Section 216-RICR-40-15-1.13 - Collaborative Pharmacy PracticeA. A Rhode Island licensed pharmacist may engage in a collaborative practice agreement with a physician/practitioner or group of physicians/practitioners, pursuant to a collaborative practice agreement.1. All collaborative practice agreements must be approved by the Board, the Board of Medical Licensure and Discipline ("BMLD"), and the Director, each of which may request revisions to any proposed collaborative practice agreement as a condition of approval. Each proposed collaborative practice agreement must first be submitted to the BOP. Upon BOP approval, the collaborative practice agreement will be forwarded to the BMLD. Upon BMLD approval, the collaborative practice agreement will be forwarded to the Director for approval.B. No collaborative practice activities may commence until the collaborative practice agreement is approved by the Director. The Director may also terminate a collaborative practice agreement at any time.C. All collaborative practice agreements must include the following: 1. Purpose of the agreement;2. Citation of the authority to establish the agreement;3. Identification and signatures of all parties to the agreement, as well as date of signature;4. Site and settings where the collaborative practice is to take place; a. The agreement shall specify the site(s) and setting(s) where the collaborative practice occurs. All services provided pursuant to a collaborative practice agreement shall be performed in a setting that ensures patient privacy and confidentiality.b. Any site locations must have secure access to a paper/electronic patient file or a paper/electronic health record for documentation of patient care that ensures patient privacy and confidentiality.c. Signatories to the collaborative practice agreement shall keep a copy of the agreement on file at their primary place(s) of practice.5. Authorization of specific patient care functions;a. The physician(s) or other practitioners shall approve all protocols and activities for pharmacist driven drug therapy management.b. The pharmacist shall have privileges including but not limited to initiating, adjusting, monitoring or discontinuing medication therapy. (1) The pharmacist(s) shall document each initiation, modification, or discontinuation of medication therapy in the secure paper/electronic patient file or paper/electronic health record system available on site. Documentation shall also include other pertinent information including but not limited to changes in conditions, telephone encounters, test results, and patient assessment.c. A physician or practitioner shall be allowed to override a collaborative practice decision made by the pharmacist when appropriate.6. Scope of conditions or diseases to be managed; A description of the types of diseases and/or conditions, medication categories involved, and medication therapies management;
7. Training and education requirements of all parties, as agreed upon by the signing parties and consistent with any applicable training and education requirements for professional licensure;8. An attestation form that all parties have professional liability insurance; All parties shall have professional liability insurance during the term of the agreement. Proof of liability insurance must be available to the Department upon request;
9. Communication requirements between parties; Care provided to the patient by the pharmacist will be in coordination with the practitioner.
10. Cross coverage and continuity of care plan; In the event either party is unable to continue the agreement, an appropriate qualified practitioners must be available for consultation during business hours.
11. Provisions for review and revisions to the collaborative practice agreement;a. Collaborative practices may review or revise their collaborative practice agreements at any time at the request of the signatories. However, the agreement must be reviewed by the signatories at least once every two (2) years. Any changes to the agreement must be signed and dated by all signatories.b. In the event substantive or material changes are made to the agreement, such as addition of new disease states or conditions to be managed, the collaborative practice agreement shall be resubmitted to for BOP, BMLD, and Director approval. (1) No substantive changes to any collaborative practice agreements may be implemented without prior approval from BOP, BMLD, and the Director.(2) Addition or removal of physicians, pharmacists and other qualified practitioners does not require BOP, BMLD, or Director approval.c. New participants in the collaborative practice agreement shall be kept up to date with names and signatures at the practice site.12. Provisions relative to signatory withdrawal from the agreement;a. A signatory may withdraw from the agreement at any time; provided, however, that in the event that withdrawal of such signatory would result in failure of the agreement for want of a party, a new party must contemporaneously be substituted consistent with the provisions of § 1.13 of this Part.b. A patient may withdraw from treatment under the agreement at any time.D. The Department may request additional information as required to determine compliance with this Part.216 R.I. Code R. § 216-RICR-40-15-1.13
Amended effective 5/17/2021
Amended effective 12/8/2022