While pts continue to suffer… bureaucrats meet to have “talks” abt this complex issue

Posted on April 22, 2015 by Pharmaciststeve

DEA, State Attorney’s staff meet to discuss prescription drug problem in Florida

http://www.wesh.com/news/dea-state-attorney-pam-bondi-meet-to-discuss-prescription-drug-problem/32491338

TALLAHASSEE, Fla. —Staff members from Attorney General Pam Bondi’s office and Drug Enforcement Administration officials had a closed-door meeting Tuesday to discuss the prescription drug issues plaguing Florida.

Assistant Special Agent in Charge of Central Florida Jeff Walsh refused to discuss the details of the meeting, saying only that it was an operational meeting and that he had no comment.

Before the meeting began, Attorney General’s aides said they would raise concerns about legitimate patient prescriptions being denied and ways the DEA could address the issue.

Both Gov. Rick Scott and Bondi have pointed the finger at the DEA. But when WESH 2 talked to the DEA earlier this year, officials said this was an issue between pharmacists and patients.

“We do not go in and tell a pharmacy or pharmacist you have to fill this,” Walsh said.

However, a recent DEA letter suggests there might be something that can be done.

A.D. Wright, the top DEA official for the state, attended Tuesday’s closed-door meeting at the DEA’s Tallahassee office. Last month he wrote a letter to Bondi saying patients unable to fill legitimate prescriptions is “very concerning,” adding, “as we joined forces to eradicate pill mills, rogue doctors and those flagrant pharmacies…I’m confident we will continue to work together in finding solutions to help our citizens.”

At the State Capitol, lawmakers are optimistic the meeting will get the ball rolling on finding a fix to the current crisis.

“I’ve spoken with the Attorney General. She’s assured me that they’re working to try to make sure this issue is being resolved,” said Rep. Dwayne Taylor. “It’s extremely important.”

“It opens up an important dialogue to truly get the true periphery of what the issue is,” said Sen. Darren Soto.

Most watched: Incident with UCF student on LSD caught on police body cams

Bondi’s office released the following statement: “Members of the Attorney General’s staff today met with members of the Drug Enforcement Agency to discuss reports of episodic incidences of patients unable to fulfill legitimate scripts for pain medication. Today’s meeting was helpful in understanding the complexities of this serious issue.”

LIST: Florida among America’s most corrupt states

LIST: Florida among America’s most corrupt states

Jail, prison generic1
1 of 12

Ferre’ Dollar/CNN

A new study from researchers at the University of Hong Kong and the Indiana University estimates that corruption is costing Americans in the 10 most corrupt states an average of $1,308 per year, or 5.2 percent of those states’ average expenditures per year. Researchers studied more than 25,000 convictions of public officials for violation of federal corruption laws between 1976 and 2008 as well as patterns in state spending. Take a look at the 10 worst states for corruption:

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For 100 years they have been trying to legislate good behavior

Posted on April 20, 2015 by Pharmaciststeve

Synthetic Pot Sends Scores to New York Hospitals

Officials say 160 people have been hospitalized in nine days

http://www.wsj.com/articles/synthetic-pot-sends-scores-to-new-york-hospitals-1429423829

NEW YORK—Synthetic marijuana has sent 160 people to hospitals in New York state in a little over a week, a spike that prompted authorities to warn Friday that the drug is dangerous and illegal.

Over 120 emergency-room visits since April 8 linked to synthetic pot—known by “spice,” ‘‘K2,” ‘‘green giant” and other street names—have been in New York City, its Health Department said Friday. The average earlier this year was two to three synthetic marijuana-related emergency room visits a day citywide.

Statewide, poison control center calls stemming from synthetic marijuana also have risen dramatically, Gov. Andrew Cuomo’s office said.

“Synthetic drugs are anything but harmless, and this rash of severe health emergencies across the state is direct proof,” he said in a statement.

Other states also have expressed concern. Alabama public health officials said Wednesday nearly 100 people had been hospitalized for problems linked to synthetic marijuana within the past month. Police in Hampton, Va., said one person died and two others were hospitalized after synthetic marijuana overdoses last weekend. In February, over 40 state attorneys general signed a letter asking oil companies to make sure gas station convenience stores don’t sell synthetic drugs.

In New York City, the Health Department is issuing reminders to stores that it is illegal to sell synthetic marijuana.

Synthetic marijuana generally consists of dried vegetation coated with chemicals that are supposed to mimic the effects of pot. Some users report that it produces a marijuana-like high, but others experience extreme anxiety, hallucinations, a rapid heart rate, vomiting and other symptoms, the federal National Institute on Drug Abuse said.

The federal Substance Abuse and Mental Health Services Administration estimates over 28,500 people went to emergency rooms nationwide in 2011 after taking the drug, a fraction of the visits linked to actual marijuana, heroin or cocaine.

“There’s no way of knowing exactly what synthetic marijuana contains,” making its effects unpredictable, New York City Health Commissioner Dr. Mary Bassett said. She issued a similar warning last summer after 15 people went to E. R.s with bad reactions to the drug in four days.

While the drug’s users often are teens and young adults, the median age is 35 in the recent cases in the city, the Health Department said.

Since 2012, New York state regulations have banned selling or possessing various chemicals used to make synthetic marijuana. Store owners and employees can be charged with a crime for selling it.

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pharmacy technician was shot during an attempted robbery Monday afternoon

Posted on April 20, 2015 by Pharmaciststeve

Pharmacy tech shot by robbery suspect

http://wavy.com/2015/04/20/person-shot-at-va-beach-pharmacy/

VIRGINIA BEACH, Va. (WAVY) — Virginia Beach police say a pharmacy technician was shot during an attempted robbery Monday afternoon.

Police dispatchers received a 911 call around 2:25 p.m. for a report of a gunshot victim at 840 South Military Highway, which is a Rite Aid Pharmacy.

Virginia Beach Police Officer James Cason said a man armed with a silver semi-automatic handgun entered the pharmacy and demanded drugs. At some point, the suspect fired at a pharmacy technician, who received injuries that were not life-threatening, according to police.

The victim was transported to a local hospital.

Cason said the suspect fled on foot, and possible left the business property in a vehicle. He is described as an African American man in his early 20s with a thin build. He is just shy of 6-feet-tall, has short hair and was wearing a dark shirt and jeans.

Anyone with information about the suspect is asked to call the Crime Line at 1-888-LOCK-U-UP℠.

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What defines the DEA’s mission, apparently, are two parts marijuana, one part cocaine ?

Posted on April 20, 2015 by Pharmaciststeve

Drug Enforcement Museum Links Drug Industry To Terrorism

What I Learned at the DEA Museum

http://www.huffingtonpost.com/bruce-barcott/what-i-learned-at-the-dea-museum_b_7100156.html

As Americans celebrate 4/20, pot culture’s answer to Octoberfest, I’m getting pelted with questions about the growing legalization movement. What’s the new pot like? What are you telling your kids? Right. I get those questions. But mainly I hear this one: Why is legalization happening now? 

Until recently, I cited two factors. First, the emergence of the Internet offered widespread access to scientific studies and counter-narratives that debunked the government’s Reefer Madness line. Second, medical marijuana served as a 20-year pilot project that calmed the fears of a worried nation. Dispensaries opened, weed was openly sold, and the pillars of civilization did not crumble. 

A few days ago, I added a third factor. It came after a visit to the Drug Enforcement Administration Museum outside Washington, D.C. 

The DEA Museum isn’t an A-list attraction. It doesn’t draw the crowds of the Smithsonian’s Air and Space Museum. But the DEA’s hall of history offers a fascinating glimpse into the evolution of the American drug war. (Here’s a blurb for you, DEA: A must-see when you’re in D.C.!) 

The exhibit floor opens with a head shop from the 1970s, a metal crack-house door from the 1980s, and a medical marijuana dispensary storefront from the 2000s. This is the federal government’s overview of America’s drug problem. There’s no meth. No heroin. No prescription pills. What defines the DEA’s mission, apparently, are two parts marijuana, one part cocaine. 

The main hall offers a more balanced take on history: Early folk medicines, opium dens, the “Just Say No” era, cocaine wars and pirate prescription pill operations. Fans of D.C.’s International Spy Museum will love the array of smuggling devices (hollowed-out heels, surfboards, truck tires, sedan side panels, and my favorite, an ultralight plane fitted with a cocaine carry basket). 

Near the gift shop stands a gleaming motorcycle. It’s displayed as an example of the asset forfeiture laws that allow the government to confiscate the property of anyone accused of a drug crime. 

As much as I enjoyed seeing the trickster tools of the smuggling trade, it was that motorcycle and the mock medical marijuana dispensary that stuck in my mind. They made me realize how out-of-touch the federal government has become with the common experience of most Americans. 

Asset forfeiture laws, a reasonable idea 30 years ago, have curdled into an outdated and corrupting tool of abuse. A Washington Post series last year exposed how forfeiture laws have turned too many local cops into old-fashioned highway bandits, seizing cash and cars from hapless out-of-town drivers. 

Legal medical marijuana, which is apparently considered a farce by the DEA, is now accepted by 86 percent of all Americans. (53 percent support full adult legalization.)  Eighty-six percent: Medical pot now outpolls the Stars and Stripes and apple pie. Many of us know someone who has benefitted from its use — a parent with cancer, a friend fighting epilepsy, or an Iraq War soldier battling PTSD. Twenty-three states and the District of Columbia now allow it. Juries are balking at the over-prosecution of patients and growers arrested in federal raids. And yet at the DEA headquarters, a medical dispensary is still displayed next to a crack-house door. 

As I exited through the gift shop, I realized I would have to add a third part to my answer. Marijuana laws are changing now because more and more voters believe the war on drugs — and especially the war on marijuana — has gone too far. It has grown into something irrational, ugly and downright mean. As citizens, we expect to be protected from dangerous drugs like meth, cocaine and heroin. But evidence and experience have changed our minds about marijuana. It’s time the federal government caught up with us. 

—

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DEA’S payments to informants, which totaled $146 million over five years

Posted on April 20, 2015 by Pharmaciststeve

swat

Justice officials launch another investigation of DEA payments to informants

http://www.post-gazette.com/news/nation/2015/04/20/Telling-for-Dollars-Justice-officials-launch-another-investigation-of-DEA-payments-to-informants/201504190057

The Drug Enforcement Administration’s spending on informants, which topped $33 million last year, is the subject of a new probe by inspectors who ripped the federal agency’s accounting a decade ago.

The Department of Justice’s Office of the Inspector General is investigating how the DEA manages and oversees informant payments, which are a controversial law enforcement tool.

The DEA’s spending on secret sources has increased much faster than its overall budget. Last week, the Justice Department , which oversees the DEA, released to the Pittsburgh Post-Gazette the agency’s total payments to informants for each of the past five fiscal years.

The disclosure came 15 months after the newspaper made Freedom of Information Act requests for documents totaling and detailing its spending on informants since 2010. The DEA’s repeated denials suggest that it has trouble tracking the dollars it dishes to informants, a decade after inspectors told it to fix its payment database.

That’s despite increasing payments to informants, which totaled $146 million over five years.

“I have to say I’m kind of shocked” by the volume of payments, said JaneAnne Murray, a federal criminal defense lawyer and practitioner in residence at the University of Minnesota Law School.

She said informants angling for lenient sentences are usually revealed to the defense, but paid sources remain in the shadows except in the rare federal cases that go to trial. As a result, the truthfulness and credibility of paid sources are rarely tested.

The dollar figures, she said, are “pretty troubling, because once you start introducing a profit motive, there’s a huge potential for fabrication.”

Justice Department spokesman Wyn Hornbuckle noted that payments to informants are “based upon the value of information or services provided.” The department’s guidelines to the DEA, FBI and other bureaus are meant to avoid inappropriate use of paid informants.

‘Lax controls’

Federal law enforcement depends on thousands of informants. Some are criminals, cooperating in the hopes of probation or shorter prison terms. Others are paid.

The Post-Gazette last year documented the appearances in the U.S. Courthouse, Downtown, of informants with decades of experience who received upward of $30,000 per bust. The newspaper also found that of nine acquittals in the courthouse over six years, four involved shaky informants — none of whom were paid and all of whom dealt with the DEA.

A review of 154 recent federal acquittals nationally found that 1 in 6 involved informant problems.

Because payments to informants can become an issue at trial, they are carefully monitored.

Informant expenditures are “watched so closely, agents aren’t allowed to pay an informant unless they have a witness,” said Dennis Fitzgerald, a former DEA agent and author of the new second edition of “Informants, Cooperating Witnesses, and Undercover Investigations: A Practical Guide to Law, Policy and Procedure.”

DEA offices must get approval from upper management before paying an informant more than $100,000 in one year, or $200,000 over multiple years.

The Office of the Inspector General found in 2005 that the DEA wasn’t following the rules. The agency’s “unreliable” database wasn’t totaling payments to the same informant from different offices or varied funding sources. The DEA’s Confidential Source Unit didn’t communicate well with its Office of Finance.

The inspectors made 12 recommendations to improve a “lax internal control environment where payments may be approved that are not reasonable, appropriate, or justified.”

‘Money squirting’

Now, according to a posting on the Office of the Inspector General’s website, inspectors are looking into “the DEA’s management and oversight of its Confidential Source Program, including compliance with rules and regulations associated with the use of confidential sources, and oversight of payments to confidential sources.” The office’s counsel wouldn’t detail the probe.

Experts said it would be surprising if the DEA completely ignored the 2005 report.

“The president of the United States puts you in charge of this program, and you find out that you’ve got all of this money squirting out from these various pots and it’s a substantial amount of money, and nobody is keeping an eye on it,” said Scott Lilly, a senior fellow with the Center for American Progress and former staff director for the House Appropriations Committee, who retired from government in 2004. “Wouldn’t that scare the hell out of you?”

The Post-Gazette, citing FOIA, asked for the DEA’s accounting policy for payments to informants. The agency provided a two-page policy, with 13 redactions encompassing well over half of the document. The DEA claimed that the release of unredacted accounting rules would “disclose techniques” and could “risk circumvention of the law.”

The Bureau of Alcohol, Tobacco, Firearms and Explosives, by contrast, released a 10-page, unredacted policy governing payments to informants. The U.S. Marshals Service provided a 15-page policy, with one phrase redacted.

Bucking trends

The DEA’s overall budget increased 3 percent from 2010 to 2014, to $2.88 billion. But its spending on informants, according to the Justice Department, jumped by one-third.

The agency paid informants $24.7 million in fiscal 2010, upward of $29 million in each of the following three years, and $33.1 million last year.

“That sounds like a lot of money to me,” Mr. Lilly said.

“If I were betraying the confidence of a drug lord,” he added, “I’d probably want a lot of money to offset the risk.”

Some other agencies have scaled back their spending on informants. The Marshals Service, for instance, paid its informants a total of around $900,000 in 2010 and 2011 but that amount decreased to $600,000 in each of the past three years. The ATF has paid informants between $4.2 million and $4.5 million in each of the past five years.

“The DEA often depends on informants that deal with, say, the cartels in Mexico, other cartels around the world,” noted Alberto Gonzales, who oversaw the Justice Department as attorney general from 2005 to 2007 and is dean of the Belmont University College of Law in Nashville, Tenn.

The FBI has not yet complied with an FOIA request of December 2013, asking for a description of all of its spending on informants, saying it will try to address it by September. Last year, the bureau used $7.2 million in Asset Forfeiture Program proceeds to reward informants, but the full extent of its spending on sources has not been released.

Global hand search

Fifteen months ago, the Post-Gazette asked the DEA to disclose any budgets or other documents describing payments to confidential informants for the years 2010 through 2014, plus breakdowns by geographic district, and itemizations of awards that are based on percentages of assets seized. The newspaper recognized that sensitive material could be redacted.

The DEA said in February 2014 that release of informant budgets would “constitute an unwarranted invasion of personal privacy” and declined to search for documents.

On appeal, the DEA wrote that to answer the request, it would have to coordinate “approximately 222 individual DEA domestic offices … as well as approximately 86 DEA foreign offices and a number of DEA Headquarters offices.”

Though it has a payment database, the DEA claimed that answering the FOIA request would take “an estimated 24,240 or more man hours, conducting hand searches to compile the information.” That breaks down to two employees for two solid weeks in each of the 308 offices.That estimate “seems exorbitant,” said Ginger McCall, director of the Open Government Project at the Electronic Privacy Information Center in Washington, D.C. “It’s a large amount of time to locate a file that they really should have readily available.”

The Office of Information Policy concluded that the DEA “does not maintain the type of records” sought and upheld the denial. Last week, the Justice Department released year-by-year spending totals but not details.

Mr. Gonzales was not surprised that the agency didn’t want to detail its informant program.

“You don’t want to hit [the cartels] over the head with this information, oh my gosh, the U.S. is paying this much for informants,” the former attorney general said. “The more we talk about what we do to gather up information to protect America, the smarter our enemy gets. They change tactics.”

Ms. McCall, an FOIA lawyer, said America’s foes should not be an excuse to keep spending secret. “These sorts of nebulous ‘it’s going to help our enemies and it’s going to help criminals’ arguments are not sufficient.”


 

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Is this why some refer to FLORIDA as “god’s waiting room ” ?

Posted on April 19, 2015 by Pharmaciststeve

For two years, Florida legislators have refused to expand Medicaid as envisioned under the Affordable Care Act. Their decision left an estimated 850,000 Floridians without healthcare insurance in the “coverage gap.” Those caught in the gap earn too much to receive Medicaid, but not enough to qualify for subsidies to buy a plan through the federal marketplace. The Miami Herald looks at how these Floridians are coping and what other states are doing to close the gap.

Reports

For 850,000 Floridians, piecemeal healthcare

With legislators seemingly deadlocked on Medicaid expansion in Florida, residents in the “coverage gap” are stitching together their medical care through personal ingenuity, half doses of medicines and low-cost clinics. It’s exhausting work, especially when you’re sick. Read more

Choosing between dinner and a medical test

Without Medicaid expansion, South Florida’s low-income residents have found out the hard way that the healthcare safety net designed to catch people before they hit bottom is no substitute for insurance. Read more

Why won’t Florida adopt Medicaid expansion?

Other states have overcome political opposition to Medicaid expansion and adopted plans to bring government-subsidized coverage to more of their low-income residents. Read more

Explainer: How 5.2 million people fell into the health insurance coverage gap

Compare states that expanded Medicaid with states such as Florida that did not expand, leaving citizens without coverage. Read more

Resources

Map: Find a low-cost healthcare provider

For the uninsured population, affordable care is limited to free clinics, which are often operated by churches or schools, and federally qualified health centers, organizations that receive grants from the federal government to care for underserved populations. Look up a facility in South Florida. Or see a list of local agencies that help with social and medical services.

Profiles

For people caught in the gap, injuries can be catastrophic and chronic illnesses may go untreated for years. How did 850,000 people find themselves in the gap, and how are they coping? Here are some of their stories.

When the caregiver can’t get care

“I feel left over, left back.’’ — Paula Bazain, caregiver

Single mother of five $4000 short for coverage

“What kind of country are we? Everybody needs insurance” — Francesca Corr, single mother

A lifetime of respiratory illnesses

“I can’t live a normal life.’’ — Genesis Rodriguez, automotive tech student

Seven years without a checkup

“Normally, you go to the doctor when something like that happens.’’ — Carlos Cuervo, salesman

Covered under Medicaid, for now

“One minute you receive Medicaid, and the next minute it’s gone.’’ — Ceslynn Watkins, former customer service rep

Two heart attacks and living in an abandoned house

“I knew exactly right away what it was because I’d felt it before. I was having a heart attack.’’ — Eric Schmidt, former construction worker

A move from NYC to Miami, a loss of coverage

“It wasn’t the welcome that I wanted from Florida.’’ — Harry Melo, student

A career in construction, until a back injury

“They just tell me I’ve been denied. Every time.” —Timothy Lane, former landscaper

Piecing together medical care

“I wish I had insurance, so I can go to a private doctor.’’ — Cynthia Louis, waiting a year to see a specialist

A few years shy of Medicare coverage, and caught in the gap

“It’s totally unfair that when you’re in need of help, you can’t get it.’’ — Vanessa Wilcox, former phlebotomist

Loss of income could mean loss of eyesight

“They won’t give me a chance. That’s not right. … I can go blind.” — Edith G. Camacho, homemaker

Diabetic relies on emergency room for care

“I would benefit more from Medicaid expansion than charity care.’’ — Vincent Adderly, former security guard

Read more here: http://www.miamiherald.com/news/health-care/article18726207.html#storylink=cpy

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Should the word “ADDICT” have the same derogatory meaning as the “N-word” ?

Posted on April 18, 2015 by Pharmaciststeve

Race lesson in the pharmacy

The Americans with Disability Act and the Civil Rights Act are parallel laws.. covering different subsections of our population. Discrimination under both laws is considered a civil rights violation. In this story, the Pharmacist took offense at being told by the customers that she should “go back to Africa”.. and referring to her by the N-word.  Should pts with subjective diseases, have a equal recourse under the ADA, when they are told to “go home” without their necessary medication and/or treated – or called – a ADDICT at the pharmacy counter?

IMO.. in this particular situation, this Pharmacist did the appropriate thing by involving other staff members and ultimately the police to DOCUMENT what was happening.  Of course, if a pt called other staff members to witness what was said.. it is likely that the other staff members will decline to get involved and/or the Pharmacist will “clam-up”.  It has been reported that under such situations… Pharmacists have threatened to call the police on the pt.  The pts need to document with video recording… if the conversation is/can be overheard by others.. it is no longer a “private conversation” and many/most two party recording laws apply.

When attempting to filing complaints about mis-treatment at the pharmacy counter… without a video recording.. it is going to  be your word against the pharmacy staff member… at best.. wrists will be slapped and the pt’s complaints will be dismissed.

http://drugtopics.modernmedicine.com/drug-topics/news/race-lesson-pharmacy

“First do no harm.” That was the credo given to me when I graduated from pharmacy school. It implied that I now wielded a degree of power as a practicing pharmacist. I took it to heart.

Pharmacists vow not to harm patients. Our calling is to help them. But should this intention be entirely one-sided? Recent events in my professional life have left me wondering whether any responsibility lies with patients not to harm their pharmacists.

Here’s my story.

The patient

I was working the Sunday weekend shift at the retail pharmacy. This was usually a low-key two-day affair that provided a respite from the weekday hustle and bustle. The patient, whom I’ll call “Betty Wiskowski,” a woman born in the early 1950s, came into the pharmacy accompanied by a pre-teen boy and a teenage girl.

I asked for the usual information: her name, the number of prescriptions she was expecting to pick up, etc.

Betty answered me adequately and I started the checkout process. She wandered off during my scanning and cash register routine, then eventually wandered back and asked whether she had any insulin ready. I checked the meds that were waiting for her and, not seeing an insulin prescription in her bag, went to a nearby computer to check her profile. I found an active prescription for Lantus vials that had not been dispensed since December 2014 and processed it to fill.

The beginning

The copay was sizeable, and I mentioned it to Betty. She asked whether I had used her insurance. I checked her third-party set-up and saw that she didn’t have active third-party insurance. We had been using one of three “discount” plans available for patients with no active insurance coverage (despite Obamacare, they do exist!).

I asked Betty whether she had her insurance card with her. She dug through her wallet and gave me her card. I updated her third-party information and reprocessed the Lantus prescription. The copay was slightly less than the “discount” copay.

After hearing the amount of her copay, Betty wanted to know why the prescription was still so pricey. I gave her my best guess: This was the first time Betty had used her prescription coverage in 2015, and the large copay was probably being applied toward a deductible.

Betty replied that she still wanted the insulin, so I finished filling the prescription and headed back to the checkout area.

Escalation

Betty was apparently taken aback that we (the pharmacy?) had not used her prescription coverage for her prescriptions before. I reviewed her “discount” copays for her other prescriptions; they were all approximately $5 for a month’s supply.

I explained that we had not been given her new insurance information previously and had used the lowest discount program available (and had not charged her a “cash” price) and reassured her that her third-party information was now updated.

Betty was adamant that she had paid a “cash price” (not a discounted price) before.

At that point I was not sure where the conversation was headed or what benefit could be had by pursuing the cash vs. discount discussion. I told Betty that that was okay and I was not going to argue with her, then resumed the checkout process.

Shock attack

At that point Betty looked at me and said, “That’s right and I know it! You know, you should just go back to Africa anyway, you’re just a nigger!”

I stopped and looked at Betty. I looked at the kids she had brought with her. They stood at the counter, looking as though nothing out of the ordinary had just occurred.

Mentally, I ran through my options. Reach across the counter and give Betty a quick and thorough “beat down.” Laugh off Betty’s comments in the interest of not upsetting her further. Call for help from store management and have her “gently” escorted from the pharmacy counter.

Defensive action

I opted for No. 3. I called the clerk at the service desk and asked for management to come to the pharmacy to help me with a patient. I then explained to Betty that she had two options: return to the pharmacy the following day (Monday), when I would not be working, or have her prescriptions transferred to another pharmacy where she could pick them up.

 Betty and the kids wasted no time telling me, “You can’t do that!”

The clerk reached the pharmacy relatively quickly and I gave him a quick rundown of the situation. He took Betty to a nearby aisle, where she proceeded to become even more vehement about the places I should go, etc. Then she headed back to the pharmacy counter to continue her tirade. Flustered, the service desk clerk beat a hasty retreat.

I could see the situation was not improving.

Reinforcements

At that point I called 911, trying to speak with the dispatcher while Betty was yelling in the background, “You’d better not be calling 911!”

The police officers arrived within five minutes and, following the service clerk’s procedure, one officer took Betty and the kids down a nearby aisle, while another officer stayed at the pharmacy counter and took my statement. 

I gave the officer a brief statement and then had to tend to a couple of other patients who wanted to pick up their prescriptions.

By this time, the store manager had joined the police officers, Betty, and the kids . I continued to concentrate and check out the other waiting patients.

Aftermath

A few minutes after my last patients had been checked out and left the pharmacy counter, I noticed the officers leading Betty and the kids away from the pharmacy area. The officer who had taken my statement earlier returned to the pharmacy and apologized to me for the experience I had just endured. He reassured me that the situation was under control and I thanked him for his help.

The store manager returned to the pharmacy with his assistant. He asked me to write a brief account of the encounter and leave it with his assistant. I filled a few more Sunday afternoon prescriptions, typed my account of the day’s events (and left a copy with the assisting manager), and went home.

Debriefing

I will readily admit that I felt an immediate sense of shock (as though I had been physically hit), anger, and disbelief when Betty decided to “play the race card.” At some point, however, the reality of the situation kicked in and I realized that it was up to me how I would react. My awareness that the dynamics of the situation involved not only Betty and me, but also the two kids with her, heavily influenced my reaction.

I was not trying to teach Betty a lesson. But I felt I had a responsibility to somehow send a message to two (seemingly) unreachable kids that Betty’s behavior was totally and completely unacceptable.

Betty had somehow reached a point in her life where she thought words like hers were acceptable. How then could I let the kids accompanying Betty know that her words were wrong and very hurtful? Calling the service desk clerk was a first step, but ultimately, calling 911 was the only true step I could have taken to get my message across.

The takeaway

We are all bombarded on a daily basis with accounts of young black men being shot dead by the police, of black-on-black violence, of the hopelessness of the “black experience” in the face of the danger present in our society as a whole. But it does not necessarily manifest itself in our workplace, in our profession as pharmacists.

How do we account for it? In the year 2015, we are all supposed to be in a better place; our mothers and fathers, aunts and uncles, grandparents all fought for our country to be in a better place. But seemingly, we are not — the Bettys survive and continue to spew their own inner ugliness into our lives.

My brief encounter with Betty forced me to choose: fight, laugh, or call for help. My decision to call for help was my way of bearing witness and my attempt to reflect the definition of right and wrong to the kids who accompanied Betty on that Sunday afternoon.

It was also, I believe, the only way I could ultimately help myself stand up as an African-American, as a female, and as a pharmacist, and let Betty know that what she did was not right.

As pharmacists — of any background — who are mindful of the injunction to “do no harm,” we do our best, every day, in the best and worst of times. In this situation, what would you have done?

Filed under: General Problems | 1 Comment »

Brace for record-breaking HIPAA violation fines

Posted on April 18, 2015 by Pharmaciststeve

Healthcare providers: Brace for record-breaking HIPAA violation fines

Office of Civil Rights (OCR) has pipeline of “unprecedented” settlements, says attorney Adam Greene

http://www.fiercehealthit.com/story/healthcare-large-hipaa-violation-fines-settlements/2015-04-17

OCR could hand down some whopping fines for HIPAA violations later this year, privacy attorney Adam Greene told govinfosecurity.com in an interview.

“We’ve heard anecdotally that [OCR] has a significant pipeline of unprecedented settlement agreements, meaning particularly high amounts” of financial penalties, says Greene, a partner at Washington law firm law firm Davis Wright Tremaine, who previously worked for the Department of Health and Human Services’ Office for Civil Rights.

The industry could see “some really surprising settlement agreements [and] potential record-breaking” financial penalties later this year, he said.

 An OCR attorney made a similar prediction nearly a year ago. Jerome B. Meites, OCR chief regional counsel for the Chicago area, said the HIPAA nforcement actions over the past year would pale in comparison to the next 12 months.

He was referring to nine settlements in the previous year totaling more than $10 million, including a record $4.8 million fine announced in May 2014 against New York-Presbyterian Hospital and Columbia University.

Despite the high-profile cases, though, research from ProPublica found OCR had levied fines just 22 times since 2009.

Greene attributed that to lack of resources. OCR receives about 10,000 complaints a year and tries to resolve all that have validity, he told GovInfoSecurity. 

The HIPAA audit program is on hold as the agency works to upgrade technology. It’s not clear when it will resume.

 

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Local veteran dying of cancer can’t get pain meds from VA

Posted on April 18, 2015 by Pharmaciststeve

Official seal of the United States Department of Veterans Affairs

http://m.wftv.com/news/news/local/local-veteran-dying-cancer-cant-get-pain-meds-va/nkt7y/  VIDEO ON WEBSITE

An Orange County veteran diagnosed with terminal colon cancer said he was given just months to live.

But after serving for more than 30 years, he said Veterans Affairs denied him pain medication that he needs to make it through the day.

Channel 9 found out the denial is being blamed on a paperwork mistake.

Leroy Brugonone said even though he’s fought in war, he had no way to prepare for his fight with the VA.

“I’m just like a number, not a countryman. I’ve fought lots of battles. Not like this,” he said.

Brugonone has colon cancer.

Doctors told him surgery or chemotherapy would not save his life.

“I pray to God I can live one more day,” Brugonone said.

He said the only thing he can do now is live comfortably and it takes several pain medicines to get him through the day. But now he says he can’t get the medicine anymore.

Brugonone said the VA told him last week he was denied because he missed too many appointments.

He said he missed them because he didn’t know when they were.

The paperwork the VA mailed him for the appointments didn’t have the date and time filled in. He said when he tried to explain, he couldn’t get anyone to listen.

“It’s my error. It’s my fault for not having a correct say on it. It’s my fault for not looking at it more closely. They are saying it’s not their fault,” Brugonone said.

If history is any indication, a resolution could take some time and doctors have given him six months to live.

VA officials in Orlando and Washington, D.C., said privacy laws prevent them from discussing Brugonone’s case, but they did say they are looking into the complaint and they don’t have a timetable on when Brugonone could get answers.

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Three US Senators they don’t feel your pain ?

Posted on April 17, 2015 by Pharmaciststeve

US Senate Bill will Pressure FDA on Slowing Opioid Approvals

http://nationalpainreport.com/us-senate-bill-will-pressure-fda-on-opioid-approvals-8825956.html

While chronic pain patients continue to worry about what they believe is a decreasing access to certain narcotic pain medications, two U.S. Senators are introducing a bill that would make it more difficult for new and generic opioid drugs to be approved by the U.S. Food and Drug Administration (FDA).

The bill is called the FDA Accountability for Public Safety Act and has been introduced by two West Virginia Senators, Democrat Joe Manchin and Republican Shelley Moor Capito.  Republican Senator David Vitter of Louisiana is also a sponsor.

“This is an American issue,” proclaimed U.S. Sen. Joe Manchin of West Virginia who spoke to the National Rx Drug Abuse Summit on April 8. “When you see Democrats and Republicans come together on an issue like this, I think that should give you some hope.”

In his press release announcing the bill, Manchin said:

“With 46 people dying every day from an overdose of prescription drugs across this country, it only makes common sense for the FDA to seek the advice of its expert panel and follow its recommendations concerning the approval of dangerously addictive drugs for public use,” Senator Manchin said. “Regrettably, the FDA has proven time and time again that it is willing to ignore its own experts and approve medications that harm consumers. This is deplorable and unacceptable. Too many lives have been lost, too many families have been torn apart, and too many communities have been affected by these potent painkillers. I am proud to continue fighting this growing epidemic by introducing commonsense legislation that takes another step toward making sure the drugs our government validates are safe.”

His Republican counterpart from West Virginia struck a similar theme.

“We must bring more accountability to the FDA and ensure that consumer safety is the number one priority when new, dangerous opioid medications are considered,” said Senator Capito.

The bill is a response to FDA’s regulation of opioid painkillers, and specifically one known as Zohydro. The drug was approved in October 2013. The FDA approved the drug despite the advice of its advisory panel, which cited the drug’s potential for abuse when recommending against its approval.

The bill (S. 954) makes the following recommendations:

  • All opioid medications would be subjected to advisory committee review and recommendation before the FDA makes a decision on approving an opioid.
  • If the Advisory Committee does not approve of an opioid medication due to concern over consumer health and safety – just as the Committee acted with respect to Zohydro – the FDA Commissioner would be required to make the final decision regarding drug approval; currently, the FDA Commissioner does not need to act when the Advisory Committee is overruled.
  • The FDA must submit a report to the Chair and Ranking Member of the relevant Committees that includes medical and scientific evidence regarding patient safety and clearly justifies why they ignored the Advisory Committee’s recommendation. The report must also include any conflicts of interest that FDA officials involved may have. Finally, the FDA is required to submit a copy of this report to any Member of Congress who requests a copy.
  • At the request of the appropriate congressional committee, the FDA Commissioner would be required to testify before Congress as to why the FDA ignored its own Advisory Committee.
  • Distribution of the drug would be prohibited until the report is submitted to Congress.

 

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