Committee advances bill letting pharmacists test and treat certain common illnesses

The Senate Regulatory Affairs and Government Efficiency Committee on Feb. 4 advanced Senate Bill 12-14, a measure that would allow pharmacists to order, perform and interpret federal Food and Drug Administration–authorized CLIA-waived tests and to initiate treatment for certain conditions, subject to statewide protocols and limits. The panel adopted an amendment and gave the bill a due-pass recommendation to the full Senate by a 5–2 vote.

Supporters said the bill is aimed at increasing access to basic care in areas with primary-care shortages. Diane McAllister of the Arizona Pharmacy Association told the committee, “This bill allows pharmacists the ability to independently initiate treatments for these small groups of patients,” and argued pharmacists already perform CLIA-waived testing and have clinical training to assess and manage simple conditions.

The bill would let pharmacists test and treat for conditions identified by CLIA-waived tests — examples cited in committee included influenza, strep throat, some COVID-19 related respiratory illnesses and HIV prophylaxis — and for conditions tied to a statewide standing order, rule or executive order issued by the Department of Health Services. The measure requires pharmacists to follow clinical standards and statewide written protocols developed by the Arizona State Board of Pharmacy. Under the version discussed in committee, pharmacists must notify a patient’s primary care provider within 72 hours of initiating treatment and within 48 hours of any adverse effects. The bill expressly prohibits pharmacists from independently initiating opioid treatment and from testing or treating minors without parental consent.

Committee debate centered on training, oversight and the minimum age for minor patients. Dr. Pamela Murphy, a pediatrician who testified in opposition, said clinical assessment goes beyond running a test and urged caution on the minimum age: “I think 6 is way too young. I would prefer to have it at 18,” she said. Professor Dawn Gerber, a PharmD and faculty member at Midwestern University who testified for herself, said pharmacy curricula now include comprehensive clinical assessment instruction and that many programs use simulation centers and hands-on patient assessment training: “All three universities include many hours of clinical assessment,” she said, citing Midwestern’s 19.5 hours and noting the Accreditation Council for Pharmacy Education’s standards.

The committee adopted the four‑page Bullock amendment. Staff described the amendment as removing a statutory consultation requirement for the State Board of Pharmacy, explicitly listing COVID-19 and other coronaviruses among authorized conditions, allowing the American Academy of Pediatrics’ Committee on Infectious Disease to be used as a treatment resource, and requiring pharmacies to display notice or include in consent paperwork that testing and treatment are being performed by a pharmacist. The amendment also establishes an independent testing-and-treatment advisory committee to assist the State Board of Pharmacy in developing protocols.

Medical groups pressed for oversight and age limits. Amanda Sheinzen of the Arizona Medical Association said physicians want a continuing conversation and “proper oversight because our belief is that this really is kind of bleeding into the practice of medicine.” Others raised workforce concerns — that shifting duties could increase burdens on pharmacists and exacerbate shortages in other settings.

Committee members expressed both support for increasing access in rural and underserved areas and concern about shifting burdens between provider groups. After debate the committee adopted the amendment and moved the bill as amended. Senator Carroll moved the bill; the amendment was adopted and the bill as amended received a due-pass recommendation to the Senate floor by a recorded committee tally of 5 ayes, 2 noes, 0 not voting.

The bill, as amended, will move to the Senate calendar; additional amendments or floor debate are possible before any final Senate vote.