AHCCCS; procurement; contracting, the official text

House Engrossed
Senate Bill

[AHCCCS;
procurement; contracting]

(now: independent
testing; treatment; pharmacists)

State of Arizona

Senate

Fifty-seventh Legislature

Second Regular Session

2026

SENATE BILL 1713

AN
ACT

Amending title 32, chapter 18, article 3,
Arizona Revised Statutes, by adding sections 32-1979.04, 32-1979.05
and 32-1979.06; relating to the state board of pharmacy.

(TEXT OF BILL BEGINS ON NEXT PAGE)

Be it enacted by the Legislature of the State of Arizona:

Section 1. Title 32, chapter 18, article 3,
Arizona Revised Statutes, is amended by adding sections 32-1979.04, 32-1979.05
and 32-1979.06, to read:

START_STATUTE32-1979.04. Pharmacists; statewide written protocol; independent testing;
treatment; health conditions; notification and insurance requirements

A. Pursuant to a statewide written protocol
approved by the board, a pharmacist may independently order, perform and
interpret tests that are authorized by the United States food and drug
administration and waived under the clinical laboratory improvement amendments
of 1988 (P.L. 100-578; 102 Stat. 2903; 42 United States Code section
201). A pharmacist may independently initiate treatment to eligible
persons who are at least twelve years of age or the age
authorized by the treatment, whichever age is older, and who have test results
that indicate the need for treatment, by a test that is authorized by the
United States food and drug administration and waived under the clinical
laboratory improvement amendments of 1988, for any of the following:

1. Influenza.

2. Group A streptococcus pharyngitis.

3. SARS-COV-2 or any
other coronavirus respiratory illness.

4. A condition related to an Emerging
or existing public health threat identified by the department of health
services for which a statewide standing order, rule or executive order is
issued.

B. When developing the statewide
written protocol, the board shall address at a minimum the following:

1. Documentation.

2. Records retention.

3. Referrals.

4. Patient screening requirements and
obtaining relevant medical history.

5. Exclusion criteria.

6. Treatment instructions based on
the patient's age and medical history.

7. Follow-up maintenance and
care plans.

8. pharmacist training and certification requirements.

C. A pharmacist who orders or
conducts testing or treats health conditions pursuant to subsection A of this
section shall use any test that may guide clinical decision-making for
which a waiver has been obtained under the clinical laboratory improvement
amendments of 1988, or the federal rules adopted thereunder, or any screening
procedure that is established by the statewide written protocol.

D. A pharmacist shall use evidence-based
clinical guidelines published by the United States centers for disease control
and prevention or the infectious diseases society of America, the american academy of pediatrics committee on infectious disease
or another clinically recognized recommendation that
aligns with standards of care in providing patient treatment pursuant to
subsection A of this section.

E. An eligible person must meet
criteria for treatment based on THE STATEWIDE WRITTEN PROTOCOL that SPECIFIES the following:

1. Patient inclusion and exclusion
criteria.

2. Explicit medical referral
criteria.

F. A pharmacist shall refer a patient
to the patient's primary care provider, if one is identified, or recommend
follow up with a primary care provider, if the patient either:

1. Is not eligible for treatment
pursuant to this section and presents with symptoms.

2. Does not respond to the initial
treatment provided pursuant to this section.

G. A pharmacist who initiates a
treatment under this section shall:

1. Notify the patient's primary care
provider, if one is identified, within seventy-two hours after initiating
treatment pursuant to this section. The notice shall include the
patient's name, the treatment initiated and the date of treatment and may be
submitted by entry into an electronic HEALTH record or by telephone, fax, mail
or email. The pharmacist shall make a reasonable effort to identify
the patient's primary care provider by at least one of the following methods:

(a) Checking
pharmacy records.

(b) Requesting
the information from the patient or, for a patient under eighteen years of age,
the patient's parent or guardian.

2. Maintain for
at least seven years a record of the results of any testing or screening for
which a treatment is initiated pursuant to this section, including a summary of
the visit, patient assessment information, history of illness, examination findings, vitals and plan of care.

3. Notify the patient's primary care
provider, if one is identified, within forty-eight hours after the
occurrence of any adverse reaction that is reported to or witnessed by the
pharmacist as a result of the treatment provided pursuant to this section.

4. Provide informational materials to
the patient requesting treatment or, for a patient under eighteen years of age,
to the patient's parent or guardian about the importance of pediatric
preventive health care visits as recommended by the American academy of
pediatrics.

H. A pharmacist may delegate the TASK of performing a test waived by the
clinical laboratory improvement amendments of 1988 to a LICENSED member of the
pharmacy staff who is under the supervision of the pharmacist.  A pharmacist
may not delegate any tasks that include clinical judgment or treatment and may
delegate only ancillary duties as allowed by board rules.

I. This section does not require a
pharmacist to provide the services authorized by this section. Pursuant to section 32-1901.01, subsection A, paragraph 21, an
employer may not overrule a pharmacist's decision to not provide services that
are authorized by this section.

J. This section does not establish a
cause of action against a patient's primary care provider for any adverse
reaction, complication or negative outcome arising from any treatment initiated
by a pharmacist pursuant to this section.

K. A pharmacist may not independently
initiate a treatment using opioids for a patient.

L. A pharmacist may not independently
order a test or screening or treat a minor without the written consent of the
minor's parent or guardian.

M. A pharmacy shall display a notice
and include in a patient's consent paperwork THAT the testing and treatment
being performed pursuant to this section ARE being performed by a pharmacist without
consultation with or oversight by a physician and that the patient should
consult with a primary care provider if symptoms continue.

N. Each pharmacy where testing and
treatment services are provided pursuant to this section shall ensure that
there is an area that provides privacy to patients for the testing and
treatment services.

o. A pharmacist shall maintain
professional liability insurance if performing services that are authorized
under this section. END_STATUTE

32-1979.05. Independent testing and treatment advisory committee; duties;
members

A. The board
shall establish the independent testing and treatment advisory committee to
assist the board in developing this state's written protocols relating to
pharmacists' independent authority to order testing and initiate treatments
pursuant to sections 32-1979.04 and 32-1979.06. The advisory
committee shall also make recommendations to the board regarding the statewide
written protocols required pursuant to that section.

B. The advisory committee shall
include at least the following:

1. Two pharmacists who are licensed
pursuant to this chapter and who are appointed by the board.

2. Two physicians who are licensed pursuant to this title, one
who specializes in primary care and one who practices in
an emergency medicine setting, and who are appointed by the Arizona medical
board or the Arizona board of osteopathic examiners in medicine and surgery. At least one of these members must have a
patient population that is substantially composed of children and adolescents.

3. One person
who represents a nonprofit patient advocacy organization and who is appointed
by the governor.

4. One nurse practitioner who is
licensed pursuant to chapter 15 of this title, who
specializes in primary care or emergency medicine, who is
able to prescribe medication and who is appointed by the Arizona state board of
nursing.

C. All advisory committee members
shall be appointed within sixty days after the effective date of this section.
If a member or members are not appointed to the advisory committee within that
time frame, the other members of the advisory committee may meet and make
recommendations to the board relating to the statewide written protocols
without the additional member or members.

D. Advisory committee members are not
eligible for compensation or reimbursement of expenses.

E. The advisory committee shall
review the statewide written protocols annually and update when necessary.

F. The board shall provide a copy of
the statewide written protocols to the chairpersons of the health and human
services committees of the house of representatives and the senate, or their
successor committees, and shall post the statewide written protocols on the
board's public website. END_STATUTE

START_STATUTE32-1979.06. Human immunodeficiency virus prevention; preexposure prophylaxis;
postexposure prophylaxis; definitions

A. In addition to the authority
provided in section 32-1979.04, a pharmacist who is licensed pursuant to this
chapter may initiate and dispense human immunodeficiency virus preexposure
prophylaxis and postexposure prophylaxis pursuant to the statewide written
protocol APPROVED by the board.

B. Before initiating a preexposure
prophylaxis, a pharmacist shall:

1. Conduct or obtain a clinical
laboratory improvement amendments-waived human immunodeficiency virus
test and confirm a negative test result.

2. Assess the patient for
contraindications, drug interactions and clinical eligibility consistent with
the current guidelines of the united states centers for disease control and
prevention.

C. Before initiating a postexposure
prophylaxis, a pharmacist shall:

1. Determine that the patient
presents within seventy-two hours after a potential exposure to the human
immunodeficiency virus.

2. Conduct or obtain a human immunodeficiency
virus test if feasible under the statewide written protocol.

3. Assess the patient for
contraindications, drug interactions and clinical eligibility consistent with
the current guidelines of the united states centers for disease control and
prevention.

D. A pharmacist who initiates therapy
pursuant to this section:

1. May dispense not more than a
thirty-day supply of preexposure prophylaxis.

2. May dispense a complete
twenty-eight-day course of postexposure prophylaxis.

3. Shall provide counseling regarding
medication adherence, potential side effects and prevention measures.

4. Shall provide the patient with a
written referral to a primary care provider or other appropriate health care
provider for follow-up care.

5. Shall notify the patient's primary
care provider of the services provided if the patient consents to the
notification.

E. The STATEWIDE WRITTEN PROTOCOL
approved by the board SHALL ADDRESS, AT A minimum, the following:

1. Minimum training requirements for
pharmacists who initiate therapy pursuant to this section.

2. Documentation and records
retention requirements.

3. Statewide written protocol
standards that are consistent with the current guidelines of the united states
centers for disease control and prevention or the infectious diseases society
of america or another clinically recognized recommendation.

F. For the purposes of this section:

1. "postexposure
prophylaxis" means a medication regimen that is approved by the united
states food and drug administration and that is initiated after potential
exposure to the human immunodeficiency virus to prevent infection.

2. "preexposure
prophylaxis" means a medication regimen that is approved by the united
states food and drug administration to prevent human immunodeficiency virus
infection in persons who are at risk. END_STATUTE