Ala. Admin. Code r. 580-2-9-.26 - Indigent Drug Program

(1) A consumer in the Indigent Drug Program (IDP) must be under the care of a licensed physician who may be either in private practice or on the staff of a mental health center.

(2) Each consumer must have a psychiatric diagnosis established before any prescription is filled.

(3) Every consumer on the IDP must be an active consumer of the center even if medication is prescribed by a non-center physician.

(4) Each consumer should receive a direct service at least every 90 days. Case notes should be completed for each contact.

(5) All chemotherapy must be documented in the consumer records in accordance with section 580-2-9-.06. Additional comments may be made on the service record and in the case notes.

(6) All prescribed medication issued by the IDP is subject to review by the mental health center's Medical Director.

(7) All consumers receiving psychotropic drugs shall be seen and evaluated by a licensed physician at intervals not to exceed a 6 month period.

(8) Approved dispensing agencies must use the IDP financial and clinical eligibility criteria as published by the Alabama Department of Mental Health. Exception: One-time only for prescriptions from a state institution, crisis stabilization program, for a documented emergency, or until compassionate need medication can be obtained.

(9) Financial information as well as clinical documentation in sufficient detail to determine eligibility for participation in the Indigent Drug Program will be in the consumer records. This information will be updated at least on an annual basis.

(10) All consumers of the Indigent Drug Program must be screened for third party eligibility. Consumers who qualify for Medicaid, insurance or compassionate need programs will not be furnished drugs that are available through these other sources.

(11) The provider shall have a policy that prohibits the sale of drugs.

(12) The provider shall establish a nominal dispensing fee to cover the costs of dispensing medication, including salary of the pharmacist, cost of containers, labels, etc. An additional charge may be assessed if it is necessary to mail any prescriptions.

(13) All records required by state and federal laws governing the storage and handling of drugs must be maintained.

(14) All prescriptions filled with drugs furnished by the State of Alabama for use in the Indigent Drug Program must be filled exclusively within the confines of the mental health center or its satellite facilities.

(15) The provider shall follow Alabama Department of Mental Health operating procedures relative to ordering, storage, and accounting for medication obtained and dispensed through the IDP.

(16) Pharmacies used for the IDP are licensed by the Alabama State Board of Pharmacy and are staffed either part-time or full-time, by a pharmacist registered in Alabama.

(17) The registered pharmacist, as the legally responsible person, shall compound (fill) and/or dispense all prescriptions.

(18) The state office must be advised of any changes in key personnel involved with the Indigent Drug Program and appropriate in-service training by the Coordinator of Community Pharmacy Services will be available, if needed.

(19) Adequate clerical support must be provided to insure that the necessary reports, records, etc., are executed.

(20) The Coordinator of Community Pharmacy Services must be notified of any planned change in the location of a pharmacy.

(a) In case of change of address of the center, the following are to be notified when the date of change is final:

1. Alabama State Board of Pharmacy.

2. Drug Enforcement Administration.

(b) Old Drug Enforcement Order Forms should be returned to the Drug Enforcement Administration, Registration Branch.

(c) New order form book for new address must be requested before placing orders for any Schedule II items to be shipped to the new address.

(21) The mental health center director shall sign an assurance that any drugs paid for through the IDP will be used only for persons who meet the clinical and financial eligibility criteria for the IDP. No drugs will be ordered for a mental health center until there is a current assurance statement on file with the Department of Mental Health.

(22) Drugs for the Indigent Drug Program must be kept separate from any other drug stock(s) or any other center supplies.

(23) Access to the pharmacy must be limited to the pharmacist and only the pharmacist shall have keys to the pharmacy. Pharmacy assistants may be in the pharmacy at the same time as the pharmacist.

(24) Drugs can be received only by an authorized representative in the absence of the Pharmacist and must be stored in a place that can be securely locked outside the pharmacy.

(25) There should be entries in the general ledger for drugs received and dispensed by each center. The value of the drugs must be included as part of the center's revenues and, when dispensed, as part of the center's expenditures.

(26) A physical inventory of drugs on hand should be taken at the close of business September 30 of each year. The value of the drugs on hand, using the prices reflected on the invoices of the prime vendor or those available from the state office should be determined. This inventory must be verified by spot checks of selected items by someone designated by the Center Director other than Indigent Drug Program personnel.

(27) Any pharmacy involved in the loss of controlled substances must notify the DEA regional office, the State Board of Pharmacy, and the Coordinator of the Community Pharmacy Service upon discovery of theft or significant loss. The DEA office will furnish a form to be filled out, along with instructions for completing the form.

(28) A prescription will be limited to 5 refills, or 6 months, whichever occurs first, unless the prescribing physician indicates more stringent directions. The quantity issued at any one time will not exceed a 33 day supply.

Notes

Ala. Admin. Code r. 580-2-9-.26

New Rule: Filed June 14, 2010; effective July 19, 2010.

Author: Division of Mental Illness, DMH

Statutory Authority: Code of Ala. 1975, § 22-50-11.