H1N1 Swine Flu: The Hospital Challenge - Webinar
Follow-up Questions to State Surgeon General, Ana Viamonte Ros, MD, MPH
November 19, 2009
1) The Department stated pharmacies would be allowed to dispense a full course of antiviral medication to ED patients who do not have the ability to pay for medications. Has the State issued any waivers to allow hospitals with an institutional pharmacy IIB license to dispense the medications to the qualified ED patients? If so, what is the process? The following is legal opinion from Department of Health General Counsel's Office allowing the dispensing of full courses of antivirals:
Legal opinion: Class II institutional pharmacies dispensing to persons not patients of the institution.
465.019(2)(b), F.S. "Class II institutional pharmacies" are those institutional pharmacies which employ the services of a registered pharmacist or pharmacists who, in practicing institutional pharmacy, shall provide dispensing and consulting services on the premises to patients of that institution, for use on the premises of that institution. However, an institutional pharmacy located in an area or county included in an emergency order or proclamation of a state of emergency declared by the Governor may provide dispensing and consulting services to individuals who are not patients of the institution. However, a single dose of a medicinal drug may be obtained and administered to a patient on a valid physician's drug order under the supervision of a physician or charge nurse, consistent with good institutional practice procedures. The obtaining and administering of such single dose of a medicinal drug shall be pursuant to drug-handling procedures established by a consultant pharmacist. Medicinal drugs may be dispensed in a Class II institutional pharmacy, but only in accordance with the provisions of this section.
Interpretation: The words, "declared by the Governor" are words of limitation. They may apply to the "proclamation" or they may apply to both "proclamation" and "emergency order." Because both readings are equally reasonable, the statutory language is ambiguous and may be interpreted by the agency responsible for administering the statute (in this case, DOH). For purposes of response to the H1N1 outbreak, a WHO-declared pandemic influenza, the Class II institutional pharmacies may dispense Tamiflu and Relenza to persons bearing valid prescriptions, who are not patients of the institution, because on April 26, 2009, Acting HHS Secretary Charles Johnson determined that a nationwide Public Health Emergency existed, with potential to affect national security, and all Florida institutional pharmacies are located within the area of the nation.
2) Are there identified contacts within each county health department for hospitals to coordinate their H1N1 activities and issues/problems? Hospitals should contact the county health department director/administrators as they can ensure the hospital representative is referred to the appropriate health department contact. Contact information for the health departments can be found at www.floridashealth.com home page by selecting the appropriate county in the "Access health services in your community" section.
3) Recent media reports indicated Florida is vetting draft guidelines for health care system triage and allocation of scarce resources. Please elaborate on this information and provide an estimate as to when the final guidelines are expected to be officially released. The draft document is posted at the following link, http://www.doh.state.fl.us/DEMO/php/PDFs/ACS_GUIDE_Ver8.pdf. The review process is in the beginning phase and a final guideline completion date has not been established at this time.
H1N1 Swine Flu: The Hospital Challenge - Webinar
Tuesday, November 10, 2009 - 1:00 p.m. to 2:30 p.m. ET
http://www.fha.org/video/H1N1SwineFluWebinar.wmv
