New Practitioner Experience News Fall 2020

OPA New Practitioner Experience (NPX) Launchpad Fall 2020

Welcome to the NPX Launchpad

Welcome to the NPX Launchpad, the quarterly newsletter intended to help you, new practitioners, excel personally and professionally.

Check out our featured articles:

• Practitioner Profile featuring Megan Johnson
• Professional Pearls by Megan Stephan
• Rx Impact by Shibu Varughese
• Money Matters by Tim Church
• A Taste of Our Kitchen by Morgan E. Farthing
• Ohio Days by Brian Ly and Noah Searls 
  
• Committee Liaison Reports: updates to keep you in tune with the Association

We hope you enjoy the NPX Launchpad and we invite each of you to take the next step in your professional growth by getting involved with NPX today!

Sincerely, your NPX Advisory Committee,

Chair: Kristine Mason, PharmD, MS
Vice-Chair: Megan Johnson, PharmD
Member-at-Large: Marilee Clemons, PharmD, BCACP
Member-at-Large: Dustin Carneal, PharmD
Member-at-Large: Kay Hoopes, PharmD
Launchpad Coordinator: Megan Stephan, PharmD

Practitioner Profile

Megan Johnson, PharmD

What is your current position and where do you work?
I currently work as a clinical specialty pharmacist specializing in oncology at the Cooper Cancer Center in Akron, Ohio. I work for Trellis RX who is partnered with Summa Health System to provide specialty pharmacy services.  

Describe your career path.
I graduated from The Ohio State University in 2018 with my PharmD and pursued post-graduate training at The University of Toledo Medical Center. I completed my PGY-1 in Managed Care, Ambulatory Care, and Community Care at UTMC in 2019 and started my position as a clinical pharmacist with Trellis Rx in July of 2019.

Describe your involvement with NPX and OPA as a new practitioner.
I will be serving as the Vice-Chair of NPX for the 2020-21 year and transitioning into the Chair role in the spring of 2021.

What excites you the most about being a pharmacist/new practitioner?

 Continue Reading...

Professional Pearls

Navigating Career Changes During COVID-19
By Megan Stephan, PharmD

As a recent graduate of a PGY-1 residency with plans to find a career in ambulatory care, to say it has been difficult to find a clinical position during the coronavirus (COVID-19) pandemic is an understatement. With so many companies going on hiring freezes or scaling back their employees, it is terribly hard to find any open pharmacy position, let alone one that is in your desired pharmacy field. This is a time of uncertainty, but it will undoubtedly turn itself back around eventually. So what should you do in the meantime? Below are some ways to keep yourself busy, while also marketing yourself to future employers:

Continue Reading...

Rx Impact

The 340Big Impact
By Shibu Varughese, PharmD

How many times has a patient come up to you and stated they cannot afford their medications? Before this second year of pharmacy residency, I felt I heard that concern almost every day. Currently, I am having an amazing opportunity completing my PGY2 at a Federally Qualified Health Center (FQHC) and learning more about the 340B program.

What is 340B? In 1990, the Medicaid Drug Rebate Program was created by Congress and required drug manufacturers to extend rebates to state Medicaid programs for covered outpatient drugs. Shortly after in 1992, Congress also wanted to provide this relief to vulnerable uninsured/underserved patients much in the same way it was being provided to Medicaid under the Medicaid rebate law. Section 340B of the Public Health Service Act of 1992 requires participating drug manufacturers to provide discounts for outpatient drugs to certain safety-net providers called “covered entities.” The program’s purpose is not only assisting underserved patients in obtaining their medications, but also to use the savings available from the drug discounts to invest in developing more comprehensive patient services and ways to reach more eligible patients. At my health center site, two patient stories stand out to me showing the impact of 340B.

Continue Reading...

Money Matters

9 Financial Questions a Pharmacist Needs to Answer During the COVID-19 Pandemic
By Tim Church, courtesy of Your Financial Pharmacist

COVID-19 has had such a significant impact on the U.S. economy that an unprecedented $2 trillion stimulus package known as the Coronavirus Aid, Relief, and Economic Security or CARES Act was recently passed. From stimulus checks, suspended student loan payments, and the ability to tap into retirement accounts, it’s important to know how these changes can not only help you through a difficult time but also be advantageous even if your income hasn’t been affected.

In addition to the CARES Act, the Internal Revenue Service’s decision to extend the tax filing date presents some unique opportunities as well.

The following are some key questions you should be answering right now in the midst of the pandemic and with the recent federal legislative changes.

Continue Reading...

A Taste of Our Kitchen

From the kitchen of Morgan E. Farthing, PharmD, by Green and Keto

Mini Keto Cheesecake Bites

Servings: 6

Calories: 194 | Total fat: 18g | Saturated fat: 11g | Trans fat: 0g | Cholesterol: 79mg | Sodium: 179mg

Carbohydrates: 2g | Fiber: 0g | Sugar: 1g | Protein:4g

CHEESECAKE INGREDIENTS

• 8 oz cream cheese
• ½ cup sweetener
• 1 large egg
• ½ tsp vanilla extract
• ¼ tsp salt

CRUST INGREDIENTS

• ½ cup almond flour
• 1 tbsp sweetener
• ¼ tsp cinnamon
• Pinch salt
• 2 tbsp butter, melted

DIRECTIONS

1. Preheat oven to 300 °F. Grease a 6 cup muffin tin or fill with paper cupcake liners
2. In a small mixing bowl, stir together the dry crust ingredients. Once the mixture is uniform, add the melted butter and stir.
3. Place an equal amount of crust mixture into each muffin cup and press firmly until flat.
4. Bake the crust for 10-15 minutes (until beginning to brown). Remove from heat and allow to cool (~10 minutes) while you make the batter.
5. In a large mixing bowl, beat the cream cheese until smooth. Stir in the remaining cheesecake ingredients until well combined.
6. Pour an equal amount of cheesecake batter on top of each crust. Allow to bake for 18-20 minutes (center of cheesecake should jiggle a bit).
7. Remove from heat and allow to cool on the counter for 30 minutes. Cover and chill in the refrigerator.

*Top with fresh berries, jam, or strawberry puree if desired.

Ohio Days

Life in Southeastern Ohio
By Brian Ly, PharmD and Noah Searls, PharmD 

Southeastern Ohio is where nature's beauty meets southern hospitality.  Experience beautiful scenery from lakes and streams for fishing and kayaking to hills and fields for hiking and hunting. Participate in many outdoor activities including 5K runs, fairs, festivals, golfing, boating, camping and unique outdoor experiences like the Soaring Cliffs Zip Line. Southeastern Ohio hosts family events such as the Bob Evan’s Farm Festival in October and the outdoor light display “Lights in December” in Gallipolis. One of the most popular attractions for viewing nature and dining is the Hocking Valley Scenic Railway.  The area has several stopping points along the way to spend the night, including Big Rock Cabins, Pine Lakes Lodge, and Salt Fork Cabins. 

No matter the reason for your visit to southeastern Ohio, you will be welcomed with a culture of family and hospitality. Coming from a suburban hometown to Southeastern Ohio can be a big change in terms of rural cultural climate and society. Pharmacists will truly appreciate the welcoming nature of the community.

News & Upcoming Events

Soaring Online through October 26: OPA Annual Conference & Tradeshow, OPA2020Virtual

Don’t miss the biggest opportunity of the year to learn, network, and connect with colleagues during OPA’s first Virtual Annual Conference and Trade Show: OPA2020Virtual! You will experience cutting-edge CPE programming, engage with knowledgeable exhibitors, hear expert commentary on practice issues you face every day and return to your practice motivated and ready to implement improved services for your patients. Because this year’s event is completely virtual, you will have access to over 40 hours of on-demand CPE without having to choose between concurrent sessions! Be part of the one meeting in Ohio that includes programming of interest for all practice sites and engage with colleagues on issues across the spectrum of pharmacy practice.

From specialized programming to exciting competitions to leadership recognition, OPA2020Virtual has it all.

>>Register Now and Join the Excitement!<<

October 14, 12:15-12:45pm: NPX Lunch + Learn, "Outpatient Management of COPD"

Presented by Marilee Clemons, PharmD, BCACP
Dr. Clemons is the Lead Clinical Pharmacist at University of Toledo General Internal Medicine and Lecturer at University of Toledo College of Pharmacy and Pharmaceutical Sciences.

NPX is seeking individuals interested in giving a brief, thirty minute Zoom presentation over lunch. Presentations will be held on the second Wednesday of each month. Contact Kristine Mason at kamason09@gmail.com if you are interested in presenting!

September 24: APhA’s Diabetes Care Certificate Training Program

October 1: OPA Awards & Leadership Nomination Solicitations Deadline

October 21: OPF Pharmacist Immunization Training Program

November 8: Midyear Meeting- Save the Date!

December 2: Long-Acting Injectables Training Program

Committee Liaison Reports

Legal & Regulatory (June 11)
Liaison: E. Michael Murphy

The Legal and Regulatory Affairs Committee met on June 11^th to discuss legislation in the General Assembly and provide updates on current pharmacy issues. Discussions began with an update on issues related to the Ohio Department of Medicaid (supplemental dispensing fees, provider ID numbers, and COVID-19 policy changes) and the Ohio Board of Pharmacy (COVID-19 regulatory changes). Due to success of much of the regulatory changes involving pharmacists related to COVID-19 the Board has expressed interest in working to make much of the changes permanent.

Current bills in the General Assembly include:

Pharmacy Benefit Managers:

• HB 396: Pharmacy Benefit Managers: Impose comprehensive reforms on pharmacy benefit managers. OPA believes that while some of this bill is beneficial not all of it is and is working on another bill that carries forward the good components of this legislation
• HB 482/SB 263: 340B discriminatory contract: Prohibit a pharmacy benefit manager from taking certain actions with respect to reimbursements made to health care providers that participate in the federal 340B Drug Pricing Program. OPA expects this to be passed and signed into law

Drug Pricing:

• HB 385/SB 231: Insulin pricing: To require the Attorney General to investigate insulin pricing and prepare and submit a report. OPA is supportive of this but does not believe it will pass.
• HB 387/SB 232: Insulin copay: Cap cost-sharing for prescription insulin drugs. OPA is supportive of this but does not believe it will pass.
• HB 469: Copay accumulators: Prohibit certain health insurance cost-sharing practices (Would require PBMs to allow patients to use whatever payment they choose in order to pay for their medications)
• SB 97: Cost estimates health care: Would require that patients receive cost estimates prior to receiving certain services. OPA is supportive of this but does not believe it will pass.

Other Issues:

• HB 29: Dextromethorphan sales: Prohibit sales of dextromethorphan without a prescription to persons under age 18. OPA is now supportive of this bill
• HB 214: Drug label readers for blind: Would provide prescription drug readers for visually impaired patients. OPA is supportive of this but does not believe it will pass.
• HB 341: Addiction treatment drugs: Expand access to long-acting injectables. This has been passed by both chambers and is headed to the Governor
• HB 418: Medication switches: Prohibit plans from forcing a patient to switch therapy during the middle of the year after they are stabilized on therapy. OPA does not believe this will end up passing.
• HB 420: Emergency Rx refills: Increase the frequency at which a pharmacist may refill certain prescriptions on an emergency basis and to require health benefit plans to cover drugs dispensed in those situations
• SB 20: Drug disposal: Would require dispensing a “chemical composition for use in disposing any unused portion of the drug” (i.e., Deterra bag) when dispensing of controlled substances. OPA opposes this but does not believe it will pass.
• SB 59: Naloxone education: Require the State Board of Pharmacy to educate certain license holders about the law authorizing naloxone dispensing without a prescription. OPA is supportive of this and expects it will pass.
• SB 252: Prohibit fail first on cancer drugs: Prohibit "fail first" coverage of drugs used to treat stage four advanced metastatic cancer. OPA is supportive of this but the bill is not currently moving. There is a decent chance it may pass.
• SB 303: Consult agreement expansion: This is the top legislative priority for OPA. Has passed the Senate and is currently in the House Health Committee. It would expand types of tests pharmacists can order, can enter into with NP, PA, Nurse Midwives, CRNAs
• SB 308: Civil immunity for healthcare providers – Pharmacies are included in this, so as long as pharmacies are making a good faith effort to protect the public they are immune from civil lawsuit. OPA supportive of this bill.
• HB 679 – Allows providers to engage in telehealth services. Pharmacists not included in original draft and OPA is working with the senate to include language around pharmacists in this bill. OPA is supportive of this and believes it has a decent chance of passing

Provider Status Update:

• Federal: The American Medical Association is advocating against pharmacist provider status. OPA is working with national partners to assist in their advocacy work on including provider status language in future legislation
• State: Despite MCOs sharing interest in compensating pharmacists for their cognitive services, the Ohio Department of Medicaid (ODM) has been slow to update internal provider definitions and MCO contracts. Governor DeWine is now aware of this and has stated he will help to address this issue. Under ODM, MCOs have begun moving forward independently with programs to begin paying pharmacists for their clinical services.

The meeting concluded around discussion related to pharmacist ability to test and treat for flu and strep throat and if there is interest within the membership to pursue legislation in the General Assembly. Overall, it was a productive and informative committee meeting, and the first official committee meeting held over Zoom. There are plenty of opportunities to advocate for change with many current and future bills in the General Assembly.

Preparedness Task Force (June 25)
Liaison: Kelsey Schmuhl

The Practice Advancement and Innovation (PAI) Committee met virtually on June 25, 2020. The committee focused its conversation around current legislation and the implementation of provider status. 

Legislatively, OPA is working diligently to get things accomplished by the end of the calendar year. This is the last year of the general assembly, so any legislation not passed by the end of the year will be deleted from the books and has to be restarted.  OPA is currently tracking 40-50 bills. We focused on the following at the PAI meeting:

1. HB 341 – this bill would modify the existing long-acting injectable legislation. Specifically, it would delete “opioid antagonist” and replace it with any injectable medication for the treatment of opioid use disorder. For example, this would apply to the long acting injectable, Sublocade, which is an extended release buprenorphine injection.
2. HB 699 and 700 – this is a Vivitrol-focused initiative to expand access and streamline the process for pharmacists and even non-healthcare providers to administer Vivitrol. This legislation would also require a pharmacist to counsel on any new opioid prescription that is more than a 5-day supply. Language has been incorporated into the bill that would require the Dept. of Medicaid to make a billing code for pharmacists to do this.
3. SB 303 – The PAI Committee was joined by Senator Nathan Manning to discuss SB 303, which would expand upon the current collaborative practice law. Specifically, SB 303 would allow pharmacists to order any lab test rather than just blood and urine test and it would allow pharmacists to collaborate with physician assistants, nurse practitioners, nurse anesthetists, and nurse midwives. SB 303 passed out of the Senate unanimously and is now in the House.

On the provider status front, COVID-19 has allowed OPA to build a narrative around pharmacists being paid for clinical services.  It became clear that failure to implement provider status was holding up COVID-19 testing by pharmacists and that if the state wanted pharmacists to provide these services, there needed to be an incentive. The urgency around the need for COVID-19 testing has pushed the Dept. of Medicaid to take action.  They will soon be making a set of draft rules public that would outline the process for getting pharmacists provider IDs. These rules should be available for review and comments soon.

Please consider the following action items if you are looking to get involved:

1. Follow-up with your House Representative to show your support of SB 303
2. If you would like to be more engaged in provider status implementation, fill out the Ohio Pharmacy Services Survey (found in OPA Newsline emails)
3. Talk with your friends and colleagues about joining OPA. Membership renewal and join rates are very low at the moment and we need Ohio Pharmacists invested in OPA so they can continue this important work on our behalf!

All meetings are held at the OPA office, 2674 Federated Blvd, Columbus 43235 at 10:00 am unless otherwise noted. Please visit the OPA committee webpage for more information.

Get Involved with the Launchpad Newsletter

Help us write the next newsletter! Articles may be submitted for Practitioner Profile, Professional Pearls, Rx Impact, Ohio Days, or A Taste of Our Kitchen. Have an idea for another article relevant to new practitioners? You can submit that as well! 

Sign up for upcoming articles on our Google Doc Here.

Articles should be submitted in a Word document to Megan Stephan at m-stephan@onu.edu. Photographs for articles should be submitted as attachments for higher quality pictures. Thank you!