A BILL TO BE ENTITLED
AN ACT to protect the public's HEALTH by increasing access to immunizations and vaccines through the expanded role of immunizing pharmacists.
The General Assembly of North Carolina enacts:
SECTION 1.  G.S. 90‑85.3(r) reads as rewritten:
"(r)	"Practice of pharmacy" is as specified in G.S. 90‑85.3A."
SECTION 2.  Article 4A of Chapter 90 of the General Statutes is amended by adding a new section to read:
"§ 90‑85.3A.  Practice of pharmacy.
(a)	A pharmacist is responsible for interpreting and evaluating drug orders, including prescription orders; compounding, dispensing, and labeling prescription drugs and devices; properly and safely storing drugs and devices; maintaining proper records; and controlling pharmacy goods and services.
(b)	A pharmacist may advise and educate patients and health care providers concerning therapeutic values, content, uses, and significant problems of drugs and devices; assess, record, and report adverse drug and device reactions; take and record patient histories relating to drug and device therapy; monitor, record, and report drug therapy and device usage; perform drug utilization reviews; and participate in drug and drug source selection and device and device source selection as provided in G.S. 90‑85.27 through G.S. 90‑85.31.
(c)	A pharmacist who has received special training may be authorized and permitted to administer drugs pursuant to a specific prescription order in accordance with rules adopted by each of the following: The Board of Pharmacy, the Board of Nursing, and the North Carolina Medical Board. The rules shall be designed to ensure the safety and health of the patients for whom such drugs are administered.
(d)	An approved clinical pharmacist practitioner may collaborate with physicians in determining the appropriate health care for a patient, subject to the provisions of G.S. 90‑18.4.
(e)	A pharmacist who (i) holds a current provider level cardiopulmonary resuscitation certification issued by the American Heart Association or the American Red Cross, or an equivalent certification, (ii) has successfully completed a certificate program in vaccine administration accredited by the Centers for Disease Control and Prevention, the Accreditation Council for Pharmacy Education, or a similar health authority or professional body approved by the Board, (iii) maintains documentation of three hours of continuing education every two years, designed to maintain competency in the disease states, drugs, and vaccine administration, and (iv) has successfully completed training approved by the Division of Public Health's Immunization Branch for participation in the North Carolina Immunization Registry may administer any vaccine or immunization recommended or required by the Centers for Disease Control and Prevention, including a vaccine for travel outside the United States, subject to the following limitations and requirements:
(1)	A pharmacist may administer a vaccine or immunization to a minor who is at least seven years of age, but less than 14 years of age, only (i) pursuant to a specific prescription order and (ii) at the request of the minor's parent, guardian, or person standing in loco parentis to the minor.
(2)	A pharmacist may administer a vaccine or immunization without a specific prescription order to a minor who is at least 14 years of age, but less than 18 years of age, only at the request of the minor's parent, guardian, or person standing in loco parentis to the minor.
(3)	A pharmacist may administer a vaccine or immunization without a specific prescription order to any patient 18 years of age or older, at the patient's request.
(4)	A pharmacist who administers a vaccine or immunization to any patient pursuant to this subsection shall do all of the following:
a.	Maintain a record of any vaccine or immunization administered to the patient in a patient profile.
b.	If the patient has identified a primary care provider, notify the patient's primary care provider of any vaccine or immunization administered to the patient within 24 hours after administration.
c.	Record any vaccine or immunization administered to the patient in the North Carolina Immunization Registry within 24 hours after administration."
SECTION 3.  G.S. 130A‑153 reads as rewritten:
"(a)	The required immunization may be obtained from a physician licensed to practice  medicine; a local health department; or a pharmacist, in accordance with the provisions of G.S. 90‑85.3A(e). Local health departments shall administer required and State‑supplied immunizations at no cost to uninsured or underinsured patients with family incomes below two hundred percent (200%) of the federal poverty level. A local health department may redistribute these vaccines only in accordance with the rules of the Commission.
(b)	Local health departments shall file monthly immunization reports with the Department. The report shall be filed on forms prepared by the Department and shall state, at a minimum, each patient's age and the number of doses of each type of vaccine administered.
(c)	Immunization certificates and information concerning immunizations contained in medical or other records shall, upon request, be shared with the Department, local health departments, a pharmacist administering the required immunization in accordance with G.S. 90‑85.3A(e), and the patient's attending physician. In addition, an insurance institution, agent, or insurance support organization, as those terms are defined in G.S. 58‑39‑15, may share immunization information with the Department. The Commission may, for the purpose of assisting the Department in enforcing this Part, provide by rule that other persons may have access to immunization information, in whole or in part.
(d)	A physician, pharmacist, or local health department may immunize a minor with the consent of a parent, guardian, or person standing in loco parentis to the minor. A physician, pharmacist, or local health department may also immunize a minor who is presented for immunization by an adult who signs a statement that he or she is authorized by a parent, guardian, or person standing in loco parentis to the minor to obtain the immunization for the minor. Notwithstanding any other provision of this Chapter, a pharmacist's authority to administer vaccines or immunizations to a minor is limited to the authority specified in G.S. 90‑85.3A(e)."
SECTION 4.  G.S. 130A‑154(a) reads as rewritten:
"(a)	A physician, pharmacist, or local health department administering a required vaccine shall give a certificate of immunization to the person who presented the child for immunization. The certificate shall state the name of the child, the name of the child's parent, guardian, or person responsible for the child obtaining the required immunization, the address of the child and the parent, guardian or responsible person, the date of birth of the child, the sex of the child, the number of doses of the vaccine given, the date the doses were given, the name and address of the physician, pharmacist, or local health department administering the required immunization and other relevant information required by the Commission."
SECTION 5.  This act becomes effective October 1, 2011.