GENERAL GOVERNMENT
CABINET
Board of Pharmacy
(As Amended at ARRS,
November 10, 2015)
201 KAR 2:220. Collaborative care
agreements.
RELATES TO: KRS 315.010(4), 315.121,
315.040(4), 315.191(1)(a)
STATUTORY AUTHORITY: KRS 315.191(1)(a)
NECESSITY, FUNCTION, AND CONFORMITY: KRS
315.191(1)(a) authorizes the Board of Pharmacy to promulgate administrative
regulations to regulate and control matters relating to pharmacists, pharmacist
interns, pharmacy[pharmacist] technicians, pharmacies, wholesale
distributors, and manufacturers. This administrative regulation
establishes minimum requirements for the development and maintenance of
collaborative care agreements between[an individual] pharmacist and[an
individual] practitioner.
Section 1. A collaborative care agreement
shall:
(1) Be in writing;
(2) Be signed and dated by[the]:
(a) Each[Individual]
practitioner; and
(b) Each[Individual]
pharmacist who is a party to the agreement;[and
(c) Patient or care giver;]
(3) Provide the method for referral of
patients to be managed under the agreement[that upon termination of the
agreement the individual practitioner or individual pharmacist shall notify the
patient in writing]; and
(4) State the method for termination of
the agreement[; and
(5) Contain the information
specified by Section 2 of this administrative regulation].
Section 2. The following information
relating to a patient managed under the collaborative care agreement shall be
maintained by the pharmacist[A collaborative care agreement shall
contain the following information]:
(1) [Patient]Name;
(2) [Patient]Address and phone[telephone]
number;
(3) Emergency notification contact[Protocol,
criteria, standing orders, or other method by which services are authorized];
(4) Date of birth, weight, height, and
gender;[The method established for the assessment of patient outcomes,
if appropriate; and]
(5) Medical history, including:
(a) Known diseases;
(b) Known allergies;
(c) Reactions and conditions relating
to:
1. Prescription medications; and
2. Nonprescription medications;
(d) Current prescription regimen; and
(e) Current nonprescription regimen;
(6) Lab tests ordered, including
results of lab tests;
(7) Assessment of patient outcomes;[and]
(8) Notes relating to the care and
course of therapy of the patient; and
(9) Documentation of patient
consent to receive care under the collaborative care agreement[Lab
tests that may be ordered].
Section 3. Documentation[Notes]
relating to the care and course of therapy of the patient pursuant to
the agreement[The following information relating to a collaborative
care agreement shall be maintained by a pharmacist][and] shall
be documented in the patient’s record maintained by the pharmacist, provided
to the collaborating practitioner, and be readily available to other
healthcare professionals providing care to the patient[:
(1) Emergency notification contact;
(2) Date of birth, weight, height, and
gender;
(3) Prescription regimen;
(4) Nonprescription regimen;
(5) Medical history; including:
(a) Known diseases;
(b) Known allergies; and
(c) Reactions and conditions relating
to:
1. Prescription regimens; and
2. Nonprescription regimens;
(6) Lab tests ordered, including
results of lab tests;
(7) Assessments of patient outcomes;
(8) Notes relating to contacts between
the individual pharmacist and the individual practitioner concerning the care
and course of therapy of the patient; and
(9) Documentation of the specific
counseling information provided to the patient or care giver].
Section 4. A collaborative care
agreement shall comply with KRS 315.010(4) and contain
the following information:
(1) Protocol, criteria, standing
orders, or other method by which services are authorized;
(2) The method established for the
assessment of patient outcomes, if appropriate; and
(3) Lab tests that may be ordered.
Section 5. A collaborative care
agreement and information and records required by the provisions of this
administrative regulation[,] shall be maintained:
(1) At the pharmacist’s practice site; and
(2) For at least five (5) years after
termination.
JOEL THORNBURY, President
APPROVED BY AGENCY: October 15, 2015
FILED WITH LRC: October 15, 2015 at 4
p.m.
CONTACT PERSON: Steve Hart, Executive
Director, Kentucky Board of Pharmacy, State Office Building Annex, Suite 300,
125 Holmes Street, Frankfort, Kentucky 40601, phone (502) 564-7910, fax (502)
696-3806.