Relating to the regulation of pharmacists and the practice of pharmacy, including the administration of a medication and the ordering and administration of an immunization or vaccination by a pharmacist.

89(R) HB 3540 - Engrossed version - Bill Text

89R27007 DNC-F

By: Harless, Howard, Darby

H.B. No. 3540

A BILL TO BE ENTITLED

AN ACT

relating to the regulation of pharmacists and the practice of

pharmacy, including the administration of a medication and the

ordering and administration of an immunization or vaccination by a

pharmacist.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Section 551.003(33), Occupations Code, is

amended to read as follows:

(33) "Practice of pharmacy" means:

(A) providing an act or service necessary to

provide pharmaceutical care;

(B) interpreting or evaluating a prescription

drug order or medication order;

(C) participating in drug or device selection as

authorized by law, and participating in drug administration, drug

regimen review, or drug or drug-related research;

(D) providing patient counseling;

(E) being responsible for:

(i) dispensing a prescription drug order or

distributing a medication order;

(ii) compounding or labeling a drug or

device, other than labeling by a manufacturer, repackager, or

distributor of a nonprescription drug or commercially packaged

prescription drug or device;

(iii) properly and safely storing a drug or

device; or

(iv) maintaining proper records for a drug

or device;

(F) performing for a patient a specific act of

drug therapy management delegated to a pharmacist by a written

protocol from a physician licensed in this state in compliance with

Subtitle B; [
or
]

(G)
ordering or
administering an immunization or

vaccination
subject to Section 554.052(c-1); or

(H)

administering an immunization or

vaccination, other than an immunization or vaccination as

authorized under Section 554.052(c-1), to a patient under a

protocol or prescription from a licensed health care provider

[
under a physician's written protocol
].

SECTION 2. The heading to Section 554.004, Occupations

Code, is amended to read as follows:

Sec. 554.004. ADMINISTRATION OF MEDICATION
; ORDERING AND

ADMINISTRATION OF IMMUNIZATION OR VACCINATION
.

SECTION 3. Section 554.004, Occupations Code, is amended by

amending Subsection (a) and adding Subsections (a-1) and (a-2) to

read as follows:

(a) The board shall specify conditions under which a

pharmacist may administer medication
and order or administer
[
,

including
] an immunization
or
[
and
] vaccination. The conditions

for ordering or administering an immunization or vaccination
must

ensure that:

(1) [
a licensed health care provider authorized to

administer the medication is not reasonably available to administer

the medication;

[
(2)

failure to administer the medication, other than

an immunization or vaccination, might result in a significant delay

or interruption of a critical phase of drug therapy;

[
(3)
] the pharmacist possesses the necessary skill,

education, and certification as specified by the board to
order or

administer the
immunization or vaccination
[
medication
];

(2) not later than the third business day
[
(4)

within

a reasonable time
] after administering
an immunization or

vaccination
[
medication
], the pharmacist notifies the licensed

health care provider responsible for the patient's care that the

immunization or vaccination
[
medication
] was administered;

[
(5)

the pharmacist may not administer medication to a

patient at the patient's residence, except at a licensed nursing

home or hospital;

[
(6)

the pharmacist administers an immunization or

vaccination under a physician's written protocol and meets the

standards established by the board;
] and

(3)
[
(7)
] the authority of a pharmacist to administer

an immunization or vaccination
[
medication
] may [
not
] be delegated

to a certified pharmacy technician who possesses the necessary

skill, education, and certification as specified by the board to

administer the immunization or vaccination
.

(a-1)

A pharmacist satisfies the notice requirement of

Subsection (a)(2) if the immunization or vaccination administered

by the pharmacist is recorded in the immunization registry

maintained by the state.

(a-2)

A pharmacist shall inform the child receiving an

immunization or vaccination and the adult caregiver accompanying

the child of the importance of an annual well-child visit with a

pediatrician or other licensed primary health care provider.

SECTION 4. Sections 554.052(a), (b), (c), and (c-1),

Occupations Code, are amended to read as follows:

(a) The board by rule shall require a pharmacist to notify a

physician who prescribes an immunization or vaccination
not later

than the third business day
[
within 24 hours
] after
the date
the

pharmacist administers the immunization or vaccination.
A rule

adopted under this subsection must provide that a pharmacist

satisfies the notice requirement if the immunization or vaccination

is recorded in the immunization registry maintained by the state.

(b) The board shall establish minimum education and

continuing education standards for a pharmacist who
orders or

administers an immunization or vaccination. The standards must

include
federal
Centers for Disease Control and Prevention

training, basic life support training, and hands-on training in

techniques for administering immunizations and vaccinations.

(c) Supervision by a physician is adequate if the delegating

physician:

(1) is responsible for formulating or approving an

order or protocol, including the physician's order, standing

medical order, or standing delegation order, and periodically

reviews the order or protocol and the services provided to a patient

under the order or protocol;

(2) [
except as provided by Subsection (c-1), has

established a physician-patient relationship with each patient

under 14 years of age and referred the patient to the pharmacist;

[
(3)
] is geographically located to be easily

accessible to the pharmacy where an immunization or vaccination is

administered;

(3)
[
(4)
] receives, as appropriate, a periodic status

report on the patient, including any problem or complication

encountered; and

(4)
[
(5)
] is available through direct

telecommunication for consultation, assistance, and direction.

(c-1) A pharmacist may
order or
administer [
an influenza

vaccination
] to a patient
who is at least:

(1)

three years of age an influenza immunization or

vaccination and SARS-CoV-2 immunization or vaccination; and

(2)

five years of age an immunization or vaccination

if the immunization or vaccination is:

(A)

authorized or approved by the United States

Food and Drug Administration or listed in the routine immunization

schedule recommended by the federal Advisory Committee on

Immunization Practices published by the federal Centers for Disease

Control and Prevention; and

(B)

ordered or administered in accordance with

the federal Advisory Committee on Immunization Practices

vaccine-specific recommendations
[
over seven years of age without

an established physician-patient relationship
].

SECTION 5. This Act takes effect immediately if it receives

a vote of two-thirds of all the members elected to each house, as

provided by Section 39, Article III, Texas Constitution. If this

Act does not receive the vote necessary for immediate effect, this

Act takes effect September 1, 2025.