<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".03" citation="COMAR 10.34.40.03" title_num="10" subtitle_num="34" chapter_num="40" heading="Requirements to Prescribe Contraceptives.">
  <paragraph num="A.">
    <text>Board Responsibilities. The Board shall develop and adopt the following items, in consultation with stakeholders to be determined by the Board:</text>
    <paragraph num="(1)">
      <text>A self-screening risk assessment questionnaire that a patient shall complete before a pharmacist may prescribe contraceptives for a patient;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>A standard procedure contraceptive algorithm which the pharmacist shall use to perform a patient assessment for purposes of determining:</text>
      <paragraph num="(a)">
        <text>Whether to prescribe contraceptives; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Which contraceptive options to prescribe;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>A notification form to be submitted by a pharmacist before prescribing contraceptives; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Other forms and procedures for:</text>
      <paragraph num="(a)">
        <text>The prescription of contraceptives; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Referral to a primary care or reproductive health care practitioner for treatment.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Notification.</text>
    <paragraph num="(1)">
      <text>Except as provided in §B(2) of this regulation, at least 15 days before prescribing contraceptives, a pharmacist shall submit to the Board a notification form, which includes an attestation of completion of a Board-approved training program.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>A pharmacist who has undergone training for prescribing contraceptives as part of the pharmacist’s formal educational program:</text>
      <paragraph num="(a)">
        <text>Is exempt from completing a Board-approved training program; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>At least 15 days before prescribing contraceptives, shall submit to the Board a notification form, which includes an attestation of the pharmacist’s formal education program.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>A pharmacist may not prescribe contraceptives until the pharmacist receives a written confirmation from the Board accepting the pharmacist’s notification form.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Pharmacist Responsibilities.</text>
    <paragraph num="(1)">
      <text>For each new patient requesting contraceptive services, and at a minimum of every 12 months for each returning patient, a participating pharmacist shall:</text>
      <paragraph num="(a)">
        <text>Obtain the completed Board-approved self-screening risk assessment questionnaire from the patient; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Utilize and follow the Board-approved standard procedure contraceptive algorithm to:</text>
        <paragraph num="(i)">
          <text>Perform the patient assessment;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Determine whether to prescribe contraceptives; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Determine which contraceptive options to prescribe.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Upon completion of all requirements established by the Board and after review of all relevant information, a pharmacist may prescribe contraceptives, if deemed clinically appropriate.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>If contraceptives are prescribed, the pharmacist shall:</text>
      <paragraph num="(a)">
        <text>Refer the patient:</text>
        <paragraph num="(i)">
          <text>For additional care to their primary care practitioner or reproductive health care practitioner; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>If the patient does not have a primary care practitioner or a reproductive health care practitioner, to a family planning provider or a licensed clinician who provides reproductive health care services;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>Provide the patient with a visit summary; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Document the encounter and maintain records pursuant to Regulation .05 of this chapter.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>Upon completion of all requirements established by the Board and after review of all relevant information, if the pharmacist does not prescribe contraceptives, the pharmacist will provide a visit summary to the patient which provides the basis for the decision not to prescribe contraceptives.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>A pharmacist may not prescribe contraceptives before January 1, 2019.</text>
    </paragraph>
  </paragraph>
</regulation>