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Pharmacies received emergency authority during the COVID-19 pandemic to vaccinate most Minnesotans, and now they want funding and permission to make that gig permanent.

Leaders of Minnesota's struggling independent and small chain pharmacies gathered with DFL lawmakers Tuesday at the Capitol to advocate for the expansion, arguing that it would preserve vaccine access in rural and urban areas and help keep pharmacies in business. Bipartisan bills cosponsored by 25 lawmakers would allow pharmacies to provide flu and COVID-19 vaccines to anyone 3 and older, and other recommended vaccines to anyone 6 and older. They also would engage in practice agreements with doctors that would allow them to collect lab specimens, interpret basic test results, and modify or discontinue drug therapies.

The medical landscape has changed since the pandemic, and some clinics are relying on their local pharmacies to take on more vaccinations, said Jason Miller, clinical program manager for the Coborn's pharmacy chain. Many clinics didn't want to risk purchasing much of the COVID-19 vaccine earlier this year when it switched from being federally funded to commercially available, he said, so families had to go to pharmacies if they wanted those shots.

"We would take a significant step backwards in terms of access to care for residents in Minnesota" if the legislation isn't passed, Miller said.

Even before the pandemic, pharmacists could provide flu shots to Minnesotans 6 and older, and other recommended vaccines to people 13 and older. But they received permission under a federal emergency order to provide COVID-19 and other vaccines to those 3 and older during the pandemic, and to empower pharmacy technicians to administer the jabs. The terms of that federal order are slated to expire at year's end.

The legislation would also ensure that pharmacists are paid by Minnesota's Medical Assistance program at the same rate as doctors to administer vaccines and basic tests for strep and other infections. The program for low-income Minnesotans and those with disabilities provides health benefits to roughly one-fifth of the state's population.

The proposal is one of three that DFL lawmakers championed Tuesday to stabilize Minnesota's pharmacy industry, which has lost a third of its independent pharmacies and a fifth of its small chain pharmacies since 2018. Other bills would increase the payment rates by which pharmacies are paid for dispensing medications and administering basic health care services. Fiscal notes estimate the three bills combined would cost a total of nearly $2 million next year and $3.4 million the year after that.

Customers of St. Paul Corner Drug stood with pharmacists and lawmakers to advocate for the changes, citing problems they had getting their medications when their health plans switched them to chain or mail-order pharmacies. Dave Little, 74, said his local pharmacy was much more helpful filling his prescriptions to manage glaucoma and prevent stroke, and that a mail-order company had a "glitchy" website and "illogical" policies that made him jump through hoops to get refills.

"At my age, you start to lose your ability to jump through hoops," he quipped.

The Minnesota Medical Association, representing the state's doctors, said in a statement that it supports the financial relief for pharmacies but believes pediatric vaccinations are best provided during well-child visits with doctors. As a compromise, the legislation would prevent pharmacists from providing vaccines other than COVID and flu to preschoolers, and require them to counsel parents about the benefits of well-child visits.