Procedure for Impaired Pharmacist

PURPOSE: This rule establishes an efficient and timely process for the disposition of information and tentative board action concerning impaired pharmacists to the attorney general’s office for purposes of preparing a complaint and streamlines the procedure utilized in interviewing pharmacists who are chemically impaired. (1) The executive director shall receive information concerning the impairment of licensees and coordinate any investigations that seek to substantiate information concerning a possible impairment. (2) Investigations by board inspectors or division investigators concerning chemically impaired licensees will be collected and reviewed by the executive director. Cases will be divided into two (2) categories. (A) Category A. Chemically impaired licensees where additional information is evident that known distribution of AND INSURANCE controlled substances or legend drugs to other individuals has taken place. (B) Category B. Chemical impairment of a licensee where controlled substances, legend drugs or alcohol have been acquired for personal use only. (3) Cases which fall into Category A will be referred to the board for appropriate action. (4) Cases which fall within Category B will be subject to administrative review as a preliminary action to facilitate any corrective actions deemed necessary by the board. (5) The following shall constitute office procedures involving Category B cases: (A) Normal procedures for completing field investigations and assimilating other pertinent information will be followed; (B) If the director believes that a case falls into Category B of this policy, s/he shall consult with the president of the board concerning the appropriateness of an administrative review; (C) If approval by the president is given, the director shall take actions necessary to set up a meeting with the licensee who is the subject of the investigation. In addition, other individuals such as legal counsel for the board may be asked to attend, along with any staff member, as necessary; (D) A statement concerning due process procedures and the rights of the licensee will be read at the beginning of the review meeting. A complete record of the administrative review meeting shall be maintained by the board office. Notice that the president of the board has been notified and that s/he has given approval for an administrative fact-finding meeting shall be entered into the record; (E) A format during the fact-finding meeting will be followed that allows the licensee to provide a statement of his/her own as well as a question/answer period allowed to discuss the aspects of the case centering on the chemical impairment issues or on any related concerns about the individual’s ability to practice pharmacy; (F) After the fact-finding meeting is concluded, a summary will be provided to each member of the board within the appropriate agenda, along with recommendations from the director as to any action to be taken. In addition, the president will be contacted and provided any follow-up information that could warrant changes in administrative procedures. The president, by executive order, may initiate an affidavit to the board attorney of an intent to file a complaint with the Administrative Hearing Commission. Once an order is executed, the information on the case shall be forwarded to the attorney for necessary legal preparation; and (G) The entire board shall consider the case in closed session as to whether or not to file a complaint against the licensee and consider the recommendations made as to terms. Once the board authorizes a complaint, the attorney for the board shall assure that the appropriate filings take place. (6) When an impaired pharmacist is disciplined by the board and a term of the discipline is that s/he participate in a chemical dependence treatment program, the impaired pharmacist shall select a program which meets the following guidelines: (A) Persons who are involved in the treatment or counseling of a Missouri board-licensed pharmacist must submit written documentation of their credentials and qualifications to provide treatment or counseling; (B) A written agreement or contract must be provided and executed between the counselor(s) and the licensee, outlining the responsibilities of each party for a successful treatment and monitoring program. The agreement must include a provision for sharing information concerning all aspects of therapy between the treatment facility or counselors, or both, and the Missouri Board of Pharmacy; (C) An initial evaluation report must be completed and provided to the board outlining the licensee’s present state of impairment, the recommended course(s) of treatment, the beginning date of treatment and an assessment of future prospects for recovery; (D) A copy of the proposed treatment plan must be provided to the board and must include a provision outlining the method of referral to an appropriate after-care program; (E) The counselor(s) must provide progress reports to the board as follows: 1. Inpatient therapy—monthly reports; 2. Outpatient therapy—quarterly reports; and 3. After-care programs—semiannual reports; (F) The treatment program must include randomized and witnessed body fluid testing and analysis, with any drug presence not supported by a valid prescription to be reported to the Missouri Board of Pharmacy; (G) The treatment program must include a provision for reporting any violation of the treatment contract or agreement by the licensee to the board; and (H) All reports outlined in this protocol must be provided in writing to the board for a counselor or treatment facility, or both, to be approved for the treatment of a licensee undergoing disciplinary board action. AUTHORITY: sections 338.140, RSMo Supp. 1989 and 338.240, RSMo 1986.* This rule originally filed as 4 CSR 220-2.170. Original rule filed Oct. 1, 1987, effective Jan. 14, 1988. Amended: Filed Nov. 15, 1988, effective March 11, 1989. Moved to 20 CSR 2220-2.170, effective Aug. 28, 2006. *Original authority: 338.140, RSMo 1939, amended 1981, 1989 and 338.240, RSMo 1951.