Board of Pharmacy Responses to COVID-19 Outbreak - UPDATED

Newsletter

3.20.2020

Information updated as of 11/13/2020

The following are the current state Board of Pharmacy responses to the COVID-19 outbreak. New information since the last update is bolded and italicized. We will update this page regularly as new information comes in, so watch this space. If you have any questions, please contact your Quarles & Brady Pharmacy attorney or:

Nicholas H. Meza: (602) 229-5439 / nicholas.meza@quarles.com

State	Response
Alabama	Declared state of emergency Board issued guidance addressing the following: Pharmacist remote order verification permitted for institutional and hospital pharmacies Emergency refills authorized General guidance on limiting exposure and safety methods Guidance on prescriptions for Schedule II-V controlled substances via telemedicine consults Schedule II medications may be prescribed electronically, or by calling in or faxing an emergency prescription to the pharmacy Additional clarification from DEA regarding the dispensing of Schedule II medications pursuant to an emergency oral prescription Joint Notice of Enforcement Discretion by Alabama State Boards of Medical Examiners and Pharmacy Extension of training deadline for pharmacy technicians Prescriptions for hydroxychloroquine and chloroquine Pharmacist testing for COVID-19 Board issued temporary pharmacist and pharmacy permit applications: Temporary Pharmacist Permit Application Temporary In-State Pharmacy Permit Application
Alaska	Declared state of emergency Division of Corporations, Business and Professional Licensing is posting COVID-19 information here Board reiterated existing emergency rules, including emergency pharmacist permits and emergency refills Board issued FAQ document addressing the following: Pending emergency regulations Prescriptions for albuterol Emergency oral prescriptions for Schedule II controlled substances Staffing and operational changes Hydroxychloroquine and chloroquine Board promulgates emergency rule addressing the following: Expanding tasks which a nationally certified pharmacy technician may perform Allowing a cashier or bookkeeper to work in a pharmacy without being licensed as a pharmacy technicians Permitting pharmacist administration of drug orders to patients with prescriber's order Allowing for the receipts of an oral prescription from an authorized agent of a practitioner Alleviating certain administrative functions of pharmacists Streamlining application and renewal requirements Expanding shared pharmacy service functions Allowing for temporary relocations during the emergency without a need to apply for a new or separate license Allowing dispensing of any quantity of drug if certain conditions are met The Board of Pharmacy proposes to make permanent regulation changes made by emergency regulation relating to the practice of pharmacy under the authority of AS 08.80 and 12 AAC 52, including pharmacist duties, pharmacy interns, pharmacy technicians, pharmacy technician with national certification, license renewal, shared pharmacy services during emergency, refills, labeling, prescriptions by electronic transmission, transfer of a prescription drug order, substitution, emergency preparedness, independent administration of vaccines and related emergency medications, and definitions Board issued FAQ on emergency regulations Written comments deadline: 4:30 p.m. on 05/14/2020 Board issued instructions on emergency permit application Joint Statement on Medications to Treat COVID-19 issued by Boards of Pharmacy, Medicine, and Nursing Board issued guidance on COVID-19 ordering and testing *Board issued guidance regarding pharmacist and pharmacy intern and technician administration of COVID-19 tests and vaccines* Remote pharmacy practice for pharmacists and technicians is permitted by existing law
Arizona	Declared state of emergency triggering emergency rules permitting emergency refills and out of state pharmacist practice without licensure under A.R.S. § 32-1910 Executive order Governor issued Executive Order 2020-17, addressing the following pharmacy licensing requirements: Defer requirements to renew licenses set to expire between 03/01/2020 and 09/01/2020, by 6 months from expiration date unless renewal can be completed online Defer requirements to complete CE by 6 months, unless requirements can be completed online Suspend rules preventing or limiting amount of online alternative hours permitted to renew a license If examinations cannot be provided via electronic or remote format, Board to issue provisional license for applicant meeting certain requirements The Board posted an updated FAQ document providing guidance addressing: Controlled substance inventories Dispensing of CII opioid prescriptions with hard copy prescriptions Verbal orders for CII prescriptions Medication substitutions and interchanges NABP Passport licensing Emergency rules and statutes Continued pharmacy operations Emergency refills and dispensing Remote pharmacy Compounding Limited COVID-19 exposure Changes in pharmacy hours Licensing and permitting waivers and NABP Passport Face-to-face counseling Hydroxychloroquine and chloroquine Governor issued Executive Order 2020-20 expanding access to pharmacies and addressing the following issues: Allows pharmacists to dispense emergency refills of maintenance medications for up to 90 days Waive electronic prescribing requirements of A.R.S. § 36-2525(D) Revises rules to mirror DEA's emergency oral prescription requirements allowing for paper prescription follow-up from 7 to 15 days Waive hospital prescribing restrictions for multi-dose medications Places restrictions on the filling of hydroxychloroquine and chloroquine Pharmacists may exercise professional judgment to interchange therapeutically equivalent medications of the same FDA drug classification unless otherwise noted by the prescriber Waive requirement for companies producing hand sanitizer to have a permit Allows Arizona pharmacies to receive pharmaceuticals from unpermitted wholesalers or third-party logistics providers in another state provided the entity is licensed in their home Allows Arizona wholesalers and pharmacies to receive pharmaceuticals from unpermitted manufacturers in another state or country if the unpermitted manufacturer is registered with the FDA and has a current GMP inspection within the past 6 months Department of Health Services extended standing order for COVID-19 testing, authorizing any licensed pharmacist to order and administer SARS-CoV-2RT-PCR tests for any individual in accordance with the conditions of the order. Order now set to expire on 12/21/2020. Board posted information related to remdesivir distribution Board issued waiver to R4-23-604(K)(e)(11) to allow wholesale distribution of short-dated medications provided certain requirements are met Board formed a seven-member panel to address COVID-19 issues. Quarles & Brady Partner Roger Morris has been appointed as a public member of the committee. The Board will meet on a weekly basis to address issues raised by the committee. Remote pharmacy practice for pharmacists and technicians is permitted by existing law Licensees can ask questions directly of the Board here
Arkansas	Declared state of emergency Board has posted FAQs and guidance addressing: Limiting hours of operation: Pharmacies can limit their hours of operations to 40 hours a week without approval, but reducing to less than 40 hours a week requires contacting the office Service delivery via drive-through: Pharmacies can lock their front doors and serve patients via delivery, drive through, or curb-side pickup Limiting potentially sick patient interaction: Pharmacies can request patients who have a fever or may have been exposed to the illness not to enter the pharmacy Refills without response from prescriber: Pharmacists can refill medications pursuant to Arkansas Statutes 17-92-102 so long as certain requirements are met The Board also reminds providers to be mindful of shortages of PPE and also that the Board of Pharmacy is aware of these shortages Additional guidance documents: DEA guidance on how to prescribe controlled substances to patients during COVID-19 COVID-19 guidance for pharmacies and pharmacists ASBP recommendations concerning potential compounding PPE shortages USP guidance for compounding alcohol-based hand sanitizer during COVID-19 pandemic USP response to shortages of garb and PPE for sterile compounding during COVID-19 pandemic Chloroquine and hydroxychloroquine information from the Arkansas Department of Health FDA Updates Temporary Policy Regarding Non-Standard PPE Practices HHS PREP Act Information on Pharmacist Vaccines Board issued emergency suspension of following rules: Requirements for endorsement on a pharmacist or intern license to administer medications Requirements for current CPR to administer medications Requirements for endorsement to act as consultant pharmacist 1:1 intern to pharmacist ratio waived Therapeutic substitution when prescriber is unavailable under certain circumstances The Board may review and consider approval of remote pharmacy practice by pharmacists for retail pharmacies
California	Declared state of emergency Board issued multiple waivers addressing the following: EXPIRED 07/19/2020: Pharmacist Direct Supervision of Interns - Business and Professions Code section 4114 EXPIRED 08/12/2020: Reassessment/Revalidation/Re-evaluation Requirements for Sterile Compounding Staff Competencies - Title 16, California Code of Regulations, sections 1751.6(e)(2) and 1751.7(b) and (d) EXPIRED 10/09/2020: Pre-licensure inspection at Proposed Location of an Automated Drug Delivery System (ADDS) - Business and Professions Code (BPC) sections 4119.11(a)(9) and BPC 4427.2(e) EXPIRED 08/05/2020: Certification in Basic Live Support - Business and Professions Code section 4052.8(b)(2) Restoration of Retired or Canceled Pharmacist License - BPC section 4200.5(d), Related to Retired Licensees; BPC section 4402(b), Related to Canceled Pharmacist Licenses; and BPC section 4403, Related to Payment of Fees for Reissuance or Renewal of License EXPIRED 07/01/2020: Use of Sterile Disinfectant Agents - Title 16, California Code of Regulations, section 1751.4(d)(1) Duty to Consult - Title 16, California Code of Regulations, section 1707.2(a) Use of PPE in Certain Compounding Aseptic Isolators or Compounding Aseptic Containment Isolators - Title 16, California Code of Regulations, section 1751.5 EXPIRED 06/22/2020: Inventory Reconciliation Report of Controlled Substances - Title 16, California Code of Regulations, section 1715.65(c) EXPIRED 03/27/2020: Sterile Compounding Renewal Requirements for Facilities Located Within a Hospital - BPC sections 4127.1(c) & (d) and 4127.15(b) EXPIRED 07/24/2020: Prohibited Acts Involving Dangerous Drugs or Devices - BPC sections 4169(a)(1) and 4161(b) EXPIRED 06/24/2020: Staffing Ratio of Pharmacists to Intern Pharmacists - BPC section 4114(b) EXPIRED 06/24/2020: Staffing Ratio of Pharmacists to Pharmacy Technicians - BPC sections 4115(f)(1) and 4127.15(c)(2); and Title 16, California Code of Regulations, section 1793.7 EXPIRED 10/31/2020: Remote Processing - BPC section 4071.1(a) Signature Requirement for Receipt of Delivery of Drugs - BPC section 4059.5 Prescriber Dispensing Medication to Emergency Room Patient - BPC sections 4068(a)(1), 4068(a)(5), and 4068(a)(6) EXPIRED 09/22/2020: Requirement for Consulting Pharmacist to Make Quarterly Visits to Clinic - BPC sections 4182(a) and (b)/BPC 4192(a) and (b) EXTENDED THROUGH 09/22/2020: USP <797> Requirements Related to Use of Personal Protective Equipment - BPC section 4126.8 EXPIRES 07/24/2020: Use of Alcohol Sanitizer before Donning Sterile Gloves - Title 16, California Code of Regulations, section 1751.5(a)(5) EXPIRED 07/01/2020: Intern Pharmacist Licenses - BPC section 4208 Waiver requests can be made to compounding.waivers@dca.ca.gov Any licensee needing a waiver may submit a request for such to compounding.waivers@dca.ca.gov. The Board respectfully requests that such submissions include the following: License number(s) A brief statement regarding the extent of the waiver sought A brief statement detailing how the declared emergency caused the need for the waiver Relevant laws that the licensee is requesting are waived Authorized contact person. An authorized contact person includes any owner, officer, member, pharmacist-in-charge, or other individual otherwise authorized to act on behalf of the licensee Reiterated guidance from FDA on compounding hand sanitizer Pursuant to the Governor's Executive Order N-39-20, during the state of emergency the Director of the California Department of Consumer Affairs may waive any statutory or regulatory requirements with respect to a professional license, including pharmacist licenses Additional information and the application to restore your license can be found here Board issued general COVID-19 information document for licensees summarizing Declared State of Emergency, waivers, and board resources Board posted list of sources for compounded products in high demand Department of Consumer Affairs (DCA) issued "Order Waiving Restrictions on Pharmacists Ordering and Collecting Specimens for COVID-19 Tests" DCA: Guidance on Pharmacists Ordering and Collecting Specimens for COVID-19 Tests
Colorado	Declared state of emergency Board issued guidance document and Emergency Rule 30.00.00 suspending various pharmacy statues and rules, including the following: Suspension of the ratio requirements for pharmacists/pharmacy technicians currently required under § 12-280-122, C.R.S. Suspension of Pharmacy Board Rule 5.00.60 and requirements around closure and notification, which deem a pharmacy to be closed if the compounding/dispensing area is not open for business the minimum number of hours specified in Rule 5.01.40(a) Suspension of Pharmacy Board Rule 5.01.40, which currently requires a minimum number of hours of operation for PDOs (prescription drug outlets) Suspension of Pharmacy Board Rule 6.00.30, which sets forth the qualifications for pharmacists to engage in drug therapy management and thereby restricts pharmacists from conducting screening tests for the coronavirus, so as to ensure that pharmacists may conduct screening tests in pharmacies and other testing centers Suspension of Pharmacy Board Rule 14.00.80(e) that currently requires consultant pharmacists to perform consultant pharmacist visit to inspect, and document the inspection, on a quarterly basis for the pharmacy they are managing Suspension of Pharmacy Board Rule 17.00.30, which sets forth pharmacist qualifications for collaborative pharmacy practice, including the requirements for education Suspension of Pharmacy Board Rule 19.01.10 regarding qualifications to give vaccines Suspension of Pharmacy Board Rule 26.00.20(g) which outlines remote pharmacy practice requirements for pharmacists, thereby allowing remote practice without application Suspension of Pharmacy Board Rule 21.20.90(d)(e)(f) and requirements regarding sterile compounding and shortages around garbing supplies so as to ensure compounding pharmacies have adequate supplies Suspension of all requirements for pharmacy technician certification pursuant to § 12-280-115.5, C.R.S., and Pharmacy Board Rule 29.00.00 to allow additional time for certification Board issued guidance regarding dispensing of prescriptions for hydroxychloroquine A FAQ document was also posted on the Board website Board issued notice stating that Colorado prescribers and pharmacists must adhere to Colorado law regarding oral prescriptions for Schedule II controlled substances Governor implemented a statewide mask ordinance applicable to all persons over the age of 10 when entering or moving within any public indoor space; updated guidance has been provided relating to the mask ordinance
Connecticut	Declared state of emergency Executive Order No. 7B COVID-19 response website notes that pharmacies are now allowed to compound hand sanitizer to implement Executive Order 7B Executive Order 7I Pharmacists may exercise professional judgement in refilling a prescription that is not a controlled drug Department of Consumer Protection, rather than Commission of Pharmacy, is given authority to grant a waiver or modification of any regulation pertaining to the operation of a pharmacy Executive Order 7GG Temporarily suspends controlled substance registration requirement for practitioners Department of Public Health issued order reinstating requirement that the collection and analysis of a COVID-19 specimen be made by a licensed physician or other licensed person authorized by law to make diagnoses, including pharmacists Executive Order 7KK Provides that pharmacists are permitted to order and administer FDA-approved COVID-19 tests Order suspends licensure and registration requirements for out-of-state pharmacists, pharmacies, and pharmacy interns until 07/22/2020 Drug Control Division issued document regarding refills and reissuance of controlled substance prescriptions Drug Control Division issued document regarding garbing Drug Control Division issued document providing approval for the transfer or distribution of drugs or controlled substances between hospital pharmacies and licensed pharmacies, regardless of ownership Drug Control Division issued document permitting remote order entry and remote order entry verification for pharmacy technicians, pharmacy interns, and pharmacists during declared state of emergency Drug Control Division issued guidance document for maintaining an adequate supply of chronic prescription medication during the COVID-19 pandemic The Connecticut Essential Safe Store Rules of Economic and Community Development applies to retail pharmacies Executive Order 7HHH Authorization for continued temporary suspension of the requirements for licensure, certification, or registration of out-of-state providers, including pharmacists, for the duration of the public health and civil preparedness emergency
Delaware	Declared state of emergency Division of Professional Regulation issued a letter addressing telehealth and prescriptions of controlled substances pursuant to telehealth Remote pharmacy practice for pharmacists and technicians has not been addressed by the Board
District of Columbia	Declared state of emergency Remote pharmacy practice for pharmacists and technicians has not been addressed by the Board Board issued COVID-19 guidance regarding the following topics: Early refills Licensure and registration Sterile compounding Expectation of continued standard of care Remote order entry waiver Remote verification of prescription orders waiver Waiver of requirements for non-resident pharmacies and non-resident distributor/manufacturers Unexpected closures Pharmacists may engage in COVID-19 testing, with limitations Department of Health released updated guidelines for COVID-19 testing, reporting, and discontinuation of home isolation Department of Health released guidance for emergency regulations regarding COVID-19 testing by pharmacists and pharmacy staff Department of Health released guidance regarding SARS/CoV-2 antigen testing
Florida	Declared state of emergency Governor extended declaration of state of emergency until 11/03/2020 Board has reiterated its emergency fill provisions: Pharmacist, in his or her professional judgment, may refill prescriptions early. In accordance with Section 465.0275, Florida Statutes, pharmacists may dispense up to a 30-day supply of maintenance medication for a chronic condition provided that: The medication is essential to the maintenance of life or to the continuation of therapy in a chronic condition; In the pharmacist’s professional judgment, the interruption of therapy might reasonably produce undesirable health consequences or may cause physical or mental discomfort; The dispensing pharmacist creates a written order containing all of the prescription information required by this chapter and chapters 499 and 893 and signs that order; and The dispensing pharmacist notifies the prescriber of the emergency dispensing within a reasonable time after such dispensing. Emergency Rule Hearing to be held March 19 to discuss Consultant Pharmacist Obligations Per Board staff, the Board is not moving forward with an emergency rule to modify the current regulatory structure and scope of practice regarding working from home. Remote pharmacy practice for pharmacists and technicians is permitted by existing law Department of Health issued emergency order permitting health care professionals holding a valid, unrestricted, and unencumbered license in any state, territory, and/or district to render services in Florida during a period not to exceed 30 days State Surgeon General issued emergency order suspending section 483.813 of Florida statutes, requiring a pharmacist to be separately licensed to perform a clinical laboratory test, and section 465.001(13), which prohibits a pharmacist from ordering, administering, or reporting the results of COVID-19 tests Board issued notice requiring the reporting of COVID-19 for health care providers and facilities State Surgeon General issued emergency order allowing licensed pharmacists and registered pharmacy interns to administer FDA-approved vaccines to individuals, including those under the age of 18.
Georgia	Declared state of emergency Board adopts emergency policy and statement of interpretation. The policy specifically addresses emergency refill dispensing of prescription drugs (excluding controlled substances), temporary recognition of non-resident licensure, and temporary pharmacy facilities. Applicants interested in temporary licensure and registration should also review the attached materials. Temporary Pharmacy Technician Registration Application Temporary Pharmacy Intern License Application Temporary Pharmacist License Application Policy 14 Public Emergencies Policy #14 of the Georgia Board of Pharmacy (Board) provides for the refills of certain medication for up to 30 days for persons in the areas covered by a State of Emergency declared by the Governor of the State of Georgia. This policy is consistent with O.C.G.A. Section 26-4-80(j) and the Governor’s Emergency Declaration. The Board is clarifying that persons who are located in emergency areas may also receive a 30-day refill of medication by a Georgia pharmacy or pharmacist without risk of disciplinary action by the Board so long as certain requirements are met. COVID-19 Statement of Interpretation Board promulgates COVID-19 emergency rules addressing: Remote order verification by pharmacists Delivery by mail Governor issued executive order permitting pharmacists and technicians to work remotely to complete computer-based processing of prescriptions Governor signed executive order encouraging all "healthcare-related practices and services" that have elected to cease operations due to the spread of COVID-19 to begin treating patients as soon as practicable in accordance with guidance from the CDC, CMS, and this order Board adopted emergency rule to temporarily waive practical examination from the licensing requirements *Governor extended emergency order until 12/09/2020 at 11:59 p.m.*
Hawaii	Declared emergency proclamation No Board action to date Governor issued executive order permitting out-of-state physicians and nurses to dispense, prescribe, and administer controlled substances in Hawaii without having to register with state if certain conditions are met. EO also suspends reporting of dispensation of controlled substances to the electronic prescription accountability system. Remote pharmacy practice for pharmacists and technicians is permitted by existing law Governor signed executive order directing all health care facilities and professionals (including pharmacists) to "render assistance in support of the State's response to the disaster recognized by the Emergency Proclamations." Governor signed executive order suspending various rules and regulations regarding offsite dispensing of medication for treatment by Opioid Treatment Programs, as well as rules related to remote data entry by pharmacists and interns Board announced that new and renewal license applications for pharmacies and wholesale distributors can now be submitted online Governor issued executive order suspending the following state laws: H.R.S. 329-38(a)(1)(C) - Now allowing a fax, scan, or photograph of a written prescription to be delivered to the dispensing pharmacists within 15 days of the emergency oral prescription H.R.S. 461-5 - Waiving the licensure and accompanying requirements to permit graduates of a pharmacy college to be employed by a pharmacist within 180 days of degree conferral H.R.S. 461-9(a); H.A.R. 16-95-79(a) and 16-95-80(a) - Now allowing a registered pharmacist who is currently and actively licensed, and pharmacy interns who are currently and actively permitted by the Board, to fill, compound, or receive prescriptions by remote data entry Governor extended disaster emergency relief proclamation until 11/30/2020. The Mayor of the County of Kaua'i issued a supplementary emergency proclamation effective only for the County. The supplementary proclamation incorporates all of the emergency provisions of the governor's emergency orders, but it extends the expiration date until 01/29/2021.
Idaho	Declared state of emergency Board issued FAQ document addressing: Temporary licensure for facilities and individuals Temporary rule enacted placing parameters on the dispensing of prescriptions for chloroquine and hydroxychloroquine Pharmacy closures and medication limitations Waivers may be submitted to info@bop.idaho.gov responses will be issued within 24 hours Modifications to the refill rule, permitting a pharmacist to refill prescriptions when the prescriber is unavailable Reiteration of DEA's temporary exemptions to emergency oral prescriptions Remote pharmacy practice for pharmacists and technicians is permitted by existing law Board allows pharmacists to issue COVID-19 tests Governor issued executive order reorganizing professional licensing boards, including board of pharmacy, to now be under the ultimate direction of the Divisions of Occupational and Professional Licenses Idaho is now in Phase Four of re-opening. The following changes to the Board of Pharmacy's emergency rules have been made: New applications must be submitted with fingerprints and other required credentials to be complete Board is no longer granting immediate licensing or registration Applications will be processed as they were prior to the pandemic All immediate 30-day technician registrations are now expired All outstanding elements of an application must be completed immediately for the registration to be extended to the full length of the term Temporary Rule 705 (medication limitations regarding chloroquine / hydroxychloroquine / azithromycin) is rescinded Governor renewed emergency proclamation until 10/04/2020 Board issued notice of pharmacy-based COVID-19 testing grant application Board issued notice that NABP will no longer be accepting COVID-19 passport applications beginning 10/01/2020 *Governor renewed emergency proclamation until 11/04/2020*
Illinois	Declared disaster proclamation pursuant to 20 ILCS 3305/4 Additional executive orders available here Illinois already allows pharmacists to work remotely. As of 03/17/2020, the Board is also approving on a case-by-case basis technician work-from-home models. Additional information from the Illinois Department of Financial and Professional Regulation (IDFPR) can be found here Guidance on delivery during emergency declaration Guidance on remote processing during emergency Guidance on use of PPE by compounding pharmacies during emergency Proclamation modifying professional license and certification statutes for certain out-of-state professions, including pharmacies Proclamation modifying professional license statutes for Illinois-licensed pharmacists to administer COVID-19 tests Board released compounding guidance Governor issued executive order extending provisions of most COVID-19-related executive orders, including Order 2020-23 (Actions by the Illinois Department of Financial and Professional Regulation for Licensed Professionals Engaged in Disaster Response), until 06/27/2020 Secretary signed proclamation allowing pharmacists to work in or with a CLIA-certified lab for facility with a CLIA waiver Governor issued executive order extending provisions of most COVID-19-related executive orders, including Order 2020-23 (Actions by the Illinois Department of Financial and Professional Regulation for Licensed Professionals Engaged in Disaster Response) until 10/17/2020. The provisions related to the following have been extended: Telehealth Background checks Fingerprint submissions Licensing requirements for health care professionals engaged in disaster response Governor issued executive order extending emergency until 11/14/2020
Indiana	Declared public health disaster emergency Executive Orders 20-12 and 20-13 issued addressing the following: Suspension of 1:6 pharmacist to pharmacy technician ratio and authorization of a 1:8 ratio Supervision of technicians working remotely for data entry, insurance processing, and other ministerial and non-dispensing tasks now permitted For non-controlled substances, suspension of the restriction on a refill being limited to no more than the quantity on the most recent refill or a 30-day supply, and permission to dispense a one-time 90-day emergency refill Telemedicine prescriptions for opioids permitted under certain circumstances Licensure waivers for pharmacies and pharmacists with expired licenses Remote pharmacy practice for pharmacists is permitted by existing law and, pursuant to Executive Order 20-12, is now permitted for pharmacy technicians Pharmacists, technicians, and trainees have been deemed "critical" and will be given priority by the Professional Licensing Agency Governor issued executive order regarding the following pharmacy-related: Extension of professional license and permit renewal deadline to 06/04/2020 Access to COVID-19 test results by health care providers Face coverings mandated by Governor via executive order *Governor renewed declaration of public health disaster emergency order until 12/01/2020*
Iowa	Declared public health disaster emergency The Board issued an FAQ document addressing: Continued pharmacy operations Prescription delivery Prescription limitations, counseling substitution, and emergency refills Remote processing now permitted by pharmacists and technicians Licensing waivers Compounding The Board issued guidance on the re-use of PPE Board releases guidance noting that it intends to exercise risk-based enforcement discretion for non-compliance with rules related to the practice of pharmacy in the wake of the state of emergency Remote pharmacy practice for pharmacists and technicians is permitted Board issued joint statement and guidance regarding prescriptions for hydroxychloroquine, chloroquine, and azithromycin Board issued guidance regarding the new Proclamation of Disaster Emergency. New guidance discusses the following topics: Drug product selection Expired technician and trainee licenses Continuing education requirements License/registration renewal Criminal background check requirements Non-resident pharmacists practicing in Iowa Initial pharmacy licenses Examination requirements Board issued a press release regarding the distribution of COVID-19 test kits into Iowa Board issued a response to the Governor's Proclamation of Disaster Emergency Board announced that PTCB exams are available via online proctoring Board issued press release on emergency pharmacist licensure Board issued response to governor's proclamation extending regulatory relief to pharmacists and pharmacies Individual practitioners and researchers may now do the following online: Apply for an initial Iowa Controlled Substances Act (CSA) registration Apply for an additional CSA registration for a separate location where the practitioner or researcher maintains supplies of controlled substances Reactivate a CSA registration that expired more than four months ago Board issued response to governor's proclamation regarding drug product substitution, expired technician trainee licenses, continuing education requirements, license and registration renewal, clinical practice experience requirements, background checks, out-of-state licensure, and examination requirements Board offered COVID-19 vaccination program provider agreement on website Governor extended certain emergency provisions related to pharmacists, including therapeutic drug product substitution, license expiration suspension and renewal requirements, and suspension of examination requirements *Board responded to governor's reissue of emergency order, which expires 11/15/2020*
Kansas	Declared state of emergency Board issued FAQ and a COVID-19 guidance memo addressing: Board reiterates existing emergency refill rule Board plans to proceed with regular renewal schedule Remote Work: The Board now permits remote work by pharmacy employees, including technicians. This allowance only applies to pharmacies physically located in Kansas and persons licensed or registered with the Board. This allowance is only in effect until rescinded by the Board as published and noticed on the Board website. Guidelines for work-from-home models are detailed in the memo. Board encourages vigilance in processing new prescriptions for chloroquine and hydroxychloroquine, and recommends reaching out to prescribers to verify diagnosis Emergency use of hydroxychloroquine and chloroquine obtained from strategic national stockpile Updated guidance from DEA regarding emergency oral prescriptions Waivers for 18-month inspection requirements for non-resident pharmacies Board will not be using new NABP Passport for obtaining emergency or temporary Kansas licenses at this time Steps to set up and register a pharmacy in a field hospital Board conveyed that Pearson Vue is reopening testing sites with 50% capacity Board announced it will not pursue disciplinary action against licensees or registrants that operate in accordance with the DEA COVID-19 5% rule exception Board updated its COVID-19 information memorandum with new information on the following topics: Board operations Renewals Upcoming guidance regarding Governor's executive orders Best practice recommendations Remote working Examinations and testing Governor issued executive order extending professional and occupational licenses during state of disaster emergency Board issued notice regarding HHS' expansion of PREP Act, which allows pharmacists to now administer immunizations to children ages 3-18 *Remote work allowance to remain in effect until 02/19/2021, when it will be reviewed by the Board of Pharmacy*
Kentucky	Declared state of emergency; Executive Order 2020-224 triggers emergency rule (emergency rules extended until 11/05/2020) Pharmacists may dispense emergency refills up to 30-day supply for non-controlled substances Pharmacists may operate temporary pharmacy in area not designated on pharmacy permit Pharmacies may dispense drugs needed to treat COVID-19 pursuant to protocols established by CDC and NIH Board issued FAQ document providing guidance on the following: Continued operation of pharmacy, change in operating hours, and temporary closure Reuse of PPE Pharmacists and technicians are permitted to work remotely pursuant to Executive Order 2020-223 Compounding of hand sanitizer Board issued document summarizing directives from special called Board meeting on 03/25/2020: Restrictions on the dispensing of chloroquine, hydroxychloroquine, or azithromycin Temporary licensure/registration for pharmacists and technicians. Additional guidance found here. Pharmacy sanitation guidance Kentucky Office of Inspector General issued clarification that Kentucky pharmacists must still follow Kentucky's more stringent controlled substance dispensation law during state of emergency, as opposed to DEA's relaxed rules Board issued FAQs regarding hydroxychloroquine, chloroquine, mefloquine, and azithromycin prescriptions Board issued amendments to regulations, including: ADS and LTCF drug stock (201 KAR 2:370) Therapeutic interchange (201 KAR 2:280) PIC change extension (201 KAR 2:205) Initial application notarization requirements (201 KAR 2:020) Kentucky Department for Public Health issued a call for volunteers to assist during the COVID-19 pandemic, including volunteer pharmacists Board released guidance on COVID-19 testing by pharmacists Governor issued order expanding the definition of the "practice of pharmacy" and permitting pharmacists to initiate, order, and administer COVID-19 tests under certain conditions Governor issued minimum requirements for businesses, including pharmacies, that are reopening or remained open, to be implemented by 05/11/2020 Governor issued executive order mandating face coverings in public places Department of Public Health issued order declaring the following: A licensed clinician's order shall not be required in Kentucky for a lab services provider to perform and bill for a SARS-CoV-2 molecular diagnostic test Health insurers shall not require from beneficiaries or laboratories a licensed clinician's order as a precondition of covering the cost of testing Clinicians participating solely in the processes necessary to collect, submit patient specimens, and/or perform point-of-care COVID-19 molecular diagnostic testing shall not establish a formal clinical-patient relationship, unless professional medical advice beyond providing this testing service is otherwise explicitly provided
Louisiana	Declared state of emergency Board issued FAQ for "Questions Already Answered as of 04-15-2020" *Governor reissued emergency proclamation until 11/06/2020* Governor issued the following executive orders related to COVID-19: 97 JBE 2020 - Extension of Emergency Provisions 96 JBE 2020 - Extension of Public Health Emergency (mandating face coverings) 75 JBE 2020 - Extension of Emergency Provisions 74 JBE - Extension of Public Health Emergency Board is maintaining a COVID-19 website with guidance: 09/11/2020 - Guidance Document: Extension of Public Health Emergency 08/07/2020 - Guidance Document: Extension of Public Health Emergency 07/24/2020 - Guidance Document: Extension of Public Health Emergency 07/02/2020 - 2020-COVID-19-ALL-020: Extension of Original Order 03/14/2020 - FDA Guidance Document for Pharmacies Compounding Hand Sanitizer for OTC Sale 03/17/2020 - Guidance Document: Immunizers 03/17/2020 - Guidance Document: Marijuana Pharmacies 03/17/2020 - Guidance Document: Hospital Pharmacies 03/18/2020 - Guidance Document: Prescription Dispensing, Compounding of Sterile Preparations, Remote Access to Medical Order, Board Operations 03/21/2020 - Guidance Document: Remote Processing by Pharmacy Personnel 03/22/2020 - Emergency Rule: Limitation on Dispensing Chloroquine & Hydroxychloroquine for COVID-19 03/22/2020 - Guidance Document: Pharmacy-to-Pharmacy Transfers of Drug Stock 03/23/2020 - Emergency rule rescinded 03/25/2020 - Guidance Document: Limitation on Dispensing Chloroquine & Hydroxychloroquine During COVID-19 03/26/2020: Guidance Document: Flexible Staffing Ratios During COVID-19 Public Health Emergency 03/26/2020 - Guidance Document: Verbal Prescriptions for Controlled Substances Listed in Schedule II 03/28/2020 - NABP Passport: A Temporary Permission to Practice Pharmacy During the COVID-19 Public Health Emergency 04-03-2020 - Guidance Document: Flexible Staffing (revised) 04/08/2020 - Guidance Document: Extension of Emergency Period 04/14/2020 - Guidance Document: Therapeutic Interchange by Pharmacists 04/14/2020 - Guidance Document: Waiver of 5% Rule re Distribution of Controlled Substances Between Registrants 04/14/2020 - Guidance Document: Recommendations for Therapeutic Marijuana Products 04/15/2020 - Authority for Pharmacists to Order COVID-19 Testing 04/30/2020 - Guidance Document: Extension of Emergency Period 05/15/2020 - Guidance Document: Extension of Public Health Emergency 06/05/2020 - Guidance Document: Extension of Public Health Emergency
Maine	Declared state of emergency Remote pharmacy practice for pharmacists and technicians has not been addressed by the Board Board proposes emergency rule removing the PIC physical presence requirement in certain circumstances at Opioid Treatment Programs (OTPs) Board released memorandum regarding governor's executive order, discussing the following: Expanded telehealth services Licensure requirements Temporary non-resident and inactive licenses Board released statement on dispensing chloroquine, hydroxychloroquine, and azithromycin Board released COVID-19 guidance paper containing information on the following items: Telehealth/telepharmacy Remote data processing; working from home Pharmacists, interns, and technicians working across state lines Main pharmacists', interns', and technicians' license requests for licensure reinstatement Pharmacist/technician ratio waiver request Pharmacy hours; deviations and changes Emergency supply Therapeutic substitutions Sterile compounding Prescription transfer by a pharmacy or technician Pop-up pharmacy facilities and temporary pop-up hospital facility Wholesale distributor licensed in most states ships from its distribution center in another state into Maine without obtaining a Maine license Pharmacy employee safety Waiver of the 5% limit on prescriptions sent by mail within Maine and mail order pharmacies located outside Maine, but not licensed in Maine Alternative prescription drug order delivery methods LTC facility; drug destruction without oversight of a consultant pharmacist NAPLEX score transfer Ordering and administration of COVID-19 tests
Maryland	Declared state of emergency Governor issued an executive order stating that all licenses, permits, registrations, and other authorizations issued by the state, its agencies, or any political subdivision that would expire during the current state of emergency will be extended until the 30th day after the state of emergency is lifted Governor issued executive order restricting the filling of prescriptions for "restricted drugs" (e.g., chloroquine, hydroxychloroquine, and azithromycin) Board guidance Remote processing by pharmacists and technicians permitted Emergency refills permitted Sterile compounding guidance given regarding PPEs and hand sanitizer License expirations extended Maryland Secretary of Health issued directive stating that manufacturers, wholesale distributors, or other entities engaged in the sale, purchase, distribution, or transfer of FDA-approved prescription devices for emergency medical reasons relating to COVID-19 are exempt from Maryland licensure requirements provided the entity is licensed or otherwise authorized to engage in such activity in its home state Board issued a reminder regarding pharmacists' right to refuse to refill prescriptions that are not, in their professional judgment, clinically appropriate (specifically referencing chloroquine and hydroxychloroquine) Board issued announcements regarding exams, criminal background checks, and live continuing education Board announced that online technician exam testing is available Board issued temporary policy regarding non-standard PPE practices for sterile compounding by pharmacy compounders not registered as outsourcing facilities during pandemic Board authorized licensed pharmacists to conduct COVID-19 tests Governor renewed declaration of state of emergency
Massachusetts	Declared state of emergency FAQs have been posted to the Board website addressing issues including, but not limited to: Curbside delivery allowed Compounding products that are essentially copies of commercially available products in the event of shortages is only allowed under certain circumstances Board does not intend to take enforcement action regarding perpetual inventory counts Pharmacists may dispense an "emergency supply" on a prescription with no remaining refills Compounding hand sanitizer - Pharmacists are allowed to compound hand sanitizer according to USP <797> and sell it OTC Department of Public Health issued order addressing: Remote processing of prescriptions by pharmacy technicians now permitted Implementation of garb conservation Emergency authorization to practice pharmacy in Massachusetts Emergency prescription refills Central filling of prescriptions Board issued clarification regarding OTC hand sanitizer guidance, stating that compounding is acceptable as long as the formula is issued by an entity with validated, reviewed formulas, the pharmacist complies with USP <797>, and the sanitizer is labeled with the statement "for external use only." Additionally, OTC compounded hand sanitizer can only be sold to end users. Massachusetts Commissioner of Public Health issued order relaxing the time in which oral prescriptions of controlled substances must be reduced in writing (previously 7 days, now 15 days) Board issued memo to long-term care facilities regarding extension of time for inspecting, re-stocking, and resealing of emergency medication kits Board released recommended actions for a pharmacy if an employee is presumed or confirmed to be positive for COVID-19 Board allowed pharmacists to extend beyond-use dates for compounded sterile preparations to conserve drug supply during the emergency period as outlined in the USP Compounding Expert Committee's guidance document Board voted to allow pharmacists and interns to order, administer, read, and report COVID-19 tests, and to allow pharmacists and interns to administer COVID-19 vaccines, with further guidance to be made available by the Board in the future
Michigan	Declared state of emergency Executive Order 2020-152 rescinds remote technician certification allowance (2020-124). Remote supervision is now only permitted for pharmacy students through the end of the emergency period. Executive Order 2020-150 rescinds expanded scopes of practice for pharmacists (2020-61). The following license requirements are suspended for all health care professional licensees through the end of the emergency period: An exam, to the extent that administration of exam was canceled while emergency declaration was in effect Fingerprinting, per judgement of the Michigan Department of Licensing and Regulatory Affairs (LARA) Continuing education Professional certifications of individuals in basic life support, advanced cardiac life support, and first aid shall remain in effect, even if they are otherwise due to expire Governor Whitmer signed Executive Order 2020-71 (rescinded and replaced with Executive Order 2020-168 in order to extend the effective period until 09/07/2020), requiring pharmacies to employ several protection mechanisms, including ensuring that everyone within the pharmacy is wearing a mask Pharmacies must create at least two hours per week of dedicated shopping time for vulnerable populations, which for purposes of this order are people over age 60, pregnant people, and those with chronic conditions, including heart disease, diabetes, and lung disease Order will expire 09/07/2020 On 04/24/2020, Michigan's House introduced five bills that, taken together, would codify Executive Orders 2020-61, 2020-56, and 2020-49 (which suspends certain regulatory requirements for health care facilities and nursing providers). Specifically, HB 5724 includes the remote technician authorization permitted in EQ 2020-56, and would remain in effect as long as the pharmacy is responding to the state of emergency announced as a result of COVID-19. A helpful summary of all five bills can be found here. Proposed legislation, SB 880 and SB 920, contain similar language permitting pharmacy technicians to work remotely LARA has provided limited guidance permitting pharmacies to hire unlicensed individuals who by education, training, or experience meet the requirements of licensure normally required of pharmacists and technicians LARA issued guidance to licensed prescribers and dispensers regarding over-dispensing of hydroxychloroquine or chloroquine to those intending to stockpile For COVID-19-related questions regarding licensing and regulation topics, send emails to lara-covid-19-questions@michigan.gov
Minnesota	Declared state of emergency Board-issued COVID-19 guidance addresses: Pharmacy closures and continuation of operations Delivery of prescriptions Dispensing into Minnesota without a license Counseling expectations Remote access now permitted for pharmacists and technicians Relaxation of technician ratios Compounding Controlled substance dispensing License renewals Dispensing of chloroquine, hydroxychloroquine, and azithromycin Pharmacy personnel exposure guidance PMP requirements Pharmacist-administered COVID-19 testing Exceptions to wholesale drug requirements Executive Order 20-23 authorizes the following: Health-related licensing boards may defer continuing education requirements and process applications without a full set of fingerprints Board of Pharmacy to enforce 30-day dispensing limitation on chloroquine or hydroxychloroquine Executive Order 20-16 requires: Any Minnesota business, nonprofit, or non-hospital health care facility, whether veterinary, dental, construction, research, institution of higher learning, or other, in possession of PPE, ventilators, respirators, or anesthesia machines (including any consumable accessories to those devices) that are not required for the provision of critical health care services or essential services and were not produced by the organization for the purpose of sale, must undertake an inventory of such supplies no later than 03/25/2020
Mississippi	Declared state of emergency Board has consolidated all guidance on its COVID-19 landing page The Board issued an emergency declaration on CII prescriptions: Call-in prescriptions for CII drugs are allowed at this time. The normal 48-hour rule has been waived and is now up to a 30-day limit Pharmacists will need to receive a hard copy of the prescription within 7 days of the called-in prescription This rule is only in effect during the Governor’s Declaration of the State of Emergency It is recommended that this should only be used in an absolute emergency when a written or electronic prescription may not be obtained. Because of the strict requirement of the 7-day hard copy prescription, there could be major issues with the DEA if this is not followed. Pharmacists are expected to use professional judgment. There is NO requirement to fill any prescription that you determine should not be filled. Board has since modified this declaration to confirm with DEA guidance Board issued guidance clarifying prescription signature requirements Board issued guidance regarding emergency refills Board issued guidance permitting pharmacies to compound hand sanitizer Controlled substance inventory requirements extended until 07/01/2020 Board issued guidance regarding dispensing chloroquine and hydroxychloroquine Board issued guidance regarding COVID-19 testing by pharmacies Board issued guidance for pharmacies that are not registered as outsourcing facilities wishing to temporarily compound certain drugs for hospital patients Board issued recommendations regarding coping with garb and sIPA shortages Remote pharmacy practice by pharmacists and technicians not currently permitted
Missouri	The Board has established a COVID-19 page Despite prior guidance (see below), the Governor has approved extending the following statutory/rule waivers until 09/01/2020: Remote data entry for pharmacy technicians and intern pharmacists (e.g., from home) Compounding of commercially available products for hospitalized patients pursuant to FDA guidance Compounding by pharmacies for hospitalized patients without a patient-specific prescription in compliance with FDA guidance Distribution of compounded preparations by hospital pharmacies without a patient-specific prescription during the State of Emergency to treat COVID-19 patients, or to assist hospitals who are unable to provide the compounding services due to the State of Emergency Waiver of end-product testing for designated Risk Level 3 preparations for hospitalized patients pursuant to FDA guidance (see Attachment A for additional requirements) Remote final product verification Governor Michael Parson issued Executive Order 20-12, which extended all approved COVID-19 statutory/rule waivers until 12/30/2020. As a result, all Board waivers set to expire on 06/16/2020, and 09/15/2020, will remain in effect until 12/30/2020. Board announced that, pursuant to Executive Order 20-04, all emergency licensing and regulatory waivers will terminate at Midnight on 06/15/2020. The following summary lists the waivers that will be rescinded and no longer effective after 06/15/2020: Unlicensed practice by non-resident pharmacists, pharmacy technicians, intern pharmacists, and non-resident pharmacies during the State of Emergency Substitution of albuterol inhalers with inequivalent FDA-rated inhalers without prescriber approval Expanded emergency dispensing allowances, including dispensing a 60-day emergency supply. *Section 338.200 would apply as enacted. Waiver of designated Class-J Shared Services pharmacy permit and compliance requirements Compounding of commercially available products pursuant to the approved waiver Compounding without a patient-specific prescription Waiver of end-product testing for designated Risk Level 3 preparations Dispensing medication without a pharmacist present (even if previously verified by a pharmacist) Remote final product verification Remote pharmacy technician supervision Remote data entry by pharmacy technicians/intern pharmacists (e.g., from home). However, note that the Board has a pending rule that would allow remote data entry by a pharmacy technician/intern pharmacist. The final rule will not be effective until August 2020 due to Missouri's mandatory rulemaking requirements. The Board is discussing legal options to allow remote data entry between 06/15/2020, and the final effective date of the rule in August. Licensees will be notified of any updates. At this time, licensees should prepare to transition all pharmacy technicians/intern pharmacists performing remote data entry activities back to the pharmacy by June 15. Board guidance on pharmacist-administered COVID-19 testing Board guidance on licensure updates and renewals Board guidance on pharmacy cleanliness and safety Board guidance document on COVID-19 issues and questions Remote work: Off-site pharmacists and technicians may perform non-dispensing activities Hard copy prescriptions and facsimile prescriptions can only be accepted at a licensed pharmacy location Summary of all Board waivers received due to COVID-19 as of 05/01/20: Emergency dispensing for up to 60-day supply Pharmacists may substitute albuterol inhalers with those listed in FDA's Orange Book Non-resident licensing waiver for pharmacists, pharmacy technicians, and pharmacies (waiver form available here) Dispensing previously verified medicaton Sterile compounding pharmacies may accept Aseptic Technique Skill Assessment Results Dispensing of non-patient specific compounded preparations by hospital pharmacies Remote verification Prescription/medication order transfers Informed consent disclosures when engaged in remote counseling Permits technology-assisted supervision Explicitly permits remote data entry sites Permits pharmacy technicians to perform non-dispensing activities outside of a licensed pharmacy Technician renewal deadline moved to 07/31/2020 Supplemental guidance document on waivers received due to COVID-19 Additional pharmacy waivers, as of 03/31/2020: Pharmacies may dispense an emergency supply of controlled substances to a patient if the pharmacy that originally filled the prescription is closed or unable to fill the prescription due to the state of emergency Annual inventory due extended to no later than 120 days after Executive Order 20-02 is terminated Temporary hospitals or other health care facilities may operate without obtaining a controlled substance registration A full list of requested and approved waivers is available here Joint Statement issued with Board of Pharmacy and Board of Registration for the Healing Arts regarding prescriptions for hydroxychloroquine, chloroquine, and azithromycin
Montana	Declared state of emergency Governor Bullock issued directive implementing Executive Orders 2-2020 and 3-2020 and providing for the use, delivery, and reimbursement of telemedicine and telehealth services, expanding modes of delivery for pharmacists practicing telemedicine Governor Bullock issued directive implementing Executive Orders 2-2020 and 3-2020 and easing licensing requirements for health care providers during the emergency, permitting non-resident and retired pharmacists and technicians to practice in Montana The Montana Department of Labor & Industry released guidance regarding the prescribing and dispensing of chloroquine and hydroxychloroquine Board has posted limited guidance on its website addressing: Interstate Licensure Recognition Registration - Board is permitting pharmacists and technicians licensed and in good standing in another state to practice in the state upon completion of its interstate licensure application and subsequent approval by the Board Emergency Refill Rule - ARM 24.174.836 Remote pharmacy information - Board cites central filling & processing rule, does not discuss remote practice from an unlicensed location Technicians - usage must be included in approved utilization plan The Board of Pharmacy issued a temporary emergency rule, MAR 24-174-75, to suspend the requirements for monthly in-person inspections of telepharmacy sites until 08/05/2020 Remote pharmacy practice for pharmacists and technicians has not been addressed by the Board
Nebraska	Declared state of emergency Governor Ricketts released Executive Order 20-10, permitting pharmacies licensed in other states to practice in Nebraska, and loosening licensure requirements for pharmacist applicants The US Department of Health and Human Services (HHS) has been working with the Governor's office and expects an executive order addressing pharmacies in the coming days Remote pharmacy practice for pharmacists and technicians has not been addressed by the Board
Nevada	Declared state of emergency Declaration of Emergency Directive 009: All licenses and permits issued by the State of Nevada, Boards, Commissions, Agencies, or political subdivisions that are set to expire during the state's declaration of emergency are extended 90 days from the current expiration date, or 90 days from the date the state of emergency is terminated, whichever is later Declaration of Emergency Directive 011: Board of Pharmacy shall temporarily waive certain licensing requirements to allow the practice of currently unlicensed pharmacists and pharmacy technicians Waiver and exemptions shall apply to individuals who currently hold a valid license in another state, whose licenses are suspended for licensing fee delinquencies or continuing education requirements, and who have retired from practice in any state Pharmacists and technicians are authorized to practice outside the scope of their specialization, within the limits of their competency, to the extent necessary to augment and bolster Nevada's health care system No licenses shall be suspended for any administrative reasons until 60 days after directive expires Board updates can be found here Waivers: The Board is issuing waivers to certain regulatory requirements with guidance to assist licensees in addressing operational needs during the COVID-19 outbreak while still protecting the health and safety of Nevadans. The waiver process is detailed here. Remote order entry: The Board has temporarily authorized the practice of remote order entry for all licensed/registered pharmacy personnel (pharmacists, intern pharmacists, and pharmaceutical technicians). The guidance can be accessed here. PPE guidance: The Board has temporarily authorized licensees conducting sterile compounding to reuse certain personal protective equipment (PPE). The guidance can be accessed here. Compounding hand sanitizer: The Board has temporarily authorized the compounding and sale of certain alcohol-based hand sanitizer products by Nevada-licensed pharmacies and outsourcing facilities. The guidance can be accessed here. COVID-19 testing: The Board has temporarily authorized licensed/registered pharmacy personnel (pharmacists, intern pharmacists, and pharmaceutical technicians) to perform COVID-19 testing off-site, in non-pharmacy areas. The guidance can be accessed here. Supervision: The Board has partially waived the existing regulation on the number of pharmaceutical technicians/technicians in training that a pharmacist may supervise in a pharmacy. The guidance can be accessed here. Emergency refills: The Board issued guidance on the authority of a pharmacist to issue refills pursuant to NRS 639.2394 to promote patient access to needed medications during the COVID-19 outbreak (i.e., emergency refills). The guidance can be accessed here. Counseling: The Board has issued guidance for pharmacists and pharmacies on socially distanced methods of patient counseling and prescription delivery. The guidance can be accessed here. MAT: The Board has received requests for information regarding medicated assisted treatment (MAT) utilizing telemedicine and the delivery of prescription medication during the COVID-19 outbreak. The Drug Enforcement Administration (DEA) guidance on this topic can be accessed here. Chloroquine and hydroxychloroquine: The Board has adopted an emergency regulation in Chapter 639 of the Nevada Administrative Code that restricts the prescribing and dispensing of chloroquine and hydroxychloroquine during the COVID-19 outbreak. The emergency regulation can be accessed here. Stock transfers: The Board has issued guidance on the existing authority for the transfer of a drug between pharmacies to alleviate a temporary shortage. The guidance can be accessed here. In-person dispensing: The Board has partially waived certain requirements for dispensing controlled substances or dangerous drugs to human and animal patients to permit socially distances methods of dispensing during the COVID-19 outbreak. The partial waiver can be accessed here. Immunization certification: The Board has partially waived existing regulations requiring continued certification of pharmacists and intern pharmacists in basic cardiac life support from the American Heart Association to administer immunizations during the COVID-19 outbreak. The partial waiver can be accessed here. Hospital pharmacy technicians: The Board has partially waived certain restrictions on the services which may be performed by pharmaceutical technicians in hospitals in response to COVID-19. The partial waiver can be found here. Techs in training: The Board has temporarily authorized registered pharmaceutical technicians in training to be rotated and utilized at multiple Nevada-licensed pharmacies, and authorized an extension of time for pharmaceutical technicians in training to renew their registrations in response to the COVID-19 outbreak. The guidance can be accessed here. Valid prescriptions: Emergency Directive 011 temporarily waives licensing requirements for certain qualified physicians to prescribe controlled substances, and for certain qualified physicians and nurse practitioners to prescribe non-controlleds for a limited duration during the COVID-19 outbreak
New Hampshire	Declared state of emergency Board issued general guidance regarding COVID-19 responses and telehealth guidance found here. Due to the current state of emergency around the COVID-19 Health Advisory, all Board and licensing business is being done electronically via email at this time. Please do not call the office or any Board phone listed on this page at this time. Email pharmacy.licensing@oplc.nh.gov and your inquiry will be responded to as soon as possible during normal business hours, Monday-Friday, 8:00am-4:00pm. Thank you for your patience and understanding during this time. Board has adopted the following emergency rules: Prescription refill: Interim supply - A pharmacist may refill a prescription drug order without the authorization of the prescribing practitioner Pharmacists may accept a faxed-in prescription for a Schedule II controlled drug Consulting pharmacists do not need pre-approval to act as agents of the board for purposes of destruction of controlled drugs, and may witness the destruction of controlled substances remotely via videoconferencing Vaccine qualifications and application: During a state of emergency, the Board shall allow pharmacists 60 days past the expiration of the state of emergency to complete requirements to administer vaccines Board may waive substantive rules as required during COVID-19 crisis. The Board also issued a standing order to allow the Board to act quickly in deciding on waiver requests made under this rule. Governor Sununu issued two executive orders addressing pharmacy practice: Emergency Order #13: Temporary allowance for New Hampshire pharmacists and pharmacies to compound and sell hand sanitizer over the counter, and to allow pharmacy technicians to perform non-dispensing tasks remotely Emergency Order #14: Temporary authorization for out-of-state pharmacies to act as a licensed mail-order facility within the State of New Hampshire The Department of Health and Human Services issued an emergency order limiting prescriptions of chloroquine, hydroxycholorquine, and albuterol inhalers to a 30-day supply Remote pharmacy practice for pharmacists and technicians is permitted
New Jersey	Declared state of emergency Board has issued guidance and this clarification: Waivers: The Board of Pharmacy is currently permitting pharmacies to apply for wavers in the following scenarios: reuse of PPE in compounding; change in hours of operation; relaxed requirements to capture counseling signatures at POS (note waiver does not contemplate remote counseling). Extended closure requests must be submitted before the full Board for approval, and early refills, dispensing to a 90-day supply of medication, and relaxed requirement for delivery protocols do not require waivers. Guidance does not contemplate work from home. New Jersey Board of Pharmacy, Guidance for Pharmacy Community Regarding COVID-19. Actions not requiring waiver: 90-day fills or early refill; delivery protocols Remote pharmacy practice for pharmacists and technicians permitted if requirements outlined in this document are met and pharmacy supplies the requested information to the Executive Director via email at rubinaccioa@dca.njoag.gov Governor Murphy issued Executive Order 109, requiring any business or non-hospital health care facility in possession of PPE, ventilators, respirators, or anesthesia machines that are not required for the provision of critical health care services to undertake an inventory of such supplies and send that information to the state by 03/27/2020 Governor Murphy issued Executive Order 112, authorizing the Division of Consumer Affairs to temporarily reactivate the license of any health care professional who previously retired from practice in New Jersey, either by placing their license on inactive status or allowing their license to lapse. EO 112 also provides immunity for any health care facility (defined to include pharmacies) from civil damages alleged to have been sustained as a result of an act or omission undertaken in good faith while providing services in response to COVID-19 Governor Murphy issued Executive Order 113, authorizing the Director of Emergency Management to seize real or personal property (including "medical resources") from private entities for the purpose of protecting public health Department of Consumer Affairs Administrative Order No. 2020-06 and Waiver No. W-2020-10 expressly permit pharmacists to order COVID-19 testing, collect specimens from within or immediately outside of the pharmacy, perform testing, interpret and analyze results, and monitor patient data. Order and waiver language is available here.
New Mexico	Declared state of emergency Board has issued the following guidance on its FAQ page: Updated emergency dispensing declaration, available here Prescription Adaptations Guidance Therapeutic Interchange Guidance Emergency dispensing declaration, available here Emergency dispensing declaration specific to compounding drugs for hospitalized patients, available here Sterile compounding garb and PPE shortage, available here Pharmacists may decline to fill when inappropriate or questionable prescribing or stockpiling occurs, available here Consultant pharmacist visitation duties, available here and here Temporary exceptions to Schedule II Controlled Substance oral prescribing, available here Pharmacists may order and administer COVID-19 testing, available here Health Cabinet Secretary Kathyleen Kunkel released a Public Health Order requiring the following: No health care provider or wholesale medical supplier in New Mexico with an inventory of PPE may reduce its inventory of PPE by selling, allocating, or otherwise distributing it without prior approval from the New Mexico Department of Health No health care provider or wholesale medical supplier in New Mexico may sell, allocate, or otherwise distribute PPR outside of New Mexico without prior approval from the New Mexico Department of Health Within three (3) business days of this Order, each health care provider and wholesale medical supplier in New Mexico with an inventory of PPE shall make a report to the New Mexico Department of Health describing its inventory of PPE Remote pharmacy practice for pharmacists and technicians is permitted by existing law
New York	Declared state of emergency The Office of the Professions is posting executive order summaries implicating pharmacy and other health professions Executive Order 202.27 (extended until 06/20/2020 by Executive Order 202.32) extends the suspension or modification of any law suspended in Executive Order 202, or any amended or modified executive order thereafter, which allows for the practice of a profession in the state of New York without a current New York licensure or registration Executive Order 202.10 (extended further until 08/05/2020 by EO 202.48, extended further until 09/04/2020 by EO 202.55, extended further until 10/04/2020 by EO 202.60, *extended further until 11/03/2020 by EO 202.67) temporarily suspends and modifies laws in response to COVID-19 outbreak, including: Subdivision (1) of Section 6801 of the Education Law, Section 6832 of the Education Law, and Section 29.7(a)(21)(ii)(b)(4) of Title 8 of the NYCRR, to the extent necessary to permit a certified or registered pharmacy technician, under the direct personal supervision of a licensed pharmacist, to assist such licensed pharmacist, as directed, in compounding, preparing, labeling, or dispensing of drugs used to fill valid prescriptions or medication orders for a home infusion provider licensed as a pharmacy in New York, compliant with the United States Pharmacopeia General Chapter 797 standards for Pharmaceutical Compounding - sterile preparations, and providing home infusion services through a home care agency licensed under Article 36 of the Public Health Law Executive Order 202.11 (extended further until 08/05/2020 by EO 202.48, extended further until 09/04/2020 by EO 202.55, extended further until 10/04/2020 by EO 202.60, extended further until 11/03/2020 by EOD 202.67) permits pharmacists and pharmacist technicians to work remotely, and permits registered pharmacies and outsourcing facilities to compound certain alcohol-based hand sanitizer products Order 202.11 also amends Executive Order 202.10 related to restrictions on dispensing hydroxychloroquine and chloroquine for prophylactic purposes as follows: No pharmacist shall dispense hydroxychloroquine or chloroquine except when written: as prescribed for an FDA-approved indication; for an indication supported by one or more citations included or approved for inclusion in the compendia specified in 42 U.S.C. 1396r-8(g)(1)(B)(i); for patients in inpatient settings and acute settings; for residents in a subacute part of a skilled nursing facility; or as part of a study approved by the Institutional Review Board. Order 202.11 also suspended sections of the Education Law and associated regulations, to the extent necessary to temporarily permit registered resident pharmacies and outsourcing facilities to compound certain alcohol-based hand sanitizers Executive Order 202.15 (extended further until 08/06/2020 by EO 202.49, extended further until 09/04/2020 by EO 202.55, extended further until 10/04/2020 by EO 202.60, extended further until 11/03/2020 by EO 202.67) temporarily suspends and modifies the Education Law and Regulations to the extent necessary to allow a NY-licensed pharmacy to receive drugs and medical supplies or devices from an unlicensed pharmacy, wholesaler, or third-party logistics provider (3PL) located in another state to alleviate temporary shortages of a drug or device that could result in the denial of health care under the following conditions: The unlicensed location is appropriately licensed in its home state, and documentation of the license verification can be maintained by the NY pharmacy The NY pharmacy maintains documentation of the temporary shortage of any drug or device received The NY pharmacy complies with all record-keeping requirements for each drug and device received, and the records are readily retrievable for 3 years following the end of the emergency The drug or device was produced by an authorized FDA-registered manufacturer Executive Order 202.16 (extended further until 08/02/2020 by EO 202.49, extended further until 09/04/2020 under EO 202.55, extended further until 10/04/2020 by EO 202.60, extended further until 11/07/2020 by EO 202.67) temporarily suspends and modifies the Education Law and Regulations to the extent necessary to permit individuals to perform testing for the detection of SARS-CoV-2 or its antibodies in specimens collected from individuals suspected of suffering from a COVID-19 infection. Individuals performing testing must meet the federal requirements for testing personnel appropriate to the assay or device authorized by the FDA or the New York State Department of Health. Executive Order 202.18 (extended further until 08/06/2020 by EO 202.49, extended further until 09/04/2020 by EO 202.55, extended further until 11/07/2020 by EO 202.67) temporarily suspends and modifies the Education Law and Regulations to the extent necessary to extend the triennial registrations of pharmacy establishments who are currently registered and whose registration is set to expire on or after 03/31/2020. An application for re-registration of such registrations shall be submitted no later than 30 days after the expiration of Executive Order 202. Also, per Executive Order 202.18 (extended until 07/07/2020 by EO 202.39; extended further until 08/20/2020 by EO 202.53), a pharmacist who has an unencumbered license and is currently in good standing in New York State, can practice in this state for the duration of the COVID-19-related state of emergency declared by the Governor in Executive Order 202, without civil or criminal penalty related to lack of registration. Per Executive Order 202.36 (effective until 07/21/2020, per EO 202.44, extended further until 09/04/2020 by EO 202.55, extended further until 09/20/2020 by EO 202.59, extended further until 10/23/2020 by EO 202.65, extended further until 11/19/2020 by EO 202.70*), temporary suspension and modification of education law and regulations to the extent necessary to allow a questionnaire administered through an asynchronous electronic interface or electronic mail that is approved by a physician licensed in the state of New York to be sufficient to establish a practitioner-patient relationship for purposes of ordering a clinical laboratory test The Office of Professions has issued a FAQ document addressing: PPEs Temporary suspension of CPR and BLS live course requirement Relaxation of recordkeeping requirements pursuant to Executive Order 202.10 Protective measures pharmacies should take to help prevent the spread of COVID-19 Notification requirements in the event a pharmacy needs to temporarily close due to a potential COVID-19 exposure Guidance regarding the remote processing of prescriptions and medication orders from unregistered sites The ability of manufacturers, repackers, and wholesalers located outside of New York and not registered in New York to deliver prescription medications and devices into New York The ability of pharmacies located and registered in New York to receive drugs and medical supplies or devices from an unlicensed pharmacy, wholesaler, or 3PL located outside New York to alleviate temporary shortages
North Carolina	Declared state of emergency Executive Order No. 116 Board is posting updated guidance here The Board will exercise discretion and will not enforce provisions of the temporary COVID-19 Drug Preservation Rule as they apply to oseltamivir and azithromycin only. The other provisions of the temporary rule will continue to be enforced. On 10/21/2020, the US Department of Health & Human Services (HHS) issued a declaration under the PREP Act authorizing "qualified pharmacy technicians" to administer ACIP-recommended vaccines to patients ages three (3) to eighteen (18) and FDA-approved COVID-19 vaccines to patients ages three (3) and older under the supervision of a qualified pharmacist. This declaration also clarified the ability of qualified pharmacy interns to administer such vaccines but, for purposes of North Carolina, those clarifications do not change pharmacy intern administration authorized as previously discussed in Board documents. In response to the HHS declaration regarding pharmacists ordering and administering COVID-19 vaccines, the Board provided updated guidance to describe the conditions under which pharmacists and pharmacy interns may exercise such authority and how the conditions differ from existing North Carolina law The Board is reminding pharmacies that they may not make claims that supplements or other products treat COVID-19 or promote "immunity" to COVID-19. Such claims are prohibited under state and federal law. The North Carolina Department of Health and Human Services (NC DHHS) issued a statewide standing order for diagnostic COVID-19 testing. The State Health Director also issued a temporary order requiring all health care providers ordering or conducting COVID-19 diagnostic tests to report all results, positive and negative. Each week, NC DHHS assesses NC's COVID-19 collection, testing, and processing capacity. Every Monday, a survey will be distributed to stakeholders engaged in these activities. NC DHHS asks that collectors and testers complete this survey by the end of the day on Tuesday. The Board issued a reminder that the Board accepts remote continuing education as live if it is, in fact, live, and allows attendees to participate in real time The Board issued a waiver and clarification concerning pharmacy intern status for 2020 pharmacy graduates NC DHHS updated its provider guidance on COVID-19 testing During the declared state of emergency, the Board will not require licensure by exam applicants to submit a Certificate of Graduation with an affixed school seal. The certificate may also be submitted electronically to the BOP portal. The Board noted that it has received several inquiries from pharmacies who have received marketing materials for point-of-care COVID-19 antibody tests. The Board reminds pharmacies that these tests are not FDA-authorized and at present the FDA has not issued an EAU for any COVID-19 antibody tests to be administered in a lab holding a CLIA waiver. These marketing materials should be reported to the North Carolina Attorney General's Office. Board mentioned the CDC guidance on spotting counterfeit respiratory protection equipment and reminded pharmacists to report counterfeit and price gouging to the NC Attorney General's office NC DHHS is working to expand COVID-19 specimen collection and testing capacity. Pharmacist-managers should have now received an email from info@ncbop.org with a survey link. The survey is intended to gauge willingness to perform COVID-19 testing at the pharmacy, as well as willingness to collect specimens for subsequent lab testing. NC DDHS issued a request for qualifications from vendors to provide COVID-19 testing and contact tracing. DHHS is prioritizing working with minority-owned business vendors and vendors who retain a diverse workforce. Board issued guidance for pharmacies regarding supplier price gouging. Pharmacies are directed to contact the Attorney General's office regarding any suspicions. Emergency Services Waiver: Addresses remote work permissions and processes. Remote pharmacy practice for pharmacists and technicians is now permitted by the Board upon submission of a waiver. Expanded Waiver Baseline Waiver EXPIRES 12/31/2020 Out-of-state pharmacists and out-of-state certified technicians who wish to practice in North Carolina during the declared state of emergency must obtain an NABP Passport to do so. The NABP Passport is a license verification process administered by the National Association of Boards of Pharmacy to assist in the pandemic response. Emergency rule passed to mitigate shortages of hydroxychloroquine, chloroquine, lopinavir-ritonavir, ribarvin, oseltamivir, darunavir, and azithromycin Reactivation of Pharmacist Licensure to Provide for Patient Care NOTE: As of 03/18/2020, the Board is not accepting temporary reactivation applications. This is a preparedness step. There is no identified immediate need for additional pharmacists to assist with COVID-19 containment and treatment efforts. In the coming days, the Board will develop and publish a temporary reactivation application form. Pharmacists are advised to continue to monitor the Board’s website for updates on this, and other, matters. Recommendation for Compounding Garb Shortages (updated 04/16/2020) Board has created a pathway for the temporary reactivation of certain pharmacist licenses to provide patient care during the state of emergency The pharmacist completes a temporary reactivation application and submits it to the Board at emergency@ncbop.org Board issued guidance on the prescriptions for hydroxychloroquine, chloroquine, azithromycin, kaletra and other medications. Governor Cooper issued an executive order placing occupancy limitations on retail establishments, including pharmacies. Pharmacies are now limited to no more than 20% of the business' stated fire capacity, or five customers for every thousand square feet of the location's total square footage. See FAQ on the order here. Board is compiling a list with the help of Mutual Drug of pharmacists and pharmacy personnel who may be able to assist if a pharmacy becomes short-staffed In response to the US Department of Health and Human Services' declaration regarding pharmacists ordering and administering COVID-19 vaccines, the Board provided updated guidance to describe the conditions under which pharmacists and pharmacy interns may exercise such authority and how the conditions differ from existing NC law. A new law was passed extending, for a period of five months, the validity of a driver's license that expired on or after 03/01/2020, and before 08/012020. When a pharmacy is reviewing an ID as required for dispensing certain controlled substances (see here), a North Carolina license whose expiration has been extended by this statute is "current" and acceptable. Pharmacists should also be aware that the COVID-19 Recovery Act lessens ID check requirements in certain respects "for the duration of the COVID-19 emergency." Pharmacists "may confirm the identity of an individual seeking dispensation of a prescription by the visual inspection of any form of government-issued photo identification." The Board issued guidance reminding individuals and pharmacies that any interference with the pharmacist-manager's efforts to adjust work flows and processes within a pharmacy to reduce coronavirus transmission subjects a pharmacy and/or pharmacist permittee to disciplinary action
North Dakota	Emergency declaration Additional updates The North Dakota Board of Pharmacy created a COVID-19 screening form to be used when pharmacists administer COVID-19 tests, available here Executive Orders 2020-09 and 2020-05.1 issued, addressing: Authority to administer emergency refill prescriptions Licensure waivers The authority to administer tests is extended to allow licensed pharmacists to administer COVID-19 testing, under guidance from the North Dakota Department of Health No Board action to date Remote pharmacy practice for pharmacists and technicians has not been addressed by the Board
Ohio	Declared Emergency declaration The Department of Health Director's order to stay at home includes additional requirements from pharmacies if the pharmacies want to remain open Technician trainees who are set to have their registrations expire any time between 03/09/2020 through 07/31/2020 (previously 05/31/2020) will be provided with an automatic six-month extension to the trainee's registration Board has published guidance here. Topics include, but are not limited to the following (where an express expiration is not included, the guidance or waivers are in effect until rescinded by the Board): Remote practice permitted of technicians and pharmacists. Valid until rules for remote order entry by licensed and registered pharmacy personnel go into effect. Compounding guidance on hand sanitizer. Updated 06/11/2020. Authorized automatic exemptions to rule authorizing compounding of drugs in shortage areas. Updated 04/23/2020 Reuse of PPE. Updated 04/14/2020 to align with recently released PPE conservation guidance issued by FDA. Emergency refills authorized Pharmacists, pharmacy interns, and technicians licensed in other states may work in Ohio pharmacies under certain conditions Extension of renewal dates for pharmacy technicians. Valid until 07/29/2020, *extended further until 12/01/2020*. Authorized an extension of basic life-support training certifications for pharmacists and pharmacy interns. Pharmacist or intern must obtain recertification no later than 12/01/2020. Authorized the temporary expansion of maximum days' supply. Effective until rescinded by the Board. Authorized sterile compounding for another licensee (i.e., central compounding) Updated 04/23/2020 Authorized technicians may stock automated drug storage systems and clarified position on technicians transferring prescriptions Authorized extension of drug distributor customer due diligence. Annual due diligence requirements are extended until 11/29/2020. Authorized expedited licensure of drug distributors. Effective until rescinded by the Board. Authorized sale and shipment of non-reportable dangerous drugs that are in shortage by unlicensed out-of-state facilities. Effective until rescinded by the Board. Authorized the compounding and sale of certain alcohol-based hand sanitizer products by Ohio-licensed pharmacies and outsourcing facilities Authorized use of temporary satellite locations for storage and use of dangerous drugs Authorized temporary extension of annual controlled substances inventory requirements. For any annual controlled substance inventory during the time frame set forth in the resolution, the Boar extends the date to obtain the inventory to 08/01/2020. EXPIRED. Authorized nurses (LPN, RN, APRN) to stock automated drug storage systems within a terminal distributor or dangerous drugs under certain conditions, and includes clarifying guidance for this authorization Authorized pharmacists, pharmacy interns, and certified pharmacy technicians to conduct FDA-approved COVID-19 testing under certain conditions, and includes clarifying guidance for this authorization. Updated 05/27/2020 (Clarifying that pharmacists can order COVID-19 testing per guidance issued by HHS) Authorized the delegation to an Ohio-licensed APRN who is designated as a certified nurse practitioner (CNP), clinical nurse specialist (CNS), certified nurse midwife (CNM), or physician assistant (PA) the management of a consult agreement authorized under Section 4729.39 of the Revised Code. Effective during period of state of emergency. Authorized Ohio pharmacies to request a temporary waiver to permit a pharmacist to supervise up to five pharmacy technician trainees at a time (up from the current limit of three) Formally adopted FDA's "Temporary Policy for Compounding of Certain Drugs for Hospitalized Patients by Outsourcing Facilities During the COVID-19 Public Health Emergency" for Ohio-licensed outsourcing facilities. Effective for duration of national public health emergency. Authorized the temporary waiver of the 5% limit on the occasional wholesale sales of dangerous drugs by a licensed pharmacy set forth in Rule 4729:5-3-09 of the Admin. Code Extended recertification of primary and secondary engineering controls in accordance with guidance issued by USA Formally adopted FDA's "Temporary Policy on Repackaging or Combining Drug Products During the COVID-19 Public Health Emergency" for Ohio-licensed pharmacies, repackagers, and outsourcing facilities. Effective for duration of national public health emergency. Authorized a licensed terminal distributor of dangerous drugs to mail or deliver non-controlled drugs to patients that have been personally furnished by a prescriber that is employed or contracted by the terminal distributor. Valid until rescinded by the Board or the Board finalizes corresponding rules authorizing the shipment of drugs that have been personally furnished by a prescriber. Formally adopted FDA's "Temporary Policy on Prescription Drug Marketing Act Requirement for Distribution of Drug Samples During COVID-19 Public Health Emergency" Board passed emergency rule regarding prescription requirements for chloroquine or hydroxychloroquine. Rule was updated on 4/14/2020 to also address prescriptions for patients discharged from an emergency department (ED), for probable COVID-19 diagnosis. The prescriber is required to notate on the prescription that the patient has been discharged from an ED with probable COVID-19 diagnosis and prescription should be for no more than a 7-day supply (no refill authorized). On 04/30/2020, the Ohio Department of Health Director issued an order that permits businesses, except those specifically listed, to reopen as long as workplace standards are met. The order implements uniform requirements that pharmacies and the BOP licensees and registrants are required to comply with to remain open, available here. This guidance replaces all previous infection control guidance issued by the Board.
Oklahoma	Emergency declaration Board Waiver guidance: The Oklahoma State Board of Pharmacy (OSBP) will be considering issuing waivers for rules on a case by case basis. The OSBP is requesting that these waiver requests be sent to in writing. The OSBP is asking that these waiver requests indicate the name, address, license number of the entity needing the waiver and the reason for needing a waiver. Waivers will be approved for limited time periods. The Board OSBP issued a form for COVID-19 waiver requests Governor issued Third Amended Executive Order 2020-07 placing requirements on prescriptions for chloroquine or hydroxychloroquine. On 05/12/2020, the Governor enacted the Sixth Amended Executive Order that removed all restrictions regarding prescriptions for hydroxychloroquine and chloroquine. Remote pharmacy practice for pharmacists and technicians is only permitted upon submission of a waiver on a case-by-case basis
Oregon	Emergency declaration The Board issued guidance addressing the following: Safe work environment and routing pharmacy services Chloroquine/hydroxychloroquine temporary rule update Pharmacy intern: School-based internship ratio Pharmacy drug outlet: Annual controlled substance inventory Inactive pharmacist license reactivation Controlled substance refills Temporary Pharmacies permitted Emergency Licensure to be considered Emergency Pharmacy Rules: Do not apply to controlled substance medications Temporary Compounding of Certain Alcohol-Based Hand Sanitizer: The Oregon Board of Pharmacy permits this practice – guidance document from the FDA. Note: Permitted for OTC-sales and for patient-specific prescriptions A pharmacy may deliver or mail medications to patients (permitted any time) Pharmacy interns and pharmacy technicians may perform limited remote pharmacy functions. All licensees participating in remote processing should complete the Remote Processing Checklist and must notify the Board at pharmacy.board@oregon.gov. Hydroxychloroquine and chloroquine dispensing limitations In-state pharmacy drug compounding: Registered Oregon pharmacy drug outlets, located in Oregon, may compound drugs in shortage in accordance to all requirements set forth in the FDA's Temporary Policy Considerations for Reopening of Oregon and the End of the Declared Public Health Emergency (PHE): Temporary rules and advisories will end and change options at the end of the declared PHE Clarification of 04/08/20 Statement Related to Vaccines and Routine Pharmacy Services. The 04/08/2020 statement was not meant to be interpreted as an overall prohibition on vaccination. Rather, pharmacists are expected to use judgment to assess the individual circumstances of an identified patient need in tandem with assessing whether services, like vaccine administration, can be provided safely. Emergency Rule OAR 855-007-0085 adopted prohibiting the dispensing of chloroquine and hydroxychloroquine for presumptive treatment or prevention of COVID-19 Rule modified to allow dispensation of said drugs for COVID-19 only if written for a patient enrolled in a clinical trial by an authorized investigator *Rule no longer applies* Emergency Rule OAR 333-024-3000 for COVID-19 Testing at Waived Laboratories FAQ document issued regarding prescription therapy for COVID-19 patients Board posted the Oregon Health Authority's memo and guidance relating to remdesivir allocation and the Oregon Hospital Agreement regarding the same Statewide mask requirement implemented by Governor Brown On 07/14/2020, the Board voted to send two current COVID-19 temp rules through the formal rulemaking hearing process. One is related to pharmacist supervision of technician and interns for certain remote processing tasks; if adopted, this will remain in effect through the declared emergency timeframe only, unless repealed sooner. The second rule is related to SRI intern ratio for the 2020-2021 academic year. On 07/15/2020, the FDA sent an update noting that the Agency has added dexamethasone sodium phosphate to the lists of drugs for temporary compounding by outsourcing facilities and pharmacy compounders during the COVID-19 public health emergency. See https://www.oregon.gov/pharmacy/Documents/COVID-19_Comprehensive_Communication_Doc.pdf On 07/16/2020, temporary rule OAR-855-007-0086 was adopted. It obligates OBOP licensees and registrants to comply with the Governor's executive orders enacted during declared emergencies.
Pennsylvania	Declared state of emergency Pennsylvania Department of State issues document suspending certain licensing and regulatory requirements for pharmacies and pharmacists during state of emergency: Allows remote pharmacy practice for pharmacy technicians and pharmacy interns Suspends registration requirements of non-resident pharmacies Suspends certain licensure requirements to allow expedited temporary licensure to pharmacy practitioners and pharmacies in other states to provide goods and services to Pennsylvanians, for the duration of the state of emergency. The Temporary Pharmacist Licensure Form is available here. Suspends the regulations that require a pharmacy to immediately turn in its permit in the event it closes or ceases operations The Board issued prescribing suggestions for hydroxychloroquine The Department of State issued guidance stating the following: Neither the Pennsylvania Pharmacy Act nor any of the state Board's regulations impose signature requirements for delivery/receipt of prescriptions The Department has waived the "direct, immediate and personal" supervision requirements for pharmacy interns who have completed their Advanced Pharmacy Practice Experiences (APPE) rotation and/or are within 90 days of graduating from pharmacy school Where direct supervision was called for, pharmacy interns within 90 days of graduation may now be supervised "indirectly" The Department waived the requirement that pharmacy intern certificates are only valid for 6 years and cannot be renewed Licensed pharmacy practitioners are granted the requisite authority needed to carry out end-to-end COVID-19 testing, including but not limited to ordering, testing, and communicating results The Department has waived the restrictive definition of "satellite pharmacy" and allows ancillary sites during the COVID-19 emergency to be considered "satellite pharmacies" The Department waived the statutory emergency prescription section to allow pharmacists to issue a 30-day supply for an emergency script as opposed to a 72-hour supply only for nonscheduled legend drugs and Schedule V controlled substances. Pharmacists may dispense a 90-day supply of a medication (nonscheduled legend drugs) at one time by using the refills on the medication. Pharmacist license renewal deadlines falling between 09/01/2020 and 10/01/2020 have been extended until 12/29/2020 Board issued waiver expanding the age range of persons to whom pharmacists may administer influenza vaccinations to individuals 3 years of age or older
Puerto Rico	Declared state of emergency No Board action to date Remote pharmacy practice for pharmacists and technicians has not been addressed by the Board Administrative Order 434 Dispensing of chloroquine and hydroxychloroquine limited to five days if prescription contains a diagnosis of COVID-19. Refills are not permitted. Administrative Order 435 Allows pharmacies located in Puerto Rico to mail to patients non-controlled prescriptions Administrative Order 441 Allows emergency refills for non-controlled substances without prescriber authorization if patient presents the prescription bottle, which indicates the dosage, frequency, and patient name, to pharmacist Allows prescriber to write a Schedule II prescription for up to 90 days Administrative Order 452 Extends CS license expiration through 07/31/2020, and health professional license expiration through 12/31/2020 Administrative Order 459 Allows pharmacies, subject to certain requirements, to order COVID-19 tests
Rhode Island	Declared state of emergency Department of Health relaxes regulatory enforcement for health care professional licensing, including out-of-state pharmacists The Department is no longer issuing temporary licenses to out-of-state pharmacists Emergency rule enacted regarding off-label prescribing of medications to treat COVID-19 Emergency rule enacted related to pharmacy practice and procedures that allows for pharmacists to dispense an emergency 90-day supply of prescribed medications that are not controlled substances; to auto-substitute prescribed products without adherence to dispense-as-written directives; allows pharmacy interns in other states to work in Rhode Island pharmacies; and allows pharmacists and technicians to work remotely Remote pharmacy practice for pharmacists and technicians has not been addressed by the Board Any license due to expire 07/01/2020 or earlier is granted a 90-day extension for renewal with no penalties or late fee Rhode Island Department of Health has promulgated a regulatory amendment regarding regarding safe activities by covered entities during the COVID-19 emergency, available here: Regulation amendments allow employers to establish universal rules regarding face coverings, require covered entities to designate an individual ensuring compliance, and allow issuance of civil penalties for violation of the regulations and any applicable executive order Rhode Island Department of Health has promulgated a regulatory amendment regarding safe activities by covered entities during the COVID-19 emergency Regulation amendments allow employers to establish universal rules regarding face coverings, require covered entities to designate an individual ensuring compliance, and allow issuance of civil penalties for violations of the regulations and any applicable executive order Updated regulation requires covered entities to develop protocols to ensure capacity limits and physical distancing are maintained, including in bottleneck spaces and points of ingress and egress; notes that congregating and/or mingling in an establishment is prohibited; allows sampling of goods only where single-use applicators or no-touch options are provided; and provides additional requirements for specific kinds of establishments, including restaurants and entertainment venues Amended regulation allowing for enforcement of COVID-19-related executive orders allow for a $500 penalty per each individual violation
South Carolina	Declared state of emergency The Board has issued guidance and orders on the following: Permitting temporary permits Remote order entry is now permitted for pharmacists and technicians Extension of license and permit renewal deadlines Further extended to 09/30/2020, for pharmacy technicians and all facilities Use of automated pharmacy pickup kiosks Order establishing safe harbor for preparation of pharmaceutical products in light of PPE shortage Controlled substances: SC DHEC Bureau of Drug Control hereby authorizes a ONE TIME early refill of Schedule III-V prescriptions for valid refills that are due within the next seven (7) days In the case of an emergency situation, a pharmacist may dispense a controlled substance listed in Schedule II upon receiving oral authorization of a prescribing individual practitioner under certain circumstances DHEC's Bureau of Drug Control extends expiration date for SC controlled substances registrations expiring on 04/01/2020, to 04/20/2020 Joint guidance addressing prescriptions for hydroxychloroquine, chloroquine, and azithromycin Guidance for COVID-19 testing by pharmacists Board issued update regarding consultant pharmacists and access to clinics; Board statement allows for virtual monthly visit to be conducted in lieu of in-person visit if access limited and pharmacist comfortable with the approach Board provided an overview of the expansion of certain pharmacists' and pharmacy interns' ability to order and/or administer certain vaccines under the PREP Act
South Dakota	Declared state of emergency. The state of emergency was extended until at least 12/30/2020. Board issued a COVID-19 Memorandum, which addresses the following topics: The state mandated the Board to cancel inspections for the next three (3) weeks (until 04/08/2020); The Board advises pharmacies to waive the signature requirement for non-controlled substance prescriptions to help avoid the spread of COVID-19; Emergency dispensing for non-controlled substances; Compounding of hand santizer; and Addressing PPE shortages Remote pharmacy practice for pharmacists and technicians is permitted by the Board RESCINDED 06/05/2020:The Board issued a policy statement that places restrictions on the dispensing and distribution of chloroquine, hydroxychloroquine, mefloquine, and azithromycin The Board issued guidance related to pharmacy personnel exposure and potential pharmacy closures The Board approved multiple emergency rules (which were them incorporated into the governor's Executive Order 2020-16) related to pharmacy operations, including: Requirements for licensure as a pharmacist Temporary licensure for pharmacists Supervision of interns Internship requirements Reciprocal licensing for out-of-state pharmacists Emergency refills when a prescriber cannot be reached Timeframe for permit renewals Reporting changes in ownership Substituting equivalent drug products Administering naloxone Quantity limits in emergency kits Transferring prescriptions, including the number of refills and who may conduct the transfer Eliminating licensure requirements for non-resident pharmacies Administration of immunizations Technician application and certification procedures Pharmacist-to-technician ratios Allowable technician tasks Remote pharmacy operations Garbing for sterile compounding The Board approved an emergency rule which allows the Board to waive licensure requirements for non-resident wholesalers (S.D. Admin. R. §20:60:02:01) The Board issued a policy statement on pharmacists conducting COVID-19 testing. It is the Board's policy that, during the COVID-19 Federal Emergency, pharmacists may order, perform, and report COVID-19 tests without a separate provider order or collaborative practice agreement, provided certain requirments are met
Tennessee	Declared state of emergency EXPIRED 09/29/2020 The provisions of Tennessee Code Annotated, Section 63-10-207(a) and (c), are hereby suspended to allow a pharmacist to dispense an extra 30-day supply of maintenance prescriptions without proper authorization to persons as is necessary to respond to and prevent the spread of COVID-19 in Tennessee, subject to all other provisions of Tennessee Code Annotated, Sections 63-10-207 and 63-1-164 *Executive Order 63, effective until 12/15/2020 (through Executive Order 67),* provides for the following: The order permits remote pharmacy practice for pharmacists and technicians The order suspends provisions of Tenn. Comp. R. & Regs. 1200-06-03-.16 to allow testing for COVID-19 at alternate testing sites without prior approval by the Medical Laboratory Board. This provides pharmacies the authority to engage in emergency testing for COVID-19. Pharmacies in Tennessee may administer COVID-19 testing EXPIRED 09/29/2020: Application for Health Professional Practice By Executive Order The Board released a "Top 10 Things You Can Do to Prepare for COVID-19" checklist for pharmacies The Department of Health released a statement regarding hydroxychloroquine, chloroquine, and azithromycin. The statement does not place any restrictions on the prescribing or dispensing of these drugs, but does urge caution. The Board waived the requirement for patients to be counseled face-to-face as stated in Rule 1140-03-.01(1). Extended through 12/31/2020. The Board waived the requirement that filling/stocking of all medications in the automated dispensing system shall be completed by a pharmacist or pharmacy technician under the direct supervision of a pharmacist. Extended through 12/31/2020.
Texas	Declared state of emergency Governor temporarily suspended certain rule requirements pertaining to pharmacy practice, including: §291.17 - the annual inventory notarization requirement in §291.17(c)(3) §291.33 - the requirement in §291.33(c)(1)(B)(iii) to have in-person contact for patient counseling in order to allow patient counseling to be performed by telephonic consultation §291.36 - the requirement in §291.36(2) to obtain to obtain an inspection within the last renewal period in order to renew a Class A-S pharmacy license §291.54 - the requirement in §291.54(a)(13) to obtain an inspection within the last renewal period in order to renew a Class B pharmacy license §291.77 - the requirement in §291.77(2) to obtain an inspection within the last renewal period in order to renew a Class C-S pharmacy license §291.106 - the requirement in §291.106(4) to obtain an inspection within the last renewal period in order to renew a Class E-S pharmacy license §291.121 - the requirement in §291.121(d)(3), (4)(C)(i) to the extent necessary to expand the pilot program for automated systems in order to allow for remote automated dispensing §295.15 - the requirement in §295.15(c)(2)(C) to maintain documentation of current certification in American Heart Association's Basic Cardiac Life Support for Health-Care Providers or its equivalent in order to provide immunization or vaccination under written protocol of a physician §291.76 - the requirement in §291.76(c)(1)(B)(xiv) for a pharmacists to visit an ambulatory surgical center at least once each calendar week §291.151 - the requirement in §291.151(c)(1)(B)(xiv) for a pharmacist to visit a freestanding emergency medical care facility at least once each calendar week §295.7 - the expiration dates of pharmacists licenses in §295.7 §295.8 - the continuing education requirements for pharmacists in §295.8(a)(1) §297.3 - the expiration dates of pharmacy technician registrations and the continuing education and fingerprint requirements in §297.3(d)(1)-(3) §297.5 - the expiration dates of pharmacy technician trainee registrations in §294.5 §297.8 - the continuing education requirements for pharmacy technicians in §297.8 §283.5 - the requirement for board approval as a preceptor to supervise a pharmacist-intern performing pharmacist duties in §283.5(a)(1) §291.32 - the requirement that only a pharmacist may receive oral prescription drug orders and reduce the orders to writing, and transfer or receive a transfer of original prescription information on behalf of a patient in §291.32(c)(2)(A), (K) to allow these duties to be performed by pharmacy technicians The Board provided a COVID-19 resource page, which includes information on: *Immunization guidance* *COVID-19 testing guidance* *Emergency dispensing of prescriptions (no longer on page, but link still active)* *Sterile compounding guidance* *Compounding hand sanitizer guidance (no longer on page, but link still active)* *PPE guidance (no longer on page, but link still active)* *Destruction of drugs at LTC facilities* The Board released a policy statement confirming that pharmacists in Texas may order and administer COVID-19 tests that have been CLIA-waived or approved by the FDA EXPIRED 07/17/2020: Board adopts emergency rule limiting prescriptions of chloroquine, hydroxychloroquine, mefloquine, or azithromycin The Board also issued additional guidance on this topic. The Board reaffirmed that, in a declared emergency, existing Texas law allows a pharmacist to dispense up to a 30-day supply of a prescription drug, other than a Schedule II controlled substance, without the authorization of the prescribing practitioner if certain conditions are met Remote pharmacy practice for pharmacists and technicians is permitted by existing law Board details procedures for emergency temporary pharmacist licensure and emergency temporary pharmacy technician registration The Department of Health and Human Services issued a guidance document on conducting sales of pseudoephedrine products during the COVID-19 disaster declaration The Board announced that it will conduct many of its compliance inspections virtually. Details of how virtual inspections will be conducted can be found here. *Pharmacies must enroll in the Texas Department of State Health Services (DSHS) Immunization Program to be eligible to administer COVID-19 vaccines in Texas once they are available*
Utah	Declared state of emergency The Board has issued a guidance document which addresses: Emergency compounding of hand sanitizer Reuse of PPEs Emergency refills The Board is issuing COVID-19 emergency licenses for pharmacists, pharmacy technicians, and pharmacies Remote pharmacy practice for pharmacists and technicians is not prohibited by existing law The Board issued a guidance statement regarding hydroxychloroquine and chloroquine. The statement does not place any restrictions on the prescribing or dispensing of these drugs, but does suggest certain limitations. The Board issued a rule waiver that allows pharmacies to conduct a controlled substance inventory 120 days before or after their regularly scheduled inventory date in 2020, or 120 days after the end of the declared emergency The Board issued a rule waiver that allows pharmacy interns to practice under "General Supervision" during the declared emergency. General Supervision is defined in Utah Admin Code R156-1-102a "Global Levels of Supervision." The Board issued guidance for assigning beyond-use dates for USP <79> product The Board provided guidance regarding face-to-face counseling. Under this guidance, pharmacists may supplement traditional face-to-face consultation and interact with patients through technological means, e.g., text, chat, video chat, telephone. Patients should be provided supplemental materials with the prescription on the methods available for them to speak with the pharmacist. The Department of Health issued a standing order that allows Utah-licensed pharmacists to screen, order, and administer an FDA-approved COVID-19 test. Pharmacists may delegate test administration to Utah-licensed pharmacy interns or pharmacy technicians.
Vermont	Declared state of emergency Governor added Addendum 14 to Executive Order 01-20, ordering close-contact businesses to cease in-person operations beginning at 8:00pm on Monday, 03/23/2020 through 06/15/2020. The order includes a phased approach for the opening of businesses affected by the order. Board issued a guidance document Clarifies that so-called 90-day switches are permissible to minimize person-to-person contact and repeat pharmacy contacts Clarifies that remote consultation with a first-time prescriber does not undermine the legitimacy of a prescription order, so long as the pharmacist is comfortable that there has been a bona fide medical assessment and exercise of prescriber discretion Acknowledges and endorses FDA policy allowing compounders to make alcohol-based hand sanitizer products Addresses expected PPE shortages—a matter of more concern to hospitals and compounders than to retail pharmacies States that a pharmacist may extend a previous prescription for a maintenance medication for which the patient has no refills remaining, or for which the authorization for refills has recently expired, if it is not feasible to obtain a new prescription or refill authorization from the prescriber States that a pharmacist may, with the informed consent of the patient, substitute an available drug or insulin product for an unavailable prescribed drug or insulin product in the same therapeutic class if the available drug or insulin product would, in the clinical judgment of the pharmacist, have substantially equivalent therapeutic effect even though it is not a therapeutic equivalent For the duration of the declared state of emergency in Vermont, such licensed entities are authorized to source drugs from unlicensed sites, so long as source sites are licensed in good standing in any US jurisdiction A retail pharmacy compelled to close temporarily for COVID-19 reasons is excused from the requirements of Board of Pharmacy Administrative Rule 8.3 if it promptly emails a concise statement of reasons and expected duration to Board Addresses pharmacy staff working from home Authorizes pharmacists to order and administer COVID-19 tests approved by FDA and the Vermont Department of Health for pharmacy-based sample collection or administration (pursuant to Executive Order 01-20) Remote pharmacy practice for pharmacists is permitted by existing law and now permitted for technicians by board guidance The Department of Health issued a statement regarding the use of non-approved drugs for COVID-19 treatment. Specifically, the statement warns against the inappropriate use of chloroquine and hydroxychloroquine. The statement does not place any limits on prescribing or dispensing. The Vermont Legislature passed emergency legislation waiving licensure requirements for health professionals from other states in response to the COVID-19 state of emergency Vermont Immunization Registry (IMR): Before administering any pediatric vaccine, a pharmacist must review each patient's current IMR "forecaster," the patient record of vaccines administered and due. Immunizations must be reported into the IMR via HL7, batch, or direct entry. Immunizations should also be communicated to the child's pediatrician.
Virginia	Declared state of emergency The Board has a guidance document which addresses: Early refills Emergency CII prescriptions (hard copy must be provided in 15 days, instead of 7 days) Inpatient hospital pharmacy dispensing Compounding of hand sanitizer PPE reuse Permits assistance from pharmacists and technicians in other states Permits remote processing by technicians Emergency closing of a pharmacy Pharmacy trainee allowance Stat box and emergency kit replacement Compounding for another hospital Nurses practicing at an opioid treatment program (OTP) pharmacy may assist pharmacists Mailing dispensed drugs and proof of identity requirements The 5% distribution rule Admission to licensure examinations Per Board guidance, as of 01/01/2021, pharmacists and pharmacy technicians may not practice in Virginia unless they are properly licensed or registered with the Virginia Board of Pharmacy The Board provided guidance stating that "pharmacists, along with pharmacy technicians and pharmacy interns under the supervision pharmacist may perform CLIA-waived tests." The Board clarified that "the FDA has clearly articulated which point of care tests for COVID-19 are considered CLIA-waived according to an EUA." The Virginia Department of Health also developed a Pharmacy Checklist to assist pharmacists collecting samples and performing COVID-19 diagnostic (molecular) tests Per guidance from the Virginia Board of Pharmacy, pharmacists licensed in Virginia may order and administer vaccinations without authorization of a prescriber and pharmacy interns may administer such vaccinations under pharmacist supervision as long as they meet the requirements set forth in the declaration of the HHS Secretary. 18VAC110-20-271 requires pharmacists to report the administration of these vaccines to the Virginia Immunization Information System (VIIS).
Washington	Declared state of emergency Pharmacy Quality Assurance Commission (PQAC) has posted a COVID-19 Response Packet which addresses: The impacts of COVID-19 on compounding; Pharmacy operation recommendations; Delivery of prescription medications outside of the pharmacy; Compounding hand sanitizer; License renewal procedures for non-resident pharmacies; and Other frequently asked questions The Pharmacy Commission will hold special meetings (via webinar) on Wednesdays and Fridays during the coming weeks to address COVID-19 and other urgent issues A pharmacy technician may perform order entry from a remote location as long as they are under the supervision and control of a pharmacist The PQAC released a statement on chloroquine and hydroxychloroquine. The Commission reiterated that these drugs are not yet FDA-approved for COVID-19 and, as such, it discourages inappropriate prescribing of these medications for prophylaxis, as doing so may restrict access for patients that really need appropriate therapy. The governor issued Proclamation 20-32 related to health care worker licensing. The provisions, which will be in effect until 11/09/2020 (unless extended), include waiving certain requirements related to: "Immediate" supervision of technicians; Retired pharmacist licenses; Continuing education requirements for pharmacists; Seven hours of HIV/AIDS training for pharmacists; Continuing education requirements for pharmacy technicians; and Four hours of HIV/AIDS training for pharmacy technicians and pharmacy assistants. The commission will not refer or take enforcement actions against licensees or pharmacies that accept donated or manufactured hand sanitizer (using USP and/or non-USP grade ingredients) without obtaining a manufacturer license for consumer use and for health care personnel for the duration of the public health emergency The Secretary of Health has extended health professional license expiration dates for licenses up for renewal between 04/01/2020, and 09/30/2020. The Department of Health issued a reminder for all health care professionals that those who took advantage of the extended time to renew must renew their credential on or before 09/30/2020 in order for their credential to remain effective and avoid late fees. EXPIRED: The PQAC has extended the self-inspection process until 05/31/2020. This impacts the following types of pharmacies: hospital, long-term care, nuclear, sterile compounding, and non-sterile compounding The Department of Health has temporarily suspended routine state compliance inspections in all health care facilities they regulate, including the facilities regulated by the PQAC The governor issued Proclamation 20-36 related to health care facilities and surge capacity. The provisions, which will be in effect until 08/01/2020 (unless extended), include: Pharmacies will not need Commission approval to utilize pharmacy technicians and assistants (RCW 18.64A.040(1), and (2); RCW 18.64A.060; WAC 246-901-020(3); WAC 246-901-035; and WAC 246-901-100); The “license of location” requirement for pharmacies has been waived and suspended (RCW 18.64.043(1), (2)(a), and (3)); Pharmacies do not need to notify the Commission thirty days before commencing differential hours (WAC 246-869-020(10)); and All persons engaged in the manufacture and distribution of hand sanitizer to the public, may do so without obtaining a manufacturer license or shopkeeper registration (RCW 18.64.020, RCW 18.64.044, RCW 18.64.045, and RCW 18.64.250(1), (2)) The governor issued Proclamation 20-36 related to health care facilities and surge capacity. The provisions, which will be in effect until 11/09/2020 (unless extended), include: Pharmacies will not need Commission approval to utilize pharmacy technicians and assistants (RCW 18.64A.040(1) and (2), RCW 18.64A.060, WAC 246-907-020(3), WAC 346-901-035, and WAC 246-901-100) The "license of location" requirement for pharmacies has been waived and suspended (RCW 18.64.043(1), (2)(a), and (3)) Pharmacies do not need to notify the Commission 30 days before commencing differential hours (WAC 246-869-020(10)) All persons engaged in the manufacture and distribution of hand sanitizer to the public may do so without obtaining a manufacturer license or shopkeeper registration (RCW 18.64.020, RCW 18.64.044, RCW 18.64.045, and RCW 18.64.250(1), (2)) The PQAC adopted an emergency rule which amends WAC 246-887-020 by: Increasing the duration of time a practitioner has to deliver a signed prescription when authorizing an emergency prescription of a Schedule II substance to the pharmacy from seven days to 15 days; and defining what a "signed prescription means and allows for a practitioner to accomplish this requirement through paper, electronic transmission, facsimile, photograph, or scanned copy The PQAC adopted an emergency rule which amends WAC 246-887-020 by: Increasing the duration of time a practitioner has to deliver a signed prescription of a Schedule II substance to the pharmacy from seven days to 15 days; and Defining what a "signed prescription" means and allows for a practitioner to accomplish this requirement through paper, electronic transmissions, facsimile, photograph, or scanned copy Pharmacists in Washington may order and administer COVID-19 coronavirus tests. Administering the tests falls under their scope of practice identified in RCW 18.64.011(28). The PQAC produced a bulletin clarifying its position regarding Washington-licensed pharmacists ordering, administering, and reporting results of COVID-19 tests to patients.
West Virginia	Declared state of emergency The Board is maintaining a COVID-19 resource page and a memo with helpful guidance, which addresses: Ability to provide emergency refills and gross up of remaining refills. Managing shortages of PPE needed for sterile compounding Signature for Received Prescriptions Early Refills for Controlled Substances Pharmacy Technician to Pharmacist Ratios Pharmacy emergency closures Pharmacy preparedness Continuing Pharmacist Education (CPE) Temporary permits for out-of-state pharmacists, technicians, and interns PPE and sterile compounding Submitting reports to the CSMP Licensure renewal and expiration Fills for office-based treatment programs Immunizations EXPIRED 08/25/2020 New temporary rule passed on 03/21/2020 limiting prescriptions of hydroxychloroquine and chloroquine Remote pharmacy practice for licensed pharmacy professionals (pharmacists, pharmacy interns, and pharmacy technicians, and pharmacy technician trainees) is permitted The Board issued an update pertaining to the prescribing and dispensing of Schedule II controlled substances. The update discusses exemptions to rules to § 15-1-17.1.6.c and § 15-2-8.9.2, which were recently put into place. The Board issued a statement that it "is currently working with the Governor's office and the WV Bureau of Public Health to determine the appropriate pathway forward for WV [to allow pharmacists to administer COVID-19 tests]. An order has been requested and is being discussed. Guidance will be coming regarding this topic as soon as it is available." The Board issued a guidance document detailing the two pathways for COVID-19 testing in West Virginia pharmacies. The Board issued a statement that "the performance of CLIA-waived tests is within the scope of the practice of pharmacist care provided they are administered in accordance with the FDA's CLIA requirements."
Wisconsin	Declared state of emergency The declaration empowers the Board to issue waivers for certain state laws related to the practice of pharmacy The Board granted a rule variance that allows pharmacists and compounding pharmacy personnel to re-use PPE during the COVID-19 public health emergency. Variance extended until 10/30/2020. Remote pharmacy practice for pharmacists and technicians is not currently permitted by the Board The Board granted a rule variance that allows pharmacists to dispense in locations that are not licensed pharmacies. Variance extended until 10/30/2020. ORDER EXPIRED WITH EXPIRATION OF PUBLIC HEALTH EMERGENCY DECLARATION ON 05/11/2020: The Governor released Emergency Order 16. Under the EO, a pharmacist with a valid and current license issued by another state may practice under that license and within the scope of that license in Wisconsin without first obtaining a temporary or permanent license, provided certain conditions are met. EO also suspends renewal provisions for licensees. The Department released a letter and a document addressing FAQs related to Emergency Order 16 The provisions of EO 16 were extended through the issuance of Emergency Order 20 The Governor released Emergency Order 2, effective 10/01/2020. Under the EO: A pharmacist with a valid and current licensed issued by another state may practice under that license and within the scope of that license in Wisconsin without first obtaining a temporary or permanent license, provided certain conditions are met. The EO also suspends renewal provisions for licensees. Any valid health care provider license that expires during the emergency declaration shall remain valid for 30 days after the conclusion of the emergency declaration Any health care provider with a license that has lapsed in the last 5 years may apply for reinstatement without paying renewal fees or completing the continuing education requirement The Board granted a variance to allow holders of wholesale distribution licenses to distribute drugs from facilities that are not licensed in Wisconsin but are licensed in other states should Wisconsin facilities shut down. Variance extended until 10/30/2020. The Board granted a variance to allow wholesale distributors to deliver prescription drugs and devices to addresses approved by the Board ("surge sites"). Variance extended until 10/30/2020. The Department of Safety and Professional Services issued a memorandum detailing the procedures by which any credential holder may request a waiver from continuing education requirements for licenses that are renewing during the public health emergency The Pharmacy Examining Board granted a variance to modify Wis. Stat. § 450.07(1) and Wis. Admin. Code § 12.03(1). The variance allows a manufacturer to temporarily manufacture needed PPE without a license during a period of declared emergency. Variance extended until 10/30/2020. The Pharmacy Examining Board issued a variance to Wis. Admin. Code § Phar 7.01(1)(e) and (em) to temporarily relax the consulting and delivery requirements when delivering medications or devices to a patient. Variance extended until 10/30/2020. The Wisconsin legislature passed Act 185, which includes a provision to extend the deadline for pharmacist license renewals through 08/30/2020. Per the Pharmacy Examining Board's memo on Act 185, pharmacists who are unable to complete their Continuing Education (CE) requirements because of COVID-19-related disruptions may request a CE waiver. Pharmacists in Wisconsin may order and administer COVID-19 coronavirus tests The Wisconsin legislature passed Act 185, which includes: A provision to extend the deadline for pharmacist license renewals through 08/20/2020. Per the Pharmacy Examining Board's memo on Act 185, pharmacists who are unable to complete their continuing education (CE) requirements because of COVID-19-related disruptions may request a CE waiver. A provision adding Wis. Stat. Ann. §450.11(5)(br), which allows for emergency refills of non-controlled drugs Pharmacists in Wisconsin may order and administer COVID-19 coronavirus tests. They may also order tests, including CLIA-waived tests, through a collaborative practice agreement with a physician (Wis. Stat. 450.033). This authority is independent of the COVID-19 public health emergency and, therefore, does not require an executive order. The authority will continue when the public health emergency ends. The Board issued a variance that allows any person with a valid and current license to practice pharmacy issued by another state to practice under that license and within the scope of that license in Wisconsin without first obtaining a temporary permit, so long as certain conditions are met. Variance extended until 10/30/2020. The Board issued a variance that allows any pharmacy with a license in good standing issued by another state to deliver drugs and devices to persons in Wisconsin without a Wisconsin license. Variance extended until 10/30/2020.
Wyoming	Declared state of emergency Board has issued a guidance document addressing the following: Prescriptions for azithromycin, chloroquine, and hydroxychloroquine Temporary closures Reuse of PPEs Compounding hand sanitizer Health care emergency preparedness inventory evaluation tool A warning about fraudulent COVID-19 products and other scams *COVID-19 vaccine administration by pharmacists, interns, and technicians* Remote pharmacy practice for pharmacists and technicians has not been addressed by the Board The Wyoming Board of Medicine issued a statement on COVID-19 Prescribing and Conservation of Health Resources. The statement addresses, but does not place limits upon, the prescribing and dispensing of chloroquine and hydroxychloroquine.

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