Board Meeting Minutes

Thursday, June 5, 2008  --10:00 a.m. MDT
Rapid City Regional Hospital
353 Fairmont Boulevard
Rapid City, SD

Members Present:  President Duncan Murdy, members Arvid Liebe, Steve Statz, Jeff Nielsen, and Arlene Ham-Burr.  

Others present: Executive Secretary Ron Huether; Earl McKinstry and Randy Jones, SD Board of Pharmacy inspectors; Rene Hixon, Board of Pharmacy Secretary; Bob Coolidge, SD Department of Health; Sue Schaefer, Director, SD Pharmacists Association; Dana Darger, Pharmacy Director, Rapid City Regional Hospital; Curt Rising, Pharmacist, Medicine Shoppe; Chris Sonnenschein, representing the SD Pharmacists Association; Robwert Gruzynski, SD Med Temps; Lisa Rave, CIGNA Tel-Drug; Steve Petersen, Pharmacy Director, Avera McKennan Hospital; Ann Oberg, SD Pharmacy Technicians Association; David Fagerskog, McKesson Pharmaceutical.

The meeting was called to order by President Murdy at 10:10 a.m.

The meeting agenda was accepted with an amended time for Curt Rising’s presentation; approved by a vote of the board members.

MINUTES
Meeting minutes from the April 10, 2008, meeting had been approved electronically by the board members and will be posted on the Board web site.

REPORTS
Financial Reports
The financial reports were reviewed and approved.  Activity reports showed number of licenses and verifications processed during the month of November.  Monthly revenue reports were discussed.  Discussion was held as to what impact any national licensure would have on board revenue.  Huether said he felt the expenses will be closer to revenue because of full staffing levels and more staff involvement in training and meetings.

Sue Schaefer presented the SD Pharmacists Association financial report and budget reflecting the amount provided by pharmacist renewals in South Dakota.  Board members asked that a full report be provided.  There was discussion related to use of funds as directed in SDCL 36-11-6.  Board members asked Schaefer to present a proposal at the September meeting on promotional media spots for American Pharmacy Month in October. The Board will consider assisting with funding the spots. There was discussion among the board members and pharmacists present regarding SDPhA annual convention – dates, participation, programming, vendor sponsorships, etc.    

Reports
Inspectors Jones and McKinstry reported on inspection activities.  They are placing emphasis on nonprescription drug licenses to assure compliance.

Huether and McKinstry visited the Pennington County Jail at the request of Diana Raga, Nurse Manager.  The purpose of the visit was to evaluate the current medication procurement, storage and administration process.  It was observed that at least  60 percent (more than 200) of the inmates are on prescription medication. Diamond Pharmacy (Pennsylvania) current provides the pharmacy services.  It was apparent that more “on-site” pharmacist participation would be of benefit and may even reduce costs.

Statistical Reports showed the number of new and renewed licenses in all categories since April. License verifications continue to increase.

Huether reported on a voluntarily pharmacist license submission.  Board action may be required following appropriate investigation.

Educational Presentation:  Dana Darger, Rapid City Regional Hospital Pharmacy Director, and hospital staff gave a tour of the pharmacy and updated hospital rooms to the Board members.  

OLD BUSINESS
Technician Ratio:  (This presentation was out of sequence to the agenda due to a conflict.)  Curt Rising, Medicine Shoppe, Rapid City, representing the retail pharmacy task force, presented a statement regarding the proposal to change pharmacy technician-to-pharmacist ratio to 3:1. His retail and long-term-care pharmacy uses advanced technology and a robot to fill prescriptions which eliminates errors and enables the pharmacist to spend more time with patients.  He views increasing the technician-to-pharmacist ratio as a way of increasing patient-level customer service and reducing errors. Board members toured Medicine Shoppe after the meeting adjourned.

Steve Peterson, Avera McKennan Pharmacy Director, also spoke in support of a 3:1 technician-to-pharmacist ratio.

Ann Oberg, SD Pharmacy Technicians Association President, commented on the American Society of Hospital Pharmacists position that supports educational requirements prior to the national technician certification exam.

Huether distributed a draft of proposed additions to the rules related to the technician ratios (ARSD 20:51:29:19).  The group agreed that item #10 should be changed to read “Technicians above a 2:1 ratio must have completed a Board of Pharmacy approved technician education program and have passed a Board approved pharmacy technician certification examination;”  Board members also agreed that this section should be consistent for mail order, retail, and long-term-care.

USP/NF 797:  There is a Task Force assisting with drafting proposed rules related to sterile compounding.  Task force members are: Dana Darger, Chad Scholten, Steve Peterson, Ron Johnson, Sandy Jacobson, Doug Smith, Earl Hinricher, and Eric Kutscher.  We expect to have a draft to review at the September board meeting.  The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) will start surveying hospitals to USP 797 standards if states have not yet adopted rules. We intend to have a draft of our proposed rules for review at our September meeting.

NEW BUSINESS
Avera Doctors Plaza 2 Pharmacy Variance:  A request for a variance was submitted by Steve Petersen, Director of Pharmacy, to increase technician ratio by one for this specialized compounding pharmacy pending finalization of the Board of Pharmacy’s review of ARSD 20:51:29:19:92--Exception to ratio for retail pharmacy. Arvid Liebe made a motion, with a second by Arlene Ham-Burr, that the pharmacy be issued a variance for one year or until rules are in place to increase the technician ratio. Mr. Petersen would need to request an extension of variance if rules are not enacted in one year. Motion carried, with Statz and Nielsen abstaining.

District V NABP/AACP:  This meeting will be held August 6-8, 2008, in Fargo.  Motion was made and carried that the members be approved for three days per diem and expenses for the meeting.

MPJE:  Steve Statz made a motion to proceed with implementation of the Multi-State Jurisprudence Examination in South Dakota. Motion seconded by Arlene Ham-Burr. Implementing this national test will require rules changes and a trip to NABP in Chicago to set up test questions and format.  Motion carried.

Hosting National NABP Meeting:  Board member Arlene Ham-Burr and  Michelle Linz (Rapid City Convention and Visitors Bureau) have asked us to make a proposal to NABP for hosting a national meeting in Rapid City. Huether will draft a letter to NABP pitching South Dakota as a possible convention site.

Telepharmacy Rules Hearing:  A rules hearing was held at 3:00 p.m.

The regular board meeting resumed at 4:00 p.m.

OTHER BUSINESS
SDSU Scholarship Program – Brian Kaatz, Dean of the SDSU College of Pharmacy described a new computer program that the College is implementing.  It will be used to record each student’s experiential training.  The Board of Pharmacy, pharmacist preceptors, students and faculty will have access to the information. The program will enhance the ability to track and document successful student progression and outcomes. The College is seeking funding support to cover part of the cost of implementation and on-going support.  The Board directed Huether to work with DOH officials on the appropriate procedure to provide $20,000  in financial support for this project.

The Board of Pharmacy members expressed their appreciation to Brian Kaatz for his association with the Board in the capacity of Dean to the College of Pharmacy.  He will be retiring from the position at the end of June.

Miscellaneous
The group shared concerns with various issues related to drug diversion and abuse of prescription drugs.  There is a definite need to improve processes for alerting Doctors and Pharmacists about drug seekers and/or doctor shoppers.  Bob Coolidge, Department of Health, spoke in favor of a universal federal prescription monitoring system.  Currently many states have implemented monitoring systems and the differences among these systems make reporting and interpretation somewhat difficult.

Other Important Dates     

August 7-9                   District 5 NABP/AACP Meeting, Fargo
September 5                 Board of Pharmacy Meeting, Avera McKennan, Sioux Falls
September 9-11           SDSU College of Pharmacy ACPE Accreditation Visit
December 12               Board of Pharmacy Meeting, Sioux Falls

The meeting was adjourned at 4:30 p.m.