Report of the Fortieth Annual Session of the CSHP House of Delegates

The fortiethannual session of the California Society of Health-System Pharmacists House of Delegates was held at the San Diego Sheraton Hotel and Marina, Harbor Island II & III, in conjunction with Seminar 2015, the Society’s annual meeting.

Chairperson Brian Kawahara convened the meeting at 8:05 a.m. on Sunday October 11, 2015.

Brian Kawahara introduced CSHP Interim CEO and Secretary of the House of Delegates MaryAnne Bobrow, President Stacey Raff, Chair of the Board of Directors Betty Jue, President-elect Kethen So, Treasurer Jason Bandy, and the Parliamentarian for the 2015 House of Delegates, Robert Ignoffo.

Role and Function of the House of Delegates

Brian Kawahara described the purposes and functions of the House and emphasized its responsibility for establishing policy. The number of delegates eligible to vote this year was 152.

Roll Call

Following the enrollment of delegates, Secretary Bobrow reported that a quorum was present.Included are CSHP officers, directors, past presidents, and delegates representing CSHP-affiliated regional chapters, student delegates from each of the California schools of pharmacy, pharmacy technician members, and the California Pharmacists Association.

Approval of Minutes

Brian Kawahara called for a motion to approve the minutes of the thirty-ninth Annual Session of the CSHP House of Delegates as published on the CSHP website. The minutes were approved by voice vote.

Report of the President and CSHP Board of Directors

President Stacey Raffpresented a report on behalf of herself andthe Board of Directors. A copy of that report will be published as part of these proceedings. Delegates voted to accept the report.

Report of the Treasurer

Treasurer Jason Bandy presented his report on behalf of the Board of Directors.The House postponed acceptance of the report in the absence of written documentation. A copy of the 2015 report will be published by December 31, 2015. Delegates will vote on acceptance of the report at the annual 2016 House of Delegates meeting.

Report of the Interim CEO

MaryAnne Bobrow presented the Executive Vice President and CEO report. This report was presented for the information of delegates and did not require action by the House.

Report of the Committee on Nominations

Chairperson of the CSHP Committee on Nominations Ken Perrin briefly explained the nomination process, then introduced and acknowledged the members of the2014-2015 Committee on Nominations:

Name / Chapter
Ken Perrin (Chair) / Golden Gate
Janice Akashi / San Gabriel Valley
Gene Borelli / San Fernando Valley
Sian Carr-Lopez / Diablo
Pauline Chan / Sacramento Valley
James Colbert / San Diego
Laura Morodomi / Central Valley
Doreen Schneider / Golden Empire
Judith Nakao / South Bay/Long Beach

The following nominees for CSHP offices were presented and approved:

For President-elect

Victoria Ferraresi (Quatra County)

Doug Monroe (Orange County)

For Board of Directors – 3 Year Term

Johnny Wong (Diablo)

Jennifer Cashman (Central Valley)

Jim Walsh (Sacramento Valley)

Harminder Sikand (San Diego)

James Scott (San Fernando Valley)

Elaine Law (Golden Gate)

For Board of Directors – 1 Year Term

Lisa Lum (South Bay/Long Beach)

Maria Serpa (Sacramento)

New Practitioner Executive Committee Chair

Nicole Nguyen (Golden Gate)

Judy Mai (San Diego)

For Delegates to the ASHP House of Delegates

Kristine Parbuoni (Inland)

Bill Yee (Central Valley)

Steve Gray (Inland)

Brian Kawahara (Inland)

Christine Antczak (Central Valley)

Kim Tallian (San Diego)

Harminder Sikand (San Diego)

Kethen So (Golden Gate)

Stacey Raff (Golden Gate)

Rich Levy (South Bay/Long Beach)

Scott Takahashi (San Gabriel Valley)

Cindy Odegard (South Bay/Long Beach)

Vicky Ferraresi (Quatra County)

Corbin Bennett (Sierra)

Stacy Yang (Orange County)

Victoria Serrano Adams (Golden Gate)

Ken Perrininvited each of the nominees to stand and be recognized as he called their names and thanked them for their willingness to serve. Brian Kawahara thanked Ken Perrin for serving as Chair of the Committee on Nominations.

Action on Proposals and Resolutions

Chair of the CSHP Board of Directors Betty Jue introduced 61 proposals for consideration by the House.

For the complete text of all proposal,visit the CSHP website thenchoose “House of Delegates,” select“HOD Materials,” then select “2015Proposals”.

Proposal 00715

To Adopt as CSHP Professional Policy #2015-67, ASHP Policy 1123: Statement on Leadership as a Professional Obligation – Approved.

CSHP approves the ASHP Statement on Leadership as a Professional Obligation.

Proposal 01215

To Adopt as CSHP Professional Policy #2015-01: Medical Marijuana – Approved.

The California Society of Health-System Pharmacists:

  1. Supports legislation that changes marijuana from a Schedule I to Schedule II in order to promote and expand the scope of research on its potential medical benefit.
  2. Encourages continuing research to define the therapeutically active components, effectiveness, safety and clinical use of medical marijuana.
  3. Further, supports the development of additional marijuana-based compounds that meet the FDA definition of a drug product.
  4. Supports the development of processes that would ensure standardized formulations, potency, and quality of medical marijuana products to facilitate research.
  5. Proposes the development of policies addressing the procurement, storage and distribution of medical marijuana for research purposes consistent with all applicable laws and regulations.
  6. Supports the prohibition of marijuana smoking in settings where smoking is prohibited.
  7. Encourages continuing education that prepares the pharmacist to respond to patients and clinician questions about therapeutic and legal issues surrounding medical marijuana use.

Proposal 01315

To Adopt as CSHP Professional Policy #2015-18: Pharmacist Exempt Status – Approved.

  1. CSHP Board approve the following language for pharmacist exempt status legislation to be submitted to legislative counsel:

Labor Code

Division 2. Employment Regulation and Supervision; Part 2. Working Hours; Chapter 5. Pharmacies

850. No person employed to sell at retail drugs and medicines or to compound physicians’ prescriptions shall perform any work in any store, dispensary, pharmacy, laboratory, or office for more than an average of nine hours per day, or for more than 108 hours in any two consecutive weeks or for more than 12 days in any two consecutive weeks, except that any registered pharmacist may be so employed and may perform such work for the full period of time permitted by this section.

850.5. Notwithstanding section 850, a pharmacist who is granted advanced practice pharmacist recognition by the Board of Pharmacy pursuant to Section 4210 of the Business and Professions Code, pharmacists practicing under 4052.1 and 4052.2, or a pharmacist who is enrolled in a postgraduate residency program, shall be permitted to adopt alternative workweek schedules.

851. No person employing another person to sell at retail drugs and medicines or to compound physicians’ prescriptions shall require or permit such employee to perform any work in any store, dispensary, pharmacy, laboratory, or office for more than an average of nine hours per day, or for more than 108 hours in any two consecutive weeks or for more than 12 days in any two consecutive weeks, except that any registered pharmacist may be so employed and may perform such work for the full period of time permitted by this section.

851.5. Except on Sundays and holidays, and except for a period of time for meals, not to exceed one hour in length, the hours of work permitted per day by this chapter shall be consecutive. This section does not apply to hospitals employing only one person to compound physicians’ prescriptions.

852. The employer shall apportion the periods of rest to be taken by an employee so that the employee will have one complete day of rest during each week.

853. Any person who violates any provision of this chapter is guilty of a misdemeanor punishable by a fine of not less than forty dollars ($40) nor more than one hundred dollars ($100) or by imprisonment for not exceeding 60 days, or both.

854. The provisions of this chapter shall not apply in any case of emergency. The word “emergency” shall be construed as being accident, death, sickness or epidemic.

855. The provisions of this chapter are enacted as a measure for the protection of the public health.

856. The Labor Commissioner shall enforce this chapter.

Proposal 01515

To Adopt as CSHP Professional Policy #2015-21, ASHP 1317: Education and Training in Health Care Informatics – Approved.

The California Society of Health System Pharmacists:

  1. Recognizes the significant and vast impacts of health-system information systems, automation, and technology changes on safe and effective use of medications.
  1. Supports the fostering, promotion, and development of and participation in formal health care informatics educational programs for pharmacists, pharmacy technicians, and student pharmacists.

Proposal 01615

Not Adopt as CSHP Professional Policy, ASHP 1015: Minimum Hiring Standards for Pharmacy Technicians – Approved.

Our current Policy 2012-09, Technician Regulations reflects more accurately our position on Pharmacy Technicians and the regulations for hire and advancement.

Proposal 01715

To Adopt as CSHP Professional Policy #2015-22, ASHP Policy 0804: Collaboration Regarding Experiential Education – Approved.

That CSHP adopt as professional policy:

Collaboration of Schools of Pharmacy and Health-System Teaching Sites.

CSHP promotes collaboration of health-system teaching sites with the schools of pharmacy (nationally or regionally), for the purpose of fostering preceptor development, standardization of experiential rotation schedule dates and evaluation tools, and other related matters.

Proposal 01815

To Adopt as CSHP Professional Policy #2015-23, ASHP Policy 0919: Intimidating or Disruptive Behaviors – Approved.

That CSHP adopt as professional policy:

Intimidating or Disruptive Behaviors.

  1. CSHP affirms the professional responsibility of the pharmacist to ensure patient safety by communicating with other health care personnel to clarify and improve medication management.
  1. CSHP encourages hospitals and health systems to adopt zero-tolerance policies for intimidating or disruptive behaviors.
  1. CSHP encourages hospitals and health systems to develop and implement education and training programs for all health care personnel to encourage effective communication and discourage intimidating or disruptive behaviors.
  1. CSHP encourages colleges of pharmacy and residency training programs to incorporate training in communications and managing intimidating or disruptive behaviors.
  1. CSHP will collaborate with other organizations to support codes of conduct that minimize intimidating or disruptive behavior in hospitals and health systems.

Proposal 01915

To Adopt as CSHP Professional Policy #2015-24, ASHP Policy 1008: Employment Classification and Duty Hours of Pharmacy Residents – Approved.

That CSHP adopt as professional policy:

Pharmacy Resident Employment Hours and Duty Classification.

  1. CSHP supports that pharmacy residents should be classified as exempt employees.
  1. CSHP supports that pharmacy residents be subject to duty hour limits (similar to resident physicians) with respect to all clinical and academic activities during their training program in accordance with the Accreditation Council on Graduate Medical Education (ACGME) standards and ASHP accreditation standards for pharmacy residency programs.

Proposal 02015

To Adopt as CSHP Professional Policy #2015-25, ASHP Policy 1012:Quality Consumer Medication Information– Approved.

That CSHP adopt as professional policy:

Quality Consumer Medication Information.

  1. CSHP supports efforts by the Food and Drug Administration (FDA) and other stakeholders to improve the quality, consistency, and simplicity of written consumer medication information (CMI).
  1. CSHP encourages the FDA to work in collaboration with patient advocates and other stakeholders to create evidence-based models and standards, including establishment of a universal literacy level, for CMI and affirms that research should be conducted to validate these models in actual-use studies in pertinent patient populations.
  1. CSHP affirms that state boards of pharmacy should require that pharmacies comply with FDA-established standards for content, format, and distribution of CMI.

Proposal 02115

To Adopt as CSHP Professional Policy #2015-26, ASHP Policy 1022: Patient Access to Pharmacy Services in Small and Rural Hospitals– Approved.

That CSHP adopt as professional policy:

Patient access to pharmacy services in small and rural hospitals.

  1. CSHP supports the standard that all patients should have 24-hour access to a pharmacist responsible for their care, regardless of hospital size or location.
  1. CSHP supports alternative and innovative methods of pharmacist review of medication orders before drug administration when onsite pharmacist review is not available.
  1. CSHP supports the use of remote medication order review systems that communicate pharmacist approval of orders electronically to the hospital.
  1. CSHP supports the requirement that pharmacists have access to pertinent patient information required for safe and effective order verification, regardless of proximity to patient.
  1. CSHP supports that verbal and electronic communication between pharmacist and hospital staff be available at all times.

Proposal 02215

To Adopt as CSHP Professional Policy #2015-27, ASHP Policy 1114: Pharmacist Accountability for Patient Outcomes – Approved.

That CSHP adopt as professional policy:

Accountability of pharmacists for patient outcomes.

  1. CSHP affirms that pharmacists, pursuant to their authority over a specialized body of knowledge, are autonomous in exercising their professional judgment and accountable as professionals and health care team members for the safe and effective use of medications and their related outcomes.
  1. CSHP encourages pharmacists to define practices and associated measures of effectiveness that support their accountability for patient outcomes.
  1. CSHP promotes pharmacist accountability as a fundamental component of pharmacy practice to other health care professionals, standards-setting and regulatory organizations, and patients.

Proposal 02315

To Adopt as CSHP Professional Policy #2015-62, ASHP Policy 1319: Statement on the Pharmacy Technician’s Role in Pharmacy Informatics – Approved.

The California Society of Health System Pharmacists approves the ASHP Statement on the pharmacy technician’s role in pharmacy informatics.

Proposal 02415

To Adopt as CSHP Professional Policy #2015-28: Endorsing Pharmacist – Approved.

That CSHP adopt as professional policy:

  1. CSHP endorses pharmacist and pharmacy technician certification from organizations that follow the accreditation standards set forth by the National Commission for Certifying Agencies (NCCA) such as the Board of Pharmacy Specialties (BPS), the Commission for Certification in Geriatric Pharmacy (CCGP) and the Pharmacy Technician Certification Board (PTCB).

Proposal 02515

To Adopt as CSHP Professional Policy #2015-29, ASHP Policy 0917: Pharmacy Residency Training; and ASHP Policy 704 Residency Programs with Modification – Approved.

Adopt the following as CSHP Professional Policy:

Pharmacy Residency Training Programs.

  1. CSHP encourages that all pharmacy residency programs become ASHP-accredited as a means of ensuring and conveying program quality.

2.CSHP encourages the continued efforts to increase the number of ASHP-accredited pharmacy residency training programs and positions.

Proposal 02615

To Adopt as CSHP Professional Policy #2015-30: Preservation of Antimicrobials for Medical Treatment – Approved.

That CSHP adopt as professional policy:

Preservation of Antimicrobials for Medical Treatment.

  1. CSHP encourages the Food and Drug Administration (FDA) eliminate future approval of antimicrobials for nontherapeutic uses in agricultural animals that represent a safety risk by contributing to antibiotic resistance.
  1. CSHP encourages efforts to phase out and eliminate the nontherapeutic uses of antimicrobials previously approved by the FDA.
  1. CSHP supports the therapeutic use of antimicrobials in animals only under the supervision of a veterinarian.
  1. CSHP encourages the FDA, Centers for Disease Control and Prevention, and other stakeholders to monitor and limit, when effective alternatives are available, the therapeutic use of antimicrobials that are essential to the treatment of critically ill human patients.
  1. CSHP encourages the inclusion of pharmacists in antimicrobial surveillance and related public health efforts based on pharmacists’ knowledge of antimicrobial drug products and antimicrobial resistance.

Proposal 02715

To Adopt as CSHP Professional Policy# 2015-31: The Pharmacist’s Role in Antimicrobial Stewardship and Infection Prevention and Control – Approved.

That CSHP adopt as professional policy:

The Pharmacist’s Role in Antimicrobial Stewardship and Infection Prevention and Control.

  1. CSHP supports the ASHP statement on the Pharmacist’s Role in Antimicrobial Stewardship and Infection Prevention and Control.
  1. CSHP recognizes that pharmacists have a responsibility to take prominent roles in antimicrobial stewardship programs and participate in the infection prevention and control programs of health systems.

Proposal 02815

To Adopt as CSHP Professional Policy #2015-63, ASHP Policy 0819: Roles and Responsibilities of the Pharmacy Executive – Approved.

That CSHP adopt as professional policy:

Roles and Responsibilities of the Pharmacy Executive.

CSHP approves the ASHP Statement on the Roles and Responsibilities of the Pharmacy Executive.

Proposal 03115

Not Adopt as CSHP Professional Policy, ASHP Policy 0905: Credentialing & Privileging by Regulators, Payers & Providers for Collaborative Therapy Management – Approved.

That CSHP not adopt as professional policy, ASHP Policy 0905.

Proposal 03215

Not Adopt as CSHP Professional Policy, ASHP Policy 0907: Supply Chain – Approved.

That CSHP not adopt ASHP policy 0907.

Proposal 03815

To Adopt as CSHP Professional Policy #2015-32: Ethical use of Placebos in Clinical Practice – Approved.

That CSHP adopt as professional policy:

Ethical use of Placebos in Clinical Practice.

  1. CSHP affirms that the use of placebos in clinical practice is ethically unacceptable.
  2. The use of placebos is acceptable only under the auspices of an investigational review board approved clinical trial and placebo use is not to the detriment of the patient, unless the patient has given his or her informed consent accepting such risk.
  1. CSHP encourages hospitals and health systems to develop policies and procedures to guide clinicians in making informed decisions regarding the use of placebos.

Proposal 03915

To Adopt as CSHP Professional Policy #2015-33, ASHP Policy 707: Standard Drug Administration Schedules –Approved.

That CSHP adopt as professional policy: