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According to Karen Noonan, M.A., ASHP’s director of State Affairs and Grassroots Advocacy, it’s this advancement of the profession as a whole that makes advocacy at the state level so important. “State governments – the legislatures and boards of pharmacy -- define what pharmacists can and cannot do,” she said. “The joke is that if you’ve seen one state, you’ve seen one state, but states tend to follow each other. For example, Indiana will ask what Illinois is doing. If an issue catches fire in one state, often it will spread out and become an issue in multiple states nearby.”

To help address these issues, the Society’s Government Affairs Division partners with state affiliates to reach out to state legislatures and boards of pharmacy. ASHP also serves as a conduit that unites affiliates in a spirit of collaboration.

States confronting similar issues are often at different stages of advocacy and implementation, Noonan said. For example, 43 states allow CDTM to one degree or another. They differ not so much on what pharmacists can do in terms of initiating or modifying treatment, but the practice settings in which pharmacists may do so. Noonan monitors the remaining seven states to determine which ones are trying to establish CDTM and where they might need assistance.

Issues concerning technicians and advanced technician authority (such as “tech check tech”) also vary by state, but ASHP position papers offer a blueprint for advocacy and aim for standardized education and certification nationwide—goals that complement and dovetail with the objectives outlined in the Pharmacy Practice Model Initiative (PPMI) for advancing the role of the pharmacist.

“For pharmacists to practice at the top of their license and fully use their education and skills as experts in safe medication use, the pharmacy technician has to perform his or her job in an optimum manner,” said Noonan. “A well-trained, well-regulated tech [technician] workforce enhances our opportunity to advance PPMI. When states rewrite their pharmacy practice acts, that is our opportunity to try to advance our policy positions and maximize the opportunity for ASHP’s positions to be included.”

Health information technology is a hot topic, as well. Remote medication order processing and computerized prescription order entry are all regulated, and ASHP watches proposed rules to compare them to the Society’s official guidelines and positions. “The questions are: Does a proposed rule comply with our guidelines, does it help ensure safe medication use, and will it be burdensome on the pharmacist?” said Noonan.

The regulation of pharmacies within a given health system has bubbled to the surface in different ways depending on the state. Such regulations affect multi-campus health systems and hospitals that have pharmacies in different units.

For example, proposed rules may seek to ensure that centralized pharmacies and satellite pharmacies share common electronic files or technology to process orders. “When you have multiple pharmacies in the same health system, you want to make sure there is no disconnect in communication,” said Noonan.

To learn more about ASHP’s advocacy at both the national and state levels, visit the Advocacy section of www.ashp.org.
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