key: cord-0925580-n8knqb5o authors: Murray, Kara L; Burgess, L Hayley; Miller, Karla M title: Navigating regulatory statutes during the Coronavirus Disease 2019 date: 2020-05-14 journal: Am J Health Syst Pharm DOI: 10.1093/ajhp/zxaa147 sha: bc3423ebb2ae72a24935faba222b6ffcb4f2c287 doc_id: 925580 cord_uid: n8knqb5o Disclaimer: In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. In December 2019, the disease we now know as COVID-19 began its spread across the world. On January 30, 2020, a little over a month later and the sixth time in history, the World Health Organization (WHO) declared a global health emergency, followed by the characterization of the disease as a pandemic on March 11 th . The United States declared a national emergency on March 13, 2020, with the Centers for Disease Control and Prevention following with a strong warning against gatherings of greater than 10 people. 1 [3] [4] This has resulted in a unprecedented change in the regulatory and economic framework of our country. What does all of this mean to healthcare systems and our workforce? Under normal, pre-COVID-19, situations, many state BOP questions could be answered simply by picking up the telephone and speaking to a local individual. Today, however, this is rarely the case. Many BOPs are working remote as well. Voice message notifications or alerts on state BOP websites indicate the best contact methods for staff during this time. Contacting twenty different state BOPs may seem tedious, or time-consuming, but this situation has the potential to be an experience of great collaboration. Our health-system, as with many across the United States, has moved at a rapid pace, working to understand all new facets of COVID-19, including regulatory statutes. The scale of our health-system has been a tremendous fortune, as we have hospitals, free-standing emergency rooms, ambulatory surgery centers, physician practices, and urgent care centers located within 20 different states. As we worked to develop regulatory framework and guidance surrounding some very unique areas within the pharmacy space, we have come to the understanding that the new virtual work environment is that of many across this nation. On a mission to determine each state's stance regarding pharmacy licensure for off-site alternate sites of care (i.e. field hospitals), pharmacy licensure for retired or out-of-state pharmacists and pharmacy technicians, prescribing restrictions for COVID-19 medications, and dispensing rules for hospitals and/or emergency rooms, we first began by reviewing BOP websites to determine if emergency rules were written and posted. If specifics were not readily found, we began to contact each state BOP via the contact method indicated. While one would assume a slow turn-around-time due to inundation of email messages, our experience was the exact opposite. For all 20 state BOPs contacted, email responses were received typically within were prepared with responses for all questions. Many states, however, had not yet encountered a scenario where an off-site alternate site of care or field hospital was required. While answers to some questions were not immediately available, all state BOPs replied via email or telephone to discuss further, with some states even requesting assistance writing the rule. An excellent example of BOP comradery and preparation is the Louisiana BOP. The state of Louisiana was one of the first states in the nation to surge in COVID-19 cases, particularly in the New Orleans area. The first case was reported on March 9, 2020. 6 As of today, Louisiana remains 9 th in the nation in terms of total COVID-19 cases, with 22,532 cases and 1,156 deaths. 2 Approximately ΒΌ of the total cases within the state are in New Orleans. 6 The early onset allowed for less BOP preparation time than other states. The Louisiana BOP, however, was quick to rise to the occasion and quickly prepared numerous emergency rules. Our health-system has a joint-venture affiliation with a large academic medical center within New Orleans. One rule in particular was the allowance for pharmacists and pharmacy technicians licensed in another state, but not in Louisiana, to obtain a passport through the National Association of Boards of Pharmacy (NABP) Passport program. The NABP Passport is a licensure verification process administered by NABP to assist in the pandemic response. This was particularly useful to our health-system, as the facility had recently hired a new Pharmacy Operations Manager, who had relocated to New Orleans from Texas. Unfortunately, due to the COVID-19 pandemic, his Louisiana pharmacy licensure exam was postponed to June. The emergency rule allowing utilization of the NABP Passport allowed for the new Pharmacy Operations Manager to begin work at the hospital and effectively aid in the treatment of COVID-19 patients. extremely positive. All BOP colleagues were extremely helpful, and, as always did their very best to answer all questions as quickly as possible. Our new normal may be different, but our states BOPs were quick to navigate new processes. For that our health-system would like to offer our extreme gratitude for their timely regulatory response and quick action creating and enforcing emergency rules. Defining Moments of a Growing Pandemic United States Coronavirus Cases 7 governors still haven't issued stay-at-home orders. Here's why. CNN Politics COVID-19 Closed Schools. When Should They Reopen? Education Next Reveals 88% of Organizations Have Encouraged or Required Employees to Work From Home Due to Coronavirus 118 COVID-19 cases across the state