October/November 2016 Inside: PREPARING FOR ZIKA WOMEN IN PHARMACY INSURER RATE HIKES
Robbery, burglary, and diversion in Georgia — and what you can do Taking Pills Student loan refi nancing for GPhA members SoFi saves pharmacist borrowers an average of $448 a month1
Apply through SoFi.com/GPhA to get a 0.125% rate discount2 on student loan refi nancing.
Terms and Conditions Apply. SOFI RESERVES THE RIGHT TO MODIFY OR DISCONTINUE PRODUCTS AND BENEFITS AT ANY TIME WITHOUT NOTICE. See sofi .com/ legal for a complete list of terms and conditions. SoFi loans are originated by SoFi Lending Corp (dba SoFi) California Finance Lender #6054612. NMLS #1121636. 1Monthly savings calculation is based on all SoFi members with a pharmacist degree who refi nanced their student loans between 7/1/15 and 6/30/16. The calculation is derived by averaging the monthly savings of SoFi members with a pharmacist degree, which is calculated by taking the monthly student loan payments prior to refi nancing minus the monthly student loan payments after refi nancing with SoFi. SoFi’s monthly savings methodology for student loan refi nancing assumes 1) members’ interest rates do not change over time (projections for variable rates are static at the time of the refi nancing and do not reflect actual movement of rates in the future) 2) members make all payments on time. SoFi’s monthly savings methodology for student loan refi nancing excludes refi nancings in which 1) members elect a SoFi loan with a shorter term than their prior student loan term(s) 2) the term length of the SoFi member’s prior student loan(s) was shorter than 5 years or longer than 25 years 3) the SoFi member did not provide correct or complete information regarding his or her outstanding balance, loan type, APR, or current monthly payment. SoFi excludes the above refi nancings in an effort to maximize transparency on how we calculate our monthly savings amount and to minimize the risk of member data error skewing the monthly savings amount. 2If you apply through SoFi.com/GPhA and are approved, the interest rate shown in the Final Disclosure Statement will include an additional rate discount because of your organization’s SoFi partnership at the time of loan origination. Offer good for new customers only. contents
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14 3 12 COVER STORY: TAKING PILLS prescript legal injection Your autumn to-do list We was robbed! Robberies and burglaries continue to plague Three must-do items for every Pharmacists’ responsibilities if pharmacies in Georgia (and across the country). pharmacist they’re robbed or burglaized Here are some stories — and the experts’ tips on 4 23 how to prevent and react to theft and diversion news keeping pace from outside your pharmacy ... and in. What’s up in the Georgia GPhA’s stake in the Pace pharmacy world Alliance continues to pay off Women in pharmacy, insuring the uninsured, members make the 25 news, and more PharmPAC Investors in the future of 10 pharmacy in Georgia zika Fight the bite 27 Eradicating myths about the contact us Zika virus Who does what at GPhA — and how to reach us 11 calendar 28 10 Upcoming events postscript A message from President Lance Boles 7
Georgia Pharmacy magazine President and Chair of the Board Director of Communication & Editor SUBSCRIPTIONS is the official publication of the Lance Boles Andrew Kantor Georgia Pharmacy is distributed as a regular Georgia Pharmacy Association. [email protected] membership service, paid for with membership President-Elect Liza Chapman dues. Non-members can subscribe for $50 per year First Vice President Tim Short Art Director domestic or $65 per year international. Single issues Unless otherwise noted, the entire Immediate Past President Carole Erger-Fass are $10 per issue domestic and $20 international. contents of this publication is licensed Tommy Whitworth Practicing Georgia pharmacists who are not under a Creative Commons Attribution- members of GPhA are not eligible for subscriptions. NonCommercial-ShareAlike 4.0 International Chief Executive Officer license. Direct any questions to the editor at Scott Brunner, CAE POSTAL [email protected]. Georgia Pharmacy (ISSN 1075-6965) is published bi- [email protected] monthly by the GPhA, 6065 Barfield Road NE, Suite ADVERTISING 100 Sandy Springs, GA 30328. Periodicals postage All advertising inquiries should be directed to Denis paid at Atlanta, GA and at additional mailing offices. Mucha at [email protected] or (770) 252-1284. POSTMASTER: Send address changes to Georgia Media kit and rates available upon request. Pharmacy magazine, 6065 Barfield Road NE, Suite 100 Sandy Springs, GA 30328.
October/November 2016 Georgia Pharmacy 1 phmic.com 800.247.5930
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Opportunities, knocking Should something HERE’S A 3-POINT AUTUMN TO-DO LIST FOR PHARMACIST happen to you... LEADERS LOOKING TO ELEVATE YOUR PROFESSION. is your family covered? Life insurance isn’t for you, it’s for them. 1 2 3 Do you have life insurance? We can help. Get briefed Go vote Grab coffee
… at one of GPhA’s autumn regional … on November 8. It’s Election Day 2016, … with your legislators — and brief them Legislative Briefing dinners. You’ll hear and the entire Georgia General Assembly on those pharmacy legislative priorities. what you need to know about our 2017 is up for election. Later this year PharmPAC Much about pharmacy is complicat- legislative priorities (it’s an ambitious, will send out a list of candidates who back ed — practically a foreign language. You important agenda!) pharmacy — they’ll have been evaluated need to be the interpreter. It’s essential “ Pharmacists Mutual Companies is a company and you’ll walk away prepped to based on their votes on your behalf and their that we brief them before they come to built on integrity, professionalism, moral ethics, discuss those issues with your legislator. demonstrated support for pharmacy and the Atlanta in January, and you’re the person and above all a gentle and caring touch that Protect your family’s You’ll also get an hour of CPE credit, sup- patients you serve. who understands the issues —more im- ensures your final wishes will truly come to per, and great face-time with pharmacist If your pharmacy practice is a factor in portantly, you’re a constituent. Reach out fruition. Pharmacists Mutual is a cut above the financial future with colleagues in your area. Briefing dinners your voting decision, you owe it to yourself now and invite your state representative rest and has successfully restored my faith in the start October 4 and run through Novem- to consider PharmPAC’s recommended can- and senator to your pharmacy so they can value of insurance. life insurance. Georgia Pharmacy ber 15. Go to GPhA.org/briefings to didates. After all, these are the folks we’re see first-hand the services you provideASSOCIATION I would gladly recommend Pharmacists Mutual Call us today and experience the register for the one nearest you. counting on to carry our legislative priorities and can hear your concerns on your turf. BLACK & WHITE OPEN come January. And have a fresh pot of java ready. to anyone without reservation and am forever Pharmacists Mutual difference. GLOSS/GRADIENT FLAT COLOR
1 thankful for their steadfast diligence and desire to make sure my loved one’s final wishes were 800.247.5930 carried out.” Grow your leadership skills… Dr. Elizabeth Odumakinde, MD at GPhA’s November 20 Women’s Pharmacy Leadership Symposium this November. Women have certainly made strides in the pharmacy profession, but for some it still can often seem like a “man’s world.” But the fact is, men and women communicate and lead in different ways. As more women enter pharmacy in growing positions of influence, there is a call to focus leader- ChFC® ship development on issues specific to women and what it means to be a professional trailblazer. Hutton Madden, Brian Miller This workshop is specifically designed for women in entry- and mid-level management positions 800.247.5930 ext. 7149 800.247.5930 ext. 8060 in the profession. This live, classroom program focuses on developing strategies for increasing your 404.375.7209 352.672.1395 lead and to influence others. For details and to register, go toGPhA.org/women-in-pharmacy .
Products underwritten through The Pharmacists Life Insurance Company, a subsidiary of Pharmacists Mutual. Scott Brunner, CAE, is GPhA’s chief executive officer. Contact him at [email protected]. Not licensed to sell all products in all states. October/November 2016 Georgia Pharmacy 3 news
IMPORTANT: LICENSE RENEWAL HAS BEGUN The Georgia Board of Pharmacy has begun the online renewal process for active pharmacist and nuclear pharmacist licenses. All pharmacists must renew their licenses this year. For more information, visit the board’s website at gadch. mylicense.com/eGov. Remember: All pharma- cist and nuclear pharmacist licenses expire on December 31, 2016. RISING TO THE TOP: And if you’re lacking the required CPE credits, now’s the time to fix that: Check out A LEADERSHIP SYMPOSIUM GPhA.org/education for lots of opportunities for members. FOR WOMEN IN PHARMACY
The evidence is undeniable -- so development on issues specific to MANY SENIORS much so that it probably doesn’t women, and she’s coming to GPhA much qualify for news at this point: to spread that message — in a six- AREN’T TAKING Women are entering the pharmacy hour live symposium for women in THEIR BLOOD profession at higher rates than men. pharmacy. PRESSURE If you want to put a sharper point In Rising to the Top: A Leadership on that, here you go: According to Symposium for Women in Pharma- MEDS the American Association of Colleges cy, Dr. Flynn will explore strategies Almost half of seniors with of Pharmacy, of the total number of for women in the pharmacy world high blood pressure aren’t students enrolled in first professional that will help them be their best taking their meds, according degree programs for fall 2015, 61.4 — as coworkers, practitioners, and to the CDC — probably be- percent were women. managers. cause they feel fine ... at least Both research and experience tell There will be time for discussing until they have a heart attack us that men and women communi- issues of management and lead- or stroke. cate and lead in different ways. What ership, with the ultimate goal of It’s a good reason to talk to does this pharmacy gender gap mean building a community of women in them about the importance of for pharmacy leadership? phamracy who support one anoth- maintenance drugs. We can assume we’re in for a par- er’s careers. adigm shift. Some would argue the The date is November 20, 2016. read more @ shift is already well underway. The cost is $200, including lunch. To gphabuzz.com Management expert Dr. Jan register or to find out more about Flynn of Georgia College believes this unique opportunity, go to that it’s time to focus leadership GPhA.org/women-in-pharmacy.
4 Georgia Pharmacy October/November 2016 Insuring uninsured Georgians: 2017 three plans INSURER RATE HIKES How do you offer access to health childless adults who earn less than IN GEORGIA insurance for poor Georgians with- 100 percent of the federal poverty out looking like you’re supporting level ($11,880 per year) — that’s The 587,000-plus Geor- Obamacare and Medicaid expan- about 565,000 people. gians who buy individual sion? A bipartisan task force from 2) Simply enroll adults who earn up health plans — i.e., they the Georgia Chamber of Commerce to 138 percent of the poverty level don’t get it through offers several plans, according to (about $16,394) in Medicaid. their employers — are Georgia Health News. 3) Use Medicaid funds to enroll those looking at rate increases The issue is this: How do you people in private insurance plans. across the board from the help the hundreds of thousands If approved, the federal govern- state’s insurers next year. of adult Georgians who don’t have ment would pay 100 percent of those (Note that in many cases children and earn between about Medicaid costs until 2020, when it federal tax breaks will $4,039 and $11,880 per year — too would drop to 90 percent. keep the costs lower for much to qualify for Medicaid, but And what about the costs after policyholders.) too little to qualify for federal tax 2020? It turns out that expanding credits for insurance? coverage to the uninsured actually The Georgia legislature’s stance brings more money into the state. HUMANA has been ‘you don’t.’ That’s beginning The Urban Institute did an analysis to change, though, as more states and found that — thanks to a com- 67.5 % either expand Medicaid to more bination of increased healthcare and HARKEN HEALTH childless adults (like Louisiana) or related jobs (yes, including pharma- develop an alternative (like Arkan- cists and techs), plus the increased sas). As of 2015, Georgia ranked 46th in productivity of Georgians who were 51 % the country for healthcare coverage. healthier — “For each dollar that ALLIANT The task force suggested three Georgia would have to spend on options: Medicaid expansion, it would gain 1) Provide Medicaid coverage to $8.68 to $9.42 in federal spending.” 21 % KAISER PERMANENTE 17.6 % MARK YOUR CALENDARS AMBETTER (PEACH STATE) Day at the Dome dates 15.6 % (plural!) Why the increases? Part Due to the overwhelming num- To accommodate the large of the Affordable Care Act ber of participants this past year number of attendees — and requires the federal gov- (more than 400), GPhA is sched- assure better interactions with ernment to pay insurers uling two Pharmacy Days at the lawmakers — two schools of to help offset the addi- Dome for 2017. pharmacy will participate on tional costs incurred by The event(s) provide an oppor- each of the two dates, as follows: their insuring less-healthy tunity for student pharmacists to people, but Congress advocate for pharmacy, and for January 31, 2017: hasn’t actually approved GPhA to flex its political muscle UGA and PCOM the money. So insurers by filling the halls of the state have to pass the costs capitol with white-coated practi- February 21, 2017: along until Congress gets tioners-to-be. Mercer and South its act together.
Source: Georgia Office of Insurance
October/November 2016 Georgia Pharmacy 5 news VACCINE PROMOTION FOR BACK-TO- SCHOOL TIME Representing pharmacists and pharmacies before the Georgia Pharmacy Board, GDNA and DEA.
AREAS OF PRACTICE Professional Licensing Medicare and Medicaid Fraud and Reimbursement Criminal Defense Administrative Law
Healthcare Law The good folks at the California Phar- Legal Advice for Licensed macists Association have a bunch of free Professionals high-quality flyers, signs, and more you can download and print — it’s a ‘back to school immunization media kit’ available at CPhA.com/backtoschoolkit. (Note WWW.FRANCULLEN.COM that it’s CPhA, not GPhA.) Good stuff for (404) 806-6771 • [email protected] your windows and counter.
GEORGIA LOOKS TO BAN SYNTHETIC OPIOID U-4 You can buy U-4 (aka U-47700) online for about $40. One Floyd teen may already be dead from overdosing on the powerful (7.5 times stronger than morphine!) painkiller. So now at least one Georgia senator is looking to ban it, and quickly. Senator Chuck Hufstetler of Rome is hoping Governor Deal will pass an executive order outlawing U-4 it, rather than waiting for the legisla- ture to convene next year.
REMEMBER: NO FLUMIST THIS YEAR In case you forgot, don’t be giving patients FluMist this year. It (probably) doesn’t work. Both the CDC and the American Academy of Pediatrics say so and recommend regular shots for pa- tients. Even kids. Have the lollipops ready.
6 Georgia Pharmacy October/November 2016 AETNA WON’T SELL Patients won’t be able to buy individual health insurance plans from Aetna in Georgia in 2017. In retaliation for the gov- INDIVIDUAL HEALTH ernment’s refusal to approve its merger with Humana, Aetna PLANS IN GEORGIA has pulled out of all insurance exchanges; the U.S. Senate is investigating the company f0r the move. (Aetna will still offer ANY MORE group-coverage plans through employers.)
NCPA PRESIDENT CALLS OUT PBM PRICING
Brad Arthur, presi- dent of the National Proud Corporate Sponsor of the Community Phar- Georgia Pharmacy Association macists Association, recently appeared on & Pharmacists across Georgia. CNBC where he let his feelings on the PBM industry be known — specifically, the lack of pricing transparency around it. “There’s a huge issue with the PBMs,” he said. “They operate within a sphere of secrecy.” The PBM industry is hiding be- hind this notion that they’re managing costs on behalf of payers, when in fact they’re doing nothing more than preserving their particular segment of healthcare spending.” Check out GPhA. Walgreens pharmacists provide valuable org/arthurcnbc for services to our patients and communities. the video. These services include: - Patient medication consultation read more @ - MTM & adherence gphabuzz.com support - Immunizations - Specialty prescriptions
October/November 2016 Georgia Pharmacy 7 news
NCPA’S CONVENTION IS COMING OCTOBER 15
Our friends at the National Community Pharmacists Association are having their annual convention in New Orleans, October 15–19. It’s full of courses, workshops, strategies, networking… you MEMBERS IN THE NEWS get the idea. If it’s anything like last year, you’ll be joining Sharon Sherrer honored by ACA 2015-16 Albert E. Rosica, Jr. Memorial more than 3,000 community GPhA past president Sharon Award from the American College of pharmacists from around the Sherrer of Marietta ( above) — the Apothecaries Research & Education country… and be talking about 2016 recipient of GPhA’s Larry L. Foundation. it for weeks. Visit NCPAnet. Braden Meritorious Service Award The award is presented each year org for more. — has been honored with the “to a pharmacy practitioner for his or her contributions to pharmacy education through participation in pharmacy clerkship programs, serv- ing on various college committees, teaching, working with the alumni association, and making other con- tributions to academic programs.”
Helping seniors at home — meet Sharon Clackum A big shout-out to Georgian Sharon Clackum, a geriatric pharmacist featured in the August Pharmacy Today (GPhA.org/sclackum) for her work helping seniors continue living at home.
AARP turns to Mercer’s Susan Miller for advice Susan Miller, a GPhA member and professor and chair of the Depart- ment of Pharmacy Practice at Mercer, was the main source in an AARP story on when to switch to generics… and when not to: “9 Types of Medications You Should Think Twice About Replacing.” Read it at GPhA.org/smiller.
8 Georgia Pharmacy October/November 2016 GEORGIA PHARMACY MEET BLINK HEALTH
CHAMPS Blink Health says it can reduce pharmacist your Blink Card and SPEAK TO the price of generic meds. Here’s ask to process Blink as the pri- the idea: Search for a medication mary payor. Your copay is $0.” CONGRESS on BlinkHealth.com. If you like According to Blink, it’s accept- the price, you pay right there, ed “at your local pharmacy and Your Georgia congress- on the site. Then you “Fill your all major chains,” and its prices men are working for prescription at your pharmacy can be less than some insurance you: U.S. representatives like you normally do. Show the co-pays. Buddy Carter, Doug Collins, and Austin Scott spoke on the House floor during a special or- der session of Congress. They were urging support of the Phar- macy and Medically Underserved Areas En- hancement Act, which would allow Medicare to reimburse pharmacists for the clinical services they can provide. Carter in particular highlighted the lack A continuous quality of physicians in many improvement program rural areas of the can be a lifesaver! country. Provider status MAKE YOUR PATIENTS AND for pharmacists, Carter YOUR PHARMACY SAFER. explained, would yield dividends not only for patients, but for health- care costs as well. Collins encouraged a hearing on the Phar- macy and Medically Underserved Areas En- hancement Act, which would allow Medicare beneficiaries in “medi- cally underserved areas” to use services provided by pharmacists through Medicare Part B. “Pharmacists are the FOR LESS THAN A DOLLAR A DAY ... most accessible health- • Increase patient safety – learn from collected safety data and online resources care professionals out • Maintain compliance – meet accreditation, credentialing, PBM and state QA requirements there,” Carter said. “We • Reduce costs – increase operations efficiency, reduce potential risk and cut down on “re-do” Rxs • Safeguard your data – Patient Safety Organizations offer confidentiality and legal protection in America, if we are ever going to get our healthcare costs under Learn more at www.medicationsafety.org or call us at (866) 365-7472. control, we have to take The Alliance of Medication Safety (APMS) is a federally listed Patient Safety Organization (PSO). advantage of that.”
October/November 2016 Georgia Pharmacy 9 news
GEORGIA NEAR THE BOTTOM FOR HEALTH COVERAGE
Georgia ranks third worst in the nation for Uninsured Rates by State: 2015 health coverage, with (civilian noninstitutionalized population) it’s 13.9 percent unin- sured putting it ahead of only Texas and Alaska, according to the latest data from the Census Bureau. And with 1,388,000 unin- sured people, Georgia also ranks fourth worst in sheer number. In the meantime, the national rate of unin- sured people is at the lowest level recorded: 8.6 percent. read more @ gphabuzz.com Source: Kaiser Family Foundation
You are a leader—an educator, a trusted Calendar advisor, a counselor. Let us help you manage your day-to-day business so you can October 4 – November 10 focus on what matters most—your patients. November 15 CPEasy webinar: GPhA Regional Legislative Pharmacies and Their Relationships with To learn more, visit Briefings cardinalhealth.com/ Various locations: See back Prescribing Physicians and communitypharmacyadvantage page for details Beneficiaries GPhA.org/briefings/fall2016 (7:30 PM; 1.5 hours CPE) © 2016 Cardinal Health. All Rights Reserved. CARDINAL HEALTH, the Cardinal Health LOGO are trademarks or registered trademarks of Cardinal Health. Lit. No. 1RI16-529023 (06/2016) GPhA.org/cpeasy October 15–19 2016 NCPA Annual November 17
1RI16-529023_Georgia Pharmcay Association Ad_FINAL.indd 1 5/26/16 11:19 AM Convention, New Orleans CPEasy webinar: ncpanet.org/meetings/annual- Confronting Drug Diversion convention (7:30 PM; 1.5 hours CPE) GPhA.org/cpeasy November 3 CPEasy webinar: The False November 20 Claims Act and Pharmacies Rising to the Top: A (7:30 PM; 1.5 hours CPE) Leadership Symposium for GPhA.org/cpeasy Women in Pharmacy GPhA.org/women-in- pharmacy
10 Georgia Pharmacy October/November 2016 zika
Fight the bite ERADICATING THE MYTHS ABOUT THE ZIKA VIRUS
BY RIYA PAULOSE
As pharmacists, you’ve got the power and the ingredients: picaridin, DEET, IR3535, or oil of lemon street cred to calm your patients about Zika. And eucalyptus — aka para-menthane-diol. Nothing else the CDC and WHO have a great deal of infor- has been confirmed to actually repel mosquitos. mation about the Zika virus — information you should know and spread to equip patients (and MYTH: The Zika virus is being locally transmitted yourself) with the tools they need. in Georgia For starters, help dispel some common myths FACT: The cases of Zika in Georgia have all been about Zika. travel related. As of mid-September 2016, there has not been a single report confirming the virus was MYTH: All mosquitoes can carry the Zika virus. obtained from a local mosquito bite. FACT: Only two species do:: Aedes aegypti and Ae- des albopictus. Ae. albopictus are known to span all WHILE WE’RE WAITING FOR A VACCINE, over Georgia but the Ae. aegypti are only found in TAKE PREVENTATIVE MEASURES. certain parts of the state, usually in residential areas. Georgia pharmacists can help by… MYTH: Mosquitos need a large amount of water n providing patients with accurate, up-to-date to lay their eggs. information on Zika: causes, prevention, and FACT: As little as a bottle cap full is all they need what signs and symptoms to watch for; to lay a few thousand eggs. Note, however that it n encouraging pregnant women to take advan- must be standing water; that’s why devices such tage of CDC’s resources and testing algorithms; as fountains and “water wigglers” prevent them n educating patients on safe/protected sex; from laying eggs in ponds and bird baths. n handing out pamphlets to patients that provide information about how to detect, test, and MYTH: People infected with the Zika virus exhib- report the Zika virus; it obvious symptoms. n staying up to date with the progress being FACT: Only about one in five patients who test made by CDC and WHO.
Georgia Pharmacy positive for Zika experience any symptoms at all, ASSOCIATION and those are usually mild: conjunctivitis, fever, Get more information directly at or BLACK & WHITE OPEN CDC.gov/zika
rash, arthralgia, and joint pain. WHO.int/topics/zikaGLOSS/GRADIENT. FLAT COLOR
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MYTH: The virus can only be transmitted via Riya Paulose is a Mercer University student phar- mosquito bites and from mother to infant. macist who completed a rotation in pharmacy FACT: The Zika virus can also be transmitted via association management with GPhA this summer. blood transfusions and unprotected sex with a male. Even if the man does not show symptoms during intercourse, the virus can still be passed on to his partner. And no, there is no evidence of Zika virus trans- mission via breast milk. Affiliated Pharmacy Program Retailers working with Retailers MYTH: Any insect repellant will protect against bites from mosquitos. Support | Leverage | Innovation FACT: The CDC says you should only use EPA-regis- www.thriftywhite.com/app | [email protected] tered insect repellants that include one of the active
October/November 2016 Georgia Pharmacy 11 legal injection
We was robbed!
Greg Reybold, GPhA ‘s vice president of public policy explain below, there are also Board of Pharmacy re- and association counsel, answers your questions about quirements and, when the loss involved controlled Georgia pharmacy law. This isn’t legal advice, of course, substances, federal reporting requirements. just his interpretation of the law. If there was a burglary or robbery attempt but nothing was actually taken, am I subject to What are some of the legal any reporting requirements under Board of implications arising out of Pharmacy Rules? a robbery or burglary of a Georgia Board of Pharmacy rules provide that pharmacy? “thefts or breakins” require immediate notification If your pharmacy has been to the Board of Pharmacy. Thus, if there is a break- robbed or burglarized, there in and nothing was actually taken, you still must are a number of implica- notify the Board. With regard to an attempted tions, some of which are robbery where nothing was actually taken, it does GREG REYBOLD specific to the health care not appear that Board Rules require notification. and pharmacy field. Generally, filing a police Nonetheless, the prudent course of action would report and notifying your insurance carrier in a be to notify the Board immediately anyway. timely fashion are necessary steps for all busi- nesses. Also, in the event that there were employ- What are the Board of Pharmacy notification ees or customers injured, there will likely be other requirements when a robbery or break-in has considerations: notifying the business’s liability resulted in some type of loss? carrier and, for injured employees, complying As I explained above, the Board of Pharmacy pro- with applicable Georgia Workers’ Compensation vides that “thefts” require immediate notification requirements — including preparing the Employ- to the board. Note that the word “theft” doesn’t er’s First Report of Injury form immediately after specify what is stolen. Thus, it appears theft of knowledge of the injury and forwarding it to the anything from a pharmacy requires immediate businesses insurer. notification to the board. That in and of itself is a lot. Unfortunately, for In the case of a theft or loss of drugs or devices, pharmacies, it doesn’t stop there. Notification to the rule requires immediate notification to the the pharmacy’s wholesaler will likely be necessary, board and to GDNA; immediate notification is and there may be specific contractual notification defined to mean “written notification sent within requirements in that regard. Moreover, and as I’ll 24 hours of the event.” With regard to the theft of controlled substances, the board requires notification to GDNA and the DEA within three days of discovery of a theft, loss, or unaccounted for controlled substance. Of note, this three-day requirement appears to be inconsistent with the immediate notification requirement and federal regulations on this point. As such, providing notification within one business day would be advisable. The rule also requires sending a DEA form 106 to GDNA and DEA within 10 days of receipt of the report. Finally, the board also requires immediate
12 Georgia Pharmacy October/November 2016 “CALLOUT GOES HERE SEEING writing within one business day of discovery of such loss or theft. Note, this is stricter than GDNA FROM MANY OUTSIDE ORGANIZATIONS rules, which require notification to the DEA within three days of discovery. Federal regula- SUCH AS THE CDC, THE NATIONAL tions also require completion of DEA form 106, although federally no time limit is specified. GOVERNORS ASSOCIATION, THE Also, pharmacies need to be aware of the HI- PAA Breach Notification rule, in the event patient SURGEON GENERAL, AND OTHERS.” health information is breached or stolen. When there is a breach, notification is required to the individuals affected, to the Secretary of Health
Georgia Pharmacy notification when there has been a theft, destruc- and Human ServicesASSOCIATION (different timelines depend- tion, or loss of records required to be maintained ing on size of breach), and to the media in certain BLACK & WHITE OPEN
under state or federal law. circumstances.GLOSS/GRADIENT FLAT COLOR
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Are there any federal requirements when a robbery or break-in has resulted in some type of Use of this article, or the information it contains, does not con- stitute any legal advice, does NOT establish any attorney-client loss? relationship, and does NOT create any legal duty on the part of Yes, when there has been a theft or significant the author or the Georgia Pharmacy Association. When making loss of controlled substances, federal regulations a decision that may have legal consequences, readers should require notification to the DEA field office in consult with qualified legal counsel.
DO YOU HAVE AN ISSUE YOU’D LIKE TO SEE ADDRESSED IN THIS COLUMN? LET US KNOW — SUBMIT IT TO GREG AT [email protected].
October/November 2016 Georgia Pharmacy 13 cover story
16 Georgia Pharmacy October/November 2016 Taking Pills Robbery, burglary, and diversion in Georgia — and what you can do
BY ANDREW KANTOR
et’s follow the dominoes: We’ve known how addicting opioids are since at least the Civil War. We tried to limit their use (in 1924 heroin became illegal), but patients were still in pain. Over the decades pharmaceutical companies developed alternatives — think Percocet and Vicodin — even as doctors were hesitant to prescribe them. Then came the ’90s when the pendulum swung. There was a push to treat pain more. They called it “the fifth vi- tal sign,” and doctors were urged to prescribe painkillers, not the least by the pharmaceutical companies. Hospitals were (and still are) judged in part by patients’ pain levels. Welcome OxyContin. Painkiller prescriptions skyrocketed, increasing four-fold just from the early to the mid-1990s, according to the National Institute on Drug Abuse. And with those prescriptions came a high ... and addiction. LCome the 2000s and the pendulum swung back. Restrictions tightened as we realized the problem. Pain clinics shut down, “doc shopping” was tracked, prescription drug monitoring programs were established. The supply and availability of opioids were squeezed. But not the demand. Result: Millions of people are addicted to drugs that have become much harder to get. And where there’s a demand like that, you can bet someone will find a way to meet it — legal or, more often, illegal. In case you haven’t heard, pharmacies are being robbed and burglarized, and the target in almost every case is painkillers.
October/NovemberOctober/November 2016 2016 Georgia Pharmacy 17 Source: Pharmacists Mutual
cover story
• In Athens, Dublin, and Atlanta, employees tal. But we’ll get to that in a moment. were threatened with guns Different kinds of pharmacies face different • In Colbert, thieves broke in overnight threats. Chains are much more likely to be the vic- • In Snellville they took a sledgehammer and tims of internal theft, while independents are more came through the wall likely to be burglarized, according to Pharmacists • In Dublin, they used a boxcutter and the threat Mutual Insurance Company. (See the box, “Who’s of a gun robbing who?”) Both, however, are equally suscepti- • In Conyers, three pharmacies were burgled ble to armed robbery. So let’s look at that first. over four nights That’s only a partial list — and it’s only from the DETERRENCE first half of 2016. It’s what happens when you’re storing thousands of dollars’ worth of products In the 12 months from July 2015 through June people are literally dying to get hold of. 2016, there were 18 pharmacy robberies reported in Often the thieves are caught on video (crawling Georgia — at least 18 in which controlled substanc- on the floor to avoid motion detectors in one case, es were stolen, anyway — according to Dennis using that sledgehammer in another), and the Troughton, PharmD, of the Georgia Drugs and next day’s news story has the line “...the suspect Narcotics Agency. In total, thieves made off with got away with oxycodone and hydrocodone pills.” 41,481 doses of C-IIs, he said, in pill or liquid form. And unlike other businesses, pharmacy own- In some cases they brandished knives. In others, ers may face legal issues if they can’t account for guns. In others, the threat of a gun. inventory — not to mention some significant cash- Do we have to say this? When preparing for the flow issues, too. possibility of armed robbery, the number one goal Before we talk about what’s happening and is no one gets hurt. At the end of the day, money is what you can do, let’s get some terminology out of just money, pills are just pills. the way. You want to do what you can to prevent a rob- In law enforcement, the universe of people bery, but if it does happen your goals are simple: illegally acquiring prescription drugs is called drug 1. Make sure no one gets hurt. diversion. It includes breaking in, armed robbery, 2. Make it as easy as possible for law enforce- faking prescriptions, hijacking trucks... the whole ment to catch the thief. enchilada. But first, prevention. We’re only concerned with some parts of that You can’t prevent someone from attempting to universe here: rob you, but you can take steps to deter them. Robbery: When an outsider demands the phar- Top of the list, be obvious about it. If you have macy staff give them medications, usually with cameras (hidden or otherwise), announce that fact the threat of force. clearly. It also helps if you say that the video is Theft or burglary: When someone physically stored offsite. (See the box, “Cameras, candidly.”) breaks into the pharmacy during off-hours to steal CVS, Kroger, and Walgreens, for example, have medication, with no threat of force involved. begun installing time-delay safes in their pharma- Internal theft: When insider steals medication cies for schedule II drugs. There’s a waiting period using his or her position (e.g., an employee), either — five, 10, 15 minutes — before they can be opened. by physically taking it or by altering paperwork. More importantly, though, they make it clear So yes, you’re fighting at least a three-front war. that the safe is on a delay; advertising the fact is And you means pharmacists, techs, and employees what makes it most effective. A robber knows he’ll — at big pharmacies and small ones, chains and have to wait before the drugs will be available, and independents. time is not on his side. (Walgreens wouldn’t talk to A quick search of news stories in Georgia and us for this story, but in 2014 the company did tell you’ll see a long list of chain and independent Drug Topics magazine that it’s seen a “dramatic pharmacies that have been victims just this year. reduction” in crime thanks to those safes.) And let’s not forget the state’s 2016 poster child for Another potential step is to require than anyone internal theft: Emory University Midtown Hospi- entering the store remove hats, sunglasses, and
18 Georgia Pharmacy October/November 2016 THREATSTHREATS BYBY PHARMACYPHARMACY TYPE TYPE CHAIN PHARMACIES INDEPENDENT PHARMACIES
ROBBERIES ROBBERIES
BURGLARIES EMPLOYEE THEFT
EMPLOYEE THEFT BURGLARIES Source: Pharmacists Mutual
hoodies. If your store have a panic button, some- are over within a minute. Once that happens, you one refusing to comply might gain you a few extra want to dial 911 and/or sound the alarm and treat seconds to reach or push it. anyone who’s injured. And consider installing a measuring tape at your Then lock the doors and keep them closed until doors (public and non-public) to help determine the police arrive — yes, that means asking witnesses robber’s height, assuming you have video cameras. to stay. And write down everything you remember Pharmacists Mutual, the DEA, and the security about the robber. Have anyone else in the store do experts at RxPatrol agree that staff training is cru- the same, ASAP. Memory is incredibly fleeting and cial. It should cover preventing (or at least deterring) fickle. Hand out pens and paper, and explain to a robbery, signs to watch for (e.g., someone ‘casing staff and customers what’s going on. the joint’), and what to do if confronted by a thief. Protect the crime scene, too. Don’t touch any- RxPatrol, in fact, offers free training videos at thing the robber has (think: door handles), and if rxpatrol.com, and recommends contacting your he passed a note, be sure you know where it is — local police about educating staff. In short, you but don’t touch it. need to be prepared and be trained. The statistics aren’t great — only about two- thirds of pharmacy robberies are solved — but COOPERATE AND OBSERVE every step you take and take quickly can put the odds in your favor. What happens if you do get robbed? Rule #1: Cooperate. No amount of inventory WHEN THE CAT’S AWAY or paperwork is worth someone’s life. (And that includes the thief’s. If you think there are a lot Especially for independent, stand-alone pharma- of legal issues if your narcotics are stolen, they’re cies, burglary is a bigger issue than robbery; they nothing compared to what would happen if you usually aren’t open 24 hours or surrounded by a killed or injured someone.) retail store. (See the box, “Who’s Robbing Who.”) The DEA is clear about this: “Do not resist!” it says. The methods have changed over the years. “Cooperate fully with the robber … do exactly what “Years ago they’d throw a brick through the you are told to do, nothing more and nothing less.” front window,” said Fred Sharpe of Albany, who That said, you should be preparing for the police owns 28 independent U-Save-It pharmacies in later. Make mental notes on the robber(s), says the Georgia. He’s been broken into, he estimates, 50 to DEA, especially what can’t be changed: Age, height, 60 times over the past 25 years. weight, tattoos, scars, left- or right-handedness, His preferred method of deterrence is making and other body features. it as tough as possible to even get into the store … It may seem like forever, but most robberies but it’s been an arms race. When he swapped out
October/November 2016 Georgia Pharmacy 19 2015 Recipients of the “Bowl of Hygeia” Award
2015 Recipients 2015of the Recipients “Bowl of theHygeia” “Bowl of Award Hygeia” Award
Dan McConaghy Tom Van Hassel Nicki Hilliard Robert Shmaeff Sherman Gershman Kevin Musto Fritz Hayes Ron Stephens Alabama Arizona Arkansas California Connecticut Delaware Florida Georgia
Dan McConaghy Tom Van Hassel Nicki Hilliard Robert Shmaeff Sherman Gershman Kevin Musto Fritz Hayes Ron Stephens Dan McConaghy Tom Van Hassel Nicki Hilliard Robert Shmaeff Sherman Gershman Kevin Musto Fritz Hayes Ron Stephens Alabama Arizona Arkansas California Connecticut Delaware Florida Georgia Dan McConaghy Tom Van Hassel Nicki Hilliard AlabamaRobert ShmaeffArizona Sherman GershmanArkansas KevinCalifornia Musto ConnecticutFritz Hayes DelawareRon Stephens Florida Georgia Alabama Arizona Arkansas California Connecticut Delaware Florida Georgia
Kerri Okamura Steven Bandy Jane Krause Richard Hartig Robert Nyquist Larry Stovall Lloyd Duplantis Kenneth McCall Kerri Okamura Steven Bandy HawaiiJane Krause RichardIllinois Hartig Robert IndianaNyquist Larry Stovall Iowa Lloyd Duplantis KansasKenneth McCall Kentucky Louisiana Maine Kerri Okamura Steven Bandy Jane Krause Richard Hartig Robert Nyquist Larry Stovall Lloyd Duplantis Kenneth McCall Hawaii Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Hawaii Illinois Indiana Iowa Kansas Kentucky Louisiana Maine
Kerri Okamura Steven Bandy Jane Krause Richard Hartig Robert Nyquist Larry Stovall Lloyd Duplantis Kenneth McCall Hawaii Illinois Indiana Iowa Kansas Kentucky Louisiana Maine
Butch Henderson Paul Jeffrey Derek Quinn Jenny Houglum Robert Wilbanks Richard Logan Butch Henderson Paul Jeffrey Derek Quinn Jenny Houglum Robert Wilbanks Richard Logan Maryland Massachusetts Michigan Minnesota Mississippi Missouri Maryland MassachusettsButch HendersonMichigan Paul Jeffrey Derek Quinn Minnesota Mississippi Missouri Jenny Houglum Robert Wilbanks Richard Logan Maryland Massachusetts Michigan Minnesota Mississippi Missouri
Butch Henderson Paul Jeffrey Derek Quinn Jenny Houglum Robert Wilbanks Richard Logan Maryland Massachusetts Michigan Minnesota Mississippi Missouri
Gayle Hudgins Heather Mooney Richard Crowe Edward McGinley Amy Bachyrycz Benjamin Gruda Gayle Hudgins Heather Mooney Richard Crowe The “Bowl of Hygeia” Edward McGinley Amy Bachyrycz Benjamin Gruda Montana Nevada New Hampshire The “Bowl of Hygeia” New Jersey New Mexico New York Montana Nevada New Hampshire New Jersey New Mexico New York
Gayle Hudgins Heather Mooney Richard Crowe Edward McGinley Amy Bachyrycz Benjamin Gruda The “Bowl of Hygeia” Montana Nevada New Hampshire New Jersey New Mexico New York
Gayle Hudgins Heather Mooney Richard Crowe Edward McGinley Amy Bachyrycz Benjamin Gruda The “Bowl of Hygeia” Montana Nevada New Hampshire David Moody Kevin Oberlander Danny Bentley GordonNew Richards, Jersey Jr. Ann ZweberNew Mexico Thomas MatteiNew YorkDeborah Newell Sharm Steadman David Moody Kevin Oberlander Danny Bentley Gordon Richards, Jr. Ann Zweber Thomas Mattei Deborah Newell Sharm Steadman North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina
David Moody Kevin Oberlander Danny Bentley Gordon Richards, Jr. Ann Zweber Thomas Mattei Deborah Newell Sharm Steadman North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina
Renee Sutton Mac Wilhoit Jim Cousineau Marvin Orrock John Beckner Gregory Hovander Renee Sutton Mac Wilhoit Jim Cousineau Marvin Orrock John Beckner Gregory Hovander South Dakota Tennessee Texas Utah Virginia Washington David Moody Kevin Oberlander Danny Bentley Gordon Richards,South Jr. Dakota Ann ZweberTennessee ThomasTexas Mattei DeborahUtah Newell VirginiaSharm SteadmanWashington North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina
Renee Sutton Mac Wilhoit Jim Cousineau Marvin Orrock John Beckner Gregory Hovander South Dakota Tennessee Texas Utah Virginia Washington Terri Smith Moore David Flynn Brian Jensen Randy Harrop Terri Smith Moore David Flynn Brian Jensen Randy Harrop Washington DC West Virginia Wisconsin Wyoming Washington DC West Virginia Wisconsin Wyoming
Renee Sutton Mac Wilhoit Jim Cousineau Marvin Orrock John Beckner Gregory Hovander South Dakota Tennessee Texas The Bowl of HygeiaUtah award program was originallyVirginia developed by theWashington A. H. Robins Company to recognize pharmacists across the nation for outstanding service to their communities. Selected through their respective professional pharmacy associations, each of these dedicated individuals has made uniquely personal contributions to a strong, healthy community. We offer our congratulations and thanks for their high example. The American Pharmacists Association Foundation, the National Alliance of State Pharmacy Associations and the state pharmacy associations have assumed responsibility for continuing this prestigious recognition program. All former recipients are encouraged to maintain their linkage to the Bowl of Hygeia byTerri emailing Smith Moorecurrent contact informationDavid Flynn to [email protected] Jensen The Bowl of Randy Harrop Washington DC West Virginia Wisconsin Wyoming Hygeia is on display in the APhA Awards Gallery located in Washington, DC.
Boehringer Ingelheim is proud to be the Premier Supporter of the Bowl of Hygeia program. Terri Smith Moore David Flynn Brian Jensen TheRandy Bowl Harrop of Hygeia award program was originally developed by the A. H. Robins Company to recognize pharmacists across the nation Washington DC West Virginia Wisconsin Wyoming for outstanding service to their communities. Selected through their respective professional pharmacy associations, each of these dedicated individuals has made uniquely personal contributions to a strong, healthy community. We offer our congratulations and thanks The Bowl of Hygeia award program was originally developed by the A. H. Robinsfor Company their high to example.recognize The pharmacists American acrossPharmacists the nation Association Foundation, the National Alliance of State Pharmacy Associations and the for outstanding service to their communities. Selected through their respectivestate professional pharmacy pharmacy associations associations, have assumed each responsibility of these for continuing this prestigious recognition program. All former recipients are dedicated individuals has made uniquely personal contributions to a strong, healthyencouraged community. to maintain We offer their our linkagecongratulations to the Bowl and of thanks Hygeia by emailing current contact information to [email protected]. The Bowl of for their high example. The American Pharmacists Association Foundation, the NationalHygeia isAlliance on display of State in the Pharmacy APhA Awards Associations Gallery locatedand the in Washington, DC. state pharmacy associations have assumed responsibility for continuing this prestigious recognition program. All former recipients are encouraged to maintain their linkage to the Bowl of Hygeia by emailing current contactBoehringer information Ingelheim to [email protected]. is proud to be the The Premier Bowl of Supporter of the Bowl of Hygeia program. Hygeia is on display in the APhA Awards Gallery located in Washington, DC.
Boehringer Ingelheim is proud to be the Premier Supporter of the Bowl of Hygeia program. cover story
plate glass windows for laminate security glass, for example, thieves would go through the drive- through window. So he added bars there and FAST FACTS FROM reinforced the other entrances. THE DEA All that goes to goal number one when dealing with potential burglary: Prevent a would-be thief n The most common medications pharmacy robbers seek are from attempting to steal from you in the first opiates and benzodiazepines, oxymorphone, oxycodone, place. That means both making it difficult, and by methadone, Percocet, Xanax, and Valium. making it obviously difficult. n The typical pharmacy robber is often a white male in his 20s David Ledbetter of Clarkesville, for example, or 30s who wears a hat, sunglasses, or some other material owner of Clarkesville Drug, was burglarized that covers his face. “semi-successfully” in 2014 when thieves punched n The majority of robbery cases involve a note given to out the deadbolt lock on his pharmacy’s front pharmacy staff. door on the Sunday after Thanksgiving. n Most pharmacy robberies are over in less than a minute. So he made a few small but significant changes. n 69 percent of pharmacy robberies are solved. He got a bigger, better safe — a gun safe, in fact — that he’s bolted to the floor. More importantly, perhaps, is that the safe is obvious to customers. Ledbetter isn’t going for subtle. “The more obvious infrared scanners. And more. You’ve got options.) you are, the more high-profile it is, the better off And talk with your security company and local you’ll be,” he said. “Make it big, make it beefy.” police about providing the cops with a video feed if Take another common anti-theft tool: sur- your alarm sounds — it’s called a “verified alarm.” veillance cameras. They can help catch a thief With 98 percent of burglar alarms being false ones by identifying him, but they can also help deter (according to the Texas Police Chief’s Association), one by letting him know he’s being watched and you can’t entirely blame the police if they don’t recorded. always respond in seconds; that boy’s cried wolf It all part of the message: Don’t bother trying before. But with a video feed at their disposal, to rob us. Or, as Pharmacists Mutual puts it, “All seeing the masked guy rummaging through your things being equal, a criminal is more likely to shelves will light a fire under the constabulary. You avoid a ‘hardened target’ if they can.” might even get an insurance discount. Oh, and make sure your alarm has a backup in HARDENED TARGETS case the phone or power lines are cut. Pharmacist Mutual laments, “Many of the alarms that are If you can’t deter them from trying, your next step taken out do not have any form of line security, is preventing them from succeeding. Let’s face it, all such as cellphone back-up, to alert the alarm com- the warning in the world isn’t going to stop some pany of tampering.” Both Fred Sharpe and David people. As Valerie NeeSmith, pharmacy sales man- Ledbetter go a step further: If their stores’ power ager for Kroger’s Atlanta division put it, a warning is cut, their alarm company will notify them and is great but, “For a person who’s an addict and just they can decide whether to investigate. desperate, I don’t know that it’s a deterrent.” Finally, inspect your premises. Think like a Alarms are critical, of course. But they have to thief. Look for weak spots, and don’t forget to work and be used correctly. Pharmacist Mutual think three-dimensionally; more than one in sev- — which obviously has a horse in the theft-pre- en pharmacy burglars enter through the roof or a vention race — recommends having the system wall, often from an adjacent property that doesn’t professionally installed, testing it regularly, and have an alarm. updating and changing codes, especially if an Then reinforce: Good fences make good neigh- employee leaves. bors, after all. Sharpe is a proponent of a solid (“Alarms,” by the way, can mean everything from defense. “In some places [burglars] have two or window-breakage sensors, to motion sensors and three doors they have to bust through,” he said.
October/November 2016 Georgia Pharmacy 21 cover story
Result: Only one burglary in the past three years. 3SI Security Systems, for example, sells Phar- (Not that they haven’t tried, he said. He’s found maTracker bottles — containers for narcotics with dents in the back door.) GPS chips embedded in them. If the bottle leaves the premises, the company can track its location IS IT SAFE? anywhere in the world. And then there are smoke devices, like Smoke- OK, so the Bad Guys get inside. How can you min- CloakDNA. If your alarm is triggered, it fills the imize loss? One way you might hear is to keep all store with a harmless smoke to cut visibility — but your C-IIs in a safe. it also leaves a DNA fingerprint on everything, David Ledbetter gives that a big thumbs-up. That including the thieves. If they’re caught, you can bigger safe he bought isn’t something from the local prove they were in your store. five-and-dime. He’s clear about the quality issue: (No, GPhA isn’t endorsing either of these com- Don’t skimp; talk to a gun distributor if you’re not panies. They’re just two examples of some of the sure. more high-tech theft prevention products.) “Get the best you can get,” he says. “If you just Of course, one of the bigger threats to pharma- get a Mickey Mouse thing, they’re gonna beat the cies doesn’t need to break into the store at all. heck out of it or carry it out,” he says. (One sug- gestion he had: Look for ‘scratch-and-dent’ sales at INSIDE JOBS stores like Tractor Supply Company.) Result: In April 2016, thieves cut his main power Shall we talk about the elephant in the room supply and broke through the front door via “a big when it comes to employee drug diversion in enough rock.” But his heavy-duty safe paid off. The Georgia? thieves made off with ... some generic Singulair. Between 2008 and 2013, more than 2 million Good luck selling that on a streetcorner. doses of prescription drugs were stolen from Em- But there are some downsides to be aware of, ory University Midtown Hospital by employees, and that might explain why about three-quarters including 1.2 million doses of Vicodin, 110 gallons of pharmacies don’t have a safe. (!) of promethazine with codeine, and more than Losses, according to Pharmacists Mutual, are 420,000 doses of Xanax. actually slightly higher in pharmacies with safes. Internal theft is more likely in a larger facility Why? Because thieves do their homework, and — a chain pharmacy or, obviously, a university only the sophisticated ones are going to bother hospital. (Again, see “Who’s robbing who?”) targeting those locations. They’ll be prepared to In fact, “We focus most of our efforts on prevent- disable alarms and break into the safe, and once ing internal theft,” said Kroger’s NeeSmith. And they get in, all the valuable drugs are in one conve- looking at the records, she said, “We found a lot nient spot. of cases where it’s the person you’d least expect” The reality is, there’s only so much you can do — the “higher-performing people” who might be once thieves are inside. Motion detectors add looking to keep that extra edge. another line of defense, of course, and there are In some cases, employees grab a few pills here several … interesting options. and there for personal use. In others they’re looking to acquire larger quantities they can sell. Sometimes they work alone, sometimes they have accomplices. WE’RE NUMBER 5 And in all cases, GPhA’s association counsel Greg Reybold points out, you are culpable as pharma- Bad news: According to the DEA, in 2015 Georgia ranked number cist in charge. 5 of the U.S. states for armed pharmacy robberies. So what are the most common ways employees divert drugs? According to Purdue Pharma, RxPa- The (somewhat) good news: Despite the ranking, there were trol, and the DEA: only 12 armed pharmacy robberies reported that year in the state. n Filling prescriptions for deceased patients n Providing unauthorized early refills
22 Georgia Pharmacy October/November 2016 Manage your keys. Don’t allow keys that unlock sensitive areas to be taken off site. (And stamp all CAMERAS, CANDIDLY keys “Do Not Duplicate.”) Give every employee his or her own alarm code, Closed-circuit video cameras are a popular way to deter theft and change them when an employee leaves. and potentially assist law enforcement afterwards. But experts If non-pharmacy staff need to go behind the from the DEA, Purdue Pharma, and RxPatrol offer some caveats counter — e.g., repairmen, contractors — make and tips. sure they’re escorted at all times. A combination of visible and hidden cameras is best. Visible Pay particular attention to waste and returns — to deter theft, hidden in case the thieves try to avoid being those present an opportunity for internal theft. caught on them. Log and witness everything. If you want the cameras to do more than act as a deterrent, Beyond these, NeeSmith has her own recom- invest in high-resolution, low-light-capable models. “Zoom and mendations: enhance” to identify criminals only works on TV. n Review and reconcile counts of controlled The cameras’ recordings should be stored off-site, or at least drugs regularly. in a secure, non-obvious location. n Check in inventory quickly — don’t let it sit out. If possible, some of the cameras should be mounted at eye n Review and monitor orders of controls. level, not just from above. And be sure they’re pointed at areas n Double- or even triple-count controls. likely to be targeted, including registers and shelves holding controlled substances. And remember that The last item is particularly helpful when trying Finally, test the equipment regularly, and re-aim cameras as to prevent someone stealing one or two pills. “Per- necessary. sonal use cases, quite frankly, are the hardest to catch,” NeeSmith said. Requiring at least one other person to verify a count — to say, “Yes, I agree with n Filling phony written or called-in prescrip- you” — makes theft significantly harder, she said. tions (The third, incidentally, is where Emory slipped n Short-filling prescriptions; as NeeSmith point- up. Pharmacy techs were piggybacking extra or- ed out, that’s easiest to do with “as needed” ders of controlled drugs onto legitimate ones. The drugs that patients might not be counting hospital didn’t catch the duplicate orders.) n Replacing tablets with “look alike” tablets The Georgia Board of Pharmacy is looking at n Opening bottles/packages, removing tablets, changing some of its rules, including proposing then replacing and gluing the seal one that would require an electronic “perpetual inventory.” If there’s a material discrepancy in that So what’s to be done? inventory (say, 20 percent, although that hasn’t been decided) the pharmacy must take a physical FAMILY MATTERS inventory and report the findings to GDNA. But that’s still in the works. Stopping your employees from stealing is a tough When all’s said and done — when employees gig. On the one hand, you hired these people be- are trained, when alarms are installed, when doors cause you trust them. You don’t want them to feel and windows are secured — we all know it’s al- like potential criminals every moment they’re at most impossible to prevent 100 percent of thieves. work. It’s a needle to thread: Trust, but verify. It’s a fact of life, especially in a business where Law enforcement and insurers offer some sug- you’re dealing in a small but expensive product gestions for doing just that. that’s in high demand on the street. Do background checks before hiring. (Shameless Keep in mind, though, that the precautions you plug: If you’re a member of GPhA’s PEO, back- take to prevent go beyond protecting your inven- ground checks are part of the benefits package tory. They’re also protecting patients and Geor-
Georgia Pharmacy you pay for.) gians in general. Every theft you prevent ASSOCIATIONmeans Limit access. Not every employee needs access less out there. As David Ledbetter said, simply, “I BLACK & WHITE OPEN to every area of the pharmacy. don’t want to put drugs out on the street.” GLOSS/GRADIENT FLAT COLOR
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October/November 2016 Georgia Pharmacy 23 GPhA’s Insurance Solutions get covered!
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Way back in 1985, GPhA became a charter member Alliance: Not only is it owned by state pharmacy of the Pace Alliance (pacealliance.com) — an inde- associations, it distributes all its profits to them, pendent pharmacy buying group (affiliated with to fund programs and projects supporting phar- McKesson), that today is owned by us and 18 other macy at the state level. state pharmacy associations. The other goal is to “advocate and negotiate on It’s turned out to be a good investment on our behalf of Pace member independent pharmacies part — Pace has been providing GPhA with a in order for them to continue to be viable and solid revenue stream (read: More money to work competitive.” for Georgia pharmacists). Its 2015 contributions Pace membership is open to independent phar- to GPhA were the highest in a decade, and 2016 is macies nationwide. To learn more about how the already looking to be a great year. Pace Alliance can serve your pharmacy, contact In fact, that’s one of the two goals of the Pace Curtis Woods at (785) 843-6912. —Andrew Kantor
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October/November 2016 Georgia Pharmacy 23 SUNDAY, OCTOBER 23, 2016 • MACON MARRIOTT & CENTREPLEX SAVE THE DATE
AIP FALL MEETING AGENDA 3 Hours Registration opens at 7:00 a.m. of CPE Credit Programs include: • High Performance Network update CONTINENTAL • Counseling Your Patients on Drug Induced Nutrition Depletion and Vitamin Supplementation BREAKFAST & LUNCH • The Unaccountable Pharmacy: Accounting Fundamentals and Tax Strategies for Retail Pharmacies PROVIDED • 340B Made Easy- The Nuts & Bolts for a Successful 340B Contract Pharmacy • Tips and Tricks- Preparing for and Surviving a PBM Audit
Plus • Legislative Update • Networking with Partners
SHOW YOUR SUPPORT — ATTEND THIS YEAR’S AIP FALL MEETING Registration: Please fill out and fax back to (404) 237-8435
Member’s Name: Nickname: Pharmacy Name: Address: E-mail Address (please print): Will you be joining us for lunch (Noon – 1:00PM)? q Yes q No How many total will be attending? Names of Staff/Guests:
INVESTING IN PHARMPAC IS INVESTING IN YOUR PRACTICE.
2016 PHARMPAC INVESTORS The following pharmacists, pharmacy technicians, students, and others have joined GPhA’s PharmPAC. The contribution levels are based on 2016 investment as of August 31, 2016.
Titanium Investors ($2,400 or $200/month) Diamond Investors ($4,800 or $400/month)
RALPH BALCHIN TOMMY BYRAN BEN CRAVEY NEAL FLORENCE DAVID GRAVES Fayetteville St. Simons Island Hawkinsville LaFayette Macon
CHARLIE BARNES Valdosta
LON LEWIS TOMMY LINDSEY BRANDALL LOVVORN JEFF SIKES DEAN STONE St. Simons Island Omega Bremen Valdosta Metter
Platinum Investors Gold Investors MAC McCORD ($600 or $50/month) Atlanta ($1,200 or $100/month)
William Cagle Mark Parris James Bartling Mack Lowrey Hugh Chancy Wallace Partridge Nicholas Bland Chad McDonald Keith Chapman Houston Rogers Lance Boles Bobby Moody Wes Chapman Daniel Royal William Brewster Sujal Patel Dale Coker Tim Short Bruce Broadrick William Prather Billy Conley Teresa Smith Liza Chapman Greg Reybold SCOTT MEEKS Blake Daniel Carl Stanley Marshall Curtis Daryl Reynolds Douglas Al Dixon Dennis Strickland Mahlon Davidson Brian Rickard Jack Dunn Chris Thurmond Sharon Deason Andy Rogers Robert Hatton Danny Toth Robert Dickinson John Sherrer Cassie Hayes Alex Tucker Ed Dozier Sharon Sherrer William Huang Tommy Whitworth Kevin Florence Danny Smith Marsha Kapiloff Kerry Griffin Michael Tarrant Ira Katz Michael Iteogu James Thomas Jeff Lurey Stephanie Kirkland William Turner FRED SHARPE Albany Jonathan Marquess Ashley Kunkle Chuck Wilson Drew Miller George Launius H.D. Wilson Laird Miller Steve Wilson
David Graves, Macon, PharmPAC chairman
October/November 2016 Georgia Pharmacy 25 2016 PHARMPAC INVESTORS (CONTINUED)
Silver Michael Crooks Kaitlin Brannen John Ewing Edwin Laws Daniel Royal investors Mandy Davenport Marcia Brock Michael Farmer Allison Layne John Sandlin ($300 or Melanie DeFusco Winston Brock Vernon Ford John Leffler Edward Schutter $25/month) Wendy Dorminey Jesse Brown Michelle Ford Eddie Madden Bryan Scott Renee Adamson Smith John Drew Diane Brown Matthew Frazier Ralph Marett Jennifer Shannon Michael Adeleye Bill Dunaway Wendy Buttrey Elbert Fricks Tyler Mayotte Gary Sheffield Nelson Anglin Benjamin DuPree Ron Cain Raymond Fulp Susan McCleer Thomas Sherrer Michael Azzolin James Elrod Stephanie Cann John Galdo Herbert McGinty Brice Sikes Larry Batten Sheri Gordan Robert Cecil Richard Garrett Charles McWilliams Michael Sims James Carpenter Larry Harkleroad Tina Chancy John Gleaton James McWilliams Chad Smith David Carr Hannah Head Melissa Chewning Samuel Goldberg Aubrey Miller James Strickland Jean B Cox Phillip James David Clements Eric Goldstein Rodney Miller William Tatum Gregory Drake Brenton Lake David E Clements, Sr. James Goodson Hani Mussad Leonard Templeton Yolanda Ellison Micheal Lewis Dawn Collier Richard Griffin Anita Naik Tim Thompson Marshall Frost Mary Meredith Margaret Collins-Free Edmund Hackney Albert Nichols Sonny Thurmond Amy Galloway Amy Miller Chandler Conner Michelle Hamel Charles Nicholson Charles Tigner James Jordan Jonathan Riley Robert Cook Johnathan Hamrick Anna Oberste Tommy Tolbert Susan Kane Amanda Stankiewicz Hewlette Cook Maxwell Hancock Robert Oliver F. Trotter Willie Latch Krista Stone Meryl Cook John Hansford Brenda Owens Edward Turner Tracie Lunde James Strickland Raye Coplin Bobby Harrell Amanda Paisley Laura Tyson Kalen Manasco Carey Vaughan Matthew Crist Winton Harris Carl Parker Christopher Vaughan Pamala Marquess Flynn Warren Betsy Crowder Joshua Hartsell Larry Parrish Sheila Walker Hillary Jack Mbadugha Amanda Crowe Earl Henderson F Paul H. Weitman Bill McLeer Member William Crowley Shawn Hodges Kelli Peavy David Wells Donald Piela, Jr. investors Richard Crumpton Clay Hogan Amon Peters Rebecca White Steven Purvis (up to $150) J. Ernie Culpepper Joe Holt Christy Phillips-Malcom Mark White Terry Shaw Sylvia Adams Charles Culpepper Woody Hunt Whitney Pickett Douglas Wilkinson Jonathan Sinyard Casey Allen-Hayes Mary Dalziel James Hunt Rose Pinkstaff Jonathon Williams Kenneth Rogers Myron Anderson Ann Damon Mark Hurley Kimberley Potter Timothy Wilson Austin Tull Jim Anderson Angela Davis Scotty Jarvis Lewis Powell Keith Winslette Lindsay Walker Ann Ayers Suleman Daya Johnny Joe Perry Prather Stephen Winslette Bronze Suzanne Bagby Stacy Dickens Elizabeth Johnson Robert Probst Christopher Winslow investors Gary Bailey Jessica Duffey Jami Justus Jeff Ratliff Mark Winters ($150 or Marla Banks Sheila Dukes Payal Kakadiya Ola Reffell William Wolfe $12.50/ Richard Bass Terry Dunn E. Kemp F. Paul Rhett William Wood month) India Bauder Eric Durham Charles King Ashley Rickard Larry Woodruff Bonnie Ali-Warren Thomas Beckham Robert Dykes Amy King Donna Riggins Joseph Woodson Phil Barfield William Bedingfield David Eldridge Erin Kovarik Gerald Riggins Curant Health Waymon Cannon Fred Bishop Larry Ellis Charles Kovarik Tom Roberts Integrated Financial Gp. Sharon Clackum Karen Braden Frank Erwin Georgie Langford Carlos Rodriguez-Feo
HELP US REACH OUR GOAL FOR 2016! In this election year it’s critical that PharmPAC raises enough funding to As of August 31, 2016 support pro-pharmacy candidates for $95,829.50 the Georgia legislature. You can bet the PBMs will be well funded! $0 $25,000 $50,000 $75,000 $100,000 $125,000
Thank you to all our PharmPAC investors for their contributions to the future of pharmacy in Georgia. Visit GPhA.org/PharmPAC or call (404) 419-8118 to find out more.
26 Georgia Pharmacy October/November 2016 Georgia Pharmacy ASSOCIATION
contact Get in touch
BLACK & WHITE REACHOPEN US AT 404.231.5074 OR GPhA.ORG
For membership questions For operational or Mary Ritchie accounting questions: GPhA’S MEMBER Director of Membership Dianne Jones SERVICE Operations Vice President of Finance & PARTNERS (404) 419-8115 Administration [email protected] (404) 419-8129 GLOSS/GRADIENT FLAT COLOR InfiniTrak [email protected] GPhA LEADERSHIP For questions about our infinitrak.us President & Chair of the Board magazine, blog, websites, Patricia Aguilar Track and trace LANCE BOLES, Hartwell or social media Accounting Coordinator compliance software 1 [email protected] Andrew Kantor [email protected] (844) 464-4641 Director of Communication (404) 419-8124 President-Elect [email protected] Pharmacy Quality LIZA CHAPMAN, Dawsonville Commitment [email protected] For questions about our pqc.net educational offerings First Vice President Quality assurance Phillip Ratliff TIM SHORT, Cumming compliance resources Education Consultant [email protected] For assistance with (866) 365-7472 [email protected] independent-pharmacy issues Immediate Past President For questions about any of Jeff Lurey, R.Ph. Pharmacy Technician TOMMY WHITWORTH, our insurance products VP of Independent Pharmacy Certification Board LaGrange Denis Mucha (404) 419-8103 ptcb.org [email protected] Manager — Member Services [email protected] (800) 363-8012 Chief Executive Officer (404) 419-8120 For questions about your SoFi SCOTT BRUNNER, CAE [email protected] AIP membership sofi.com/gpha [email protected] Verouschka “V” Betancourt-Whigham For questions about Student-loan refinancing Manager of AIP Member Services Directors governmental affairs (855) 456-7634 MICHAEL AZZOLIN, Bishop Greg Reybold (404) 419-8102 [email protected] [email protected] Vice President of Public Policy UBS [email protected] SHARON DEASON, Newnan AIP Member Service ubs.com/team/wile [email protected] For questions about the Board Representatives Financial planning of Directors or for scheduling Rhonda Bonner (404) 760-3000 AMY MILLER, Gainesville the CEO (229) 854-2797 [email protected] Ruth Ann McGehee [email protected] FRED SHARPE, Albany Executive Assistant and Charles Boone [email protected] Governance Manager (478) 955-7789 Got a concern about a GPhA (404) 419-8173 [email protected] JONATHAN SINYARD, Cordele program or service? Want to [email protected] [email protected] Melissa Metheny compliment or complain? (678) 485-6126 Drop a note to RENEE SMITH, Columbus [email protected] [email protected]. [email protected] Gene Smith CHRIS THURMOND, Athens (423) 667-7949 vildrug@bellsouth.net [email protected]
October/November 2016 Georgia Pharmacy 27 postscript
Securing our future
Webster defines ‘security’ as DIR fees, touted as a way to reduce cost sharing the state of being protected at the pharmacy for our patients, improve or safe from harm or things integrity in the Medicare Part D system — and that are done to make peo- do both with cost neutrality. ple or places safe. As this A coalition of pharmacy groups led by APhA issue of Georgia Pharmacy continues to gain support for provider status has focused on pharmacy and to recognize pharmacists as providers, thus LANCE BOLES security, I would like to making pharmacists eligible to receive pay- challenge you to think of ment for services from Medicare that we are ways that we can contribute to securing a bet- already trained to provide. There is also federal ter future for the profession of pharmacy. MAC transparency legislation proposed to We currently operate in a system whereby ensure fair and equitable treatment to pharma- roughly 50 percent of all prescriptions dis- cies that participate in federal programs. pensed in the majority of pharmacies are paid for by dollars derived from the federal govern- And now a call to action: an opportunity ment. It is clear the impact that the federal that we all can take to secure and expand the government exerts over our profession through profession of pharmacy and the many oppor- product reimbursement. tunities for patient care that come with being There are several bipartisan initiatives before a pharmacist. There are a number of ways that Congress that stand to both protect and pro- each of us can contribute to the goal of securing vide service opportunities for pharmacists. Just a better future for our profession. last week, NCPA announced a House and Sen- n Get to know your representatives in Con- ate version of a resolution to ban retroactive gress — it’s important that your members of Congress have a pharmacist’s expertise to call on when there are issues that are affecting our profession. n Host a member of Congress in your practice setting. GPhA can provide you contact infor- mation and talking points if you would like to host a visit. n Ask your member of Congress to sign on and support each of these three key pieces of federal pharmacy legislation I mentioned, if they have not already. n Join APhA, ASHP, NACDS, or NCPA at their
Georgia Pharmacy annual legislative conference for anASSOCIATION opportu- nity to meet with your members of Congress BLACK & WHITE OPEN
and their staffs in Washington D.C.GLOSS/GRADIENT FLAT COLOR
1
Lance Boles is GPhA’s 2016-2017 president and owner of independent pharmacies in Hartwell, Ga. and Iva, S.C.
28 Georgia Pharmacy October/November 2016 Coverage You Need. Service You Deserve. A Price You Can Afford. Georgia Pharmacy ASSOCIATION
GEORGIA PHARMACY FOUNDATION, INC. 6065 Barfield Road NE | Suite 100 Sandy Springs, GA 30328
BLACK & WHITE OPEN GET UPDATED AND GET FED: GPhA’S FALL REGIONAL LEGISLATIVE BRIEFINGS AND DINNERS
SPACE IS LIMITED! GLOSS/GRADIENT REGISTERFLAT COLOR Register today at NOW 1 GPhA.org/briefings for your region’s meeting and dinner, and get updated on the issues we’re working on during this legislative session.
Region 1 October 6 Savannah Region 2 October 4 Valdosta Region 3 October 13 Columbus Region 4 October 11 Peachtree City Region 5 October 5 Sandy Springs Region 6 October 26 Macon Region 7 October 6 Acworth Region 8 October 4 Waycross Region 9 October 13 By webinar Region 10 October 26 Athens November 15 Gainesville Region 11 October 5 Augusta Region 12 October 11 Dublin