1. (a)

   1. (1) If a pharmacy is funded primarily by state or federal funds and/or if prescription drugs are to be purchased, maintained, or dispensed by a pharmacist in a facility that purchases drugs from Arkansas state contracts, and that facility does not meet the requirements set by the Arkansas State Board of Pharmacy to obtain a licensed pharmacy permit, a hospital pharmaceutical services permit, or a nursing home consultant’s permit, then an exception may be made to issue an institutional pharmaceutical services permit.

   2. (2) The institutional pharmaceutical services may be in facilities that:

      1. (A) Provide extended health care to resident patients; and
      2. (B) Are funded primarily by state or federal funds.
   3. (3) The permit shall be issued in the name of the licensed pharmacist-in-charge.

2. (b) A licensed pharmacist employed or otherwise engaged to provide pharmaceutical service may have a flexible schedule of attendance in the institution, provided, however, the pharmacist must be physically present in the institution for a sufficient number of hours weekly to:

   1. (1) Maintain an adequate supply of medications at the service area from which medications are administered;
   2. (2) Maintain all records;
   3. (3) Perform other pharmaceutical services authorized by law; and
   4. (4) Provide adequate control and accountability of all drugs under his or her responsibility.
3. (c) Medication for patients shall be on an individual prescription basis by order from a licensed physician and the pharmacist shall dispense drugs, properly labeled, to be used for patients being treated at the facility.

4. (d)

   1. (1) Facilities are to be provided for the storage, safe-guarding, preparation, and dispensing of drugs.
   2. (2) Equipment and supplies necessary to the facilities’ safe and economical operation shall be provided.
   3. (3) Special locked storage space is to be provided to meet all requirements for storage of controlled drugs and other prescription drugs.
5. (e) All policies and procedures related to the institutional pharmaceutical services must first be approved by the board before a permit will be issued.

6. (f)

   1. (1) Special floor stock or backup to meet emergency needs such as when the pharmacy is closed will be permitted only when specifically outlined in the policies and procedures.

   2. (2) The policies and procedures shall include:

      1. (A) Lists establishing quantity limits of these emergency drugs;
      2. (B) The method of replacement;
      3. (C) Maintenance of records accounting for drugs used; and
      4. (D) Proper preparation and labeling by the pharmacist.

7. (g) With recognition of the Drug Enforcement Administration’s statement of policy regarding emergency kits for long-term care facilities, and recognizing the Drug Enforcement Administration’s definition of long-term care facilities, the following requirements must be met for facilities with institutional pharmaceutical services permits to store emergency kits containing controlled substances and/or other legend drugs in these facilities in Arkansas:

   1. (1) All contents of the emergency kit will be provided by one (1) pharmacy designated by the facility;
   2. (2) The facility holding an institutional permit with the board must have resident patients to which the facility provides extended health care;
   3. (3) The controlled and legend drugs must remain the property of and under the responsibility of the pharmacy, which must have an Arkansas permit;
   4. (4) All medications must be administered only on the order of a practitioner, and medications administered from the nurse’s supply must be recorded as a prescription by the pharmacy prior to the pharmacy’s replacement of the drug in the emergency supply;
   5. (5) All medication records must be maintained as required by law, and out-of-date drugs must be properly destroyed by the pharmacy;

   6. (6) Careful patient planning should be a cooperative effort between the pharmacy and the nursing department at the facility to make all medications available, and the emergency supply:

      1. (A) Should only be used for emergency or unanticipated needs; and
      2. (B) Shall not become a routine source or supply;
   7. (7) The pharmacy is responsible to ensure compliance with this part, and any abuse or misuse of the intent of this part shall be immediately reported to the board; and

   8. (8)

      1. (A) Storage conditions for the emergency kit shall meet all state and federal requirements.
      2. (B) The storage conditions shall be set out in the policy and procedures of the facility.

8. (h) Drug categories for emergency kits in facilities with institutional pharmaceutical services permits. The following is a list of categories of drugs that are acceptable in emergency kits in facilities with institutional pharmaceutical services permits in accordance with this part:

   1. (1)

      1. (A) Analgesics and controlled drugs.
      2. (B)

9. (i) Schedule II injectable.

   1. (ii) Limit: one (1).

      1. (iii) Maximum quantity: two (2);

   2. (2)

      1. (A) Schedule III, IV, or V injectable.
      2. (B) Limit: one (1).
      3. (C) Maximum quantity: ten (10);

   3. (3)

      1. (A) Schedule III, IV, or V oral medications.
      2. (B) Limit: two (2).
      3. (C) Maximum quantity: six (6);

   4. (4)

      1. (A) Anticonvulsants, injectable controlled drugs.
      2. (B) Limit: one (1).
      3. (C) Maximum quantity: four (4); and

   5. (5)

      1. (A) Anxiolytics, injectable controlled drugs.
      2. (B) Limit: one (1).
      3. (C) Maximum quantity: four (4).

Codification Notes: This section as promulgated prior to codification into the Code of Arkansas Rules provided as follows: “(Amended 10/2001)"