Revision 23-4; Effective Nov. 17, 2023
To facilitate immediate client access to, and compliance with, contraceptive methods and related medications, grantees must be capable of providing limited pharmaceutical services (including contraceptive methods and related medications) to family planning clients at each clinic site funded by HHSC FPP.
Grantees are required to have at least a Class D pharmacy on-site at each HHSC family planning clinic site, have applied for a Class D pharmacy license through the Texas Pharmacy Licensing Board, or have obtained approval for a Class D pharmacy exemption from HHSC.
It is the grantee’s responsibility to ensure that all contraceptive methods and related medications approved for reimbursement by HHSC FPP are made available at no added charge to the client.
Pharmacies must follow federal and state laws relating to security and record keeping for drugs and devices. The inventory, supply and provision of pharmaceuticals must be conducted according to state pharmacy laws and professional practice regulations. It is essential that each facility keep an adequate supply and variety of drugs and devices on-site to effectively manage the contraceptive needs of its clients.
Class D Pharmacy Exemption
If extenuating circumstances prohibit a license from being granted, or if having an exemption would facilitate client access to contraceptive methods and related medications, a grantee may request an exemption to the requirement to have a Class D pharmacy.
A request for an exemption must be made in writing using Form 1061 to HHSC and will be considered on a case-by-case basis. A request for an exemption must:
- describe the process through which a person obtains medication from the referral pharmacy or pharmacies; and
- demonstrate that referring clients to an off-site pharmacy benefits the agency or clients.
The following criteria must be met to be considered for an exemption:
- A signed and fully executed memorandum of understanding (MOU) with referral pharmacy or pharmacies which includes the purpose of cooperation and details coordination between the grantees and the referral pharmacy or pharmacies to provide the following medications:
- Non-clinician administered hormonal contraceptive methods [oral contraceptives, transdermal hormonal contraceptives (patch) and vaginal hormonal contraceptives (ring)]; and
- Other medications necessary to treat the health care needs of the family planning patient population.
- The agreement made with referral pharmacy or pharmacies must not create barriers to the client receiving the prescribed medication.
- The referral pharmacy or pharmacies must be within a reasonable distance of participating clients.
- Clients do not incur additional costs (such as a co-payment) to obtain medications.
- The grantees has a written policy that ensures clients can obtain prescribed medication refills from the cooperating pharmacy or pharmacies without an additional clinic visit (unless medically indicated or necessary).
An exemption request will be reviewed by HHSC staff and, depending on the justification and circumstances specific to each clinic site, may or may not be granted. The HHSC staff reserves the right to approve or deny an exemption request based upon the merit of the justification.
The pharmacy exemption process is not complete until the grantee receives either an approval or a denial in writing from HHSC. Grantees are responsible for notifying HHSC of any changes to clinic’s pharmacy status.
Note: The grantee must provide the following contraceptive methods and services on-site, regardless of Class D pharmacy exemption status:
- injectable hormonal contraceptives;
- barrier methods and spermicides; and
- counseling and education on sexual abstinence.