DEC. 2013

The Official PublicationOf The Florida Pharmacy Association

A look at the top five health concerns from 2013 and the top five threats for 2014

THE CDC’S

TOP10

2 | F L O R I D A P H A R M A C Y T O D A Y

1989Twenty-five years ago

■ The second Pharmacy in the 21st Century (P21) conference was held in Williamsburg. The concept of pharmaceutical care was formally introduced by Hepler and Strand and enthusiastically accepted.

Pharmacy Time Capsule 2013

By: Dennis B. Worthen Lloyd Scholar, Lloyd Library and Museum, Cincinnati, OHOne of a series contributed by the American Institute of the History of Pharmacy, a unique non-profit society dedicated to

assuring that the contributions of your profession endure as a part of America’s history. Membership offers the satisfaction of helping continue this work on behalf of pharmacy, and brings five or more historical publications to your door each year. To learn more, check out: www.aihp.org

1939Seventy-five years ago

■ Western Massachusetts School of Pharmacy opened in Williman-sett, MA, although it was never accredited.

1964Fifty years ago

■ The survey, Mirror to Hospital Pharmacy, was pub-lished. Data included that less than 40 percent of all hospitals employed approximately 2,000 full-time pharmacists.

1914One hundred years ago

■ The federal Harrison Narcotic Act passed to regulate and tax the importation, production and distribution of narcotics.

1889One hundred twenty-five

years ago

■ Walden University (Meharry Pharmaceutical College) opened in Nashville.

D E C E M B E R 2 0 1 3 | 3

VOL. 76 | NO. 12DECEMBER 2013THE OFFICIAL PUBLICATION OF THEFLORIDA PHARMACY ASSOCIATIONP H A R M A C Y T O D A Y

florida

Departments 2 Time Capsule

4 Calendar

4 Advertisers

5 President’s Viewpoint

7 Executive Insight

20 Buyer’s Guide

FeaturesAdherence — It Only Takes a Minute to Be Heart Healthy

CDC’s Top TenA Look at The Top Five Health Concerns From 2013 and The Top Five Threats For 2014

Alligator Management

9

10

12

4 | F L O R I D A P H A R M A C Y T O D A Y

E-MAIL YOUR SUGGESTIONS/IDEAS TO

dave@fiorecommunications.com

Mission Statements:of the Florida Pharmacy Today JournalThe Florida Pharmacy Today Journal is a peer reviewed journal which serves as a medium through which the Florida Phar-macy Association can communicate with the profession on advances in the sciences of pharmacy, socio-economic issues bearing on pharmacy and newsworthy items of interest to the profession. As a self-supported journal, it solicits and accepts advertising congruent with its expressed mission.

of the Florida Pharmacy Today Board of Directors The mission of the Florida Pharmacy Today Board of Directors is to serve in an advisory capacity to the managing editor and execu-tive editor of the Florida Pharmacy Today Journal in the establishment and interpreta-tion of the Journal’s policies and the manage-ment of the Journal’s fiscal responsibilities. The Board of Directors also serves to motivate the Florida Pharmacy Association members to secure appropriate advertising to assist the Journal in its goal of self-support.

AdvertisersEPC ..................................................................... 15HCC...................................................................... 3KAHAN HEIMBERG, PLC ............................ 15PPSC ................................................................... 15

2013 - 2014

FPA Calendar DECEMBER

25-26 Holidays - FPA Office Closed

JANUARY

1 FPA Office Closed

11 Young Pharmacist Leadership Conference Orlando

12 FPA Strategic Planning RetreatOrlando

20 Martin Luther King Day - FPA Office Closed

25 FPA Law and Regulatory ConferenceSandestin

31 Last day to submit election ballots

FEBRUARY

4-5 Florida Board of Pharmacy meetingOrlando

28 Awards Nomination Deadline

MARCH

4 Legislative Session Begins

10-11 Florida Pharmacy Health Fair and Legislative Days Tallahassee

15 Deadline to Submit Resolutions

22-23 FPA Council and Committee meetings/Board of Directors meeting

28-31 APhA Annual Meeting Orlando

APRIL

1-2 Florida Board of Pharmacy meetingTampa

5-6 FPA Clinical ConferenceTampa

18 Good Friday, FPA Office Closed

20 Easter

CE CREDITS (CE cycle)The Florida Board of Pharmacy requires 10 hours LIVE Continuing Education as part

of the required 30 hours general education needed every license renewal period.Pharmacists should have satisfied all continuing education requirements for

this biennial period by September 30, 2015 or prior to licensure renewal. Consultant pharmacists and technicians will need to review their licenses and registrations by December 31, 2014.

For Pharmacy Technician Certification Board Application, Exam Information and Study materials, please contact the FPA office.

For More Information on CE Programs or Events:Contact the Florida Pharmacy Association at (850) 222-2400 or visit our Web site at

www.pharmview.com

CONTACTSFPA — Michael Jackson (850) 222-2400FSHP — (850) 906-9333U/F — Dan Robinson (352) 273-6240FAMU — Leola Cleveland (850) 599-3301NSU — Carsten Evans (954) 262-1300

DISCLAIMER Articles in this publication are designed to provide accurate and authoritative information with respect to the subject matter covered. This information is provided with the understand-ing that neither Florida Pharmacy Today nor the Florida Pharmacy Association are engaged in rendering legal or other professional services through this publication. If expert assistance or legal advice is required, the services of a competent professional should be sought. The use of all medications or other pharmaceutical products should be used according to the recommendations of the manufacturers. Information provided by the maker of the product should always be consulted before use.

For a complete calendar of events go to www.pharmview.comEvents calendar subject to change

D E C E M B E R 2 0 1 3 | 5

E-MAIL YOUR SUGGESTIONS/IDEAS TO

dave@fiorecommunications.com

“And the Winner Is...”

The President’s ViewpointTERRY GUBBINS , FPA PRESIDENT

We have completed our first annual student membership drive, and the numbers are

impressive! I want to thank all of the FPA members (pharmacists and stu-dents), who made this event successful.

To remind you of the specifics, the pharmacy school with the highest percentage of students as members of FPA will receive a $1,000 check from us. This was also the first year of our $20 one-time membership fee to cover the student’s FPA membership during their entire school career. No need to renew every year!

I am proud to say that we now have over 1,300 student members in FPA! And, just like football in the Sunshine State, our schools were very compet-itive and made a real race out of the membership drive. Our Top Three schools all have over 40 percent of their students as members of FPA.

The No. 1 pharmacy school in the state, with the highest percentage of its students as members of FPA, is the

University of South Florida, at 48 per-cent. Congratulations, Bulls! Following close behind the Bulls, only 2 percent-age points away, is the University of Florida, at 46 percent. Great job, Gators! Rounding out our Top Three schools is Florida A&M, with 41 percent. Over 250 Rattlers are members of FPA!

Now, with over 1,300 student mem-bers in FPA, we need to keep you en-gaged and active in FPA. Please join us January 11 in Orlando for our first annual Young Pharmacist Leadership Conference. You can register on our website in advance or at the door on January 11. Whatever you do, please join us. And don’t forget to join us for Legislative Days, March 10 and 11, in Tallahassee. We had 400 students at-tend last year. How many of our 1,300 student members will be able to join us this year? You will also be able to reg-ister for this on our website as we get closer to March.

Again, thanks to everybody who made this student membership drive a

success. Congratulations to the Univer-sity of South Florida for winning the contest. And WELCOME to the over 1,300 student members! ■

Terry Gubbins 2013-2014 FPA President

6 | F L O R I D A P H A R M A C Y T O D A Y

JOIN TODAY!

Florida Pharmacy AssociationSee "Viewpoint", continued on page 6

The Florida Pharmacy Association gratefully acknowledges the hard work and dedication of the following members of the FPA leadership who work diligently all year long on behalf of our members.

Goar Alvarez ............................................................................ Chairman of the BoardTerry Gubbins ..............................................................................................FPA PresidentSuzanne Kelley ........................................................................................ President ElectAlexander Pytlarz ...............................................................................................TreasurerGary Koesten ............................................Speaker of the House of DelegatesBob Parrado ...................................Vice Speaker of the House of DelegatesTim Rodgers, Director ..........................................................................................Region 1Michael Hebb, Director ......................................................................................Region 2Stephen Grabowski, Director ......................................................................Region 3 Raul N. Correa, Director ...................................................................................Region 4 Jason Beattie, Director ....................................................................................Region 5 Scott Tomerlin, Director ....................................................................................Region 6Kimberly Jones, Interim Director ............................................................... Region 7Raul Gallo, Director ................................................................................................Region 8Nadine Seabest, Interim Director ..............................................................Region 9Richard Kessler ..................................................................................... President FSHPMichael Jackson .......................................Executive Vice President and CEO

Florida Pharmacy Today Journal Board

Chair......................................................Jennifer Pytlarz, jlc_rxdoc@hotmail.comVice Chair ........................................................ Don Bergemann, don@bceinfo.comTreasurer ...................Stephen Grabowski, sgrabowski@seniormmc.comSecretary ..................................................................Stuart Ulrich, Stuarx@aol.comMember ................................................Joseph Koptowsky, docjik1215@aol.comMember .......................Rebecca Poston, rebecca_poston@doh.state.fl.usMember ...................................................... Carol Motycka, motycka@cop.ufl.eduMember .......................................................Cristina Medina, cmmedina@cvs.com Member ...............................................................Norman Tomaka, FLRX9@aol.comMember ..................Verender Gail Brown, brownvgrx4304@hotmail.comExecutive Editor ...............Michael Jackson, mjackson@pharmview.comManaging Editor ..................Dave Fiore, dave@fiorecommunications.com

2013 FPA Board of Directors

PHARMACY BRIEFS

Compounding Bill Passes SenateIn Washington, D.C., the Senate

passed H.R. 3204 related to compound-ing and track and trace of prescription drugs. According to the Internation-al Academy of Compounding Pharma-cists, if H.R. 3204 were signed into law by President Obama, traditional com-pounding would continue to be exempt from the act’s manufacturing require-ments. Mass producing compounders will have to register with the Food and Drug Administration as outsourcing fa-cilities and subject to laws required of prescription drug manufacturers.

Also included in the legislation is language designed to create a nation-wide tracking system for prescription drugs to keep counterfeit and stolen drugs out of the distribution system. This is very similar to the pedigree pro-gram that has been in place here in Flor-ida for a number of years. Prescription drug wholesaling and manufacture li-censing in this state is within the Bu-reau of Drugs, Devices and Cosmetics of the Department of Business and Pro-fessional Regulation.

New Online Board of Pharmacy Applications Available

The Florida Department of Health Division of Medical Quality Assurance

See Briefs, continued on page 8

D E C E M B E R 2 0 1 3 | 7

It seems that there is always a con-troversy surrounding prescription drug pricing. This has been a mys-

tery and puzzle that the passage of time never seems to address. Consum-ers have become so frustrated over the years with prescription drug pricing that the government has been asked to intervene to provide more clarity. Websites have been developed over the years to help consumers make provider choices based on prescription drug pric-ing. Florida has such a resource with a partnership between the Florida Attor-ney General’s Office and the Agency for Health Care Administration. Members should take a peek at the state-managed website. The prices in this site are pre-sumably updated monthly.

So what are the latest trends in prescription drug pricing?

The Florida Pharmacy Association receives a host of calls each day on vari-ous pharmacy issues from our member-ship. A large number of calls are relat-ed to sudden and significant increases in the cost of certain prescribed medi-cations with no real reason for the in-crease. It has been suggested that some of the increases are related to the imple-mentation of the Affordable Care Act provisions that may limit price increas-es at some point in the future. If this is the case, then manufacturers may have some uncomfortable explaining to do.

Generally, the prices of commodi-ties increase and decrease with eco-nomic factors such as supply, demand and the cost to produce and distrib-ute. None of these issues seem to be the case for certain products that have been on the market for many years and may have multiple suppliers. If our readers are looking for an answer to this ques-tion, it is disappointing that the answer

cannot be found in this article. The Flor-ida Pharmacy Association does not col-lect pricing information for prescription drugs.

What we can share with you is that these pricing adjustments are creating significant issues for pharmacy busi-nesses that need to be addressed. For example, we are aware that prices may change each time a prescription drug is purchased by a pharmacy. We are also aware that the typical pharmacy has a

large percentage of their business pro-cessed though third-party programs and that payment for these pharmacy services are determined by contract.

Many of these contracts may include a maximum allowable cost list or MAC list. What our members are telling us is that the cost of certain prescription drugs are changing at an alarming rate; however the cost basis in MAC pricing programs has not keep pace with the changes. This may result in a pharmacy dispensing medications at or below the cost of acquisition.

So what can be done about this issue?

The pricing of prescription drugs cannot be influenced by the Florida

Pharmacy Association. Any efforts to do so could create serious legal issues. Members are encouraged to discuss pricing-related issues in your pharmacy with state policy makers such as your state representative and senator or con-gressman.

The current system of reimburse-ment for pharmacy businesses and the way MACs are being used today is harmful to both small and large busi-nesses. It could have an effect on pa-tient access to certain medications as pharmacies begin reviewing the types of services they are able to provide. The FPA has already been interviewed by a south Florida news station and dis-cussed with key members of the Flori-da Legislature on this issue.

Questions should be raised by pur-chasers of prescription drug services clarifying MAC pricing. Perhaps a pol-icy statement by the Florida House and Senate on the transparency of MAC pricing should be considered. ■

The Price is Right. Or is it?

Executive InsightBY MICHAEL JACKSON, RPHMICHAEL JACKSON, BPHARM, EVP & CEO, FLORIDA PHARMACY ASSOCIATION

Michael Jackson, B.PharmThe Florida Pharmacy

Association does not collect pricing

information for prescription drugs.

8 | F L O R I D A P H A R M A C Y T O D A Y

Executive Vice President/CEOMichael Jackson

(850) 222-2400, ext. 200Director of Continuing Education

Tian Merren-Owens, ext. 120Controller

Wanda Hall, ext. 211 Educational Services Office Assistant

Stacey Brooks, ext. 210Coordinator of Membership

Christopher Heil, ext. 110

FLORIDA PHARMACY TODAY BOARDChair............................................. Jennifer Pytlarz, BrandonVice Chair ..................Don Bergemann, Tarpon SpringsTreasurer ..............................Stephen Grabowski, TampaSecretary ........................Stuart Ulrich, Boynton BeachMember .................................... Joseph Koptowsky, MiamiMember .............................Rebecca Poston, TallahasseeMember ............................. Carol Motycka, St. AugustineMember ...................................Cristina Medina, HollywoodMember ................................Norman Tomaka, MelbourneMember .............................Verender Gail Brown, OrlandoExecutive Editor ........Michael Jackson, TallahasseeManaging Editor ........................Dave Fiore, Tallahassee

This is a peer reviewed publication. ©2013, FLORIDA PHARMACY JOURNAL, INC.ARTICLE ACCEPTANCE: The Florida Phar-macy Today is a publication that welcomes articles that have a direct pertinence to the current practice of pharmacy. All articles are subject to review by the Publication Review Committee, editors and other outside referees. Submitted articles are received with the understanding that they are not being considered by another publication. All articles become the property of the Florida Pharmacy Today and may not be published without written permission from both the author and the Florida Pharmacy Today. The Florida Pharmacy Association assumes no responsibility for the statements and opinions made by the authors to the Florida Pharmacy Today.

The Journal of the Florida Pharmacy Association does not accept for publication articles or letters concerning religion, politics or any other subject the editors/publishers deem unsuitable for the readership of this journal. In addition, The Journal does not accept advertising material from persons who are running for office in the association. The editors reserve the right to edit all materials submitted for publication. Letters and materials submitted for consideration for publication may be subject to review by the Editorial Review Board.

FLORIDA PHARMACY TODAY, Annual sub-scription - United States and foreign, Indi-vidual $36; Institution $70/year; $5.00 single copies. Florida residents add 7% sales tax.

FLORIDA PHARMACY ASSOCIATION

610 N. Adams St. • Tallahassee, FL 32301850/222-2400 • FAX 850/561-6758

Web Address: http://www.pharmview.com

FPA STAFF

See Briefs, continued on page 14

Pharmacy Briefs, continued from page 6

announces that some pharmacy pro-fessions may now apply online. This process will eliminate mailing time and expedite your application. Apply online, using your user ID and pass-word, and receive a response within 10-13 business days.

Once applicants create an account in the Online Licensure Application using an email address and password, they will have up to a year to complete the application and pay the applica-tion fee. The online tool is dynamic and keeps the applicant informed of any deficiencies and the current status of their application. It can be used by the following applicants who wish to apply and pay using a credit or debit card:

■ Pharmacy interns, both U.S. and foreign graduates

■ Registered Pharmacy Technicians ■ Consultant Pharmacists ■ Nuclear Pharmacists ■ Registered Pharmacy Technician

training programs

To access the Online Licensure Ap-plication, go to:

■ www.FLHealthSource.com ■ Select the Apply for a License - the

Practitioner Services page is dis-played

■ Click on Create an Account ■ Choose Board of Pharmacy from

the Board/Council dropdown menu.

■ Choose your profession ■ Enter email address ■ Create a password

FPA Leadership Election Tool Now Available

The 2014 election of Florida Phar-macy Association (FPA) officers is now underway. Members should have re-ceived a postcard with ballot instruc-tions on how to select your next FPA president and regional director. We are using an electronic balloting system to

make it easy to make your selection of candidates. All you will need to do is to log into www.pharmview.com with your username and password. The polls will be kept open until midnight, January 31, 2014. A committee of elec-tion canvassers will be assembled to certify the election and the winners will be announced in February. Watch your mailbox for your ballot post card.

FPA Meets with Florida’s Attorney General Staff

FPA visited with Rob Johnson, Di-rector Legislative and Cabinet Affairs and Matthew Dunagan, Chief Policy Analyst, Prescription Drug and Spe-cial Projects Section of the Office of the Attorney General (AG) to discuss our interest in sustainable funding of the Prescription Drug Monitoring Pro-gram (PDMP). Attending on behalf of the FPA, in addition to FPA’s CEO Mi-chael Jackson, were Robert Beck and Claudia Davant of Adams Street Ad-vocates and John Lockwood, General Counsel of the FPA.

Our goal for this meeting was to share the FPA’s interest in PDMP and

D E C E M B E R 2 0 1 3 | 9

Take a minute, save a life. The statis-tics on cardiovascular health in this na-tion are sobering. Not only is heart dis-ease, including stroke, the leading cause of death in the United States, but every 25 seconds an American will have a coronary event, and about every min-ute someone will die from one. Heart disease isn’t known as “the silent kill-er” without a reason. The importance of adherence is especially heightened with cardiovascular medications, which can pose a greater risk of adverse events if doses are missed or suddenly stopped, even if the patient is “feeling fine” while their blood pressure skyrockets.

In his presidential address, Dr. Ralph Sacco, MD, FAHA, president of the American Heart Association, said that “we are facing a global crisis, and must work together to improve the health of our patients, the public, and ourselves.” To that end, his association has set an ambitious, 10- year goal to improve the cardiovascular health of all Americans, by reducing the occurrence of cardio-vascular diseases and stroke deaths by 20 percent by the year 2020. The AHA has identified seven factors and behav-iors for ideal cardiovascular health, something we at NCPA believe ev-ery community pharmacist can have a hand in promoting, both through im-proving medication adherence and pa-tient education.

They are called “Life’s Simple Sev-en,” core elements to building healthier lives. Sacco noted that these factors are not new, but the approach to address-ing them is. By making the distinction

of referring to them as ‘health factors’ as opposed to ‘risk factors’, the AHA be-lieves that this will help patients to “un-derstand and embrace the benefits of healthy living.” What are they? A com-bination of ideal levels (blood pressure, blood sugar, and cholesterol), and life-style choices (diet, physical exercise, ap-propriate weight, and non-smoking), something community pharmacists counsel their patients on every day. Re-inforcing adherence can be a simple act; taking a minute to discuss diet or check blood pressure, done consistent-ly can make a real difference. There’s a good chance many of your patients are not meeting their goals, so don’t pass up the opportunity to talk with them about their health factors whenever they are picking up a new prescription, or you’ve noticed a dosage increase in their medications.

The AHA acknowledges that they will not be able to improve the cardio-vascular health of the country alone, and that what’s needed is more collab-oration and interdisciplinary partner-ships. NCPA sees their goal as being synergistic with what we are trying to achieve with medication adherence and can’t wait to see what community phar-macists can do to improve the heart health of their patients.

Take a minute to talk to your patients about the ABCs of heart disease:

A, as in hemoglobin A1CB, for blood pressureC, for cholesterol

Who knows, with those ABCs, you might just save a life.

Do you have an adherence idea, tip, or program that is working in your pharmacy? Let us know. Send an e-mail to adherence@ncpanet.org.

Reprinted with permission from National Community Pharmacists As-sociation in the February 2011 issue of America’s Pharmacist. For more infor-mation about NCPA, visit www.ncpa-net.org.

Adherence — It Only Takes a Minute to Be Heart Healthy

In his presidential address, Dr. Ralph Sacco, MD, FAHA, president of the American Heart Association, said that “we are facing a global crisis, and must work together to improve the health of our patients, the public, and ourselves.”

10 | F L O R I D A P H A R M A C Y T O D A Y

As 2013 comes to a close, CDC looks back on the top five health concerns of the year while preparing for the project-ed health threats of 2014. Read the whole story: CDC’s 2013: A Year in Review.

Let’s take a look back through some of the highlights of 2013.

Tips From Former Smokers Campaign Launched in March of 2012, this campaign was the first-ev-

er paid national tobacco education campaign. In 2013, a study released by CDC indicated that more than 200,000 Americans had quit smoking and 1.6 million smokers attempted to quit smoking immediately. These results exceed the campaign’s original goals of 500,000 quit attempts and 50,000 successful quits.

Listeria & Advanced Molecular Detection, CDC uses Ad-vance Molecular Detection to reduce impact of Listeriosis

Listeria, ranking third as a cause of death from major food-borne germs in the United States, sickens about 1,600 people each year. In 2013 CDC used whole genome sequencing along with diagnostic testing for the first time to help clarify which patients’ illnesses were related to an outbreak of listeriosis as-sociated with consumption of contaminated cheese. The use of new Advanced Molecular Detection tools allowed CDC to successfully define the outbreak strain and more easily and quickly show which illnesses are part of an outbreak and re-spond sooner.

Million Hearts®, Preventing Heart Attacks and Strokes

CDC released a Vital Signs in 2013 showing that at least 200,000 deaths each year from heart disease in the U.S. could be prevented through changes by individuals, such as stop-ping smoking, more physical activity, and less salt in the diet; community changes to create safe places to exercise and smoke-free areas; improvements in managing high blood pressure, high cholesterol, and diabetes; and improvement in acute care, secondary prevention, and rehabilitation. CDC also developed and distributed new resources, recommenda-tions, and protocols, to help health care professionals, com-munities, and individuals work together to contribute to the Million Hearts® goal of preventing 1 million heart attacks and strokes by 2017.

Healthcare – Associated Infections, Eliminating Healthcare-Associated Infections

On any given day, about 1 in every 20 hospitalized patients has an infection caused by receiving medical care. In 2013, CDC has found that bloodstream infections in patients with central lines have decreased by 44% and surgical-site infec-tions have decreased by 20% since 2008, and that following CDC protocols could cut some dialysis-related bloodstream infections in half.

The CDC’s Top TenA Look at The Top Five Health Concerns From 2013 and The Top Five Threats For 2014

Source: Centers for Disease Control and Prevention

D E C E M B E R 2 0 1 3 | 11

Celebrating 10 Years of PEPFAR, Fighting International HIV/AIDS

Throughout the past decade, CDC has been advancing sci-ence and innovation, and making strategic investments to build the capacity of host countries to lead their own respons-es to the AIDS epidemic. In 2013, PEPFAR prevented the one millionth baby from being infected with HIV and has 6.7 mil-lion people on treatment, with incidence falling in nearly all PEPFAR countries.

America’s health protection agency previews the five health threats that loom for 2014.

Antibiotic Resistance and Advanced Molecular Detection, The End of the Antibiotic Era

Every year, more than two million people in the U.S. get in-fections that are resistant to antibiotics and at least 23,000 peo-ple die as a result. In 2014, CDC will continue to work with federal, state, and local partners towards improving antibiotic use, preventing infections and the spread of resistance, gath-ering data on antibiotic-resistant infections, and developing diagnostic tests to track the development of resistance.

Preventing Prescription Drug Abuse and Overdose, Prescription Drug Overdose: A Growing Epidemic

Deaths from prescription painkillers have reached epi-

demic levels in the past decade, and more than 16,500 peo-ple died from painkiller overdoses in 2010. CDC continues to track prescription drug overdose trends to better understand the epidemic and in 2014, will continue to focus on com-prehensive state efforts to develop, implement and evaluate promising strategies to prevent prescription drug abuse and overdose.

Global Health Security, Securing our Global Health Borders

Infectious disease outbreaks, whether natural, intention-al, or accidental, are still among the foremost dangers to hu-man health and the global economy. Through strategic invest-ments in critical public health systems, CDC will be working more closely with Ministries of Health to increase their abil-ity to prepare for and respond to public health threats and re-duce the risk of these threats crossing borders.

HPV Vaccination, HPV Vaccine is Cancer Prevention

For both boys and girls, HPV vaccination rates continue to be well below the Healthy People goals for 2020, leaving an entire generation susceptible to HPV-related cancers. In 2014, CDC will continue to monitor adolescent vaccination cover-age levels and will continue to outreach and education to cli-nicians through continuing medical education, partnership with professional associations, and other educational oppor-tunities to help strengthen vaccine recommendations and eliminate missed opportunities for HPV vaccination.

Polio, A World Without Polio The world is closer than ever to ending polio everywhere,

thanks to the efforts of CDC and the Global Polio Eradica-tion Initiative. However, challenges must be addressed in 2014 to meet the goal of eradicating polio once and for all. CDC is working together as part of a committed global effort to change history and end polio forever.

Deaths from prescription painkillers have reached epidemic levels in the past decade, and more than 16,500 people died from painkiller overdoses in 2010.

12 | F L O R I D A P H A R M A C Y T O D A Y

Draining the swamp is hard, but do-ing so while fending off alligators can present a real challenge. As a pharmacy leader or manager, just getting the job done every day is hard enough. How do you make sure the job gets done when you are presented with a whole new set of requirements that you didn’t expect?

Let me tell you about my swamp and the alligators that tried to do me in. As-signed as an Interim Director of Phar-macy (DOP) in a large medical/trauma hospital filled to capacity, I took over without any face time or turnover with my predecessor. This ensured that my hands were full learning about the staff and supervising the day-to-day activi-ties while also trying to determine the compliance status of my new facility. Needless to say, the job itself was daunt-ing, but the staff was doing a great job taking care of patients (draining the swamp) and I was making good prog-ress in finding and fixing problems.

However, a short while after I took over as director, the alligators struck. First, the State Board of Pharmacy in-spector appeared on the doorstep to as-sess USP 797 compliance. The next day, the Ethics and Compliance Officer ar-rived to check on our compliance with controlled substance requirements. And then 11 days later, a team of five showed up for an operational assessment to de-termine our compliance status. At the end of two weeks, I had 60 deficiencies (alligators) nipping at my ears, each one requiring immediate action.

Perhaps this is a good spot for a new-ly assigned DOP to be in because the

deficiencies didn’t happen on my watch. However, I now owned them and no matter what, I was expected to execute the corrective actions right away.

So, how to attack the alligators while continuing to drain the swamp? I used five steps to gain control of the situa-tion.

Set the Direction ■ Assign Priorities

Focus the Efforts ■ Delegate Activities

Track Success

Perhaps the first step is the most critical. Set the Direction. Defining all of the action items that need to be ac-complished is critical. In my case, the three different assessments clearly de-fined my requirements. I consolidat-ed them into one list, which helped me get a sense of the total requirements. It is important to get them down on pa-per in a format that makes sense to you. I used an action plan spreadsheet that included the deficiency, what needed to be done, a priority system, responsibili-ties, outcome expected and a deadline for completion. Use what works for you (see chart below).

Next is to determine which item or items are most important. Assign Pri-orities. Not everything can be done at the same time. If you try to shotgun it, you do nothing very well and every-thing poorly. And remember, you are still responsible for making sure the day-to-day pharmacy activities contin-ue unabated while working on this new set of tasks. Keep the staff focused on the pharmacy and set your priorities on the most important action items. In my case, the Board of Pharmacy was No. 1 and then the controlled substance is-sues came next.

Step three is to Focus Your Efforts. This is related to prioritization. Howev-er, it is really marshaling your resourc-es to apply the maximum effort to get the next most critical task done. If you have a need that requires you to use the same people to accomplish two dif-ferent tasks, don’t split your resources. Get the highest priority task done first, and then redirect your staff to the sec-ond. Continually reassess your priori-ties based on the ever-changing arena in which you live. Sometimes new alli-gators arrive or new swamp-draining requirements appear that need to be in-tegrated into the action plan.

Alligator ManagementBy Wayne Cheatum

Problem, Issue, or Deficiency

Finding, Recommendation,

Activity Priority

Responsible Person

Outcome Expected

Estimated Completion

D E C E M B E R 2 0 1 3 | 13

One of the most important things to learn is to Delegate. Don’t go it alone. Engage your staff in what needs to be done. Share the wealth. One of my men-tors expressed it this way, “None of us is as smart as all of us.” Task them, but give them good guid-ance. Be specific in what you want to see

at the outcome and expect them to com-plete the tasks. When you delegate, you must hold the person accountable for completion. Otherwise it ends up back on your desk. Give them the joy of kill-ing a few alligators.

Last but not least is to Track Suc-cess. Share your action plan with your staff and get their buy-in. Let them par-ticipate in making the improvements. Pharmacy is a team effort so keep the team involved and informed. Show them what they have accomplished. Make sure to follow up with every item that you delegated. Show progress at every staff meeting. Your staff will ap-preciate where you have been and what you have accomplished together.

The staff and I survived. We com-pleted all but four of the tasks in the months after the alligators arrived. I left confident that I had left the phar-macy better than I found it and that the swamp would continue to be drained. Besides, I had a chance to kill a few al-

ligators in the interim.So, see if you can apply these

steps to your swamp.Set The Direction, Assign Priori-

ties, Focus Your Efforts, Delegate and Track Success. Then, you can kill a few alligators of your own.

Wayne Cheatum is a retired Air Force Colonel and Pharmacist. He previously led the largest pharmacy in the Air Force at Lackland AFB in San Antonio, Texas. Wayne is currently a Transitional Lead-er with CompleteRX, a national pharmacy management company.

“It’s hard to remember that your primary purpose is to drain the swamp when you’re up to your ears in alligators”

14 | F L O R I D A P H A R M A C Y T O D A Y

our ideas on possible funding sourc-es. We suggested to the AG’s office that pharmacists’ licensure fee trust funds have traditionally exceeded what is needed to regulate our profession. While the idea and proposal from FPA’s leadership did not specifically expand the funding of PDMP beyond the avail-able pharmacy licensure fee trust funds we did indicate that we are encouraging the other provider groups to join with us in our campaign to help keep PDMP going. Some of the benefits of PDMP program include helping pharmacists to manage clinical patients being treat-ed with addictive pain medications, re-duction in doctor shopping and deaths. The FPA is challenging the other health professions to join this campaign.

FPA Raises Concerns over Tramadol Transition to Controlled Substance Status

In our FPA Breaking News section on the Pharmview.com home page we announced that the Drug Enforcement Administration is giving consideration to adding tramadol to the list of con-

trolled substances. A comment period to the Department of Justice has been opened until January 3, 2014. This issue was discussed at a recent meeting of the FPA Board of Directors in Orlando. The FPA Board of Directors believes that this drug should be listed as a drug of concern and added to the list of report-able drugs within the PDMP program rather to the list of controlled substanc-es. The position of the FPA was shared with the Florida Office of Attorney Gen-eral.

Joint Op-ed Calls for Expanding Services Offered by Pharmacists (from NCPA)

Prior to the NCPA annual conven-tion and trade show in Orlando, the Or-lando Sentinel published an op-ed, au-thored jointly by NCPA and the FPA, calling for the government to recog-nize pharmacists as healthcare pro-viders. With the Affordable Care Act taking effect and the expectation that millions of new beneficiaries will join the healthcare market in the coming months, there will be additional strain

on a system that is already experiencing a shortage of doctors, and that shortage will continue to grow. Given the train-ing pharmacists receive, they can help fill the void in access to care, yet the fact that pharmacists are not recognized as providers prevents them from being compensated for the services they pro-vide.

Gaining pharmacist recognition as providers is a priority for NCPA and NCPA staff will be working diligently with policymakers to give them a bet-ter understanding of the positive im-pact such recognition would have on the healthcare system as a whole. Phar-macist recognition as providers is good policy and good medicine.

■ Keep your dues current with the most accurate information in your membership accounts

■ Register for conferences and educational programs ■ Register online and you can print a receipt instantly without having to

wait for one to be mailed to you ■ Your continuing education credits earned through FPA programs will

be published as transcripts and certificates in your member record

The All-new FPA Website is Now OnlinePharmview 3.0 offers more features, greater access and increased opportunities for member interaction.

Take advantage of all the possibilities and visit your new website today at www.pharmview.com.

Pharmacy Briefs, continued from page 8

D E C E M B E R 2 0 1 3 | 15

A PhArmAcist And A LAwyer

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SAVE THE DATE—JULY 9-13, 2014

Marriott Harbor Beach Golf Club Resort and Spa

3030 Holiday Drive Ft. Lauderdale, Florida 33316

For room reservations call

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Florida Pharmacy Association 610 North Adams Street

Tallahassee, Florida 32301

Phone: (850) 222-2400 Fax: (561) 6758

www.pharmview.com

JULY 9-13 , 2014

124th Annual Meeting and Convention of the Florida Pharmacy Association

D E C E M B E R 2 0 1 3 | 17

CALL FOR RESOLUTIONS TO THE 2014 HOUSE OF DELEGATES

The House of Delegates Board of Directors will meet in March 2013 to review and approve resolu-tions for the Annual Meeting. The deadline for submitting resolutions is March 15, 2014! PLEASE NOTE THIS DEADLINE.

The following information will be needed when submitting resolutions:

1. Name of organization: The name of the organization submitting the resolutions(s);2. Name and telephone number of individuals: A contact in the event clarification or further

information is needed; 3. Problem: A statement of the problem addressed by the resolution;4. Intent: A statement of what passage of the resolution will accomplish;5. Resolution Format: Please type and use double spacing.

TITLE OF RESOLUTION

NAME OF ORGANIZATION

WHEREAS , AND

WHEREAS :

THEREFORE BE IT

RESOLVED (THAT THE FPA OR SUBDIVISION OF FPA)

CONTACT NAME AND PHONE #:

PROBLEM:

INTENT:

Return this form to: Membership Coordinator, Florida Pharmacy Association, 610 North Adams Street, Tallahassee, Florida 32301 or fax (850) 561-6758

The Florida Pharmacy Association (FPA) is accredited by the Accreditation Council of Pharmacy Education as a provider of continuing education. The FPA is also a Florida Department of Health approved provider of continuing education and reports to CEBroker

SAVE THE DATE—JULY 9-13, 2014

Marriott Harbor Beach Golf Club Resort and Spa

3030 Holiday Drive Ft. Lauderdale, Florida 33316

For room reservations call

(888) 789-3090

Florida Pharmacy Association 610 North Adams Street

Tallahassee, Florida 32301

Phone: (850) 222-2400 Fax: (561) 6758

www.pharmview.com

JULY 9-13 , 2014

124th Annual Meeting and Convention of the Florida Pharmacy Association

18 | F L O R I D A P H A R M A C Y T O D A Y

APhA Foundation and NASPA Bowl of Hygeia

Awarded to a pharmacist for out-standing community service above and beyond professional duties. The use of the following selection criteria is re-quired:

■ The recipient must be a Florida li-censed pharmacist and a member of FPA.

■ The recipient must be living. Awards are not presented posthumously.

■ The recipient has not previously re-ceived the award.

■ The recipient is not currently serving nor has he/she served within the immediate past two years on its award committee or an officer of the association in other than an ex offi-cio capacity.

■ The recipient has compiled an out-standing record of community ser-vice, which, apart from his/her spe-cific identification as a pharmacist, reflects well on the profession.

James H. Beal AwardAwarded to the "Pharmacist of the

Year." Criteria:

■ The recipient must be a Florida reg-istered pharmacist and a member of the FPA.

■ The recipient has rendered outstand-ing service to pharmacy within the past five years.

Technician of the Year AwardAwarded annually to a Florida phar-

macy technician who is recognized for his/her outstanding performance and achievement during his/her career.

Criteria: ■ Candidate must be a member of the

Florida Pharmacy Association for at least two years.

■ Candidate must have demonstrated contributions and dedication to the advancement of pharmacy techni-cian practice.

■ Candidate must have demonstrated contributions to the Florida Pharma-cy Association and/or other phar-macy organizations.

■ Candidate must have demonstrated

commitment to community service. ■ Candidate is not a past recipient of

this award.

R.Q. Richards AwardThis award is based on outstanding

achievement in the field of pharmaceu-tical public relations in Florida.Criteria:

■ The recipient must be a Florida reg-istered pharmacist and a member of the FPA.

■ The recipient has displayed out-standing achievement in the field of pharmaceutical public relations in Florida.

Frank Toback/AZO Consultant Pharmacist AwardCriteria:

■ Candidate must be an FPA member, registered with the Florida Board of Pharmacy as a consultant pharma-cist in good standing.

■ Candidate should be selected based on their outstanding achievements in the field of consultant pharmacy.

DCPA Sidney Simkowitz Pharmacy Involvement Award

Presented annually to a Florida pharmacist who has been active at the local and state pharmacy association level in advancement of the profession of pharmacy in Florida.Criteria:

■ A minimum of five years of active involvement in and contributions to the local association and FPA.

■ Candidate must have held office at local-level pharmacy association.

■ Member in good standing for a pe-riod of at least five years in the FPA and must have served as a member or chairman of a committee of the association.

■ Candidate must have been active-ly involved in a project that has or could potentially be of benefit to members of the profession.

Pharmacists Mutual Companies Distinguished Young Pharmacist Award

Awarded to a young pharmacist for their involvement and dedication to the

practice of pharmacy.Criteria:

■ Licensed to practice for nine (9) years or less.

■ Licensed to practice in the state in which selected.

■ Participation in national pharmacy association, professional programs, and/or community service.

IPA Roman Maximo Corrons Inspiration & Motivation AwardInteramerican Pharmacists Associa-tion created this award to honor the memory of Roman M. Corrons who in-spired and motivated countless phar-macists to participate actively and as-pire to take on leadership roles in their profession. Roman was always there with guidance and support that moti-vated pharmacists and encouraged vi-sionary leadership, approachable active membership and succession planning. This award recognizes the motivators among us who inspire others to contin-ue to advance the profession.Criteria:

■ The recipient must be a Florida Li-censed Pharmacist and a member of the FPA.

■ Candidate should motivate others to excel within the profession by en-couraging them to be leaders.

■ Candidate is not necessarily an asso-ciation officer, but guides, supports and/or inspires others.

A brief description on the candidate’s motivational/inspirational skills must accompany the nomination.

The Jean Lamberti Mentorship Award

The Jean Lamberti Mentorship Award was established in 1998 to honor those pharmacists who have taken time to share their knowledge and experience with pharmacist candidates. The award is named in honor of long time FPA member Jean Lamberti for her effort in working with pharmacy students.Criteria:

■ The recipient must be an FPA mem-ber.

■ The recipient must serve as a role model for the profession of pharmacy.

C A L L F O R N O M I N A T I O N S F P A A W A R D S 2 0 1 3 - 2 0 1 4

D E C E M B E R 2 0 1 3 | 19

DEADLINE FOR NOMINATIONS: FEBRUARY 28, 2014

Upsher Smith Excellence in Innovation Award

Awarded to honor practicing phar-macists who have demonstrated inno-vation in pharmacy practice that has re-sulted in improved patient care.Criteria:

■ The recipient has demonstrated inno-vative pharmacy practice resulting in improved patient care.

■ The recipient should be a practic-ing pharmacist within the geograph-ic area represented by the presenting association.

Cardinal Generation Rx AwardThe Cardinal Health Generation Rx

Champions Award recognizes a phar-macist who has demonstrated excellence in community-based prescription drug abuse prevention. The award is intend-ed to recognize outstanding efforts with-

in the pharmacy community to raise awareness of this serious public health problem. It is also intended to encour-age educational prevention efforts aimed at patients, youth and other members of the community.

The nominee must be a pharmacist who is a member of the state association. Self-nominations are allowed. Applica-tions will be evaluated based upon the following criteria:

■ Commitment to community-based educational prevention efforts aimed at prescription drug abuse

■ Involvement of other community groups in the planning and imple-mentation of prevention programs

■ Innovation and creativity in the cre-ation and implementation of preven-tion activities

■ Scope/magnitude of prescription drug abuse efforts

■ Demonstrated impact of prescription drug abuse prevention efforts

I AM PLEASED TO SUBMIT THE FOLLOWING NOMINATION:

Name:

Address:

FOR THE FOLLOWING AWARD:

(Nomination Deadline February 28, 2014)

APhA Foundation and NASPA Bowl of Hygeia

James H. Beal Award

R.Q. Richards Award

Frank Toback/AZO Consultant Pharmacist Award

DCPA Sydney Simkowitz Award

Pharmacists Mutual Co. Distinguished Young Pharmacist Award

Academy of Pharmacy Practice Practitioner Merit Award

The Jean Lamberti Mentorship Award

IPA Roman Maximo Corrons Inspiration & Motivation Award

Upsher Smith Excellence in Innovation Award

Technician of the Year Award

Cardinal Generation Rx Award

NOMINATED BY:

Name:

Date Submitted:

Signature:

Please describe briefly below the nominee's accomplishments, indicating why you feel he or she should receive this award. (Attach additional sheets if necessary.)

C A L L F O R N O M I N A T I O N S F P A A W A R D S 2 0 1 3 - 2 0 1 4

F P A A W A R D S N O M I N A T I O N F O R M

MAIL NOMINATONS TO: Annual Awards, Florida Pharmacy Association, 610 N. Adams St., Tallahassee, FL 32301(850) 222-2400 FAX (850) 561-6758 DEADLINE FOR NOMINATIONS IS FEBRUARY 28, 2014

20 | F L O R I D A P H A R M A C Y T O D A Y

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BUYER’S GUIDEADVERTISERS: This is a special section designed to give your company more exposure and to act as an easy reference for the pharmacist.

P H A R M A C Y T O D A Yflorida

Advertising in Florida Pharmacy TodayDisplay Advertising: please call (850) 264-5111 for a media kit and rate sheet. Buyers’ Guide: A signed insertion of at least 3X per year, 1/3 page or larger display ad, earns a placement in the Buyers’ Guide. A screened ad is furnished at additional cost to the advertiser. Professional Referral Ads: FPA Members: $50 per 50 words; Non-members: $100 per 50 words; No discounts for advertising agencies. All Professional Referral ads must be paid in advance, at the time of ad receipt.

AHCA MEDICAID PHARMACY SERVICES2727 Mahan DriveTallahassee, FL 32308(850) 412-4166www.fdhc.state.fl.us/medicaid/pharmacy

AMERICAN PHARMACISTSASSOCIATION (APhA)Washington, D.C. (800) 237-2742www.pharmacist.com

AMERICAN SOCIETY OF HEALTH SYSTEM PHARMACISTSBethesda, MD (301) 657-3000www.ashp.com/main.htm

DRUG INFORMATION CENTERPalm Beach Atlantic University(561) 803-2728druginfocenter@pba.edu

FLORIDA BOARD OF PHARMACY4052 Bald Cypress WayBin #C04Tallahassee, FL 32399-3254(850) 245-4292www.doh.state.fl.us/mqa

FLORIDA POISON INFORMATION CENTER NETWORK(800) 222-1222www.fpicn.org

NATIONAL COMMUNITY PHARMACISTS ASSOCIATION 100 Daingerfield Road Alexandria, VA 22314703.683.8200703.683.3619 faxinfo@ncpanet.org

RECOVERING PHARMACISTS NETWORK OF FLORIDA(407) 257-6606 “Pharmacists Helping Pharmacists”

FREQUENTLY CALLED NUMBERS