89R3938 DNC-F
	By: Flores	S.B. No. 254

	A BILL TO BE ENTITLED
	AN ACT
	relating to the administration of a medication and the ordering and
	administration of an immunization or vaccination by a pharmacist.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1.  Section 551.003(33), Occupations Code, is
	amended to read as follows:
	(33)  "Practice of pharmacy" means:
	(A)  providing an act or service necessary to
	provide pharmaceutical care;
	(B)  interpreting or evaluating a prescription
	drug order or medication order;
	(C)  participating in drug or device selection as
	authorized by law, and participating in drug administration, drug
	regimen review, or drug or drug-related research;
	(D)  providing patient counseling;
	(E)  being responsible for:
	(i)  dispensing a prescription drug order or
	distributing a medication order;
	(ii)  compounding or labeling a drug or
	device, other than labeling by a manufacturer, repackager, or
	distributor of a nonprescription drug or commercially packaged
	prescription drug or device;
	(iii)  properly and safely storing a drug or
	device; or
	(iv)  maintaining proper records for a drug
	or device;
	(F)  performing for a patient a specific act of
	drug therapy management delegated to a pharmacist by a written
	protocol from a physician licensed in this state in compliance with
	Subtitle B; [or]
	(G)  subject to Section 554.052(c-1), ordering or
	administering an immunization or vaccination to a patient who is at
	least three years of age; or
	(H)  if the patient is younger than three years of
	age and is referred to a pharmacist by a physician, administering an
	immunization or vaccination to a patient under a physician's
	written protocol.
	SECTION 2.  The heading to Section 554.004, Occupations
	Code, is amended to read as follows:
	Sec. 554.004.  ADMINISTRATION OF MEDICATION; ORDERING AND
	ADMINISTRATION OF IMMUNIZATION OR VACCINATION.
	SECTION 3.  Section 554.004(a), Occupations Code, is amended
	to read as follows:
	(a)  The board shall specify conditions under which a
	pharmacist may administer medication and order or administer [,
	including] an immunization or [and] vaccination. The conditions
	for ordering or administering an immunization or vaccination must
	ensure that:
	(1)  [a licensed health care provider authorized to
	administer the medication is not reasonably available to administer
	the medication;
	[(2)  failure to administer the medication, other than
	an immunization or vaccination, might result in a significant delay
	or interruption of a critical phase of drug therapy;
	[(3)]  the pharmacist possesses the necessary skill,
	education, and certification as specified by the board to order or
	administer the immunization or vaccination [medication];
	(2) [(4)]  within a reasonable time after
	administering an immunization or vaccination that is prescribed by
	a licensed health care provider [medication], the pharmacist
	notifies the licensed health care provider responsible for the
	patient's care that the immunization or vaccination [medication]
	was administered;
	[(5)  the pharmacist may not administer medication to a
	patient at the patient's residence, except at a licensed nursing
	home or hospital;
	[(6)  the pharmacist administers an immunization or
	vaccination under a physician's written protocol and meets the
	standards established by the board;] and
	(3) [(7)]  the authority of a pharmacist to administer
	an immunization or vaccination [medication] may [not] be delegated
	to a certified pharmacy technician.
	SECTION 4.  Sections 554.052(a), (b), (c), and (c-1),
	Occupations Code, are amended to read as follows:
	(a)  The board by rule shall require a pharmacist to notify a
	physician who prescribes an immunization or vaccination not later
	than the 14th day [within 24 hours] after the date the pharmacist
	administers the immunization or vaccination.
	(b)  The board shall establish minimum education and
	continuing education standards for a pharmacist who orders or
	administers an immunization or vaccination. The standards must
	include federal Centers for Disease Control and Prevention
	training, basic life support training, and hands-on training in
	techniques for administering immunizations and vaccinations.
	(c)  Supervision by a physician is adequate if the delegating
	physician:
	(1)  is responsible for formulating or approving an
	order or protocol, including the physician's order, standing
	medical order, or standing delegation order, and periodically
	reviews the order or protocol and the services provided to a patient
	under the order or protocol;
	(2)  [except as provided by Subsection (c-1), has
	established a physician-patient relationship with each patient
	under 14 years of age and referred the patient to the pharmacist;
	[(3)]  is geographically located to be easily
	accessible to the pharmacy where an immunization or vaccination is
	administered;
	(3) [(4)]  receives, as appropriate, a periodic status
	report on the patient, including any problem or complication
	encountered; and
	(4) [(5)]  is available through direct
	telecommunication for consultation, assistance, and direction.
	(c-1)  A pharmacist may order or administer an immunization
	or [influenza] vaccination to a patient who is at least three [over
	seven] years of age if the immunization or vaccination is:
	(1)  authorized or approved by the United States Food
	and Drug Administration or listed in the routine immunization
	schedule recommended by the federal Advisory Committee on
	Immunization Practices published by the federal Centers for Disease
	Control and Prevention; and
	(2)  ordered or administered in accordance with the
	federal Advisory Committee on Immunization Practices
	vaccine-specific recommendations [without an established
	physician-patient relationship].
	SECTION 5.  This Act takes effect immediately if it receives
	a vote of two-thirds of all the members elected to each house, as
	provided by Section 39, Article III, Texas Constitution. If this
	Act does not receive the vote necessary for immediate effect, this
	Act takes effect September 1, 2025.