[Ord. No. 17-07, 11-9-2017]
A. Sections
225.800 through
225.808 shall be known as the "Cass County Prescription Drug Monitoring Program ("PDMP")."
B. The
provisions of this Article shall serve to enact the development and
administration of a program for monitoring the prescribing and dispensing
of Schedule II, III, and IV controlled substances by professionals
licensed to prescribe or dispense such substances within Cass County;
establishing penalties for violations thereof; authorizing the County
Commission to accept grants and donations in support of the PDMP;
and appropriating the same upon receipt for support of the PDMP.
C. The
provisions of this Article shall apply to all unincorporated and incorporated
areas of the County, including municipalities, located within the
geographic boundaries of the County.
D. The
provisions of this Article shall not apply to persons licensed pursuant
to Chapter 340, RSMo., when operating within the course and scope
of their license under Chapter 340, RSMo.
E. This
Article shall be construed and interpreted in accordance with the
provisions set forth in Ordinance Number 26352, adopted by St. Louis
County, Missouri, on March 1, 2016 and codified in Sections 602.800
through 602.808 of the Code of Ordinances of St. Louis County, Missouri.
[Ord. No. 17-07, 11-9-2017]
As used in Sections
225.800 through 225. 808, the following terms shall have the meanings ascribed to them, thus:
CONTROLLED SUBSTANCE
A drug, substance or immediate precursor in Schedules I through
V as set out in Chapter 195, RSMo.
DEPARTMENT
The Cass County Health Department ("CCHD").
DIRECTOR
The Director of CCHD, or the person or persons duly designated
by the Director to carry out the duties of the Director.
DISPENSER
A person who delivers a Schedule II, III or IV controlled
substance to a patient. However, the term does not include:
1.
A hospital as defined in Section 197.020, RSMo., that distributes
such substances to inpatient care or dispenses prescriptions for controlled
substances at the time of discharge from such facility;
2.
A practitioner or other authorized person who administers such
a substance; or
3.
A wholesale distributor of a Schedule II, III or IV controlled
substance.
PATIENT
A person who is the ultimate intended user of a controlled
substance for whom a prescription is issued or for whom a controlled
substance is dispensed, not including a hospice patient enrolled in
a Medicare-certified hospice program who has controlled substances
dispensed to him or her by such hospice program.
[Ord. No. 17-07, 11-9-2017]
A. The Director shall establish and maintain a program for monitoring the prescribing and dispensing of all Schedule II, III and IV controlled substances by professionals licensed to prescribe or dispense such substances in Cass County, and may implement such departmental rules which in the opinion of the Director are necessary to implement such program. The program established and maintained by the Director shall operate so as to be consistent with Federal law concerning regulation of narcotics and with privacy of lawful users of same. The rules may provide for the Director to suspend the requirement of reporting a particular category of information pursuant to Subsection
(B) of this Section, if the Director determines that so reporting will conflict with collection of other reported information by the collection management system of the monitoring program. The rules shall be effective upon approval of the County Commission.
B. Within
seven (7) business days of having dispensed a Schedule II, III or
IV controlled substance, the dispenser of same shall submit to CCHD
by electronic means information regarding such dispensing. The information
submitted for each dispensing shall at minimum include:
1. The pharmacy's Drug Enforcement (DEA) number;
2. The date of dispensation;
3. If dispensed via a prescription:
a. The prescription number or other unique identifier;
b. Whether the prescription is new or a refill;
c. The prescriber's DEA or National Provider Identifier (NPI) number;
d. The National Drug Code (NDC) of the drug dispensed;
e. The quantity and dosage of the drug dispensed;
f. An identifier for the patient to whom the drug was dispensed, including
but not limited to any one of the following: a driver's license number;
the patient's government-issued identification number; the patient's
insurance cardholder identification number; or the patient's name,
address and date of birth.
C. The
dispenser's submission of the required information to CCHD shall be
in accordance with transmission standards established by the American
Society for Automation in Pharmacy or any of its successor organizations.
D. The
Director is authorized to issue a waiver of the electronic transmission
requirement to a dispenser demonstrably unable to comply with the
requirement. A waiver shall expire one (1) year from the date of its
issuance. Required information submitted under a waiver shall be submitted
within the same time frame as is required herein for electronic transmission.
E. A dispenser
who has not received a waiver of the electronic submission requirement
but who, due to unforeseen circumstances, is temporarily unable to
transmit dispensation information electronically may upon application
to the Director receive an extension of up to ten (10) business days
in which to submit the required dispensation information by electronic
transmission, which extension may be renewed upon subsequent showing
of need by the applicant dispenser.
F. The
Director shall make a decision concerning an application for a waiver
or extension within five (5) business days of receipt thereof. An
applicant for a waiver or extension who has been aggrieved by a decision
of the Director may appeal the decision to the County Commission within
five (5) business days of the Director's decision.
[Ord. No. 17-07, 11-9-2017]
A. Except
when provided to persons or agencies authorized by this Chapter to
receive such information, dispensation information submitted to CCHD
is a closed record and not subject to public disclosure except as
provided by law. No person shall provide such information to any person
or agency not authorized by this Chapter to receive it. A request
for dispensation information made under Chapter 610, RSMo., shall
be referred to the County Counselor, who shall take all reasonable
and lawful steps to ensure non-disclosure of the information.
B. The
Director shall develop and maintain procedures to ensure that the
privacy and confidentiality of patients and personal information collected,
recorded, transmitted and maintained are not disclosed to persons
not authorized by this Chapter to receive dispensation information.
[Ord. No. 17-07, 11-9-2017]
The Director may permit dispensers located in Counties other
than Cass County to transmit dispensing information to CCHD, either
on a voluntary basis or pursuant to local or State law. Permission
shall be conditional upon the dispenser complying in all respects
with the provisions of this Chapter.
[Ord. No. 17-07, 11-9-2017]
The Director shall review dispensation information transmitted
to CCHD, and if the Director develops a reasonable belief that a violation
of law has occurred, or develops a reasonable belief that a breach
of professional standards has occurred, the Director shall notify
the appropriate law enforcement agency or the appropriate professional
licensing, certification or regulatory agency. The Director may provide
any dispensation information requested by such entities when advised
that such information is required for conduct of an official investigation.
[Ord. No. 17-07, 11-9-2017]
A. Dispensation
information and other data compiled by CCHD in connection with monitoring
program established by the Director may be provided to the following
persons upon a duly made request:
1. Persons, whether in or out of the State of Missouri, who are authorized
to prescribe or dispense controlled substances, if the requesting
person demonstrates that the request is made for the purpose of providing
medical or pharmaceutical care for a patient;
2. Persons who request their own dispensation information in accordance
with law;
3. The State Board of Pharmacy;
4. Any State board charged with regulating a professional authorized
to prescribe or dispense controlled substances, and which has duly
requested the information or data in the course of a current and open
investigation into the acts of a professional under the jurisdiction
of the State board. Only information related to the subject professional
shall be provided by the Director.
5. Local, State and Federal law enforcement or prosecutorial officials,
both in or outside of Missouri, who are engaged in the administration,
investigation of enforcement of laws governing prescription drugs
based on a specific case and under a subpoena issued pursuant to court
order.
6. The MO HealthNet division of the Missouri Department of Social Services
regarding MO HealthNet program recipients.
7. A judge or other judicial officer under a subpoena issued pursuant
to court order.
B. In
addition to the above-specified persons, the Director may provide
dispensation information and data to public or private entities for
statistical or education purposes; however, the Director shall first
delete any information that could reasonably be thought usable to
identify individual persons.
[Ord. No. 17-07, 11-9-2017]
This Article shall not be construed or interpreted to require
a pharmacist or prescriber to obtain dispensation information possessed
or maintained by the Department.
[Ord. No. 17-07, 11-9-2017]
A. No
person, absent lawful authority, shall knowingly access or disclose
prescription or dispensation information maintained by CCHD pursuant
to the PDMP, or knowingly violate any other provision of the PDMP.
B. Any
person convicted of violating this Section shall be punished by a
fine of up to one thousand dollars ($1,000.00) or up to one (l) year
in jail, or both.