A bill that colloquially became
known as “the Zoomcare bill” passed the House with 58 votes on Wednesday,
paving the way for the clinic chain’s physician assistants to begin dispensing
bottled, non-narcotic medication starting in June. Senate Bill 1565 already
passed the Senate unanimously earlier this session, and now awaits Governor
Kitzhaber’s signature.
The bill’s advocates say it ties
into the state’s efforts to reform healthcare by expanding the type of
providers who can dispense medication, which in turn increases access. “It’s a
good bill,” said Rep. Jim Thompson (R-Dallas). “It allows us more flexibility
in how we deliver healthcare, particularly through urgent care.” “As we’re
looking for innovative ways to deliver healthcare, this is one small way to do
it,” said Rep. Bill Kennemer (R-Oregon City).
The bill creates makes any
Zoomcare clinic a "drug outlet," which are licensed with the Oregon
Board of Pharmacy and are required to comply with the board’s regulations on
storing, labeling and handling medications. ZoomCare will be required to
contract with a licensed pharmacist, who’ll be in charge of complying with the
board’s regulations. That person will be responsible for getting a license from
the Oregon Medical Board for a license to dispense drugs, and train ZoomCare’s
physician assistants, review their dispensing records, and ensure that
physician assistants communicate with patients about any other medications
they’re taking and educate them about the new drugs. Physician assistants will
also be required to complete a training program, to be developed by the Oregon
Medical Board and the Board of Pharmacy, on drug dispensing.
ZoomCare, which provides basic and preventive care using physician assistants,
will only be allowed to dispense bottled, non-narcotic medications, such as
common antibiotics and analgesics for acute care and basic preventive illness.
The bill is the result of numerous negotiations between Len Bergstein, Zoomcare’s
lobbyist, and representatives of the Oregon State Pharmacy Association and the
Oregon Pharmacy Coalition. Those organizations strenuously opposed a similar
bill during the 2011 session, citing concerns about patient safety, given that
the original bill did not call for any oversight from a regulatory agency.
“This was an enormously
contentious bill last session,” Thompson said. This time around, the bill also
had a powerful ally in Senate President Peter Courtney (D-Salem), its sponsor,
and faced no opposition, with pharmacy groups remaining neutral. Sometimes it
simply takes a few legislative sessions for a good idea to stick, said
Bergstein, who called the bill a “modest but meaningful reform.” “We believe
it’s good legislation,” said Bill Cross, the lobbyist for the Oregon State
Pharmacy Association. “The amended version that includes the Board of Pharmacy
will be a good step toward addressing patient safety.” Cross also expects the
bill to be a model for future legislation if other healthcare providers decide
to pursue prescription dispensing. Originally, Senate
Bill 1565 included nurse practitioners along with physician assistants, but
Bergstein said “we couldn’t quite work out the language.” The Oregon State
Pharmacy Association wouldn’t agree on including physician assistants in the
bill, according to Cross, who said it could have blurred the distinctions among
the various provider groups and threatened pharmacists. “To have four years of
specialized training in pharmacology and [then] see physician assistants who
have very few hours of training [beginning to dispense] is a bit disconcerting”
about the profession’s future, he said. But he added that the legislation is an
example of how the healthcare industry is evolving to reduce costs, meet
patients’ needs, and increase access by having health providers take on
responsibilities typically not traditional of their particular profession.