H3988: Pharmacists and Pharmacy Technicians

Reading about the H3988, the initial reaction was one of sheer perplexity. "Why is this necessary?" was the first question that popped up. It's a direct attack on parental rights, sneaking in medical treatments without clear guidelines for parental consent. Why is the South Carolina General Assembly so keen on crafting legislation that chips away at medical freedom? Makes no sense.

SUMMARY 

H3988 makes changes to the Pharmacy Practice Act (SC Code of Laws CHAPTER 43) to allow pharmacists to delegate certain tasks to trained pharmacy technicians and pharmacy interns. The bill also allows pharmacists to dispense certain drugs without a written order or prescription and lowers the vaccine recipient age to twelve as to when a pharmacist may administer a vaccine without a written order. Additionally, the bill authorizes pharmacy technicians who have the required certifications and training to administer vaccinations under the direct supervision of a pharmacist and amends the certification and training requirements for pharmacy interns to administer vaccines. Further, the bill renames the Joint Pharmacist Administered Vaccines Committee as the Joint Pharmacist Access Committee.

Concerns #1

Section 1

“(e) initiation, ordering, and administration of a test, including COVID tests, that is waived under the federal clinical laboratory improvement amendments (CLIA) of 1988 and authorized by the Food and Drug Administration. Pharmacists may delegate the authority to administer tests provided for in this subsection to a trained pharmacy technician or pharmacy intern;

The sections (e) and (f) pertain to the expanded roles of pharmacists and, by delegation, trained pharmacy technicians and pharmacy interns in conducting certain medical tests, such as CLIA-Waived Tests (Clinical Laboratory Improvement Amendments (CLIA)). CLIA-waived tests include a wide range of diagnostic tests, such as certain blood glucose tests, rapid strep tests, and, as mentioned, COVID-19 tests that are authorized by the Food and Drug Administration (FDA). 

South Carolinians need to ask, why do we need to codify this, especially when these tests come with the following challenges: false positives or false negatives, errors in test results, errors in interpretation of test results, and, more importantly, their ineffectiveness in detecting new variants, which WILL lead to higher rates of false negatives or false positives.

Concerns #2

Additionally, Section (e) of H3988 mirrors the language and approach of the Public Readiness and Emergency Preparedness (PREP) Act, particularly regarding the allowance for pharmacy technicians and interns to administer vaccines under specific conditions.

AGAIN: Why is it necessary to codify this into law?

Is the goal to widen healthcare access? We're talking healthcare, but are we just circling back to vaccines? Seems like South Carolinians can already tick that box with their family doc. Or is this about lining pockets, making sure healthcare providers get a fatter cheque from insurance for a wider service range? Sounds about right. And let's not skirt around the real kicker: boosting testing to push up those vaccination numbers. As for Big Pharma and their political marionettes steering the ship? Absolutely, no doubt about it.

Concerns #3

(f) collection of specimens, notifications, reporting of patient results, and referring patients to other health care providers for follow-up care pursuant to a written joint protocol of the Joint Pharmacy Access Committee; or”. 

The whole tracking and data collection spiel tied to test results? That's a slippery slope we're treading on. Especially when you factor in the notorious inaccuracy of these tests. Expanding government surveillance under the guise of public health? Now that's a red flag if I ever saw one.

Concerns #4 **MAJOR ISSUE!**

Section 4: Dropping the age to 12 for pharmacists to give shots without a doctor's say-so, as H3988 spells out, is riddled with issues. The glaring gap here? H3988 doesn't make it crystal clear that kids, especially 12-year-olds, can't get jabbed by pharmacists without their parents saying yes. No clear cut rule saying "get the parents' nod first" means we're treading into murky waters where kids might get vaccinated on the sly.

Also, please note that under SC law, Section 63-5-340:

“Minor’s consent to health services. Any minor who has reached the age of sixteen years may consent to any health services from a person authorized by law to render the particular health service for himself and the consent of no other person shall be necessary unless such involves an operation which shall be performed only if such is essential to the health or life of such child in the opinion of the performing physician and a consultant physician if one is available.”

And 

South Carolina Code of Laws Section 63-5-350:

“Health services to minors without parental consent. Health services of any kind may be rendered to minors of any age without the consent of a parent or legal guardian when, in the judgment of a person authorized by law to render a particular health service, such services are deemed necessary unless such involves an operation which shall be performed only if such is essential to the health or life of such child in the opinion of the performing physician and a consultant physician if one is available.

It's also important to note that current law allows pharmacists and pharmacy interns working under the direct supervision of a pharmacist, who meet certain conditions, to administer the influenza vaccine to individuals aged 3 and older.

Concerns #5

H3988 is expanding this law to include the administration of ALL vaccinations to individuals aged 12 and older by pharmacists and pharmacy technicians. This change represents a significant broadening of pharmacists' scope of practice in South Carolina, going beyond the previous authorization focused primarily on influenza vaccinations and opening up the potential for pharmacists and pharmacy technicians to vaccinate more children. 

This raises the question: will this increase the number of vaccine injuries? As many know, vaccine injuries are real and do occur, so why would the SC General Assembly want to make it easier for kids to get vaccinated and not under parental & doctor supervision?

Concerns #6

Also, what is even more alarming is the expansion of pharmacists' and pharmacy technicians' roles to administer all vaccinations, including the COVID-19 vaccine, to individuals aged 12 and older, as mentioned in the amendment. 

Considering the high risk of injury associated with this vaccine, why would the general assembly expand the paths to getting this vaccine?

Other concerns with H3988:

• REPEAT: Without explicit language demanding parental consent in this proposed law, it sets a dangerous precedent open to interpretation, jeopardizing parental rights.

• The bill wrongly presents as 100% safe, effective and necessary, which is misleading and what makes this bill hazardous.

• A pharmacist, or their supervising tech or intern, likely won't lose their license for merely omitting a consent form or not reporting to the patient's doctor.

• Currently, prescriptions are a crucial legal safeguard ensuring minors receive vaccines with parental consent. This bill dismantles that safeguard, potentially leading to more minors being vaccinated without their parents' approval.

Legislative Action:

Calling all South Carolinians! This law? We don't need it, plain and simple. If that strikes a chord with you, it's high time to voice out. Reach out to the House 3M committee. Tell them this isn't what we want or need.

The House 3M committee with be discussing this bill on Tuesday, Feb 27, 1 1/2 hours after adjournment of the House.

Update 3/1/24

H3988 has successfully advanced from the House Medical, Military, Public, and Municipal Affairs Committee and is now moving to the House Floor for further consideration.

Note: the bill was amended but it did not get any better.

Legislative ACTION

What action can you take? Reach out to your Representative to express your opposition to this bill. Your voice matters in shaping the outcome.

Update 4/18/24

On April 18, 2024, the Senate Medical Affairs Committee amended Bill H3988. The amendment, which had been discussed and conceptually approved in the subcommittee, was outlined in a document presented for consideration in a larger committee setting. The amendment includes changes to the age requirements for vaccine administration and additional training requirements for pharmacy technicians and interns. We will provide further details once we review the language in the amended version. H3988 has passed the committee and is now headed to the Senate floor.

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