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A Peer-Reviewed Journal | Vol. LXXIII, No. 3 | JUL.AUG.SEP 2017

Craig Logemann IPA’s 139th President INSIDE: 2017 Annual Meeting Recap Legislative Session Review EcoReturns: Iowa’s New Med Disposal Program


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 Sarah Derr, PharmD Shannon Rudolph, PharmD

2017 Annual Meeting pg. 10

A look at everything - policy discussions, awards, silent auction - that made the 2017 IPA Annual Meeting a success!

OFFICERS CHAIRMAN Rick Knudson, PharmD, BCPS, MS, MBA, Clear Lake PRESIDENT Craig Logemann, RPh, BCACP, CDE, Ankeny PRESIDENT-ELECT Cheryl Clarke, BS Pharm, RPh, FAPhA, Waukee TREASURER Sue Purcell, RPh, Dubuque SPEAKER OF THE HOUSE Steven Martens, PharmD, Grundy Center VICE SPEAKER OF THE HOUSE Jim Hoehns, PharmD, FCCP, BCPS, Cedar Falls

TRUSTEES REGION 1 Christopher Clayton, PharmD, MBA, Manchester REGION 2 Thane Kading, BS Pharm, RPh, Iowa City REGION 3 Rachel Digmann, PharmD, BCPS, Ankeny REGION 4 Carol Anderson, PharmD, Mason City AT LARGE Jessica Frank, PharmD, Winterset Deanna McDanel, PharmD, BCPS, BCACP, Coralville Heather Ourth, PharmD, BCPS, BCGP, Ackworth Nora Stelter, PharmD, CHWC, Urbandale HONORARY PRESIDENT June Johnson, BS, PharmD, FASHP, FCCP, BC-ADM, Des Moines PHARMACY TECHNICIAN Meg Finn, CPhT, North Liberty STUDENT PHARMACISTS Michael Harvey, Drake University Grant Jerkovich, 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.

Legislative Session Recap A review of the issues an bills tackled during the 2017 session. pg. 32

EcoReturns Iowa’s new non-controlled medication disposal program. pg. 25

FEATURES

2017 Annual Meeting Recap . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Speaker’s Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Policies Adopted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 IPA Awards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Student Column: The Importance of Engaging in Your State Association . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 2017 Commencements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 Legislative Session Recap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

IN EVERY ISSUE

CEO’s Column . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 President’s Page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Health Care Hot Topics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Iowa Pharmacy News . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Practice Advancement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Public Affairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Technician’s Corner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 IPA Foundation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 Member Section . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 IPA Action . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 Calendar of Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 Pharmacy Time Capsule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Mission Statement

The Iowa Pharmacy Association empowers the pharmacy profession to improve health outcomes. JUL.AUG.SEP 2017 |

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CEO’S COLUMN

“She’s got a rebel heart a country mile wide; There’s a little bit of devil in her angel eyes.” - “Angel Eyes” by Love and Theft

ELLA

I

contemplated a few different topics for this Journal’s editorial. But my heart kept coming back to Ella. Ella was the life of every backyard party we’ve had. In a sea of young children, she was the one orchestrating the chaos, or at least making sure everyone was included. She knew exactly where the snacks were (or doughnuts if it was breakfast), and would sneak an extra when she thought no one was looking. While tall for her age, she was young enough to jump up and give great big hugs with her arms, and legs, wrapped tightly around you. I’m fairly certain that she gave me one of those hugs every time we were together. She was exuberant, loving and silly.

her mischievous smile, her wild, loving energy, and her tiny yet boisterous voice calling me KP (which was always drawn out as kaaaaaayy-peeeeeee).

Ella was a healthy and strong 5 ½ year old when she unexpectedly and entirely too soon died from sepsis. But in those 5 years - every waking moment of those years - she lived life to the fullest. Ella was the middle child of our close friends, Kate and Jess. Kate is a pharmacist and IPA member; so even though she was too young to know it Ella was part of the Iowa pharmacy family. Not a day has passed that I don’t think of Ella. I miss

Ella’s light continues to shine bright for everyone who knew her. It’s been three months since her death, and her light provides me daily reminders of love, childhood innocence, and gratitude. If I can spread Ella’s light beyond my own family to my pharmacy family, it would be to share a few of these reminders with you.

Our friends have shown more strength and grace since losing their daughter than I knew was humanly possible. Yet, to hear them speak of Ella’s final hours, they credit the real strength to the medical team at UI Stead Family Children’s Hospital that fought to save Ella’s life. The PICU team fought for Ella as though she was their own daughter and never left her side for 12+ hours; they didn’t eat, they didn’t break, and they didn’t step away. One nurse was overheard saying a prayer for this beautiful child.

Hug those you love, really hug them tight and squeeze a few seconds longer;

Eat the ice cream, 2 scoops, and sneak a giant spoonful from the tub when no one’s watching; Sing to your heart’s content, and I mean really, REALLY sing; Be thankful for the noise; Don’t be afraid of the mud, or the rain, or grass stains (Ella was the ballerina with grass-stained knees); Be grateful for the important people in your life – and tell them so; Be present. Many of us have an ‘Ella’ - someone who has touched our life while she was with us on Earth, but once gone continues to touch us in an even bigger and stronger way. And, hopefully, touches the lives of people she never had the chance to meet. Rest in peace sweet girl. ♥

Kate Gainer, PharmD Executive Vice President & CEO Iowa Pharmacy Association

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PRESIDENT’S PAGE

Craig Logemann, RPh, BCACP, CDE Ankeny IPA President

IPA President Craig Logemann’s inaugural address at IPA’s Annual Meeting on June 16, 2017 in Coralville

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t’s an honor to be chosen as the 139th President of our association. I look forward to representing and serving the association and Iowa pharmacy professionals. I am grateful for the opportunity to listen and learn from you this next year as we partner together. Before I make my general comments, I would like to recognize some important guests who are with me this evening. First, I would like to recognize my wife Joelle. Being back in Coralville brings back good memories for us, as we met here at the University about 30 years ago as we both graduated from Iowa. Thank you for all your love and support. Our two daughters were unable to be with us tonight. Bria just graduated

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from the University of Northwestern St. Paul and is currently living in the Twin Cities. Jayde will be a Junior at Northwestern College in Orange City. She is working full-time at a Church Camp in Clear Lake this summer. I am pleased to have some close personal friends, Pastor Danny Capon and his wife Brenna, as my guests tonight. I also want to acknowledge several people who had an influence on my life before I became a pharmacist. I’m a true believer that people and events in your past help direct your future paths in life. My parents, Don and Elvera, were farmers in NorthCentral Iowa, approximately 20 miles from where our outgoing President

Knudson grew up. My father passed away ten years ago from Parkinson’s Disease and my mother still lives on the family farm near Swea City. My parents taught me the importance of hard work and taking pride in doing your best in whatever you do. I am also thankful for my home town pharmacist, Jack Van Norman. Jack was an influential leader in our small town of about 600 people. A few years ago, Jerod Work, Gayle Mayer and I presented a poster at the Annual Meeting highlighting the impact Jack had on our community. From our knowledge, 14 young people from the area became pharmacists during his time in Swea City. His professional involvement with the Iowa Board of Pharmacy and the Association serve as a reminder of the importance of giving back to the profession. He received the Bowl of Hygeia award in 1978 and served as IPA Honorary President in 1988. His example in the community encouraged me to pursue pharmacy. I also want to recognize a few other pharmacists who had an impact on my life. I recall my two clinical preceptors during my B.S. Pharmacy training at the University of Iowa,


PRESIDENT’S PAGE

Gary Milavetz and Jay Currie. They were, and continue to be, leaders in our profession. I completed a Family Medicine rotation with Dr. Currie at the Cedar Rapids Family Medicine Residency Clinic. At the time, I never imagined that I would work in a clinic setting. Seven years later, I became the first pharmacy faculty at the Iowa Lutheran Hospital Family Medicine residency program, and 22 years later, I have the pleasure of working in a clinic setting. I also want to say thanks to our dedicated and talented IPA staff. Your ongoing commitment to the Association’s mission and vision is greatly appreciated. Finally, I want to acknowledge my UnityPoint Health colleagues. I am proud to work in an organization that has allowed me to grow professionally. It is a pleasure to work with so many dedicated pharmacists and clinic employees. Thanks for being here tonight to celebrate with me. Whenever you begin a new venture in life, it is fitting to consider the past, present and future specifics of the situation. As I approach the Presidency of the Iowa Pharmacy Association, I have been reflecting on these questions. What has the past been like for the profession of pharmacy in Iowa? What is the current status of our profession? And where are we heading together in the future? Looking back, I consider the progress I have witnessed in the 29 years I have been a pharmacist. It’s hard to fathom the technological advances we have seen in our field during that time frame. During my time as an intern at the University of Iowa Hospitals and Clinics, I prepared

prescription labels on a typewriter in the outpatient pharmacy. My residency project was to assist in selecting the first computer system for that pharmacy. Now, we have automated filling stations with linked computer systems and many other technological advances. I also reflect on the growth and expansion of residency training programs. When I completed my residency at UIHC, I was one of four residents in our class. Now, we are approaching 50 residents in the state of Iowa. The expanding opportunities for our graduating students highlight the evolving role pharmacists have in a variety of settings. Recently, I was reviewing some documents on my iPad on a program called Evernote. I was in the process of deleting some outdated documents that I no longer needed. One of the documents I was reviewing had been created in October 2011 during the ACCP Annual Meeting in Pittsburgh. A few months previous to the meeting, I had been asked by Iowa Health System corporate leaders to begin mapping out a plan for advancing MTM services in the ambulatory setting. So, during the ACCP meeting, I was attending sessions dealing with practice advancement in the ambulatory environment. I’m not a 100% sure if the list of six priorities typed into Evernote were my original thoughts or if I had taken ideas from the various session presenters. But here is the list of the six foundational principles I considered most important as we looked to the future of MTM growth in our health system. 1. Assist health system in meeting quality goals 2. Document value of clinical services provided by the MTM team 3. Improve the medication use system in the outpatient setting 4. Improve communication between pharmacists in different settings 5. Improve the efficiencies of providers in the health system 6. Be part of the interdisciplinary team I realize the practice of pharmacy is diverse and understand that not all of

these six principles will apply to every setting. But if we embrace the basic tenets of these principles, we will remain vital team members for the patients we serve. In this present healthcare environment, we have the opportunity of assisting our healthcare teams achieve the “triple aim”. So, what does the profession of pharmacy look like in 2017 and the years ahead? I see an engaged workforce who wants to make a difference in improving healthcare. It is my belief that the future of Iowa pharmacy will be in “good hands” if we are guided by the association’s value statements. Let me emphasize some key thoughts from our value statements. Collaboration: Seek opportunities to partner with key stakeholders to achieve common goals and tackle healthcare challenges. Advocacy: Promote the value of the pharmacy profession to payers, policy makers and patients and enable our members to do the same. Innovation: Strive for excellence by actively pursuing “what’s next” for pharmacy practice. Education: Provide high quality educational resources and opportunities to equip an engaged and innovative membership Engagement: Cultivate a culture that drives members to be actively engaged within their profession and provide them with opportunities to make an impactful contribution. Leadership: Invest in the future of the pharmacy profession by nurturing leaders and innovators who inspire others to transform the profession. Positive Patient Outcomes: The health and safety of the patient is at the core of everything that the profession and this association does, guided by the principle of “if it’s good for the patient, it’s good for pharmacy.” First, in the area of collaboration, I want us to consider the important partnerships JUL.AUG.SEP 2017 |

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PRESIDENT’S PAGE

that IPA has developed and will continue to pursue. We will continue working diligently with members of our Public Health Department, especially on the topic of prescription drug abuse. We also will continue building relationships with various provider groups, such as the Iowa Medical Society and other health care professional groups. Second, in the area of advocacy, we will continue to meet with payer groups and policy makers to discuss evolving roles of our pharmacists and pharmacy technicians. We also need to clearly define the role of advanced pharmacy technicians and ensure stability of this workforce. This is a vital ingredient for pharmacists being able to operate at the top of their license. Third, we will continue to highlight the innovative work of our pharmacy teams across the state. I am particularly interested in how we can share project information from our state’s residency programs. We need to find a venue where our membership can learn about the innovative projects being completed at these residency sites. In addition, I am excited about the IPA Foundation’s newly created [Outcomes Innovative Pharmacy]grant program which will help fund innovative practice advancement projects. Fourth, we will continue to provide high quality educational programming in a variety of different formats for our members, both live and virtual options. We will continue to partner with CEI (Collaborative Education Institute) as our resource manager for these quality educational offerings. Fifth, we will explore ways to expand the networking opportunities within our membership. One opportunity could be the further development of learning communities where our members can connect either virtually or face-to-face, such as BPS study groups. Sixth, we will prioritize the development of future leaders within our profession. We will continue to provide leadership training for young pharmacists and

“We must be silent before we can listen. We must listen before we can learn. We must learn before we can prepare. We must prepare before we can serve. We must serve before we can lead.” - William Arthur Ward student/resident pharmacists. These are model programs which link new professionals with the Association’s mission and vision. Finally, it is imperative for our profession to share our patient care successes with others. I want to say thanks to all the individuals who shared their research and practice information during our annual IPA Poster Presentation. As I have stated before, I’m a firm believer in team-based care. Let’s continue to find ways to make our mark in the healthcare team and remain irreplaceable members of the team. As I conclude my presentation, I want to share a few inspirational thoughts for your consideration. I’ve been reading through a book called, Slave Leadership. The author makes the point that if you want to be an effective leader you need to be willing to serve the people you are leading. As one of your chosen leaders for 2017-2018, I challenge the IPA Board of Trustees to consider the following quote: We must be silent before we can listen. We must listen before we can learn. We must learn before we can prepare. We must prepare before we can serve. We must serve before we can lead. - William Arthur Ward

It is my pledge that we will listen and learn from you. The voice of our membership, especially in the areas of policy creation and committee recommendations, will help guide our leadership team during the upcoming year. The goal of many leaders is to get people to think more highly of the leaders. The goal of a great leader is to help people to think more highly of themselves. - J. Carla Nortcutt I am fully convinced that Iowa has some of the most engaged and committed pharmacy professionals in our nation. Our respect will continue to grow if we look for ways to advance our role and presence on the healthcare team. I challenge each of you to engage in building new relationships in your medical community. I also challenge you to share your patient care successes with your team members and fellow pharmacists. Thanks for being leaders in your families, your communities and your work settings. You are the voice and messengers for Iowa pharmacy and will help advance our profession in the days ahead. Thanks again for your participation in attending the Annual Meeting and for your involvement with the Iowa pharmacy family! ■ JUL.AUG.SEP 2017 |

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Thank you to the over 180 IPA members who made the 2017 IPA Annual Meeting in Coralville a great success! The 2017 House of Delegates was highlighted by an allstar lineup of keynotes that included a panel of national association leadership and RADM Pamela Schweitzer, assistant surgeon general and chief pharmacy officer for the U.S. Public Health Service. This, of course, was in addition to lively policy discussion, committee meetings, exhibit hall and the poster program. The meeting wasn’t all work as members celebrated the inauguration of Craig Logemann as IPA’s 139th president and then helped the IPA Foundation raise over $13,000 at the annual Silent Auction. Annual Meeting ended with the sweet conclusion of a new fundraiser for the IPPAC - details on page 18.

Adopted Policy . . . . . . . . . p. 15 Board Transition . . . . . . . . . p. 17 Awards . . . . . . . . . . . . . . p. 20 Silent Auction . . . . . . . . . . p. 42

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2017 IPA ANNUAL MEETING

MINDSET FOR THE FUTURE Susan Vos, PharmD, FAPhA Iowa City, Iowa 2016-2017 Speaker of the House

Speaker Susan Vos’ address during the first session of the 2017 IPA House of Delegates on June 16, 2017 in Coralville

O

ctober 15, 1947 - This is the day I imagine my career in pharmacy began. You see, the pharmacy class of 1948 at the University of Tennessee had only 50 students, five of which were women. When Captain William B Staggs began pharmacy school, the odds were against him that he would find his future wife in that class. However, the odds had been in his favor for the last few years. He had just completed his time as a fighter pilot in World War II, flying 56 missions with nearly 300 combat hours. Soon after the first few weeks of pharmacy school, he asked his classmate, Betty, on a date. By graduation day, they were married with one child and another one on the way. They moved to east Tennessee and opened a community pharmacy near my grandmother’s family farm. They may not have known it at the time, but they were

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creating their legacy. Their children and grandchildren would go on to work in healthcare and lead their communities because of the example they saw in Bill and Betty. The shoulders I was lucky enough to sit on belonged to my father, the eldest son of Bill and Betty, who owned and operated pharmacies in middle Tennessee. On the side, he served as the mayor of our small town and led medical mission teams to underserved populations around the world through our church. His soda fountain served many free meals—to all police officers as a way to deter robberies and to families who found themselves in need of a meal. Like some of us, I got my start in pharmacy at a young age—my first job was at the age of 5 years old and included dusting shelves, scooping ice cream, and running the cash register. The role models I had in my family shaped who I became as a pharmacist. So, back to October 15, 1947. What happened on that day? My grandparents along with their classmates began their own student chapter at the University of Tennessee of what is known today as the American Pharmacists AssociationAcademy of Student Pharmacists. According to history books, the

role of student branches of APhA at that time were to allow students to come together and discuss mutual problems and issues facing the profession with the first student branch being created in 1922 in North Carolina. The decision they made in 1947 to begin a student pharmacy organization on their campus would later influence their granddaughter and countless students because of the opportunities professional organizations had created for student pharmacists. I often wonder if they realized their actions that day would still be discussed 70 years later. I wonder if they realized that student pharmacist organizations would play an enormous role in the development of future students. I would imagine that all student pharmacists of that day would be smiling to know that one of our policies this year stemmed from student discussion and a new business item presented by the student delegation from Drake and Iowa last year regarding Translation and Interpretation Services. This story reminds me of what a mentor of mine told me, “With every action, we are either creating or eliminating opportunities for those that come after us.” There are countless problems we are facing today in healthcare and


2017 IPA ANNUAL MEETING come from a greek word meaning “end, purpose or goal.” As we work to solve our problems through the deliberation of this House of Delegates, the wise delegate Bob Osterhaus has told us, “if it is good for the patient, it is good for pharmacy.” Many of us have repeated this quote and I wonder how many times we will need to remind ourselves of this during our house deliberations today and tomorrow. As a health care professional, the patient is our telos; the patient is our endpoint.

pharmacy practice. This speech will not discuss any of them. However, this speech will address three mindsets for us to consider when faced with problems as big as Mount Everest. These ways of thinking avoid short-term fixes while focusing us on the future of our profession. These three types of thinking are Transgenerational thinking, Futures thinking, and Telos thinking. Let us keep these three mindsets as our touchstones today as we discuss issues and construct policies for our profession. First, transgenerational thinking. Just as Winston Churchill said, “The farther back you can look, the farther forward you are likely to see” transgenerational thinking focuses beyond just one single lifespan and incorporates the building block effect previous generations have on future generations. The story of my grandparents’ illustrates how their actions influenced future generations. Many of the problems we face today are not necessarily new ones. A fond memory of the past year of serving as your speaker was the chance I had to celebrate John Forbes at the APhA meeting as he received the Hubert H. Humphrey Award for his contributions in government and legislative service. Toward the end of our celebration dinner, John, Steve Firman, and Bob Greenwood began telling stories from back-in-the-day. While I do not recall specifics of the stories, I do recall that hearing the storytellers made me feel good about our profession. I recall feeling that the problems we talk about today are similar to the ones they encountered early in their careers. In business for 175 years, watchmaker Patek Phillipe

uses the motto, “You never actually own at Patek Phillipe, you merely look after it for the next generation.” If we approach our professional obligation for pharmacy as looking after it for the next generation, I believe our problem solving will transcend to our future generations. And, as I listened to the storytellers that evening—John, Steve, and Bob, I strongly believe that the previous generations have laid a strong foundation for us to continue to build our profession. Secondly, Futures thinking. Futures thinking embraces the idea that each of us perceives problems and solutions through a different lens. Some lenses will be foggier than others; some lenses will be rose-colored—we all come to the house of delegates wearing our own unique lens. It is important that we hear the perspectives of everyone because there isn’t just one future, but there are many futures that we can envision. The lens through which I see mental health has been fogged by the numerous family members and friends I have watched who struggle with mental health on a day-to-day basis. In the prehouse of delegates CE webinars I learned just how grim the outlook is on mental health for Americans and that Iowa ranks at the bottom when it comes to access to mental health care. Pharmacists can make a difference in the lives of patients who struggle with mental health. So, let us be futures thinking when it comes to solving this problem as we discuss policies on mental health today. There isn’t just one right answer, there are many to help us get to a place where patients have access to the mental health services they need. The third mindset is Telos thinking. Telos

The role of the House of Delegates is to pass forward-thinking policies that stand the test of time. Now is not the time to sit quietly in your seats, this association needs to hear your voice and to see the solution through each of our lenses collectively. Your story matters to this association and to the generations that will follow you. When I discovered my grandparents had been charter members of my college’s student organization, it was too late for me to hear the stories from my grandmother because she had died from Alzheimer’s just a few years earlier. Therefore, I encourage you to tell your story so that we can build on the foundations laid by former pharmacists and leaders.

“Now is not the time to sit quietly in your seats...Your story matters to this association and to the generations that will follow you.” In 1947, my grandparents helped ignite a flame that became a large student organization. In 1965, this House of Delegates held its first session. Both began as a way to discuss issues facing our profession and both have served as a training ground for many leaders in our profession. What will be remembered about 2017? What will be said about these policies 70 years from now? This weekend, remember our touchstones -focus on futures for generations-to-come while keeping our telos mindset on the patient. Thank you for the opportunity to serve as your speaker of the house. ■

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2017 IPA ANNUAL MEETING

THANK YOU! SPONSORS

Independent Pharmacy Cooperative UnityPoint Health Novo Nordisk Wellmark NACDS NuCara Pharmacies Hy-Vee Drake University College of Pharmacy & Health Sciences University of Iowa College of Pharmacy SafeNetRx

PUDLO PIE’D FOR

EXHIBITORS

Allergan Pharmaceuticals Astellas Pharma US Inc Boehringer Ingelheim Cardinal Health Fresenius Kabi HD Smith Ideal Protein of America Independent Pharmacy Cooperative Iowa Department of Public Health IPA Foundation IPPAC Iowa Board of Pharmacy & IMP3 Lilly Diabetes McKesson Metro RPh Novo Nordisk Diabetes Division Novo Nordisk Obesity Division Nutri-Dyn Omnicell Onnen Company PBA Health Pfizer Pharmacists Mutual Companies PharmServ Staffing QS/1 SafeNetRx Smith Drug Company UCB

SUPPORT FOR STUDENT ATTENDANCE Bruce Alexander Tim Becker Michele Evink Joshua Feldmann Bob Greenwood TJ Johnsrud

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Julie Kuhle Nick Lund Kristin Meyer Bob Stessman Tim Welty

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“Pie in the Face for IPPAC” was a sweet, new fundraising event at Annual Meeting for the Iowa Pharmacy Political Action Committee (IPPAC). Attendees donated to the IPPAC by purchasing tickets to place in the buckets of the three volunteers Kate Gainer, Bob Greenwood and Anthony Pudlo. The “winner” would receive the a pie in the face after Saturday’s House of Delegate session adjourned. Anthony was the “winner” and Bob was the lucky one chosen to serve up the pie. Over $3,000 was raised for the IPPAC, which supports IPA’s advocacy efforts by strengthening relationships with state legislators. Thanks all who donated and to Kate, Bob and especially Anthony for being good sports!


2017 IPA ANNUAL MEETING

2017 HOUSE OF DELEGATES: POLICIES ADOPTED 17-U1: Specialty Pharmacy Practice

1. IPA supports a definition of specialty pharmacy practice that is pharmacistdriven; includes dispensing, distribution, and reimbursement of specialty medications; and provides case management, comprehensive counseling, and other services that are specific to patients with rare, lifethreatening, or chronic conditions in collaboration with other healthcare providers. 2. IPA opposes specialty pharmacy programs which preclude the direct involvement of any willing pharmacist in the provision of individualized care to patients with specialty pharmacy needs. 3. IPA supports open access to specialty pharmacy accreditation that is voluntary, pharmacist-driven, transparent, consensus-based, reasonably executable, and affordable.  

17-U2: Mandate for Electronic Prescribing of Controlled Substances

1. IPA supports mandated electronic prescribing of controlled substances, as a method to prevent diversion and promote public safety, in collaboration with other stakeholders.

17-U3: Interpretation and Translation Services for Pharmacy Practice

1. IPA supports identification and utilization of professionally validated interpretation and translation services that are individualized to a pharmacy’s patient demographics to provide optimal patient care. 2. IPA supports ongoing education for pharmacists, student pharmacists, and pharmacy technicians in the areas of interpretation and translation services and cultural competency.

17-R1: Pharmacist’s Patient Care Role in Mental Health

1. IPA supports the role of pharmacists in improving access to mental health care by providing health screenings, triage, and referral. 2. IPA supports the role of pharmacists in providing comprehensive medication management for mental health conditions to optimize patient outcomes. 3. IPA supports pharmacist administration of mental health medications such as long-acting injectable medications. 4. IPA supports mandatory coverage by payers for pharmacist-delivered mental health care services and medication administration.

17-R2: Pharmacy Technicians on the Iowa Board of Pharmacy 1. IPA supports the inclusion of one certified pharmacy technician on the Iowa Board of Pharmacy, in addition to five pharmacists and two public members on the Board.  

17-R3: Proper Handling and Disposal of Hazardous Drugs

1. IPA supports the proper handling and disposal of hazardous pharmaceutical products and associated supplies by health professionals. 2. IPA supports the development of educational programs and competency evaluations for health professionals on the proper handling and disposal of hazardous pharmaceutical products and associated supplies. 3. IPA opposes the placement of a disproportionate financial burden on pharmacies for the proper handling and disposal requirements of hazardous pharmaceutical products and associated supplies. 4. IPA supports patient access to prescribed hazardous pharmaceutical products and expanded patient education on safe handling and disposal of hazardous pharmaceutical products and associated supplies.

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2017 IPA 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, the current Leadership Pharmacy class, and the deans from both Iowa colleges of pharmacy gathered for this year’s dinner at Carver Hawkeye Arena’s Feller Club Room in Iowa City. Those recognized included outgoing board members, current Leadership Pharmacy participants, and committee chairs.

2016-2017 committee chairs recognized

Then President-elect Craig Logemann (center-right) receives recognition from McKesson by Jeff Aden (center-left) and Paula Deck (center)

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| The Journal of the Iowa Pharmacy Association

Outgoing IPA President Rick Knudson (center-right) receives ASHP recognition from ASHP Past President Lisa Gersema (center-left)


THANK YOU IPA BOARD OF TRUSTEES! Bob Greenwood, RPh - Waterloo Chairman of the Board Susan Vos, PharmD, FAPhA - Iowa City Speaker of the House Ryan Jacobsen, PharmD, BCPS - Iowa City Trustee - Region #2 Jerod Work, PharmD - Sioux Center Trustee - Region #4 Brett Barker, PharmD - Nevada Trustee at Large Stevie Veach, PharmD, BCACP - Tiffin Trustee at Large Jane DeWitt, RPh - Iowa City Honorary President Nick Vollmer, Student Pharmacist Drake University Casey O’Connell, Student Pharmacist The University of Iowa

Outgoing 2016-2017 Board Members

IPA would like to thank the outgoing trustees listed to the left 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.

Welcome 2017-2018 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 began their term developing a strategic plan and priority projects for the association at the board retreat on July 13-14 in Moravia.

Rick Knudson, PharmD, BCPS, MS, MBA Clear Lake Chairman of the Board Craig Logemann, RPh, BCACP, CDE Ankeny President Cheryl Clarke, BS Pharm, RPh, FAPhA Ankeny President-Elect

Carol Anderson, PharmD Mason City Trustee - Region #4 Jessica Frank, PharmD Winterset Trustee at Large Deanna McDanel, PharmD, BCPS, BCACP Coralville Trustee at Large

Sue Purcell, RPh Dubuque Treasurer

Heather Ourth, PharmD, BCPS, BCGP Ackworth Trustee at Large

Steven Martens, PharmD Grundy Center Speaker of the House

Nora Stelter, PharmD, CHWC Urbandale Trustee at Large

Jim Hoehns, PharmD, FCCP, BCPS Cedar Falls Vice Speaker of the House

June Johnson, BS, PharmD, FASHP, FCCP, BC-ADM Des Moines Honorary President

Christopher Clayton, PharmD, MBA Manchester Trustee - Region #1

Meg Finn, CPhT North Liberty Pharmacy Technician

Thane Kading, BS Pharm, RPh Iowa City Trustee - Region #2

Michael Harvey Student Pharmacist Drake University

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

Grant Jerkovich Student Pharmacist The University of Iowa JUL.AUG.SEP 2017 |

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2017 IPA ANNUAL MEETING

ANOTHER PERSPECTIVE Now that you’ve seen IPA’s recap of the 2017 IPA Annual Meeting, see the event through the eyes, or devices, of those who attended. With the Annual Meeting app, attendees were able to share their experience with each other. Here is a sample of the 201 photos and comments shared within the app.

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The 2017 IPA & IPA Foundation Annual Report

2017 ANNUAL REPORT See the events, achievements and people that made 20162017 a great year at IPA!

Available online at

www.iarx.org/AnnualReport

SAVE THE DATE

June 8-9, 2018

2018 IPA Annual Meeting Des Moines Downtown Marriott JUL.AUG.SEP 2017 |

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Professional Awards 2017

Bowl of Hygeia

Tim Becker, RPh, BSPharm, of Mason City

Robert G. Gibbs Distinguished Pharmacist

Honorary President

Jane DeWitt, RPh, PhD of Iowa City

Bernard Sorofman, PhD, FAPhA, of Iowa City

Distunguish Young Pharmacist Brett Barker, PharmD, of Nevada

Excellence in Innovation

Jordan Schultz, PharmD, MSCS, BCACP, of Iowa City

Presented by Patrick Wilsbacher and Kim Dornbier of Pharmacists Mutual

Health-System Pharmacist of the Year

Michael Brownlee, PharmD, MS, FASHP, of Iowa City

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Patient Care Partner

Ann Broderick, MD, MS, of Iowa City

Pharmacy Technician of the Year

Jane McLaughlin, CPhT, of Iowa City


IPA takes great pride in recognizing individuals for their contributions of leadership, patient care, professional involvement and public service. The following awards were presented during the 2017 IPA Annual Meeting.

Karbeling Leadership Award Anne Stella, Drake University Casey O’Connell, The University of Iowa Presented by the IPA Foundation

Poster Presentation

Superior Patient Outcomes Through an Integrated Specialty Pharmacy Practice Model at the University of Iowa Hospitals and Clinics (UIHC) Alex Mersch, PharmD, MBA, BCPS; Kim Spading, RPh, MBA;Â Emily Dierickx, PharmD Presented by the IPA Foundation

Appreciation Award - Individual

Patricia Quinlisk, MD, MPH, D.Sc. (Hon), of Des Moines

50 Year Pharmacists

Sharon Scott, Johnston; Portia Licht, Waterloo; Alan Robinson, Estherville; TJ Johnsrud, Conrad; Robert Sack, Manchester

Appreciation Award - Corporate Pace Alliance

Not pictured: Mark Bailey, Gilbert, AZ; Kathleen Bakken, Decorah; Ronald Anderson, North Bend, NE; Wiliam Adams, Morrison, IL; William Abel, Jr., Fort Madison; John Anderson, Silverton, OR; David Carlson, Iowa City; Donald Cassady, Des Moines; Ronald Day, Nashua; Orrin Gabsch, Lajolla, CA; Dean Good, Vinton; Jane Huff, Hereford, AZ; Ronald Hebdon, Temecula, CA; John Hutchison, Mount Carroll, IL; James Holmstedt, Cedar Rapids; Dorothy Nieman, Sergeant Bluff; James Manning, Sioux City; David Parsons, Longmont, CO; Kermit Sheker, Edmonds, WA; Lester Swick Jr., Council Bluffs; Daniel Toal, Urbandale; Edward Tucker, Council Bluffs; Henry VanElsen, Newton; Lawerence VanHeukelom, Des Moines; Kirk Wilson, Martin, SD; Kent Wildrick, Johnston; Michael Woodring, Keokuk; Dale Yoder, Maquoketa; Keith Zierke, Urbandale

Received by Curtis Woods, CEO, Pace Alliance JUL.AUG.SEP 2017 |

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YOUR

&

PROFESSIONAL SKILLS

REPUTATION DON’T HAVE TO BE DAMAGED AS A RESULT OF IMPAIRMENT.

The Iowa Monitoring Program for Pharmacy Professionals (IMP3), a voluntary, confidential program of the Iowa Board of Pharmacy, is designed to assist pharmacists, pharmacist interns and pharmacy technicians in

P 3 I M

obtaining the necessary help for successful rehabilitation from substance abuse as well as mental and physical disabilities. This provides an opportunity for licensed professionals to receive proper treatment and maintain their professional status, while protecting the safety of the public.

I

O W A

IOWA MONITORING PROGRAM

for Pharmacy Professionals

To learn more about IMP3, visit imp3.iowa.gov. To self-report to IMP3, contact IMP3 staff at 515.725.2253.


HEALTHCARE HOT TOPICS

New WHO Essential Medicines List Addresses Antibiotic Resistance

New Medicare Cards will not Include Social Security Numbers

The list, which the WHO has published since 1977, is updated every two years and provides a model list of medications that it considers to be the most safe and effective to meet the most important needs of health systems.

ASHP Releases 5 Recommendations as Part of Choose Wisely Campaign

The World Health Organization released its latest Essential Medicines List, and for the first time in the list’s history, created three categories to guide when certain antibiotics should be used. “Access” – which includes drugs like amoxicillin – have a lower potential for resistance and should be available at all times. Antibiotics in the “watch” category are second-choice treatments like ciprofloxacin that should only be used to treat a small number of infections. The “reserve” group is the last resort antibiotics that should be used for lifethreatening infections with multidrugresistant bacteria.

FDA Allows DTC Genetic Tests

In a first, the FDA will allow 23andMe to sell genetic tests for disease risks directly to consumers. The test will report on markers for 10 diseases including Parkinson’s and Alzheimer’s. Customers who submit the test will access their results online and have access to genetic counselling at an additional charge. The results include disease risk, ancestry and other genetic traits. The approval is expected to open a floodgate of direct-toconsumer genetic tests.

CMS has announced that starting in April 2018, it will start issuing new Medicare cards with a new, randomly assigned Medicare Beneficiary Identifier (MBI) that replaces the Social Security-based Health Insurance Claim Number (HICN) currently used. The new cards will better protect beneficiaries from fraud and identity theft. CMS must replace all Medicare cards by the congressionally set deadline of April 2019. CMS has begun an outreach campaign to help providers prepare for the new MBI. Providers will also have a 21-month transition period to use either the MBI or the HICN to ease the transition.

On June 1, 2017, ASHP released five recommendations “to facilitate optimal medication use for patients in acute and ambulatory care settings” as part of the national Choosing Wisely campaign. Most recommendations by ASHP focus on appropriate use of medications in order to ensure patient safety. These recommendations emphasize the importance of medication management in patient care and place a greater value on the pharmacist’s role on the healthcare team. Choosing Wisely is part of a multi-year effort led by the ABIM Foundation to support and engage physicians in being better stewards of finite health care resources.

CMS Initiative Reduces Use of Antipsychotics in Nursing Homes

CMS began a five-point strategy in 2011 to improve dementia care and to reduce the number of antipsychotics used for nursing home residents. The strategy included (1) engaging stakeholders, (2) creating and disseminating educational resources, (3) public reporting, (4) enhancing guidance and training of state surveyors, and (5) increasing enforcement of state regulations. Since 2011, the initiative has reduced the prevalence of antipsychotic use among long-term nursing home residents by 33%. This strategy is being considered as a blueprint for other quality of care issues.

PhRMA to Force Members to Spend on R&D The Pharmaceutical Research and Manufacturers of America (PhRMA) created new membership rules forcing drug manufacturers to spend more on research and development. Specifically, PhRMA is requiring members to spend 10 percent or more of their sales over the next three years and at least $200 million per year on research and development. The new rules seek to back up industry claims that high drug prices cover the cost of research and development, an argument that has been criticized as drug makers face scrutiny over the high drug prices. The rules also coincide with efforts to repair the industry’s image through an ad campaign. ■

COMPLETE THE AMBULATORY CARE SELF-ASSESSMENT Every pharmacy practice is providing direct patient care services. Often these services are referred to as ambulatory care services regardless if they are based in a community pharmacy, LTC pharmacy, embedded in a clinic or outpatient pharmacy. To see where you stand, IPA encourages you as a practitioner or as a community-based or outpatient pharmacy to complete an Ambulatory Care Self-Assessment. The results of this assessment and accompanying action plan will not only help you improve your practice’s provision of direct patient care services, but the aggregate results will be utilized by IPA to help better serve members and pharmacies across the state.

To complete the free ambulatory care self-assessment, visit www.amcareassessment.org, create an account, and get your results today. JUL.AUG.SEP 2017 |

23


IOWA PHARMACY NEWS

Insurer Exits Leave Few Choices for Individual Coverage in 2018; Insurance Division Scrambles In April, the two largest companies offering individual health insurance policies, Wellmark Blue Cross & Blue Shield and Aetna, announced that they would no longer provide individual policies starting in 2018. The exits affected 47,000 Iowans (21,000 from Wellmark and 36,000 from Aetna) who had purchased federally subsidized policies through the health insurance exchanges created by the Affordable Care Act (ACA). Both companies cited the market conditions created by the ACA and the lack of young, healthy people buying insurance as the reason for their actions. Wellmark reported a $90 million loss in its three years of offering plans through the Iowa individual market. The exits of Wellmark and Aetna left Medica, which insures 14,000 Iowans through individual plans, as the only insurer left in the state offering individual coverage in all 99 counties. In May, Medica indicated that it too may exit the Iowa market, questioning its ability to fill the coverage gap. However, one month later, they announced that they would remain in Iowa, but at a price as it’s rates were expected to increase by 43.5 percent. Prior to Medica’s announcement to remain in Iowa for 2018, and facing the potential of no health insurance options for 72,000 Iowans, the Iowa Insurance Division (IID) requested a waiver from the Centers for Medicare and Medicaid Services (CMS) that would allow the state to implement a “stop gap” measure proposed by Iowa Insurance Commissioner Doug Ommen. The proposal would adjust how federal funds are used to assist with insurance premiums including shifting more money to assist young adults, using a reinsurance

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| The Journal of the Iowa Pharmacy Association

program to help insurers cover the costs of extremely expensive health problems and offering a single standard plan. Insurers would still be barred from denying coverage based on pre-existing conditions or limiting coverage. At the time of publication, the proposal was still being considered by CMS.

IPA Introduces the New Iowa MPJE Study Guide! On June 1, 2017, IPA published its Iowa MPJE Study Guide to assist recent graduates and new-to-Iowa pharmacists who are studying for the Iowa Multistate Pharmacy Jurisprudence Examination (MPJE).

Des Moines News Station Tackles Opioids in Iowa KCCI Channel 8, a CBS affiliate in Des Moines, aired a special on opioid addiction in Iowa. “State of Addiction,” which was broadcast from Mercy Medical Center in Des Moines, brought together healthcare providers, addiction specialists, law enforcement and victims and their families to bring awareness to the issue. Panelists talked about the scope of the issues, told stories of their addiction and what’s being done in healthcare, government and law enforcement for treatment and prevention. Among the panelists was pharmacist and Iowa Representative John Forbes of Urbandale. The 80-minute special was part of the station’s yearlong reporting on opioid addiction in Iowa.

Iowa Sees Record Take Back Day Results

The guide includes useful features like information on how to register for the exam, questions in a table format to allow learners to fill in their answers, answers to each question with reference to where to find the information in Iowa Code and Administrative Code, and a terminology section of key terms to know. The digital-only publication is available through the IPA Store. Be sure to spread the word to any recent grads and incoming out-of-state residents or pharmacists you know. IPA members receive a significant discount. For more information or to order, go to www.iarx. org/MPJEStudyGuide.

The Governor’s Office of Drug Control Policy (ODCP) announced that a record 11,710 pounds of unwanted or expired medications were collected in Iowa during the DEA’s National Prescription Drug Take Back Day on April 29. The amount collected beat the previous Iowa collection record by over a ton. Iowa’s record collection was part of the record breaking 900,386 pounds of medication collected nationwide. This was the 13th Take Back Day held nationally since 2010. In Iowa, over 44 tons of medication have been safely disposed of through these events. The next DEA National Prescription Take Back Day is Saturday, October 28, 2017. ■


IOWA PHARMACY NEWS

TAKEAWAY TRANSITIONS TO ECORETURNS FOR MEDICATION DISPOSAL

On July 1, IPA initiated a new partnership with SafeNetRx to rollout the EcoReturns medication disposal program to replace the TakeAway program as the state’s disposal program for non-controlled substances. Like TakeAway, the EcoReturns units ensure the safe disposal of all non-controlled medications, including liquids, but not needles nor controlled substances. While much of the program will remain the same, the partnership with SafeNetRx will provide a new automated reorder process for pharmacies. Participating pharmacies will simply return their full EcoReturns units and, once received, SafeNetRx will send the replacement. With SafeNetRx, all collection and destruction activity will remain in Iowa. In addition, our new partnership with SafeNetRx encourages the use of their drug repository program, which redistributes unused and properly handled medications to underserved populations here in Iowa. Like the TakeAway program, EcoReturns is still funded by the Iowa Board of Pharmacy and there is no cost for pharmacies to participate. During this transition, participating pharmacies are encouraged to continue using the TakeAway units they currently have until those units are full and ready to be returned. New EcoReturns units will be shipped when the TakeAway units need to be replaced. Additional information about the transition, including an FAQ for pharmacies, can be found at www.iarx.org/EcoReturns.

Iowa Medication Disposal Milestone

Iowa’s medication disposal program, TakeAway, reached a milestone in May with over 175,000 pounds of unused or expired medications collected since the program began in November 2009. Over 400 pharmacies across Iowa currently participate in the program.

The Iowa Monitoring Program for Pharmacy Professionals (IMP3) was established in 2016 to monitor and support pharmacy professionals who report problems with mental health, physical disabilities, or drug and alcohol abuse or dependence. The IMP3 believes pharmacy personnel’s professional skills and reputation do not have to be damaged as a result of impairment if monitoring and supportive services are put in place at an early stage. IMP3 is designed to assist pharmacists, pharmacist interns and pharmacy technicians in obtaining the necessary help for a successful rehabilitation from substance abuse as well as mental and physical disabilities. With a recent overhaul in the recovery program for impaired pharmacy professionals and now administration directly by the Iowa Board of Pharmacy, there are significant changes to the program that pharmacy professionals need to understand. With a greater emphasis in the IMP3 on self-report and engaging professionals into the program, all pharmacy professionals should understand how the program operates, the eligibility requirements, and privacy issues that are dictated in Board of Pharmacy regulations. This one hour program will provide case-specific discussions on where and how the IMP3 will be useful for you and your colleagues and is accredited for pharmacy law CPE accreditation for pharmacists and pharmacy technicians. Events are being planned in coordination with local pharmacy association meetings, so plan to attend a local event near you in 2017!

EVENTS PLANNED:

Quad Cities - September 28, 2017 Des Moines - October 12, 2017 Mason City - October 19, 2017

JUL.AUG.SEP 2017 |

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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!


STUDENT COLUMN

STUDENT PHARMACIST PERSPECTIVE

THE IMPORTANCE OF ENGAGING IN YOUR STATE ASSOCIATION

P

rovider status advocacy, current healthcare issue mitigation and promotion of pharmacy services are a small portion of the impact the Iowa Pharmacy Association (IPA) has on the profession. The Iowa Pharmacy Association is a dynamic, evolving organization whose work has a significant effect on the patients we serve. Throughout this past year, I’ve had the unique and eyeopening experience of serving as the Drake student representative on the Iowa Pharmacy Association Board of Trustees. This experience has provided innumerable opportunities that will carry with me throughout my professional career. That being said, I will highlight a few major points that I have taken away. IPA provides a platform from which a strong, unified pharmacy voice promotes change. United change is championed by creating dialogue between all pharmacists, technicians, and students to promote forward, progressive thinking. Numerous events such as Legislative Day bring all practice settings together for health care and pharmacy advocacy. Advocacy is one of the many pharmacy responsibilities we have to improve the lives of those we serve.

The association is leading an enterprise that, ultimately, affects numerous lives and every decision needs to be made with valuable input. IPA works to serve all of its members by focusing on specific priorities and areas that require advancement. As a current student pharmacist, it is impressive that a professional organization represents an entire state of people while maintaining individual relationships with all of its members. Iowa will continue to hold an outstanding pharmacy reputation nationally with the continuous efforts of IPA which seeks input from all members. Finally, IPA prides itself on the vast membership network created from professional relationships. Events like IPA Goes Local allows for members to meet other pharmacy professionals from around their area and voice

Student Pharmacists from Drake University and The University of Iowa at the 2016 IPA Annual Meeting

Nicholas Vollmer 2018 PharmD Candidate Drake University 2016-2017 IPA Board of Trustees

“IPA prides itself on the vast membership network created from professional relationships.” their opinions on key issues affecting pharmacy and health care as a whole. Networking and maintaining professional relationships are important for new idea development and understanding the current state of the pharmacy profession. The IPA serves patients through representation of all members. By being an involved member, it allows all of us to play a role in impacting the profession and the lives of our patients. Iowa Pharmacy Association’s strong unified pharmacy voice paired with excellent patient care initiatives will transform healthcare, essentially transcending to the patients we serve. ■

JUL.AUG.SEP 2017 |

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PRACTICE ADVANCEMENT

CPESN Site Visits Assist in Advancing the Network

CPESN Iowa mobilized 12 volunteers to complete a baseline evaluation of the 84 sites participating in the network. The purpose of these visits was to determine where each site was with the five core services: medication reconciliation, adherence packaging, clinical medication synchronization, immunizations, and complete medication review with disease state management. Additionally, these visits will assist in identifying the educational needs of the sites and provide best practice sites to guide pharmacies who may need some additional assistance in implementing each of the services. Through review of the site visits reports, a few successful practices were identified in implementing the five core services. Clinical medication synchronization and adherence packaging is successful when a pharmacy technician plays a role. These services are especially successful when a pharmacy technician takes the lead on the processes of these services. Medication reconciliation is successful when the pharmacy partners with local clinics, hospitals and nursing facilities. Identification of patients who need immunizations is the most successful when the pharmacist partners with local community organizations (such as nursing homes, banks, employer groups, etc.) and administers annual influenza vaccines to these groups. Finally, utilizing residents and students to assist in delivering these services provides additional assistance and quality care to patients. Rotation students are eager to learn and participate in these services. Residents provide a more longitudinal approach to offer and improve these services. Thank you to the volunteers who made this effort possible: Elisha Andreas Josh Borer Tammy Bullock Connie Connolly Mickey Cooper Sarah Derr

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Joshua Feldman Courtney Gent Becky Halbur Greg Hoyman Matthew Maker Jane Moeller

| The Journal of the Iowa Pharmacy Association

Iowa’s Participation in the Enhanced MTM Initiative

As a part of the “better care, smarter spending, healthier people” approach to improving health delivery, the Centers for Medicare & Medicaid Services (CMS) launched a five-year initiative on January 1, 2017. This initiative is intended to improve payment incentives and regulatory flexibility to promote enhancements in the Medication Therapy Management (MTM) program. The initiative called the Part D Enhanced MTM model tests whether providing Part D sponsors with additional payment incentives will lead to improved therapeutic outcomes while reducing Medicare expenditures. As part of Region 25 – which includes Iowa, Minnesota, Montana, North Dakota, South Dakota, Wyoming, and Nebraska – Iowa has five payors who are participating in this initiative. As the payors develop their plan for this initiative they have reached out to IPA and Iowa practice advancement networks such as the Community Pharmacy Enhanced Services Network (CPESN) to partner with pharmacies in Iowa. Payors are excited to work with pharmacies to provide better patient care and decrease healthcare costs. Additional information can be found on the CMS website.

SIM & Care Coordination in Iowa

The Center for Medicare & Medicaid Innovation (CMMI) awarded Iowa as one of the 11 states to receive a federal grant over four years to participate in the State Innovation Model (SIM) Phase Two Test States. The Iowa Healthcare Collaborative was awarded this grant and has subcontracted with IPA for the third year of the four-year grant. IPA is working closely with the pharmacies in these communities to assist in contributing to the SIM. IPA recognizes that the role of the pharmacist in this initiative will vary based on your practice setting and other healthcare providers in your community. By partnering with these pharmacies to

provide better care coordination and an increased understanding of resources available in your community, SIM will provide better patient outcomes and decrease total cost of care. If you are in a SIM community and would like to become engaged in this initiative please reach out to IPA.

Value-Based Pharmacy Program

A large commercial payer in the state launched their Value-Based Pharmacy Program this year with 65 pharmacies invited to participate in the initial launch. Performance data will be shared with each of the pharmacies that choose to participate in this initiative in the month of July. The initial commitment to this program is for 3 years. The payer does expect to invite additional pharmacies to join the program in the coming years. IPA continues to partner with the payer to assist pharmacies in advancing and transforming their practice.

WISEWOMAN Program Expands to Include Diabetes and Cardiovascular Care

The Iowa Department of Public Health (IDPH), Division of Health Promotion and Chronic Disease Prevention, Iowa Care for Yourself program, was awarded funds from the Centers for Disease Control and Prevention (CDC) to help reduce cardiovascular morbidity and mortality through early detection, screenings, treatment, and other intervention services. In doing so, the Iowa WISEWOMAN program has partnered with community pharmacists to provide medication therapy management (MTM) services for program participants. Beginning in July 2016, local public health departments identified individuals with newly diagnosed or previously diagnosed, yet uncontrolled hypertension that would be referred to participating pharmacists for the following services: 1. Initial in-person visit will include a comprehensive medication review, completion of the Million Hearts DRAW Tool and blood pressure measurement.


PRACTICE ADVANCEMENT

2. Follow-up phone call within 2 weeks of initial visit 3. Second follow-up phone call 6-8 weeks after initial visit 4. Follow-up in-person visit 12 weeks after initial visit to review participant adherence and hypertension control, complete post-intervention DRAW tool and blood pressure measurement. After initial success was seen in a small pilot in Des Moines, the program expanded into the Clinton, Dubuque, Maquoketa, and Spencer communities in 2016-2017. In July 2017, the program has continued to expand into additional communities across Iowa as well as expand into other disease states like diabetes and high cholesterol. On June 16, 2017, IDPH hosted a meeting of WISEWOMAN participating pharmacies during the IPA Annual Meeting. This meeting was used to discuss the limited number of participants receiving MTM this year, and the expansion of MTM services to include not only hypertension, but also high cholesterol and diabetes. Participating pharmacies were asked to discuss the successes and challenges seen with the WISEWOMAN program across Iowa. â–

2017 PRACTICE ADVANCEMENT FORUM IPA hosted its third consecutive Practice Advancement Forum on the day before the 2017 IPA Annual Meeting in Coralville, Iowa. The forum brought together pharmacists, pharmacy technicians and student pharmacists from across the country. The forum featured speakers from across the state and across country with presentations that built off each other from a high level of healthcare transformation and down to the practice level. A panel of pharmacists and pharmacy technicians spoke to the importance of using technicians to allow pharmacists time to engage in clinical services. In addition, forum attendees heard an impactful presentation on communicating with patients - no matter how difficult they may be - to improve patient health and outcomes. The Practice Advancement Forum is supported by the Iowa Department of Public Health and will return on June 7, 2018, in conjunction with the 2018 IPA Annual Meeting in downtown Des Moines.

Participating Pharmacies for WISEWOMAN: Atlantic: Rex Pharmacy Cedar Rapids: CarePro Pharmacy Centerville: Hy-Vee Pharmacy Clinton: Wagner Pharmacy Council Bluffs: All Care Health Center Davenport: Community Health Care Pharmacy & Hy-Vee Pharmacy Des Moines: Primary Health Care Dubuque: Mercy Family Pharmacy Maquoketa: Osterhaus Pharmacy Sioux City: Thompson Dean Drug Spencer: Thrifty White Waterloo: Greenwood Drug & People’s Pharmacy

JUL.AUG.SEP 2017 |

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CLASS OF 2017

CONGRATULATIONS!

Drake University College of Pharmacy and Health Sciences Class of 2017 Benson Abraham Krista Allbee Austin Arnold Spencer Baer Elizabeth Bald Katie Beachner Trisha Benjamin Kendra Borchers Krystin Bradshaw Christina Bravos Linh Cao Michael Cardamone Emily Cook Nathan Davis Anna Fischer Amy Frew Angela Giannetto Andrew Greely Rebecca Gross Tori Groves Carolyn G’Sell Katelin Hardisty Michelle Hartman Nicole Hartsock Lindsay Hawkins Nathan Hemsley Alyse Herman Hanna Hollingsworth

30

Bonnie Hoots Dylan Horton Emily Householter Emma Huepfel Samuel Huntington Tyler Ishman Kelsey Japs Aubrey Johnson Kayla Jonason Steven Jordan Jessin Joseph Samantha Julsen Andrew Kallman Kelsey Klein Jamie Knie Madison Koppin Shane Kozlowski Molly Krook Ted Lindgren Laura Litwin Jenna Luitjohan Sara Magill Krista Maguire Shannon Mahony Katelyn Marr Nathaniel Martin Jessica Marx Samantha Maryan

Maren McGurran Kyle McNett Morgan McPherson Kalie Miller Taylor Monson Celia Morton Patrick Murphy Megan Nelson Kya Norby Brady Oates Molly Obermark Mary Shea O’Brien Sarah O’Rourke James Orris Eunice Park Manali Patel Alex Pettit Marica Potkonjak Andrea Prince Bergen Quaerna Suzanne Rettey Carolyn Riedl Melissa Rieger Hayley Runde Andrew Ruplin Omar Saleh Pamela Sanford Hannah Sauer

Marissa Schaefer Diana Schreier Sameep Sheth Jaclyn Shine Anna Showalter Alex Smith Derek Sprang Emily Spring Grant Stimes Brett Stolberg Amanda Supercynski Adati Tarfa Krystle Thai Brittany Thelemann Keisha Troendle Erica Truong Matthew Van Rahul Verma Jacqueline Vonderhaar Andrew Wagner Danielle Walla Cariann Walsh Dylan Webster Zachary Wright Laura Zahr Nathan Zimmermann

Photos: Drake University College of Pharmacy and Health Sciences

| The Journal of the Iowa Pharmacy Association


CLASS OF 2017

CONGRATULATIONS!

The University of Iowa College of Pharmacy Class of 2017 Mousa Abuissa Meagan Adamsick Eddy Airiohuodion Rebecca Anderson Allison Barker Ashley Beckman Allison Bernard Alison Bieber Mark Binder Jenna Blunt Christine Butler Jacqueline Camacho Ashley Campbell Daniel Carlsen Luke Carlson Vilasatry Chanthinouvong Erin Chaplin Courtney Converse Kristin DeCook Douglas Dual Rachel Fetters Chase Fifield Brianne Forgie Estefany Garcia Katherine Garczek Rachel Gean Reese Geis Brandon Gerleman Amanda Gillispie

Meghan Griebel Rachel Grolmus Alex Hagg Sylvie Hall Alyssa Haught Ashley Hickey Kayla Hoogendoorn Mark Hopper Emily House Eric Hundley Alanah Johnson Marshall Johnson Renu Johnson Dana Jones Benjamin Jorgensen James Kay Natalie Kelly Melissa Kessler Chelsea Khaw Jordan Kunkel Danielle Larson Joshua Lemm Anneka Levra Carrie Linn Alexandra Lovell Angela Lutwitze Andrew Martin Emily Matthews Laura Meadow

Chenise Meyer Paige Milbach Kyla Miles Jesse Monthei Logan Murry Jaclyn Myers Nahal Nassabeh Laura Nesheim Andrea Neubauer Hoang Nguyen Minh Nguyen Robert Nichols Michael Obrien Kristen Peterson Jacob Polson Heather Purscell David Quach Mary Tatjana Ramos Rachel Reinsvold Katherine Reynolds Addy Rickels Julia Rippe Danielle Ritchie Amanda Rixen Zachary Rose Jennifer Ross Ashley Sabus Christopher Sanchez Thomas Sayre

Monica Schmidt Tricia Schneider Erin Schreiber Valerie Shane Katharyn Smith Brittney Snitker Brett Spiek Taylor Steckler Panagiota Terzis Jenna Tingleff Phi Trinh Michael Trisler Susan Voong Alyssa Vosecky Amanda Waggett Devin Welke Daniel Widman Hayley Wittnebel Shavea Zapata Juan PhD Graduates Ali Azeez Ali Al Jumaili Nattawut Leelakanok Yingjian Li Peng Yu Phawanan Sawangchan Josephine Schamp

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

JUL.AUG.SEP 2017 |

31


2017 LEGISLATIVE SESSION

2017 LEGISLATIVE SESSION RECAP Bill Wimmer, JD Wasker, Dorr, Wimmer & Marcouiller IPA Legal & Legislative Counsel

recognized by the FDA, and the Board of Pharmacy must provide a link to that list. IPA supported the bill that was signed by Gov. Branstad on March 10.

Prescription Drug Monitoring Program Angela Davis, JD Wasker, Dorr, Wimmer & Marcouiller IPA Legal & Legislative Counsel

For IPA, 2017 represented a “step back and reload” year legislatively, but IPA’s staff and lobbyists were still busy advocating for the profession. IPA was actively engaged on several issues and pieces of legislation that impact pharmacy practice.

Step-Therapy Drug Protocols

IPA supported (HF 233) which allowed exemptions from steptherapy protocols by PBMs and insurance companies. This legislation establishes a clear and uniform system for using, overriding, and appealing step therapy protocols. It affirms the right of health care professionals to make decisions regarding patient treatment. Gov. Terry Branstad signed the bill on April 19.

Biosimilars

The biosimilar bill (HF 305) gives pharmacists the authority to dispense generic biologics rather than the more expensive name-brand varieties, as long as the prescriber did not specify that the biologic medication must be a specific brand. Pharmacists must use only those interchangeable biosimilars

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Two bills passed this session will expand the use of Iowa Prescription Drug Monitoring Program (PMP). HF 524 authorized the Iowa Board of Pharmacy to enter into information exchange agreements with any state in the country. Prior to this legislation, the board was only able to make such agreements with border states. The bill was signed by Gov. Branstad on May 12. Another bill, HF 523, gave state and county medical examiners access to the PMP and was signed into law on April 19.

Board of Pharmacy Bill

IPA supported the Iowa Board of Pharmacy’s bill (SF 484) which included proposals for alternate board members, drug disposal program funding, an impaired professionals program, and pharmacy internet sites.

Additional Issues

IPA was also actively involved in issues like medical cannabis, immunization exemptions (against, per IPA policy 16-U3), and educating legislators on the importance and fairness of maintaining the statutorily established pharmacy reimbursement rate of AAC + $10.02 (survey-based dispensing fee) within managed care for Medicaid. ■

Meet with Your Legislators

With Congress set to recess in August, and healthcare being a hot topic, it is the perfect opportunity to meet with your congressman and state legislator or invite them to tour your practice and showcase the value of pharmacies to patients and communities. IPA encourages you to consider this important opportunity to represent the pharmacy profession in Iowa. Sharing your stories and experiences in caring for your patients go a long way to advancing practice through state and federal legislation. IPA can provide talking points on important issues and a stepby-step checklist to make the process easy. Tours are an opportunity to educate your elected officials on concerns like PBM regulation, opportunities to improve patient access through provider status legislation, and the importance of pharmacy to public health. IPA will provide you with all the necessary tools including setting up the visit, setting an agenda, and talking points on important issues anticipated this next legislative session. Our members’ efforts to engage with their elected officials is critical to all of the association’s advocacy efforts. If you are interested, please contact IPA at 515-270-0713 or ipa@iarx.org.


Student Loan Refinancing

Refinancing student loans with SoFi saves pharmacists an average of $408 a month1. Refinance at SoFi.com/IPA to get a $100 welcome bonus2 with your loan. Why refinance with SoFi?

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Get your $100 welcome bonus2 at SoFi.com/IPA Checking your rate will not affect your credit score.3

Terms and Conditions Apply. SOFI RESERVES THE RIGHT TO MODIFY OR DISCONTINUE PRODUCTS AND BENEFITS AT ANY TIME WITHOUT NOTICE. To qualify, a borrower must reside in an eligible state and meet SoFi's underwriting requirements. SoFi refinance loans are private loans and do not have the same repayment options that the federal loan program offers such as Income Based Repay-ment or Income Contingent Repayment or PAYE. SoFi loans not offered to residents of Nevada. Other state restrictions may apply. See eligibility requirements at sofi.com/legal. Licensed by the Department of Business Oversight under the California Finance Lender Law License No. 6054612. SoFi loans are originated by SoFi Lending Corp., NMLS # 1121636. 1See sofi.com/disclaimer1 2Welcome bonus will be issued electronically once you become a SoFi borrower; you have submitted a completed application with documents and your loan has been disbursed. Offer good for new customers only. 3To check the rates and terms you may qualify for, SoFi conducts a soft credit pull that will not affect your credit score. A hard credit pull, which may impact your credit score, is required if you apply for a SoFi product after being pre-qualified.


PUBLIC AFFAIRS

MCO PHARMACY CONCERNS IN IOWA RESOLUTION TO ISSUES; NEW ISSUES IDENTIFIED MCO Concerns Improve in Iowa With the change to the managed care organizations (MCOs) on April 1, 2016, there have been multiple concerns from pharmacies across the state. IPA continues to collect member specific concerns regarding the transition of Medicaid to an MCO model. Thank you to all who have submitted concerns, issues and questions to IPA. Most pharmacies who submit concerns have called the MCO helpline and worked with the provider representative to resolve the issue. IPA is able to escalate concerns to the appropriate persons with each MCO and the State. In the last quarter, IPA has had two main concerns that staff have worked with the MCOs and the Iowa Medicaid Enterprise to resolve. The first issue is that pharmacies have been receiving payment below the Actual Acquisition Cost (AAC)

for brand prescriptions submitted to Amerigroup. Amerigroup and their related PBM, Express Scripts, have stated that the FUL price list was loaded in April instead of the AAC price list that was contracted. IPA has been working with Amerigroup to resolve this issue, and is now in communication with Iowa Medicaid Enterprise. IPA has been told that once resolved, pharmacies should expect all claims to be retrospectively corrected. The second issue that has come to the attention of IPA is the processing of cross-over claims for DME supplies. Some pharmacies have noted difficulty processing test strips and lancets for patients with both Medicaid and Medicare coverage. Medicare requires these claims to be submitted with both a start and end date, and Medicaid only requires the dispensing date. Therefore, the end dates are then read by Medicaid as a “future fill date” resulting in a rejected claim. This rejection appears to only occur with

Amerigroup claims. Although no solution has currently been offered by the MCO, pharmacies have found success by working with their respective software vendor or switch company so that claims are submitted to Medicare with both start and end dates, while only dispensing dates are submitted to Medicaid. IPA continues to work with the MCOs and the Iowa Medicaid Enterprise to resolve these concerns. Has your pharmacy encountered an issue with the MCO’s? Please contact IPA via the IPA website. ■

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.

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PUBLIC AFFAIRS

New Iowa Insurance Commissioner On January 30, Governor Brandstad appointed Doug Ommen as the new Iowa Insurance Division (IID) Commissioner. Ommen has had over 30 years of experience in public service and has served as the Deputy Insurance Commissioner in Iowa since 2013 and as the interim Insurance Commissioner when Nick Gerhart stepped down at the end of 2016. Previously, Ommen served as Missouri’s insurance commissioner and provided leadership in consumer protection. IPA has met with Ommen twice to discuss Iowa’s PBM statute and regulations.

Iowa Medicaid $10.02 Dispensing Fee Implemented

MEMBERS ADVOCATE FOR PHARMACY AT NCPA FLY-IN April 26 and 27, IPA members traveled to Washington DC for NCPA’s Fly-In to advocate for the profession of pharmacy. Members Matt Osterhaus, Steve Firman, Casey O’Connell, Annie Stella, Robert Nichols, and Bob Greenwood met with Iowa’s six legislators to discuss PBM transparency and the advancement of pharmacy in Iowa. Capitol visits led to great discussions on the importance of pharmacy with each legislator. Iowa legislators continue to be supportive of the key issues facing the profession of pharmacy.

On March 21, CMS approved the state’s Medicaid dispensing fee of $10.02 with an effective date of August 1, 2016. This informational letter from the Iowa Medicaid Enterprise (IME) explains the process that will be taken to retroactively adjust claims from the August 1 effective date. The fee was announced last August and was determined by a biannual cost of dispensing survey conducted by IME of all Medicaid participating pharmacies. Although the dispensing fees were expected to be retrospectively adjusted by June 30, 2017, pharmacies continue to see complete claims reversed and later resubmitted to reflect the new dispensing fee. At times, the reversal and resubmission occur on different days. IPA continues to work with each of the MCO’s and Iowa Medicaid to discuss ways to streamline this process for minimal financial impact on pharmacies in the future.

New DHS Director Appointed

Gov. Kim Reynolds appointed Jerry Foxhoven as the new director of the Iowa Department of Human Services. Foxhoven most recently was executive director of Clinical Programs and Professor of Law at Drake University’s School of Law, and has a long history as a lawyer advocating for children and families. IPA looks forward to working with Foxhoven as we continue to navigate Iowa Medicaid and the evolving role of pharmacists delivering health services. ■ JUL.AUG.SEP 2017 |

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PUBLIC AFFAIRS

BOARD OF PHARMACY: SUMMER UPDATE Adoption of Telepharmacy Regulations

The Board of Pharmacy moved to adopt and filed new regulations for telepharmacy practice in Iowa (Chapter 13). The Board took into account comments from pharmacists and pharmacies around the state as it worked to adopt these final rules, which detail issues on technician training, policy and procedures in a telepharmacy, and onsite staffing by a pharmacist. Barring no hiccups in the regulatory approval process, these telepharmacy regulations should become effective on September 6, 2017.

Notice of Intended Action – Chapter 16 – Nuclear Pharmacy

The Board of Pharmacy has sought feedback directly from nuclear pharmacies in the state as it updates its regulations on nuclear pharmacy (Chapter 16). Much of the newly proposed regulations support standards established by the U.S. Pharmacopeia (USP) regarding nuclear practice and handling of hazardous medications. Public comments are being collected through August 22, 2017 on these proposed rules.

the survey will be utilized by the Board of Pharmacy’s rules committee and evaluated by IPA to best understand how to address these standards in Iowa.

Update on New Database

The Board of Pharmacy has been working with a new vendor to manage online license and registration renewals for pharmacy professionals, pharmacies, and wholesalers. The Board is currently working to build the online database to the specifications needed by the Board of Pharmacy. It is the hope of the Board to go live with the new database beginning with the pharmacist license renewal process in 2018.

Upcoming Open Session of the Iowa Board of Pharmacy

The next open sessions of the Iowa Board of Pharmacy are August 30, 2017 and November 1, 2017, at the board office in Des Moines, Iowa. You may also listen to a recap of each of these meetings through the BOP: What, Why & How podcast. ■

USP 800 – Handling of Hazardous Drugs

The Iowa Board of Pharmacy has announced plans to adopt USP 800 standards in their regulations across all pharmacy practice settings, to be effective July 1, 2018. To gauge understanding and preparedness for compliance with these newly formed standards, IPA and the Iowa Board of Pharmacy have drafted a short 14-question survey regarding how pharmacy practices currently handle hazardous drugs. The results of

Tune-in to IPA’s BOP: What, Why & How podcast following each Iowa Board of Pharmacy meeting to recap the board’s actions and earn pharmacy law CE. More information at www.iarx.org/BOP_Podcast.

Pharmacy on the Mind of Iowa’s Regulatory Boards Prescriptive Authority of Iowa Psychologists

Throughout 2016 and 2017, the Iowa Board of Medicine and Iowa Board of Psychiatry have held regular workgroup meetings to craft regulations to enact SF 2188 (passed in 2016) regarding prescribing authority of psychologists. A joint workgroup of both boards has been working through issues around baseline education and the ongoing testing and validation of services provided by the prescribing psychologists. IPA continues to monitor this issue closely for its impact on pharmacy practice and the role of pharmacists within teambased care.

Board of Nursing – Expansion of CPAs with ARNPs

During their July 19, 2017, meeting, the Iowa Board of Nursing discussed their progress on reviewing and revamping the regulations to their entire regulatory chapters, specifically Chapter 7 regarding advanced registered nurse practitioners (ARNPs). Within Chapter 7, the Board of Nursing plans to specify the authority of ARNPs to delegate tasks to pharmacists through the use of collaborative practice agreements (CPAs). While CPAs is one component of a larger process in rewriting Chapter 7, IPA expects to see final proposed regulations by the Board of Nursing in late 2017 with rules becoming effective in early 2018.

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TECHNICIAN CORNER

TECH TIDBITS Highlights from IPA’s monthly e-newsletter specifically for pharmacy technician members. Iowa’s Naloxone Standing Order

A hot topic in Iowa recently has been the approval of a statewide standing order for naloxone. It is a medication that is involved in reversing opioid drug overdoses. The standing order allows eligible recipients to obtain naloxone without a prescription. An eligible recipient is defined as anyone at risk of an opioid overdose, a first responder, or a family member or friend who could assist someone in the situation of an opioid overdose. It is important to obtain allergy information prior to dispensing a naloxone kit. Additional inform about the standing order and implementation into Iowa pharmacies can be found at www.iarx.org/naloxone. The chart to the right details which naloxone products the statewide standing order allows the pharmacy to dispense.

Poison Ivy Prevention

Reactions to poison ivy are common during the spring months when people are planting flowers and cleaning their yards from the past winter. Many have heard the expression “leaves of three, leave it be,” but may not know poison ivy also produces flowers in the summer. The flowers progress to off-white berries in the fall, and the leaves change colors just like the trees. Poison ivy can be found growing anywhere, including on the ground, climbing up trees, or even as a shrub. Contact with the plant, particularly the urushiol from the sap, causes an allergic reaction in many people. Exposure can also occur through pets, garden or fishing tools, clothes, or inhalation from burning yard waste. Prevention is the best way to avoid the itchy rash, but treatment options are available for those affected by the allergen.

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Kit

Must contain the following:

Intranasal naloxone with atomizer kits

• Two Luer-Jet Luer-Lock syringes (prefilled 2mg/2ml naloxone hydrochloride) • Two mucosal atomization devices (MAD) • Step-by-step instructions for administration of intranasal naloxone including a possible second dose, instructions for calling 911, rescue breathing, and monitoring victim until professional help arrives

Intranasal naloxone spray kits

• One package of two 4mg doses of naloxone nasal spray (ex. Narcan) • Step-by-step instructions for administration of intranasal naloxone including a possible second dose, instructions for calling 911, rescue breathing, and monitoring victim until professional help arrives

Intramuscular auto-injector naloxone kits

• One naloxone hydrochloride 0.4mg/0.4mL prepackaged kit with: • 2 auto-injectors + audio instructions • 1 training device (ex. Evzio) • Step-by-step instructions for administration of intranasal naloxone including a possible second dose, instructions for calling 911, rescue breathing, and monitoring victim until professional help arrives • Note: Evzio auto-injector only available in 2mg doses

***Important: this standing order does NOT include naloxone prescription vials that require a syringe and needle.

Preventing exposure to poison ivy takes a little extra time but is relatively simple. While the best prevention is obviously avoidance, this is not always possible. The American Academy of Dermatology recommends wearing long pants, long sleeves, boots, and gloves when exposure is possible. If skin is going to be exposed, applying a skin-care barrier cream containing bentoquatam is an option, but the individual should reapply according to package directions. Once inside, postexposure, be sure to wash all clothing and anything that may have been in contact with the plant. However, prevention may not always work, resulting in an itchy, raised rash that may display in streaks. There may be blisters, swelling, and hives. It’s important to remember the rash itself is not contagious, but any remaining oil from the plant can be transferred to other people or pets if not washed thoroughly. Fortunately, there are many options to relieve some of the symptoms. To start, taking short, cool oatmeal or baking soda baths can help soothe the itchiness. Similarly, cool compresses can relieve

some itching. Topical applications recommended by the American Academy of Dermatology include calamine lotion or hydrocortisone cream/lotion. While oral antihistamines (Benadryl) can help with symptoms, topical antihistamines (Camphor, Benadryl creams) may actually worsen itching and should be avoided. Even without treatment, symptoms should improve within a week or two. While the reaction is typically mild to moderate, some severe symptoms warrant a visit to a physician or hospital, where steroids are likely to be prescribed. Severe warning symptoms include a rash covering most of the body, genitals, or face, severe swelling or itching, or any trouble breathing or swallowing. Knowing how to prevent exposure to urushiol and how to treat the rash will make this fall season a more an enjoyable one for those spending time outdoors.


TECHNICIAN CORNER

COPD 2017 GOLD guidelines: What You Need to Know

Many patients are affected by chronic respiratory diseases. In 2010, COPD was the 4th leading cause of death. The WHO states that COPD is projected to be the 3rd leading cause of death by 2030 unless preventive measures are taken. Smoking remains the single most important modifiable risk factor. Optimizing therapy for patients with this disease state is extremely important, yet very complex. There are many different inhalers to choose from, but the recent update to the GOLD guidelines may help decrease the difficulty in choosing an inhaler. COPD is a chronic, progressive disease that includes symptoms of sputum production, difficulty breathing, and chronic cough. It is diagnosed and monitored by a test called spirometry. This test helps measure the speed and depth of air into the lungs. COPD is broken down into 4 different grades based off symptoms and spirometry. The most common inhaler medications used for respiratory diseases are called bronchodilators and are broken into 2 different categories: beta agonists and

muscarinic antagonists. These allow the lungs to dilate & relax, causing a decrease in symptoms. Another class of medications, long-acting muscarinic antagonists (LAMA), can be used in addition to long-acting beta agonists (LABA) as they work via a complementary mechanism.

Grade

First-Line

Second-Line

A

Bronchodilator (SABA or SAMA)

Assess the effect: • Continue current med • Stop current med • Switch to alternative

B

Long-acting bronchodilator (LABA or LAMA)

Assess symptom frequency: • Continue current meds • LABA + LAMA

C

LAMA

Assess exacerbation frequency: • Continue current meds • LAMA + LABA • LABA + ICS

D

LAMA + LABA + ICS

In Addition to first line: Roflumilast (chronic bronchitis) Macrolide (past smoker)

There are now two inhalers which combine LABA and LAMA in the same device for optimal maintenance therapy. 1. Stiolto Respimat (tiotropium bromide/ olodaterol), developed by Boehringer Ingelheim Pharmaceuticals, Inc. The active ingredients are dispensed via a slow-moving mist, dosed once daily in 2 puffs, and does not contain steroids. The effects last for a full 24 hours and only take about 5 minutes to begin working. Rescue inhalers should still be available to the patient in the event of an exacerbation. 2. Anoro Ellipta (umeclidinium bromide/vilanterol) developed by

GlaxoSmithKline. It is dosed once daily and comes as a blister strip full of powder. You can help your pharmacist by assessing patients’ adherence to their inhaler regimen and making sure they are properly educated on the correct method of administration. Another important aspect in the realm of inhalers is verifying patients are only taking one medication from each class… Inhaled corticosteroids, short-acting beta agonists, long-acting beta agonists, shortacting muscarinic antagonists, and longacting muscarinic antagonists. ■

PTCB REDESIGNS OFFICIAL CERTIFICATES On May 15, the Pharmacy Technician Certification Board (PTCB) released a redesigned version of the Official PTCB Certificate. Certified pharmacy technicians can access and download the new certificate from their PTCB account for free. Both designs are still considered valid. In addition, on June 1, 2017, PTCB stopped automatically mailing paper certificates to newly certified technicians. Pharmacy technicians who scheduled their PTCE after June 1 will be able to print their certificates from their PTCB account as soon as their score report is available, typically within one to three weeks from their exam date. ■

New certificate design

Discontinued certificate design

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TECHNICIAN CORNER

NEWLY PTCB CERTIFIED IOWA TECHNICIANS January 1 - March 31, 2017

Please join IPA in congratulating the following pharmacy technicians on becoming PTCB-certified! Chase Allen Michael Allenback Kathleen Alscher Brandon Ash Ashley Baker Dexter Banouvong Hunter Barnhart Tessa Barringer Emily Baum Taylor Beatty Kati Bell Dinka Brdar Maria Castro Castro Elise Chang Zachary Christensen Alexandria Cline Kathleen Collins Brenda Conn Gerald De Maris Gabrielle Delorbe Jonny Draper Mattie Early Alyssa Erie Irina Fadeeva Fatima Fadl Victoria Fletcher

Deborah Foss Lucia Frayre Gabriella Frost Rosa Garcia Bradley Geiger Lauren Goeser David Gomer Alexandria Gomez Joshua Hagedorn Alexander Hall Stephanie Hanson Elizabeth Hanstein Brandon Hefel Courtney Howe Nicole Hulsebus Siera Jeffrey Annette Johnson Bryan Johnson Traci Johnson Fatmata Kamara Alexandra Kastli Maleah Kern Leah Kinney Chad Klauer Bailey Klinger Erin Knight

Brenda Koenig Srehita Kotla Logan Kubovec Jennifer Kuisle Michael Kuntz Dorothy Lapcheske Thanh-nhan Le Ashley Leute Amy Lickiss Bobbie Lippert Regan Liss Vilaphonh Lo Susan Longhurst Kathleen Lyon Matt Mallisee Shawn McCurdy Stephanie Mealey Raegan Menke LeAnn Meyer Lea Mikkelson Tracie Morgan Haley Morrison Tricia Morton Charles Murphy Ali Naraghi Marqui Nelson

Elodie Pannkuk Jamie Panosh Lindsay Papousek Ruju Patel Sharla Paup Christina Peterson Carlye Polacek Shannon Powers Linda Quibell Christina Rauch Andrea Reed Joshua Reedy Devon Rettkowski Faith Riedesel Alyssa Riniker Maria Rittel Lucas Roach Linda Robinson Kasumi Rupert Logan Schmalfeldt Sylvia Schmidt Austin Schoening Hannah Schroer Abbey Schwery Karlee Shaffer Jaeger Shaw

Bailey Shie Darcy Sibenaller Kathleen Sibley Shayna Skokan Megan Smith Alexis Soukup Isabel Stanger Akia Taplin Amanda Thompson Angela Ties Tyler Trimble Emily Ullmann Jade Van Meeteren Alexandra Visek Georgi Wachendorf Veronica Walker Anna Warner Mary Weber Rebekka Weber Caleb Wynstra Abigail Yahnke Alexis Zwank

CPhT Recertification CPE for FREE! Join IPA and receive CEI’s Technican Libarary for FREE! The Technician Library includes pharmacy technician certification CPE activities in categories consistent with the PTCB Domains, including pharmacy law, patient safety, immunizations, and current drug therapy. Also included are live webinars to get those live credit hours. Members: 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 CPE! www.iarx.org/membership | 515.270.0713 | ipa@iarx.org

JUL.AUG.SEP 2017 |

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IPA FOUNDATION

IPA FOUNDATION BOARD OF DIRECTORS TRANSITIONS TO 2017-2018 With the new administrative year comes a new IPA Foundation Board of Directors. The foundation would like to welcome the new directors Gary Milavetz and Bob Greenwood. In addition, Bill Baer and Jay Currie will again, serve the Foundation as president and vice president, respectively.

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

Gary Milavetz, BS, PharmD, RPh, FCCP, FAPhA 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

Bob Greenwood, RPh Waterloo

Tom Halterman, RPh West Des Moines

Julie Kuhle, RPh Indianola

Bob Stessman, RPh Manning

John Swegle, PharmD, BCPS Mason City

2017 SILENT AUCTION: FUN & FUNDS FOR THE FOUNDATION The 2017 IPA Foundation Silent Auction featured over 90 items up for bid. A Yeti cooler filled with craft beer and a regulation Drake University cornhole (bags) set were the hotly contested items this year. In addition to bidding on the 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. Over $13,000 was raised to support foundation initiatives to support student pharmacists and practice advancement across the state! â–

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IPA FOUNDATION

KARBELING LEADERSHIP AWARD 2017 recipients reflect on Jerry’s impact on the profession and recap their D.C. trip Casey O’Connell 2018 PharmD Candidate The University of Iowa

I

never had a chance to meet Jerry Karbeling, namesake of IPA’s Karbeling Leadership Award, but the stories I have heard of him speak of a passionate pharmacist and a loyal friend. This April I had the opportunity to learn about Jerry’s life and legacy while attending the NCPA Congressional Pharmacy Fly-In in Washington, D.C. with past and present IPA leaders that knew him well. Throughout this event we honored Jerry by toasting his memory and by engaging in one of his favorite activities--political advocacy. In the span of 24 hours our pharmacy delegation personally met with each of Iowa’s congressmen and with the senior healthcare advisors of both our senators. During each encounter we educated our audience on the training and skills every pharmacist possesses, the role pharmacists have in our current healthcare model, and the ways

pharmacists will save money and improve outcomes when we are finally recognized as healthcare providers. We also discussed the unique role that pharmacy benefit managers (PBMs) serve in reimbursing pharmacists and asked for their support in increasing PBM transparency. To my surprise, every meeting we attended held a remarkably positive tenor throughout despite Washington’s political climate. Democrats and Republicans alike received our message and expressed support for our agenda as they shared stories of pharmacists back home that have personally provided care for them. This experience showed me the power of a grassroots campaign and gave me a new appreciation for lifelong political advocates like Jerry Karbeling. Receiving the Karbeling Leadership Award was an incredibly humbling experience, but after learning about the man Jerry chose to be and walking in his footsteps I have never been more motivated to care for patients and to advocate on behalf of my profession.

Anne Stella 2018 PharmD Candidate Drake University

T

he Karbeling Leadership Award is named after the one and only Jerry Karbeling. A man with incredible integrity, compassion, and love for the pharmacy profession and the patients we serve. His organizational and political

involvement is an example of what makes an engaged pharmacy professional. His legacy is seen in all those whom he mentored, motivated, and believed in. From all the stories I heard about Jerry, he was abundantly aware of how legislation determines what we can do for our patients. Because of this, he saw it as his duty to be involved to ensure that the voices of our patients were being heard. To honor this quality, the Karbeling Award recipients take part in the NCPA Congressional Fly-In. This April, I had the privilege of speaking with all six Iowa legislators or their staff about the value that pharmacists can play in a community practice setting. I learned so much from the pharmacists and older students that sat in on these meetings with the Iowa legislature. They taught me everything from presenting the topic to be discussed, to engaging our legislator in the effects of various legislation on the care that could be provided to patients, to following up with any legislators or staff who had questions. I gained some incredibly valuable lessons for navigating how to make your voice heard on Capitol Hill. This tool will come in very useful as I continue to engage our legislature on the topics most concerning the health of our patients and our ability to serve them. Jerry, thank you for your example that shines through all those you touched. With this new year of Karbeling Award Recipients and all of those to follow, your legacy lives on. ■ JUL.AUG.SEP 2017 |

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IPA FOUNDATION

REFLECTIONS FROM IPA’S FIRST EXECUTIVE FELLOW Sarah Derr, PharmD 2016-2017 IPA Executive Fellow

T

his year has been a perfect whirlwind of learning, projects, professional engagement, and personal growth! After a lot of thought, finding the right words to describe this past year has proven to be quite difficult. I am beyond grateful for the opportunity I have had to serve as the inaugural IPA Executive Fellow, and having the privilege to work with so many of you. After I interviewed at IPA, I drove back to Minnesota knowing this fellowship was the perfect fit. This past year has been the most rewarding and exciting year of my life and career thus far. First and foremost, I am thankful to all of you, the IPA membership, for welcoming me into the Iowa pharmacy family. The opportunity to work with the best pharmacists in the nation has been inspiring and provided a strong foundation for my career. Getting to know so many of you on both a professional and personal level has been extremely fulfilling. Serving you as IPA facilitated various projects including resolving MCO concerns, facilitating the ChargeUP Calls, and creating naloxone resources has given me purpose and I’m so thankful to have assisted you in advancing the profession of pharmacy and caring for patient across the state of Iowa. I also want to thank the 2016-2017 IPA Board of Trustees and IPA Foundation Board of Directors. Your

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guidance, advice and constant support throughout this last year have helped me reach my goals while contributing to the mission and vision of IPA. I greatly enjoyed working on the threeyear strategic plan and leadership agenda, and assisting with the first year of the Outcomes Innovative Pharmacy Grant. Thank you for dedicating your time to advance the profession and provide guidance to IPA!

do more than I ever dreamed! Your passion has ignited the needed flame that will carry pharmacy into the future and your innovative thinking and perseverance have no equal. I’m excited to be an engaged IPA member and work alongside all of you in the coming years. ■

Association Impact of the Executive Fellow

Finally, I want to thank the IPA staff. David, Laura, Mindy and Marla, you have provided so much support and assistance throughout this last year as I stumbled through some projects and needed time to learn what Iowa pharmacy was all about.

In the first year of the Executive Fellowship, IPA and its members benefited greatly though expanded clinical initiatives, strengthened partnerships and new initiatives, thanks to the hard work of our first fellow, Sarah Derr, PharmD.

Anthony and Kate, you have been so much more than preceptors. You have been my mentors, friends, and a support system this past year. The opportunity to be exposed to every aspect of the association, of Iowa pharmacy and healthcare as a whole has prepared me well to continue to pursue my professional goals.

IPA strengthened relationships with collaborating organizations like the Iowa Healthcare Collaborative (IHC), Iowa Department of Public Health, and the Iowa Hospital Association. In addition, IPA assisted IHC with the State Innovation Model, or SIM.

Thank you to each of you for making this past year the best year yet. I cannot wait to see where my career takes me and I’m beyond excited to stay in Iowa and continue to impact healthcare for Iowans as the first pharmacist on staff at the Iowa Healthcare Collaborative. It is bittersweet to be wrapping up this year and moving onto my next steps. This experience has been the highlight of my training and I look forward to continuing to apply it to healthcare in Iowa. As Kate once said, IPA isn’t kicking me out; my stipend is just coming to an end. Believe me, if I could work for free I would! This association and the members of IPA have inspired me to

IPA provided increased support to those pharmacies participating valuebased networks include the Iowa Community Pharmacy Enhanced Services Network (CPESN Iowa) startup. The fellow was also integral in increasing IPA’s focus on addressing member issues with the Iowa Medicaid MCOs. In addition, IPA developed several new initiatives including the Iowa MPJE Study Guide, the IPA past president/ resident mentorship program, and the new legislator pharmacy visit program to reach out to newly elected (Nov. 2016) state legislators. All of this was possible thanks to Sarah’s efforts as the IPA fellow. IPA is looking forward to building on a successful first year.


IPA FOUNDATION

LEADERSHIP PHARMACY WELCOMES 2017 CLASS

IPA would like to congratulate 2017 Leadership Pharmacy participants from Iowa:

Leadership Pharmacy, a leadership program for new practitioners, began its 29th year with a live conference on August 3-6, 2017, 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.

Andrea Bennett, PharmD - Mercy Medical Center – Cedar Rapids

Since its inception in 1989, over 350 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.

Lauren Adair, PharmD - OutcomesMTM Jennifer Alexander, PharmD - NuCara Pharmacy – Pleasant Hill

Brittany Bruch, PharmD, BCACP - University of Iowa Hospitals & Clinics Laura Elliott, PharmD - UnityPoint Health – Iowa Lutheran Tisha Field, PharmD - Broadlawns Medical Center Shellie Fravel, PharmD, BCPS - University of Iowa College of Pharmacy Tyson Ketelsen, PharmD - VA Medical Center – Iowa City Emma Kraayenbrink, PharmD - Mercy Family Pharmacy – Dubuque Jessica Nesheim, PharmD - Mercy Medical Center – Des Moines

Leadership Pharmacy appreciates the support of these sponsors:

CONGRATULATIONS!

CONGRATULATIONS LAURA!

Michelle Fravel, PharmD, BCPS

On your selection to the 2017 Leadership Pharmacy Conference! A BIG thank you to all pharmacists and technicians in the state for the health care and leadership you provide every day to Iowans!

Laura Elliott, PharmD

...on your selection to the 2017 Leadership Pharmacy Conference!

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MEMBERS SECTION

IPA MEMBER SPOTLIGHT:

Mindi Jorgenson PharmD, CDE and Isaac (3); she enjoys sewing, costume making, art, and being an active volunteer at her church. She continues to be involved in pharmacy through IPA, ASHP, 340B Health, two mission trips to the Lakota Reservation, and free medical clinics when she can find them.

Written by:

Katie Schlebecker 2018 PharmD/MPA Candidate Drake University

Path to Pharmacy

Mindi Jorgenson didn’t always think she’d be a successful Director of Pharmacy in a Critical Access Health System; in fact, she hoped to begin her journey at the University of Iowa studying art. Mindi began working at Drug Town Pharmacy (now HyVee Drug Stores) when she was 16. As she was about to graduate high school, she found her plans changing thanks to the recommendation of a mentor, the Drug Town pharmacist – Jean Imwe. With Mindi’s excellent aptitude for chemistry and Jean’s recommendation, she changed her major to Pre-Pharmacy and never looked back. Mindi graduated from the University of Iowa College of Pharmacy with a PharmD in 1997 and has since become a Certified Diabetes Educator (CDE). She began her career as a pharmacist 20 years ago working at Regan’s pharmacy in Waukon, Iowa; and throughout her years as a pharmacist, she has held various management positions in retail pharmacies, clinic pharmacies, pharmacy call centers, and hospitals. When she is not enjoying precious time with her husband, Jeff, and two lovely children, Olivia (7)

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Current Pharmacy Practice

Personally, Mindi admits she probably spends more time with physicians than she does patients. As the Director of Pharmacy at Pella Regional Health Center, Mindi wears many hats. She runs the P&T committee with the help of the health center’s physicians. She also presents to the Clinic Administrative Committee (CAC) for adoption and implementation of collaborative practice agreements and other pharmacy programs in the clinics. As the pharmacy programs are expanding, Mindi hopes to increase her time with patients in the diabetes clinic utilizing her CDE designation. Mindi has started diabetes clinics in two hospitals where she had previously worked, and even received recognition from the American Diabetes Association for the programs she initiated at Marengo Memorial Hospital. Mindi was drawn to Pella Regional Health Center because of their mission: “To provide healthcare and healing services with Christian compassion.” In regards to Pella Regional, she states it’s “truly amazing to work at a facility that has such a great focus on a great mission.” The health center features a busy surgery center, a 25-bed hospital, an OB department, and seven clinics in rural communities. The health system pharmacy team is comprised of a hospital pharmacy and retail pharmacy; and hopefully

a pharmacist in the ambulatory care area, as Mindi is currently working on a scope of practice and collaborative practice agreement.

Mindi is proud to see her pharmacists working on med recs and engaging physicians to assure their patients can be compliant when they leave. Developing and implementing innovative pharmacy programs and increasing Pella Regional Health System’s presence in rural health care is the most rewarding experience of Mindi’s job; however, it is also the most challenging. Mindi states that rewarding pharmacists can be tough in innovate pharmacy programs since they tend to have low reimbursement rates and can be difficult to implement. The health center currently has a partially decentralized pharmacist, IV technicians, newly implemented anesthesia workstations, and Mindi’s favorite – pharmacists that take part in the discharge counseling process. Mindi is proud to see her pharmacists working on med recs and engaging physicians to assure their patients can be compliant when they leave.

Looking to the Future

When asked about where she sees pharmacy in the future, Mindi recalled an experience she revered during her time in a free medical clinic at the University of Iowa. In this clinic, Mindi saw a different side of pharmacist-physician relationships. She described the physicians coming to the pharmacy window saying, “I have a patient with ____, what do we have that can treat that?”. Since the pharmacy was stocked with patient samples that would often change due to their availability, it was up to the


MEMBERS SECTION

pharmacist to determine what was in stock that could best treat the patient. Mindi believes that this teamwork is the best way to practice providing patient care as a pharmacist.

Ultimately, Mindi envisions a future when pharmacists are embraced for dose adjustments and monitoring in ambulatory care and hospitals. Better utilizing pharmacists for their skills and education level is also where Mindi believes the profession could improve. Since pharmacists are more accessible to patients than any other healthcare provider, she encourages pharmacists to constantly look for ways to improve patient health, including: monitoring adverse drug events and patient outcomes; checking blood sugars, INRs, and blood pressure; assessing asthma technique; and embracing other monitoring parameters as needed. Ultimately, Mindi envisions a future when pharmacists are embraced for dose adjustments and monitoring in ambulatory care and hospitals.

Mindi challenges IPA members to experiment and think outside what is considered standard pharmacy operating procedures. To reach this future of pharmacy, and to better prepare for change, Mindi encourages IPA members to “be involved: participate in every webinar and seminar you can. Always keep well informed on changes in healthcare industry, and find ways to support your profession.” Developing better partnerships with local physicians and patients are essential, and overall IPA members should find ways to drive change and promote health in their practice and community. Lastly, Mindi challenges IPA members to experiment and think outside what is considered standard pharmacy operating procedures. ■

MEMBER MILESTONES Sam Williams, a P3 student pharmacist at the University of Iowa College of Pharmacy was elected President-Elect of the NCPA National Student Leadership Council. Congratulations Sam! Congratulations to Tammy Sharp-Becker, CPhT, on her new role as 340B Pharmacy Technician Coordinator for UnityPoint Health Des Moines! Patty Kumbera, RPh, has joined the advisory board of PrescribeWellness. Congratulations Patty! Congratulations to Michael Wolnerman, RPh, on his new position as senior sales executive for ReMy Health Inc. If you have a member milestone to share, please submit it to ipa@iarx.org

WELCOME NEW IPA MEMBERS! APRIL 1 - JUNE 30, 2017: Casey Anderson, Atlantic Mallory Balm, Waukee Kristin Berger, Ankeny Anna Burns, Des Moines Caroline England, Ankeny Katie Gaspar, Iowa City LuAnn Ihnken, Atlantic Jessica Johnson, Maquoketa Evelyn Luing, Ankeny Kristi Mathis, Ankeny Kris Mennen, Coralville Tara Nygaard, Muscatine Rory Sallach Ruma, Missouri Valley Andrew Schleisman, Omaha, NE Ashley Schroeder, Silver City Claire Steinbronn, Coralville Angela Taylor, Urbandale Angela Warren, Ankeny

THANK YOU FOR SUPPORTING IPA!

LOOKING TO GET PUBLISHED? Consider submitting your research manuscript to be peer-reviewed by the Journal of IPA. Here is what we are looking for: Research Reports: Original research involving medication effectiveness, safety, pharmacoeconomics, pharmacokinetics, pharmacogenomics, interactions, adherence and use, and pharmacy practice. Meta-analyses are also considered research. Review Articles: Comprehensive, significant, critical, and analytical reviews that include essential information on a well-delineated subject. Reviews must synthesize and critically evaluate available data rather than simply describing the findings. Case Reports: New or unusual events in one or more patients that expand the knowledge about common disease states or provide significant information about drug safety, adverse reactions, interactions, or usage. Special Contributions: Articles on unusual, topical, or historical subjects concerning the profession of pharmacy. Contact IPA prior to submission. Submission guidelines can be found at www.iarx.org/Journal. Please send articles to IPA@iarx.org.

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IPA ACTION ASHP Delegates Advancing Policy

L to R: Lisa Mascardo, Shane Madsen, Kate Gainer, Dave Weetman

Iowa pharmacists Lisa Mascardo, PharmD, FASHP; Shane Madsen, PharmD, BCPS; and Dave Weetman, RPh, MS, were integral members of the ASHP House of Delegates, providing input and support to advance important professional policy. Each delegate attended the Regional Delegate Caucus (RDC) in Chicago and the ASHP Summer Meeting hosted this June in Minneapolis. The ASHP House of Delegates debated several policy topics, including: pharmaceutical distribution systems, controlled substance diversion prevention, collaborative practice, pharmacist’s leadership role in glycemic control, and therapeutic and psychosocial considerations of transgender patients.

Education Advisory Committee Creating New Resources

On May 2, IPA’s Education Advisory Committee met to discuss several IPA educational initiatives. For the 2018 Midwest Pharmacy Expo, the committee discussed the importance of conducting a needs assessment for both pharmacists and pharmacy technicians to better identify their specific educational needs. The creation of a Board of Pharmacy Specialties (BPS) study groups was discussed to assist pharmacists in the state of Iowa who are taking a BPS exam for the first time or recertifying by sitting for the exam. Finally, this committee discussed several topic options for the 2018 IPA Goes Local meetings.

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IPA & IDPH Discuss Pharmacy– Public Health Collaboration

The National Association of Chronic Disease Directors (NACDD), in coordination with CDC, selected the Iowa Department of Public Health (IDPH) and IPA to participate in a learning program designed to accelerate team-based care using the pharmacists’ patient care process (PPCP) and collaborative practice agreements (CPA) to manage high blood pressure. This learning program supports the priorities of grant projects and collaborations between IPA and the IDPH by focusing on team-based approaches to hypertension control including selfmeasured blood pressure monitoring, lifestyle modification, and medication therapy management.

IPA’s Anthony Pudlo with Terry Meek from IDPH

Anthony Pudlo, IPA staff, and Terry Meek, health systems coordinator within the Bureau of Chronic Disease Prevention and Management at IDPH, attended the live workshop on May 24-25, 2017. The objectives of the workshop were to: 1) Provide methods and resources to public health practitioners to engage pharmacy partners, 2) Use the Pharmacists’ Patient Care Process (PPCPs) for the management of high blood pressure, 3) Develop, execute, and implement collaborative practice agreements (CPAs), 4) Prepare selected teams to serve as workshop facilitators within their state to educate independent pharmacists and primary care physicians on CPAs and the PPCP, 5) Approach payers to seek support for sustainable pharmacy practice models, and 6) Enable awardee teams to be champions and resources in their local regions on implementing and supporting PPCP and CPAs.

IPA was able to provide insight to other states that were looking for better collaboration between the pharmacy profession and public health initiatives. Since the workshop, IPA and IDPH have participated in conference calls with representatives from other selected teams to share lessons learned and best practices around expanded use of CPAs.

Working in Rural Iowa – Pharmacists Make an Impact

As part of their outreach efforts, the Iowa Rural Health Association hosts a spring workshop around the topic of provider shortages in rural Iowa. The workshop – Addressing Iowa’s Critical Need for Health Care Providers in Rural Area – brought together a variety of stakeholders from the local communities in the area to discuss the unique challenges in recruiting health care providers. Events were scheduled on May 12 in Fayette and May 16 in Storm Lake. Workshop attendees heard from local providers as they shared their story of why they chose to work in rural Iowa, what keeps them there, the unique challenges and opportunities they face, and what communities should do to recruit and keep providers in rural areas. In Fayette, workshop attendees were able to hear from IPA member, David Scott, PharmD, RPh, MBA, of Scott Pharmacy in Fayette. While the Storm Lake event was unfortunately cancelled due to low registration, the event would have spotlighted IPA member, Brenda Fowler, RPh, with Sac City Drug in Sac City.

Iowa Governor’s Conference on Public Health

IPA members had a strong presence at the Iowa Governor’s Conference on Public Health in April. The conference theme was Building Health Equity: Where We Work, Live, and Play and included a variety of programs on a wide range of topics affecting Iowans. Several IPA members attended this conference and IPA had several members present on pharmacy topics.


IPA ACTION

IPA’s Sarah Derr presenting at Iowa Governor’s Conference on Public Health

Cheryl Clarke, BS Pharm, RPh, FAPhA, and Renee Sedlacek from Drake University presented on Poverty Simulations Impact on Pharmacy Student Attitudes Toward Poverty. Sarah Derr, PharmD, IPA’s executive fellow, presented on Value Based Health Care Understanding Where Pharmacy Aligns. There were several great questions on how current pharmacy initiatives align with public health initiatives. Laura Sands, Jon Rosmann and Bernard Sorofman, PhD, FAPhA, presented on the Iowa Drug Donation Repository – Saving Lives and Reducing Waste. This provided a great overview of how public health and other healthcare professionals can assist in reducing pharmaceutical waste and repurpose properly packaged medications to help those in need.

IPA Spreading Seeds of Innovation

IPA staff and leadership have been invited to numerous state and national pharmacy meetings to present on the strategy, research results, challenges and successes, as well as the story behind eight years of experience with Iowa’s New Practice Model (NPM). The NPM has incorporated workflow efficiencies, specifically using trained and certified pharmacy technicians to perform final product verification (tech-checktech) that provides additional time for pharmacists to provide clinical services to their patients. Recently, Kate Gainer, PharmD, and Megan Myers, PharmD, (NPM Project Consultant) were the keynote at the Nebraska Pharmacists Association Annual Meeting. Gainer has also presented to the Maryland Pharmacists

Association Board of Directors and is scheduled to present this fall in Tennessee. Gainer, Myers, and Mike Andreski, RPh, (NPM researcher from Drake University) were all selected to present at the APhA Annual Meeting last March; and Anthony Pudlo, PharmD, MBA, shared NPM data and strategy at the Pharmacy Technician Consensus Summit hosted in Dallas earlier this year. Mike and Megan presented research posters at the IPA Annual Meeting and American College of Clinical Pharmacy virtual poster symposium. The success of Iowa’s NPM is a result of many key stakeholders working collaboratively and Iowa pharmacists and pharmacy technicians pushing the innovation envelope. Many states are turning to Iowa to follow our lead in advancing the roles of pharmacy technicians and expanding time pharmacists spend in direct patient care to improve the public health. The NPM is an important example of Iowa’s leadership in the pharmacy profession.

Iowa Diabetes Prevention Summit

About 1 in 3 adults in the U.S. have prediabetes, and about 9 out of 10 people with prediabetes do not know they have it. People with prediabetes are at high risk for developing type 2 diabetes. Fortunately, people with prediabetes can take steps to prevent type 2 diabetes. On May 3-4, 2017, the Iowa Department of Public Health in collaboration with the Center for Disease Control and Prevention (CDC) convened the 2017 Iowa Diabetes Prevention Summit to determine strategic actions needed to prevent type 2 diabetes in Iowa. Summit attendees worked to address issues around awareness of prediabetes, availability and coverage of the National Diabetes Prevention Program (NDPP), and screening, testing, and referring to the NDPP. Drake pharmacy faculty, IPA staff, and other invited guests participated in active workgroups on these topics over the two-day event. As the state of Iowa develops its diabetes prevention plan, IPA will advocate for the role of the pharmacist in screening, testing, and

referring patients into NDPP programs as well as pharmacies serving as education locations for the NDPP. The NDPP is a proven lifestyle change program that can help prevent or delay getting type 2 diabetes. The NDPP is a year-long program with one-hour classes that meet weekly at first, and later switch to meeting monthly. The two goals of the program are to: 1) Increase physical activity to 150 minutes a week. 2) Lose 5 to 7 percent of body weight. Since the event was held in May, IPA has already held follow-up meetings with representatives from the Iowa Department of Public Health to act on recommendations coming forward from the diabetes prevention plan.

Pharmacist-Provided HPV Vaccines Spotlighted at 2017 Cancer Consortium Conference

IPA members Kelly Kent, PharmD, (Towncrest Pharmacy) and Bill Doucette, PhD, (The University of Iowa College of Pharmacy) presented at the 2017 Iowa Cancer Consortium Conference on HPV vaccination in pharmacies. The topic was well-received by the conference attendees as the vaccination rates for follow-up vaccines in the HPV series is dismal in Iowa.

Bill Doucette (L) and Kelly Kent (R) presenting at 2017 Iowa Cancer Consortium Conference

Kent and Doucette spotlighted the efforts of Towncrest Pharmacy to work through a collaborative practice agreement to administer the 2nd and/or 3rd shot in the HPV series at the local pharmacy.

JUL.AUG.SEP 2017 |

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Resources to Expand your Practice at www.iarx.org IPA provides many resources on our website (www.iarx.org) to help our members advance their practices. These resources are meant to help you expand your practice and provide guidance on multiple efforts that the profession of pharmacy is working to advance. Some of these resources are listed below. To find them, look under Resources > For Pharmacy Practice or use the search feature at top of the site.

Collaborative Practice Agreements

Antimicrobial Stewardship

Sample practice agreements are available for the following disease states:

As antibiotic resistance continues to grow across the nation, pharmacists are key players to provide antibiotic stewardship in both inpatient and outpatient settings. IPA has compiled several resources to assist pharmacists in creating programs and communicating the importance of antimicrobial stewardship with both patients and other providers.

• Anticoagulation (both inpatient and outpatient) • Asthma • COPD • Dyslipidemia • Hypertension • Statin Use in Diabetes • Therapeutic Interchange • Tobacco Cessation If you have sample collaborative practice agreements to add to this list of resources please contact IPA at IPA@iarx.org.

Immunizations Find information about the current rules regarding immunizations in Iowa,the reporting system, and other resources and sample protocols available for the following: • Full ACIP Recommended Vaccines • Summary of Influenza Vaccines • Travel vaccines (IDPH’s policy on Yellow Fever)

Naloxone Statewide Standing Order Legislation successfully passed in 2016 to allow pharmacists to dispense naloxone under a statewide standing order. IPA has created and compiled several resources to assist pharmacists in navigating the statewide standing order and providing important counseling to patients and caregivers who wish to have naloxone on hand. Resources include a template policies and procedures document and patient education brochures.

More Resources are on the Way

Quality Metrics & Payment As a nation, we are moving away from a fee-for-service based health care system to one that focuses on patient outcomes and quality care. The IPA website features information on quality measures at the national level and provides resources to assist your practice in focusing on patient outcomes.

Medication Safety IPA encourages every pharmacy practice setting to collaborate with other health care professionals and patients to facilitate medication safety at all patient touchpoints. The IPA website provides additional information and links to the following initiatives to assist with medication safety in your practice: • Statewide Medication Safety Strategy: statewide strategy to improve medication safety for all Iowans. • Generation Rx: program to enhance medication safety and combat the increasing misuse and abuse of prescription drugs through educational prevention. • Katy’s Kids: program to teach children about medicines and medicine safety. Presentations are given to kindergarten through second grade classrooms by pharmacists and student pharmacists in the community.

Will be adding content on several public health initiatives including smoking cessation and substance abuse, as well as resources for care coordination, practice advancement, practice innovation and more!

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IPA Presence at Iowa Healthcare Collaborative Conferences

IPA members have been active at recent Iowa Healthcare Collaborative (IHC) Conferences and have brought a strong voice to these conferences to share what pharmacists can do with a variety of other healthcare providers. In addition to attending these conferences, IPA members have had a strong presence on panel discussions to inform other healthcare providers of what pharmacists are currently doing in the state of Iowa. In May, IPA members Randy McDonough, PharmD, MS, CGP, BCPS; Anthony Pudlo, PharmD, MBA; Diane Reist, BS Pharm, PharmD, RPh; and Pamela Wiltfang, PharmD, MPH, BA, CHES, discussed best practices for care coordination and ways to improve medication reconciliation during the Compass PTN Learning Community.

TEEING OFF FOR THE FUTURE OF PHARMACY

FRIDAY, SEPT. 8, 2017 Cheri Schmit (L) moderates a panel (R) with Jeff Olson, Matthew Maker and Ashley Loeffelholtz

The Legacy Golf Club Norwalk, IA

In June, IPA member Cheri Schmit, RPh, facilitated a panel of IPA members Ashley Loeffelholz, PharmD; Matthew Maker, PharmD; and Jeff Olson, RPh, to a group of healthcare providers about the CPESN and efforts to advance pharmacy practice in the state of Iowa at the Care Coordination Conference. IPA looks forward to continuing to partner with IHC to highlight how pharmacies can assist healthcare providers and patients in reaching their goals.

Follow IPA on Instagram

In May 2017, IPA debuted its Instagram account with the intent of providing members and followers a look at how the association works to fulfill its mission to empower the pharmacy profession to improve patient care. Follow IPA at @IowaPharmacyIPA, as the association highlights members, leaders and staff as they collaborate, innovate and advocate to advance pharmacy practice. ■

Register as a foursome or twosome at discount or as your own awesome self. And, don’t forget to purchase your mulligans online when you register!

Register by August 28 at www.iarx.org/EGGolfClassic Proceeds benefit the IPA Foundation’s support of student pharmacists at Drake University & The University of Iowa.


IPA ACTION

CALENDAR OF EVENTS 7-10 ACCP Annual Meeting - Phoenix, AZ

AUGUST 2017 29

Iowa Health & Social Media Conference - Des Moines

30

Iowa Board of Pharmacy Meeting - Des Moines

31

IPA Goes Local: Southwest Iowa Pharmacists Association - Council Bluffs

SEPTEMBER 2017 8

Eggleston Granberg Golf Classic - Norwalk

12

2/2/2 Webinar:

19

IPA Residents Meeting - Iowa City

19

College Night: The University of Iowa - Iowa City

21

IPA Goes Local: Johnson County Pharmacy Association - Iowa City

28

College Night: Drake University - West Des Moines

28

IMP3 Live - Quad Cities

10

2/2/2 Webinar

10

IPA Goes Local: Northwest Iowa Pharmacists Association - Spencer

12

IMP3 Live - Des Moines

14-18 NCPA Annual Convention - Orlando, FL 18

Wisconsin Human Papilloma Virus (HPV) Vaccine Summit - Green Bay, WI

19

IMP3 Live - Mason City

26

Wisconsin Human Papilloma Virus (HPV) Vaccine Summit - Eau Claire, WI

NOVEMBER 2017 1

Iowa Board of Pharmacy Meeting - Des Moines

2-5

ASCP 2017 Annual Meeting & Exhibition

8

Iowa Healthcare Collaborative 14th Annual Conference

OCTOBER 2017

14

State Innovation Model (SIM) Learning Community

4-8

14

2/2/2 Webinar:

IDWeek - San Diego, CA

IPA’s free monthly webinar series held on the second Tuesday of every month at 2:00 p.m. CST. September 12, 2017: October 10, 2017: November 14, 2017: Register for an upcoming 2/2/2 or view previous webinars at www.iarx.org/222.

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Save the Date:

February 16-18, 2018 Holiday Inn Des Moines-Airport & Conference Center

www.MidwestPharmacyExpo.com


PHARMACY TIME CAPSULE

19 67

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

JANUARY

The Iowa Pharmacy Service Corporation (IPSC) is announced as a “pre-paid prescription service”. The purpose and powers of the Corporation were to “establish, maintain, and operate a non-profit pharmaceutical service plan, whereby pharmaceutical services are provided at the expense of the corporation to any person who has an individual plan or is a subscriber to the plan” within the state of Iowa and states bordering Iowa. An annual survey by the American Association of Colleges of Pharmacy showed: 73 Colleges of Pharmacy in the US, 13,068 pharmacy students total (the largest enrollment to date in 1967), a 6.9% increase in female students and a 5.6% increase in male students, and only 14.5% of all pharmacy students were female.

MAY

The 88th Annual Convention held in Waterloo, Iowa on May 5-8 with 512 registered attendees. William S. Apple, 1967 Remington Award Winner, gave the keynote address and C. Boyd Granberg was inducted as president of IPhA. The convention also included the first, “Senior Students Day” hosted on May 8 to allow graduating students to attend sessions and events, even including a Senior Pharmacy Banquet

JULY

The Iowa Medical Assistance Program, authorized by Title XIX (Medicaid), was inaugurated on July 1, 1967. Medicaid was authorized by the Social Security Amendments of 1965, and enabling legislation was enacted by the 62nd Iowa General Assembly in 1967. Pharmacists were encouraged by IPhA to participate in Title XIX, and IPhA played a major role in the development of the state plan.

AUGUST

Max Eggleston, past president of IPhA (1960-1961) and owner of Stauffer Pharmacy in Waverly Iowa, elected 115th president of APhA for 1968-1969. Max also served many roles in IPhA, as well as the President of the Iowa Interprofessional Committee receiving the A.H. Robins “Bowl of Hygeia” for outstanding community service in 1966. First vice president of IPhA, Gale Stapp, Oskaloosa won the first place blue ribbon in the ostrich race at the county fair.

NOVEMBER

Phillip J. Levine, assistant professor at Drake University, publishes the article “Technicians” in the Iowa Pharmacist. The article covered the debate over the need for nonprofessional personnel to work under the supervision of a pharmacist. An ad hoc committee of APhA was studying the problem in the US, and the federal government supported the idea to help pharmacists meet the expanded needs of the public, especially with the new demands from Medicare and Medicaid. Both hospitals and community pharmacies were considering the addition of professionals similar to countries like Great Britain and Canada.

DECEMBER

Louis C. Zopf, Dean at University of Iowa College of Pharmacy, publishes an article titled “Consideration of the Professional Fee” in the Iowa Pharmacist. Coupled with the results of the Professional Fee Study Questionnaire from fall of 1966 presented in October, he leads a moving discussion of implementing a “professional fee” (cost of service + profit) to ultimately charge patients for the professional services rendered by the pharmacists. Pharmacies in 1967 generally used the concept of “gross margin” for pricing procedure, and debated the benefit of using a professional fee. Only 4% of pharmacies in Iowa charged a professional fee in 1966-1967.

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.

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ADVERTISER

NEED A RELIEF PHARMACIST? CONTACT “JOSEPH IN RELIEF” Joseph Thompson, RPh 9616 Quail Ridge Urbandale, IA 50322 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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Inspiring generosity and fulfilling the aspirations of the pharmacy profession through support of education, practice based research, and practice development 1960: The Iowa Pharmacy Foundation is established The first student scholarships and loans are awarded by the foundation to student pharmacists at Drake University and The University of Iowa

1978:

1970

Max W. Eggleston Executive Internship in Association Management is established to provide student pharmacists an educational experience in professional association management.

1992:

1990

Funding is given to Claxton Pharmacy – CR for a project evaluating the implementation of pharmaceutical care in an independent community pharmacy. The outcome of this research helped lay the framework for modern MTM models.

2007:

2000 With support from both colleges of pharmacy and the IPA Foundation, the Collaborative Education Institute (CEI) was incorporated to serve continuing education needs of Iowa pharmacists and pharmacy technicians.

2011: The Thomas R. Temple Leadership Endowment established to support leadership initiatives, including the Leadership Pharmacy Conference. The endowment was completed in 2016.

1960 1967: First two grants given by the foundation to each college of pharmacy in Iowa to advance their facilities and education they could provide for student pharmacists.

1980 1989:

The Leadership Pharmacy Conference is established to assist new practitioners with developing their leadership skills.

1994: Iowa Center for Pharmaceutical Care (ICPC) is established with the help of $300,000 and staff support from the foundation, Drake University College of Pharmacy and the University of Iowa College of Pharmacy to allow community pharmacists to implement more patient care services.

2010 2010: The New Practice Model Task Force began meeting as a continuation of an unofficial discussion group started by the foundation in 2009. The task force leads to the creation of the New Pratice Model pilot program to study tech-check-tech in 17 Iowa community pharmacies.

Since its establishment in 1960, the Iowa Pharmacy Association Foundation has invested in the future of the pharmacy profession in Iowa by building strong leaders, investing in innovative practice initiatives and securing high quality education for tomorrow’s practitioners. The result has been, and continues to be, a progressive and innovative culture in Iowa that continues to lead in how pharmacy is practiced across the country. Consider investing in the future of your profession by donating to the IPA Foundation general fund today at www.iarx.org/IPAFWaystoDonate. All donations to the IPA Foundation are 100% tax deductible.


IPA Journal - July/Aug/Sept 2017  
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