Sen. Fred Mills won approval for two bills on Wednesday from the Senate Health and Welfare Committee, which he chairs.
SB55 seeks to put Louisiana’s prescription monitoring program to work in combating the surge in opioid abuse in the state. SB75 would reform the operation of the 25 state health professional licensing boards that exist in the Louisiana Department of Health, including adding consumer representation to each of them.
Mills spoke with The Independent by phone on Wednesday afternoon after committee action on his bills.
“The prescription monitoring program has been in place for eight or nine years and with SB55 I’m trying to use that system to help identify opioid users who might be doctor or pharmacy shopping,” Mills, a pharmacist, explains.
The bill would require anyone licensed to prescribe opioids to be automatically enrolled in the PMP. That online database already tracks prescriptions for Schedule II narcotics. Opioids are included in that category but use of the system has been low among physicians. Mills bill mandates enrollment and a new requirement for continuing education credits related to the use of the system, and directs the licensing boards of prescribers to promulgate rules regarding the mandatory use of the system.
“As the East Baton Rouge coroner testified, our goal here is to avoid creating future addicts by keeping a closer watch on prescribing opioids and the ability of some patients to get prescriptions filled multiple times,” Mills says.
Any medical provider prescribing opioids for a patient for a period of more than 90 days would be required to enter the prescription information in the PMP. Prescriptions for cancer patients, hospital patients, those with intractable pain, and those declared terminally ill are excluded from the provisions of the bill if it becomes law. The bill would also require those conducting research on opioids to obtain a license to use them from the state Board of Pharmacy.
Mills says that in the third quarter of 2016 less than half of the 26,625 doctors and pharmacists eligible to use the PMP system have sought access to the system. Only about a quarter of doctors and pharmacists (6,262) actually use the system.
SB75, Mills says, is an attempt to apply best practices of other states to bring Louisiana’s 25 health professional licensing boards into the modern era.
“Louisiana has the lowest consumer representation on health professional licensing boards in the United States,” Mills explains. “My bill would require that each of the 25 boards have at least one consumer advocate on them who has no ties to the profession either by training or family relation.”
The bill would also provide for hearings before administrative law judges for any health professional subject to disciplinary action.
“The boards currently act as sheriff, district attorney, prosecutor, judge, jury and executioner,” according to Mills. “Hearing officers are either board attorneys or attorneys contracted by the board. Many licensees feel that they do not get a fair hearing when so much of the hearing is dominated by the board itself.”
Mills says the boards would retain their investigative powers but hearings on disciplinary actions recommended by the boards as a result of their investigations would be presided over by administrative law judges.
“SB75 transfers all hearings in disciplinary matters to the Division of Administrative Law where the board can present their case and the licensee can defend himself, and both parties can have the benefit of a fair and impartial ruling by an administrative law judge,” Mills declares.
The bill would also allow consumers to take complaints about the boards to the Department of Health. Mills says that although the boards operate under the LDH umbrella they are autonomous. Complaints about the boards would be reviewed by LDH with reports on each one submitted to the complainant, the board and the governor. Mills says the boards remain autonomous but his hope is that governors will use the reviews to evaluate performance of board members.
Mills says he also wants LDH to provide more budget oversight for the boards and to review spending each of the boards. The bill would also prevent the boards from granting employee merit raises in years when LDH does not issue merit raises to its employees.
Finally, SB75 would require the boards to justify their existence by sunsetting them as now happens to each department in state government.
“Every four years every agency in Louisiana must be re-created in a process called sunsetting,” MIlls says. “SB75 would require each board to independently secure their own re-creation in the year in which LDH is re-created. The mere re-creation of LDH shall not alone constitute a re-establishment of the boards.”
Both bills are now on the Senate calendar and can be subject to debate and votes at any time. If the bills win Senate approval, they will move to the House where they will be referred to committee by Speaker Taylor Barras. If the bills win committee approval, they move to the full House for debate and votes. The Senate and House must agree on any differences resulting in the bills from the action of the two bodies.