1. United States Public Health Service -National Clinical Pharmacy Specialist (NCPS) Presentation prepared 9-9-15 Presentation prepared by: CDR Anne Marie Bott, LCDR Jinny Meyer, LCDR John Collins, and LCDR Randy Steers

2. National Clinical Pharmacy Specialist (NCPS) What is NCPS? – A national certification recognizing pharmacists privileged at the local level to perform duties in expanded clinical roles.

3. Background The October 18, 1996 memorandum from the Indian Health Service (IHS) Director established IHS pharmacists as primary care providers (PCPs) and allowed for privileges to include prescriptive authority. Clinical pharmacy specialist (CPS) is included in the IHS definition of a PCP for the purposes of workload reporting, program planning, and reimbursement from all third party payers. http://www.ihs.gov/IHM/index.cfm?module=dsp_ihm_sgm_main&sgm=ihm_sgm_9602

4. Background (2 of 3) The National Clinical Pharmacy Specialist Committee (NCPSC) was established by the Chief Pharmacy Officer (CPO) in 1997 to provide a mechanism to assure that all IHS NCPSs display a uniform level of competency.

5. Background (3 of 3) NCPS Certification Expands Beyond IHS 2008 – Bureau of Prison (BOP) – Memorandum of understanding (MOU) established collaboration between the IHS and BOP pharmacy programs to include recognition of BOP pharmacists as NCPS certified. 2013 – All USPHS agencies – At the request of the USPHS CPO, NCPS pharmacy certification was extended to encompass all USPHS pharmacists regardless of agency.

6. Objectives of NCPS Committee Promote and recognize evidence-based clinical competency of USPHS pharmacists on a national basis. Maintain standards of NCPS-defined advanced scopes of practice for USPHS pharmacists. Evaluate collaborative practice agreements (CPAs) to assure consistency with national NCPS criteria for certification. Serve as the body that reviews the credentials, training, education, and experience of applicable pharmacists and grant NCPS certifications. Serve as a resource for local facilities seeking to develop and implement a pharmacy-based CPA.

7. NCPS Certification by the Numbers Total Certifications - 689 Active Certifications-483 Total Pharmacists-489 Active Pharmacist-347 Data updated 6/2/2015

8. NCPS Certifications by Disease State Data updated 6/2/2015

9. NCPS Certifications by Area Data updated 6/2/2015, Pharmacist may hold multiple certifications in differing disease states

10. NCPS Outcomes Phase I – Mandatory outcomes reporting – Implemented January 2013 Phase II – Standardized reporting by disease state – Implemented in stages Tobacco Cessation: May 2015 Anticoagulation: August 2015 Others: TBA

11. Applicant Review NCPS Application Current state pharmacy license Evidence of 2 years at facility, 1 year practicing as a CPS at local facility Current continuing education hours Letter of attestation from applicant’s NCPS or physician supervisor Postgraduate documents (at least 1 of the 5) – Residency certificate – Specialty board certification – Clinician’s license (state) – Disease state management certificate – Narrative detailing clinical experience

12. Applicant Review (Continued) Copy of pharmacist’s disease state management protocol/ CPA – Critical elements within protocol/CPA Pharmacists are authorized to: – Order and interpret labs – Perform limited physical assessment – Prescribe (initiate, modify, and discontinue) medications per protocol Evidence of local medical staff approval Evidence of 30 charts reviewed with the past 12 months Outcomes submitted

13. Impact on USPHS Pharmacy Practice Advancing the profession of pharmacy through – innovative clinical disease state management clinics. – credentialing, privileging, and inclusion of pharmacists on medical staff. Improving patient access to quality care – clinics available across 2 agencies in over 100 hospitals and clinics throughout 29 states. Initiating mandatory submission of clinical outcomes to the NCPSC for collection and analysis. Developing a library of disease state management protocols/CPAs that standardize and further improve the quality of patient care. Established a system to recognize and formally certify the competency and expanded scope of clinical pharmacists on a national level.

14. NCPSC Membership The NCPSC has pharmacy and medical provider representation from IHS regions and BOP. *non-voting member NCPS Members Great PlainsAlaskaAlbuquerque BemidjiBillingsNashville NavajoOklahomaPhoenix PortlandBOP memberIHS Physician member BOP Physician memberData Analyst & Applications Coordinator* Ex-officio members*

15. NCPSC Contact Information Additional information about the NCPSC is located on the website: https://dcp.psc.gov/osg/pharmacy/ncps.aspx NCPSC Leadership – LCDR Jinny Meyer, Chair – CDR Anne Marie Bott, Chair-Elect – CDR Dana Springer, Secretary – LCDR John Collins, Data Analysts and Application Coordinator As of 6/2/2015

16. United States Public Health Service -National Clinical Pharmacy Specialist (NCPS) For more information: https://dcp.psc.gov/osg/pharmacy/ncps.aspx #USPHSPharmacy #USPHS #NCPS Presentation prepared by: CDR Anne Marie Bott, LCDR Jinny Meyer, LCDR John Collins, and LCDR Randy Steers