IPA Journal - Jul/Aug/Sep 2016

A Peer-Reviewed Journal | Vol. LXXII, No. 3 | JUL.AUG.SEP 2016

Rick Knudson IPA’s 137th President

INSIDE: Relive the 2016 Annual Meeting Legislative Session Recap Apply for an Outcomes Innovative Pharmacy Grant

TABLE OF CONTENTS 8515 Douglas Avenue, Suite 16, Des Moines, IA 50322 Phone: 515.270.0713 Fax: 515.270.2979 Email: ipa@iarx.org | www.iarx.org

PUBLICATION STAFF David Schaaf, Managing Editor Kate Gainer, PharmD Anthony Pudlo, PharmD, MBA, BCACP Laura Miller

OFFICERS

2016 Annual Meeting Recap pg. 8

Relive the 2016 IPA Annual Meeting! See the adopted policies, award recipients and read Speaker CoraLynn Trewet’s House of Delegates address.

CHAIRMAN Bob Greenwood, RPh, Waterloo PRESIDENT Rick Knudson, PharmD, BCPS, MS, MBA, Clear Lake PRESIDENT-ELECT Craig Logemann, RPh, BCACP, CDE, Ankeny TREASURER Sue Purcell, RPh, Dubuque SPEAKER OF THE HOUSE Susan Vos, PharmD, FAPhA, Iowa City VICE SPEAKER OF THE HOUSE Steven Martens, PharmD, Grundy Center

TRUSTEES REGION 1 Christopher Clayton, PharmD, MBA, Manchester REGION 2 Ryan Jacobsen, PharmD, BCPS, Iowa City REGION 3 Rachel Digmann, PharmD, BCPS, Ankeny REGION 4 Jerod Work, PharmD, Sioux Center AT LARGE Jessica Frank, PharmD, Winterset Nora Stelter, PharmD, CHWC, Urbandale Brett Barker, PharmD, Nevada Stevie Veach, PharmD, BCACP, Tiffin

2016 Legislative Session Recap Our legislative counsel recaps all of the activity from this year’s session. pg. 30

Outcomes Innovative Pharmacy Grant IPA Foundation is now accepting applications. See how to apply. pg. 39

FEATURES

2016 IPA Annual Meeting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 2016 IPA Awards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Feature: Pharmacists Mutual Pursues Provider Case in Texas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Congratulations Class of 2016 . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Legislative Session Recap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

HONORARY PRESIDENT Jane DeWitt, RPh, Iowa City PHARMACY TECHNICIAN Meg Finn, CPhT, North Liberty STUDENT PHARMACISTS Nick Vollmer, Drake University Casey O’Connell, The University of Iowa

The Journal of the Iowa Pharmacy Association is a peer reviewed publication. Authors are encouraged to submit manuscripts to be considered for publication in the Journal.

For author guidelines, see www.iarx.org.

“The Journal of the Iowa Pharmacy Association” (ISSN 1525-7894) publishes 4 issues per year: January/ February/March issue; April/May/June issue; July/August/ September issue; and October/November/December issue by the Iowa Pharmacy Association, 8515 Douglas Avenue, Suite 16, Des Moines, Iowa 50322. Periodicals postage paid at Des Moines, Iowa and additional mailing offices.

POSTMASTER: Send address changes to: The Journal of the Iowa Pharmacy Association, 8515 Douglas Ave., Suite 16, Des Moines, IA 50322. Published quarterly, The Journal is distributed to members as a regular membership service paid for through allocation of membership dues.

Subscription rates are $100 per year, single copies are $30. Printed by ColorFx; Graphic design done by the Iowa Pharmacy Association.

IN EVERY ISSUE

CEO Editorial . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 President’s Page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Health Care Hot Topics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Iowa Pharmacy News . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Practice Advancement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Public Affairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 Technician’s Corner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 IPA Foundation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 Member Section . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 IPA Action . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 Calendar of Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 Pharmacy Time Capsule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

Mission Statement

The Iowa Pharmacy Association empowers the pharmacy profession to improve health outcomes.

JUL.AUG.SEP 2016 |

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CEO EDITORIAL

TAKING A LEAP

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nly ten Iowa pharmacists have served the profession of pharmacy in the highest elected office as president of a national pharmacy association. In the past 137 years, this elite group of IPA members climbed to this level of leadership within APhA, ASHP, NCPA, ACCP and AACP. Most recently, Matt Osterhaus from Maquoketa, Iowa, was installed as APhA president in 2014. During his installation in Orlando, IPA hosted a dinner and presented Matt with a gift. With over 120 of Matt’s personal family and pharmacy family in attendance, the gift presentation dropped jaws and even left some (his mother Ann and Marilyn, his wife) speechless. It was a gift to go skydiving.

may not be the path of least resistance, nor does it come without careful thought and deliberation. But, saying yes to skydiving has a lot of similarities to saying yes in your profession.

Fast forward 2 years later, after a successful term in the APhA presidential office, I quietly whispered to Matt, “if you ever want to go skydiving, just say the word.” I was thinking (hoping?) he may have forgotten about the gift presentation, but alas he said “yes.” As with leadership opportunities, saying ‘yes’

Executive Vice President & CEO Iowa Pharmacy Association

I should also mention that after Matt said “yes;” he said, “and you’re going with me.” So here I am to tell you about our experience skydiving earlier this summer.

As with leadership in our profession, skydiving is an opportunity to make new friends. You may not know those around you when the day starts and you show up at the jump zone hanger, but there is nothing better than a shared experience to create friendships! Whether that shared experience is jumping out of a plane or serving on a Board or committee.

Skydiving, like leadership, is exhilarating and terrifying (free falling for 5,000 feet) followed by pure enjoyment and breathtaking beauty (9,000 feet of parachute sailing with a view of Iowa’s countryside in midJuly).

Matt Osterhaus receives his skydiving gift at the 2014 APhA Annual Meeting

Kate Gainer, PharmD

With both skydiving and leadership, it’s important to realize that you’re not the first and certainly won’t be the last. Our group was in the 5th plane up, and we watched 50+ skydivers leap out of the plane and land safely before we boarded and ascended to 36,000 feet. With leadership in our profession, those pharmacists who paved the way before us created a culture that makes collaboration contagious, innovation inspiring and leadership fun.

The jumpers (L to R): Angie Spannagel, Matt Osterhaus, Leman Olsen, Sally Buser, Kate Gainer, Bobby Scott

And lastly, skydiving, like leadership is something you’ll talk about for days, if not years that follow (just ask Matt O!). Similarly, experience on an IPA committee or the IPA Board of Trustees provides stories to tell and successes to share.

Besides this editorial, there’s no actual connection between skydiving and leadership… so feel free to leap from a plane without taking on a professional leadership role; or be confident that you can serve in IPA without skydiving as a prerequisite.

Whether you decide to do one or the other, or both, I can guarantee you’ll be thankful you took the leap! ■

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PRESIDENT’S PAGE

MOVE THE NEEDLE Rick Knudson, PharmD, MS, MBA, BCPS Clear Lake, Iowa IPA President

IPA President Rick Knudson’s inaugural address at IPA’s Annual Meeting on June 17, 2016 in West Des Moines, Iowa

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ood evening and thank you.

Thank you for the opportunity to serve our association, our profession and to serve each of you as the 137th President of IPA. I am honored and humbled by the trust you have placed in me.

Those of you who know me well know about my love and respect for all things “Iowa” (and I speak here of our state… no offense to all the “Iowa” Hawks here in the room!). I have had the privilege of calling Iowa my home for my entire life, minus a one year stent across the border for residency. Tonight represents a special event for me as it is the only time, to date, in my career that both of my families – and I do consider all of you my pharmacy family – have come together in one spot.

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Growing up in Iowa is a great experience and I will tell you that small town Iowa is an even more unique and special opportunity.

I grew up on a farm (one with an “F” not a “Ph”) in Northwest Iowa.

Estherville to be exact. There is a saying to the effect that “you can take the boy out of the farm, but you can’t take the farm out of the boy”… And I guess that is true of me as well. My truck’s license plate is a testament to that fact! (PHRMBOY) Tonight my parents, Harold and Janet (who still live on that family farm) are here with me. All I can say is “thank you” for the opportunities you have given me and for your love and support over the years. I must also recognize several other special guests who have joined me this evening. My sister Becky, and my sister Kim and her husband Kevin are also able to be here with me tonight. Thank you for coming.

There is another crew that I must thank, and while they are not here with us live tonight they are with me wherever I go. My three kids...

Nate, Kate and Sam. I thank them for helping me to realize my full potential as a father, for loving me, missing me, and making me feel like the most important person in the world whenever I come home! Oh, and trust me, if they were here you would have

known it… there is rarely a quiet moment at our house!

Next, I must thank my partner in all things, my wife Jen. You are my sounding board, the voice in the back of my head reminding me to “go for it”, my one true love. You are always there for me supporting my dreams and endeavors, picking up the slack when I am gone nights and weekends.

Filling in for me when I miss a parentteacher conference or any number of family issues. Never once have you complained and you support me in all that I do. Thank you and I love you!

I would be remiss if I didn’t take this opportunity to thank the IPA staff and leadership. Kate and team, thank you for your dedication to our profession.

You are all tireless proponents for pharmacy and are truly second to none! Also, I would like to thank my fellow executive committee members as well as the Board of Trustees for your guidance and dedication.

Finally, a thank you to my Iowa pharmacy family – all of you. Those of you that I know well and those that I have only just met or have yet to meet.

Thank you for your guidance, your counsel, your friendship and your trust. I will do my best to make sure it is well placed.

PRESIDENT’S PAGE

Alright, now that the “thank yous” are taken care of let’s shift gears. It is time, as they say, to “talk shop”. As I was putting my remarks together for this evening, I reminded myself that one of the goals of a presidential address is to energize and reinvigorate all of us so that we can go into the world and advance the care of the patients we serve while simultaneously advancing our profession. In case you are wondering, that is no easy task here in Iowa! You have heard it before, but it bears repeating. Iowa Pharmacy is a unique and special place to be. Please know that the grass is, in this case, definitely NOT greener on the other side. Be proud and be happy that you practice pharmacy here in a state where the norm is “ahead of the curve” and the “status quo” is the place where we were yesterday.

accomplished due to your grassroots efforts. Please know that our advocacy efforts will continue to be a centerpiece of the Association’s work and you will be called upon again in the future. In addition to PBM work IPA has helped foster discussions around pharmacy enhanced service networks and payersponsored networks. The goal of these types of activities centers on provider status which translates into better access and care for our patients. The provider status initiative is probably the most active and cohesive effort between state and national organizations that I have ever seen in my years as a pharmacist. I challenge anyone in this room to open the latest email from whichever national organizations you belong to and not find information about provider status.

“Be proud and be happy that you practice pharmacy here in a state where the norm is ‘ahead of the curve’ and the ‘status quo’ is the place where we were yesterday.”

Over the coming year I am going to be talking to all of you about moving from gaining provider status (or the conceptual phase) to “being” providers (or the action phase). My editorials in The Journal, our leadership discussions, Board of Trustee agendas, all of these avenues will focus on actions. Small actions, big actions, simple or complex… but action. It is my belief that gaining provider status is more than a designation written somewhere in a federal law but rather it is about a paradigm shift. A paradigm shift that starts here, in this room, with all of us.

Are we ready to assume responsibilities, risks and rewards of provider status? Have you prepared yourself and your practice for this fundamental shift? If provider status passed Congress tomorrow, are you truly ready for what that means? Some of you may answer an emphatic “yes” others may not be quite as certain. Over the next year we will continue to focus efforts and resources on this topic to ensure that the profession here in Iowa is ready for the next step forward.

My year as president-elect was a great personal learning experience for me.

Those of you who precept students know that you must be on your “A-game” as students challenge you on a day-by-day basis. Well, I have learned that service to IPA is much the same, very challenging and strenuous but exceedingly rewarding.

I have also learned that my day-to-day work is likely different than your daily work and yours is different from others in this room. IPA is that common platform that gives us the opportunity to work with and for one another with the goal of better serving patients. To accomplish this IPA has been focusing on three core strategic areas: 1) patient care, safety and health outcomes, 2) membership and 3) advocacy. Next month, during the Board of Trustee retreat, IPA leadership and staff will work to create a refreshed strategic plan that will span the next several years.

The three areas above will undoubtedly be continued focus areas but there may be additional ideas that come to light during that process. Stay tuned!

We, collectively, have advanced areas such as PBM regulation by the Iowa Insurance Division much of which was

to each of you is to materialize, in a very tangible way, at least one thing you have heard or learned about over the last two days. Do it now. Be bold. Next year when we gather for our Annual Meeting (Expo would be great too) I will look forward to hearing how you moved the needle in your practice.

I truly believe that we, the profession of pharmacy, are now, finally, reaching the true heights of our training and our calling. A tidal wave of need, understanding and necessity for our services is now opening doors that only a few short years ago were not only closed but locked tightly. It is our continued responsibility to walk through those doors and beyond.

In closing, I would not be doing my job as an invigorating speaker if I didn’t leave you with several inspirational quotes that will help carry you through the days ahead. Consider the following: “Destiny is not a matter of chance, but of choice. Not something to wish for, but to obtain.” - William Jennings Bryan “You may be disappointed if you fail, but you are doomed if you don’t try.”

- Beverly Sills “Control your own destiny or someone else will.” - Jack Welch And finally, to come full circle with my love of all things Iowa, one of the most appropriate quotes I can think of…

“If you build it, they will come.”

- Field of Dreams ■

Yesterday during the Practice Advancement Forum we heard many examples of ways to move our practices forward. I would ask you the following questions. Have you done something in your practice to move the needle? Where or what were you doing five years ago? Is today different? My personal challenge JUL.AUG.SEP 2016 |

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In a House of Delegates first, student pharmacist delegates presented a new business item addressing language barriers in providing patient care. The item was referred to committee.

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Thank you to the over 180 IPA members who made the 2016 IPA Annual Meeting in West Des Moines a great success!

Friday featured lively policy discussion in the House of Delegates, committee meetings, the poster program, and a “nice” lunch squeezed in. Keynotes during both House of Delegates sessions focused on delivering value as part of the healthcare team. The meeting wasn’t all work as members celebrated the inauguration of Rick Knudson as IPA’s 137th president and then helped the IPA Foundation raise $14,000 at the annual Silent Auction.

Adopted Policy . . . . . . . . . p. 13 Board Transition . . . . . . . . . p. 14 Awards . . . . . . . . . . . . . . p. 16 Silent Auction . . . . . . . . . . p. 40

READ ALL ABOUT IT! Iowa Nice Guy, Scott Siepker, gives a entertaining, motivational and Iowa-centric presentation during lunch.

Read the 2015-2016 IPA Annual Report online at www.iarx.org/AnnualReport JUL.AUG.SEP 2016 |

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2016 ANNUAL MEETING

SAY YES! CoraLynn Trewet, MS, PharmD, BCPS, CDE Ankeny, Iowa 2016-2017 Speaker of the House

Speaker CoraLynn Trewet’s address during the first session of the IPA House of Delegates on June 17, 2016 in West Des Moines, Iowa

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t is an honor for me to stand before you as your Speaker. You are my colleagues, friends and family.

This house was one of my first experiences of pharmacy in Iowa. For a little history and a little exercise, how many of you were sitting in this house in 1999? Student pharmacists and new practitioners, look around, these are your leaders in Iowa pharmacy.

For me, it is a time to say thank you.

Thank you for raising me in this house. Thanks for giving me a seat at the table. For those of you that joined the table since 1999, you have been my colleagues and friends. Thank you for teaching me how to be a pharmacist in Iowa. I feel so very blessed.

The tagline of the Iowa Pharmacy Association is “One Profession. One Voice.” Some of you know that in addition to studying pharmacy at

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Drake University, I studied vocal performance. The IPA House of Delegates as the governing body of IPA. Is it one voice or all of our voices together? Do we sing the same song? Do we sing the same notes?

Do we actually have to agree? Or is it the harmonies that make the House of Delegates a beautiful song? The chord that goes into a minor key, but through the dissonance the song resolves. After all the discussion, we adopt policy (unanimously without amendments would be my preference). Policy, like music, stays with us. It is like singing to Prince getting ready on a Friday night in college, we may not be going out at 10 pm anymore, but we can sing and dance to the tune.

What do the songs of policy look like? Let’s see. What year was this “tune” adopted?

“The Association supports the right of patients to be informed about their drug therapy and the obligation of the pharmacist to provide patients information which will help achieve optimal drug therapy.

Pharmacists should provide drug related information to their patients by verbal consultation, by written or printed material, or any other means or combination of means that is best suited to an individual patient’s needs

for specific information. Judgments regarding the content of prescription drug related information should be made by the pharmacist, being cognizant of the patient’s right to know.”

This was 1978-U1 Patient Counseling.

The year your speaker was born.

Now, 37 years later this policy is still our song. Did you know that 84,000 individuals in Iowa are limited English proficient? Nearly 50,000 of these individuals speak Spanish. Can you counsel a patient in Spanish? I cannot. Today we will discuss a new business item specific to providing better patient counseling to this group of patients.

“IPA supports and encourages the development of collaborative practice agreements between pharmacists and prescribers that provide for drug therapy management of patients.

IPA supports legislative or regulatory provisions that authorize collaborative drug therapy between prescribers and pharmacists.”

This was 2001-R1 Collaborative Practice. That was the year I was the IPA Executive Intern. Has it really been 15 years since we began advocating for collaborative drug therapy? In 2004, the Board of Pharmacy and Board of Medicine

2016 ANNUAL MEETING

enacted collaborative practice rules.

Yesterday, we spent the entire day learning and networking to build collaborative practice in Iowa. Are we there yet? Some may say yes. Others may say no. No, we are not going to vote.

A policy from 1978. A policy from 2001.

Policies that today are shaping how we practice pharmacy in Iowa. How did we get here? One profession. One voice. Many singers. Many delegates. I have a few memories from the house and phoned a friend for a few of their own. Each started with one saying yes to a call for action.

• Someone stood up to say patients should have freedom of choice to select a provider of health care products and services.

• Former Speaker and Former President Bob Osterhaus stood up and said “if it is not good for the patient, it is not good for pharmacy.”

• There were many who stood with passion for and against technician certification and the doctor of pharmacy degree.

• Many stood up in opposition to the unsafe pharmacist work environments that were negatively impacting patient safety. Not only did they adopt policy but also a committee with the Iowa Board of Pharmacy.

• Former Speaker Randy McDonough had data in hand and more than one patient story to stand up and fight for PBM reform policy that would be used to pass important legislation the following year.

Each of these and many others, served as building blocks to the leadership of Iowa pharmacy. John Hope Bryant, founder of the nonprofit organization Operation Hope, had this to say about giving, leadership and passion. “Real leadership is about finding your passion, about becoming an expert in and around what you are for, in a world increasingly expert at what it is against ~ and then taking bold action on that thing! A real legacy is built around what you have to give, not what you get…Give what you have, where you have it.”

Jerry Karbeling was not just a pharmacist.

He was a friend, mentor and colleague to me and many others here. Following his too soon departure from Iowa Pharmacy, this was the button we wore to honor Jerry. Just like John Hope Bryant, Jerry had real leadership. Jerry had a passion for pharmacy that was contagious. Jerry had a love for politics and policy. He found his passion in serving patients.

He became an expert in pharmacy and the patients of Iowa and he took bold action to make sure they were the focus.

One example of his action I specifically remember, was working closely with the manufacturers of Oxycontin® when the drug first came to market. He worked passionately to educate pharmacists on appropriate opioid management during a time many were against the new drug.

This afternoon we will discuss abusedeterrent formulations of opioids and other medications.

In 2003, the IPA Annual Meeting started with an outing at an Iowa Cubs game.

Here I am in this picture with one of their biggest fans, Jerry Karbeling. That evening, Al Shepley had the pleasure of throwing out the first pitch and I had the

honor of singing the National Anthem.

One of the best things about Jerry was he said “yes.” His legacy was built around what he had to give. And he could get you to “say yes.” Jerry would tap you on the shoulder and say, “if not you, then who?”

I kept this picture on my desk at work to remind me to send that letter to a state senator or accept a student wanting to shadow me. Because Jerry could assure you that the letter you sent to your state senator, it matters. The student that you let shadow you, it matters. The call you made to the new nurse practitioner in town, it matters. You matter. Say “yes.”

“Allow your passion to become your purpose, and it will one day become your profession.” Gabrielle Bernstein.

What is your passion? What is your purpose? Is pharmacy your profession?

You said yes to serving in the House of Delegates. Now what? The 2016 House of Delegates, just like 1978, 2001 and every other year, will leave a legacy around what we have to give. What do you want for your profession? That’s what this House of Delegates is all about. Having a passion for pharmacy, becoming an expert for our patients, and taking action to make Iowa pharmacy better. You have much to give.

Say yes. ■

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2016 ANNUAL MEETING

A SHARED EXPERIENCE The new Annual Meeting app allowed attendees to share their experiences with each other and now you can see it from their point of view.

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2016 ANNUAL MEETING

2016 HOUSE OF DELEGATES: POLICIES ADOPTED 16-U1: Confidentiality of Pharmacy Professionals in Recovery

16-R1: Value-Based Pharmacy Networks

1. IPA supports a standardized process for the reporting of discipline against pharmacy professionals that promotes public safety, while protecting individual rights of confidentiality.

1. IPA supports value-based pharmacy networks that improve the quality of medication use and patient outcomes, and that reduce total cost of care through an interdisciplinary and collaborative process.

2. IPA supports a pharmacy recovery program that maintains the integrity and professional standing of the individual in recovery.

3. IPA supports a non-disciplinary track for impaired pharmacy professionals that encourages self-reporting.

4. IPA supports education and outreach to maintain and expand recovery programs for impaired pharmacy professionals.

16-U2: Abuse-Deterrent Formulations 1. IPA supports ongoing efforts to evaluate the efficacy and safety of abuse-deterrent medication formulations.

2. IPA supports access to and coverage of prescription medications with evidence-based abuse-deterrent properties.

3. IPA supports the role of pharmacists in the development of patient treatment plans that may include evidence-based abuse-deterrent formulations.

16-U3: Immunization Requirements 1. IPA supports the immunization recommendations of the Centers for Disease Control and Prevention (CDC) for all individuals without medical contraindications.

2. IPA supports removal of non-medical exemptions from statute(s) requiring mandatory immunizations, including those for childcare and school attendance.

2. IPA supports pharmacists taking an active lead in the design of performance measures in collaboration with key stakeholders that recognize quality pharmacy services.

3. IPA supports value-based pharmacy networks that utilize fair and transparent pay for performance programs, wherein pharmacies may be eligible to receive bonus payments, separate and distinct from the full product and dispensing cost reimbursement.

4. IPA supports mechanisms to allow a consistent, transparent, and timely process for quality reporting to pharmacies in a value-based pharmacy network.

5. IPA supports the provision of educational resources to promote high quality pharmacy services within a value-based pharmacy network.

16-R2: Privileging of Pharmacists 1. IPA supports employers and institutions adopting and implementing a site specific privileging process that determines pharmacists’ responsibilities and specific patient care services.

2. IPA supports employers and institutions having a process that determines pharmacists have attained and maintain the qualifications and competencies necessary for the granting of specific privileges.

3. IPA supports the development of strategies and tools for pharmacists, employers, and institutions in their initial and ongoing privileging process.

THANK YOU! SPONSORS

Cardinal Health Novo Nordisk Thrifty White Affiliated Pharmacy Program SafeNetRx Wellmark Omnicell Hy-Vee Inc NuCara Pharmacy National Association of Chain Drug Stores AmeriHealth Caritas The University of Iowa College of Pharmacy Drake University College of Pharmacy & Health Sciences

EXHIBITORS

Iowa Pharmacy Association Foundation Iowa Pharmacy Recovery Network Pharmacists Mutual Companies Pharmetika Fresenius Kabi USA, LLC Pfizer Lab Rx Inteniors, Inc AbbVie PBA Health Iowa Department of Public Health CSL Behring QS/1 PharmServ Staffing Onnen Company McKesson

STUDENT SPONSORS Bruce Alexander Tim Becker Kate Gainer Sarah Grady Greg Hoyman Kristin Meyer Jim Miller Nick Lund Lisa Ploehn

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2016 ANNUAL MEETING

THANK YOU IPA BOARD OF TRUSTEES! John Swegle, PharmD, BCPS, Mason City Chairman of the Board CoraLynn Trewet, MS, PharmD, BCPS, CDE - Ankeny Speaker of the House Steve Firman, BS Pharm, MBA, FAPhA - Cedar Falls Treasurer Kristin Meyer, PharmD, CGP, CACP, FASCP - Marshalltown Trustee - Region #1 Erik Maki, PharmD, BCPS - Johnston Trustee - Region #3 David Weetman, BS Pharm, MS - Iowa City Trustee at Large Laura Knockel, PharmD, BCACP - North Liberty Trustee at Large

Thank You Outgoing 2015-2016 Board Members

IPA would like to thank the outgoing Board of Trustees members listed to the right for their dedication and service to the pharmacy profession in Iowa. Their leadership guided the association through several important issues this year and their insight has been invaluable in strengthening pharmacy practice in our state.

G. Jean Gallogly, CPhT - Vincent Pharmacy Technician Dennis Jorgensen, RPh - Panora Honorary President Christina Bravos, Student Pharmacist Drake University Robert Nichols, Student Pharmacist The University of Iowa

Welcome 2016-2017 IPA Board of Trustees

IPA welcomes the incoming Board of Trustee members and thanks them for their willingness to serve the profession this year. The board begins their term developing a strategic plan and priority projects for the association at the board retreat on July 14-15 in Dubuque.

Bob Greenwood, RPh - Waterloo Chairman of the Board Rick Knudson, PharmD, BCPS, MS, MBA Clear Lake President

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Christopher Clayton, PharmD, MBA Manchester Trustee - Region #1 Ryan Jacobsen, PharmD, BCPS - Iowa City Trustee - Region #2

Craig Logeman, RPh, BCACP, CDE - Ankeny President-Elect

Rachel Digmann, PharmD, BCPS - Ankeny Trustee - Region #3

Sue Purcell, RPh - Dubuque Treasurer

Jerod Work, PharmD - Sioux Center Trustee - Region #4

Susan Vos, PharmD, FAPhA - Iowa City Speaker of the House

Brett Barker, PharmD - Nevada Trustee at Large

Steven Martens, PharmD - Grundy Center Vice Speaker of the House

Jessica Frank, PharmD - Winterset Trustee at Large

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Nora Stelter, PharmD, CHWC - Urbandale Trustee at Large Stevie Veach, PharmD, BCACP - Tiffin Trustee at Large Jane DeWitt, RPh - Iowa City Honorary President Meg Finn, CPhT - North Liberty Pharmacy Technician Nick Vollmer, Student Pharmacist Drake University Casey O’Connell, Student Pharmacist The University of Iowa

2016 ANNUAL MEETING

CELEBRATING LEADERSHIP Each year, IPA hosts a Leadership Dinner prior to Annual Meeting to recognize the past, present and future leadership within Iowa pharmacy and the association. Current and incoming board members, past presidents and honorary presidents, past Leadership Pharmacy participants, and the deans from both Iowa colleges of pharmacy gathered for this years dinner at the Glen Oaks Country Club in West Des Moines. Those recognized included outgoing board members, current Leadership Pharmacy participants, and committee chairs.

Outgoing IPA President, Bob Greenwood

2015-2016 Committee Chairs

2015 Leadership Pharmacy Class

Joan Stover named an Honorary Member after 34 years of service at IPA

Outgoing IPA Foundation President Tim Becker

SAVE THE DATE

2017 ANNUAL MEETING June 16-17, 2017

Coralville Marriott | Coralville, Iowa JUL.AUG.SEP 2016 |

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2016 IPA AWARDS

CONGRATULATIONS TO THE 2016 IPA AWARD RECIPIENTS! IPA takes great pride in recognizing individiuals for their contributions of leadership, patient care, professional involvement and public service. The following awards were presented by IPA’s 2015-2016 president, Bob Greenwood and executive vice president and CEO, Kate Gainer during the 2016 IPA Annual Meeting.

Robert G. Gibbs Distinguished Pharmacist

Honorary President

Lloyd Jessen, BS Pharm, JD, of Des Moines

Dennis Jorgensen, RPh, of Panora

Excellence in Innovation

Distinguished Young Pharmacist of the Year

Chris Donner-Tiernan, PharmD, MBA, of Fort Dodge

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Bowl of Hygeia Kenneth Anderson, RPh, of Preston

| The Journal of the Iowa Pharmacy Association

Ashley Dohrn, PharmD, CGP, of Le Claire Presented by Pharmacist Mutual

2016 IPA AWARDS

Health-System Pharmacist of the Year Erik Maki, PharmD, BCPS, of Johnston

Patient Care Partner Award Aneesa Afroze, MD, of Des Moines Pictured with nominators Kelly Percival and Jeff Brock

IPA Appreciation Award Visionaries of the Outcomes Innovative Pharmacy Endowment: (L to R) Matt Osterhaus, RPh, FASCP, FAPhA; Tom Halterman, RPh; Michele Evink, MS, PharmD, CGP, FASCP; Jim Miller, RPh; Ray Buser, RPh

Pharmacy Technician of the Year Tammy Sharp-Becker, CPhT, of Ames

GenerationRx Award Noelle Johnson, PharmD, BCACP, CGP of Urbandale Presented by Julie Thien (l) and Mike Hope (r) of Cardinal Health JUL.AUG.SEP 2016 |

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2016 IPA AWARDS

Poster Presentation Award Karbeling Leadership Award Robert Nichols, The University of Iowa Elizabeth Bald, Drake University Presented by Tim Becker, IPA Foundation President

Changes in Pharmacy Practice Due to a Change in Prescription Refill Processing: The Iowa New Practice Model Evaluation of Physician–Pharmacist Collaboration Model Micheal Andreski, BSPharm, MBA, PhD Megan Myers, PharmD Presented by the IPA Foundation

50 Year Pharmacists Eugene Lutz, Altoona, IA; John Dobbs, Raymore, MO; Ann Marcalus, Jewell, IA; Frederick Marcalus, Jewell, IA; Lyle Boes, Sioux Falls, SD Not Pictured: Larry Argotsinger, Oakland, IA; Daniel Ashton Jr., Effingham, IL; Cherie Cremers, Iowa City, IA; Gail Deatherage, Hollywood, FL; Gary Ellett, Perry, IA; Patrick Griffith, Council Bluffs, IA; David Horejsi, Hamburg, IA; William Henning, Cordova, IL; Melvin Henrichsen, Black Hawk, SD; Arnold Karig, Isle of Palms, SC; Thomas Keleher, Omaha, NE; Robert Newton, West Des Moines, IA; James Ricke, Esterville, IA; Ronald Smith, Camache, IA; Roger Zobel, West Des Moines, IA

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| The Journal of the Iowa Pharmacy Association

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FEATURE

PHARMACISTS MUTUAL PURSUES CASE TO ESTABLISH COMPOUNDING PHARMACISTS AS HEALTH CARE PROVIDERS IN TEXAS Don McGuire, RPh, JD General Counsel Pharmacists Mutual Companies

P

harmacists Mutual Insurance Company defended a case against our insured pharmacy that had important implications for the pharmacy profession. In this case, the patient received an infusion of Lipoic Acid in her physician’s office in 2011. She suffered adverse reactions which resulted in weeks of hospitalization and permanent blindness. The patient blamed her injuries on the compounded Lipoic Acid and filed suit against her physician, the pharmacy, and six of its pharmacists.

The allegations against the pharmacy and pharmacists included assertions that the Lipoic Acid was negligently prepared and was of an unsafe design.

Cases filed in Texas against physicians and other health care providers fall under the Texas Medical Liability Act. The Act requires that the plaintiff file an expert report within 120 days of the suit being filed. Failure to file the required expert report will result in dismissal with prejudice of the case upon the motion of a health care provider. The patient here did not file

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an expert report against the pharmacy or the pharmacists. The pharmacy and pharmacists moved for dismissal.

The trial court denied the defendants’ motion concluding that the patient’s claims were not health care liability claims as defined in the Act and the pharmacists were not health care providers as defined in the Act. The pharmacy and pharmacists appealed the ruling. The Texas Court of Appeals affirmed the trial court’s decision and distinguished between pharmacists dispensing compounded medications directly to patients (covered by the Act) and those pharmacists providing compounded medications to physicians for office use (not covered by the Act).

Following this ruling, the pharmacy and pharmacists appealed to the Texas Supreme Court.

The Texas Supreme Court reversed the previous rulings and ordered that the case be dismissed pursuant to the Texas Medical Liability Act for the failure to provide the expert report.1 The Supreme Court concluded that the patient’s claims were health care liability claims as defined under the Act and that the pharmacists in this case were health care providers as defined under the Act. Analyzing the Act, the Texas Pharmacy Act, and the Board of Pharmacy regulations, the Court concluded that compounding

pharmacists providing office use compounds to physicians were indeed health care providers and that the patient’s claims constituted a health care liability claim.

Other insurance carriers may not have recognized how detrimental the trial court and court of appeals decisions were to the practice of pharmacy. From a purely economic perspective, other insurers may have settled the case following the trial court’s ruling to end defense costs and avoid a potentially large judgment.

However, Pharmacists Mutual not only provides insurance protection for the pharmacy profession, but is an active promoter of the profession of pharmacy and the value that it can provide to the health care system in this country. The decision to push the case forward resulted in compounding pharmacists providing office use compounded medications being considered as health care providers under the Texas Medical Liability Act. This respect for, and promotion of, the pharmacy profession is what sets Pharmacists Mutual Insurance Company apart from other pharmacy insurers. ■

Randol Mill Pharmacy, et al. v. Stacey Miller and Randy Miller, 465 S.W.3d. 612, (Tex., April 24, 2015).

1

HEALTHCARE HOT TOPICS

WHO Rejects Call to Delay Olympics Due to Zika Virus

The WHO rejected a call from over 150 experts from more than one dozen countries which recommended to postpone or move the Summer 2016 Olympics in Rio de Janeiro due to the Zika virus. This section of the world is one of the hardest hit by the Zika virus and the experts consider the mosquitokilling efforts to be inadequate. Olympic visitors were given precautions about preventing transmission of the virus.

ACC/AHA/HFSA Releases Updated Heart Failure Guidelines Entresto (valsartan/sacubitril) and Corlanor (ivabradine) were highlighted as two new therapy options in a focused update to the ACC/AHA/HFSA heart failure guidelines. Entresto was added as a recommendation for patients with chronic heart failure with reduced ejection fraction. It reduces morbidity and mortality and has support of a randomized controlled study reducing composite endpoint cardiovascular death or heart failure hospitalization by 20%. Corlanor was also added as a recommendation for certain patients to reduce heart failure hospitalization via a heart rate reduction.

IDPH Discloses Increase in Immunization Exemptions in Iowa

The number of religious immunization exemptions increased for the 2015-2016 school year with 95.42% of students in grades K-12 and 92.12% of children in childcare having received all required vaccines. During IPA Annual Meeting in June, the policy committee stated support of the removal of all non-medical exemptions from statutes requiring mandatory immunizations for all children.

CDC States 1 in 3 Antibiotics are Unnecessary

New data found in the Journal of the American Medical Association by the CDC found that at least 1 in 3 antibiotics

prescribed in the U.S. is unnecessary.

The majority of unnecessary antibiotics were prescribed for conditions caused by viruses. The CDC is working to lessen the effects of antibiotic resistance through many efforts including provider and patient education, supporting program expansion and development, and tracking of antibiotic use and resistance.

announcement, the DEA emphasized the importance of safe medication disposal as the majority of prescription drug abusers report that they get their drugs from friends and family and 8 out of 10 new heroin users started by abusing prescription drugs.

FDA Revises Warnings on Metformin in Reduced Kidney Function

In an analysis of previously publish studies, researchers found that only one of the 14 antidepressants studied seem useful for children or teenagers with major depression. Researchers stated that Prozac was the only drug that worked better than placebo in this population.

The FDA revised their recommendations regarding the use of metformin in diabetic patients with reduced kidney function. It now states metformin is safe to use in patients with mild kidney impairment and in some patients with moderate kidney impairment. Kidney function for metformin use should now be measured using glomerular filtration rate estimating equation.

USPSTF Issues Recommendation Statement for Aspirin Primary Prevention Use

A low-dose aspirin regimen is recommended as primary prevention of cardiovascular disease and colorectal cancer for men and women between ages 50 and 59 with no increased risk of bleeding, a 10% or higher chance of developing CVD in the next 10 years, expectation to live at least another 10 years, and willingness to take a daily dose for the same amount of time. For patients age 60 or above, the decision to start aspirin should be on a case-by-case basis.

Record Setting Take Back Day

The DEA announced that its April 30 National Prescription Drug TakeBack Day collected a record 447 tons of unwanted medications at 5,400 sites across the country. In Iowa, 9,084 pounds of unwanted medications were collected at 112 sites across the state.

The previous record was 390 tons collected in the spring of 2014. In its

Study Finds Most Antidepressants Don’t Work for Young Patients

With a total of 34 drug trials, 22 of which were paid for by pharmaceutical companies, researchers cautioned that the quality of the research they studied was so low, that the findings should not change how patients are treated. Despite the fact that researchers were unable to definitively determine if the drugs were effective or even safe, it called into question the medications used to treat depression in young patients.

CDC Investigating ColistinResistant Superbug

The CDC is anticipating more people in the U.S. to be carrying a newly discovered super bug after a strain of colistin-resistant E. coli bacteria found in a Pennsylvania woman’s urine. The E. coli bacteria contained the mcr-1 gene making it resistant to colistin, which is considered an antibiotic of last resort because it is used to treat other superbugs that are resistant to antibiotics. This is the first time that the gene has been found in an individual in the U.S. Though the strain is treatable with other antibiotics, the ability of colistin resistance to spread easily through this gene is causing concern as it could lead to superbugs that cause infections that are untreatable. ■

JUL.AUG.SEP 2016 |

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IOWA PHARMACY NEWS

POLK COUNTY RAISES AWARENESS FOR HEAT-RELATED ILLNESSES Nathan Peterson, PharmD PGY2 ID Resident Mercy Medical Center Des Moines

In an effort to combat heat-related illness this summer, the Iowa Pharmacy Association (IPA) is partnering with the Polk County Health Department (PCHD) to develop resources for community pharmacies designed to raise awareness about heat-related illnesses, such as heat exhaustion and heat stroke, along with the danger associated with extreme heat.

“Extreme heat kills more Americans each year than hurricanes, lightning, tornadoes and floods combined,” said Rick Kozin, director of the Polk County Health Department. “If people take the proper precautions during extreme heat conditions, tragic events like death are less likely to happen.” According to the National Weather Service office in Des Moines, 2015 was the 4th hottest year on record, and 2016 may be even hotter for Iowa.1,2 This summer, local pharmacies in Polk County were encouraged to support this public health campaign and serve as daytime cooling centers open to the public during the summer months. Polk County Health Department provided information for pharmacists and patients, including window flyers for drive-through windows and counseling points for pharmacists for certain medication classes.

Local pharmacies are highly integrated within their communities and can easily reach people at risk for heat-related illnesses. Pharmacies directly manage patients highly prone to heat-related illnesses, namely people 65 years of age and older, overweight patients, and patients who have chronic health conditions or take certain medications. In addition, pharmacists are seen as a local, trusted source of health information.

Many medications can increase risk for heat-related illness among patients

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with chronic disease. Vasoconstrictors, diuretics, beta-blockers, opioids, antidepressants, sedatives, thyroid medications, antipsychotics, and anticholinergics all have unique mechanisms that can impede the body’s natural response to heat. Pharmacists are best-positioned to warn of the dangers of these medications, how best to alleviate risk, and what to do in case of emergency.

Finally, patients visiting their local pharmacies should always be reminded about storing medications in the hot weather. Medications especially susceptible to degradation or alteration from extreme heat include: • Insulin • EpiPens • Chemotherapy • Any liquid medication • Transplant medications • Anticoagulants • Thyroid medications • Arthritis medications • Nitroglycerin Community pharmacies have a strong commitment to the well-being of their communities and initiatives like addressing health risks of extreme heat.

Providing a venue to educate and create awareness among patients and the general public may help reduce the health risks of extreme heat. The pilot project with Polk County Health Department demonstrates the benefit of partnering with a local health department to positively impact communities in Iowa.

To make sure patients are adequately prepared, information for pharmacies including window flyers for drivethrough windows, counseling points for pharmacists, and high-risk medications, can be found at the Polk County Health Department website. (http://www. polkcountyiowa.gov/health/).

1. Des Moines Register interview, January 2016 http://www.desmoinesregister.com/story/ weather/2016/01/20/hottest-year-record/79057018/ 2. http://data.giss.nasa.gov/gistemp/tabledata_v3/ GLB.Ts+dSST.txt

Iowa Prescription Drug Corporation Changes Name to SafeNetRx

On April 20, 2016, the Iowa Prescription Drug Corporation changed its name to SafeNetRx. The new name was chosen to reflect the organization’s dedication to serving the safety net population and the evolution and expansion of its services to provide low-cost pharmaceutical access for that population. Aligning with the change, the organization unveiled a new website (www.safenetrx.org) and Twitter account.

The Iowa Prescription Drug Corporation was established in 2001 by a group of dedicated professionals, including Iowa’s elected leaders, physicians, nurses, and pharmacists to make free and lowcost medications available to those in need of assistance while also reducing environmental waste and generating significant cost savings. To date, more than 70,000 people have benefited from the organization’s programs totaling more than $15 million in free medication and supplies.

IPRN Transitions to Board of Pharmacy Administration

On July 1, 2016, administration of the basic functions of the Iowa Pharmacy Recovery Network (IPRN) transitioned to the Iowa Board of Pharmacy (BOP) and was renamed the Iowa Monitoring Program for Pharmacy Professionals (IMP3). The BOP will collaborate with the Iowa Board of Medicine to manage the program including sharing staff resources to handle case management.

IPRN participants are not required to transition to IMP3.

There will also be a IMP3 committee comprised of a licensed pharmacist, a representative from Drake University College of Pharmacy and Health Sciences, a representative from The University of Iowa College of Pharmacy, a professional specializing in recovery, and the executive director (or director’s designee) of the BOP. The committee will review participants’ requests, contracts, and recommendations from staff.

IOWA PHARMACY NEWS

As part of this transition, the BOP is in the process of creating a new website for the program. Additional information is available on the BOP’s website.

Iowa Pharmacists Elected to APhA Leadership Positions Two Iowa pharmacists and IPA members were elected to national leadership roles with the American Pharmacists Association (APhA).

Randy McDonough, PharmD, MS, CGP, BCPS was elected to the APhA Board of Trustees and will serve a threeyear term starting in March of 2017.

Randy is the co-owner and director of clinical services of Towncrest Pharmacy in Iowa City and Solon Towncrest Pharmacy. He is also the cofounder of Innovative Pharmacy Solutions. Randy is actively involved in IPA and community pharmacy advancement initiatives.

Wendy Mobley-Bukstein, PharmD, BCACP, CDE was elected to the 20172019 APhA Academy of Pharmacy Practice and Management (APhA-APPM) Executive Committee as a Member-at-Large! Wendy is an Assistant Professor of Pharmacy Practice at Drake University College of Pharmacy and Health Sciences. Wendy will be installed at the APhA Annual Meeting and Exposition in San Francisco on March 24-27, 2017.

for this strategy. During the meeting, the task force reaffirmed the tactics to address medication effectiveness, safety, and coordination. The task force focused it discussion on adding additional tactics to the goal of data collection and monitoring, which will help better track the efforts of this statewide strategy.

to begin working with the BOP staff to develop regulations. These rules will likely come before the Boards of Pharmacy and Nursing for approval.

The statewide strategy focuses on essential goals, including:

IPA Unveils a New Podcast Series with the Board of Pharmacy

1. Medication effectiveness: Every medication is assessed to ensure it has an intended medical use, is effective and safe, and is able to be taken by the patient as intended 2. Medication safety: Routinely achieve patient goals with zero tolerance for preventable harm 3. Coordination: Aligned clinical strategies between stakeholders that ensures maximum medication effectiveness and safety 4. Data: Use data to monitor and advance “medication use system” strategies

Congratulations Randy and Wendy and thank you for your willingness to serve the profession in Iowa and beyond!

The medication safety and effectiveness strategy has been integrated within the State Innovation Model (SIM) grant activities awarded to the IHC/IDPH. The vision of the Iowa SIM program is achieved by a direct correlation to three primary aims: 1) improve population health, 2) transform health care, and 3) promote sustainability. Most recently community care coordination grants were awarded to six Iowa communities.

Pharmacists in these areas have been encouraged to review the statewide medication safety and effectiveness strategy and be an advocate at the local level to address the immediate healthcare needs of their community.

State Medication Safety and Effectiveness Strategy

Iowa Board of Nursing Votes on Collaborative Practice Agreements

IPA continues to advocate for and promote the role of the pharmacist on the healthcare team through active engagement on the IHC-IDPH task force on medication safety and effectiveness.

The task force recently convened in May 2016 to reassess the statewide strategy on medication safety and effectiveness that was approved in 2015, and determine modifications needed

Currently the BOP and Board of Medicine have joint rules, which permit physicians to enter into CPAs with pharmacists.

At the June 21st Iowa Board of Nursing meeting, IPA made a presentation on collaborative practice agreements (CPAs) and requested that the Board of Nursing work collaboratively with the Iowa Board of Pharmacy (BOP) to develop rules that would permit Advanced Registered Nurse Practitioners (ARNPs) to enter into CPAs with pharmacists. The Board of Nursing approved this request, and plans

Following the April Iowa Board of Pharamcy meeting, IPA launched its first ever podcast. “BOP: What, Why & How” is a 20-minute discussion hosted

by IPA’s Anthony Pudlo with BOP staff, Andrew Funk and Jennifer O’Toole. IPA will record and release these quick and informative podcasts following each BOP meeting throughout the year. The discussions focus on the meeting agenda items, including regulatory changes and proposals, legislative activity, waiver requests and educational topics.

Listen after each BOP meeting to understand: • WHAT actions were taken by the BOP • WHY the BOP took the actions it did • HOW BOP action will impact the practice of pharmacy in Iowa Episodes are posted on the IPA website and the podcast is available on iTunes and Google Play.

Medication Disposal Changes in Iowa

Since November 2009, IPA has administered the Iowa Takeaway program for safe disposal of unused or expired medications. With recent updates to the administration of the program, the statewide medication disposal program in Iowa will continue beyond July 1, 2016, with a few changes.

JUL.AUG.SEP 2016 |

23

BEComE A mEmBEr of THE iowA PhArMAcy AssociAtion

Position yourself to lead and shape the future of your profession and join a network of pharmacists, pharmacy technicians and student pharmacists advocating the advancement of practice for the health and well-being of our patients.

AdvAntAges for You Equipping you for today’s rapidly evolving health care system with free and convenient CPE and opportunities to connect with colleagues across the state.

AdvocAcy for Your ProfEssion Enabling you to confidently engage your elected officials while representing your interests with the Board of Pharmacy, state agencies, health care organizations, and provider groups.

85

%

of membership dues directly fund initiatives that advance the pharmacy profession

AdvAnceMent for Your PrACTiCE Creating opportunities for you and your colleagues to collaborate with healthcare teams and integrate pharmacy practice into emerging healthcare models.

iowA PhArMAcy needs your unique voice And exPerience!

leArn More & join todAy At

www.iArx.org FREE CPE!

iPA members receive cei’s relicensure or recertification cPe Buckets for free!

All the required CPE for relicensure or recertification conveniently bundled by CEi and free for iPA members!

IOWA PHARMACY NEWS

What has changed?

The Iowa Board of Pharmacy (BOP) has contracted with Assured Waste Solutions to provide a limited number of pharmacies the option to install a DEAcompliant lockbox unit for controlled substance medication disposal. These units can also accept non-controlled substances if a pharmacy chooses to install a lockbox. In these pharmacies, this unit will replace the traditional TakeAway disposal box currently being used. Interested pharmacies must contact the BOP to sign up.

The previously provided DEA-compliant MedSafe units and TakeAway envelopes for controlled substance disposal provided through IPA will no longer be available through this statewide program.

Pharmacies that have a MedSafe unit or TakeAway envelopes should still use these items until they are full/used up.

What has stayed the same?

The BOP has contracted with IPA to administer the TakeAway program for collection of non-controlled substance medications for disposal. Outpatient or community-based pharmacies

can still participate in the TakeAway program through IPA for disposal of non-controlled substances. IPA will continue to subcontract with Sharps Compliance, Inc. to provide the network of pharmacies with 20-gallon TakeAway boxes at no charge.

Pharmacies can still request appearances

by Pill Dude, Iowa TakeAway’s mascot.

A revamped mascot (that will be easier to transport!) will be available in the fall of 2016.

IPA will continue to work closely with stakeholders and advocates for proper medication disposal and strategies to address prescription drug abuse and misuse on behalf of the pharmacy profession and patients in Iowa.

Rex Pharmacy Named 2016 Pharmacy of the Year

Congratulations to owner Josh Borer, PharmD, and the staff at Rex Pharmacy in Atlantic, Iowa, on being named the 2016 Pharmacy of the Year by McKesson. The award recognizes independent pharmacies that are driving the future success of

Josh Borer and family receive the Pharmacy of the Year Award at McKesson ideaShare in Chicago

independent pharmacy through the delivery of superior patient care.

In presenting the award, McKesson highlighted Rex Pharmacy’s top 20% performance in all quality measures.

Josh’s drive to keep the over 75-year-old pharmacy a healthcare destination has led to the implementation of a medication synchronization program that has more than 415 patients enrolled. The shift to an appointment based model has allowed Josh and his staff to implement services that continue to focus on their patient’s health as a whole. ■

JUL.AUG.SEP 2016 |

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CLASS OF 2016

CONGRATULATIONS!

Drake University College of Pharmacy and Health Sciences Class of 2016 Nashmi Albadarin Melissa Albrecht Mikias Alemayehu Jasmine Anderson Marissa Ausman Aaron Beck Annette Blyakher David Book Brittney Borts Emily Brandner Lauren Bricker Geena Brickson Michael Buege Travis Carlson Danielle Case Justine Choe Jacqueline Chorzempa Katrina Coen Benjamin Dagraedt Haley Deering Douglas Dlouhy Brittany Domagalski Ty Drake Stephanie Duehlmeyer Lindsey Eichwald James Ellison Kristen Elwood Sarah Evans Nadezhda Fedotovskikh

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Anne Feldman Brandon Fields Mark Fouad Natalie Gadbois Gavin Gardner Lindsey Garner Emily Gjelhaug Christopher Goodwin Karly Grettenberg Kelly Gunderson Ellen Heikens Samantha Hilt Kendra Holcer Michael Jacobson Vaibhav Kadakia Stephanie Keca Haley Kessinger Carson Klug Olivia Lehman Jake Lehmann Henry Lin Kaitlyn Linell Eric Liu Joseph Lutgen Paul Mahling Travis Marsh Kathryn Marwitz Cory Middendorf Yvette Mitchell

Jessa Mordini Scott Morrett Jonathan Mueller Tyler Nauman Jared Netley Amy Newton Amy Ngai Nhut Nguyen Erik Nielsen Jessica Nightser Carly Noyes Hailey O’Neill Paul Orstad Zachary Pape Evelyn Parenteau Udit Parikh Kayla Pearson Amanda Penland Stacy Reid Alison Richards Andrew Riesberg Caitlin Robertson Joshua Roehrick Natalie Roy Anna Shields Erin Skahill Talli Smith Steven Soseman Chloe Stacy

Lucy Stanke Kayla Stein Andrew Stessman Hannah Stonewall Lauren Stratton Erin Swinghamer Allison Tenhouse Stephanie Tesch Vimal Thottapurathu Alissa Tillotson Stephanie Vanchipurakal Alex Weirich Nicole Westenberger Rebecca Wilson Jacqueline Ye Tina Yin Joseph Zieminski Adam Zimbeck Bradley Zimmermann

Photos: Drake University College of Pharmacy and Health Sciences

| The Journal of the Iowa Pharmacy Association

CLASS OF 2016

CONGRATULATIONS!

The University of Iowa College of Pharmacy Class of 2016 Kasey S. Abel Elisha M. Andreas Sylmarie Arroyo Ian D. Bakewell Deann J. Beck Adam G. Bernabe Alicia A. Berry Alyssa L. Billmeyer Natalie D. Blaine Brandle S. Blakely Courtney M. Brown Courtney N. Brown Erika R. Brown Michael J. Brunner Elizabeth M. Cataldo Kathryn M. Caves Albert L. Chan Marciha D. Chatman Alyssa K. Cosnek Kelsey A. Daedlow Brittany N. Dougherty Michael A. El-Kass Mary K. Ensminger Christian J. Erickson Anna M. Espeland Kaleb J. Fincher Garrett W. Fouth Elizabeth M. Glynn Jacob M. Goddard Jessica E. Goff Chelsea M. Goldsmith

Rylee J. Goosen Kathryn E. Gross Wahid H. Habib Seongmee Han Amaris N. Hanson Christa A. Heckenlively Jessie M. Henry Mark A. Hogan Hilary C. Holt Grant J. Houselog Seamus D. Hughes Laura A. Hummelgard Marisa K. Jorgenson Kylee C. Karlic Christine J. Kim Alexander E. Kincaid Edward R. King Jeffrey D. Kofmehl Michelle A. LaFever Michelle E. Lee Jenna N. Lensmeyer Caitlin J. Lickteig Jonathan R. Linder Anastasia J. Lundt Michael D. Maize Corey J. Marin Molly E. Martin Maya Mesghali Jacob A. Meyer Christina L. Miller Vi T. Missiaen

Gregory E. Morgensen Hieu Nguyen Long T. Nguyen Leslie A. Noty Shiny Parsai Parth G. Patel Aaron D. Peck Hayley N. Perrin Jacob J. Peterson Rebecca M. Petrik Ryan P. Phelan Molly E. Polzin Jeremy D. Price Monica K. Rauch Joshua M. Rose Jeffery T. Ross Alex M. Ruffcorn Kolby S. Sackett Samantha J. Sagert Robert J. Salmon Tyler B. Sandahl Jacqueline N. Scheid Jatessa J. Schrank Noel D. Schulte Kristi L. Sharp Nichole J. Sly Stephen M. Smith Chayla R. StantonRobinson Laura M. Steinauer Eric R. Stephens

Britney L. Stillmunkes Carolyn J. Stoneking Laurie L. Terpstra Tiffany A. Tierney Philip E. Tobias ShanraĂŠl M. Vinel Candance L. Wagenknecht E. Bradley Waldo Kyle L. Walther Weishi Wang Sara M. Wirth Hao Wu Muhammad W. Younus Anne E. Zepeski Jiexuan Zhang With Distinction PhD Graduates Kawther Ahmed Amal Ayyoub Ioana Craciun Colin Higgins Yingjian Li Carlos Peroza-Mesa Eric Rodriguez Jacob Simmering Ben Urick Brigitte Vanle Yiran Zhang

Photos: The University of Iowa Office of Strategic Communications\Justin Torner

JUL.AUG.SEP 2016 |

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PRACTICE ADVANCEMENT

the Board of Pharmacy (BOP) in August.

Error rates for technician-verified refills remained low throughout the initial pilot, and were similar to pharmacist-verified refills. There was a statistically significant increase in the number of patient care services provided and time spent in patient care.

Practice Advancement Forum Equips for Practice Change

For the second year in a row, IPA hosted the Practice Advancement Forum to inform and engage pharmacists, pharmacy technicians, and student pharmacists about key initiatives occurring across the state of Iowa that utilize the expertise of the pharmacist to assist patients in appropriate medication use. With support from the Iowa Department of Public Health, IPA convened the 2016 forum in conjunction with the IPA Annual Meeting on June 16 in West Des Moines. With an emphasis on applicable “how-tos,” close to 100 IPA members were able to learn about: • Pay-for-performance models of care delivery • Changes in Medicare payment • Collaboratives that engage practitioners and hospitals together • Integration of pharmacy across the continuum of care • Identifying healthcare quality metrics that need the help of pharmacy • Potential reimbursement mechanisms for pharmacist-provided services • Effectively partner with physicians based on their practice needs Throughout the day, presenters provided attendees key action steps to make change happen in their practices. These action steps included:

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1. Get involved with the State Innovation Model (SIM) 2. Participate in the Hospital Engagement Network (HEN) 3. Get involved with the Iowa Health Information Network (IHIN) 4. Know accountable care organizations (ACO) in your geography and reach out to ACO leadership 5. Evaluate publicly reported ACO plan data…identify major chronic conditions for which you have pharmacy solutions.

Mark your calendars for the 2017 Practice Advancement Forum, which is planned for June 15, 2017, in Coralville. If you have ideas or suggestions for specific topics that should be covered, please contact IPA@iarx.org.

New Practice Models Shows Promise; Expands Research into 2017

The IPA New Practice Model (NPM) Initiative continues to grow. With the support of the National Association of Chain Drug Stores (NACDS), the Community Pharmacy Foundation, and Telligen, seventeen pharmacies across the state implemented tech-check-tech (TCT) for refill prescriptions, as a means to provide advanced pharmacy services.

The fourteen active sites from both Phase 1 and 2 completed data collection for the initial pilot in July 2016, and IPA anticipates presenting a final report to

NPM stakeholders met in March and June of 2016 to discuss future directions, and successfully pursued BOP approval for a second pilot to expand TCT to include new prescriptions as part of a Phase 3 rollout. The BOP also approved a Phase 4 research project for sites that include the ability to continue TCT for refills only without direct support of the NPM project manager. IPA is participating in active discussions with the BOP to evaluate the long-term plans with the NPM with the possibility of development of TCT legislation and regulations for community pharmacy practice.

WISEWOMAN Program Expands Across Iowa

The Iowa Department of Public Health’s Iowa WISEWOMAN Program provides cardiovascular screening and interventions for women aged 40-64, un- or underinsured and low income.

Following a successful pilot in Des Moines, the program is expanding within the state, partnering with community pharmacists in the Dubuque, Clinton, Maquoketa, Sioux City and Spencer areas to provide medication therapy management (MTM) services to program participants in July.

A program coordinator at the local public health department identifies participants, who have newly diagnosed hypertension and prescribed medication or previously diagnosed and uncontrolled hypertension while on medication, to be referred to MTM services performed by the local community pharmacist. While providing MTM services, pharmacists are specifically asked to take blood pressure measurements at initial and follow-up visits, complete DRAW tool assessment

PRACTICE ADVANCEMENT

State Innovation Model Community Care Coalition Grantees 1.

2.

3.

4.

5.

6.

for each participant at each visit, provide two follow-up calls per participant, and communicate with regional program care coordinators regarding participant assessment and goals.

The goal with this current expansion of the program is to see continued successful integration of pharmacist care coordination for this patient population, and ultimately expand this MTM program statewide.

Progress Continues with Wellmark High Performing Pharmacies Network

Wellmark is working closely with IPA to implement a network of High Performing Pharmacies (HPP) including 75 pharmacies across the state of Iowa.

The HPP Network is intended to use a population management approach for community pharmacists to work with patients and providers to improve the quality of care and reduce total cost of care. Wellmark and the HPP Network pharmacies will cooperate to identify a panel of targeted patients for each pharmacy, provide services needed by those patients to optimize their medication therapy, and share pharmacy performance information. Pharmacy payment for this advanced pharmacy care will use an innovative capitated pay-for-performance approach. Quality metrics will be collected and analyzed for four disease states (diabetes, asthma, dyslipidemia and depression) as well as monitoring total cost of care, emergency room utilization and hospital readmission.

IPA hosts ChargeUP webinars twice a month to provide updates on the Wellmark HPP initiative, share best practice tips, and provide updates on guidelines and other clinical information for pharmacies in the HPP Network.

The exact launch date of this program has not yet been set. IPA will continue to work closely with both Wellmark and the HPP Network pharmacies as this initiative progresses.

SIM Strategies Implemented Across C3 Communities

The Centers for Medicare and Medicaid Services (CMS) State Innovation Model (SIM) grant is providing unique opportunities for several pharmacists across Iowa to collaborate with providers and community leaders to test new payment and service delivery models.

IPA has been working with the Iowa Healthcare Collaborative (IHC) to engage pharmacies in six designated communities.

The current phase of SIM is working to connect stakeholders through Community Care Coalitions (C3s) locally-based coalitions of health and social service stakeholders collaborating to promote the coordination of health and community-based resources across care settings and systems of care. C3s are designed to: • Implement population-based, community-applied interventions related to the Iowa SIM Statewide Strategies • Address social determinants of health through care coordination • Participate in process improvement • Educate on the benefits of community-based strategies to support healthy behaviors • Build and participate in referral processes Stakeholders are currently coming together to implement strategic plans focused on medication safety and

Community Health Partners of Sioux County Dallas County Public Health Nursing Services Great River Medical Center Linn County Board of Health Marion County Public Health Department Webster County Health Department

effectiveness (see page 23) and diabetes care. With more direct access to patients than most providers, pharmacy has a key role in these initiatives in deciding how to best implement them. This is also an opportunity to increase the quality and spectrum of services available to patients through collaboration with different providers in these communities and prepare the profession for future payment models based on quality measures.

Community Pharmacy Enhanced Services Network

Five Iowa pharmacist luminaries are leading the development of the Community Pharmacy Enhanced Services Network (CPESN) as a pharmacy performance network that has adopted the tenets of value-based health care through committing to offer a menu of enhanced pharmacy services demonstrated to improve quality of patient care and reduce overall health care costs. This model was successful in North Carolina, where Community Care of North Carolina (CCNC) received a CMMI grant to expand CPESN to other states. CCNC is working with Iowa pharmacists to support their pharmacy performance network.

Pharmacies who are a part of the CPESN are offering core services such as comprehensive medication review, medication synchronization, immunizations, adherence packaging/ counseling, and medication reconciliation. The luminaries will oversee workgroups to continue to develop and grow this network. ■

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2016 LEGISLATIVE SESSION

2016 LEGISLATIVE SESSION RECAP Bill Wimmer, JD Wasker, Dorr, Wimmer & Marcouiller IPA Legal & Legislative Counsel

Angela Davis, JD Wasker, Dorr, Wimmer & Marcouiller IPA Legal & Legislative Counsel

T

he 2016 legislative session was a busy time for IPA, with staff and lobbyists actively advocating for IPA’s legislative priorities and additional pharmacy bills that were introduced.

STATE LEGISLATIVE PRIORITIES Medication Refill Synchronization

Although medication synchronization was a priority entering the legislative session, IPA chose to approach the issue outside of the legislative process and engage directly with Wellmark.

However, a bill (SF 2078) was introduced by another party and IPA

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chose to support the bill. Though the bill passed with bipartisan support in the Senate, it failed to make it past the first legislative funnel in the House.

Several attempts were made to insert the language into other vehicles and it was amended into the Health and Human Services budget bill. However, it was removed at the last minute due to fiscal concerns. IPA is continuing to work with healthcare payers, legislators and key stakeholders to implement policies that allow patients and pharmacies to easily synchronize chronic medications.

Statewide Protocols

IPA’s outreach to groups such as the Iowa Department of Public Health, the Board of Pharmacy, Iowa Medical Society, and others laid groundwork for expanding pharmacists’ role in patient care. No affirmative legislation was created prior to session with the understanding that more extensive conversations with the executive branch and others were necessary to determine the best way to incorporate pharmacists into the health care model more extensively.

Bills on meningococcal vaccination requirement, hormonal contraception and naloxone access opened conversations on the expanded role

of pharmacy through collaboration in delivering care to Iowans.

Board of Pharmacy Bill

IPA supported the Iowa Board of Pharmacy’s bill (SF 453) which included the Board’s proposals on nonresident pharmacy, telepharmacy and outsourcing facility licensure, alternate board members, and definitions regarding pharmacy practice.

The board’s proposal on telepharmacy generated the most attention and debate. While the Senate unanimously passed the bill last session, House members raised a number of concerns including the protection of rural, independent brick-and-mortar pharmacies. In the last weeks of session, a compromise was reached allowing telepharmacy to expand across Iowa, but only if new facilities are over 10 miles away from an existing brick-and-mortar facility. The Board of Pharmacy will have licensing and inspection authority and the ability to waive the 10-mile restriction.

The bill passed with amendments in both chambers and was signed by Governor Branstad on April 21.

2016 LEGISLATIVE SESSION

STATE REGULATORY PRIORITIES Pharmacy Benefits Manager Administrative Rules

Passage of administrative rules effective June 1, 2016, which implement HF 2297 (2014) and HF 395 (2015). Both pieces were passed unanimously by both chambers despite increased lobbying efforts by PBM groups. The new rules give the Iowa Insurance Division explicit authority to audit PBMs and request information, including pricing methodology for generic drug prices.

Medicaid/Managed Care

Legislative Activity The shift from state-run Medicaid to a privately-run Managed Medicaid model proved to be the most contentious issue this session. Senate Democrats repeatedly protested the switch to managed care by taking a series of symbolic votes calling for breaking managed care organization (MCO) contracts or enhancing oversight.

The House’s GOP leadership refused to take up the bills House Republicans and Senate Democrats reached a compromise on oversight provisions though the Health and Human Services Appropriations bill. Under the bi-partisan proposal, another position would be added to the Office of the Long-Term Care Ombudsman that would have greater oversight authority over the MCOs. In addition, a pre-existing committee within DHS will have oversight of Medicaid and have additional seats for consumer representatives. Another oversight measure which requires MCOs to submit data on health care outcomes for patients was also approved.

Executive Branch Medicaid Reimbursement Last legislative session, several months were spent working with the executive branch and educating them on the importance of IME’s current reimbursement formula—average acquisition cost plus a dispensing fee based on a biannual survey. Though IPA

received assurances from the governor’s office that the reimbursed formula would remain following switchover to MCOs. However, the speed of the transition caused some items to fall through the cracks during the contract process— including pharmacy reimbursement.

IPA’s government relations team began work in the fall (2015) with the governor’s health policy advisor, Nick Pottebaum, to ensure that Iowa pharmacists weren’t forced to accept national reimbursement rates set by national MCO contracts with PBMs. After months of meetings with the executive branch, the reimbursement rate made it into the MCO contract amendment.

Medicaid Specialty Pharmacy MCOs and PBMs attempted an endrun around the pharmacy agreement by forcing specialty drug patients to obtain medicine by mail from out-of-state PBM warehouses, essentially cutting out Iowa’s only specialty pharmacy and IPA member, Hy-Vee. IPA’s government relations team worked closely with HyVee and Amber Pharmacy to craft talking points and other educational materials for the governor’s office and IME leadership. After a series of meetings, provider contracts were given to Hy-Vee by all of the MCOs’ PBMs, resulting in uninterrupted patient care.

Cost Savings Measures IPA’s government relations team participated in multiple meetings with the governor’s health policy advisor and IME leadership on cost savings strategies to the state that would allow pharmacists to be more fully incorporated into the health care team. MTM educational material and examples of programs conducted in other states were circulated and discussed. Follow up meetings have been requested specifically by Mikki Stier and Nick Pottebaum to discuss possible opportunities in the future.

ADDITIONAL ISSUES BOP Dispensing Program Access

by the Board of Pharmacy as a way to enhance the current controlled substance monitoring system. Under the new law, the BOP is directed to upgrade its electronic tracking program so that prescribers and pharmacists can easily access it on a need-to-know basis. The information will be used to help identify patients who are potentially addicted, at risk of addiction or who are obtaining medication to sell on the street. Once scrubbed of identifying data, the BOP can release statistical information for educational, statistical, public policy or research purposes.

Controlled Substance Schedule Changes

This law (SF 2116) expands the list of controlled substances to other substances that mimic illegal drugs.

Additional Medication

Though not an IPA initiative, the bill (SF 2214) was added to the association’s priority list as session got underway.

While initially intended to work jointly with medication synchronization, it independently clarifies existing code by affirming pharmacists’ discretion to fill multiple months’ prescription in one visit—which creates an even playing field with mail order pharmacies.

Psychologist Prescribers

This legislation (SF 2188) was designed to address one of the nation’s most pronounced psychiatrist shortages. The bill essentially creates a professional track comparable to a physician assistant.

Under this program, a psychologist could undergo two years of special training on psychotropic drugs, and prescribe medication to patients under the supervision of a psychiatrist. The psychiatric community strongly opposed the legislation. Although this bill had piqued the IPA’s interest for some time, the association didn’t push for definitive lobbying action. Following an up hill battle in both chambers, the bill passed with amendments two days before the session adjourned. ■

This legislation (SF 2102) was put forth

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PUBLIC AFFAIRS

BOARD OF PHARMACY STRATEGIZES AND ACTS ON THE FUTURE OF PRACTICE Board of Pharmacy Retreat The Board of Pharmacy met on June 28, 2016 for the purpose of strategic planning. They were assisted by Michael Burleson, past president of NABP and former executive director at the Kentucky Board of Pharmacy. The Board discussed multiple topics that impact pharmacy practice and safety of patients in Iowa, including: licensing categories, technology in practice, compounding practice, prescription drug abuse, and the role of pharmacy technicians. While many issues were identified as key priorities for the Board, 2016 and beyond will be a busy time for the Board of Pharmacy as they work to act in the best interest of the public.

Beginning July 1, 2016, the Board established the Iowa Monitoring Program for Pharmacy Professionals (IMP3).

IMP3 is designed to assist pharmacists, student pharmacist, and pharmacy technicians in obtaining the necessary help for a successful rehabilitation from substance abuse as well as mental and physical disabilities. The Board plans to educate Iowa pharmacy professionals at the local level with CPE learning activities organized through the local pharmacy associations across the state.

Telepharmacy Proposed Regulations After several years of joint task force meetings, various pilot projects, and recent passage of legislation, the Board approved proposed regulatory changes seeking public comments. The current proposed rules provide standard for provision of pharmacy services to patients through the use of audio-visual technologies that link a telepharmacy site to a managing pharmacy. In the newly proposed 657 IAC Chapter 13, the proposed rules require a written agreement between the managing pharmacy and the telepharmacy site, identify general requirements of each site and associated staff, and specify that a telepharmacy cannot open within 10 miles of another outpatient pharmacy that dispenses medications to patients.

USP Compounding Standards After a Compounding Task Force was convened and recommendations developed in 2015, the Board of Pharmacy amended its compounding regulations to utilize USP Chapters <795> and <797> as the standards for non-sterile and sterile compounding practice in Iowa. The Board of Pharmacy’s new compounding rules within IAC 657 Chapter 20 took effect on November 18, 2015. All pharmacies in Iowa engaging in sterile or non-sterile compounding need to be compliant with USP compounding standards. Over the past several Board meetings, multiple hospital pharmacies have submitted waiver requests to provide ample time for a pharmacy to adopt the current and anticipated new USP standards and comply with the Board of Pharmacy regulations. The Board understands the necessary changes needed for a pharmacy practice to adhere to the USP standards and they have been approving time extensions for various pharmacies on a case-by-case basis. ■

IMP3 Replaces IPRN On June 30, 2016, the Board of Pharmacy did not renew its contract with the Iowa Pharmacy Recovery Network (IPRN) to manage the peer-monitoring program for recovering pharmacy professionals.

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To learn more about this program, visit: https://pharmacy.iowa.gov/misc/ iowa-monitoring-program-pharmacyprofessionals-imp3.

Sen. Joni Ernst Visits Guthrie County Hospital Guthrie County Hospital (GCH) welcomed Sen. Joni Ernst as she visited with the pharmacy staff and physicians in an effort to better understand the importance of provider collaboration and pharmacists’ services at a critical access hospital in both inpatient and outpatient settings.

During the visit coordinated by IPA, Sen. Ernst was genuinely interested in learning about the collaboration that exists between physicians Dr. Steve Bascom and Dr. Josh Strehle and pharmacists DeeAnn Wedemeyer Oleson, PharmD, and Brenda Halling.

While not unique to GCH, the physician-pharmacist team was able to provide real life examples to the senator of how their collaborative practice provides better care and outcomes to Iowans.

Also during this visit, Sen. Ernst and GCH staff discussed the barriers to patient care that are created by PBMs. Both the physicians and pharmacists shared patient examples of PBMs interfering with the care they provide to their patients.

The Battle Continues – PCMA v. State of Iowa Following dismissal of all five claims in the U.S. District Court for the Southern District of Iowa, PCMA appealed the court’s ruling on two of the five claims, specifically related to ERISA and the

PUBLIC AFFAIRS

dormant commerce clause on October 7, 2015. The 8th Circuit Court of Appeals heard oral arguments from the attorneys representing PCMA and the State of the Iowa in Minneapolis, MN, on June 14.

We are now awaiting the decision from the three judge panel. IPA has worked closely with the National Community Pharmacists Association (NCPA) and the law firm Katten Muchin Rosenman LLP throughout the litigation to author an amicus brief in support of the state and provide expertise as needed.

Representing Iowa Pharmacy on the Medical Assistance Advisory Council (MAAC) & DHS Council IPA has representation on two important bodies that are legislatively charged with oversight responsibilities for Iowa Medicaid. IPA is a member of the MAAC and MAAC Executive Committee, which is chaired by Gerd Clabaugh, Director of the Iowa Department of Public Health and meets throughout the year with quarterly Executive Committee meetings. IPA is represented by Jessica Smith, PharmD, MPH, pharmacist from Mercy Family Pharmacy in Dubuque and Kate Gainer, PharmD, IPA’s executive

vice president and CEO. Additionally, IPA member Kim Spading, RPh, MBA, pharmacy manager from the University of Iowa Hospitals and Clinics in Iowa City, was appointed by Governor Branstad to serve on the Department of Human Services Council, which is chaired by Charles Palmer, the director of the Iowa Department of Human Services.

Through these roles, as well as the open channel of communication between IPA and the Iowa Medicaid Enterprise and three managed care organizations, IPA is able to constantly share pharmacy feedback related to Medicaid policies and the transition to managed care in Iowa.

Iowa Congressmen Push CMS for DIR Transparency In June, members of the U.S. Senate and House sent letters to the Centers for Medicare and Medicaid Services (CMS) urging them to finalize guidance that provide transparency to Direct and Indirect Remuneration (DIR) fees.

Sixteen Senators, led by Sen. Chuck Grassley of Iowa, signed the Senate’s letter. IPA has been working with Sen. Grassley’s office on this issue and assisted with the letter. Iowa’s Rep. Dave Loebsack

was among the leaders on the House’s letter with Iowa’s Rep. Rod Blum also among the 30 representatives to sign it.

The letters refer to CMS’s Proposed Guidance on Direct and Indirect Remuneration and Pharmacy Price Concessions that was proposed in 2014. The guidance would standardize reporting by drug plan sponsors of price concessions received from and incentive payments made to participating pharmacies. The guidance would also require the fees to be reflected or estimated at the point of sale – providing a more accurate figure to the pharmacist on what the final reimbursement would be.

This was not the first time Iowa’s elected leaders called out CMS on this issue. In October 2015, Rep. Loebsack was among 11 representatives that sent a similar letter to CMS. In February, Iowa’s Rep. David Young wrote his own letter urging CMS to finalize the proposed guidance.

IPA also took the opportunity to discuss DIR fees with all six members of Iowa’s congressional delegation while visiting them in Washington, D.C., during the NCPA Congressional Pharmacy Summit in May. ■

NCPA CONGRESSIONAL PHARMACY SUMMIT A delegation of Iowa pharmacists and student pharmacists joined over 350 pharmacists in Washington, D.C., for the 2016 NCPA Congressional Pharmacy Summit. IPA held office meetings with all six members of Iowa’s congressional delegation and used the opportunity to discuss provider status, PBM regulation and direct and indirect remuneration (DIR) fees with each of Iowa’s elected officials and their staffs.

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TECHNICIAN CORNER

TELEPHARMACY:

THE TECHNICIAN ROLE Meg Finn, CPhT Technician Supervisor University of Iowa Hospitals & Clinics Ambulatory Care Pharmacies Pharmacy Technician Trustee

P

harmacy in Iowa continues to be very innovative and forward thinking; always looking to progress to a more advanced pharmacy practice. This rings true not only for pharmacist advancement and the expansion of services, but in expanding and developing the role of pharmacy technicians.

One current area of focus is telepharmacy, which utilizes a combination of pharmacy personnel and modern technology to provide care to patients in areas where pharmacy services are not readily available. By utilizing these technologies, telepharmacy allows for the enhancement and expansion of current services offered in a variety of pharmacy settings.

Telepharmacy provides significant opportunity for technicians to enhance their skill sets and perform at the top level of their certification.

These advances in technology and practice will provide technicians chances for development in the form of additional training and advanced technical responsibilities. If we capitalize on these ways to expand the technician role, we are also enabling pharmacists to broaden the scope of their practice and continue to find new ways to improve patient care.

Technicians are able to offer valuable input regarding the effects of these changes on the technician role

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as well as pharmacy as a whole.

As IPA members, technicians are able to provide suggestions and feedback regarding current issues by volunteering and actively participating in the various committees. As IPA technicians, we are also given the opportunity to participate in the rulemaking process by constructively voicing our thoughts and providing an alternative perspective. This can strongly impact the future of telepharmacy, and pharmacy, in Iowa.

“The technician is the primary face of the pharmacy” As a provider of care in a retail telepharmacy setting, the technician is the primary face of the pharmacy.

Similar to a traditional retail pharmacy, the technician is the first person the patient will encounter in their pharmacy experience and has the most direct one-on-one patient contact. The technician is responsible for maintaining the operations and supporting the care and services provided to the patients in the physical pharmacy setting, while working with and under the supervision of the (primarily) offsite pharmacist. The technician role in telepharmacy requires that the individual be responsible, resourceful and reliable, among many other strong attributes. Attention to detail and consistency remain primary focuses of the technicians, ensuring that the needs of both the patient and the pharmacist are met.

Technicians may also need to take on additional “pharmacy maintenance” responsibilities, as they will be the primary person present in the pharmacy each day.

Telepharmacy can be integrated into

many pharmacy services outside of retail as well. Services such as remote/electronic bedside counseling allow technicians in a health system pharmacy to become even more involved in direct patient care, while allowing the pharmacist additional time to focus on the clinical aspects of their position, without losing that “patient touch.” Increases in remote verification can also have a positive impact on workload for pharmacists, allowing them to optimize the use of their time and improve productivity.

There is a continued focus in healthsystems, and all of pharmacy, on continuity of care. These advances and the advancement of the technician role can contribute to this valued objective.

Telepharmacy and the expansion of the technician role give pharmacies in the state of Iowa the opportunity to promote and foster a higher standard level of performance in pharmacy technicians. As technology allows pharmacy services to expand, we will need to ensure that increasing the number of qualified technicians remains a focal point. This should include not only increasing the technician population in Iowa, but focusing on the utilization of the knowledge and experience the state’s current technicians have to offer, providing support and enabling the technician population to work to their full potential.

Beginning in 2020 technicians will be required to complete an American Society of Health-Systems Pharmacists (ASHP) accredited training program prior to sitting for the Pharmacy Technician Certification Board (PTCB) exam.

As show of support and leadership of continued advancement to the

TECHNICIAN CORNER

field of Pharmacy, the University of Iowa College of Pharmacy has facilitated a Technician Education Summit, including the community colleges from across the state and many pharmacy leaders. They have begun and continue to work toward a solution to this impending requirement.

It is imperative that the result will yield ASHP accredited programs in the state of Iowa that produce qualified, educated technicians to enhance the current Certified Technician workforce.

With the many advances occurring every day, as technicians in Iowa it is our responsibility to ensure that we are informed of what is occurring in the pharmacy world. We need to educate ourselves on changes in standards and practices, offering perspective on how these changes affect our daily work. It is important to make sure that we see the bigger picture and keep an open mind regarding progress, while embracing change and educating others on the role of the pharmacy technician. Pharmacy is ever-changing, and it’s our job to make sure that we continue to change as well. ■

Looking for recertification CPE? IPA Technician Members Receive ALL Required CPE for CPhT Recertification for FREE! Pharmacy technician members of IPA now receive the Recertification Bucket from CEI for FREE! The Recertification Bucket includes Pharmacy Technician Certification CPE activities in categories consistent with the PTCB Domains, structured as 10 one-hour written modules that you can print and complete on the go. Also included are live and on demand webinars in the area of pharmacy law and patient safety.

Login at www.iarx.org/cei_buckets to take advantage of this new benefit for members and spread the word to your colleagues.

JOIN NOW & receive your free recertification bucket! www.iarx.org/membership 515.270.0713 | ipa@iarx.org

THE PTCB

ADVANTAGE • Improved employment opportunities • Demonstrated value to the pharmacy team • Validated achievement • Future career growth options • Prestige among coworkers • Potential for higher salary

Certification by PTCB is the gold standard for pharmacy technicians.

Many employers now require their employees to be PTCB-Certified Pharmacy Technicians (CPhTs).

PTCB has a new website, a streamlined application process, sponsorships, and free verifications. The Pharmacy Technician Certification Exam (PTCE) reflects current knowledge areas demanded across all practice settings. PTCB’s requirements to become a CPhT include a high school diploma and a passing score on the PTCE. Learn more and apply at www.ptcb.org.

Get the

PTCB ADVANTAGE SETTING THE STANDARD www.ptcb.org

CONNECT ONLINE:

Become a

PTCB CPhT TODAY JUL.AUG.SEP 2016 |

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TECHNICIAN CORNER

NEWLY PTCB CERTIFIED IOWA TECHNICIANS April 1 - June 30, 2016

Please join IPA in congratulating the following pharmacy technicians on becoming PTCB-certified!

Brittney Ager, Cedar Falls Spencer Aldridge, Des Moines Katelynn Aycock, Adel Athena Barbas, Council Bluffs Emily Barmore, Cedar Rapids Taylor Blackford, Des Moines Shirley Boomgarden, Humboldt Kerri Buckley, Orange City Benjamin Burling, Nevada Abigail Butler, Altoona Savannah Calixto, Washington Delaney Cheek, Nevada Charity Clark, Keota Kelsey Coates, Ames Theresa Coleman, Des Moines Kathryn Cooley, Adel Abigail Cowan, Des Moines Jack Curran, Humboldt Niklaus Diers, Marion Jessica Edwards, Denison Erin Elliott, North Liberty Amber Ellis, Ames Morgan Erickson, Sioux City Brittany Erickson, Washington Caresa Evans, Coralville Taylor Evans, Urbandale Ciesco Febrian, North Liberty Michael Fett, Cedar Rapids Robert Fischer, Iowa City Renee Ford, Ottumwa Ashley Foster, Des moines Ronald Frantz, Davenport Emily Funke, Dyersville Emma Galbraith, Des Moines Christina Garces, Iowa City Allison Gardner, Toddville Dane Gerdes, Cedar Falls Heather Gleason, Oskaloosa Samuel Goldsberry, Waterloo Kaitlyn Groenbeck, Davenport Sarah Gronau, Durango Victoria Haag, Mason City Bree Hagg, Fort Dodge Cheyeandra Hampsmire, Sergeant Bluff Theresa Hanley, Mason City

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Steven Hay, Marion Whitney Hess, Ames Zachary Hogan, North Liberty Danielle Hughes, Tracy Analisa Iole, Marshalltown Akali Jack, Davenport April Jackson, Sioux City Rita Jones, West Branch Samantha Kalous, Cedar Rapids Lillian Keitges, Ames Amber Kielly, Hiawatha Michelle Klein, Le Mars Jordan Knotts, Lamoni Kirstan Koetters, Sioux City Abigail Kolar, Sergeant Bluff Natalie Kontz, Cedar Rapids Elisha Koppman, Carroll Michelle Lactaoen, West Des Moines Megan Laughlin, Fort Dodge Phat Le, Sioux City Joshua Lenth, Iowa City Jade Lindsey, Council Bluffs Paige Lindsley, Iowa City Bryanna Long, Boone Tayronda Lottie, Cedar Rapids Sarah Lowenberg, Cedar Rapids Sydney Lunardi, Bettendorf Ciera Madison, Sioux City Jeffrey Mannix, Iowa City Jacquelyn Mareau, Sloan Amber McCall, Johnston Colton McConnell, Armstrong Benjamin Medbourn, Sioux City Jose Mendoza-Jaramillo, Waterloo Cheryl Miller, Beaman Todd Mitchell, Grand Junction Shiela Moore, Hamburg Tyler Morrison, Manchester Chase Muenzenmeyer, Cedar Rapids Connie Myers, Davenport Sarah Nelson, Sioux City Shelly Nelson, Gowrie Phuong Nguyen, Davenport Christopher Noty, Atlantic Michael O’Brien, Waterloo

Alexis O’Callaghan, Blue Grass Kristin Ockenfels, Center Point Derrick Okine, Sioux City Jill O’Malley, Iowa City Henryson Omoregie, Iowa City Aaron Parkinson, Ankeny Michele Payne, Knoxville Joanna Perkins, Coralville McKenzie Pfeffer, West Des Moines Lan Anh Pham, Cedar Rapids Lisa Pham, Des Moines Tien Pham-Bonnett, Des Moines Jordan Pierce, North Liberty Julia Pink, Cedar Rapids Jennifer Piper, Norwalk Latisha Preat, Des Moines Helen Ramirez Say, Sioux City Benjamin Rice, West Des Moines Andrew Ruden, Oxford Miriam Rueger, Hubbard Lisa Ruopp, Grinnell Charlie Rupp, Iowa City Carolyn Sager, Davenport Esmeralda Saucedo, Sioux CIty Nickolas Scott, Iowa City Amanda Smilich, West Des Moines Jessica Strahl, Des Moines Crystal Strayer, Davenport Lauren Streets, Dubuque Fiora Thorne, North Liberty Tin Tran, Sioux City Amy Turner, Knoxville Tammy VandeKamp, Melbourne Kaise Vanourney, Central City Zedena Voigt, Carroll Emily Wheelen, Sioux City Tiffiny Wilkins, Fort Madison Jackson Willette, North Liberty Carley Williamson, Audubon Marina Wirth, Ames Lara Wurtz, Richland Ivy Xue, Ankeny Nathan Yanda, Ames

IPA FOUNDATION

IPAF BOARD OF DIRECTORS TRANSITIONS TO 2016-2017

IPA WELCOMES SARAH DERR AS EXECUTIVE FELLOW

With the new administrative year comes a new IPA Foundation Board of Directors.

First, the foundation would like to express its deepest appreciation to the following directors for their years of serving the profession and the foundation:

On July 6, IPA welcomed Sarah Derr, PharmD, as the association’s first executive fellow. Sarah is a 2015 graduate of the University of Minnesota and recently completed a Pharmaceutical Care Residency with Fairview Pharmacy Services in Minnesota.

Tim Becker, RPh, concluded his term after 9 years of service including 3 years as president.

Sue Purcell, RPh, will step down following 8 years of service to become the treasurer of the IPA Board of Trustees.

The foundation would like to welcome the new directors Steve Firman, Tom Halterman and John Swegle who have joined the board for 2016-2017. In addition, Bill Baer and Jay Currie have been named Foundation president and vice president, respectively.

2016-2017 IPA Foundation Board of Directors

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Bill Baer, RPh, CGP Chariton President

Jay Currie, PharmD, FCCP, FAPhA Mount Vernon Vice President

Renae Chesnut, BS Pharm, EdD, MBA Des Moines Drake University College of Pharmacy & Health Sciences

Bernard Sorofman, PhD Iowa City The University of Iowa College of Pharmacy

Kate Gainer, PharmD West Des Moines Secretary/Treasurer

Carl Chalstrom, RPh Anamosa

Steve Firman, BS Pharm, MBA, FAPhA Cedar Falls

Tom Halterman, RPh West Des Moines

Julie Kuhle, RPh Indianola

Cheri Rockhold Schmit, RPh Ames

Bob Stessman, RPh Manning

John Swegle, PharmD, BCPS Mason City

| The Journal of the Iowa Pharmacy Association

In addition to her passion for advancing the profession and providing excellent patient care, Sarah brings extensive experience in association work and leadership on a state and national level. As a student she was active in the American Pharmacists Association (APhA), including an APPE rotation, in addition to several student organizations.

Following graduation, she became active in the Minnesota Pharmacists Association, serving on several committees.

As the IPA fellow, she will be immersed in the day-to-day activities of the association and work closely with IPA staff to continue advancing IPA’s mission.

She will work to expand IPA’s clinical initiatives, attend state and national pharmacy meetings, gain exposure to all aspects of association work, and provide insight and assistance to the association.

The IPA Executive Fellowship in Association Management was created to support the development of individuals interested in association management through training and experience in leadership, advocacy, professional affairs and problem-solving at IPA. Individuals who complete the fellowship will be well prepared for leadership positions in a variety of settings in the profession of pharmacy and health care. The fellowship is supported by the IPA Foundation. ■

IPA FOUNDATION

IPA FOUNDATION NOW ACCEPTING APPLICATIONS FOR OUTCOMES INNOVATIVE PHARMACY ENDOWMENT GRANT The IPA Foundation is now accepting applications for grants from the Outcomes Pharmacy Innovative Pharmacy Endowment to support innovative pharmacy practice initiatives in the state of Iowa.

The foundation is looking to support the next generation of innovative pharmacy ideas through the endowment. Applicants must be pharmacists that are currently licensed in Iowa or an Iowa based researcher working with innovative pharmacy practice by Iowa pharmacists.

Applicants must also be active members of the Iowa Pharmacy Association.

The endowment was established by the original investors of OutcomesMTM, a medication therapy management (MTM) service provider based in Iowa. In 1999, the Iowa Pharmacy Association provided seed money to support this innovative startup, which became a national leader in MTM services. Following the purchase of OutcomesMTM by Cardinal Health in 2015, the endowment was created as a way for those original investors to give back to the pharmacy profession and keep the innovative spirit and legacy of the company and Iowa pharmacy alive.

Applications must be submitted by December 1, 2016. Finalists will be required to present to the foundation’s Board of Directors in February 2017 and funding notices will be released on April 1, 2017.

More information about the application process and requirements including the application form can be found at www.iarx.org/OutcomesGrant. ■

Grant Requirements Applicants must:

• Be a current Iowa licensed pharmacist or Iowa based researcher working with innovative pharmacy practice by Iowa pharmacists.

• Be active members of the Iowa Pharmacy Association.

• Present in person their grant proposal to the IPA Foundation Board of Directors at the February Board meeting.

• Present a poster at an IPA Annual Meeting following the conclusion of their grant project and final payment.

• Submit an interim and final report to the IPA Foundation and publish a summary in The Journal of the Iowa Pharmacy Association.

Application Procedure

The application process requires 1) completed application form and 2) project proposal. All applications must be submitted online as a word document or PDF by 11:59 PM CT on December 1, 2016. Project proposals should not exceed five typewritten pages (Times New Roman, 11 point font, 1.5 line spacing). Please visit www.iarx.org/OutcomesGrant for details related to the project proposal requirements and submission.

Review Procedures

Upon receipt, IPA Foundation staff will review submitted applications and project proposals for completeness. Eligible applications will be reviewed and ranked by a grant selection committee established from the IPA Foundation Board of Directors. Technical assistance on evaluation of methodology will be sought out as required. Grant Application Scoring will be ranked, based on: • Significance of innovation to the future pharmacy practice in the State of Iowa • Clarity of project objectives • Project design • Adequacy of the resources available to complete the project • Key personnel qualifications • Evaluation strategy to determine value/outcome of the project • Budget (complete, reasonable)

Grant Cycle

June 1, 2016 - Outcomes Grant Announcement; RFP sent to IPA membership December 1, 2016 - Application form and project proposal due February 2017 - Grant presentations made to IPA Foundation Board of Directors April 1, 2017 - Funding notices released to all applicants November 1, 2017 - Interim reports due to IPA Foundation Board of Directors TBD - Final reports due (based on project timeline) June 2018 - Grant Poster Presentations at IPA Annual Meeting TBD - Project summary published in Journal of the IPA

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IPA FOUNDATION

IPA would like to congratulate 2016 Leadership Pharmacy participants from Iowa:

LEADERSHIP PHARMACY WELCOMES 2016 CLASS

Christina Baumgart, PharmD VA Clinic, LaCrosse, WI (Winneshiek Medical Center in Decorah, IA, at time of acceptance) Leigh Boehmer, PharmD, BCOP Mercy Medical Center - North Iowa Kari Heitzman, PharmD Iowa Methodist Medical Center

Leadership Pharmacy, a leadership program for new practitioners, will begin its 27th year with a live conference on August 4-7, 2016 in Galena, IL. This is a unique opportunity for pharmacists in their first three to fifteen years of practice that provides strong leadership training, increases awareness of state and national pharmacy issues, encourages involvement in professional and community activities, and develops new practitioners for leadership roles within the profession.

Alex Hoopes, PharmD Network Performance, OutcomesMTM

Since its inception in 1989, over 340 Iowa pharmacists have completed Leadership Pharmacy and have gone on to become IPA presidents, board members, committee chairs, and leaders within their practice sites. This program is available to pharmacists in Iowa and Wisconsin who are interested in becoming leaders in their profession. Twenty pharmacists, ten from each state, are selected annually to participate.

Sarah Schmidt, PharmD Walgreens

Andrea Kjos, PharmD, PhD Drake University College of Pharmacy and Health Sciences Shane Madsen, PharmD, BCPS University of Iowa Hospitals and Clinics Kelly Percival, PharmD, BCPS Drake University College of Pharmacy and Health Sciences

Jill Stegall, PharmD Wheaton Franciscan Healthcare Dustin Villhauer, PharmD Hy-Vee Pharmacy #1151

SILENT AUCTION RAISES $14,000 FOR IPAF The 2016 Silent Auction featured over 90 items up for bid, include KISS tickets, a Go-Pro Camera and skydiving, yes skydiving, with Matt Osterhaus. A pair of garden stones featuring Drake University and The University of Iowa logos were hotly contested and added a bit of friendly rivalry to the evening. In addition to bidding on a fantastic array of items, the Silent Auction featured the Red Envelope Challenge, beer and wine ring toss and closed the evening with a rousing game of heads or tails.

The IPA Foundation would like to thank everyone who donated items, placed winning bids, threw rings and accepted the Red Envelope Challenge. Your efforts raised over $14,000 to support foundation initiatives to support student pharmacists and practice advancement across the state! â&#x2013;

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LEADERSHIP PHARMACY

Congratulations Kari!

Leadership Pharmacy appreciates the support of these sponsors:

Kari Heitzman, PharmD

...on your selection to the 2016 leadership Pharmacy Conference and academy!

Congrats!

Congratulations to

Sarah Schmidt, PharmD, RPh for her selection by the Iowa Pharmacy Association as a participant in the 2016 Leadership Pharmacy Conference.

IPA FOUNDATION

KARBELING LEADERSHIP AWARD 2016 recipients reflect on Jerry’s impact on the profession and recap D.C. trip Elizabeth Bald 2017 PharmD Candidate Drake University

I

cannot adequately put into words how honored and humbled I am to have received the Karbeling Leadership Award. Although I never had the opportunity to meet Jerry, I feel as though I know him from all of the incredible stories that I have heard from so many people that knew him and loved him.

Based on what I have heard about Jerry, I can see his legacy being carried on in the lives of others.

Jerry’s passion for associations, students, policy, and advocacy inspire and encourage me to remain engaged with the profession and involved with my state association throughout my career.

In addition, his ‘all in’ attitude serves as a constant reminder for me to do everything to the best of my ability. I hope to follow in Jerry’s footsteps by pursuing a career in academia and one day serving as president of the Iowa Pharmacy Association. It is my hope that Jerry’s legacy will live on through me.

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Robert Nichols 2017 PharmD Candidate The University of Iowa

A

s a 2016 Karbeling Leadership Award recipient, I was joined

by IPA leadership during my trip to Washington, D.C., for the National Community Pharmacists Association (NCPA) Congressional Pharmacy Summit in May. The purpose of this conference is to bring pharmacists and students from across the country to carry community pharmacy’s legislative message to Capitol Hill.

This year’s legislative priorities included: MAC transparency (H.R. 244), any willing pharmacy (H.R. 793 and S. 1190), and pharmacist provider status (H.R 592 and S. 314). In addition to discussing the aforementioned legislation, we asked the Iowa congressional delegation to sign on to letters urging CMS to move

forward on proposed guidance on DIR fees. The NCPA planners held workshops on the legislative priorities, lobbying 101, and DIR fees, engaging pharmacists and student pharmacists in discussion to better prepare for our congressional visits. The discussions elicited a breadth of content that was truly fascinating. I enjoyed learning key intricacies of the congressional process and the significance of building relationships with the congressional staff.

One of my favorite moments about this trip was listening to stories about the namesake of this award, Jerry Karbeling.

Following the first day of Capitol Hill visits, the IPA leadership entertained Sam Williams (P2- The University of Iowa) and I with an evening meal at one of Mr. Karbeling’s favorite restaurants.

Steve Firman was eager to persuade everyone to order the lobster bisque, the prime rib, and the crème brûlée as they began to share stories. I took pleasure in hearing how Jerry touched each of their lives. Evidence of his love and dedication to family, friends, and pharmacy was exemplified in their testimonies; and it brought further gratification to know that I was being awarded in his honor.

The NCPA Congressional Pharmacy Summit was a truly energizing event.

I witnessed the passion for legislative advocacy that Jerry Karbeling strived to instill in his friends and colleagues. I was honored to be chosen for this award and given the opportunity to learn alongside such inspiring leaders. ■

FRIDAY, SEPT. 23, 2016

Brown Deer Golf Club | Coralville, IA Registration: 11:00am Shotgun Start: 1:00pm BBQ & Awards: 6:30pm

GIvE uS YouR BEST ShoT! Whether your game resembles Phil Mickelson or Bill Murray, join us for a fun-filled day on the golf course! All proceeds benefit the IPA Foundationâ&#x20AC;&#x2122;s support of student pharmacists at Drake University and The University of Iowa colleges of pharmacy.

Register today at iarx.org/EGGolfClassic

MEMBERS SECTION

IPA MEMBER SPOTLIGHT:

DIANE REIST, BS, PharmD both Creighton University and the University of Iowa. Diane has been committed to numerous pharmacy organizations at every level, and her involvement does not stop with pharmacy, as she has served her community through various committees and organizations.

Written by:

Gavin Gardner 2016 PharmD Candidate (when written) Drake University College of Pharmacy and Health Sciences

Why Pharmacy

We have all had a mentor who has helped guide our careers. For Diane it was a high school chemistry teacher that suggested she do something in the health field like dentistry or pharmacy. She couldn’t really see herself with her hands in people’s mouths so pharmacy sounded like a much better choice.

Education

Just like that Diane graduated from the University of Iowa in 1981 with a Bachelor of Science in Pharmacy. Then in 2007 Diane went on to receive her Doctorate of Pharmacy, graduating magna cum laude from the University Of Florida College Of Pharmacy.

Career

If you have practiced pharmacy in or around Cedar Rapids you have surely come across Diane. She got her start as a staff pharmacist Mercy Medical Center where she went on to work in serval capacities. In 2009 Diane left Mercy Medical Center and has undertaken a number of roles, most recently being Pharmacy Practice Specialist in Transitional Care, with the University Of Iowa Hospitals and Clinics. Throughout her career Diane has also served as an Adjunct Assistant Pharmacy Professor, at

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“I want desperately to make those encounters be the positive and healing experiences that they are meant to be”

Motivating Factors

Diane described her motivation as not being grandiose, but I see her source of motivation centered on people she cares about being powerful and sustainable. Diane said, “My original motivator was my family – I was the only girl and the first one to attend college – they were always hugely supportive of me and pushed me when I needed it. I remember my mother helping me to study my Top Two Hundred Drugs Cards – she couldn’t pronounce the drug names but she could spell them as she quizzed me.

Early in my career my motivator was wanting to make positive changes and make my mentors and patients proud of me. As I grew and my family and church family grew older, the most powerful motivator has been seeing the confusion, failed therapy and fear that can be generated by encounters with the healthcare system. I want desperately to make those encounters be the positive and healing experiences that they are meant to be. I want to smooth out the bumps and help every patient to have a positive outcome with their medication therapies.

Current Position

Diane’s current position as Pharmacy Practice Specialist in Transitional

Care is quite exciting, she describes it as “the best job I ever had, because I feel like I truly am doing what a pharmacist should be doing and is able to do.” Her group at the University of Iowa received funding to organize and implement an interdisciplinary transitional care team with the aim of improving the flow of information from tertiary care centers to primary care centers and critical access hospitals. Her team’s work has been spotlighted in an AJHP article. The basis of their work begins with direct contact with the patient in house and also a follow up 4-6 weeks after discharge. This is a very unique project that has incorporated real time communication between multiple health care professionals all with improving patient outcomes in mind.

Vision for the Future

On the horizon Diane sees a valuebased payment system as the next big change. However in regards to change she states that “changing things just for the sake of making change (or meeting regulations/guidelines) is wasteful, expensive and even dangerous. The days of disjointed care and poor communication as patient’s transition between each step of their healthcare journey need to dissolve into a smooth coordination by their healthcare providers. By partnering and finding ways to communicate with each other in real time with current and accurate information we will not only reduce the amount of time that is spent by each discipline, the money that is wasted, the adverse events that are created, the frustration that patients feel but we will be providing true quality care. That is something that payers will be willing to pay for!” ■

MEMBERS SECTION

Welcome NEW IPA MEMBERS APRIL 1 - JUNE 30, 2016: Zach Winter, Plymouth, MN Diana Glieck, Lawton Ashley Adersen, Chariton Elizabeth Wiederin, Omaha, NE Marites Fadale, Maquoketa Derek Grimm, Spencer Jennifer Erickson, Dubuque Cindy Balvanz, Wellsburg

THANK YOU FOR SUPPORTING IPA!

MEMBER MILESTONES Annie Stella, a P2 student pharmacist from Drake University, was hired by IPA as a special projects intern. Congratulations and welcome Annie!

Congratulation to Matt Farley, PharmD, who was named Supervisor, Inpatient Pharmacy Operations at UnityPoint Health - St. Luke’s in Cedar Rapids.

Nick Lund, PharmD, MPA, was named pharmacy manager at the Park Avenue Hy-Vee in Des Moines. Congratulations Nick!

Congratulations to Abby Cate, PharmD, who was named pharmacy manager at the Corydon Hy-Vee Mainstreet.

Sharon Meyer, PharmD, of Urbandale was re-appointed by Governor Branstad to a second three-year term on the Iowa Board of Pharmacy. Congratulations Sharon and thank you for serving the profession in this capacity!

Michael Wolnerman, RPh, of Des Moines was appointed

by Governor Branstad to serve on the State Board of Health.

Congratulations Michael and thank you for serving the profession in this capacity!

1-(877)-360-0095 www.buy-sellapharmacy.com A 15-year track record of successfully completing more than 400 independent pharmacy sales.

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This is what we do every day, all day. It’s a full time job. Don’t 10. Closing the Deal attempt it on your own. Let us help you get to the end of the road successfully. Visit our website to view a list of references that you can contact.

JUL.AUG.SEP 2016 |

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IPA ACTION ASHP 2016 Summer Meeting & Exhibition

2016 IPA GOES LOCAL BRINGS PATIENT SAFETY, BOARD OF PHARMACY PRESENTATIONS TO LOCAL ASSOCIATIONS IPA completed it’s first “leg” of the 2016 IPA Goes Local program, partnering with five of Iowa’s 8 local associations this spring, and is looking forward to visiting the remaining three this fall.

• Stewardship of Drugs with Potential for Abuse, Use of Methadone to Treat Pain, Controlled Substance Diversion and Patient Access

This year’s program featured a 1-hour patient safety presentation by several member volunteers from advanced clinical practices sharing clinical pearls and team-based care practices to improve the health outcomes of patients with diabetes and hypertension. In addition to the CE presentation, Andrew Funk, PharmD, the executive director of the Iowa Board of Pharmacy, gave an introduction and presentation on board activity.

• Pharmacy Technician Training and Certification, Career Opportunities for Pharmacy Technicians • Developing Leadership Competencies, Interprofessional Education and Training, Cultural Competency • Timely Board of Pharmacy Licensing The full policy statements can be found on ASHP’s website, www.ashp.org (click News > Press Releases > June 29, 2016).

Iowa pharmacists were represented by delegates John Hamiel of Waterloo, Lisa Mascardo of Iowa City, and Dave Weetman of Iowa City.

See below for dates for the remaining IPA Goes Local events in southwest Iowa, Johnson County and northwest Iowa, and if you are in those areas, watch your inbox for registration information.

2016 Remaining Dates August 25 Southwest Iowa Pharmacists Association September 29 Johnson County Pharmacy Association October 20 Northwest Iowa Pharmacy Association

Watch for communication from your local association for details on time, location and registration or visit www.iarx.org/GoesLocal.

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The American Society of Health-System Pharmacists (ASHP) Summer Meeting and Exhibition was held June 11-15, 2016 in Baltimore, MD. Gathered at this meeting was a wide variety of pharmacists who discussed best practices throughout the 5-day conference. Core themes emerged including the power of storytelling, lean tools for use in pharmacy, and medication safety. The House of Delegates session grabbed headlines with its approval of a policy calling for a ban on direct-to-consumer advertising of prescription drugs and medication containing devices. The ASHP House also approved additional policies including:

NASPA Presidents-Elect Retreat

Each year, the National Alliance of State Pharmacy Associations (NASPA) hosts a presidents-elect retreat for state pharmacy associations’ incoming presidential officers and each state’s chief executive officer. In May of 2016, Rick Knudsen and Kate Gainer attended this two-day conference in Denver, CO. In addition to state pharmacy associations, several national associations were represented with president-elects from APhA, NCPA and IACP. National association CEO’s,

IPA ACTION including Steve Anderson (NACDS) and Tom Menighan (APhA) participated in a panel presentation on industry trends and national strategies.

Over 35 states were represented at the retreat. Knudsen and Gainer returned from the retreat with several ideas to enhance the Board’s strategic plan and specifically focusing on new practitioners, provider status, role of pharmacy technicians and business development opportunities for IPA.

Pace Alliance Continues Its Success

Pace Alliance, Inc. held its 2016 Annual Shareholders Meeting in conjunction with McKesson ideaShare on June 27, 2016 in Chicago. At the Annual Shareholders Meeting, Curtis J. Woods, CEO of Pace Alliance reported that Pace recorded another outstanding year in 2015 and 2016 is on track to be successful, also.

Pace’s success resulted in outstanding financial contributions to IPA in 2015, recording the highest level in the last ten years. In partnership with McKesson, Pace continues to be one of the top partners and financial contributors to IPA. Pace Alliance is an independent pharmacy buying group owned by 19 state pharmacy associations, including IPA. IPA was one of the first state pharmacy associations to join Pace in 1985. The Board of Directors of Pace Alliance, Inc. consists of one person from each of the Pace states. Kate Gainer, executive vice president & CEO of IPA serves on the Pace board as IPA’s representative. Kate is also a member of the Pace Executive Committee.

Pace has a two-fold mission: 1) to generate revenue for the Pace Shareholder Organizations and 2) to advocate and negotiate on behalf of Pace member independent pharmacies in order for

them to continue to be viable and competitive. And, for 31 years, Pace Alliance has fulfilled its mission with overwhelming success.

Pace membership is open to Independent Pharmacies nationwide. Through its exclusive contract with McKesson, the Pace-McKesson program is available anywhere McKesson services pharmacies.

For more information, contact the Pace office (www.pacealliance.com) and Pace will provide details about the PaceMcKesson program and the advantages of membership in Pace.

Pace Alliance is the only buying group in the nation that is owned by state pharmacy associations and distributes all of its profits to the associations to fund programs and projects supporting pharmacy at the state level. IPA is extremely appreciative to McKesson for the generous financial contributions to IPA through Pace. ■

STRENGTHEN ADVOCACY. STRENGTHEN PHARMACY.

The Iowa Pharmacy Political Action Committee is a fund used to strategically strengthen relationships with legislators that are supportive of pharmacy interests. Your contributions to the IPPAC aid in advocating for practice advancement, PBM regulation and other important issues facing our profession.

For more information or to contribute, visit www.iarx.org/IPPAC IPPAC can only accept individual contributions. Corporate contributions can be made to the Legislative Defense Fund or the Pharmacy Practice Preservation Fund. Visit the website above for more information.

JUL.AUG.SEP 2016 |

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IPA ACTION

CALENDAR OF EVENTS AUGUST 2016 25

IPA Goes Local: Southwest Iowa Pharmacists Association - Council Bluffs

30-31 Iowa Board of Pharmacy Meeting - Des Moines

2/2/2 Webinar: Election Forecast and Pharmacy’s PAC

23

Eggleston-Granberg Golf Classic

23-24 Bill Burke Student Leadership Conference 29

IPA Goes Local: Johnson County Pharmacy Association

OCTOBER 2016 3-6

AMCP Nexus 2016 - Washington, D.C.

6

IPA Residents Meeting - Johnston

6

College Night - Drake University - Johnston

11

2/2/2 Webinar: Medicaid Panel

11

College Night - University of Iowa - Iowa City

IPA Goes Local: Northwest Iowa Pharmacists Association - Spencer

23-26 ACCP Annual Meeting - Hollywood, FL

NOVEMBER 2016

SEPTEMBER 2016 13

20

1-2

Iowa Board of Pharmacy Meeting - Des Moines

4-6

ASCP Annual Meeting - Dallas, TX

8

State Innovation Model Learning Community - Altoona

8

2/2/2 Webinar: State Innovation Model

DECEMBER 2016 4-8

ASHP Midyear Clinical Meeting - New Orleans, LA

5

IPA’s ASHP Midyear Iowa Reception - New Orleans, LA

13

2/2/2 Webinar: Naloxone for Pharmacists

15-19 NCPA Annual Convention - New Orleans, LA

IPA’s free monthly webinar series held on the second Tuesday of every month at 2:00 p.m. CST. August 9: TakeAway: Updates and Changes to Iowa’s Medication Disposal Program September 13: Election Forecast and Pharmacy’s PAC October 11: Medicaid Panel November 8: Naloxone for Pharmacists Register for an upcoming 2/2/2 or view previous webinars at www.iarx.org/222.

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Wednesday, January 25, 2017 Embassy Suites & Iowa State Capitol, Des Moines, IA www.iarx.org/ipalegday

Save the Date:

February 17-19, 2017 Holiday Inn Des Moines-Airport & Conference Center

www.MidwestPharmacyExpo.com

PHARMACY TIME CAPSULE

19 62

Issues & Events that have shaped Iowa pharmacy (or are fun to remember!)

APRIL:

IPhA’s newest president, Elmer Norgaard was inducted at the 83rd Iowa Pharmacists Association Convention in Sioux City, IA, on April 17, 1962.

AUGUST:

Marilyn Monroe died by apparent overdose of sleeping pills.

OCTOBER:

President John F. Kennedy signed the Kefauver Harris Amendment (aka “Drug Efficacy Amendment”) to the Federal Food, Drug, and Cosmetic Act of 1938. The amendment required for drug manufacturers to provide proof of the effectiveness and safety of their drugs before approval, required drug advertising to disclose accurate information about side effects, and stopped cheap generic drugs being marketed as expensive drugs under new trade names as new “breakthrough” medications.

The amendment was in response to the thalidomide tragedy in which thousands of children born with birth defects as a result of their mothers taking thalidomide for morning sickness.

NOVEMBER:

Eleanor Roosevelt died from complications of tuberculosis.

FUN FACTS:

The examination fee was $10. A record is kept of all pharmacists licensed and a fee of $5 is required each year for the renewal of certificates. The examination (NAPLEX) fee now costs $505 and the fee for the MPJE is $210 During the 1961-63 bienniums two major construction projects started at the State University of Iowa: Completion of Pharmacy Building and Psychopathic Hospital research addition. A total of $1,635,000 was appropriated by the Fiftyeighth General Assembly for the two preceding projects.

Life membership for the Medic-Alert rapid identification (bracelet tags) cost only $5.

Remington Honor Medal Recipient (American pharmacy’s highest honor): Harry J. Anslinger Harvey A.K. Whitney Award Recipient (Health-System pharmacy’s highest honor): Grover C. Bowles

The Iowa Pharmacy Association Foundation is committed to the preservation of the rich heritage of pharmacy practice in Iowa. By honoring and remembering the past, we are reminded of the strong tradition we have to build upon for a prosperous future for the profession.

JUL.AUG.SEP 2016 |

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ADVERTISER

NEED A RELIEF PHARMACIST? CONTACT “JOSEPH IN RELIEF” Joseph Thompson, RPh 9616 Quail Ridge Urbandale, IA 50322

1.888.278.0846 h. 515.278.0846 | c. 515.991.2684

ADVERTISE IN OUR PUBLICATIONS Place your ad/classified ad with us. All ads, contracts, payments, reproduction material and all other related communication should be addressed to David Schaaf at dschaaf@iarx.org or call the IPA office at 515.270.0713 for more information.

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