CHAPTER 118 HOUSE BILL No. 2759 (Amended by Chapter 159) An Act relating to the pharmacy act of the state of Kansas; authorizing pharmacists to
administer drugs under certain conditions; amending K.S.A. 1999 Supp. 65-1626 and
65-1626a and repealing the existing sections.
Be it enacted by the Legislature of the State of Kansas:

      Section  1. K.S.A. 1999 Supp. 65-1626 is hereby amended to read as
follows: 65-1626. For the purposes of this act:

      (a) ``Administer'' means the direct application of a drug, whether by
injection, inhalation, ingestion or any other means, to the body of a patient
or research subject by:

      (1) A practitioner or pursuant to the lawful direction of a practitioner,
or;

      (2) the patient or research subject at the direction and in the presence
of the practitioner.; or

      (3) a pharmacist as authorized in section 3 and amendments thereto.

      (b) ``Agent'' means an authorized person who acts on behalf of or at
the direction of a manufacturer, distributor or dispenser but shall not
include a common or contract carrier, public warehouseman or employee
of the carrier or warehouseman when acting in the usual and lawful course
of the carrier's or warehouseman's business.

      (c) ``Board'' means the state board of pharmacy created by K.S.A. 74-
1603 and amendments thereto.

      (d) ``Brand exchange'' means the dispensing of a different drug prod-
uct of the same dosage form and strength and of the same generic name
than the brand name drug product prescribed.

      (e) ``Brand name'' means the registered trademark name given to a
drug product by its manufacturer, labeler or distributor.

      (f) ``Deliver'' or ``delivery'' means the actual, constructive or at-
tempted transfer from one person to another of any drug whether or not
an agency relationship exists.

      (g) ``Direct supervision'' means the process by which the responsible
pharmacist shall observe and direct the activities of a pharmacy student
or pharmacy technician to a sufficient degree to assure that all such ac-
tivities are performed accurately, safely and without risk or harm to pa-
tients, and complete the final check before dispensing.

      (h) ``Dispense'' means to deliver prescription medication to the ulti-
mate user or research subject by or pursuant to the lawful order of a
practitioner or pursuant to the prescription of a mid-level practitioner.

      (i) ``Dispenser'' means a practitioner or pharmacist who dispenses
prescription medication.

      (j) ``Distribute'' means to deliver, other than by administering or dis-
pensing, any drug.

      (k) ``Distributor'' means a person who distributes a drug.

      (l) ``Drug'' means: (1) Articles recognized in the official United States
pharmacopoeia, or other such official compendiums of the United States,
or official national formulary, or any supplement of any of them; (2) ar-
ticles intended for use in the diagnosis, cure, mitigation, treatment or
prevention of disease in man or other animals; (3) articles, other than
food, intended to affect the structure or any function of the body of man
or other animals; and (4) articles intended for use as a component of any
articles specified in clause (1), (2) or (3) of this subsection; but does not
include devices or their components, parts or accessories, except that the
term ``drug'' shall not include amygdalin (laetrile) or any livestock remedy,
as defined in K.S.A. 47-501 and amendments thereto, if such livestock
remedy has been registered in accordance with the provisions of article
5 of chapter 47 of the Kansas Statutes Annotated.

      (m) ``Electronic transmission'' means transmission of information in
electronic form or the transmission of the exact visual image of a docu-
ment by way of electronic equipment.

      (n) ``Generic name'' means the established chemical name or official
name of a drug or drug product.

      (o)  (1) ``Institutional drug room'' means any location where prescrip-
tion-only drugs are stored and from which prescription-only drugs are
administered or dispensed and which is maintained or operated for the
purpose of providing the drug needs of:

      (A) Inmates of a jail or correctional institution or facility;

      (B) residents of a juvenile detention facility, as defined by the Kansas
code for care of children and the Kansas juvenile justice code;

      (C) students of a public or private university or college, a community
college or any other institution of higher learning which is located in
Kansas; or

      (D) employees of a business or other employer.

      (2) ``Institutional drug room'' does not include:

      (A) Any registered pharmacy;

      (B) any office of a practitioner; or

      (C) a location where no prescription-only drugs are dispensed and no
prescription-only drugs other than individual prescriptions are stored or
administered.

      (p) ``Medical care facility'' shall have the meaning provided in K.S.A.
65-425 and amendments thereto, except that the term shall also include
facilities licensed under the provisions of K.S.A. 75-3307b and amend-
ments thereto except community mental health centers and facilities for
the mentally retarded.

      (q) ``Manufacture'' means the production, preparation, propagation,
compounding, conversion or processing of a drug either directly or in-
directly by extraction from substances of natural origin, independently by
means of chemical synthesis or by a combination of extraction and chem-
ical synthesis and includes any packaging or repackaging of the drug or
labeling or relabeling of its container, except that this term shall not in-
clude the preparation or compounding of a drug by an individual for the
individual's own use or the preparation, compounding, packaging or la-
beling of a drug by: (1) A practitioner or a practitioner's authorized agent
incident to such practitioner's administering or dispensing of a drug in
the course of the practitioner's professional practice; (2) a practitioner,
by a practitioner's authorized agent or under a practitioner's supervision
for the purpose of, or as an incident to, research, teaching or chemical
analysis and not for sale; or (3) a pharmacist or the pharmacist's author-
ized agent acting under the direct supervision of the pharmacist for the
purpose of, or incident to, the dispensing of a drug by the pharmacist.

      (r) ``Person'' means individual, corporation, government, govern-
mental subdivision or agency, partnership, association or any other legal
entity.

      (s) ``Pharmacist'' means any natural person licensed under this act to
practice pharmacy.

      (t) ``Pharmacist in charge'' means the pharmacist who is responsible
to the board for a registered establishment's compliance with the laws
and regulations of this state pertaining to the practice of pharmacy, man-
ufacturing of drugs and the distribution of drugs. The pharmacist in
charge shall supervise such establishment on a full-time or a part-time
basis and perform such other duties relating to supervision of a registered
establishment as may be prescribed by the board by rules and regulations.
Nothing in this definition shall relieve other pharmacists or persons from
their responsibility to comply with state and federal laws and regulations.

      (u) ``Pharmacy,'' ``drug store'' or ``apothecary'' means premises, lab-
oratory, area or other place: (1) Where drugs are offered for sale where
the profession of pharmacy is practiced and where prescriptions are com-
pounded and dispensed; or (2) which has displayed upon it or within it
the words ``pharmacist,'' ``pharmaceutical chemist,'' ``pharmacy,'' ``apoth-
ecary,'' ``drugstore,'' ``druggist,'' ``drugs,'' ``drug sundries'' or any of these
words or combinations of these words or words of similar import either
in English or any sign containing any of these words; or (3) where the
characteristic symbols of pharmacy or the characteristic prescription sign
``Rx'' may be exhibited. As used in this subsection, premises refers only
to the portion of any building or structure leased, used or controlled by
the licensee in the conduct of the business registered by the board at the
address for which the registration was issued.

      (v) ``Pharmacy student'' means an individual, registered with the
board of pharmacy, enrolled in an accredited school of pharmacy.

      (w) ``Pharmacy technician'' means an individual who, under the direct
supervision and control of a pharmacist, may perform packaging, manip-
ulative, repetitive or other nondiscretionary tasks related to the processing
of a prescription or medication order and who assists the pharmacist in
the performance of pharmacy related duties, but who does not perform
duties restricted to a pharmacist.

      (x) ``Practitioner'' means a person licensed to practice medicine and
surgery, dentist, podiatrist, veterinarian, optometrist licensed under the
optometry law as a therapeutic licensee or diagnostic and therapeutic
licensee, or scientific investigator or other person authorized by law to
use a prescription-only drug in teaching or chemical analysis or to conduct
research with respect to a prescription-only drug.

      (y) ``Preceptor'' means a licensed pharmacist who possesses at least
two years' experience as a pharmacist and who supervises students ob-
taining the pharmaceutical experience required by law as a condition to
taking the examination for licensure as a pharmacist.

      (z) ``Prescription'' means, according to the context, either a prescrip-
tion order or a prescription medication.

      (aa) ``Prescription medication'' means any drug, including label and
container according to context, which is dispensed pursuant to a prescrip-
tion order.

      (bb) ``Prescription-only drug'' means any drug whether intended for
use by man or animal, required by federal or state law (including 21
United States Code section 353, as amended) to be dispensed only pur-
suant to a written or oral prescription or order of a practitioner or is
restricted to use by practitioners only.

      (cc) ``Prescription order'' means: (1) An order to be filled by a phar-
macist for prescription medication issued and signed by a practitioner or
a mid-level practitioner in the authorized course of professional practice;
or (2) an order transmitted to a pharmacist through word of mouth, note,
telephone or other means of communication directed by such practitioner
or mid-level practitioner.

      (dd) ``Probation'' means the practice or operation under a temporary
license, registration or permit or a conditional license, registration or per-
mit of a business or profession for which a license, registration or permit
is granted by the board under the provisions of the pharmacy act of the
state of Kansas requiring certain actions to be accomplished or certain
actions not to occur before a regular license, registration or permit is
issued.

      (ee) ``Professional incompetency'' means:

      (1) One or more instances involving failure to adhere to the appli-
cable standard of pharmaceutical care to a degree which constitutes gross
negligence, as determined by the board;

      (2) repeated instances involving failure to adhere to the applicable
standard of pharmaceutical care to a degree which constitutes ordinary
negligence, as determined by the board; or

      (3) a pattern of pharmacy practice or other behavior which demon-
strates a manifest incapacity or incompetence to practice pharmacy.

      (ff) ``Retail dealer'' means a person selling at retail nonprescription
drugs which are prepackaged, fully prepared by the manufacturer or dis-
tributor for use by the consumer and labeled in accordance with the
requirements of the state and federal food, drug and cosmetic acts. Such
nonprescription drugs shall not include: (1) A controlled substance; (2) a
prescription-only drug; or (3) a drug intended for human use by hypo-
dermic injection.

      (gg) ``Secretary'' means the executive secretary of the board.

      (hh) ``Unprofessional conduct'' means:

      (1) Fraud in securing a registration or permit;

      (2) intentional adulteration or mislabeling of any drug, medicine,
chemical or poison;

      (3) causing any drug, medicine, chemical or poison to be adulterated
or mislabeled, knowing the same to be adulterated or mislabeled;

      (4) intentionally falsifying or altering records or prescriptions;

      (5) unlawful possession of drugs and unlawful diversion of drugs to
others;

      (6) willful betrayal of confidential information under K.S.A. 65-1654
and amendments thereto;

      (7) conduct likely to deceive, defraud or harm the public;

      (8) making a false or misleading statement regarding the licensee's
professional practice or the efficacy or value of a drug;

      (9) commission of any act of sexual abuse, misconduct or exploitation
related to the licensee's professional practice; or

      (10)  performing unnecessary tests, examinations or services which
have no legitimate pharmaceutical purpose.

      (ii) ``Mid-level practitioner'' means an advanced registered nurse
practitioner issued a certificate of qualification pursuant to K.S.A. 65-1131
and amendments thereto who has authority to prescribe drugs pursuant
to a written protocol with a responsible physician under K.S.A. 65-1130
and amendments thereto or a physician's assistant registered pursuant to
K.S.A. 65-2896a and amendments thereto who has authority to prescribe
drugs pursuant to a written protocol with a responsible physician under
K.S.A. 65-2896e and amendments thereto.

      (jj) ``Vaccination protocol'' means a written protocol, agreed to by a
pharmacist and a person licensed to practice medicine and surgery by the
state board of healing arts, which establishes procedures and recordkeep-
ing and reporting requirements for administering a vaccine by the phar-
macist for a period of time specified therein, not to exceed two years.

      Sec.  2. K.S.A. 1999 Supp. 65-1626a is hereby amended to read as
follows: 65-1626a. (a) For the purpose of the pharmacy act of the state
of Kansas, the following persons shall be deemed to be engaged in the
practice of pharmacy:

      (1) Persons who publicly profess to be a pharmacist, or publicly pro-
fess to assume the duties incident to being a pharmacist and their knowl-
edge of drugs or drug actions, or both;

      (2) persons who attach to their name any words or abbreviation in-
dicating that they are a pharmacist licensed to practice pharmacy in Kan-
sas.

      (b) ``Practice of pharmacy'' means the interpretation and evaluation
of prescription orders; the compounding, dispensing and labeling of drugs
and devices pursuant to prescription orders; the administering of vaccine
pursuant to a vaccination protocol; the participation in drug selection
according to state law and participation in drug utilization reviews; the
proper and safe storage of prescription drugs and prescription devices
and the maintenance of proper records thereof in accordance with law;
consultation with patients and other health care practitioners about the
safe and effective use of prescription drugs and prescription devices; and
participation in the offering or performing of those acts, services, oper-
ations or transactions necessary in the conduct, operation, management
and control of a pharmacy. Nothing in this subsection shall be construed
to add any additional requirements for registration or for a permit under
the pharmacy act of the state of Kansas or for approval under subsection
(g) of K.S.A. 65-1643 and amendments thereto, or to prevent persons
other than pharmacists from engaging in drug utilization review, or to
require persons lawfully in possession of prescription drugs or prescrip-
tion devices to meet any storage or record keeping requirements except
such storage and record keeping requirements as may be otherwise pro-
vided by law or to affect any person consulting with a health care prac-
titioner about the safe and effective use of prescription drugs or prescrip-
tion devices.

      New Sec.  3. (a) A pharmacist may administer vaccine to a person 18
years of age or older pursuant to a vaccination protocol if the pharmacist
has successfully completed a course of study and training, approved by
the American council on pharmaceutical education or the board, in vac-
cination storage, protocols, injection technique, emergency procedures
and recordkeeping. A pharmacist who successfully completes such a
course of study and training shall maintain proof of completion and, upon
request, provide a copy of such proof to the board.

      (b) All vaccinees will be given a written immunization record for their
personal files. The administering pharmacist shall promptly report a rec-
ord of the immunization to the vaccinee's primary-care provider by elec-
tronic facsimile or mail. If the vaccinee does not have a primary care
provider, then the administering pharmacist shall promptly report a rec-
ord of the immunization to the person licensed to practice medicine and
surgery by the state board of healing arts who has entered into the vac-
cination protocol with the pharmacist. The immunization will also be re-
ported to appropriate county or state immunization registries.

      (c) A pharmacist may not delegate to any person the authority granted
under this act to administer a vaccine.

      (d) This section shall be a part of and supplemental to the pharmacy
act of the state of Kansas.

 Sec.  4. K.S.A. 1999 Supp. 65-1626 and 65-1626a are hereby re-
pealed.
 Sec.  5. This act shall take effect and be in force from and after its
publication in the statute book.

Approved April 19, 2000.
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