1. (a) Definitions. As used in this part:

   1. (1) "Correctional facility" means any place used for the confinement of persons:

      1. (A) Charged with or convicted of an offense; or
      2. (B) Otherwise confined under a court order;

   2. (2)

      1. (A) “Dispensary” means a correctional facility providing limited medical services by licensed personnel.
      2. (B) This type of facility:

2. (i) Is not licensed by the Department of Health as an infirmary; and

   1. (ii) Does not have patient beds; and
   2. (3) “Infirmary” means a correctional facility with an infirmary licensed by the Department of Health having patient beds.

3. (b)

   1. (1) If a correctional facility is funded primarily by city, county, state, or federal funds, and/or if prescription drugs are to be purchased, maintained, or dispensed 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 the board may 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 city, county, state, or federal funds.
   3. (3) The permit shall be issued in the name of the pharmacist providing consultant services to the facility.

   4. (4) Any time there is a change in the pharmacist consultant for the facility, a new permit in the name of the new pharmacist shall be obtained.

      1. (c) Medication for patients shall be on an individual prescription basis by order from a licensed prescriber, and the supervising nurse or other licensed nursing personnel shall administer properly labeled medications to be used for patients being treated at the correctional facility.

         1. (d) A licensed pharmacist named on the permit shall be employed or otherwise engaged to provide consultant pharmaceutical service at the correctional facility.

4. (e)

   1. (1) Institutional pharmaceutical services permits may be issued to correctional infirmaries and dispensaries.

   2. (2) Correctional infirmaries.

      1. (A)

         1. (i) All policies and procedures related to the institutional pharmaceutical services permit must first be approved by the board staff before a permit will be issued to ensure compliance with all existing laws and rules.
         2. (ii) Any changes to the policies and procedures related to the procurement, administration, distribution, or storage of prescription medications shall be reported to the board within thirty (30) days.

      2. (B) Policies and procedures for obtaining, dispensing, and administering drugs and biologicals shall be developed with the:

         1. (i) Consultation of an Arkansas-licensed pharmacist; and
         2. (ii) Approval of medical staff.

      3. (C)

         1. (i) Special floor stock or backup medications to meet the emergency needs of the patients in the correctional facility will be permitted only when specifically outlined in the policies and procedures manual.
         2. (ii) The policies and procedures manual shall at a minimum include:

5. (a)

   1. (1) (a)(1) Lists of emergency medications that establish quantity limits for each medication.
   2. (2) (2) Said list shall be subject to the approval of the board;

6. (b) (b) The method of replacement;

   1. (c) (c) Maintenance of records accounting for medications used; and

      1. (d) (d) Proper preparation and labeling by the pharmacy services provider.

      2. (D) The pharmacist consultant:

         1. (i) Must conduct monthly site visits; and
         2. (ii) Will be responsible for the supervision of pharmacy services.

   2. (3) Correctional dispensaries.

      1. (A) Pharmaceutical services shall be provided under supervision of licensed nursing personnel.
      2. (B) The dispensary shall maintain medical records on each patient.

      3. (C)

         1. (i) All policies and procedures related to the institutional pharmaceutical services permit must first be approved by the board staff before a permit will be issued to ensure compliance with all existing laws and rules.
         2. (ii) Any changes to the policies and procedures related to the procurement, administration, distribution, or storage of prescription medications shall be reported to the board within thirty (30) days.
      4. (D) Policies and procedures for obtaining, dispensing, and administering drugs and biologicals shall be developed with the consultation of an Arkansas-licensed pharmacist and the approval of medical staff.

      5. (E)

         1. (i) Special floor stock or backup medications to meet the emergency needs of the patients in the correctional facility will be permitted only when specifically outlined in the policies and procedures manual.
         2. (ii) The policies and procedures manual shall at a minimum include:

7. (a)

   1. (1) (a)(1) Lists of emergency medications that establish quantity limits for each medication.
   2. (2) (2) Said list shall be subject to the approval of the board;

8. (b) (b) The method of replacement;

   1. (c) (c) Maintenance of records accounting for medications used; and

      1. (d) (d) Proper preparation and labeling by the pharmacy services provider.

      2. (F) The pharmacist consultant:

         1. (i) Shall conduct quarterly site visits; and
         2. (ii) Will be responsible for the supervision of pharmacy services.

9. (f) Pharmacist consultant responsibilities. Pharmacist consultants in correctional facilities are involved in the following areas of pharmaceutical care that include drug storage, distribution, and utilization in that correctional facility:

   1. (1) Supervision of services. The pharmacist consultant shall:

      1. (A)

         1. (i) Develop, coordinate, and supervise all pharmaceutical services.
         2. (ii) The pharmacist consultant for the correctional facility must ensure that pharmacist consultation is available on a twenty-four-hours-per-day, seven-days-per-week basis.
         3. (iii) A pharmacist consultant or consultants shall devote a sufficient number of hours based upon the needs of the facility during regularly scheduled visits to carry out these responsibilities;
      2. (B) Assist the correctional facility in developing procedures to ensure the provision of emergency drugs, and shall report to the board any pharmacy refusing to provide medication for the pharmacy’s regular patients in the facility on a twenty-four-hours-per-day, seven-days-per-week basis;
      3. (C) Provide written consultation on compliance with federal and state laws governing legend drugs, including controlled substances;
      4. (D) Be knowledgeable of all laws and rules pertaining to correctional facilities, and shall communicate with the state agencies involved with enforcement and regulation of these facilities;

      5. (E)

         1. (i) Spend sufficient time to:
10. (a) (a) Evaluate discontinued or other unused medication for return or destruction;

11. (b) (b) Destroy unused medication;

    1. (c) (c) Check entries in a bound and numbered controlled drugs book; and

       1. (d) (d) Make general observations at the dispensing stations.

          1. (ii) Medications may only be returned from a correctional facility in accordance with 17 CAR § 160-1004; and
       2. (F) Indicate the day the pharmacist consultant or consultants visited the correctional facility and a brief statement of purpose, finding, and actions for each resident record reviewed;

    2. (2) Control and accountability of all legend drugs, including controlled substance.

       1. (A)

          1. (i) The pharmacist consultant shall check to see that only approved drugs and biologicals are used in the facility and shall be administered in compliance with federal and state laws.
          2. (ii) Records of receipt and disposition of all controlled drugs shall be maintained in sufficient detail to enable an accurate reconciliation.
          3. (iii) The pharmacist consultant shall determine that:
12. (a) (a) Drug records are in order; and

13. (b) (b) An account of all controlled drugs is maintained and reconciled;

    1. (3) Patient drug regimen review.

       1. (A) The primary duty of the pharmacist consultant or consultants to the patients’ concerns is to apply his or her expertise regarding drugs to the patient’s specific situation.
       2. (B) State and federal rules shall be the minimum standards for an adequate drug regimen review.

       3. (C) Additionally, the pharmacist consultant shall routinely review patient charts in accordance with state and federal rules and:

          1. (i) Ascertain that patient history and drug utilization is being properly recorded;
          2. (ii) Review drug usage, including O.T.C. and prescriptions;
          3. (iii) Review patient compliance with drug regimen;
          4. (iv) Review drug allergies or sensitivities;
          5. (v) Determine whether the patient is predisposed to side effects due to:
14. (a) (a) Disease;

15. (b) (b) Illness; or

    1. (c) (c) Age;

       1. (vi) Determine whether potential exists for significant drug interaction;

          1. (vii) Develop procedures to monitor patients’ records for signs that indicate abuse or misuse of drugs by the patient or individuals;
          2. (viii) Make recommendations regarding drug therapy to:
16. (a) (a) The physician;

17. (b) (b) Nurse; or

    1. (c) (c) Other persons involved in the patient’s care;

       1. (ix) Communicate to the facility procedures that ensure adequate pharmacy services are available for emergencies that might develop in the correctional facility for a specific patient;

          1. (x) Promote pharmacists’ ability and knowledge to:
18. (a) (a) All persons involved in patient care; and

19. (b) (b) Offer assistance in solving specific problems relating to patient drug regimen; and

    1. (xi) A pharmacist consultant or consultants shall quarterly in dispensaries and monthly in licensed correctional infirmaries:
20. (a) (a) Review patient medication records in accordance with state and federal rules; and

21. (b) (b) Consult with and provide a written report of findings to the director of nursing or the patient’s physician; and

    1. (4) Labeling of drugs and biologicals and proper storage. It is the duty of the pharmacist consultant or consultants to ascertain during each visit to the correctional facility that:

       1. (A) Medications are:

          1. (i) Properly labeled;
          2. (ii) Properly stored; and
          3. (iii) Refrigerated when needed;
       2. (B) Expiration dates are routinely checked; and
       3. (C) Appropriate accessory and cautionary instructions are on all medications when required.

Codification Notes: This section as promulgated prior to codification into the Code of Arkansas Rules provided as follows: “(11/1/2007)" "O.T.C." means over-the-counter.