Jefferson County will participate in a regional prescription drug monitoring program, perhaps as soon as July 1.
The Jefferson County Health Department’s Board of Trustees took the fight against the opioid epidemic into its own hands by voting 4-0 at its May 25 meeting to enact an ordinance to establish a Jefferson County prescription drug monitoring program (PDMP) and coordinate it with a program established by the St. Louis County Department of Public Health that includes or soon will include 21 other counties and six cities around the state.
The ordinance calls for pharmacists to provide information to the registry when they fill prescriptions for specific controlled substances, and doctors then will have access to that data.
Proponents of PDMPs say registries help doctors make educated decisions on writing prescriptions, help stop abuse of addictive medications and put an end to “doctor shopping,” in which patients go to multiple doctors in search of prescriptions.
The July 1 date to join the regional registry is contingent upon the county Health Department submitting required paperwork and other requirements in a timely matter.
Jefferson County Health Department Director Kelley Vollmar said board members decided to join the St. Louis County program after the Jefferson County Council voted 4-3 against the program on April 24.
“All (independent) county health departments have the ability to enact ordinances in the interest of public health,” she said.
Because the Jefferson County Health Department has jurisdiction over the entire county, its legislation includes all of its cities as well as unincorporated areas.
Vollmar and others have spent the last nine months advocating for the County Council to join the St. Louis County registry.
“We respect the collaborative relationship and like to partner with them, but sometimes politics get in the way,” she said. “The opioid epidemic is a public health issue that transcends politics.”
County Council members who voted against the bill to join the St. Louis County registry cited concerns with privacy and questioned how effective a PDMP would be without other initiatives to address prescription drug abuse.
The county Health Department will pay St. Louis County $2,980.32 to participate in the registry for the first year, with the cost based on the number of doctors and pharmacists who will use the program. That number is estimated at 214 for Jefferson County. There also will be an administrative fee.
Municipalities all
called for signing up
Vollmar said a number of factors led the board to its vote, and the fact that all eight of the major municipalities in Jefferson County unanimously passed resolutions asking the County Council to join was key.
“To have that support, our board felt confident in moving forward,” she said.
Tony Becker, a Crystal City councilman who helped coordinate the municipal involvement, said he was happy that the issue has been resolved.
“I want to express my gratitude to the board for taking this on,” he said. “It was not an easy choice.”
Although the County Council failed to pass its ordinance, Vollmar said she thought the discussions at the county government level were instructive.
“It was a fantastic debate that brought this issue to the forefront,” she said.
County Executive Ken Waller, who pushed for county government to join the St. Louis County registry, lauded the Health Department for stepping up.
“If we can do something in this county to prevent the loss of life from drug abuse, we have to do it. I tried to do something by taking it before the County Council, but that regrettably failed. After that, I went to Jefferson City to press for a statewide bill, only to see it die on the last day. It’s a good day for Jefferson County that the Health Department is taking this step.”
He said the board’s decision will save lives.
“Sometimes it just takes courage to do what’s right,” Waller said.
Missouri remains the only state in the nation not to establish a statewide registry, which led to St. Louis County to form its own, then invite other jurisdictions to join.
Board member John Scullin said his 28 years in the emergency medical service field offered him a perspective into the seriousness of the problem.
“This is personally important to me,” he said.
He said the health board’s action was a different way to achieve an important goal.
“There is more than one way to skin a cat,” he said.
Continuing education
Once Jefferson County is part of the registry, Vollmar said the Health Department will work to educate doctors and pharmacists about what’s required.
“The St. Louis County program has taken on the bulk of the infrastructure for outreach and education and bringing users onto the system,” Vollmar said, but added that her department will offer ongoing training to health providers.
“We want to lift them up and give them the tools and education to help them become part of the solution,” Vollmar said.
She said that education not only will center on the registry itself, but also will examine how opiates are prescribed, how patients can step down from pain medication and alternative forms of pain management.
Vollmar said the end of the long debate to establish a PDMP in the county hasn’t quite sunk in yet.
“It seems surreal,” she said.
She said she is ready, however, to begin the next chapter.
“I’m excited to see this move forward and I’m looking forward to working with our partners to find solutions for this problem for the community,” she said.
Board member Vernon Cherry was absent from the May 25 meeting.