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How many members serve on the state board of pharmacy, and how long is each term of service? VV5 members 5 year term How many public members (non-pharmacists) and how many pharmacist members serve on the board of pharmacy? VV0 public members (non-pharmacists) 5 pharmacists What is the name of the agency that issues pharmacist licenses? / / Alabama Board of Pharmacy What is the minimum age to become a licensed pharmacist? V V19 years the applicant must be a citizen or legally present in the US with appropriate documentation from the federal govt What exams are required for pharmacist licensure? / YNAPLEX, MPJE, and a Board of Pharmacy interview How long does a pharmacist have to notify the board of a change in name, home address, or employer? v¥V10 days How often is the pharmacist license renewed? VV Every other year on even years (biennially or every 2 years) What are the CPE requirements for pharmacists (e.g., how many hours per renewal period, how long is the renewal period, are live hours required, any specific CPE topic requirements)? /V¥30 hours of CPE every 2 years 6 hours must be live If a pharmacist's license lapses, what action can be taken to reinstate the license? V V License lapsed 1 to <5 years: shall provide documentation of completion of 15 hours of CPE for each lapses calendar year Licensed lapsed >5 years: satisfactory examination by the Board and any amount of CPE deemed appropriate What are the requirements to become a nuclear pharmacist? / /minimum of 200 hours of formal didactic training on the handling of radioactive material with a certificate and a course outline from an accredited college of pharmacy (or other program recognized by the State of Alabama Department of Public Health, Radiological Health Branch and the Alabama Board of Pharmacy) a minimum of 500 hours of on-the-job type training (e.g., radiopharmacy internship) under the supervision of a licensed nuclear pharmacist What are the requirements to serve as a pharmacist preceptor? /V1) must have been licensed to practice pharmacy for a minimum of 2 years 2) must attend of Board-approved training seminar for preceptors at least once every renewal cycle or be approved by the School of Pharmacy for curriculum hours Are there different levels of pharmacy technicians based on certification or training? VV No Are exams or certifications required for all technicians? V VNo required exams or certifications, but there is required training all technicians receiving their initial registration on or after January 1, 2020, must complete a board- approved training program within the first 6 months after registration and submit evidence of completion to the board within 10 days of completion What is the ratio of technicians for each pharmacist in a community/hospital setting? / /3 technicians to 1 pharmacist 1 technicians shall be certified by any credentialing organization approved by the Board additional technicians may be employed to perform supervised tasks not requiring professional judgement Are there requirements for pharmacy staff identification badges? VV All technicians shall wear a name tag, identifying them as such, while on duty What organization operates the impaired pharmacist recovery program? VV Alabama Board of Pharmacy the program is called the Board of Pharmacy Wellness Program (BOPWELLNESS) What healthcare professionals can enroll in the state's impaired pharmacist recovery program? vJ/Pharmacists, interns, and pharmacy technicians Can a healthcare professional self-enroll in the impaired pharmacist recovery program? V/Yes Are mail-order pharmacy's hours and/or toll-free number required to be listed on the prescription container labeling? / /Yes, a toll-free telephone number is required Are mail-order pharmacies required to be open for a defined number or days and hours per week? v J No, but the hours must permit the timely dispensing of drugs to Alabama patients and provide reasonable access for the Alabama patient to consult with a licensed pharmacist about their medications Does the board require a specific inspection/assessment form to be used by pharmacists? //No Are licenses required to be displayed in public view? VV Yes What are the space and/or equipment requirements for a pharmacy (e.g., pharmacy size, hot/cold water, compounding equipment, references)? V V1) a retail pharmacy shall not be less than 240 square feet 2) the surface of the prescription compounding counter shall not be less than 24 inches in width and not less than 16 square feet of unobstructed working space for one pharmacist and not less than 24 square feet of total working space where two or more pharmacists will be on duty at any time 3) the aisle space or floor area to be occupied by a dispensing pharmacist shall extend the full length of the prescription compounding counter, and it shall be clear and unobstructed for a minimum distance of 36 inches from the working side of the prescription compounding counter a label on the kit shall list the drug names, strengths, quantities, kit expiration date, and the name, address and telephone number of the supplying pharmacist when an emergency kit is opened, the pharmacist shall stock and reseal the kit within a reasonable timeframe, but not more than 72 hours What are the regulations for pharmacist breaks or the maximum break duration? V Va pharmacist can have a break or meal period for up to 30 mins the pharmacist must remain within the facility during breaks in case of an emergency During a pharmacist break, does a sign need to be posted that the pharmacist is not on duty? VVYes What intern/technician functions can be done without the presence of a pharmacist? VV Non- discretionary duties including transactions for refill medications that the pharmacist has checked, released for furnishing to the patient and determined not to require consultation by the pharmacist Are there any limitation of medication delivery (by couriers, pharmacy employees, or by kiosk)? /W No Are there any limitations to drive-up windows? / No Does the state recognize pharmacists as providers for reimbursement purposes? //Yes Does a collaborative practice agreement (CPA) need to be submitted to the board? V/Vyes the CPA must be submitted to both the Board of Pharmacy and the Alabama Board of Medical Examiners within 10 days after the CPA is signed by both parties How often does a collaborative practice agreement need to be renewed? VV Every 2 years What actions are pharmacists allowed to perform under a collaborative practice agreement (e.g., initiate, modify, monitor medications)? /VThe pharmacist may initiate, monitor, modify, and discontinue medications as authorized by the collaborating physician pursuant to the agreement Are there any restrictions on what disease a pharmacist can manage under a CPA? VV No Is every pharmacy required to have a pharmacist-in-charge? VV yes also referred to as a supervising pharmacist in Alabama Can a pharmacist serve as the supervising pharmacist (pharmacist-in-charge) at more than one pharmacy? / /No with the approval of the Board, a pharmacist may be permitting to serve as a supervising pharmacist of one pharmacy and also of an institutional pharmacy that is open less than 15 hours per week or of a non-institutional pharmacy that is open no more than the minimum number of hours allowed by the Board a new prescription can be filled for a maximum 30-day supply if written prior to the prescriber being deceased or retired an existing prescription can be refilled for a maximum 30-day supply Can pharmacists fill prescriptions written by prescribers in other countries? VV the Alabama Board of Pharmacy does not specify if it is acceptable to fill prescriptions written by prescribers of another country How many years must prescription records be kept? V/V 2 years Within what time frame from the issue date are non-controlled prescriptions permitted to be refilled? v Vthere is no expiration date for a prescription for any non-controlled, legend drug Is there a maximum number of refills permitted for non-controlled drugs? //No What is the maximum days' supply that can be dispensed for an emergency fill of non-controlled drugs without prescriber authorization? / V72-hour supply What are the additional restrictions when dispensing an emergency refill of a non-controlled drugs without prescriber authorization (e.g., time period to receive a prescription, notification of the prescriber)? WY /1) the medication is essential to the maintenance of life or the continuation of therapy in a chronic condition 10 2) the dispensing pharmacist created a written order containing all of the required prescription information 3) the dispensing pharmacist notifies the prescriber of the emergency dispensing within 72 hours What information is required to be ona prescription container label? Y V1) name and address of the dispensing pharmacy 2) serial or prescription 3) date of the prescription 4) name of the prescriber 5) name of the patient 6) name and strength of the drug 7) directions for use 8) appropriate cautionary statements, such as "caution, federal law prohibits dispensing without a prescription" and "do not take with food" 9) the expiration or discard date 10) "filled by" or "dispensed by" with at least the first initial and last name of the dispensing pharmacist Is it required to provide a larger type size on the container label for patients with visual impairment? VV/No Are patient profiles required to be kept in the pharmacy for all patients (e.g., a traveling patient on vacation getting a one-time fill)? VV Yes How long must patient profiles be kept after the last fill? V /Not addressed in Alabama law 11 What are the counseling requirements or medications delivered to the patient or sent by mail? //mail- order prescriptions must have a toll-free telephone number to call where a patient can speak with a pharmacist who has access to their records the telephone number must be placed on the label that is attached to the drug container Are pharmacies required to provide translation services to limited-English proficient (LEP) patients? VVNo What are the requirements for generic substitution (e.g., must notify the patient)? / /generic substitution is permitted if authorized by the prescriber by signing the prescription onthe "product selection permitted" signature line patient consent is not required for generic substitution in Alabama no cost saving pass-on requirement is mentioned in the Alabama law What resource(s) can be used to select a suitable substitution (e.g., Orange Book, state formulary)? Vv VJthe Orange Book What actions can be taken by the prescriber or patient to prevent generic interchange? VV the prescriber must expressly indicated that substitution is not allowed by signing the "dispense as written" signature line rather than the "product selection permitted" line 13 What documentation is required when a generic substitution occurs? / Vthe pharmacist shall record on the prescription form the name and manufacturer or distributor of any drug product dispensed oral prescription shall instruct the pharmacist whether generic substitution is acceptable and the pharmacist shall note the instructions on the file copy of the prescription Are there any drugs (e.g., narrow therapeutic index) that cannot be substituted? V/No Does the state have a conscience clause (if so, what are the stipulations of the clause, or what drugs does it specifically apply to)? VV Alabama Act 2017-189 states that a healthcare provider has the right not to participate in services that violate their conscience as long as the provider has objected in writing at least 24 hours prior to being asked to provide such services Does the state have death with dignity laws? /Wno Does the state have stricter requirements for compounding than federal requirements? //no Can out-of-state pharmacies compound drugs for dispensing to patients in this state? / /not addressed in the Alabama Law Does the state have specific requirements for labeling compounded products? / /No the label requirements are standard and include: the name and strength of the finished product, quantity dispensed, date, beyond use date, lot or batch number and name/address of pharmacy 14 Certified nurse midwives can prescribed schedule |II-V medications if they hold an active QACSC and are working under a collaborative practice agreement. Optometrists can prescribe schedule III-V controlled substances. List the schedules of drugs collected in the state's prescription drug monitoring program (PDMP). v J mandatory reporting of schedules II-V On what schedule must the pharmacy submit the records of dispensed controlled substances to the state's PDMP? V VDaily Which healthcare professionals are authorized to access the prescription drug monitoring program (PDMP)? VV Authorized representations of the certifying boards, licensed practitioners (with authority to prescribe, dispense, or administer controlled substances), designated employees of licensed physician, license certified registered nurse practitioner, licensed certified nurse midwives and licensed assistants to physicians who are authorized to prescribe, dispense, or administer controlled substances, licensed pharmacists, and authorized representatives of the Alabama Medicaid Agency Can controlled and non-controlled drugs be written on the same prescription form? / /not addressed in the Alabama law Is there a limit to the number of medications that can be written on one prescription form? VV not addressed in Alabama law Other than prescriptions for Medicaid patients, do any prescriptions require tamper-resistant security forms? /VNo 16 What security elements must be present on tamper-resistant security forms? VV follows federal requirement -- one of each of the following security elements 1) one or more features designed to prevent unauthorized copying of a completed or blank prescription form 2) one or more features designed to prevent the erasure or modification of information written on the prescription by the prescriber 3) one or more features designed to prevent the use of counterfeit prescription forms What changes can be made, at the pharmacist's discretion, to schedule II prescriptions? V /there are no direct rulings in Alabama Pharmacy Statues. Based on the DEA diversion website, a pharmacist may change or add the dosage form, drug strength, drug quantity, direction for use, or issue date only after consultation with and agreement of the prescribing practitioner. Dates for prescriptions that are dated for later fill may not be changed even after consultation with and permission of the prescribing physician. What changes can be made, at the pharmacist's discretion, to schedule Ill-V prescriptions? V/V The pharmacist may add or change the patient's address upon verification. The pharmacist may add or change the dosage form, drug strength, drug quantity, directions for use, or issue date after consultation with the prescriber. 17 How long are refilled valid for schedule III-V prescriptions? V /Schedule Ill-IV: expire 6. months after the written date on the prescription of after 5 refills, whichever comes first Schedule V: no expiration date What is the maximum number of refills allowed for schedule III-V substances? VV Schedule III and IV can be refilled up to 5 times Can a pharmacist provide an emergency filling of schedule IlI-V drugs without the prescriber's authorization? / /Schedule III: no Scheduled |V and V: yes What is the maximum days' supply that can be dispensed for an emergency refill of schedule IV and V drugs without prescriber authorization? / /72 hour supply What are additional restrictions when dispensing an emergency refill of a schedule IV and V drugs without prescriber authorization (e.g., time period to receive a prescription, notification of the prescriber)? / V1) the medication must be essential to the maintenance of life or the continuation of therapy in a chronic condition 2) the dispensing pharmacist must create a written prescription order containing all of the prescription information required by law 3) the dispensing pharmacist must notify the prescriber orally or in writing within 72 hours of the emergency dispensing 19 What controlled drug schedules require identification for dispensing (e.g., schedule II only)? v Videntification is required for schedule II prescriptions if the patient is unknown to the pharmacy staff Are pharmacists permitted to sell select schedule V cough syrups without a prescription? / /No Is naloxone distribution by a pharmacist permissible in all situation, or is it pursuant to a standing order, a protocol, or authorization from a prescriber? ¥ Vit is permissible under a standing order which can be downloaded from the Alabama Department of Public Health website or with a prescription from a healthcare provider What requirements must the pharmacist meet in order to furnish naloxone under the protocol (e.g., training program)? ¥V Vno training program is mentioned in the Alabama law must follow the standing order from the state Does the state allow pharmacists to furnish emergency contraception? /WNo What are the requirements and quantity limits for selling pseudoephedrine? ¥ V follows federal law except: 1) cannot purchase more than 7.5 grams/30 days 2) must be at least 18 years old to purchase 3) purchase information must be logged into the National Precursor Log Exchange (NPLEx) before completing the sale 4) products cannot be soldif a "stop sale" alert is generated by NPLEx 20 
