HRS 329 - Uniform control substance act Flashcards
how many members are on the hawaii advisory commission on drug abuse and controlled substances?
9-15; appointed by the governor; one member must be a member of the state council on mental health
are precursors to tighter scheduled medications automatically upgraded in schedule?
no
does the advisory committee have authroization to update the scheduling of a substance?
only temporarily, must be legislatively changed during the next regular legislative session
when is registration as a clinic required?
when an out-patient facility maintains centralized ordering/storage/record keeping of CS to be administered or dispensed to patients
what record requirements exists for clinics
centralized record signed/dated by treating provider
indicating patient, CS, date, time
must be stored with the current controlled substance inventory, ordering and receipt records
how long must clinic records be maintained?
for 5 years
how many registrations does a clinic organization require for each site?
at each principal place of business
can any providers utilize schedule I drugs?
yes for research purposes if allowed by the DEA registration
what are the filing requirements for scheduled medications?
anyone manuf/distribute/reverse distribute/dispense/transport/warehouse/handle CS file with department of public safety –> copies of order/recpeit an distribution
may CII rx’s be dispensed with oral orders?
only under emergency situations.
conditions:
* limited to adequate amount for emergency period
* reasonable effort to confirm validity of the provider
* written rx must be provided within 7 days with “authorization for emergency dispensing”
what is the max quantity you can dispense CIIs?
30 day supply (exception: single unit dose package that exceeds 30 day limit OR terminal patient certified by a physician)
May CII rx’s be refilled?
never
what are the limitations of a CII rx?
never refilled
must be written/electronic
filled w/in 7 days of written date
be given to patient no later than 7 days post-filling
stipulations for providing benzo+opioid
not for longer than 7 consecutive days unless qualified specific indications
- subsequent co-prescribing can be via phone, but in person visit required q90 days
- provider must indicate in chart the indication and that non combos are ineffective/inappropriate
what conditions are allowed for a benzo+opioid combo?
post-op pain care
chronic pain management
SUD
Cancer
palliative care
hospice car
how many times may a controlled substance be transferred?
one time only; electronic can transfer all refills
transferring a CS - sending rph responsibilities
- “VOID” on face of rx
- name/address/DEA# of new pharmacy and rph name
- date of transfer and your name
transferring a CS - recieving rph responsibilities
- “transfer” on the face of rx
- date of origional rx
- origional refills, valid refills remaining
- dates/locations of previous fills
- date of origional dispensing
- sending pharmacy name/addresss/dea/origional RX#
- sending rph name
- pharmacy name/address/DEA/rx number from original fill
how long to keep transferred rx?
5 years from last fill
can CS be faxed?
only III-IV via fax to central fill pharmacy
can CS be filled at a central pharmacy?
yes, but not CIIs
May a provider write a CS script for themselves?
only in a medical emergency
what is the max amount of sudafed packages someone may have?
3 packages
from which states can providers write for CIIs?
only hawaii
which medications require the addition of the medical need (“….for treatment of XYZ”)
methadone, buprenorphine, GHB
what are the size limits for a written CS script?
3x4” to 8x11”
are CS quantities indicated in numerical or alpha style?
both
example: four (4) tabs
when a CS is called in, what extra piece of information is required?
the oral code of the provider
when a CS is provided for a pet, is the pets name or owners name used when filling the rx?
owners name
how long does information stay in the central repository?
the ID number of the patient must be removed no later than 5 years after a prescriptions info is made available to the state agency (except if on-going investigation)
what must be included on all non-dea registered provider’s CII orders?
offial’s branch of service or agency, service identification (public service = SSN)
Whose DEA does a PA include when writing a CS - PA or MD’s DEA?
both
can cIIs be partially filled?
only if unable to supply full quantity; ameks a notation on the written rx; remaining must be filled w/in 72 hours or otherwise call provider
can non CII CS be partially filled?
yes; each partial is considered a refill; no dispensing after 3 months; cannot be refilled more than 2x times
what situations require policies for informed consent of CS
opioids >30 days
benzos + opioids
>90 MME/dose
how long is a CS good for?
CII: must be filled w/in 7 days then picked up w/in 7 days of filling
non CII CS: 3 months
can a CII be faxed?
only if a written hard copy is provided to the RPH before the medication is dispensed (same as MA)
OR if for home infusion/hospice/LTCF
can a non CII be faxed?
yes; if the provider maintains the original prescription; includes the physician’s oral code
what are the conditions for a faxed hospice CII?
* pt is enrolled in hospice program certified/paid for by medicare or state
* note on the rx that its for hospice patient
* RPH to note “HOSPICE” in red ink on fax
* original RX maintained by provider
what are the conditions for a faxed home infusion CII?
* not for PO usage
* RPH to note “Home Infusion/IV” in red ink on fax
* original RX maintained by provider
what are the conditions for a faxed LTCF CII?
* Pt is in a state licensed LTCF
* RPH to note “LTCF” in red ink on fax
* original RX to be maintained by provider
can CS be sent via e-scribing?
yes; using prudent judgement to determine validity
are take home methadone doses acceptable?
yes - but max 14 day supply
how long do records of sudafed sales need to be kept?
2 years
what is the max amount of sudafed packages someone may have?
3 packages
what is the max quantity of sudafed someone may purchase in a single day?
3.6g/day
what is the max quantity of sudafed someone may purchase in a 30-day period?
9 grams
what information must be collected during the sale of sudafed?
gneric or other name
qty sold
date of sale
name and address of wholesaler
name and address of retailer
what information is recorded/needed when dispensing a CS?
pt name
pt ID number
DOB
address
NDC code (8 digits)
date of issue
date of dispense
qty and nuber of refills authorized
MD DEA
pharmacy NABP
MD’s practice specialty/subspecialties
what special requirements do central repositories have?
they must provide 24/7 on line access to information to a state agency for all Erx’s processed
can the central repository deny access to information on CS rx’s for any reason?
only if the state agency fails to pay agreed fees and charges
how long does information stay in the central repository?
the ID number of the patient must be removed no later than 5 years after a prescriptions info is made available to the state agency (except if on-going investigation)
what is an “adequate” supply of marijuana?
7 plants at any stage, and 4 ounces of usable marijuana at any time
how long are written certifications of marijuana good for?
1 year
how many people may someone be a primary caregiver for?
only 1 at a time
can a caregiver grow marijuana for a qualifying patient?
only if the patient is a minor or incapable adult and the caregiver is responsible for the patient
or if the patient has no dispensary on their island
what situations require policies for informed consent of CS
opioids >30 days
benzos + opioids
>90 MME/dose
