A frenzied move is afoot to bring an “omnibus” bill that tackles prescription drug abuse to the House floor by Friday.
The House Human Services and Judiciary committees jointly crafted H.331 at the behest of House Speaker Shap Smith and Majority Leader Willem Jewett, D-Ripton. The impetus originally came from a host of representatives who urged them to take action on opioid addiction, Jewett said.
Rep. William Lippert, D-Hinesburg who chairs the Judiciary Committee, said the legislation is driven by “a lofty goal.”
“There is not an area of our state that hasn’t been ravaged by addiction… I think our initiative will save lives,” he said.
The Human Services committee will spend the next two days hammering out some pivotal details.
Only 36 percent of doctors who are licensed to prescribe controlled substances are registered to use the VPMS.
The bill’s centerpiece is an effort to revitalize the Vermont Prescription Monitoring System, the statewide online database that allows physicians and pharmacists to track prescriptions, alerting them to signs of abuse. Participation, which is voluntary, has been lackluster.
Only 36 percent of doctors who are licensed to prescribe controlled substances are registered to use the VPMS and among these 1,881 doctors, there isn’t data on how many actively use the database. Some 163 of 400 in-state pharmacists are registered.
H.331, as it currently stands, requires that all pharmacists and health care providers with a license to prescribe opioids register with VPMS. It does not, however, lay down requirements about how frequently they must consult it.
The bill also paves the way for the Department of Health to share information with databases in neighboring states as long as they comply with a host of privacy and security protections. Additionally, it sets up a framework for a program that would make it easier for people to dispose of their extra prescription pills, and it requires pharmacists to request identification from people before they receive prescriptions.
During a briefing on the bill at today’s Democratic caucus, the chairwoman of the human services panel, Lippert and Rep. Ann Pugh, D-South Burlington, kept a damper on a rash of other suggestions that cropped up.
Rep. Cynthia Browning, D-Arlington, spoke about the need to expedite law enforcement access to the database. “The urgency is just multiplying,” Browning said.
Rep. Paul Ralston, D-Middlebury, urged the committees to build more preventive measures into the bill and Rep. Valerie Stuart, D-Brattleboro, asked about an education component for youths.
The bill steers clear of a notable sticking point that Browning alluded to, which held up similar legislation last session — allowing law enforcement access to the database without a warrant.
The Vermont Medical Society (VMS) supports the current version of the bill, including the provision to require physicians and pharmacists to register with the VPMS. But it would oppose any mandate to require consultation of the VPMS prior to making any prescription.
“We are focusing on areas where there was consensus,” Pugh told her fellow House Democrats.
Lippert chimed in, “We’ve carved out a package that will make a difference. It will not make all the difference.”
The Vermont Medical Society (VMS) supports the current version of the bill, including the provision to require physicians and pharmacists to register with the VPMS. But it would oppose any mandate to require consultation of the VPMS prior to making any prescription. That’s better left up to The Vermont Board of Medical Practice, said Madeleine Mongeon, the deputy executive vice president for VMS.
“We don’t support legislating the practice of medicine or the standard of care because it changes so frequently,” Mongeon said.
Pugh told the House Democrats on Tuesday that the committee hasn’t made a final decision about whether the bill will further regulate how VMPS is used.
Any guidelines on usage “should be tied to improvements in the VPMS,” Mongeon said. Doctors have complained the database is clunky and takes too much time to use.
House Speaker Shap Smith says if new legislation doesn’t motivate doctors to use the database, the Legislature will mandate usage.
“I believe that if you are prescribing opiates, you should not prescribe those opiates until such time as you have checked the database, and we have to do everything to encourage doctors to do that, and if that doesn’t work then I think we ought to mandate it, and it’s just not that hard,” Smith said. “It’s just not something that should be happening. If you’re prescribing an opiate you should check to see whether somebody else has prescribed that opiate and that opiate has been dispensed to that person within the last week or so or last couple of days. It is something that you can have on a tab on a browser on a computer in your office you can check your patient list that day before the patients come in. It is accessible and it’s important.”
The commissioner of the Department of Health, Dr. Harry Chen, told VTDigger he supports mandatory registration for the VPMS, and he would support a measure to increase usage as long as “we can actually focus the use of this tool in way that will help physicians and their patients.”
“New York requires it for every prescription,” Chen said. “Massachusetts requires it for every new patient. There are a lot of different ways that may happen, and I think probably something will come out of the bill to require physicians to use it, and I am supportive of it.”