Michigan Pharmacist Journal - Jan./Feb./March 2022 by Michigan Pharmacists Association

MICHIGAN T H E O F F I C I A L J O U R N A L O F T H E M I C H I G A N P H A R M A C I S T S A S S O C I AT I O N

2 02 2 ANNUAL

CONVENTION & EXPOSITION FRIDAY, FEBRUARY 25 – SUNDAY, FEBRUARY 27

AR M

ACISTS

PH MICH IG

ON ATI CI

2022

HEALTH EQUITY

2022 Jan./Feb./March | Vol. 60, Issue 1

What’s the difference between equality and equity and why is it so important for the profession of pharmacy? (p. 14-15)

PREP ACT CHANGES

Emergency preparedness legislation has created big changes in pharmacy. As COVID-19 pills become available, more changes could be on the way. (p. 26)

MichiganPharmacists.org

VACCINATION & HIPAA Privacy laws and vaccination requirements leave many confused about their rights under the law. What does HIPAA really say? (p. 36)

IN THIS ISSUE 2022 LEGISLATIVE PRIORITIES

CSPM FOCUS

ON THE COVER

12 3 President’s Platform

16 4 C EO Corner

23 8 S tudent Focus

10 From the Foundation

22 CSPM President

28 Local Associations

Are you a “bored” member? Reinvigorate your membership and learn what MPA can do for you.

Incoming Foundation Chair Christopher Maksym takes the reins with gratitude for what has been accomplished and a vision for the future.

MPA is putting its strategic plan to work for members, with a focus on member value, team unity and financial security.

Working in long-term care, CSPM President Rod Sharp emphasizes how vital a pharmacist’s role is in early identification of long COVID.

MPA’s professional rotation gives student pharmacists a unique view of pharmacy, from regulation and advocacy to emergency preparedness and more.

Locals offer a vital avenue for engagement with both the community and profession. Learn how the Local Association Development Committee works.

EDITOR: Mark Glasper; MANAGING EDITOR: Mary Beth Wardell Michigan Pharmacist (ISSN 1081-6089) is the official journal of the Michigan Pharmacists Association, published four times a year at 408 Kalamazoo Plaza, Lansing, MI 48933. Publication Number: USPS-345-600. Phone: (517) 484-1466, Fax: (517) 484-4893 Website: www.MichiganPharmacists.org, E-mail: MPA@MichiganPharmacists.org, Advertising Information: Visit www.MichiganPharmacists.org/news/advertising or contact Bryan Freeman, MPA marketing and communications director, at (517) 377-0257 or BryanFreeman@MichiganPharmacists.org

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All opinions expressed in Michigan Pharmacist are not necessarily official positions or policies of the Association. Publication of an advertisement does not represent an endorsement. Michigan Pharmacist is subject to the standards established by the Association. Michigan Pharmacist is distributed as a regular membership service, paid for through allocation of membership dues. Nonpharmacist subscriptions are $40 annually. Postmaster send address changes to: 408 Kalamazoo Plaza, Lansing, MI 48933. Periodical postage paid at Lansing, Mich. Nothing in this publication may be reproduced in any manner, either in whole or in part, without specific written permission of the publisher. © Michigan Pharmacists Association, 2022

— PRESIDENT’S PLATFORM —

MANY REASONS TO STAY, MANY REASONS TO JOIN

s I enter my eighth year serving on the Michigan Pharmacists Association (MPA) Executive Board and begin my term as president, I am reflecting on the leaders who have preceded me. There are so many pharmacy role models here in Michigan, and we have such a collective pride in the profession. The presidents before me started off their platforms talking about growth through change, building value and embracing differences, while realizing similarities among our counterparts. I see all these themes carrying forward this year during my presidency and in the years to come. I’m thankful to you, the members, for electing me and, more importantly, for your membership in MPA! As I stated in my campaign, my top priority is to unite and protect our profession. I will support MPA actions that do that and spend time here citing a number of actions already on that course.

BY MICHAEL CROWE,

Pharm.D., MBA, CSP, FMPA, community-based specialty pharmacy manager, Walgreens; president, Michigan Pharmacists Association

Are You a Bored Member? (No Pun Intended) MPA has made and continues to make some big changes! By now, you all have at least heard of our new CEO Mark Glasper. Through Mark’s leadership, we have a much more effective organizational structure, with a team of directors responsible for several key areas of association management. My excitement for these changes is not for what was lost, rather what was gained: people with the bandwidth and expertise to oversee various critical departments of the association. Other exciting happenings include: • You’ll see Mark and MPA staff out visiting members across the state. • MPA offered a 30 percent discount on renewed memberships last year. • The Board is supporting a rotation for the location of the Annual Convention and Exposition (ACE) in the near future. • The MPA Board has dissolved and reorganized committees that were duplicative and outdated. • Recurring programs that operated at a loss are being eliminated to free up staff for the programs that members want to see happen. So many of these things I would say I’ve never seen happen in my 15 years as a member. With the recent addition of Bryan Freeman, director of marketing and communications, you should already be seeing improved communications from MPA regarding new and exciting happenings, including MPA’s new career center! And the member experience online will also improve with Jenny Mora heading up MPA’s finances and information technology (IT).

Are You an MPA Nostalgic? The ACE will be back in-person this year, Feb. 25-27 at the Detroit Marriott, Renaissance Center in Detroit. I really look forward to catching up with friends at this event every year. Similarly, MPA committees and task forces will be meeting in-person more frequently. New this year, committee charges have been developed by committee

members, rather than prescribed from the top, down. If you’re interested in serving on a committee, please reach out to me. Our legislative advocacy remains strong, with Brian Sapita serving as director of government affairs. It’s also the first full year of the MPA Government Affairs Committee operating. Expect more legislative wins for and protection of our profession. Director of Meetings & Education Alisha Swanchara is now supported by members of the MPA Education Committee, previously a task force with less autonomy, to guide MPA’s educational initiatives. We have a team at MPA with plenty of association experience and are fortunate to have Farah Jalloul, director of professional affairs, along with you, the members, serving on committees to provide the perspective of a pharmacist. And of course, we cannot forget Ron Devers, a top agent in the nation, heading up our insurance agency.

The Plan. Moving Forward. We have better defined our mission: “Unite and empower Michigan pharmacy professionals,” and through the input and collaboration of 40-plus members, we’ve created a digestible strategic plan. Rather than having 10 goals and 40 objectives, we’ve arrived at a plan with three goals – each with two objectives. Although two of the three goals focus on MPA staff and financial viability, the first goal is to put members first. We’re a membership organization! How can I not talk about membership? Thankfully, we have Scott Walsh, director of membership, whose work has begun to reverse a significant period of declining membership. The strategic plan has been used to draft an operational plan for this year; with that plan, the Board and I will support creating and maintaining what the members demand, while eliminating what does not create value.

Call to Action If you’ve read this, you’re probably a committed MPA member already. But in case you’re on the fence, I hope you’ll join or continue your membership to take advantage of what MPA can do for you, while getting a front-row seat to witness what it can do for the profession. We need you. I hope to see you at the ACE. Consider inviting someone new, so they, too, can get a taste of what MPA has to offer. 2022 Jan./Feb./March | Vol. 60, Issue 1

— CEO CORNER —

LEADING MPA STRATEGICALLY

e all have plans for the new year and your Michigan Pharmacists Association (MPA) is no exception. Over the past year, a dedicated group of volunteers from every entity under the MPA umbrella developed a new Strategic Plan for 2022-2024. The group assembled back in July 2021 for a strategic planning retreat at MPA headquarters and worked diligently on a plan to guide the organization over the next three years. Facilitators Gretchen & Loic Couraud of TwoCan Management led us through great discussions, culminating with an excellent direction for our plan going forward. Many thanks to those who participated, and we owe a special thanks to past Chair Charlie Mollien for suggesting a pharmacy acronym to make the Strategic Plan easy for all members to remember: BY MARK GLASPER, chief executive officer, Michigan Pharmacists Association

MTM. Not medication therapy management, but rather: 1. Members first 2. Team unity 3. Moving forward “Members first” captures what we’re always thinking about, our members. Building value for your membership investment is paramount, but that will only come if we’re always thinking of our members first. Everything we do is to strengthen member value, including advancing the profession.

“We are better because we are one”

“Team unity” is a governance and operations bucket we developed. We are better because we are one. The MPA Executive Board guides our direction, including practice sections, committees, local associations, etc., and staff carries out that direction. Keeping and maintaining a professional association management staff is key to making this equation work. “Moving forward” ensures financial success, and we cannot move forward without financial growth and security. The underpinning of any successful business, and MPA is a business, is the stability of its infrastructure and foundation. So, there you have it: MTM, our strategic planning acronym.

Strategic Simplicity a Year at a Time You can review the new MPA one-page strategic plan for the years 2022-2024 accompanying this column. The short format may be surprising, but every aspect is the end-result of: • Extensive interviews with Executive Board members and key stakeholders from every component of MPA, as well as association staff. Interviews included questions about MPA successes, strengths, weaknesses and challenges, its overall organization and governance, its financial situation, and its means, human and otherwise, to fulfill its mission. Interviews also covered the challenges that pharmacists face in their professional environment, as well as on the legislative and regulatory fronts. • In-depth research and analysis of trends in the industry and in the association space. Combined with the input gleaned from interviews, a set of trends and a Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis was produced for discussion and prioritization during the retreat. • A two-day retreat during which nearly 50 committed MPA stakeholders went through intense reflection and conversations — in small groups at times and as a full group at others — to review all the above materials and develop critical goals, objectives and strategies. The focus of the two-day retreat was not to list everything that could be done to better the Association but, more importantly, to identify the most critical goals, objectives and strategies to ensure the prosperity of the Association in support of its members, starting with the reversal of a decade-long loss of approximately 50 percent of its members. The level of commitment and participation all along this process was exceptional. With the new Strategic Plan in place, MPA staff embarked on developing an operational plan for implementation. Progress will be reviewed at each Executive Board meeting going forward. I look forward to highlighting Strategic Plan results in future columns, e-blasts and social media posts. And, please ask me about MTM – Members first…Team unity…Moving forward – when you see me at the Annual Convention & Exposition (ACE) Feb. 25-27, 2022 at the Detroit Marriott, Renaissance Center. I’ll have LOTS to tell you!

MichiganPharmacists.org

STRATEGIC PLAN 2022-2024

Mission: Vision:

Unite and empower Michigan pharmacy professionals One pharmacy profession, maximizing health and wellness

STRATEGIC GOALS AND OBJECTIVES

Goal 1: Objective 1: Objective 2:

Members First (Strengthen Member Value) Increase member retention rate up to 85% +/- 2% Grow membership 2 to 3% annually

Strategies • Audit, evaluate and rebalance the product & service portfolio based on membership value • Advance the profession by passing PBM reform and providing provider status for pharmacists • Design and execute a new marketing approach to communicate a clarified membership value proposition to members and prospects • Leverage information technology to clarify, track and report on MPA’s customer target markets by member classification, industry segmentation and demographics • Promote diversity, equity and inclusion in the Association

STRATEGIC GOALS AND OBJECTIVES

Goal 2: Objective 1: Objective 2: Objective 3: Objective 4:

Team Unity (Improve governing effectiveness and operational management) Maintain an average retention rate of 90% Reach an employee satisfaction rate of --% within the next three years Conduct a Board and governance baseline assessment/ evaluation Increase diversity of staff and board

Strategies • Develop and implement an integrated IT roadmap to improve efficiency and communication • Assess options and transition to a strategic, data-informed governance decision-making model • Clarify and simplify MPA’s organizational structure, its components and allied entities; align all activities with the strategic plan • Clarify, differentiate and delineate board, staff and volunteer roles and responsibilities • Adopt policy and pursue diversity, equity and inclusion within the Association board and staff • Explore membership dues restructuring models for simplicity, clarity, value and access

STRATEGIC GOALS AND OBJECTIVES

Goal 3: Objective 1: Objective 2: Objective 3:

Moving Forward (Ensure financial profitability) Adjust accounting systems to reflect economic reality of each MPA entity Achieve better balance of revenue sources Measure ROI of each product and service portfolio

Strategies • Audit accounting systems and ensure revenues and expenses (including all overhead) are accounted for where generated and incurred • Develop a reserves policy, identifying restricted and unrestricted assets, to help fund the strategic plan implementation • Analyze existing product & service portfolio for opportunities to increase ROI • Review existing and explore new, non-dues revenue streams for product alignment with mission, strategic capacity, business case for support and ROI • Develop a pricing strategy and policy to set member/ non-member prices for products and services 2022 Jan./Feb./March | Vol. 60, Issue 1

— EVENTS CALENDAR —

EVENTS CALENDAR MPA, local association and national pharmacy organization events as well as health observances are included below. For the most up-to-date information, please visit our online calendar at www.MichiganPharmacists.org/eventscalendar.

JANUARY 2022

1-31

Saturday, Jan. 1 – Monday, Jan. 31

1-31

Saturday, Jan. 1 – Monday, Jan. 31

Thursday, Jan. 13

13 17 20 24 24 26 27

FEBRUARY 2022

National Birth Defects Prevention Month Nationwide

National Slavery and Human Trafficking Prevention Month Nationwide MSHP Committee Day & Board Meeting Virtual Only

Monday, Jan. 17

Martin Luther King Day Nationwide, MPA Closed

1-28

Thursday, Jan. 20

Monday, Jan. 24

MPF Board of Trustees Meeting MPA Headquarters, Lansing MPA Executive Board Meeting Virtual & MPA Headquarters, Lansing

Monday, Jan. 24

MPA Townhall, 7 p.m. Virtual & MPA Headquarters, Lansing

Wednesday, Jan. 26 Free CE: Protecting Your Records Virtual Webinar

Thursday, Jan. 27

CSPM Board of Directors Meeting Virtual Only

MichiganPharmacists.org

25-27

Tuesday, Feb. 1 – Monday, Feb. 28

American Heart Month Nationwide

Friday, Feb. 4

National Wear Red Day for the American Heart Association Nationwide

Wednesday, Feb. 2

MSCP Committee & Board of Directors Meeting Virtual Only

MARCH 2022

1-31 22 28

Tuesday, March 1 – Thursday, March 31

National Kidney Month Nationwide

Tuesday, March 22

American Diabetes Association Alert Day Nationwide

Monday, March 28

MPA Executive Board of Directors Meeting MPA Headquarters, Lansing

Friday, Feb. 11

MSPT Board of Directors Meeting Virtual Only

Monday, Feb. 21

MPA Executive Board of Directors Meeting Virtual Only

Thursday, Feb. 24

MSHP Board of Directors Meeting Detroit Renaissance Center

Friday, Feb. 25 – Sunday, Feb. 27

MPA Annual Convention & Exposition Detroit Renaissance Center, Virtual Component Available

Please note: Some virtual board and committee meetings may be subject to a change to inperson at MPA headquarters, at the discretion of the members. Please check the online calendar or contact MPA@MichiganPharmacists.org for more information.

— BIOS AND MEMORIES —

MAURICE ‘MORRY’ Q. BECTEL Maurice Q. Bectel, former president of both the Michigan Pharmacists Association (MPA) and American Pharmacists Association (APhA), died Thursday, Oct. 28, 2021, in his home in Fort Myers, Fla. at the age of 86 after a battle with Alzheimer’s Disease. “Morry was a dear friend and colleague for over 60 years,” said former MPA CEO Louis Sesti. “He was a true leader, having served in key positions in many organizations, including MPA, APhA, PMA, PMA Foundation, MedicAlert and others. Pharmacy has lost a wonderful person.” Bectel was born July 9, 1935, to Wallace and Mildred Bectel of Muskegon, Mich. He graduated from Muskegon High School in 1954 and married his high school sweetheart, Theresa Ann Dabrowski, on July 2, 1955. He and Theresa remained happily married for 66 years until his death. Throughout his twenties, he played the drums in a jazz band called Morry Bectel and the Gentlemen of Rhythm. After serving as a medic in the U.S. Army, Bectel went to work for Charlie Hahn at Hahn Pharmacy in Muskegon. Hahn became a close friend and mentor and encouraged young Morry to become a pharmacist. Bectel followed the advice, graduating from Ferris State University with a Bachelor of Science in pharmacy in 1960. He then returned to Hahn Pharmacy, eventually taking it over upon Hahn’s retirement. The Bectel Pharmacy was a staple in the community.

Bectel served as president of MPA in 1971. In the 1980s, the Bectels sold the pharmacy and moved to Washington, D.C. where Morry was elected chairman of APhA and then interim president and chief executive of APhA. In 1994, he was named president of the PMA Foundation (now the PhRMA Foundation). He later served on the Board of the MedicAlert Foundation. He received the Remington Honor Medal from APhA in 1996, among many other awards and distinctions. After semi-retiring, Morry and Theresa headed to Fort Myers, Fla., where they were surrounded by many of their closest Muskegon friends, who had joined them in Florida for countless vacations over the years. Never one to sit still, Bectel went back behind the pharmacy counter at Costco in Fort Myers, where he continued working part-time for many years. He loved big band jazz, golf, a great glass of scotch and movies with his friends. He also loved jokes of all kinds. Morry and Theresa were blessed with six children, 13 grandchildren and three great-grandchildren to date. He was preceded in death by his parents, Wallace and Mildred and his brother, Terry Bectel. Morry is survived by his wife, Theresa, and his children and their spouses: Janet (Rob Lemonik) Nolan, Brenda (Rob) Shermetaro, Durelle (Jerry) Ray, Kim (Jim) DeLapa, Maureen (Dave) Lovell, and Robert (Robin) Bectel. He is also survived by his brothers, Jerry (Valerie) and Dick (Geraldine) Bectel, sister Carol Welch, grandchildren and great-grandchildren.

NEW STAFF BIO CARTER WESLOCK, IT MANAGER Carter Weslock joins the Michigan Pharmacists Association (MPA) as the IT manager, with more than 25 years of career experience dealing with all things in the information technology field. He is an alumnus of Michigan State University, with a bachelor’s degree in communication arts and sciences. Prior to MPA, Carter worked for several

associations, including the Michigan Association of School Boards, and has worked as an independent consultant for a wide variety of clients. When not working, Carter enjoys spending time reading, puttering around the house or spending time with family and friends. He’s looking forward to meeting all of the IT challenges the MPA has now and in the future. 2022 Jan./Feb./March | Vol. 60, Issue 1

— STUDENT FOCUS —

EXPERIENCES TO REMEMBER Two MPA Student Pharmacists’ Rotations at MPA The Michigan Pharmacists Association (MPA) welcomed two student pharmacists for a five-week elective Advanced Pharmacy Practice Experience (APPE) rotation, under the preceptorship of MPA Director of Professional Development Farah Jalloul.

BY FARAH JALLOUL, director of professional development, MPA;

ALIVIA BOWERS,

student pharmacist, South University; and

CHELSY VITANZA, student pharmacist, Creighton University

P4 student pharmacists Chelsy Vitanza, Creighton University, and Alivia Bowers, South University, will be graduating in the spring of 2022. Throughout their time at MPA, both were able to work on various projects, attend numerous internal and external meetings and hone their pharmacy management skills. Some of the projects that the student pharmacists worked on throughout their rotation included updating the statewide Michigan Department of Health and Human Services (MDHHS) monoclonal antibody (mAb) order form. The order form was a draft order form that could be utilized by clinic sites for the prescribing, dispensing and administration of COVID-19 mAb therapies in site clinic operations. With the recent quick pace of updates provided by the U.S. Food and Drug Administration (FDA) emergency use authorization (EUA), the student pharmacists had to familiarize themselves with new mAb therapies and update the order forms to include new therapies, new dosages and/or age groups, as approvals became available. Another project was assisting in the development of advanced trainings for pharmacy technicians, which

Chelsy Vitanza, student pharmacist, Creighton University “Throughout my time with the MPA, I have encountered many people and have learned many lessons that will guide me in my career as a pharmacist. It was an incredible opportunity to see the amount of hard work and commitment it takes to manage an association and improve health care for all. MPA allowed me to participate in activities that aligned with my aspirations of advocating for the profession of pharmacy. This rotation has given me the opportunity to broaden my views of pharmacy practice and build a meaningful relationship with the association. MPA is a valuable resource for pharmacists in all practice settings and an inspiration for all future pharmacists. It truly was a rewarding experience!”

MichiganPharmacists.org

will be used to obtain additional advanced training through the Pharmacy Technician Certification Board (PTCB). One MPA membership perk is the ability for MPA members to contact the Association with practicerelated questions. The student pharmacists were able to use their skills to research and find solutions to law questions as presented. In addition to assisting MPA members, the students were given the opportunity to attend Michigan Board of Pharmacy and Michigan Senate Health Policy Committee meetings with MPA Director of Government Affairs Brian Sapita. The Board of Pharmacy meetings exposed the students to disciplinary actions pertaining to the profession of pharmacy. In contrast, the Health Policy Committee meetings enriched the student pharmacists with a deepened understanding of legislation related to Michigan’s healthcare economy. The student pharmacists also witnessed advocacy and implementation of administrative rules and laws to expand healthcare professions within the state. In addition to attending meetings, the student pharmacists were involved in discussions about introducing new legislation to the Legislature. For more information about the rotation or to set up an APPE rotation, please reach out to Dr. Jalloul via email at Farah@MichiganPharmacists.org. The MPA enjoyed the opportunity to be a part of both Chelsy’s and Alivia’s journey to becoming pharmacists!

Alivia Bowers, student pharmacist, South University “After the completion of my five-week rotation with the MPA I am walking away with many new skills and a refreshed mindset to finish out my remaining rotations before entering the pharmacy career field. Every day at MPA, I was surrounded by people who continued to advocate and stand up for the field of pharmacy, which is what I was most thankful for. It taught me that no matter what path in pharmacy I choose to take after graduation, to always keep advocating for the future and surround myself with others that will do the same.”

— MEMBERSHIP —

GET PUBLISHED,

Advance Your Career BY SPENCER HIGGINS, membership development manager, Michigan Pharmacists Association Are you looking for an opportunity to strengthen your resume? What about getting your name out there in the pharmacy world? Would you like to create CE opportunities for the profession? Does sharing your knowledge with your peers appeal to you? As a member of the Michigan Pharmacists Association (MPA), you can submit articles for potential publication in MPA’s quarterly journal, the Michigan Pharmacist, or one of the Association’s other newsletters. In a time when some pharmacists spend a year searching before securing their first position, and wages are in decline, being published is a vehicle through which you can distinguish yourself among your peers and advance your career. In particular, MPA is currently seeking continuing education (CE) homestudy articles to feature in upcoming editions of the Michigan Pharmacist. If you or someone you know is interested in submitting a piece to be accredited and published for a homestudy, please contact Director of Meetings and Education Alisha Swanchara at Alisha@MichiganPharmacists.org to learn more. MPA is accepting submissions of topics for upcoming editions throughout 2022, and MPA would love to highlight our members! Article guidelines for all MPA publications, including CE articles, can be found online at www.MichiganPharmacists.org/publications/contribute. For additional questions, contact MPA Communications Manager Mary Wardell at Communication@MichiganPharmacists.org.

2022 Jan./Feb./March | Vol. 60, Issue 1

— FROM THE FOUNDATION —

MOVING PHARMACY FORWARD IN 2022

An Introductory Message from the new Foundation Chair

would like to begin by thanking the Michigan Pharmacy Foundation (MPF) Board of Trustees for entrusting me with this leadership role as the next chair of the MPF Board of Trustees. I am honored to serve, and I look forward to working with the Board and the leadership team that consists of Vice Chair Margaret (Peggy) Malovrh, Treasurer Susan Erickson and MPA CEO Mark Glasper. I would also like to acknowledge the Board’s tremendous foresight in adding a part-time executive director to the 2022 MPF budget. This is a significant move for the future of MPF.

BY CHRISTOPHER J. MAKSYM, Pharm.D., FNHIA, chair, Board of Trustees, Michigan Pharmacy Foundation

“The Foundation has a rich history of philanthropic support and success carrying out its mission, which includes advancing pharmacy through education, practice innovation and research focused on patient care, for the improvement and promotion of public health and public education.”

MichiganPharmacists.org

I want to recognize and thank past Chair Susan DeVuyst-Miller for her effective leadership during this very challenging time of COVID-19. The Board was able to fulfill all its stewardship responsibilities, virtually. I must share that it was very exciting to participate in our first in-person meeting in nearly two years at the Michigan Pharmacists Association (MPA) headquarters in Lansing this past November. I hope this continues in 2022 and beyond. The Foundation has a rich history of philanthropic support and success carrying out its mission, which includes advancing pharmacy through education, practice innovation and research focused on patient care, for the improvement and promotion of public health and public education. COVID-19 put a damper on several core MPF activities; fortunately, the Foundation was able to successfully pivot and has maintained a solid financial position to fund its mission during this time. The Board looks forward to a very productive 2022, which will include following the lead of the MPA Board of Directors by completing a Foundation-focused strategic planning retreat. The primary objective will be to create a three-year plan to increase our endowment and expand financial support of mission-related activities. Another key objective will

be to retool the Health Professional Leadership Academy (HPLA) to attract more participants and train future leaders to be professionally active and effective in advancing the contributions of pharmacists, pharmacy technicians and other healthcare professionals to improve patient care and wellness. We need to continue to communicate, demonstrate and promote the value that we bring to patients in traditional and evolving patient care settings, as well as to stakeholders in expanding healthcare marketplaces. How we define the future role of the pharmacist in health care shapes the paradigm from which we assert our value in healthcare reform, and we need to train new leaders to contribute to this very important work. I am extremely satisfied with my choice to pursue a career in pharmacy. Our potential as a profession will continue to be defined by the ongoing demonstration that pharmacists and our partners directly improve medication safety and achieve intended therapeutic outcomes cost effectively, while maintaining a high level of trust within the general public and healthcare provider communities. I look forward

to working with the Board and MPA leadership to advance the Foundation’s mission and meeting the expectations of MPA members. Your support of the Foundation is needed and very much appreciated. You may donate online at www.MichiganPharmacists.org/ foundation/contribute or by texting “DONATE2MPF” to 44-321.

— FROM THE FOUNDATION —

MPF BOARD OF TRUSTEES

The Michigan Pharmacy Foundation is proud to introduce its new officers and members of the 2022 MPF Board of Trustees. Members are elected by the board annually on a rotating basis to three-year terms. The newly elected trustees for 2022 are John Brubaker, Terry Gottschall, Denise Markstrom and James Vander Linde. Chris Maksym has been elected chair, Margaret (Peggy) Malovrh has been elected vice chair and Susan Erickson will continue in the role of treasurer. Incumbent trustees continuing their terms are Amy Adams, Rox Gatia, Gary Kadlec, Annette Rowe and Amy Smendik. Mark Glasper, MPA CEO, serves as secretary and Mike Crowe, MPA president, also sits on the board.

CHRISTOPHER MAKSYM

MARGARET (PEGGY) MALOVRH

SUSAN ERICKSON

Dexter

Okemos

Burton

MPF CHAIR

MPF VICE CHAIR

AMY ADAMS

MPF TREASURER

JOHN BRUBAKER

West Branch

ROX GATIA

Sterling Heights

Bloomfield Hills

TERRY GOTTSCHALL

GARY KADLEC

DENISE MARKSTROM

ANNETTE ROWE

AMY SMENDIK

JAMES VANDER LINDE

MIKE W. CROWE

MARK GLASPER

Grand Blanc

Williamston

Wixom

Middleville

Rochester Hills

East Lansing

Sterling Heights

PRESIDENT

Flushing

SECRETARY/CEO

2022 Jan./Feb./March | Vol. 60, Issue 1

— LEGISLATIVE UPDATE —

MPA LEGISLATIVE PRIORITIES

he Michigan Legislature returns to work this month after their holiday break. Below are the legislative priorities that have been approved by the Michigan Pharmacists Association (MPA) Executive Board. MPA continues to be the voice of pharmacy at the Michigan Capitol and is working tirelessly every day to advance the profession of pharmacy through legislation and administrative rules.

Michigan Legislative Priorities BY BRIAN SAPITA,

government affairs director, Michigan Pharmacists Association

• Advance Pharmacy Practice: Aid the Legislature, Medicaid, Michigan Department of Health and Human Services (MDHHS), managed care plans and other stakeholders in introducing legislation or integrating strategies that further utilize the services of pharmacists to provide access and improve the health care of the people of Michigan. • Pharmacy Benefit Manager (PBM) Transparency: Discuss PBM tactics that hinder patient access to care with policymakers. Identify and facilitate discussions with policy makers on fair business environments by promoting legislation that addresses issues such as prescription drug pricing and reimbursement, fair audit practices, mandatorymail order programs and PBM transparency. • Fair Pharmacy Reimbursement: Coordinate with stakeholders, such as MDHHS and the Michigan Department of Insurance and Financial Services on direct and indirect remuneration (DIR) fees and other issues to achieve fair reimbursement for pharmacy services. • Rules Promulgation: Advocate on behalf of the profession through rule promulgation efforts at the Michigan Board of Pharmacy to create fair and equal rules governing the practice of pharmacy in the state. • Opioid Epidemic: Discuss with stakeholders the creation and passing of public health policies to decrease diversion and keep patients safe while maintaining patient access to medications for appropriate use and advancing the pharmacist’s role in medication-assisted treatment.

MichiganPharmacists.org

• Access and Implementation of Technology: Advocate for the Michigan Department of Licensing and Regulatory Affairs, the Michigan Health Information Network and other stakeholders to provide pharmacists access to patient electronic health information and enhance the ability of the pharmacist to utilize technologies that result in the improved health and safety of the patients pharmacists serve. • Workplace Environment: Identify methods to encourage and enable policymakers to promote and support a culture of safety.

Federal Legislative Priorities • Direct and Indirect Remuneration (DIR) Fees: Demonstrate to policymakers the importance of national efforts to limit the inappropriate use of DIR fees as a method of recouping dollars from pharmacies after a claim has been adjudicated. • Provider Status: Operate with national organizations and pharmacy stakeholders to support access of pharmacy services to patients through the recognition of pharmacists as providers under Medicare Part B. • Reimbursement: Demonstrate the importance of national efforts to improve the frequency of updates to drug pricing standards, expand upon Medicare’s any willing pharmacy provisions and increase transparency requirements for PBMs.

— ADVOCACY UPDATE —

LOCAL ADVOCACY

CHALLENGE T

BY BRIAN SAPITA, government affairs director, Michigan Pharmacists Association

he third annual Local Advocacy Challenge at the Michigan Pharmacists Association (MPA) Annual Convention & Exposition (ACE) is in full swing. This competition is held to see which local association can raise the most money to support our advocacy efforts at the state and federal level through legislation and administrative rules. As in years past we are including the three schools of pharmacy as well, so make sure when you donate you choose the local association you belong to or your alma mater. Our goal is to raise at least $5,000 and with your help, we are more than confident that we will be successful in reaching our goal! The winner of the challenge will be the local with the highest dollar amount raised per member of its total membership contributing by 9 p.m. on Saturday, Feb. 26. The winner will be showcased at the ACE during the House of Delegates on Sunday, Feb. 27. The minimum donation to count as participation in the challenge is $10 for pharmacists and $5 for students. Make sure you donate early and often to ensure victory for your local association or school. Below are advocacy highlights that we were able to achieve because of donors like you.

2021 ADVOCACY HIGHLIGHTS • House Bill 4348 (PBM Reform), written by MPA, was introduced and is moving through the Legislature. • $34 million was secured in the state budget to increase the dispensing fee for independent pharmacies. • Pharmacy Day at the Capitol was the largest in-person event at the Capitol this year, according to the Michigan State Police. • The law allowing pharmacists to dispense an emergency 30-day supply of insulin to patients was signed into law. • MPA is working on legislation to grant pharmacists independent immunization authority. • Provider Status legislation has been introduced at the federal level: MPA and the American Pharmacists Association (APhA) are pushing hard to pass this legislation.

It is unfortunate, but a fact, that money and the appropriate distribution of money in our political system is necessary to have the opportunities to present the position of pharmacists on issues that affect our profession. Simply stated, we really need more pharmacists to make a financial commitment to our advocacy efforts. It is the responsibility of every pharmacist to support the pharmacy profession with your time, talent or treasure. Currently, we need your treasure. Please do not believe that if you don’t support pharmacy, others will do it for you. Pharmacy is a wonderful profession with a variety of opportunities for all of us. We need your financial help to maintain the vibrancy and stability of our profession. The Michigan Pharmacy PAC is a voluntary, nonprofit, nonpartisan organization that actively seeks to promote positive public health policy through the building and maintaining of relationships with candidates and elected officials. Contributions to the pharmacy advocacy fund allow our legislative team to support pharmacy-friendly legislators, participate in important events, speak on behalf of pharmacy’s interests and plan events such as Pharmacy Day at the Capitol or the Law and Policy Symposium. Additionally, we will be holding a PAC challenge between our three pharmacy schools. Alumni are always encouraged to help their alma mater win this competition. If you have any questions, please contact Brian Sapita, MPA director of government affairs at Brian@MichiganPharmacists.org or (517) 377-0254. To donate please visit https://fs27.formsite.com/7jFRIO/oblcac9wir/index.html or scan the QR code above. 2022 Jan./Feb./March | Vol. 60, Issue 1

— PROFESSIONAL DEVELOPMENT —

THE ‘GREAT’ DIFFERENCE

Why and How We Work to Achieve Health Equity

he COVID pandemic has impacted certain communities more than others. Data on the number of cases, hospitalizations and deaths due to COVID-19 show the pandemic has been devastating and disproportionate in impacting communities of color and minorities. Nevertheless, health disparity was an issue long before this pandemic. The disease has, however, shed a light on how dangerous this disparity is.

BY FARAH JALLOUL,

Pharm.D., MBA, state pharmacy emergency preparedness coordinator, Michigan Pharmacists Association

The Oxford dictionary defines disparity as a “great difference.” Healthy People 2030, an initiative by the U.S. Department of Health and Human Services to achieve data-driven national objectives to improve health and well-being over the next decade, defines “health disparity” as “a particular type of health difference that is closely linked with social, economic and/or environmental disadvantage. Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion.” The Centers for Disease Control and Prevention (CDC) defines it as “preventable differences in the burden of disease, injury, violence or opportunities to achieve optimal health that are experienced by socially disadvantaged populations.” Addressing disparities in health care is vital in achieving

social justice and equity, which in turn will improve our nation’s health outcomes. This includes understanding health equality as opposed to equity, the different social determinants of health that affect patient care, and implicit bias.

Health Equality is not Health Equity As healthcare professionals, we understand that not all patients are the same, which is why treating them all equally does not make sense. To better understand the difference between equality and equity, see Figure 1. Health equality provides a standard for care that is not customizable (i.e., everyone gets the same bicycle). In contrast, health equity provides a customizable care or treatment route based on what a patient needs to achieve the best health outcome possible (i.e., you get the bicycle that you need). Health equity is impacted by social determinants, which are factors within and outside the healthcare system.

Figure 1: Health Equality vs. Health Equity

MichiganPharmacists.org

— PROFESSIONAL DEVELOPMENT —

“Health equity means that everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care.” The Robert Wood Johnson Foundation (RWJF) Figure 2: Domains of Social Determinants of Health

Implicit Bias To address healthcare disparities and improve equity in the delivery of health care to all Michigan residents, Gov. Gretchen Whitmer issued Executive Directive 2020-07 which directed the Department of Licensing and Regulatory Affairs (LARA) to begin promulgating rules that incorporated an implicit bias training requirement. Since then, the department has adopted new administrative rules that require implicit bias training as part of the knowledge and skills necessary for the licensure or registration of healthcare professionals in Michigan. According to the Michigan Public Health Code General Rules, implicit bias is an attitude or internalized stereotype that affects an individual’s perception, action or decision-making in an unconscious manner and often contributes to unequal treatment of people based on race, ethnicity, nationality, gender, gender identity, sexual orientation, religion, socioeconomic status, age, disability or other characteristic. The training will help healthcare professionals in recognizing and mitigating implicit bias.

Social Determinants of Health Healthy People 2030 defines social determinants of health (SDOH) as conditions in the environments where people are born, live, learn, work, play, worship and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. SDOH can be grouped into five domains: economic stability, education access and quality, social and community context, health care access and quality, and neighborhood and built environment. These domains represent factors affecting the overall health of patients and outcomes, which exceed factors within the healthcare system. For example, lack of education access and quality may lead to a decline in literacy, early childhood education, vocational training, higher education, and so forth. Another example, poor social and community context, may lead to less social integration, support systems and community engagement, just to list a few.

Training on implicit bias is required as a condition for initial licensure or registration, as well as license or registration renewal for all pharmacy professionals. This training is in addition to any continuing education training required for your profession. Unlike the human trafficking training requirement, this is not a one-time training. Implicit bias training is required every time you renew your license. The new requirement takes effect on June 1, 2022, which is one year after the promulgation of the rule. Therefore, if a licensee renews on or after June 1, 2022, the training is required prior to renewal. Training should provide opportunities for interaction among participants and with the instructor. An interactive training will be offered at the Michigan Pharmacists Association Annual Convention and Exposition on Saturday, Feb. 26, 2022. To learn more about implicit bias and to test for your own self review, Project Implicit created an Implicit Association Test (IAT) which can be located at: implicit.harvard.edu/implicit. References available upon request from the MPA office.

Therefore, due to the difference of social determinants of health and how they affect patients, healthcare professionals must account for individual differences between patients to ensure health equity. To learn more about the five domains, visit www.Health.gov/HealthyPeople.

2022 Jan./Feb./March | Vol. 60, Issue 1

Welcome Back! 2022 MPA Annual Convention to be held in-person

MPA ANNUAL CONVENTION & EXPOSITION Feb. 25 - 27, 2022

The Michigan Pharmacists Association (MPA) is excited to welcome you back in-person to the Annual Convention & Exposition (ACE) from Friday, Feb. 25 to Sunday, Feb. 27, 2022 at the Detroit Marriott at the Renaissance Center once again. We’ve heard you! Pharmacists, pharmacy technicians and student pharmacists have all expressed the need and excitement to get back together for the ACE. In addition, our vendor partners cannot wait to see you all again! We have our partners that you already have strong relationships with and more new faces attending who are all committed to learning and understanding your needs to better serve you.

BY ALISHA SWANCHARA, CMP,

director of meetings & education, Michigan Pharmacists Association

After the rollercoaster of 2020 and 2021, won’t it be great to see colleagues and friends again? MPA understands the importance of face-to-face interaction, not only professionally when consulting with AR M

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patients, but also personally as we look to grow and strengthen our network of pharmacy professionals and allies and attend education sessions in seats, not just behind screens. For those who may not feel comfortable attending in-person or those who have scheduling conflicts this year, MPA is offering a full conference virtual attendance option as well. Just select the virtual attendance at registration and you will be sent all of the information for attending sessions LIVE during the convention. It is important to note that MPA is keeping the safety of our members, staff and partners top of mind. MPA will be following Centers for Disease Control and Prevention (CDC), state and Detroit Health Department guidelines for COVID-19 precautions. COVID-19 policies and guidelines will be strongly enforced for the safety of our staff and attendees.

— ON THE COVER —

KEYNOTE HIGHLIGHTS FRIDAY OPENING SESSION After a full morning of educational programming that will begin at 8 a.m. on Friday, Feb. 25, MPA is honored that our opening keynote address will be given by Scott Knoer, MS, Pharm.D., FASHP, executive vice president and chief executive officer of the American Pharmacists Association. Knoer’s presentation will focus on how the payment model for pharmacy in the United States is fundamentally flawed. He will discuss how pharmacists are not currently incentivized for the things that will best impact patient care, reduce healthcare costs and decrease racial disparities in healthcare while also improving pharmacist and technician well-being. A functional payment model that incentivizes the correct behavior — leading to improved pharmacist and technician well-being, more access to healthcare, better outcomes and lower overall costs — is necessary. Be sure that you don’t miss welcoming Scott Knoer to MPA! His presentation begins at 1:30 p.m., after the welcome address from MPA CEO Mark Glasper.

SATURDAY KEYNOTE SESSIONS Saturday, Feb. 26 is another full day of programing, beginning with education sessions taking place after breakfast (7 a.m.) at 8:30 a.m. Saturday’s keynote address will come from Phillip D. Levy, M.D., M.P.H. FAHA, FACC. Levy is a professor of emergency medicine and assistant vice president for translational science and clinical research innovation at Wayne State University, as well as the chief innovation officer at Wayne Health.

Dr. Levy’s presentation will focus on physicians and pharmacists working collaboratively. Despite strong evidence suggesting that pharmacist-led medication therapy management for chronic conditions such as hypertension is effective, collaborative practice is underutilized, with barriers to uptake on the part of both pharmacists and physicians. The goal is a better understanding of the need for and benefit of pharmacist-led medication management therapy and how it can enhance clinical practice and patient care. Dr. Levy’s address will begin at 10:15 a.m. Taking place Saturday at 2 p.m., back by popular demand, is the National Association of State Pharmacy Associations (NASPA)NMA Self-Care Challenge. The Self-Care Challenge provides students an opportunity to showcase their extensive over-the-counter (OTC) knowledge against their rival pharmacy students in a lighthearted competition while granting continuing education credits for attendees. This year’s competition will feature three students from each college of pharmacy in Michigan: Ferris State University, Wayne State University and the University of Michigan. These three student teams will compete in a three round jeopardy style competition for a chance to be crowned victor! Each round will have a lead from the team who oversees buzzing in and answering the questions for that round, while still being able to communicate with teammates. For the first two rounds, the first team to buzz in after a question is read will get a chance to answer the question. If they get it right, they get points. If they get it wrong, the question is open to the remaining two teams to buzz in and try to answer the question correctly. The third and final round allows teams to bet all or a portion of their current points on the final question, either gaining or losing the amount of points they “gamble.” The team with the most points at the end of the game wins! Careful attention has been given to create pharmacy continuing education programs that not only help pharmacists and pharmacy technicians fulfill licensure and certification requirements, but to also help you grow in your healthcare setting as a community, consultant, specialty or health-system pharmacist and as a pharmacy technician. You can earn up to 15 hours of live credit during the convention.

NEW FOR 2022 MPA has partnered with pharmaceutical sponsors to offer you product knowledge programming during lunch on Friday. From 11:30 a.m. to 12:25 p.m., attendees will be able to choose a product theater session to join while they eat lunch, which will be provided. Product theater sessions provide an opportunity for our industry partners to provide educational programs about new pharmaceutical products and services, as well as the latest in data and research findings.

AWARDS RECOGNITION Traditionally, MPA has honored the many distinguished individuals who serve and advance the profession of pharmacy and the health of our patients at our Annual Banquet & Awards Ceremony. This year, the banquet is back inperson. The awards ceremony will take place Saturday evening during the awards banquet dinner. MPA will recognize a number of worthy awardees, including our 25-, 40- and 50-year members with the Years of Membership Awards; our volunteer leaders through induction into our Pharmacy Hall of Honor, as well as our elected boards, leaders and fellows for their service. MPA also honors scholarship recipients, the MPA Pharmacist of the Year, and other honorable awardees for their noteworthy achievements. The following awards will be recognized, among others:

Years of Membership Award The Years of Membership Awards are given to honor and thank pharmacy professionals for their many years of membership and dedicated service to MPA.

Pharmacy Hall of Honor The Pharmacy Hall of Honor was established by MPA in 1986 to recognize members who have provided volunteer leadership in service to the Association by participating on committees and in designated Association programs. Each year, qualifying members who have accumulated 500 points for their volunteer activities are inducted into the Hall of Honor. In addition to the individual’s name being displayed in the Pharmacy Hall of Honor at the MPA office, the recipient receives an exclusive lapel pin to signify their accomplishment. 2022 Jan./Feb./March | Vol. 60, Issue 1

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Fellow of MPA

Excellence in Innovation Award

HOUSE OF DELEGATES

The designation Fellow of MPA recognizes the honoree’s achievements and dedication to the practice of pharmacy and the community. This distinction signifies the recipients’ actions well beyond regular pharmacy practice. The fellowship is divided into three areas: professional actions in practice, public service and Association participation, all of which help define a well-rounded pharmacist. Recipients receive an exclusive lapel pin, a certificate and recognition in the Michigan Pharmacist.

The Excellence in Innovation Award is presented annually to an individual or team who has demonstrated an innovative pharmacy practice program, resulting in improved patient care or safety, advancement of the profession, enhanced pharmacy systems or other professional development.

The MPA House of Delegates is the policyforming body of the Association. The MPA House of Delegates is comprised of pharmacy professionals from across the state and includes delegates from the Executive Board, the Michigan Society of Pharmacy Technicians, local associations, regional societies and the Michigan colleges of pharmacy. It is the responsibility of the House of Delegates to interpret the objectives of the Association as stated in its bylaws and to serve as the policy-forming body of the Association. The House of Delegates will act on all policy reports and adopt resolutions of policy directed to the Executive Board. The House of Delegates will also act on proposals for amendment of the bylaws. The House of Delegates may adopt rules of procedures for the governing and administration of the House of Delegates.

Student Scholarship Program The Michigan Pharmacy Foundation (MPF) is proud to recognize exceptional student pharmacists during the Annual Convention & Exposition. Each year, a $2,500 scholarship is awarded to at least one student pharmacist at each of Michigan’s three colleges of pharmacy. Since establishing the program in 2002, the Foundation has awarded more than $100,000 in scholarships to deserving future practitioners.

Fred W. Arnold Public Relations Award (MPF) This award is presented to an MPA member or team of MPA members who have shown outstanding achievement and dedication to the pharmacy profession through community education and awareness.

Distinguished New Pharmacist Practitioner Award The Distinguished New Pharmacist Practitioner Award is presented annually to an MPA member pharmacist who has been licensed to practice for less than 10 years and participates in local, state and national pharmacy associations, professional programs and/or community service.

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Executive Board Medal Award The Executive Board Medal Award is given annually to an individual who has demonstrated an extraordinary personal commitment to MPA. The award was developed to recognize individuals who have been instrumental to the Executive Board and to the Association in advancing pharmacy’s agenda.

Bowl of Hygeia Award The Bowl of Hygeia derives its name from the Greek goddess, Hygeia, who was the guardian over the healing potion contained in the bowl. The Bowl of Hygeia Award is given to a pharmacist who has made outstanding professional contributions and has participated in community or governmental activities that reflect well on the pharmacy profession.

MPA Pharmacist of the Year Award The MPA Pharmacist of the Year Award is given to a pharmacist who demonstrates professional excellence and exemplary service to the profession in advancing public health at either the state or local level, and displays all the traits and characteristics of someone with a true commitment to advancing the pharmacy profession and public health.

The 2022 House of Delegates will convene in-person at the Marriott on Sunday, Feb. 27, 2022, to discuss proposed policy changes, proposed resolutions and review the MPA bylaws. After discussion and a vote on any proposed changes, those resolutions are directed to the MPA Executive Board for review and recommendation.

REGISTRATION Go to MPA’s website at www. MichiganPharmacists.org/education/ convention for more convention information and to register. Once you complete your registration, you will be prompted to book your hotel room at the Marriott immediately for your convenience. We can’t wait to welcome you back!

— ON THE COVER —

We wouldn’t be able to host you without the support of our sponsors! At the time of publication, the below companies had committed to sponsoring the 2022 Annual Convention & Exposition. We thank them for their continued partnership and support.

GOLD

SILVER

BRONZE

2022 Jan./Feb./March | Vol. 60, Issue 1

— MPA EXECUTIVE BOARD —

MPA EXECUTIVE BOARD

Elections for the 2022 Michigan Pharmacists Association Executive Board were held last October, and the president-elect and board members took office Jan. 1, 2022. The newly elected leaders will be recognized virtually at a special town hall at 7 p.m. on Monday, Jan. 24. Installation ceremonies will be held in person at the MPA Annual Convention & Exposition (ACE) in Detroit, Friday, Feb. 25, to Sunday, Feb. 27.

HEATHER L. CHRISTENSEN

MIKE W. CROWE

HOPE M. BROXTERMAN

MARK GLASPER

Rockford

Grand Blanc

Traverse City

Williamston

CHAIR

HEATHER M. SOMAND

PRESIDENT

KATIE AXFORD

PRESIDENT-ELECT

JOSEPH LEONARD

SECRETARY/CEO

JOHN S. CLARK

TREASURER

SPEAKER OF THE HOUSE OF DELEGATES

VICE SPEAKER OF THE HOUSE OF DELEGATES

ANGELA FASZCZEWSKI

RYAN J. GREENLEY

JESSE H. HOGUE

RYAN D. MOORE

MICHELLE SAHR

JAMIE THARP

THOMAS TOMASKI

ZAID YOUSIF

Ann Arbor

Lexington

Rockford

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Rockford

Chassell

Ann Arbor

Flushing

Portage

Gaylord

Saline

Zeeland

Macomb

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— CSPM PRESIDENT —

COVID-19 IN NURSING HOMES The ‘Long’ and Short of It

ask up. Social distance. Safer at home. Aren’t we tired of these phrases that weren’t even part of our lexicon merely two years ago? I understand the struggle. As a pharmacist who works in two of the state’s 17 dedicated COVID hub units (all of which operate at or near capacity), I have seen the long-term effects of COVID-19 on patients. It is disheartening to witness.

BY RODNEY SHARP, RPh, long-term care consultant pharmacist; Pharmerica Long Term Care; adjunct faculty, Madonna University; president, Consultant & Specialty Pharmacists of Michigan

Let’s review some of the facts as they pertain to nursing homes in Michigan. As of Nov. 14, 2021, more than 3,800 residents have died, and as of Nov. 24, 2021, there are about 600 active COVID cases in the state’s facilities. Preventing and controlling SARS-CoV-2 in nursing homes starts with vaccination. Currently, 62 percent of Michigan nursing home staff members are vaccinated – the fourth lowest rate in the U.S. Meanwhile, 85 percent of residents are vaccinated – the fourteenth lowest in the country. It should be noted that the vaccination rate is skewed since newly admitted COVID and post-COVID patients cannot be vaccinated for several weeks after symptoms have resolved. Per Executive Directive No. 2021-4, many facilities are mandating that all staff members be vaccinated, an effort that has been quite successful over the past few months. However, this order has also led to an increase in staff shortages. Facilities continue to limit resident visitations, monitor the temperatures and symptoms of all staff and visitors, and provide frequent testing based on community infection rates and facility outbreaks. While some post-COVID residents can be rehabilitated and discharged, many will need an extended stay to recover even partially. Patients are generally debilitated in three areas: cardiorespiratory, renal and neuropathic. News media has been primarily responsible for informing the public that the majority of COVID deaths are caused by pulmonary cardiac crisis. Of the COVID survivors, many become nursing home residents, suffering from long-term pulmonary and cardiac disease. What has not been highlighted in the news, however, is the risk of decreased kidney function, particularly in COVID patients who required hospitalization and were admitted to the intensive care unit (ICU).

Kidney Disease & Long COVID According to Kristina Sauerwein of the Washington University School of Medicine in St. Louis, “After the initial 30 days of COVID-19 infection, 4,757 (5.3 percent) of the patients experienced a decrease of 30 percent or more in glomerular filtration rates (GFR), which physicians use to assess kidney function and, if applicable, determine the severity of kidney disease.” This decline in GFR is an accurate predictor of future admission and readmission rates to nursing homes. Dr. F. Perry Wilson, an associate professor at the Yale School of Medicine, states, “Since adults naturally lose about 1 percent of their kidney function per year, a 30 percent decline in GFR is akin to losing 30 years of kidney function.” According to Zyiad Al-Aly, an MD at the Washington University School of Medicine in St. Louis, “It’s essential to discover kidney dysfunction before the problem progresses and becomes harder to treat. Kidney disease is one important facet of the multifaceted long COVID-19…and it must be taken into account when caring for people with long COVID-19.” Unfortunately, kidney disease is often asymptomatic, and many patients may be unaware of their kidney decline following recovery from the virus. As pharmacists, it is critical to help COVID-19 survivors maintain a good kidney care plan in order to prevent admission to long-term care facilities. As pharmacists, when learning from communicating with our patients that they have a history of COVID-19 with hospitalization, we must discuss the possibility of organ damage. Because renal disease is often silent, we need to warn them of a potential for premature aging of their kidneys. If patients do have renal disease, you can work with them and their healthcare team to choose medication that is best at preserving their kidney function.

“Unfortunately, kidney disease is often asymptomatic, and many patients may be unaware of their kidney decline following recovery from the virus. As pharmacists, it is critical to help COVID-19 survivors maintain a good kidney care plan in order to prevent admission to long-term care facilities.”

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— CSPM FOCUS —

Biosafety and Hazardous Drug Evaluation in Healthcare Settings

he National Institute for Occupational Safety and Health (NIOSH) and United States Pharmacopeia (USP) set the standards for safe handling of drugs that may pose an occupational hazard to healthcare workers.1-2 New drugs are emerging into the market with novel biological mechanisms, including cellular and gene therapies which utilize genetic material and/or live vectors, intended to alter a patient’s genetic code or expression of genetic material to treat a disease.3 Currently, these novel mechanisms and drug therapies are not evaluated by NIOSH or addressed within USP <800> for potential occupational hazards.

Regulatory Background BY CARRIE PENZIEN, Pharm.D., BCSCP, pharmacy compounding compliance team lead, Michigan Medicine, Ann Arbor

The Occupational Safety and Health Administration (OSHA) enforces standards that, although applicable to healthcare institutions, are not specific to the specialized work carried out in this setting. USP <800> requires healthcare institutions to utilize the NIOSH List of Hazardous Drugs in Healthcare Settings to develop their institution-specific hazardous drug list.2,5 At the time of publication, USP <800> is not yet considered compendially applicable due to appeals to referencing USP chapters and will remain informational only until new versions of these chapters are official.

NIOSH List Selection Methods NIOSH routinely reviews drugs approved for human use by the U.S. Food and Drug Administration (FDA) for hazardous properties and publishes their findings approximately every two years. The hazardous properties that were evaluated in the most recent

publication of draft revisions to the NIOSH List (2020) include: carcinogenicity, developmental toxicity, reproductive toxicity, genotoxicity, organ toxicity at low doses, or toxicity or structural profile similar to other drugs identified as hazardous.5 The published NIOSH List, although a helpful reference, has some limitations. The list is not continuously updated and only includes drugs that have been FDAapproved through December 2015, leaving a significant number of new drug approvals and all research drugs to be evaluated by individual healthcare institutions for hazardous drug properties. Rapid advances in cellular and gene therapies highlight biological hazards as a unique occupational hazard that has not yet been addressed in any hazardous drug regulatory document. NIOSH limits its list to chemical-type hazards, omitting biological hazards. Biological hazards are in many ways unique, but USP <800> implementation requires the development of hazardous drug evaluation strategies and oversight that may also be utilized to evaluate potential biosafety drugs.

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— CSPM FOCUS —

“The lack of clear guidance on how various vectors and genetic therapies should be handled within the healthcare system to protect employees motivated Michigan Medicine to create a task force to develop institutionspecific protocols. The task force comprised of representatives from infection prevention and epidemiology, pharmacy, research, nursing and the IBC.” Table 1. Example Biosafety Drug Category Qualifications High Biosafety

Low Biosafety

Unclassified

Biosafety drugs with any of the following biosafety drug qualities represent a risk of transmission to healthcare workers and/or greater risk of disease in exposed individuals and risk of adverse effects should the staff member be exposed. • The drug vector is viable and classified in NIH risk group 2 or greater AND the vector is able to replicate post-exposure (replication competent). • The vector or genetic material is known to integrate into the human genome. Biosafety drugs with a viable vector (or microbiological component) that do not meet the qualifications of the High Biosafety category represent a low risk of transmission to healthcare workers and minimal risk of adverse effects should the staff member be exposed. Drugs with no risk from microbiological exposure (nonviable) and no known risk of human genome integration with external drug exposure (i.e., mRNA in a liposomal vesicle).

Current Standards for Biosafety Regulation National guidance regarding the safe handling of biosafety agents to prevent occupational exposure is currently limited to laboratory research settings and enforceable only through control of research funding.4 The National Institutes of Health (NIH) Guidelines for Research Involving Recombinant or Synthetic Nucleic Acid Molecules establishes NIH Risk Groups 1-4 for microorganisms based on their relative pathogenicity to healthy humans and establishes the requirement for each research site to utilize an Institutional Biosafety Committee (IBC) to review specific projects and make recommendations on safe handling practices.8 The Centers for Disease Control and Prevention (CDC) and NIH jointly publish the Biosafety in Microbiological and Biomedical Laboratories (BMBL).9 Although the BMBL is an advisory document, it can be enforceable under the General Duty Clause in the OSHA Laboratory Standard. The BMBL establishes Biosafety Levels (BSL) 1-4, which prescribe safe handling recommendations from facility design to engineering controls and personal protective equipment (PPE) in laboratory settings. The NIH Risk Group is one of several factors in determining under which BSL a particular research study should be handled. The final determination of BSL containment strategies is made by IBCs in NIH-funded research sites.8 There is conflicting and changing guidance between these standard laboratory resources, Investigational Review Boards (IRBs), IBCs, FDA and professional publications.4 IRBs often use the handling

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recommendations from laboratory standards when moving to human trials. These recommendations do not always translate well into pharmacy practice. For example, Adeno-Associated Viruses (AAVs) are considered BSL-1 per the BMBL and therefore do not necessarily require handling in a biological safety cabinet (BSC), so investigator brochures may not include this requirement.9 However, the use of a horizontal laminar airflow workbench to maintain drug sterility creates a positivepressure environment that pushes air from the worksite back towards the compounder, potentially exposing the compounder to a gene therapy agent. The same investigator brochure may require an N-95 mask for nursing administration but contain few or no special handling precautions for pharmacy compounding personnel. Additionally, handling recommendations within FDA package inserts for similar gene therapies are not consistent. For example, the voretigene neparvovec-rzyl (Luxturna®) package insert contains a warning statement: “LUXTURNA is an adeno-associated virus vector-based gene therapy. Follow universal biohazard precautions for handling,” as well as warnings regarding body fluid handling. Onasemnogene abeparvovecxioi (Zolgensma®), also an AAV-vector gene therapy, contains no such warnings.10-11

Categorization of Biosafety Drugs The lack of clear guidance on how various vectors and genetic therapies should be handled within the healthcare system to protect employees motivated Michigan Medicine to create a task force to develop institution-specific protocols. The task force comprised of representatives from infection prevention and epidemiology, pharmacy, research, nursing and the IBC. This taskforce developed a strategy for decision-making regarding the hazard classification of a drug with biosafety properties by considering the following risk factors: • Viability of the vector (or microbiological component), • NIH Risk Group, • Vector ability to replicate post-exposure (replication competence), and • Drug vector or genetic material ability and probability to integrate into the human genome. Biosafety classification was then determined based on the drug’s factor(s); see Table 1. At Michigan Medicine, each drug’s categorization undergoes rigorous multidisciplinary oversight. However, a significant challenge is identifying the NIH Risk Group of the vector. This information is

— CSPM FOCUS — not readily available for specific vector strains, and extrapolation from the species or viral group may be necessary through publicly accessible online databases.12 Determination of the risk of human genome integration is another challenge, which may necessitate extensive research. A helpful resource may be found by partnering with microbiological/virology experts in the IBC.

The NIOSH List creates a framework for institutional hazardous drug lists but does not include all drugs and does not address biosafety risks, necessitating that healthcare institutions develop their own standards for determining whether a drug is an occupational hazard.5 Guidance for protection in laboratory settings has been available for decades. However, additional guidance is needed to standardize occupational protections to mitigate biosafety risks in healthcare settings. References available upon request from the MPA office.

Summary Current regulatory standards for pharmacy handling of chemically hazardous drugs are published but not yet enforceable. USP <800> safe handling practice recommendations are similar and applicable to biosafety drugs with a few specific differences that should be addressed within institution-specific policies.

Exhibit 1. Example Biosafety Drug Handling Matrix4 General Rules

ACTIVITY Disposal Location Gown Type Pharmacy PEC Cleaning Receiving (see spill management for damaged packaging)

Repackaging Pharmacy PPE Pharmacy Preparation & Compounding

Transport Manipulation

Administration & Disposal

Handling of Contaminated Body Fluids

Wet Dried

EVS etc. PPE

Decontamination/Cleaning

All Staff PPE

Spill Management & Pharmacy BSC Breakdown

Gloves1,3

LOW BIOSAFETY HAZARD Regulated Medical Waste (Red) Impervious Procedure Gown Isolation Gown Full disinfection and sanitization of BSC after each product (including drip pan) Single Gloves Single Gloves Shoe covers required for HD storage areas Double Gloves with Procedure gown +/- Gown & Face Shield (splash risk)

Storage & Picking

Nursing/ Providers etc. PPE

HIGH BIOSAFETY HAZARD

Isolation Gown1

None None

All delivered in impervious labeled bag(s) Pneumatic tube delivery is not acceptable Mix, dissolve, or reconstitute any dosage form outside of pharmacy Double Gloves with Procedure Gown Mask & Face Shield +/- N-95 (irrigation/inhalation risk) Aerosolization: + isolation system and room Double Gloves with Procedure Gown With Mask & Face Shield +/-goggles (splash risk) +/- N-95 (inhalation risk)

Single Gloves +/- Gown & Face Shield (splash risk) Single Gloves +/- Gown, mask, & Face Shield (splash risk) May be manipulated within a BSC, CVE, or room air (may not be manipulated in an LAFW) +Additional garb for compounding area Liquids delivered in impervious labeled bag(s) Pneumatic tube delivery information on Michart label (Only) Dilution & withdrawal from container: Single Gloves with Isolation gown Single Gloves +/- Gown, mask & Face Shield (splash risk) +/- N-95 (irrigation/inhalation risk) Aerosolization: + isolation system and room Single Gloves +/- Gown, mask & Face Shield (splash risk) +/- N-95 (inhalation risk)

Single Gloves

Double Gloves with Procedure gown Impervious Shoe Covers Chemo “Hood” (BSC or CVE) +Additional garb for compounding area

Double Gloves with Procedure Gown Single Gloves with Gown With Mask & Face Shield +/-goggles (splash risk) +/- Mask & Face Shield (splash risk) +/- N-95 (inhalation risk) +/- N-95 (inhalation risk) Double Gloves with Impervious Procedure Gown Goggles + Face Shield & N-95 –or- PAPR4 +/- Impervious Shoe Covers as appropriate + Additional garb for compounding areas Impervious Respiratory Procedure Face Shield Full Eye Protection Impervious Shoe Covers (N-95 and PAPR2,5) 1,6 Gown

Personal Protective Equipment (KEY)

1 Gowns and gloves must be changed minimally after each patient encounter/task, between manipulation of different drugs, a spill, or when damaged 2Use of a PAPR eliminates the need for goggles and face shield 3Inspect gloves for defects prior to use 4PPE must be removed upon exiting the work area or immediate spill area 5PAPR must be worn by staff who cannot use N-95 6Hazardous drug-rated “chemo” gowns may be substituted for the impervious procedure gown. Abbreviations: PEC = Primary Engineering Control, HD = Hazardous Drug, BSC = Biological Safety Cabinet, CVE = Containment Ventilated Enclosure, LAFW = Laminar Airflow Workbench, PPE = Personal Protective Equipment, PAPR = Powered Air Purifying Respirator

2022 Jan./Feb./March | Vol. 60, Issue 1

— LEGAL INSIGHTS —

PREP ACT: WHAT YOU NEED TO KNOW AND WHAT IT MEANS FOR PRESCRIBING

BY KIM SVESKA, R.Ph.,

Pharm.D., J.D., Foley, Baron, Metzger, and Juip, PLLC

“Per the FDA guidance, despite the PREP Act allowance of pharmacists to administer COVID-19 therapeutics, the EUA contains a ‘carve-out’ saying that pharmacists are not eligible to order or prescribe Plaxlovid.”

MichiganPharmacists.org

he Public Readiness and Emergency Preparedness (PREP) Act has significantly expanded the role of pharmacy professionals through a number of declarations over the course of the COVID-19 pandemic. It may also pave the way for pharmacist prescription of oral antiviral medication.

The PREP Act authorizes the Secretary of the Department of Health and Human Services (HHS) to issue PREP Act declarations. HHS Secretary Xavier Becerra issued a declaration in March 2020 that provides immunity from liability (except for willful misconduct) for claims related to the emergency declaration. (See https://www. phe.gov/preparedness). More specifically, the PREP Act declaration provides immunity for certain individuals and entities against any claim of loss caused by, arising out of, relating to or resulting from the manufacture, distribution, administration or use of medical countermeasures, except for claims involving “willful misconduct.” The initial guidance from April 2020 authorizes pharmacists to administer COVID-19 testing. An August 2020 amendment authorizes pharmacists and pharmacy interns to administer childhood vaccinations, and guidance from September and October 2020 authorizes pharmacists, pharmacy interns and pharmacy technicians to administer childhood vaccinations and COVID-19 testing. A Dec. 4, 2020 amendment also clarifies what training and other requirements are necessary for pharmacists, interns and technicians to be authorized to render COVID-19 vaccinations and testing. A January 2020 amendment (5) permits pharmacists licensed in other states to have reciprocity for vaccinations in states in which they do not have a license. The PREP Act also provides for preemption of state law to the extent the state law is in conflict with the PREP Act. A significant amendment (9) from September 2021 expands the authorization for pharmacists, technicians and interns to administer COVID-19 therapeutics. This would include oral antiviral medications without need for a physician prescription. On Dec. 22, 2021, the U. S. Food and Drug Administration (FDA) authorized the first oral COVID-19 antiviral under an emergency use authorization for the treatment of a positive COVID-19 test. The medication will be distributed in limited supply to select pharmacies. Per the FDA guidance, despite the PREP Act allowance of pharmacists to administer COVID-19 therapeutics, the EUA contains a ‘carve-out’ saying that pharmacists are not eligible to order or prescribe Plaxlovid. Thus, a prescription is

needed from a physician or mid level practitioner. Pharmacists and national pharmacy associations have expressed in a joint statement their disappointment that the FDA decision did not include the ability of pharmacists to order this new antiviral medication, noting that pharmacists have ordered and administered nearly 200 million doses of the COVID-19 vaccine, and that they are an integral part of the country’s ability to fight COVID-19. Hopefully, when the COVID-19 antivirals receive full FDA approval, pharmacists will be able to prescribe them independently pursuant to the PREP Act. Stay tuned!

Key Provisions of PREP Act 1. L iability immunity for covered countermeasures (vaccines and other therapeutics) for physicians, pharmacists, pharmacy technicians and pharmacy interns; 2. A uthorization of pharmacists, pharmacy technicians and pharmacy interns to administer COVID-19 vaccines and perform COVID-19 testing; and 3. A llows pharmacists, technicians and interns to administer COVID-19 therapeutics, which would include oral antiviral medications. This would primarily apply to pharmacist decision-making regarding administration of oral antivirals.

— FELLOWSHIP PROGRAM —

2022-2023

MPA FELLOWSHIP PROGRAM The Michigan Pharmacists Association (MPA) has established a reputation over the years for conducting a unique fellowship program to help equip future leaders in the pharmacy profession. Whether an individual’s goal is to own a pharmacy, be a pharmacy director at a health-system, oversee a region of chain pharmacies, teach at a college of pharmacy, serve in a regulatory role or manage an association—the fellowship experience can help prepare you for these career advancements. The core mission of the executive fellowship is to produce highly competent individuals who are prepared to assume high-level leadership positions in pharmacy practice and/or a professional association by providing exceptional training in all areas of organizational development and administration, including leadership, professional advancement and business growth. The Executive Fellowship is an exciting, unique training program where you will gain experience and knowledge that you cannot obtain elsewhere. This program is designed for a pharmacist at any stage of their career, whether it is a new graduate who wants to continue their educational training or a seasoned pharmacist looking for a career change. The fellowship is conducted over 12 months. Applications are being accepted through March 30, 2022. Candidates will participate in an interview and be notified of selection status by April 30, 2022. To learn more about the fellowship experiences, scan the QR code on the right. If you have questions, please contact MPA Fellowship Director Farah Jalloul, at Farah@MichiganPharmacists.org.

AUGUSTINE BUI 2021-2022 MPA Executive Fellow “Becoming the MPA/PSI executive fellow at the Michigan Pharmacists Association has been one of the most rewarding experiences in my pharmacy career. In just the short amount of time that I’ve been with the Association, I have been able to assist in creating a COVID-19 vaccine flow chart and in updating

ADDITIONAL FELLOWSHIP INFORMATION Fellowship Details: • Application Deadline: Wednesday, March 30, 2022, by 4:30 p.m. - Access Application Online at www.MichiganPharmacists.org/Fellowship. • Fellowship Start Date: Wednesday, July 6, 2022 • Fellowship End Date: Friday, June 30, 2023 Fellow Benefits: • Stipend: $45,000 • Standard MPA employee benefits including health, dental and vision insurance • Two weeks of paid time off and traditional paid holidays • Financial support to attend the American Pharmacists Association Annual Meeting • Complimentary one-year MPA Membership Core Rotations: • Advocacy and Policy • Communications and Publications • Education and Event Planning • Executive Management and Leadership • Membership Development • Professional Practice

monoclonal antibody protocols for the state, along with many other projects and assignments. The Association is truly making a difference, both to pharmacists directly, as well as at the legislative and regulatory levels, which profoundly impact patient care for the better. If you are passionate about the future of pharmacy, the MPA/PSI executive fellowship might be just what you are looking for.”

2022 Jan./Feb./March | Vol. 60, Issue 1

— LADC FEATURE —

What Is the

LOCAL ASSOCIATION DEVELOPMENT COMMITTEE The Local Association Development Committee (LADC) hosts a Naloxone CE event to generate MPA interest in Washtenaw County at the Original Cottage Inn in Ann Arbor.

PREPARED BY DAN LOBB, pharmacy manager, Walgreens; president, Wayne County Pharmacists Association; WCPA representative to LADC; parliamentarian, MPA House of Delegates

A Brief Summary Members of the Michigan Pharmacists Association (MPA) are automatically enrolled in a local association as part of their MPA membership, so they can build relationships with colleagues in their area of the state. Locals that adopt bylaws and maintain a compliant status are eligible for all privileges and services of an affiliated association, including operational funding from MPA for each member designating that organization as their Local. The MPA Local Association Development Committee (LADC) serves as a resource to assist Locals with viability and maintaining their compliant status. LADC ensures that Locals meet the minimum requirements to be recognized as active and assists those who require aid in maintaining their active status, as well as those looking to start a new Local or reactivate an inactive Local. Members and friends of the Wayne County Pharmacists Association celebrate National Pharmacy Week with their annual Feather Bowling competition at Cadieux Cafe in Detroit.

LADC: History 101 In 1982 and 1983, MPA created a task force to review the condition of Locals. At the time, Local membership was “bundled” with membership in both MPA and the American Pharmacists Association (APhA); Locals charged their own, separate membership dues, the amount of which varied for each organization. This bundling of memberships ended in 1986. In 1984, the MPA House of Delegates (HOD) voted to create the House Rules and approve the creation of LADC, which would begin its implementation in 1986. LADC was created to provide a means of standardization and consistency for all Locals going forward.

Composition

Presidents of three Local Associations, (left to right) Hanadi Thomas of Oakland County, Ashley Blanchette of Macomb County and Stephanie Everard of Wayne County, team up to co-host the 2019 Putt-Putt for PAC: The Al Tendler Invitational at Paradise Park in Novi.

MichiganPharmacists.org

The LADC exists as a joint committee of the House of Delegates and the MPA Executive Board, with the vice-speaker of the HOD serving as chair and up to one delegate from each Local, appointed by the speaker. LADC meets four to five times per year, including virtual and in-person meetings. LADC maintains an account that is funded by MPA members who are not members of a Local. Funds from this account are used to support local association grants and other activities as approved by LADC. Currently, there are 13 active Locals in the state of Michigan.

— LADC FEATURE — Priorities of LADC

The priorities of LADC vary with each operational year, but some of its core priorities include: 1. E nsure there is active representation from a diverse mixture of Locals by working closely with the Speaker of the House on appointment recommendations as needed, 2. C reate options for current/new members to select a Local when paying MPA dues, 3. I mprove communication with members and Locals when joining/ renewing MPA membership, 4. Offer and review processes for completing annual Local reporting online, 5. A ct as responsible stewards of the LADC fund, ensuring monies are allocated to expenses that benefit MPA members and the profession, and 6. M ake recommendations to the House officers on the stance of MPA for non-active members serving as delegates.

Current Local Association Status

In order to be considered an active and compliant Local, each association must meet the eight mandatory requirements as outlined in House Rule II. These include: 1. S ubmit a list of officers for the new operational year, 2. S ubmit proof of one general membership meeting, 3. S ubmit proof of one meeting of the Local’s Executive Board, 4. S ubmit one current banking statement for all accounts held by the Local and the current financial statement, 5. Have one delegate representative at the February MPA House session, 6. S ubmit proof of incorporation, 7. S ubmit proof of 501c(6)/501c(3) status, and 8. S ubmit proof of filing 990 Tax Form.

In addition to mandatory activities, Locals may earn points for supplemental activities, as outlined in House Rule II. These points are used to assist LADC in determining awardees for the Local Association and Distinguished Local Association Awards, and include: 1. P articipate at an MPA/PAC Legislative event, 2. S ponsor a legislative function, coordinated with Pharmacy PAC, 3. C oordinate/host continuing education sessions, 4. P articipate in an LADC-sponsored leadership event, 5. C onduct a membership recruitment activity, 6. P articipate in professional, public and community activities, 7. S ubmit a resolution to the MPA House of Delegates, 8. M aintain a communication system, and 9. S ponsor social functions.

LADC Awards

There are three awards presented by LADC each year at the House session. Briefly, they include: 1. L ocal Association Achievement Award: presented to a compliant/ active Local with at least 50 points in at least five of the nine supplemental activities. 2. D istinguished Local Association Award: recognizes one Local demonstrating exemplary or innovative activities through their efforts, independent of total supplemental points. 3. E rnie Koch Striving for Excellence Award: presented to honor an individual who exemplifies commitment and responsibility to their Local in facilitating that organization’s excellence. LADC exists to ensure that MPA has vital, engaged Locals, which often serve as the “gateway” for MPA members to become professionally active. Please contact the MPA offices to get in touch with an LADC representative for additional information and support. Larry Wagenknecht contributed to this article.

2022 Jan./Feb./March | Vol. 60, Issue 1

— COVER YOUR ASSETS —

PSI Insurance Is EXPANDING Don’t let Ice Do the Same in Your Pipes

irst off, let me say that as we kick off a new year, we’re excited to announce that PSI Insurance is growing. We purchased another insurance agency in Lansing and finalized the acquisition at the end of 2021. Its staff, Scott Harris and Dave Spoelman, will be joining us in our offices at MPA’s headquarters. This new expansion will allow for more sales and greater service opportunities. Our entire growing staff looks forward to serving you. BY RON DEVERS, CIC,

CPIA, CAWC, director of operations, PSI Insurance Agency

Additionally, winter is sure to bring its share of slippery sidewalks and snow-covered cars. As if that weren’t enough, we could also face frozen pipes that burst or other damage brought on by winter weather. There are numerous things we can do to prepare, some of which are: • Keep the attic well-ventilated to avoid ice dams, which causes damage to roofs. • Keep the attic well-insulated to minimize heating costs from warmth rising through the attic from within the house. • Keep gutters and downspouts clean of leaves and other debris to allow snow and rain to drain properly from the roof.

MichiganPharmacists.org

• Disconnect hoses from outdoor spigots so that water doesn’t freeze in the pipes leading into the house and potentially burst. • Seal doors and windows of air leaks to help with heating costs and efficiency. Proper weather stripping and door sweeps can aid in keeping your house warm and costs low. • Replace HVAC filters to allow furnaces to run efficiently. • Replace batteries in smoke detectors and carbon monoxide detectors to protect your family. • Keep cabinet doors open during cold spells to allow warm air to circulate around pipes. • Allow a slow trickle to flow through faucets to keep pipes from freezing, particularly for pipes running through unprotected spaces. We at PSI Insurance Agency hope you and your family had a safe and happy holiday season, and we look forward to seeing you in the new year!

Visit MPA’s social media channels for the most up-to-date information on events, resources and issues that affect pharmacy in Michigan.

Facebook.com/ MichiganPharmacists Twitter.com/ MIPharmacists Instagram.com/ mipharm Linkedin.com/company/ michigan-pharmacistsassociation

2022 Jan./Feb./March | Vol. 60, Issue 1

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MichiganPharmacists.org

2022 Jan./Feb./March | Vol. 60, Issue 1

— CE HOMESTUDY —

PHARMACY TECHS in FOCUS

MPA Offers Variety of Courses & Trainings for Technicians Pharmacy Technician Immunization Administration Training Pharmacy technicians play a vital role in aiding the pharmacist and the patient in the delivery of health care. While health care has historically focused on treating disease, our best weapon as healthcare professionals is the prevention of disease. Increasing the availability of pharmacy-based immunization services has become critical in the area of disease prevention, especially to those patients who are most vulnerable. Pharmacy technicians can play a critical role to increase the accessibility of vaccine administration services. By working synergistically through team collaboration, the pharmacist and pharmacy technician can increase the capacity to immunize patients resulting in decreased healthcare costs. This four-part program consisting of required readings, video-recorded lectures, a virtual live seminar and an observed demonstration of immunization technique has been specifically designed for pharmacy technicians to provide them with a foundation of knowledge on existing vaccines and will provide pharmacy technicians with the skills training to administer immunizations.

MichiganPharmacists.org

This MPA training program is recognized as fulfilling the education requirements for the Pharmacy Technician Certification Board (PTCB) Immunization Administration Certificate Program. To purchase and sign up for this course visit the MPA website: www.MichiganPharmacists.org/education/pharm_tech_immun.

The Certified Compounding Sterile Preparation Technician Exam Study Guide The Compounded Sterile Preparation Technician™ (CSPT™) certification is an advanced specialty program established by the Pharmacy Technician Certification Board (PTCB). The certification allows for PTCB Certified Pharmacy Technicians (CPhTs) performing sterile compounding to demonstrate the knowledge and skill in the specialty area of compounded sterile preparations (CSP). The Certified Compounded Sterile Preparation Technician Exam Study Guide was written with the CSPT™ Exam competencies in mind. To purchase this study guide, use the order form found on our website at www.MichiganPharmacists.org/onlinestore.

— CE HOMESTUDY —

“As a nationally recognized leader in the development of technician training resources, MPA has developed a customized training program to help prepare pharmacy technicians for the PTCB certificate focused on medication history and medication reconciliation.” Medication History Advanced Pharmacy Technician Training Course As a nationally recognized leader in the development of technician training resources, MPA has developed a customized training program to help prepare pharmacy technicians for the PTCB certificate focused on medication history and medication reconciliation. The training program, Medication History and Reconciliation: Gathering All of the Pieces of the Puzzle Together for the Patient’s Complete Medication Picture, is recognized as fulfilling the education requirement for the PTCB Medication History Assessmentbased Certificate Program and prepares the pharmacy technician to complete the PTCB Medication History and Medication Reconciliation Certificate Program.

For complete program details and purchase information, visit this page on our website: www.MichiganPharmacists.org/education/ pharm_tech_medhist.

Pharmacy Tech Prep Online The Pharmacy Tech Prep Online (PTPO) training program is approved by the Michigan Board of Pharmacy and administered by Pharmacy Services Inc (PSI). This course allows individuals to acquire on-the-job training to gain the knowledge and skills necessary to achieve certification and licensure by completing the Pharmacy Technician Certification Board (PTCB) examination. While enrolled in the PSI training program, individuals are exempt from the licensure requirements that are typically expected of pharmacy technicians under the Michigan Public Health Code.

This Board-approved program exempts individuals from the licensure requirement to practice in a pharmacy as a technician as long as they are enrolled in the program. This is useful for individuals who may be looking into becoming a pharmacy technician as a new career or who may be attending a collegiate or technical program to become a pharmacy technician. For more information on enrolling and purchasing this program, visit this page on our website: www.MichiganPharmacists.org/ techprep. For all of our current offerings and what is coming soon, keep an eye on the education page on our website, www. MichiganPharmacists.org/Education-Events.

2022 Jan./Feb./March | Vol. 60, Issue 1

— PAAS NATIONAL —

HIPAA GUIDANCE:

COVID-19 VACCINATION STATUS IN THE WORKPLACE

he U.S. Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) released guidance on Sept. 30, 2021, regarding the Health Insurance Portability and Accountability Act (HIPAA) of 1996 Privacy Rule and its application to the workplace, specifically discussing the disclosure and request of COVID-19 vaccination status.

BY TRENTON THIEDE,

Pharm.D., MBA, president, PAAS National®, expert third party audit assistance and FWA/HIPAA compliance

MichiganPharmacists.org

The Privacy Rule (45 CFR Parts 160 and 164) applies specifically to covered entities (CEs), such as health plans, health care clearinghouses and health care providers who maintain or transmit individually identifiable health information, called “protected health information (PHI).” The Privacy Rule does not regulate a CE’s or its business associates’ (BA) ability to request the vaccination status of an individual. It regulates how the CE and BAs use and disclose the PHI obtained. The rule expressly states that a member of the CE’s workforce is not considered a BA and the rule does not prohibit an employer from requesting the vaccination status of its employees, a patient or a visitor, and the rule does not limit an individual from disclosing their own information to another person. In other words, even though a pharmacy is considered a CE and staff must abide by the privacy rule daily when utilizing and disclosing PHI, when the pharmacy is acting in its capacity as an employer the rule does not regulate its ability to ask employees, customers or patients about their vaccination status. The employee, customer or patient might believe they do not have to share this information per HIPAA; however, that is not a valid assertion since HIPAA does not regulate or prohibit an individual from sharing their own information. Outside of HIPAA, there may be other applicable state or federal laws which could overlap HIPAA regulations. Refer to your healthcare attorney for additional clarifications.

authorization to obtain proof of vaccination directly from a covered health care provider and an employer may require its workforce to disclose their vaccination status to a patient, if asked.

• PAAS Fraud, Waste and Abuse and HIPAA Compliance members, refer to section 10.5 of your Policy and Procedure Manual for additional information regarding the use and disclosure of PHI and Appendix B for the Request to Access or Release Protected Health Information form.

Additionally, the privacy rule does not dictate what information can be requested of its employees as a condition of employment. Even the federal equal employment opportunity laws do not prevent an employer from requiring staff to be vaccinated before entering the workplace, as long as reasonable accommodations are made per the Americans with Disabilities Act (ADA). If an employer maintains confirmation or proof of vaccination, the ADA requires those records be stored separately from the individual’s personnel file. Furthermore, an employer can require each member of its workforce to sign a HIPAA

• Refer to the OCR’s guidance document for additional scenarios, including vaccine records maintained by schools, disclosure to public health authorities, and hospitals releasing PHI relating to an employee’s vaccination status (including documented side effects of the vaccine) to an employer.

The privacy rule does prohibit a CE and their BAs from using or disclosing an individual’s medical records, including vaccination status, to an individual’s employer or other entity unless the individual approves the request in advance, or the release pertains to treatment, payment or other healthcare operations (TPO). Unless the individual has restricted the release of their PHI, the pharmacy can share the individual’s vaccination status with entities such as the individual’s primary care provider, their insurance company and the state immunization database without the patient’s consent. For disclosure to an entity outside TPO, patients must first approve the release of their protected information (including vaccination history). Be sure to keep all HIPAA-related documentation for a minimum of six years.

PAAS Tips:

PAAS National® is committed to serving community pharmacies and helping keep hard-earned money where it belongs. Contact us today at (608) 873-1342 or info@paasnational.com to see why membership might be right for you. ©2022 PAAS National® LLC All Rights Reserved

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Heather Meyers Account Manager 517-214-6778 hmeyers@rxpmp.com 2022 Jan./Feb./March | Vol. 60, Issue 1

MichiganPharmacists.org

2022 Jan./Feb./March | Vol. 60, Issue 1

MichiganPharmacists.org