Joel Ebert

USA TODAY NETWORK - Tennessee

The Tennessee state Senate on Wednesday approved a bill to provide easier access to birth control by allowing women 18 or older to obtain contraceptives directly from pharmacists.

Women seeking birth control in Tennessee have to obtain a prescription from a physician. But under the provisions outlined in a bill sponsored by Sen. Steve Dickerson, R-Nashville, a woman could obtain a prescription by going directly to a pharmacist.

Proponents of the measure say the legislation could save women money, considering they would not have to pay for a doctor's appointment before getting birth control.

Sen. Ferrell Haile, R-Gallatin, who is a pharmacist, pointed out that not every pharmacist would be able to provide birth control.

According to the bill, those interested in doing so would have to enter into a collaborative agreement with a physician, who would oversee a series of protocols for the pharmacist to follow.

Dave Chaney, a spokesman for the Tennessee Medical Association, said the bill does not give pharmacists the authority to prescribe medication.

"They would be able to provide birth control based on a medical order by a collaborative practice physician," he said.

Any pharmacist, or a pharmacy, would be allowed to charge an annual fee for providing services to women.

While explaining the need for the bill, Dickerson, who is a physician, said about half of all pregnancies are either unintended or mistimed. He pointed out that several medical organizations, including the American Congress of Obstetricians and Gynecologists, support efforts to provide easier access to birth control.

"The science is very strongly behind this," he said during the floor discussion.

Dickerson also said since pharmacists would still need to write a prescription for a woman to obtain birth control, it would still be covered by health insurance.

After hearing some opposition from three Republicans — Sens. Mark Green, R-Clarksville; Mae Beavers, R-Mt. Juliet; and Joey Hensley, R-Hohenwald — debate was closed and the chamber approved the legislation with a 24-4 vote. Five senators did not vote on the bill.

Hensley said women should have to undergo physical exams before obtaining contraception, adding that he worried about the varying degrees of strength for different products.

"I really don't know how a pharmacist is going to determine what strength that woman needs and require that that woman does have follow up," he said. "I just think this is a bad precedent. It's not like flu shots."

Beavers said she worried about the risks of getting breast cancer as a result of taking birth control, a point Dickerson said he disagreed with.

Dickerson called his measure a more conservative approach than what has been done in other states.

Noting that the bill was a compromise, Sen. Lee Harris, D-Memphis, said, "I think Sen. Dickerson and I share a priority to make sure that there is expanded access to birth control."

The legislation is one that Dickerson and Sen. Jeff Yarbro, D-Nashville, talked about introducing in the early weeks of the 2016 session. Yarbro's bill has not been discussed in committee this year.

Bill would allow pharmacists to prescribe birth control

The House version of Dickerson's bill is scheduled to be discussed in committee Tuesday.

Wednesday's action received praise from outside the legislature.

"We are encouraged by the Senate passing a bill which increases access to contraception," said Allison Glass, state director of Healthy and Free Tennessee. "Contraception helps people to avoid unintended pregnancy, but access and cost issues are common reasons why women either do not use contraception or have gaps in use.

Micah Cost, executive director for the Tennessee Pharmacists Association, said his organization worked closely with the Tennessee Medical Association, along with Dickerson and Rep. Patsy Hazlewood — the House sponsor — on the bill.

"This approach ensures a team-based approach to self-administered hormonal contraceptives, and also allows additional patient interactions with pharmacists prior to receiving self-administered hormonal contraceptives," Cost said. "This patient interaction with pharmacists will help to address possible adverse events and safety concerns regarding self-administered hormonal contraceptives. This approach also provides a mechanism for pharmacists to refer more complex patients, who may have never visited health care providers in the past, to physicians and other women’s health providers for further evaluation."

Reach Joel Ebert at 615-772-1681 and on Twitter @joelebert29.