Board Highlights - April 29, 2022

Board Highlights - April 29, 2022

Topics include Jurisprudence Examination Modernization Project update, bylaw amendments to officially adopt the NAPRA Standards for Sterile Compounding, Pharmacy Operations and Drug Scheduling Act Bylaws - Fee Schedule, Health Professions Act Bylaws - Fee Schedule, and more.

LAND ACKNOWLEDGEMENT 

On behalf of the College of Pharmacists of BC, Board Chair Steven Hopp, acknowledged and thanked the Coast Salish peoples on whose unceded traditional territories he chaired the April 29, 2022 meeting. With Board member and guests meeting in-person and virtually in different locations across BC, Steven Hopp also acknowledged that Indigenous Peoples are the traditional stewards of the lands and waters from which each member attended the meeting from. 

To the Indigenous peoples of this place we now call British Columbia: We turn our minds to you and to your ancestors. You have kept your unceded homelands strong. We are grateful to live and work here.

College of Physicians and Surgeons of BC Efforts in Cultural Safety and Humility

Dr. Derek Puddester, Deputy Registrar of the College of Physicians and Surgeons of BC (CPSBC) provided the Board with an update on CPSBC’s efforts in Cultural Safety and Humility for Indigenous Peoples.

Official Approval of the Board Meeting Guidelines

The Board approved the recently developed CPBC Board Meeting Guidelines as the document governing Board meeting procedures.

At their February 2022 meeting, the Board approved amendments to the Health Professions Act Bylaws to remove Robert’s Rules of Order as the document that governs the procedures of College Board meetings, and to replace it with a new College of Pharmacists of British Columbia Board Meeting Guidelines document, based on guidelines followed by the BC College of Nurses and Midwives.

The Guidelines were only approved in-principle in February 2022, due to the timing of associated bylaws. At that February meeting, the Board also approved amendments to the Health Professions Act Bylaws (“the HPA Bylaws”) to give authority to the Board to adopt, by special resolution, Board guidelines and policies to govern the procedures of their meetings.

The new Board Meeting Guidelines are now in effect.

Jurisprudence Examination Modernization Project Update

The Jurisprudence Exam (JE), also known as the provincial pharmacy law exam, is based on legislation contained in federal and provincial acts, their regulations and bylaws and the College’s PPPs that pertain to pharmacy operations and a registrant’s responsibility in the practice of pharmacy at entry to practice.

Completion of the JE is a requirement for registration as a pharmacist or pharmacy technician in British Columbia and is held three times per year in February, June and October.

Over the past year, the College has been working on the JE modernization project (JEMP). Every five to seven years, the College conducts a full review of the JE, in accordance with international assessment standards. This review ensures that the JE maintains its effectiveness as a valid, reliable and defensible assessment tool.

The test development portion of the JEMP began in March 2021 and spanned until March 2022. There are 6 stages of the test development cycle as follows:

Both pharmacists and pharmacy technicians were involved in every stage of the test development process.

Bylaw Amendments to Officially Adopt the NAPRA Standards for Sterile Compounding

The Board approved amendments to the Pharmacy Operations and Drug Scheduling Act (PODSA) and Health Professions Act (HPA) to adopt the National Association of Pharmacy Regulatory Authorities (NAPRA) model standards for sterile compounding. At their November 2021 meeting, the Board approved the public posting of the proposed PODSA Bylaws to adopt the Model Standards for public posting for a 90-day period. During that meeting, the Board also made the decision to restrict sterile compounding to registrants only.

Related amendments to the HPA Standards of Practice and relevant Professional Practice Policies (“PPPs”) were also posted for that comment period, even though legislation does not require the College to do so. This was done so that readers would gain clarity on the entire suite of changes proposed by the College.

College staff reviewed and considered all feedback received. One of the key themes in the feedback was concern regarding the restriction of sterile compounding to registrants only. As a result of the feedback and further consideration, the College decided not to proceed with the restriction of sterile compounding to registrants at this point. Instead, the Board directed that further research and analysis take place.

These amendments will now be filed with the Ministry of Health for 60-days to allow for a July 4, 2022 effective date. The College will be providing further information about the implementation date.

Amendments to the Pharmacy Operations and Drug Scheduling Act Bylaw – Fee Schedule

The Board approved for public posting, amendments to the Pharmacy Operations and Drug Scheduling Act (PODSA) Bylaws Schedule A – Fee Schedule, in order to operationalize the CPBC’s 2022/2023 budget.

As noted in the February 2022 discussion on the College’s 2022/2023 budget, this new budget includes a modest fee increase and will help to return College finances to a balanced budget and fully funded reserves, while enabling operations to meet the College’s Mandate and enabling staff to achieve the Strategic Plan’s goals.

The amended PODSA fee schedule will be publicly posted for a period of 90 days. After that time, it will be brought to the September 2022 Board meeting for filing approval, pending review of any feedback received.

Amendments to the Health Professions Act Bylaws – Fee Schedule

The Board approved amendments to the Health Professions Act (HPA) Bylaws Schedule D – Fee Schedule. Similar to the PODSA Fee Schedule amendments noted above, HPA fee schedule changes are necessary in order to operationalize the CPBC 2022/2023 budget, which was approved at the February 2022 Board meeting.

As noted in the February 2022 Board meeting, CPBC's new budget includes a modest fee increase, as well as a new fee for temporary registrants. Much like the PODSA Fee Schedule amendments, these changes will help return College finances to a balanced budget and fully funded reserves, while enabling operations to meet the College's Mandate, and enabling staff to achieve the Strategic Plan's goals. 

The amended HPA fee schedule is not required to be posted for public comment. It will be submitted for filing with the Ministry of Health at the same time as the PODSA version. This approach will result in a consistent schedule of fee changes as both the PODSA and HPA amendments would then come into effect at the same time.

British Columbia College of Nurses & Midwives’ Cultural Humility and Safety Journey

Cynthia Johansen, Registrar and CEO of the British Columbia College of Nurses and Midwives (BCCNM) provided the Board with an update on BCCNM’s journey toward Cultural Humility and Safety for Indigenous Peoples.

Medication Incident Reporting

The Board was given an update on the College’s progress toward the implementation of mandatory anonymous medication incident reporting in BC. At the September 2019 Board meeting, the Board directed the Registrar to require mandatory anonymous medication incident reporting in all pharmacies using any medication incident reporting platform of the pharmacy’s choosing that meets the College’s criteria. Medication incident reporting is also a key initiative in the College’s 2021/22 - 2025/26 Strategic Plan.

The College will continue to engage with Provincial Regulatory Authorities across Canada along with other internal and external stakeholders as the project progresses in BC.

Faxing of CPP Prescriptions

The Board was presented with  information  about the hard copy prescription requirements following the receipt of faxed Controlled Prescription Program prescriptions. 

The Controlled Prescription Program (“CPP”) was established to prevent prescription forgery and reduce inappropriate prescribing of drugs. Prescriptions for the controlled drugs specified in the CPP must be written on the duplicate prescription pad specially developed for this purpose. 

Typically, CPP prescriptions must be provided as a hard copy. However, in March 2020, the Board approved amendments to the PODSA Bylaws to allow for CPP prescriptions to be provided verbally or via fax. This was done in consultation with the provincial Ministry of Health in an aim to reduce barriers to care during the COVID-19 public health emergency. 

These amendments allow for CPP drugs to be dispensed upon receipt of a faxed prescription from a practitioner if doing so is permitted under a section 56 exemption to the Controlled Drugs and Substances Act (CDSA). 

This means that if a registrant receives a CPP prescription transmitted verbally or via fax, the original prescription form must be sent to the pharmacy from the practitioner by mail, within a reasonable time frame. 

Recently, the College has received concerns about the need for the original hard copy when CPP prescriptions are sent via fax. These concerns centre around the fact that in cases where a practitioner fails to mail the original hard copy. 

The Controlled Prescription Program Advisory Committee (CPPAC) has recommended further research on this issue to determine whether the hard copy requirement should be removed. 

College staff will engage with CPPAC on this issue and begin to explore these requirements, taking into consideration related requirements outlined in the CDSA. and engage the CPPAC on this issue moving forward.