8:30 AM --- FRIDAY, FEBRUARY 24, 2006
STURGIS COMMUNITY HEALTHCARE CENTER
949 HARMON STREET, STURGIS
Members Present: President Stephen Statz, members Nora Hussey, Arvid Liebe, Duncan Murdy and Executive Secretary Dennis M. Jones.
Others Present: Clifford Thomas, Pharmacy Inspector; Dana Darger, Director of Pharmacy, Rapid City Regional Hospital; Kevin Forsch, Governors Office; Mark Mickelson, Sioux Falls, and Robert DeMersseman, Rapid City, Economic Development; Jeff Nielson, CIGNA Tel-Drug; Ronald Bertsch, Ameripharm; Susan Schaefer, South Dakota Pharmacist Association; Jocelyn Prang, Medicap Pharmacy Owner, Rapid City; Earl McKinstry, Rapid City.
President Statz opened the meeting at 8:30 a.m. MST.
OLD BUSINESS
Circuit Court of South Dakota
On May 27, 2005, the State of South Dakota by and through the State Board of Pharmacy (Plaintiffs) filed a Summons and Complaint against Defendants Canada Services formerly known as Canada Drug. The Board argued that Canada Service has violated statute SDCL 36-11-15 by keeping a store for retailing medicine by a person other than a registered pharmacist and that the defendants alone or as an agent for MediMart of Winnipeg, Manitoba, Canada is not a registered pharmacy in South Dakota and is not legally dispensing drugs and medicines and as such constitutes an unlicensed practice according to SDCL 36-11-19.2, 36-11.91.3 and 36-11-19.8.
On January 19, 2006, Circuit Court Judge William Srstka, Minnehaha County, SD, issued a decision providing injuctive relief to the Board of Pharmacy according to law (SDCL 36-11-65) and the suit filed against Canada Service of South Dakota.
The Board members asked Jones to send a letter to the Minnesota Board and Ronald F. Guse, Registrar, Manitoba Pharmaceutical Association, notifying them of this ruling.
2006 Legislation
The members discussed the legislation recently passed by the South Dakota Legislature that directly affects all pharmacies, over-the-counter retail businesses and public purchases of these products.
The 2006 legislature added more restrictive language to a pseudoehedrine law first passed during the 2005 session. The intent of the revised law is to closely regulate the sale of products containing pseudoephedrine and ephedrine and hopefully discourage those who abuse or steal them to make methamphetamines. The Board will work with the Attorney Generals Office and those businesses licensed by the board to enforce the law.
Joceyln Prang recommended that the Boards’ newsletter publish the new law. The board will include the new requirements in the April 2006 newsletter.
Another law change was in SDCL 36-4A-22, SDCL 36-9A-12 and 36-9A-13 to allow Physician Assistants, Nurse Practitioners and Nurse Midwives to prescribe up to a thirty-day supply of Scheduled II medications rather than a forty-eight hour amount. This was signed by the Governor and will be effective July 1, 2006.
OPUS Packaging
Opus and other similar unit-dose systems were discussed during the last two meetings. The Board asked Jones to investigate any billing issues a pharmacy could have using these packing forms and to report back at the next board meeting.
Remote Drug Delivery
The members discussed the need to be aware and regulate those sites used by pharmacies for prescription pick-up if other than the licensed pharmacy. Jones will look at how other states address this issue. The Board would like to draft rules to regulate this practice in the future.
Report
A new report about South Dakota pharmacies was provided to the board members by Jones. This report identified the number of pharmacies and pharmacists in all sixty-six counties of South Dakota. By identifying those counties with no or very limited pharmacy services the board may be able to help bring or retain pharmacy services there now or in the future.
The members have been discussing tele-pharmacy and alternative pharmacy services for remote locations in South Dakotan and realize that this problem is not an easy fix. Many counties have only one pharmacy with the pharmacist providing the only pharmacy service to that county’s hospital. The board asked Jones to inquire with the South Dakota Hospital Association and see if any of those small hospitals could qualify for critical access funding to help pay a pharmacist salary like Tyler, Minnesota.
Approval of Minutes
Motion made by Liebe to approve minutes of February 2006 meeting. Seconded by Murdy.
NEW BUSINESS
Board Meetings
The members discussed future meetings and it was agreed that having meetings at various sites should be considered. The members felt that the following meeting dates would be practical and, if there is no conflict, should be scheduled this way:
January – Pierre
February-March –West River
May - Sioux Falls
June – various sites
September-October – Milbank retreat for planning
November-December – Sioux Falls
Presentation
Mr. Kevin Forsch from the Governor’s Office introduced a group of gentlemen who came to this meeting to provide information and to ask the board to consider an increase in the technician ratio. Mr. Nielson and Mr. Bertsch provided insight into the operation of mail-order pharmacies and how their use of automation along with the latest technology helps to fill large quantities of prescriptions at a very low error rate. Bertsch claimed the work environment for pharmacists and technicians is controlled and more focused, interruptions are limited, and the use of advanced technology are just some of the reasons errors are reduced.
Mr. Mickelson and Mr. DeMersseman addressed the factors that attract businesses to a state like South Dakota and the need to increase the state jobs. They believe that mail-order industry fits well in South Dakota from a geographical and economical perspective. After a lengthy discussion it was agreed that the board would investigate and discuss the issue at the next meeting. Mr. Forsch also asked that the Board provide him a list of questions and concerns that he will try to get answered so the board could render a decision at the next meeting. The Board reminded the group of its responsibility to protect the public welfare and safety and not place pharmacists in a situation beyond their control to safely verify all prescription orders and medications dispensed.
Statz made a motion that the board study the group request for increased ratio and move toward a hearing. Seconded by Liebe. Jones will contact states having ratios beyond 2:1, inquire as to reasons and study any requirements. Members are to receive copies of findings.
Rapid City Regional Hospital
Mr. Darger, Director at Rapid City Regional Hospital, spoke to the Board about Rapid City Regional’s decision to invest in bar-coding technology. Their pharmacy will be moving forward with its implementation. He is not requesting anything from the board, but would like to invite the board to come and see how it operates once up and working.
Technician Training
Chapter ARSD 20:51:29 requires any pharmacy utilizing a pharmacy technician to develop, implement and periodically review written policies and procedures for training technicians. The board, with the help of Earl McKinstry, looked at technician workbooks that are available for a pharmacy to purchase and can assist them with meeting the requirements of this regulation. A motion was make by Liebe that a recommendation be printed in the next newsletter. Seconded by Statz
Inspector Report
The members were given a handout of the pharmacy inspections completed during the previous eighty days by pharmacy inspectors Ronald Huether and Clifford Thomas. This is an informational report for the board members and basically highlights any points of interest addressed during the inspections.
Telephone Call
The board received a phone call during the meeting wanting to know if a pharmacy could provide packaged generic drugs free to prescribers. The prescribers apparently work for a hospital that wants to increase the use of generics drugs. As an incentive for an increase in generic drug usage the insurance industry would increase payments.
The caller was told there is a problem since he does not have FDA approval to repackage medications to sell or provide to the hospital to give to their prescribers. The hospital pharmacy may package unit-dose from the manufacturer’s bulk bottle and then provide to their own hospitalized patients, or a retail or closed pharmacy may package unit-dose medications for their patients in a nursing home, but they cannot unit-dose medications to sell or give to another business or person. This would violate FDA packaging laws.
Portable Computer
Gateway Widescreen Portable M250 or appropriate portable computer should be provided to the pharmacy inspector to facilitate filing of reports, printing forms, etc. A motion to purchase a portable computer according to state contract was made by Liebe, seconded by Murdy.
Influenza Concerns
The board has concerns that some pharmacies are not following regulations adopted for Influenza Immunization, ARSD 20:51:28 and some employers are using outside nurses to provide flu shots without providing records to the pharmacy as required. Jones was asked to look into the legality to require that a pharmacist certified to administer influenza vaccine must be available at any pharmacy providing influenza shots.
Other Items of Interest
Many pharmacies call the board’s office to ask what the schedule is for Marinol. The answer is Schedule III.
Newsletter
The board approved continuing a quarterly newsletter to all registered South Dakota Pharmacists. The cost for four issues including postage is roughly $1.70 per pharmacist per year. The board advises pharmacists that information contained in the newsletter is considered an official notification. It is the pharmacists’ responsibility to read newsletters. They are three-hole punched and should be saved in the pharmacy. In addition, all newsletters are posted on the Boards’ web site. Motion by Liebe, seconded by Hussey.
Next Meeting
The next scheduled meeting is April 3, 2006 in Sioux Falls, SD. Meeting to start at 9 a.m. CST.
