Bill Backs Emergency Prescriptions

Murray, KY – The end of this month marks the one year anniversary of the largest weather disaster in Kentucky's history. The 2009 Ice Storm knocked out power to thousands of residents across the state. After the disaster, officials took to evaluating and improving upon the response. State legislators worked during a special session to quickly pass a bill to give medical benefits to injured Kentucky National Guard soldiers who has been wounded helping in the emergency. Now with the 2010 General Assembly session in full swing, a few other bills are gaining ice-storm-related support. Angela Hatton tells us about one of them.

Nestled in a hallway between the Murray-Calloway County Hospital and the Medical Arts building is Medical Arts Pharmacy. They provide prescriptions and home medical equipment to area patients. Pharmacist-in-Charge Stefani Billington arrived at work on the first day of the ice storm to a disorganized scene. She says a member of the maintenance crew handed her an extension cord connected to the hospital generator, and said she needed to open the pharmacy.

"So it was (disgusted noise) . . . I wanted to laugh at him. I'm like, I can't open a whole pharmacy with one extension cord. They want to put on the radio, and you guys are the only one open, and there's people in the emergency room, and everybody ' and he was getting all freaked out, and so that was kind of *laughs*. I think that first half day or so we were the only place open."

Billington says many residents brought in prescriptions from other pharmacies to fill, but Medical Arts didn't have access to the computer system that connects it to the pharmacy network.

"We not having any record whatsoever, there's no way I could just say here you go. We have to have some type of written proof of what they had."

She says for vital medications, pharmacists will dispense emergency supplies.

"The patient and their health has to come first. So, I mean, if you refuse to give somebody a couple, a day's supply or something of a heart rhythm medication or a blood pressure medication and something were to happen to them, y'know that ultimately is your responsibility, so it's up to us to kind of make judgment calls."

Kentucky state representative Tom Burch of Louisville thinks pharmacists should have greater freedom to make those judgment calls. Burch chairs the Health and Welfare committee and he's the sponsor of a bill that would extend the dosage a pharmacist can dispense to a patient in an emergency.

"When a person is running short on a drug, y'know sometimes with, with a prescription sometimes bad weather or something, uh, interferes with them getting to the doctor's office or whatever might be the problem with them getting their prescription."

A proposed measure Burch submitted last year would have increased the supply limit from three days to thirty days. Details on this year's bill have not been finalized, but it's expected to be similar to last year's. Burch says the bill's failure in the past hasn't been due to a lack of legislative support.

"What we run in to problems like this year is physicians, KMA, organization like that, have not always been supportive of this type of legislation. I don't think they understand what's going on out there sometime. And, uh, they want them to clear with them every time before they get an extension of a prescription."

The KMA is the Kentucky Medical Association. A spokesman for the organization declined to comment on the 2010 bill before its finalized. However, the spokesman said the KMA has not taken as much issue with prescription extensions as it has with another component of Burch's bill, which would give pharmacists prescribing power. Some states allow pharmacists to prescribe medication on a limited basis, similar to the power given to nurse practitioners. Medical Arts' Stefani Billington says if Kentucky passed such a law, pharmacists could handle the burden.

"Actually, we get called a lot, y'know, what, what do you think this would be good for this?' or what's the dose on this?' So we do get phoned by the nurses and doctors a lot asking us questions. And we have so much reference material, if there's anything, y'know, that we feel that we don't know enough about, we can look it up."

House representatives should begin debate on a pharmacy procedures bill within the next two weeks.

Kentucky isn't likely to get another ice storm soon. Pharmacists are likely, though, to encounter more instances in which they need to dispense emergency meds. For pharmacists like Billington, whether or not the legislature revises the statute, they will still have to make judgment calls when a patient's health is on the line.