EDUCATING LEADERS IN PHARMACY AND PHARMACEUTICAL SCIENCES SINCE 1886
Author: Karl Williams, JD, MBA, BS '80
Clinical Professor and Director of Professional Affairs
Editor, Pharmacy Law
School of Pharmacy and Pharmaceutical Sciences
University at Buffalo
Technician Parity for Compounding
Under 2019 legislation creating the profession of Registered Pharmacy Technician in Article 137-A of Education Law, qualified technicians are enabled to, under the direct personal supervision of a licensed pharmacist, assist pharmacists in compounding medication.[1] Practice was limited to the “facility” environment (i.e., hospitals) until the law was amended in 2025[2] which expanded authority to all of New York’s pharmacies. In contrast to forty-six other states, and despite much interest, the 2025 amendment did not include authority for qualified technicians to administer immunizations.[3]
Unlicensed Persons
For many years before creating the profession of technician, pharmacists have utilized the services of unlicensed persons (“UPs”) to assist with technical aspects of dispensing. The “Unprofessional Conduct” rules of the Board of Regents clarified limitations on the role of unlicensed persons by identifying what they may do and what they are not permitted to do.[4] In summary, unlicensed persons and technicians are permitted to:
This list of permitted activities was codified by the legislature in Education Law at §6832. The statute did not include another portion of Regents Rules: those things UPs may not do. These prohibitions, despite not being added to statute are still legal requirements and summarized, as follows. “Unlicensed persons shall not be authorized to”:
History
Some context is useful to explain current circumstances. In 1991 a state court decided the case Sheffield v. State Education Department[5] a challenge to Professional Misconduct charges brought by the state against a hospital pharmacy that utilized two licensed practical nurses to assist in sterile compounding. The state’s claim that the hospital, supervising pharmacist, and the nurses were guilty of permitting the nurses to compound constituting the practice of pharmacy without a license. This charge formed the basis of the court’s holding that compounding is reserved for pharmacists in the definition of pharmacy practice (§6801) excluding, in particular, the licensed practical nurses. Owing to the reliance on UPs in the sterile processing functions, the result in Sheffield caused significant disruption for many of New York’s hospitals.
Perhaps acknowledging the impact of the case and the unintended consequence of dramatically altering workflow in hospital pharmacies, the Department of Education began to rely on another unprofessional conduct rule to mitigate this impact characterizing UPs work not as compounding but “repacking” – a role intended for UPs.[6] As long as UPs were properly trained and supervised and their work documented according to the rule, the actions would be tolerated under the law. The repacking interpretation of the work of UPs in assistance with compounding was an interpretation of the law by SED that was never codified in statute, rule, or regulation.
In 2018, the enforcement arm of SED, the Office of Professional Discipline (“OPD”), through routine inspections began to signal that the use of UPs in sterile compounding was inconsistent with the law and would no longer be tolerated. Word traveled rapidly among hospital pharmacists, again creating disruption. The exclusion of UPs from compounding forced pharmacists and interns to physically complete all the compounding, upsetting the workplace balance and translating into significant economic hardship for many hospitals. A large coalition of stakeholders came together to pursue legislative change.
A New Profession: Registered Pharmacy Technicians
In addition to adopting Regents rules applicable to both UPs and technicians registered with the Board of Pharmacy the 2019 legislation gave qualified technicians the authority to assist in compounding medication under the direct personal supervision of a licensed pharmacist defined as:
“supervision of procedures based on instructions given directly by a supervising licensed pharmacist who remains in the immediate area where the procedures are being performed, authorizes the procedures and evaluates the procedures performed by the registered pharmacy technicians and a supervising licensed pharmacist shall approve all work performed by the registered pharmacy technician prior to the actual dispensing of any drug.”
Authority to assist in compounding was limited to facilities licensed under “article 28 of the public health law, or a pharmacy owned and operated by such a facility” (i.e., hospitals). This was problematic for two reasons. First, it distinguished community pharmacies from hospital pharmacies. Second, because hospitals often operate outpatient pharmacies, they came into competition with community pharmacies creating a competitive disparity. No rational basis was provided to support distinguishing compounding based on the location of the pharmacy. After considerable professional advocacy and lobbying, this defect in the law was amended out in 2025.
The 2025 legislation extended the authority of registered technicians to assist in extemporaneous compounding in any pharmacy. The amendment removed references to hospitals and substituted the word “pharmacy” for “facility” thus removing the limitation to hospitals. Community pharmacies and home infusion pharmacies may now engage skilled registered technicians to assist in compounding.
To implement the new law, SED added regulations that mirrored the statute and specifying fees for licensing, qualifications, application, registration, and renewal.[7] Qualifications to becoming a registered technician include high school education or equivalent, certification from a nationally accredited program acceptable the SED, good moral character, and at least eighteen years of age.
The maximum ratio of technicians and UPs that may be supervised by an individual pharmacist was increased by the 2019 legislation. Previously 2 to 1, the 2019 law increased the ratio to 4 to 1 in all practice settings. This can be any combination of UPs and technicians with the additional caveat that the maximum number of compounding technicians that may be supervised at any time is two.
The 2025 legislation extended the authority of registered technicians to assist in extemporaneous compounding in any pharmacy. The amending legislation simply substituted the word “pharmacy” for “facility” thus removing the limitation to hospitals. Community pharmacies and home infusion pharmacies may now look to skilled and qualified technicians to assist in the process of compounding customized products.
[1] 2019 NY Laws, Chapter 414, effective April 2021. The law added §6832, and Article 137-a, including §§6840 – 6844.
[2] 2025 NY Laws, Chapter 543, effective November 2025.
[3] https://naspa.us/resource/2024-pharmacist-immunization-authority/ accessed January 25, 2026.
[4] 8 NYCRR 29.7(a)(21).
[5] 571 NYS 2nd 350 (1991), 3rd Department Appellate Division.
[6] 8 NYCRR §29.7(a)(15).
[7] 8 NYCRR §§63.14 and 63.15.
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Pharmacy Law is published as an educational service to the pharmacy community in New York State. Its sole purpose is to promote an understanding of the laws, rules, and regulations that affect the practice of pharmacy in New York. The advisory board, authors and the University at Buffalo do not hold themselves out as offering legal advice. Readers should seek counsel for specific legal questions or concerns.