United States Public Health Service

-National Clinical Pharmacy Specialist (NCPS)

Presentation prepared 8-4-15

Presentation prepared by: CDR Anne Marie Bott, LCDR Jinny Meyer, LCDR John Collins and LCDR Randy Steers

National Clinical Pharmacy Specialist (NCPS)• What is NCPS?–National certification recognizing pharmacists

privileged at the local level to perform duties in expanded clinical roles.

Background• The October 18, 1996 memorandum from the Indian

Health Service (IHS) Director established IHS pharmacists as primary care providers (PCPs) and allowed for privileges to include prescriptive authority.

• Clinical pharmacy specialist (CPS) is included in the IHS definition of a PCP for the purposes of workload reporting, program planning, and reimbursement from all third party payer.

http://www.ihs.gov/IHM/index.cfm?module=dsp_ihm_sgm_main&sgm=ihm_sgm_9602

Background• The National Clinical Pharmacy Specialist Committee

(NCPSC) was established by the Chief Pharmacy Officer (CPO) in 1997 to provide a mechanism to assure that all IHS National Clinical Pharmacy Specialists (NCPS) display a uniform level of competency.

BackgroundNCPS Certification Expands Beyond IHS• 2008 – Bureau of Prison (BOP)– Memorandum of understanding (MOU) established

collaboration between the IHS and BOP pharmacy programs to include recognition of BOP pharmacists as NCPS certified.

• 2013 – All USPHS agencies– At the request of the USPHS Chief Pharmacy Officer (CPO),

NCPS pharmacy certification was extended to encompass all USPHS pharmacists regardless of agency.

Objectives of NCPS Committee (NCPSC)• Promote and recognize evidence-based clinical competency of

USPHS pharmacists on a national basis. • Maintain standards of NCPS-defined advanced scopes of practice

for USPHS pharmacists.• Evaluate collaborative practice agreements (CPAs) to assure

consistency with national NCPS criteria for certification. • Serve as the body that reviews the credentials, training, education

and experience of applicable pharmacists and grant NCPS certifications.

• Serve as a resource for local facilities seeking to develop and implement a pharmacy-based CPA.

NCPS Certification by the Numbers• Total Certifications - 689• Active Certifications - 483

• Total Pharmacists - 489• Active Pharmacist - 347

Data updated 6/2/2015

NCPS Certifications by Disease State

395

105

45

35

25

16119 8 6 6 54 4 43 3 22 1

AnticoagulationNicotine Dependence DyslipidemiaDiabetesHypertensionImmunizationPain ManagementInpatient Pharmacokinetic Pharmacist PractitionerHIV/AIDSAsthmaCHFSeizure DisorderInfectious DiseaseHepatitis CHome-Based Pharmacokinetics AnemiaAlcohol AbstinenceChronic Kidney DiseaseCardiovascular Risk Reduction

Data updated 6/2/2015

193

101

89

77

50

40

40

3328

21 11 5 1 OklahomaPhoenixNavajoAlaskaBemidjiBOPPortlandGreat PlainsAlbuquerqueNashvilleTucsonBillingsHQ (Rockville)

NCPS Certifications by Area

Data updated 6/2/2015, Pharmacist may hold multiple certifications in differing disease states

NCPS Outcomes• Phase I– Mandatory outcomes reporting– Implemented January 2013

• Phase II– Standardized reporting by disease state– Implemented in stages• Tobacco Cessation: May 2015• Anticoagulation: August 2015• Others: TBA

Applicant Review• NCPS Application• Current state pharmacy license• Evidence of 2 years at facility, 1 year practicing as a CPS at local facility • Current continuing education hours• Letter of attestation from applicant’s NCPS or physician supervisor• Postgraduate documents (at least 1 of the 5)

– Residency certificate– Specialty board certification– Clinician’s license (state)– Disease state management certificate– Narrative detailing clinical experience

Applicant Review• Copy of pharmacist’s disease state management protocol/

collaborative practice agreement (CPA)– Critical elements within protocol/CPA

• Pharmacists are authorized to:– Order and interpret labs– Perform limited physical assessment– Prescribe (initiate, modify, and discontinue) medications per protocol

• Evidence of local Medical Staff approval• Evidence of 30 charts reviewed with the past 12 months• Outcomes submitted

Impact on USPHS Pharmacy Practice• Advancing the profession of pharmacy through

– innovative clinical disease state management clinics. – credentialing, privileging, and inclusion of pharmacists on medical staff.

• Improving patient access to quality care – clinics available across 2 agencies in over 100 hospitals and clinics throughout 29 states.

• Initiating mandatory submission of clinical outcomes to the Committee for collection and analysis.

• Developing a library of disease state management protocols/ collaborative practice agreements that standardize and further improve the quality of patient care.

• Established a system to recognize and formally certify the competency and expanded scope of clinical pharmacists on a national level.

NCPS Committee Membership• The Committee has pharmacy and medical provider

representation from IHS regions and BOP.NCPS Members

Great Plains Alaska AlbuquerqueBemidji Billings NashvilleNavajo Oklahoma PhoenixPortland BOP member IHS Physician memberBOP Physician member Data Analyst &

Applications Coordinator*Ex-officio members*

*non-voting member

NCPS Committee Contact Information• Additional information about the NCPS Committee is located

on the website: https://dcp.psc.gov/osg/pharmacy/ncps.aspx

• NCPSC Leadership– LCDR Jinny Meyer, Chair– CDR Anne Marie Bott, Chair-Elect– CDR Dana Springer, Secretary– LCDR John Collins, Data Analysts and Application Coordinator

As of 6/2/2015

United States Public Health Service

-National Clinical Pharmacy Specialist (NCPS)

For more information:https://dcp.psc.gov/osg/pharmacy/ncps.aspx

#USPHSPharmacy#USPHS#NCPS

Presentation prepared by: CDR Anne Marie Bott, LCDR Jinny Meyer, LCDR John Collins and LCDR Randy Steers