Budget Amendment ID: FY2023-S4-570
EHS 570
HIV Prevention and PrEP Access
Mr. Cyr, Ms. DiZoglio, Ms. Comerford, Mr. Tarr, Ms. Rausch and Messrs. Hinds and Montigny moved that the proposed new text be amended by inserting after SECTION __ the following sections:-
"SECTION XX. Section 1 of Chapter 94C, as appearing in the 2020 Official Edition, is hereby amended by inserting after the definition of “Extended-release long-acting opioid in a non-abuse deterrent form” the following new definition:-
“HIV prevention drug”, means drugs approved by the U.S. Federal Drug Administration (FDA) for the prevention of HIV, including but not limited to preexposure prophylaxis.
SECTION XX. Said section 1 of said Chapter 94C, as so appearing, is hereby further amended by inserting after the definition of “Practitioner” the following new definition:-
“Pre-exposure prophylaxis" means a drug or drug combination that meets the same clinical eligibility recommendations provided in guidelines of the United States Centers for Disease Control and Prevention (CDC).
SECTION XX. Said Chapter 94C is hereby further amended by inserting after section 21B the following new section:-
"Section 21C. (a) A licensed pharmacist may prescribe and dispense or administer HIV prevention drugs in accordance with regulations promulgated by the department as set forth in this section.
(b) A licensed pharmacist may prescribe and dispense or administer HIV prevention drugs according to federal Food and Drug Administration guidance and product labeling if all the following conditions are met:
(1) The patient is HIV negative, as documented by a negative HIV test result obtained within the previous seven days from an HIV antigen/antibody test or antibody-only test or from a rapid, point-of-care fingerstick blood test approved by the federal Food and Drug Administration. If the patient does not provide evidence of a negative HIV test in accordance with this paragraph, the pharmacist shall order an HIV test. If the test results are not transmitted directly to the pharmacist, the pharmacist shall verify the test results to the pharmacist’s satisfaction. If the patient tests positive for HIV infection, the pharmacist or person administering the test shall direct the patient to a primary care provider and provide a list of providers and clinics in the region.
(2) The patient does not report any signs or symptoms of acute HIV infection on a self-reported checklist of acute HIV infection signs and symptoms.
(3) The patient does not report taking any contraindicated medications.
(4) The pharmacist provides counseling to the patient on the ongoing use of preexposure prophylaxis, which may include education about side effects, safety during pregnancy and breastfeeding, adherence to recommended dosing, and the importance of timely testing and treatment, as applicable, for HIV, renal function, hepatitis B, hepatitis C, sexually transmitted diseases, and pregnancy for individuals of child-bearing capacity. The pharmacist shall notify the patient that the patient must be seen by a primary care provider to receive subsequent prescriptions for preexposure prophylaxis and that a pharmacist may not furnish a 60-day supply of preexposure prophylaxis to a single patient more than once every two years.
(5) The pharmacist documents, to the extent possible, the services provided by the pharmacist in the patient’s record in the record system maintained by the pharmacy. The pharmacist shall maintain records of preexposure prophylaxis furnished to each patient.
(6) The pharmacist notifies the patient’s primary care provider that the pharmacist completed the requirements specified in this subdivision. If the patient does not have a primary care provider or refuses consent to notify the patient’s primary care provider, the pharmacist shall provide the patient a list of physicians and surgeons, clinics, or other health care service providers to contact regarding ongoing care for preexposure prophylaxis.
(c) The department shall promulgate rules to establish statewide drug therapy protocols for prescribing and dispensing preexposure prophylaxis and other HIV prevention drugs approved by the FDA that is consistent with CDC guidelines.
SECTION XX. Section 117 of Chapter 111 of the General Laws, as appearing in the 2020 Official Edition, is hereby amended, in line 1, by inserting the words “prevention or” after the word “providing”.
SECTION XX. Section 117 of chapter 111 of the General Laws, as so appearing, is hereby amended, in line 7, by inserting the words “prevention or” after the word “provide”.
SECTION XX. Section 117 of chapter 111 of the General Laws, as so appearing, is hereby amended, in line 12, by inserting the words “prevention or” after the word “providing” the first time it appears.
SECTION XX. Section 117 of chapter 111 of the General Laws, as so appearing, is hereby amended, in line 16, by inserting the words “prevention or” after the word “and”.
SECTION XX. Section 12F of chapter 112 of the General Laws, as so appearing, is hereby amended, in line 6, by inserting the words “, or for the prevention or treatment of any disease as defined as dangerous to the public health pursuant to section 6 of chapter 111” after the word “patient”.
SECTION XX. Section 12F of chapter 112 of the General Laws, as so appearing, is hereby amended, in line 14, by inserting the words “at risk of exposure to,” after the words “to be”.
SECTION XX. Section 12F of chapter 112 of the General Laws, as so appearing, is hereby amended, in line 18, by inserting the word “, prevention” after the word “diagnosis”."