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<chapter num="21" heading="Standard of Practice for Unlicensed Personnel" title_num="10" subtitle_num="34">
  <regulation prefix="Regulation" num=".01" heading="Scope.">
    <text>This chapter establishes standards of practice and the responsibilities of licensed pharmacists and pharmacy permit holders when using unlicensed personnel in the prescription area of a pharmacy.</text>
  </regulation>
  <regulation prefix="Regulation" num=".02" heading="Definitions.">
    <paragraph num="A.">
      <text>In this chapter, the following terms have the meanings indicated.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Terms Defined.</text>
      <paragraph num="(1)">
        <text>“Board” means the State Board of Pharmacy.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>“Operational support” means tasks performed by:</text>
        <paragraph num="(a)">
          <text>An administrative clerk;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>A billing clerk;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>A cashier;</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Delivery personnel;</text>
        </paragraph>
        <paragraph num="(e)">
          <text>A file clerk;</text>
        </paragraph>
        <paragraph num="(f)">
          <text>An inventory control clerk; or</text>
        </paragraph>
        <paragraph num="(g)">
          <text>An individual engaged in janitorial services.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(3)">
        <text>“Permit holder” means a person or corporation or other legal entity holding a permit issued by the Board to establish and operate a pharmacy.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>“Pharmacy” means an establishment holding a permit under Health Occupations Article, §12-401, Annotated Code of Maryland.</text>
      </paragraph>
      <paragraph num="(5)">
        <text>“Prescription area” means that portion of an establishment to which a pharmacy permit has been issued, which contains:</text>
        <paragraph num="(a)">
          <text>Prescription drugs;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Prescription devices; and</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Patient records.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(6)">
        <text>“Supervision” means the on-site provision of management, direction, oversight, and review of tasks assigned to personnel.</text>
      </paragraph>
      <paragraph num="(7)">
        <text>“Unlicensed personnel” means individuals employed by the permit holder who provide operational support in the prescription area under the supervision of a licensed pharmacist.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".03" heading="Duties of the Permit Holder.">
    <text>The permit holder shall:</text>
    <paragraph num="A.">
      <text>Determine which operational support tasks the pharmacist may assign unlicensed personnel to perform in the prescription area;</text>
    </paragraph>
    <paragraph num="B.">
      <text>Ensure that unlicensed personnel:</text>
      <paragraph num="(1)">
        <text>Receive appropriate training for the tasks that the pharmacist assigns unlicensed personnel to perform in the prescription area;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Receive training that will enable unlicensed personnel to understand how the provisions of Health-General Article, Title 4, Subtitle 3, Annotated Code of Maryland, apply to:</text>
        <paragraph num="(a)">
          <text>Prescription records, and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>The requirements for confidentiality of patient specific information; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(3)">
        <text>When performing tasks in the prescription area, maintain proper:</text>
        <paragraph num="(a)">
          <text>Sanitation;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Hygiene;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Biohazard precautions; and</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Infection control; and</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>Ensure that unlicensed personnel are clearly identified to the consumer.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".04" heading="Duties of the Pharmacist.">
    <paragraph num="A.">
      <text>The pharmacist shall provide supervision to unlicensed personnel.</text>
    </paragraph>
    <paragraph num="B.">
      <text>The pharmacist may not delegate any pharmacy acts to unlicensed personnel.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".05" heading="Duties of Unlicensed Personnel.">
    <paragraph num="A.">
      <text>Unlicensed personnel under the supervision of a pharmacist may perform operational support which the unlicensed personnel have been trained to adequately perform in the prescription area.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Unlicensed personnel who perform duties in the prescription area shall maintain the confidentiality of patient specific data in accordance with Health-General Article, Title 4, Subtitle 3, Annotated Code of Maryland.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".06" heading="Grounds for Discipline.">
    <paragraph num="A.">
      <text>A pharmacist licensee may be subject to discipline if the pharmacist licensee violates any provision of Regulation .04 of this chapter.</text>
    </paragraph>
    <paragraph num="B.">
      <text>A permit holder may be subject to disciplinary action if:</text>
      <paragraph num="(1)">
        <text>The permit holder fails to take reasonable safeguards to ensure compliance with the regulations of the Board; or</text>
      </paragraph>
      <paragraph num="(2)">
        <text>The permit holder otherwise violates any of the provisions of Regulation .03 of this chapter.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <annotations>
    <annotation type="Authority">Health Occupations Article, §12-205(a)(3)(ii), Annotated Code of Maryland</annotation>
    <annotation type="History" subtype="Administrative History">Effective date: March 5, 2001 (28:4 Md. R. 419)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .02B amended effective January 28, 2008 (35:2 Md. R. 127)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .03 amended effective January 28, 2008 (35:2 Md. R. 127)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .03B amended effective December 10, 2001 (28:24 Md. R. 2128)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .03E amended effective November 25, 2002 (29:23 Md. R. 1811)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .04 amended effective January 28, 2008 (35:2 Md. R. 127)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .05 amended effective January 28, 2008 (35:2 Md. R. 127)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .06 amended effective January 28, 2008 (35:2 Md. R. 127)</annotation>
  </annotations>
</chapter>