglobin A1C B, for blood pressure C, for cholesterol

Who knows, with those ABCs, you might just save a life.

Do you have an adherence idea, tip, or program that is working in your pharmacy? Let us know. Send an e-mail to adherence@ncpanet.org.

Reprinted with permission from National Community Pharmacists Association in the February 2011 issue of America’s Pharmacist. For more information about NCPA, visit www.ncpanet.org.

In his presidential address, Dr. Ralph Sacco, MD, FAHA, president of the American Heart Association, said that “we are facing a global crisis, and must work together to improve the health of our patients, the public, and ourselves.”

DECEMBER 2013

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The CDC’s Top Ten A Look at The Top Five Health Concerns From 2013 and The Top Five Threats For 2014 Source: Centers for Disease Control and Prevention

As 2013 comes to a close, CDC looks back on the top five health concerns of the year while preparing for the projected health threats of 2014. Read the whole story: CDC’s 2013: A Year in Review.

Let’s take a look back through some of the highlights of 2013.

Tips From Former Smokers Campaign Launched in March of 2012, this campaign was the first-ever paid national tobacco education campaign. In 2013, a study released by CDC indicated that more than 200,000 Americans had quit smoking and 1.6 million smokers attempted to quit smoking immediately. These results exceed the campaign’s original goals of 500,000 quit attempts and 50,000 successful quits.

Listeria & Advanced Molecular Detection, CDC uses Advance Molecular Detection to reduce impact of Listeriosis Listeria, ranking third as a cause of death from major foodborne germs in the United States, sickens about 1,600 people each year. In 2013 CDC used whole genome sequencing along with diagnostic testing for the first time to help clarify which patients’ illnesses were related to an outbreak of listeriosis associated with consumption of contaminated cheese. The use of new Advanced Molecular Detection tools allowed CDC to successfully define the outbreak strain and more easily and quickly show which illnesses are part of an outbreak and respond sooner.

Million Hearts®, Preventing Heart Attacks and Strokes CDC released a Vital Signs in 2013 showing that at least 200,000 deaths each year from heart disease in the U.S. could be prevented through changes by individuals, such as stopping smoking, more physical activity, and less salt in the diet; community changes to create safe places to exercise and smoke-free areas; improvements in managing high blood pressure, high cholesterol, and diabetes; and improvement in acute care, secondary prevention, and rehabilitation. CDC also developed and distributed new resources, recommendations, and protocols, to help health care professionals, communities, and individuals work together to contribute to the Million Hearts® goal of preventing 1 million heart attacks and strokes by 2017.

Healthcare – Associated Infections, Eliminating Healthcare-Associated Infections On any given day, about 1 in every 20 hospitalized patients has an infection caused by receiving medical care. In 2013, CDC has found that bloodstream infections in patients with central lines have decreased by 44% and surgical-site infections have decreased by 20% since 2008, and that following CDC protocols could cut some dialysis-related bloodstream infections in half.

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Deaths from prescription painkillers have reached epidemic levels in the past decade, and more than 16,500 people died from painkiller overdoses in 2010.

Celebrating 10 Years of PEPFAR, Fighting International HIV/AIDSÂ Throughout the past decade, CDC has been advancing science and innovation, and making strategic investments to build the capacity of host countries to lead their own responses to the AIDS epidemic. In 2013, PEPFAR prevented the one millionth baby from being infected with HIV and has 6.7 million people on treatment, with incidence falling in nearly all PEPFAR countries.

America’s health protection agency previews the five health threats that loom for 2014.

Antibiotic Resistance and Advanced Molecular Detection, The End of the Antibiotic Era Every year, more than two million people in the U.S. get infections that are resistant to antibiotics and at least 23,000 people die as a result. In 2014, CDC will continue to work with federal, state, and local partners towards improving antibiotic use, preventing infections and the spread of resistance, gathering data on antibiotic-resistant infections, and developing diagnostic tests to track the development of resistance.

Preventing Prescription Drug Abuse and Overdose, Prescription Drug Overdose: A Growing Epidemic Deaths from prescription painkillers have reached epi-

demic levels in the past decade, and more than 16,500 people died from painkiller overdoses in 2010. CDC continues to track prescription drug overdose trends to better understand the epidemic and in 2014, will continue to focus on comprehensive state efforts to develop, implement and evaluate promising strategies to prevent prescription drug abuse and overdose.

Global Health Security, Securing our Global Health Borders Infectious disease outbreaks, whether natural, intentional, or accidental, are still among the foremost dangers to human health and the global economy. Through strategic investments in critical public health systems, CDC will be working more closely with Ministries of Health to increase their ability to prepare for and respond to public health threats and reduce the risk of these threats crossing borders.

HPV Vaccination, HPV Vaccine is Cancer Prevention For both boys and girls, HPV vaccination rates continue to be well below the Healthy People goals for 2020, leaving an entire generation susceptible to HPV-related cancers. In 2014, CDC will continue to monitor adolescent vaccination coverage levels and will continue to outreach and education to clinicians through continuing medical education, partnership with professional associations, and other educational opportunities to help strengthen vaccine recommendations and eliminate missed opportunities for HPV vaccination.

Polio, A World Without Polio The world is closer than ever to ending polio everywhere, thanks to the efforts of CDC and the Global Polio Eradication Initiative. However, challenges must be addressed in 2014 to meet the goal of eradicating polio once and for all. CDC is working together as part of a committed global effort to change history and end polio forever.

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Alligator Management

By Wayne Cheatum deficiencies didn’t happen on my watch.

However, I now owned them and no matter what, I was expected to execute the corrective actions right away.

So, how to attack the alligators while continuing to drain the swamp? I used five steps to gain control of the situation.

Draining the swamp is hard, but doing so while fending off alligators can present a real challenge. As a pharmacy leader or manager, just getting the job done every day is hard enough. How do you make sure the job gets done when you are presented with a whole new set of requirements that you didn’t expect?

Let me tell you about my swamp and the alligators that tried to do me in. Assigned as an Interim Director of Pharmacy (DOP) in a large medical/trauma hospital filled to capacity, I took over without any face time or turnover with my predecessor. This ensured that my hands were full learning about the staff and supervising the day-to-day activities while also trying to determine the compliance status of my new facility.

Needless to say, the job itself was daunting, but the staff was doing a great job taking care of patients (draining the swamp) and I was making good progress in finding and fixing problems.

However, a short while after I took over as director, the alligators struck.

First, the State Board of Pharmacy inspector appeared on the doorstep to assess USP 797 compliance. The next day, the Ethics and Compliance Officer arrived to check on our compliance with controlled substance requirements. And then 11 days later, a team of five showed up for an operational assessment to determine our compliance status. At the end of two weeks, I had 60 deficiencies (alligators) nipping at my ears, each one requiring immediate action.

Perhaps this is a good spot for a newly assigned DOP to be in because the 12

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Set the Direction ■■ Assign Priorities Focus the Efforts ■■ Delegate Activities Track Success Perhaps the first step is the most critical. Set the Direction. Defining all of the action items that need to be accomplished is critical. In my case, the three different assessments clearly defined my requirements. I consolidated them into one list, which helped me get a sense of the total requirements. It is important to get them down on paper in a format that makes sense to you.

I used an action plan spreadsheet that included the deficiency, what needed to be done, a priority system, responsibilities, outcome expected and a deadline for completion. Use what works for you (see chart below).

Problem, Issue, or Deficiency

Finding, Recommendation, Activity

Priority

Next is to determine which item or items are most important. Assign Priorities. Not everything can be done at the same time. If you try to shotgun it, you do nothing very well and everything poorly. And remember, you are still responsible for making sure the day-to-day pharmacy activities continue unabated while working on this new set of tasks. Keep the staff focused on the pharmacy and set your priorities on the most important action items. In my case, the Board of Pharmacy was No. 1 and then the controlled substance issues came next.

Step three is to Focus Your Efforts.

This is related to prioritization. However, it is really marshaling your resources to apply the maximum effort to get the next most critical task done. If you have a need that requires you to use the same people to accomplish two different tasks, don’t split your resources.

Get the highest priority task done first, and then redirect your staff to the second. Continually reassess your priorities based on the ever-changing arena in which you live. Sometimes new alligators arrive or new swamp-draining requirements appear that need to be integrated into the action plan.

Responsible Person

Outcome Expected

Estimated Completion

“It’s hard to remember that your primary purpose is to drain the swamp when you’re up to your ears in alligators” One of the most important things to learn is to Delegate. Don’t go it alone.

Engage your staff in what needs to be done. Share the wealth. One of my mentors expressed it this way, “None of us is as smart as all of us.” Task them, but give them good guidance. Be specific in what you want to see

at the outcome and expect them to complete the tasks. When you delegate, you must hold the person accountable for completion. Otherwise it ends up back on your desk. Give them the joy of killing a few alligators.

Last but not least is to Track Success. Share your action plan with your staff and get their buy-in. Let them participate in making the improvements.

Pharmacy is a team effort so keep the team involved and informed. Show them what they have accomplished.

Make sure to follow up with every item that you delegated. Show progress at every staff meeting. Your staff will appreciate where you have been and what you have accomplished together.

The staff and I survived. We completed all but four of the tasks in the months after the alligators arrived. I left confident that I had left the pharmacy better than I found it and that the swamp would continue to be drained.

Besides, I had a chance to kill a few alligators in the interim.

So, see if you can apply these

steps to your swamp.

Set The Direction, Assign Priorities, Focus Your Efforts, Delegate and Track Success. Then, you can kill a few alligators of your own.

Wayne Cheatum is a retired Air Force Colonel and Pharmacist. He previously led the largest pharmacy in the Air Force at Lackland AFB in San Antonio, Texas.

Wayne is currently a Transitional Leader with CompleteRX, a national pharmacy management company.

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Pharmacy Briefs, continued from page 8

our ideas on possible funding sources. We suggested to the AG’s office that pharmacists’ licensure fee trust funds have traditionally exceeded what is needed to regulate our profession.

While the idea and proposal from FPA’s leadership did not specifically expand the funding of PDMP beyond the available pharmacy licensure fee trust funds we did indicate that we are encouraging the other provider groups to join with us in our campaign to help keep PDMP going. Some of the benefits of PDMP program include helping pharmacists to manage clinical patients being treated with addictive pain medications, reduction in doctor shopping and deaths.

The FPA is challenging the other health professions to join this campaign.

FPA Raises Concerns over Tramadol Transition to Controlled Substance Status In our FPA Breaking News section on the Pharmview.com home page we announced that the Drug Enforcement Administration is giving consideration to adding tramadol to the list of con-

trolled substances. A comment period to the Department of Justice has been opened until January 3, 2014. This issue was discussed at a recent meeting of the FPA Board of Directors in Orlando. The FPA Board of Directors believes that this drug should be listed as a drug of concern and added to the list of reportable drugs within the PDMP program rather to the list of controlled substances. The position of the FPA was shared with the Florida Office of Attorney General.

Joint Op-ed Calls for Expanding Services Offered by Pharmacists (from NCPA) Prior to the NCPA annual convention and trade show in Orlando, the Orlando Sentinel published an op-ed, authored jointly by NCPA and the FPA, calling for the government to recognize pharmacists as healthcare providers. With the Affordable Care Act taking effect and the expectation that millions of new beneficiaries will join the healthcare market in the coming months, there will be additional strain

on a system that is already experiencing a shortage of doctors, and that shortage will continue to grow. Given the training pharmacists receive, they can help fill the void in access to care, yet the fact that pharmacists are not recognized as providers prevents them from being compensated for the services they provide.

Gaining pharmacist recognition as providers is a priority for NCPA and NCPA staff will be working diligently with policymakers to give them a better understanding of the positive impact such recognition would have on the healthcare system as a whole. Pharmacist recognition as providers is good policy and good medicine.

The All-new FPA Website is Now Online Pharmview 3.0 offers more features, greater access and increased opportunities for member interaction.

■■ ■■ ■■ ■■

Keep your dues current with the most accurate information in your membership accounts Register for conferences and educational programs Register online and you can print a receipt instantly without having to wait for one to be mailed to you Your continuing education credits earned through FPA programs will be published as transcripts and certificates in your member record

Take advantage of all the possibilities and visit your new website today at www.pharmview.com.

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PPSC is Your Partner for Success For more on how PPSC can maximize the potential of your independent pharmacy, visit www.ppsconline.com or call toll-free 888-778-9909.

Board of Pharmacy Licensure Disciplinary Proceedings Compounding Violations, Pharmacy Audit Disputes Mergers and Acquisitions Commercial, Civil and Criminal Proceedings KAHAN ◆ HEIMBERG, PLC

Pharmacist Attorney Brian A. Kahan, R.Ph., J.D. Licensed Florida Pharmacist and Attorney

STATEWIDE REPRESENTATION 561-392-9000 bkahan@kahanlaw.com 2300 N.W. Corporate Blvd., Suite 123 Boca Raton, FL 33431 The hiring of a lawyer is an important decision that should not be based solely upon advertisements. Before you decide, ask us to send you free written information about our qualifications and experience.

e bl la ai / 7 Av 24

A Pharmacist And A Lawyer

PHARMACY CONSULTING & STAFFING SOLUTIONS NO ONE PROVIDES BETTER SERVICE! Pharmacist & Technician Staffing Pharmacy Management Temporary & Vacation Coverage Open a Pharmacy (Retail & Compounding) Licensing for All States Medicaid & BOP Inspection Preparation Assistance with Insurances Policy & Procedures Buy/Sell a Pharmacy WE ARE PROVEN TO BE THE MOST RELIABLE AND TRUSTED STAFFING & CONSULTING FIRM EPC is Pharmacist Owned and Operated www.epcepc.com (855) 374-1029 DECEMBER 2013

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S AV E

T H E D AT E — J U LY

9-13, 2014

124th Annual Meeting and Convention of the Florida Pharmacy Association Marriott Harbor Beach Golf Club Resort and Spa 3030 Holiday Drive Ft. Lauderdale, Florida 33316 For room reservations call (888) 789-3090

JULY 9-13, 2014 Florida Pharmacy Association 610 North Adams Street Tallahassee, Florida 32301

Phone: (850) 222-2400 Fax: (561) 6758 www.pharmview.com

The Florida Pharmacy Association (FPA) is accredited by the Accreditation Council of Pharmacy Education as a provider of continuing education. The FPA is also a Florida Department of Health approved provider of continuing education and reports to CEBroker

CALL FOR RESOLUTIONS TO THE 2014 HOUSE OF DELEGATES The House of Delegates Board of Directors will meet in March 2013 to review and approve resolutions for the Annual Meeting. The deadline for submitting resolutions is March 15, 2014! PLEASE NOTE THIS DEADLINE. The following information will be needed when submitting resolutions: 1. Name of organization: The name of the organization submitting the resolutions(s); 2. Name and telephone number of individuals: A contact in the event clarification or further information is needed; 3. Problem: A statement of the problem addressed by the resolution; 4. Intent: A statement of what passage of the resolution will accomplish; 5. Resolution Format: Please type and use double spacing.

TITLE OF RESOLUTION NAME OF ORGANIZATION WHEREAS , AND

WHEREAS :

THEREFORE BE IT RESOLVED (THAT THE FPA OR SUBDIVISION OF FPA)

CONTACT NAME AND PHONE #: PROBLEM: INTENT:

Return this form to: Membership Coordinator, Florida Pharmacy Association, 610 North Adams Street, Tallahassee, Florida 32301 or fax (850) 561-6758

DECEMBER 2013

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C A L L

F O R

APhA Foundation and NASPA Bowl of Hygeia Awarded to a pharmacist for outstanding community service above and beyond professional duties. The use of the following selection criteria is required: ■■ The recipient must be a Florida licensed pharmacist and a member of FPA. ■■           ■■ T recipient has not previously received the award.

■■               two  on its award committee or an officer of the association in other than an ex officio capacity.

■■   has compiled an outstanding record of community service, which, apart from his/her specific identification as a pharmacist, reflects well on the profession.

James H. Beal Award Awarded to the "Pharmacist of the Year."

Criteria: ■■   must be a Florida registered pharmacist and a member of the FPA. ■■   has rendered outstanding service to pharmacy within the past five years.

Technician of the Year Award Awarded annually to a Florida pharmacy technician who is recognized for his/her outstanding performance and achievement during his/her career.

Criteria: ■■ Candidate must be a member of the Florida Pharmacy Association for at least two years.

■■ Candidate must have demonstrated contributions and dedication to the advancement of pharmacy technician practice.

■■ Candidate must have demonstrated contributions to the Florida Pharmacy Association and/or other pharmacy organizations.

■■ Candidate must have demonstrated

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FLORIDA PHARMACY TODAY

N O M I N A T I O N S commitment to community service.

■■ Candidate is not a past recipient of

this award.

R.Q. Richards Award This award is based on outstanding achievement in the field of pharmaceutical public relations in Florida.

Criteria: ■■  recipient must be a Florida registered pharmacist and a member of the FPA. ■■   has displayed outstanding achievement in the field of pharmaceutical public relations in Florida.

Frank Toback/AZO Consultant Pharmacist Award Criteria: ■■ Candidate must be an FPA member, registered with the Florida Board of Pharmacy as a consultant pharmacist in good standing.

■■ Candidate should be selected based on their outstanding achievements in the field of consultant pharmacy.

DCPA Sidney Simkowitz Pharmacy Involvement Award Presented annually to a Florida pharmacist who has been active at the local and state pharmacy association level in advancement of the profession of pharmacy in Florida.

Criteria: ■■ A minimum of five years of active involvement in and contributions to the local association and FPA. ■■ Candidate must have held office at local-level pharmacy association.

■■ Member in good standing for a period of at least five years in the FPA and must have served as a member or chairman of a committee of the association.

■■ Candidate must have been actively involved in a project that has or could potentially be of benefit to members of the profession.

Pharmacists Mutual Companies Distinguished Young Pharmacist Award Awarded to a young pharmacist for their involvement and dedication to the

F P A

practice of pharmacy.

Criteria: ■■ Licensed to practice for nine (9) years or less.

■■ Licensed to practice in the state in which selected.

■■ Participation in national pharmacy association, professional programs, and/or community service.

IPA Roman Maximo Corrons Inspiration & Motivation Award Interamerican Pharmacists Association created this award to honor the memory of Roman M. Corrons who inspired and motivated countless pharmacists to participate actively and aspire to take on leadership roles in their profession. Roman was always there with guidance and support that motivated pharmacists and encouraged visionary leadership, approachable active membership and succession planning.

This award recognizes the motivators among us who inspire others to continue to advance the profession.

Criteria: ■■ The recipient must be a Florida Licensed Pharmacist and a member of the FPA. ■■ Candidate should motivate others to excel within the profession by encouraging them to be leaders.

■■ Candidate is not necessarily an association officer, but guides, supports and/or inspires others.

A brief description on the candidate’s motivational/inspirational skills must accompany the nomination.

The Jean Lamberti Mentorship Award The Jean Lamberti Mentorship Award was established in 1998 to honor those pharmacists who have taken time to share their knowledge and experience with pharmacist candidates. The award is named in honor of long time FPA member Jean Lamberti for her effort in working with pharmacy students.

Criteria: ■■ The recipient must be an FPA member.

■■ The recipient must serve as a role model for the profession of pharmacy.

A W A R D S

2 0 1 3 - 2 0 1 4

Upsher Smith Excellence in Innovation Award Awarded to honor practicing pharmacists who have demonstrated innovation in pharmacy practice that has resulted in improved patient care.

Criteria: ■■ The recipient has demonstrated innovative pharmacy practice resulting in improved patient care.

■■ The recipient should be a practicing pharmacist within the geographic area represented by the presenting association.

Cardinal Generation Rx Award The Cardinal Health Generation Rx Champions Award recognizes a pharmacist who has demonstrated excellence in community-based prescription drug abuse prevention. The award is intended to recognize outstanding efforts with-

in the pharmacy community to raise awareness of this serious public health problem. It is also intended to encourage educational prevention efforts aimed at patients, youth and other members of the community.

The nominee must be a pharmacist who is a member of the state association.

Self-nominations are allowed. Applications will be evaluated based upon the following criteria: ■■ Commitment to community-based educational prevention efforts aimed at prescription drug abuse ■■ Involvement of other community groups in the planning and implementation of prevention programs ■■ Innovation and creativity in the creation and implementation of prevention activities

■■ Scope/magnitude of prescription

drug abuse efforts

■■ Demonstrated impact of prescription

drug abuse prevention efforts

DEADLINE FOR NOMINATIONS: FEBRUARY 28, 2014 FPA AWARDS NOMINATION FORM I AM PLEASED TO SUBMIT THE FOLLOWING NOMINATION:

NOMINATED BY:

Name:

Name:

Address:

Date Submitted: Signature:

FOR THE FOLLOWING AWARD: (Nomination Deadline February 28, 2014)  APhA Foundation and NASPA Bowl of Hygeia  James H. Beal Award

Please describe briefly below the nominee's accomplishments, indicating why you feel he or she should receive this award.

(Attach additional sheets if necessary.)

 R.Q. Richards Award  Frank Toback/AZO Consultant Pharmacist Award  DCPA Sydney Simkowitz Award  Pharmacists Mutual Co. Distinguished Young Pharmacist Award  Academy of Pharmacy Practice Practitioner Merit Award  The Jean Lamberti Mentorship Award  IPA Roman Maximo Corrons Inspiration & Motivation Award  Upsher Smith Excellence in Innovation Award  Technician of the Year Award  Cardinal Generation Rx Award MAIL NOMINATONS TO: Annual Awards, Florida Pharmacy Association, 610 N. Adams St., Tallahassee, FL 32301 (850) 222-2400 FAX (850) 561-6758 DEADLINE FOR NOMINATIONS IS FEBRUARY 28, 2014

DECEMBER 2013

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BUYER’S GUIDE florida PHARMACY TODAY

ADVERTISERS: This is a special section designed to give your company more exposure and to act as an easy reference for the pharmacist.

PHARMACY RESOURCES Abbott Diabetes Care Hernan Castellon (305) 220-0414 PPSC Retail Pharmacy Purchasing Program (888) 778-9909

LEGAL ASSISTANCE Kahan ◆ Heimberg, PLC Brian A. Kahan, R.Ph., Attorney at Law 561-392-9000 Fried Law Office, P.A. Dennis A. Fried, M.D., J.D. (407) 476-1427 The Health Law Firm George F. Indest III, J.D., M.P.A., LL.M. (407) 331-6620

PHARMACEUTICAL WHOLESALER

PHARMACY CONSULTANTS HCC Pharmacy Business Solutions Bob Miller, BPharm, CPH (800) 642-1652 Empire Pharmacy Consultants Michael Chen PharmD., CPh President (855) 374-1029 Office

TEMPORARY PHARMACISTS – STAFFING HealthCare Consultants Pharmacy Staffing Bob Miller (800) 642-1652 Empire Pharmacy Consultants Michael Chen PharmD., CPh President (855) 374-1029 Rx Relief (800) RXRELIEF

McKesson Drug Company Jim Springer (800) 804-4590 FAX: (863) 616-2953

Advertising in Florida Pharmacy Today Display Advertising: please call (850) 264-5111 for a media kit and rate sheet. Buyers’ Guide: A signed insertion of at least 3X per year, 1/3 page or larger display ad, earns a placement in the Buyers’ Guide. A screened ad is furnished at additional cost to the advertiser. Professional Referral Ads: FPA Members: $50 per 50 words; Non‑members: $100 per 50 words; No discounts for advertising agencies. All Professional Referral ads must be paid in advance, at the time of ad receipt.

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FREQUENTLY CALLED NUMBERS AHCA MEDICAID PHARMACY SERVICES 2727 Mahan Drive Tallahassee, FL 32308 (850) 412-4166 www.fdhc.state.fl.us/medicaid/ pharmacy AMERICAN PHARMACISTS ASSOCIATION (APhA) Washington, D.C. (800) 237-2742 www.pharmacist.com AMERICAN SOCIETY OF HEALTH SYSTEM PHARMACISTS Bethesda, MD (301) 657-3000 www.ashp.com/main.htm DRUG INFORMATION CENTER Palm Beach Atlantic University (561) 803-2728 druginfocenter@pba.edu FLORIDA BOARD OF PHARMACY 4052 Bald Cypress Way Bin #C04 Tallahassee, FL 32399-3254 (850) 245-4292 www.doh.state.fl.us/mqa FLORIDA POISON INFORMATION CENTER NETWORK (800) 222-1222 www.fpicn.org NATIONAL COMMUNITY PHARMACISTS ASSOCIATION 100 Daingerfield Road Alexandria, VA 22314 703.683.8200 703.683.3619 fax info@ncpanet.org RECOVERING PHARMACISTS NETWORK OF FLORIDA (407) 257-6606 “Pharmacists Helping Pharmacists”