Committee backs amendment to H588 to allow pharmacists to test and treat COVID-19, flu and strep

A little after 1 p.m. on March 11, the Government Operations & Military Affairs committee recommended a floor amendment to H588 that adds authority for pharmacists to conduct testing and provide treatment for COVID-19, influenza and strep under state protocols, supporters said.

Legislative counsel Tim Dublin told the committee the draft amendment would add a new section to 26 VSA to retitle clinical pharmacy prescribing and testing and "add a single section to the bill having to do with pharmacists," describing limits and protocol-driven authority. "This will add a single section to the bill having to do with pharmacists to be 14A," Dublin said in presenting the text.

Jennifer Coen, director of the Office of Professional Regulation, said the change was intended to expand access in targeted, time-sensitive conditions. "It allows test to treat in pharmacies for limited conditions such as namely COVID-19, influenza, and strep as a way to increase access to care," Coen said, and added that the state protocol would be developed in collaboration with the Department of Health and include public comment and specific procedural safeguards.

Rick Hildebrand, commissioner of the Department of Health, endorsed the policy on public-health grounds and emphasized the need for tight clinical windows and clear guardrails. "If we institute treatment that can shorten the duration of illness ... with influenza, if you're not diagnosed in the first 72 hours you're not eligible," Hildebrand said, stressing that inclusion and exclusion criteria and follow-up would be part of the state protocols.

Pharmacy representatives also testified in favor. Dr. Lauren Bod, legislative liaison for the Vermont Pharmacist Association, said community pharmacists are part of the primary-care infrastructure and supported delegating certain operational tasks to trained pharmacy technicians "under the supervision of a pharmacist" while leaving clinical decision‑making to pharmacists.

The Vermont Medical Society's deputy director, Stephanie Winters, said physicians support protocol-driven pharmacist prescribing but warned against broad, unrestricted authority. "We would be concerned with broad unrestricted test to treat authority," Winters said, praising the amendment’s condition- and medication-specific, protocol-driven approach and urging coordination with primary care.

Members pressed witnesses on implementation details, including who would perform the testing on site and how test results would be recorded and shared. Committee members were told testing would take place at pharmacies consistent with CLIA waiver requirements and that the state protocol would set recordkeeping and continuity-of-care expectations. Carrie Phillips, executive officer of the Board of Pharmacy, noted that many COVID and flu combination tests use the same nasal-swab method: "They are frequently the same exact test," she said.

The committee also sought clarity on whether pharmacy technicians could administer throat swabs for strep. OPR and the Department of Health said the technicians’ role beyond current COVID-authorized testing would likely require a statutory change or regulatory clarification and pledged to investigate and report back. Coen said expansion of pharmacy technician authority for non-COVID tests "would need to be a statutory amendment." Hildebrand said he would "investigate fully and get back to you" on technician scope.

Several witnesses and members discussed reimbursement and operational feasibility. The group linked implementation funding to a Rural Health Transformation (RHT) grant that was referenced as available to support startup and capital costs; committee members and witnesses noted billing and insurer pathways (Medicaid, Medicare, commercial insurers and regulatory rules) would require additional work to ensure pharmacies are paid for the service.

After questions and discussion, the committee recorded a favorable recommendation for the amendment to be presented as a floor amendment by Representative Black. The transcript records the committee taking a "thumbs" vote and reading a count as "902 on the thumbs." The committee chair said the amendment was important and that additional technical edits and consultations — notably on pharmacy technicians and billing pathways — would follow as the bill moves through the process. Lauren Hibbert also alerted the committee to a likely Senate-side amendment related to FBI background checks tied to the interstate medical licensing compact.

The committee recessed for a short break and planned further business after the pause; the amendment will next be presented on the floor as indicated in committee remarks.