Well-Being Program

PURPOSE: This rule establishes guidelines for the operation of the Well-Being Committee, pursuant to section 338.380, RSMo. (1) Definitions. (A) Board—State Board of Pharmacy. (B) Impairment—An illness, substance abuse, or physical or mental condition suffered by a licensee that is reasonably related to the ability to practice pharmacy. (C) Licensee—Pharmacist, intern pharmacist, or technician licensed or registered in the state of Missouri or who has applied for licensure or registration in the state of Missouri. (D) Well-Being Committee—The committee established pursuant to section 338.380, RSMo, authorized to create, operate, and maintain the Well-Being Program. (E) Well-Being Program—The program operated by the Well-Being Committee for purposes of early identification, intervention, treatment, and rehabilitation of pharmacists, intern pharmacists, and pharmacy technicians who may be impaired by reasons of illness, substance abuse, or as a result of any physical or mental condition. (2) The board may contract with a contractor for purposes of creating and operating the Well-Being Program. Operational costs of the Well-Being Program may be paid by the board, subject to available funding. All costs of drug screens and professional and administrative services provided to a participant shall be paid by the participant, unless otherwise provided by the board. (3) A participant may enter the Well-Being Program voluntarily or by referral of the board pursuant to a settlement agreement or other disciplinary order. Participants entering the Well-Being Program voluntarily shall be subject to and comply with all requirements of this rule. Each participant shall be financially responsible for all drug screens and any other professional or administrative service rendered on behalf of the participant. (4) Well-Being Committee Duties. (A) The committee shall oversee all aspects of the Well-Being Program including, but not limited to, program administration, staffing, financial operations, and case management. The committee shall provide services as needed to carry out the functions of section 338.380, RSMo, including, but not limited to: 1. Referring participants for appropriate assessment or evaluation and ensuring that treatment recommendations based on the assessment are followed as deemed appropriate by the board or committee; 2. Assisting the participant in obtaining evaluation and treatment; 3. Monitoring participant compliance with the contract between the committee and participant; 4. Monitoring the participant’s compliance with the terms of any board disciplinary order/agreement; 5. Monitoring treatment progress and re-entry contractual compliance; 6. Managing/monitoring random drug screens; 7. Assisting participants to re-enter practice from treatment; 8. Assisting with aftercare issues or recommendations; 9. Program development; 10. Outreach education, as requested by the board by contract; 11. Managing, ensuring, and monitoring random and scheduled drug screens; and 12. Other necessary services as agreed by the board and committee. (B) The committee shall enter into written contracts with each participant. Unless otherwise approved by the board, the contract between the committee and the participant shall be a minimum of five (5) years or the time designated by the board, and shall include, but shall not be limited to, the following conditions/requirements: 1. Each participant shall comply with all terms, conditions, or treatment identified, required, or recommended by the committee or the board for the treatment, evaluation, monitoring, or assessment of the participant; 2. Each participant shall abstain from the possession or consumption of legend medication, except as prescribed by a treating prescriber or approved by the committee; 3. Each participant shall abstain from possession and the consumption of alcohol, and the possession or consumption of illegal drugs; 4. Each participant shall submit to random drug testing unless otherwise specified by the board or committee; 5. Each participant shall enter treatment within forty-eight (48) hours following the committee’s or an approved evaluator’s determination that the participant needs treatment, unless otherwise approved by the board or committee; 6. Each participant shall report to the committee all relapses or other breaches of the contractual terms; 7. Each participant shall report to or meet with the board or committee, or a board or committee appointed designee, as may be requested by the board/committee; 8. Each participant shall attend support meetings as requested by the committee or treatment providers; 9. Each participant referred to the Well-Being Program by the board shall authorize the committee to release any and all information regarding the participant to the board; 10. Each participant voluntarily enrolled in the Well-Being Program shall authorize the committee to release any and all information or documents regarding the participant to the board upon a violation of any state or federal drug law or if the participant breaches or fails to comply with any terms of a Well-Being contract; and 11. Each participant shall be financially responsible for all drug screens and any other professional or administrative service rendered on behalf of the participant. (5) Committee Administrator Duties. (A) The Well-Being Committee shall appoint and designate a committee administrator for approval by the board. The committee administrator shall oversee and manage the daily operations of the committee and assist with committee administrative duties. (B) The committee administrator shall possess a combination of education and experience in the area of addiction counseling and be currently licensed in Missouri as a psychologist, psychiatrist, professional counselor, or clinical social worker. Upon request of the committee, the board may waive the licensure requirements of this subsection for qualified applicants that otherwise possess an equivalent combination of education and experience, as required by this rule. (C) The committee administrator shall also be familiar with licensees suffering from impairment issues which include, but shall not be limited to, the following: 1. Dependency; 2. Alcohol addiction; 3. Drug addiction; 4. Other addictive diseases; 5. Physical issues; and 6. Mental health issues. (6) Voluntary Participants. (A) Except as otherwise provided in this subsection, the identity of participants who voluntarily submit to the WellBeing Program shall remain anonymous to the board. (B) The contractor shall file a Notice of Non-Compliance with the board against any voluntary participant who breaches or fails to comply with the terms of any Well-Being Program contract or who violates any state or federal drug law. The Notice of Non-Compliance must include the participant’s name, license number, and the factual basis for the alleged contractual breach/non-compliance. The committee shall also supply to the board any information or documentation that supports or evidences the alleged non-compliance. (7) Reporting. (A) The committee shall provide to the board in writing— 1. An annual action plan and budget as directed by the board. The committee shall report on progress with regard to preparing and implementing the action plan and budget as requested by the board; 2. Progress reports with regard to each participant in or AND INSURANCE being assisted by the Well-Being Program, provided the identity of participants who voluntarily submit to the Well-Being Program shall remain anonymous to the board for purposes of these reports, except as otherwise provided by this rule; 3. Participant treatment, evaluation, and rehabilitation records as requested by the board, except as otherwise provided by this rule; 4. Quarterly income and expense reports for the WellBeing Program or other financial report requested by the board regarding the operation of the Well-Being Program; and 5. Any other report or information requested by the board, except as otherwise provided by this rule for voluntary participants. (B) Violation reporting. In addition to the other requirements of this rule, the committee shall report to the board in writing— 1. All participant violations of a board disciplinary order/ agreement, any provision of Chapter 338, RSMo, or the board regulations, or any state or federal drug law, which occurs after the date of the disciplinary order/agreement or the date the participant entered the Well-Being Program, whichever occurs first; 2. Any participant who fails to enter treatment within fortyeight (48) hours following the committee’s or an evaluator’s determination that the participant needs treatment; 3. Any participant who does not comply with the terms of a Well-Being Program contract or who resumes the practice of pharmacy before an approved treatment provider or committee has made a clear determination that the licensee is capable of practicing; and 4. Any breach of contract by the Well-Being Committee or committee administrator. (8) Confidentiality. (A) Except as otherwise provided by this rule, the committee shall provide the board access to all information pertaining to each participant referred to the committee by the board. (B) The board and committee may exchange privileged and confidential information, interviews, reports, statements, memoranda, and other documents including information on investigations, findings, conclusions, interventions, treatment, rehabilitation, and other proceedings of the board and committee, and other information closed to the public, as needed to effectuate section 338.380, RSMo, or to promote the identification, intervention, treatment, rehabilitation, and discipline (accountability) of participants who may be impaired. (C) All privileged and confidential information and other information not considered to be public records or information pursuant to Chapter 610, RSMo, shall remain privileged and confidential and closed to the public after such information is exchanged. AUTHORITY: section 338.140.1, RSMo Supp. 2022, and section 338.380, RSMo 2016.* Original rule filed Aug. 18, 2009, effective March 30, 2010. Amended: Filed Jan. 6, 2023, effective July 30, 2023. *Original authority: 338.140.1, RSMo 1939, amended 1981, 1989, 1997, 2011, 2019, and 338.380, RSMo 2007.