201 KAR 2:220. Collaborative care agreements.

      RELATES TO: KRS 315.010(4), 315.040(4), 315.191(1)(a)

      STATUTORY AUTHORITY: KRS 315.191(1)(a)

      NECESSITY, FUNCTION, AND CONFORMITY: This administrative regulation establishes, consistent with the requirements of KRS 315.191(1)(a), minimum requirements for the development and maintenance of collaborative care agreements between an individual pharmacist and an individual practitioner.

      Section 1. A collaborative care agreement shall:

      (1) Be in writing;

      (2) Be signed and dated by the:

      (a) Individual practitioner;

      (b) Individual pharmacist; and

      (c) Patient or care giver;

      (3) Provide that upon termination of the agreement the individual practitioner or individual pharmacist shall notify the patient in writing;

      (4) State the method for termination of the agreement; and

      (5) Contain the information specified by Section 2 of this administrative regulation.

      Section 2. Patient Information. A collaborative care agreement shall contain the following information relating to the patient:

      (1) Name;

      (2) Address and telephone number;

      (3) Emergency notification contact;

      (4) Date of birth, weight, height, and gender;

      (5) Prescription regimen;

      (6) Nonprescription regimen;

      (7) Medical history, including:

      (a) Known diseases;

      (b) Known allergies;

      (c) Reactions and conditions relating to:

      1. Prescription regimens; and

      2. Nonprescription regimens;

      (8) Protocol, criteria, standing orders, or other method by which services are authorized;

      (9) The method established for the assessment of patient outcomes, if appropriate; and

      (10) Lab tests that may be ordered.

      Section 3. The following information relating to a collaborative care agreement shall be maintained by a pharmacist:

      (1) Lab tests ordered, including results of lab tests;

      (2) Assessments of patient outcomes;

      (3) Notes relating to contacts between the individual pharmacist and the individual practitioner concerning the care and course of therapy of the patient; and

      (4) Documentation of the specific counseling information provided to the patient or care giver.

      Section 4. A collaborative care agreement, and information and records required by the provisions of this administrative regulation, shall be maintained:

      (1) At the pharmacist's practice site;

      (2) For at least five (5) years after termination. (23 Ky.R. 3125; Am. 3807; 4109; eff. 6-16-97.)