South Dakota State Board of Pharmacy
4305 S Louise Ave, Suite 104, Sioux Falls, SD 57106
NEW BOARD MEMBER
Governor Mike Rounds recently appointed Lisa Rave to serve a three year term on the Board of Pharmacy. She replaces Steve Statz who served on the Board since 1996. Lisa is currently the Pharmacist-in-Charge & Clinical Pharmacy Manager at CIGNA Home Delivery Pharmacy in Sioux Falls. Prior to joining Cigna over six years ago she worked as a pharmacist for a retail chain pharmacy in the Sioux Falls area. Lisa earned degrees from the SDSU College of Pharmacy (BS, 1990) and the University of Sioux Falls (MBA with a Healthcare Concentration, 2008). She serves as a Director for Heartland Consumers Power District in Madison, SD. She is married to Tim Rave and has two children, Thea & Mitch. Her hobbies include: reading, music (listening, singing, playing piano) and riding dirt bikes.
NEW REGISTERED PHARMACISTS
The following candidates recently met licensure requirements and were registered as pharmacists in South Dakota: Kathryn Dzintars, Tricia Klug, Brock Komar, Luke Merkel, Heather Strawsell, Akila Subramanian, Nah-Uyen Tran and Jafar Zand.
Pharmacy licenses have been issued recently to: Brothers Pharmacy, Brookings, Shane Clarambeau, Pharmacist-in-charge; Hy-Vee Pharmacy #7, Sioux Falls, Kristin Williams, Pharmacist-in-charge.
STAMPED OR PRE-PRINTED SIGNATURES
Prescriptions for any legend drug or controlled substance must be signed by the prescriber and NOT rubber stamped or pre-printed.
CONTROLLED SUBSTANCE ANSWERS
The Drug Enforcement Administration (DEA) has a terrific Web site for information on controlled substance regulations: www.deadiversion.usdoj.gov/. The site contains lists of controlled substances by schedule, order forms, new regulations, and much more. Of particular interest to pharmacists is the “question and answer” section.
The final language on changing information on a Schedule II prescription has not been provided by the DEA. The Board suggests that if changes are necessary the pharmacist should contact the prescriber for a new prescription until the DEA issues a final ruling.
DEA POLICY CHANGE ON PRACTITIONER AGENTS
The DEA announced policy changes that will now allow nurses (including but not limited to long-term care facility (LTCF) nurses) working in LTCF’s to act as agents of physicians prescribing schedule III through V medications. An agent may not communicate oral Schedule II prescription medication to the pharmacy on behalf of a practitioner. The federal register notice can be accessed online at http://tiny.cc/fbwuvxawm7. In the absence of an employer-employee relationship, the DEA-registered practitioner may designate an individual as his or her agent, provided the practitioner assesses the level of control they are able to exercise over the agent, the agents licensure, level of training, experience, and other factors to determine if the individual is a suitable agent and to ensure the individual will not engage in activities that exceed the scope of an agency relationship. There must be an explicit and transparent agreement between the practitioner and a proposed agent in order to establish an agency relationship. DEA believes that the agreement should be reduced to writing. The Federal Register notice provides a sample written agreement that could be used to establish an agency relationship between a practitioner and a designated agent that would allow an agent to communicate controlled substance prescriptions to a pharmacy. Practitioners may choose to establish agency relationships with multiple agents in multiple locations. Likewise, individuals designated as agents may establish multiple agency relationships with multiple practitioners. The agreement would also articulate scope of duties, within statutory limits, a practitioner may delegate to an agent. The signed and executed agreement should be kept on file by the practitioner, the practitioner’s agent, the agent’s employer (if other than the practitioner), and any pharmacist that would receive communication from the agent. Pharmacists will always have a corresponding duty to ensure that any prescription received is for a valid medical purpose, and that the prescription is prepared and dispensed in a manner consistent with state and federal regulations.
ELECTRONIC PRESCRIBING OF CONTROLLED SUBSTANCES
Board staff continues to receive many inquiries concerning electronic prescriptions for controlled substances (CSERx).
DEA issued a CSERx rule that was “effective” earlier this year. As noted in prior updates, however, this rule is effective only in the academic sense. That rule requires any system that either transmits or receives CSERx to be “certified” as meeting DEA’s security and control standards in the CSERx rule. At press time DEA had not certified any transmitting or receiving system as meeting these security standards. Accordingly, CSERx still does not meet federal law requirements. Much more information about the rule and its operation may be found at www.ncbop.org/faqs/Pharmacist/ControlledSubstanceE-RXFAQsApr2010.pdf. DEA has published frequently asked questions on CSERx, which may be found at www.deadiversion.usdoj.gov/ecomm/e_rx/index.html#faq.
So where does that leave everyone? An electronically signed prescription for a controlled substance is not in compliance with federal law at this time. DEA has also stated clearly (see DEA link above) that prescribers may not print or print and fax a prescription for a controlled substance that is electronically signed. However, the practitioner may print and fax a controlled substance prescription (Schedule III – V only) that they have manually signed. An exception is that Schedule II prescriptions for residents of long-term care facilities or for terminally ill patients may be faxed after being manually signed. A pharmacist who receives an electronic prescription for a schedule III, IV or V medication may call the prescriber, confirm the prescription, and treat it as a verbal order.
FOR CONFIDENTIAL ASSISTANCE
If you have concerns about yourself or a colleague, call the South Dakota Health Professionals Assistance Program (SD HPAP) to discuss your concerns. HPAP assists impaired pharmacists and pharmacy technicians who need help in dealing with substance abuse. Call Char Skovlund at 605-322-4048 for a confidential consultation.
BOARD OF PHARMACY MEETING DATES AND ACTION ITEMS FOR 2011
Please check our website for the time, location and agenda for future Board meetings.
We will be working on several items during 2011 that will have a direct effect on your pharmacy practice:
Implementing the Prescription Drug Monitoring Program
Considering legislation for mandatory pharmacy technician education and certification.
Updating our rules for mandatory continuing education.
Updating our rules for administration of vaccines by pharmacists.
We intend to keep you informed by attending district meetings and providing information on our web site. We hope that you will provide feedback to help the Board make good decisions.
BOARD OF PHARMACY STAFF DIRECTORY
|Office Phone 605-362-2737||FAX 605-362-2738|
|Ron Huether, Executive Secretaryfirstname.lastname@example.org|
|Kim Kocmick-Burden, Senior Secretaryemail@example.com|
|Earl McKinstry, Pharmacy Inspectorfirstname.lastname@example.org|
|Randy Jones, Pharmacy Inspectoremail@example.com|
|Board of Pharmacy Website||www.pharmacy.sd.gov|