Opioid Focus & Membership Has Its Privileges Penny S. Shelton, PharmD, BCGP, FASCP Executive Director North Carolina Association of Pharmacists

Topics To Be Covered 1 NCAP key initiatives 2 Opioid-related education & training 3 Collaborative practice bill 2018 convention and specific member benefits 4

Key Initiatives Build awareness Create value About the Association & about the role of the pharmacist Getting Pharmacy to the Table Create value Focus on what is meaningful and brings value to members Generate a voice for the profession Establish partnerships Helping set policy Advocating legislation and regulation

Public Health Initiatives Naloxone dispensing CMS special innovation project Smoking cessation CDC resources project Pneumovax™ immunization 50-64 high risk population Opioid education, training and resources for pharmacists

Opioid-related education and training Topic 2 Opioid-related education and training

NCAP Opioid Educational Initiative 2 Advanced Regional Workshops Use of Collaborative Practice Agreements Establishing Pain Contracts Establishing permanent drop & takeback / Lock your meds Establishing a syringe sells/ exchange service Work w/MDs to estab MAT SBIRT 1 Fundamental Modules Online Naloxone Eligible Candidates Chronic Pain & Addiction CDC Guidelines CSRS & Pharmacist’s Responsibility Safety, Disposal & Syringe Exchange Treatment of opioid substance use disorders 3 Certificate Level Recovery Specialist Recovery Coach Inter-Professional MAT Training

Collaborative practice bill Topic 3 Collaborative practice bill

How is collaborative practice authorized in North Carolina? Clinical pharmacist practitioner statute which was enacted in 1998. CURRENTLY: Gives certain pharmacists ability to engage in collaborative practice in which physicians can authorize the pharmacist to perform drug therapy management which includes --implementation of predetermined drug therapy --modification of prescribed drug dosages, dosage forms, and dosage schedules; and --ordering tests pursuant to a “physician, pharmacist, patient and disease specific” written agreement.

What is the state of CPP utilization in NC? 12,000 pharmacists, work & reside 193 active CPPs Vast majority HS/Clinic Vast majority of CPPs are in urban areas Closely aligns w/ health systems Few are located: East of Wake County Rural areas of the State Community 26

Pharmacists Current State of Health Care Highly educated Rapidly Increasing 65+ Population Growing Chronic Disease Burden Current State of Health Care NC to have 2nd largest nursing shortage by 2025 US Dept HHS projected physician shortage by 2020 NGA, CDC and CMS all in the past few years have put out statements or reports calling for greater utilization of pharmacists, the advancement of pharmacists in direct patient care and a call for practicing to the fullest of their degree. What else do we have? Highly educated Highly accessible Greatly underutilized resource Pharmacists

Draft Legislation to Update NC CPA Bill—entitled “An act to improve access to health care via collaborative practice agreements between physicians and pharmacists” Purpose—"Update and enhance the current collaborative practice statutes pertaining to the clinical pharmacist practitioner to reduce restrictions, improve access to care, and facilitate collaboration between physicians and pharmacists in all practice settings.”

Collaborative Practice Enhancement CPA pioneer in 1990’s—NC CPA statute pre-dates All-PharmD and Medicare Part D Landscape of pharmacy has changed significantly in 2 decades. At the time a number of concessions were made to enable pharmacists to provide collaborative care Our work we have been engaged in is seeking to: Remove a number of the barriers which prohibit or create hurdles to collaborative care Allow any physician and pharmacist in good standing to be able to engage in collaborative care Seeking to remove the physician, pharmacist, patient and disease specific language Allow NPs and PAs in practice with a physician to engage in a collaborative practice agreement Seeking to change the process from an approval process to more of a registry process Seeking to enable groups or institutions to create a single agreement for a service Seeking to allow the MD to determine how many pharmacists can be supervised per agreement

Grass Roots: Collaborative Practice Use of Video Vignettes Use of Social Media & Muster Platform Targeted Writing Campaign (Virtual Legislative Day) MD & Pharmacist Teams Visits w/ legislators Pharmacist & Stakeholder Support Draft Bill Content Simple Talking Points What CPA is Why change is needed How patients benefit

Topic 4 2018 Convention and specific member benefits

New NCAP Technologies

New Private & Public Online Communities

On-Demand CE

Member Benefit Partners

STANDING MEMBERSHIP CORPORATE RATE FOR NOVANT Pharmacists $155 ($40 or ~20% savings off membership rate of $195) PROMO CODE CHERYL18 Go online to www.ncpharmacists.org and use the appropriate promo code or call 984-439-1646 for assistance

158 members @ discounted rate just to support …. $ 4.25 158 members @ discounted rate just to support …. $ 2.98/wk ~12,000 actively licensed pharmacists in NC NCAP < 1,000 $ 4.25