FRANKFORT —
A new legal requirement that physicians check patients’ drug history and report prescriptions of painkilling drugs to the state’s electronic tracking system, KASPER, will delay treatment for critical care patients and put doctors in fear of criminal liability.
That’s what a line of physicians, hospital officials and nurses told the legislative committee responsible for overseeing implementation of House Bill 1, a new law designed to address Kentucky’s prescription drug abuse epidemic.
Dr. Robert Bratton, Chief Medical Officer for Lexington Clinic, told the committee the medical community “is not here to criticize House Bill 1. The problem of substance abuse in this state is indisputable.”
But applying the new rules, designed to halt fly-by-night clinics dispensing pain killing medication for cash without usual medical procedures, to hospitals and other critical care medical institutions will delay treatment to patients with legitimate need for the medication, such patients as emergency room, surgical and cancer patients, said several of those addressing the committee.
“The effect is an absolute delay in patient treatment,” said Roz Cordini, an attorney who represents the Kentucky Hospital Association.
Those restrictions, applied to hospitals and emergency rooms, are “not consistent with the realities of medical practice,” said Dr. Steven Stack, an emergency physician from Lexington.
Stack and Dr. Melissa Platt, president of the Kentucky Chapter of American College of Emergency Physicians, said sometimes patients in great pain simply can’t wait for their doctors to go through the procedures required by the new law. That, Platt said, forces doctors to choose between breaking the law or treating legitimate patient needs.
“It confronts the physician with the untenable choice of complying with the law or with medical ethics,” Stack added.
Committee Co-Chair Sen. Robert Stivers, R-Manchester, asked those testifying to avoid “anecdotes” and “quote chapter and verse” of the law and regulations creating problems and how those problems can be addressed. And the medical representative by and large complied. Most submitted written recommendations to address their concerns in advance of their testimony.
Stivers also asked committee members to defer questions until all the witnesses had testified. (Lawmakers wished to conclude the meeting in time to attend a memorial service in the Capitol for Gov. Steve Beshear’s chief of staff, Mike Haydon, who died unexpectedly this week.)
They explained how hospital dispensing of pain medications differs from a doctor prescribing those types of drugs which the patient then can get filled at a pharmacy; how such drugs are sometimes required on an emergency basis for children, those with traumatic injuries, surgical, cancer and terminal patients.
Beth Partin, vice president of the Kentucky Coalition of Nurse Practitioners and Nurse Midwives, explained that sometimes pregnant women decline pain medication when labor begins but when complications occur during delivery, they need emergency pain treatment.
Partin said “that is an inopportune time” to stop treatment and address administrative and legal requirements.
Despite the efficient schedule imposed by Stivers, several who wished to address the committee were unable to do so before the meeting adjourned.
The committee took no action and Stivers said anyone who did not get a chance to testify Wednesday will be invited to do so at the committee’s next meeting. That meeting hasn’t yet been scheduled.
RONNIE ELLIS writes for CNHI News Service and is based in Frankfort. Reach him at rellis@cnhi.com. Follow CNHI News Service stories on Twitter at www.twitter.com/cnhifrankfort.
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