Magazine article Drug Topics

Collision Course

Magazine article Drug Topics

Collision Course

Article excerpt

Technician battle brewing in California over ratios, TCT

The simmering battle over pharmacy technicians in California is coming to a boil once again. Pharmacists Planning Service Inc. (PPSI) has "declared war" on the state board of pharmacy and is threatening legal action over possible expansion of technician roles. At the same time, Rite Aid, which is entering California by way of its recent purchase of Thrifty-PayLess, is pushing for even fewer restrictions on the use of technicians.

"We have absolutely declared war on the board of pharmacy," said PPSI president Fred Mayer. "We've hired an attorney to go after the board, for exceeding its authority, as well as board members employed by Kaiser Permanente, by the University of California, by Safeway, and by others for conflict of interest."

Rite Aid was equally direct in insisting that less oversight is better. "Eliminate all technician ratios," advised James Krahulec, v.p. for government and trade relations. "Get away from hard-and-fast parameters. Instead, give the board the authority to check each site and authorize as many technicians as are safe. If there is to be a ratio at all, it should be the same across all sites. If this really is a safety issue, shouldn't all practice sites be subjected to the same standards? There are provisions such as equal protection, after all."

The brewing battle has two flash points: the ratio of technicians to pharmacists and using technicians to check the work of other technicians, usually called tech-checktech or TCT. Current regulations call for one tech per outpatient pharmacist and two technicians per inpatient pharmacist in most settings. The work of all technicians must be checked by a pharmacist, but many major hospitals have admitted using techs to check other techs in stretch budgets.

At the urging of the California Society of Health-System Pharmacists, the board proposed regulations in 1996 that would authorize inpatient TCT. Faced with solid opposition from the California Pharmacists Association, PPSI, the Guild for Professional Pharmacists, and nearly every other pharmacy group in the state, the board sent the proposals back to committee for hearings and study.

If the board tries to authorize TCT by regulation, Mayer said, PPSI will sue. The group claimed that the board's own attorneys have stated that TCT would require legislative change, not regulatory approval. …

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