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County Council gives first reading and airing of bill establishing a prescription drug monitoring program

St. Charles County is pushing toward establishing its own prescription drug monitoring program [PDMP] that will operate with similar programs in St. Louis County and the city of St. Louis.
Meanwhile, some residents have raised concerns about whether the program would intrude on patient’s privacy.
The County Council gave a first reading and public airing of the bill establishing the county’s PDMP at its Sept. 12 meeting. The council isn’t expected to take final action until its meeting on Sept. 26. County Executive Steve Ehlmann requested the bill, which is sponsored by Councilman Joe Brazil [District 2].
Ehlmann announced the bill on Aug. 30 after months of consideration on whether or not the county would join with St. Louis city and county in establishing a local PDMP, because of lack of action by the Missouri General Assembly. State lawmakers opposed to a statewide PDMP say they are worried about privacy concerns.
“I’ve been saying for the last month or so that with this heroin thing no one wants to admit that it’s a problem out here, but I think we’re almost to the point where every family either has been affected by this or knows another family who has,” Ehlmann told the council on Sept. 12.
Authorities view a PDMP as critical in helping deal with what they are calling a “heroin epidemic” and widespread prescription drug abuse in the St. Louis area.
Missouri is the only state in the country without a database or system to track the sale of opiate-based prescriptions. Opiate-based drugs such as Oxycontin and Vicodin are prescribed by doctors to treat pain, but can cause addiction and lead to heroin abuse.
St. Charles County Prosecuting Attorney Tim Lohmar said a monitoring program might help prevent “doctor shopping,” where abusers go through a number of physicians to get prescriptions.
“I was at a meeting with DEA [Drug Enforcement Administration] agents and U.S. attorneys around the country just last week,” Lohmar told the council. “And Missouri is known affectionately as ‘America’s Drugstore.’”
Several residents at the Sept. 12 meeting raised concerns about privacy of medical records during a public comment portion of the meeting.
“I don’t understand why they [St. Charles County] want to take away my right to privacy,” said Nina Dean, an O’Fallon resident.
Dean said PDMP proponents are “well-intentioned,” but she worried about how the county will be able to safeguard medical information that may be easily hacked.
Arnie Dienoff, another resident, also opposed the bill, saying any effort to establish as PDMP belongs in Jefferson City were state legislators can discuss it in a “broader sense.”  Resident David Guest asked if a county PDMP was a violation of Health Insurance Portability and Accountability [HIPPA] laws that protect access to private medical information.
The state has not taken action on the matter.
“We’re not looking at the people getting the drugs, we’re looking at the prescribers, that is what we are targeting,” said St. Charles County Department of Public Health director Hope Woodson, who said the county has been working with the St. Louis County Department of Public Health to implement the program.
In a memo to the council, Woodson said passage of the bill would allow the county to sign intergovernmental agreements with St. Louis County and other counties.
Woodson said data on individual prescribers would be shared with the Missouri Board of Registration for the Healing Arts, which regulates physicians.
Meanwhile, Ehlmann and Joann Leykam, the county’s director of administration, agreed that state legislation enacted to setup a statewide PDMP could override local PDMPs, depending on whether preemptive language is added.
Ehlmann said a good argument can be made that a statewide PDMP may be more effective, because doctor shoppers can move out to other counties without a PDMP.
Brazil said heroin and opiate abuse may contributing to rising crime in the county.
“We are in the trenches with this problem, we see this every day,” Brazil said. “We are forced to do something.”
In March, the St. Louis County Council passed a bill creating a PDMP in that county, which St. Louis County Executive Steve Stenger signed into law. That action was followed by the city of St. Louis.
Ehlmann said the county wanted to see if the Missouri General Assembly would pass a bill. The House did, but the bill faltered in the Senate. In addition, the county also wanted to see how St. Louis County would set up its own PDMP. He asked the council to forward any questions before they acted on the bill.
“I think we were wise to wait, I think we would be very unwise not to act,” Ehlmann said.



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