One of the worst storms to hit the Gulf Coast was hurricane Katrina which devastated the New Orleans area including many communities in and around the southern states. Florida was the recipient of displaced citizens from affected areas. That disaster caused many to reflect on Hurricane Andrew that ravaged through South Florida in August of 1992. We can never predict when the next disaster will be upon us whether it be an act of God or man made. In any case pharmacies and pharmacy providers have to take on the role of first responders and demonstrate the provider status roles that we have been preaching about over the years. The best way to get through a disaster is to have a comprehensive plan in place BEFORE the disaster strikes. That plan should be rehearsed and tested frequently to work through any glitches that may occur. Here are some tips that you may want to consider for your pharmacy and your staff.
Prepare Ahead of Time
Pharmacies may want to apply this standard to all prescriptions and not just for controlled substances.
Check the Board’s website homepage at http://floridaspharmacy.gov/ or the Florida Pharmacy Association’s web site at www.pharmview.com for guidance in the case of hurricanes.
- Assemble a list of all employees with contact information including cell phone, home phone and e-mail addresses.
- Consider turning your list into a call tree where you contact several employees who will be charged with the responsibility of calling others within your organization.
Make sure that the employee at the bottom of the call tree contacts the originator of the message so that you can evaluate whether the messaging changed in the hand off from employee to employee.
- Assemble a broadcast fax or email list of local radio and television stations with their news phone number, and a list of physician offices and hospitals.
- Obtain from the County Manager’s office a contact at the County Emergency Management Headquarters.
- Make list of contact information for wholesalers and delivery services such as UPS and FedEx.
- If the pharmacy is to be closed and/or evacuated the appropriate supervisory personnel should be notified.
- Notify local radio and television media if the pharmacy is to be closed.
- Notify the emergency management contacts for the county in your affected area. County Emergency Management Contacts can be located HERE
- When the pharmacy reopens notify all pharmacy personnel; physicians and hospitals; local radio and television media; emergency management and emergency management contacts for your county.
Facilities and Security
- Obtain waterproof covering material for later use.
- Anticipate power outages; in some cases a portable generator may be advisable.
- Ice and coolers should be available to store refrigerated products.
- Store flammable materials appropriately.
- If the pharmacy computer is down prescriptions can be dispensed manually. Labels can be typed or handwritten using a waterproof pen if possible.
- Printed drug information may not be available but patient counseling must still occur.
- Refill authorizations may be difficult or impossible to obtain.
- If the pharmacy is to be closed and evacuation is warranted the pharmacist-manager should produce 2 sets of backup tapes or disks of all drug inventory and all prescription information. One set of information could be kept in a safe place and another kept off-site in the possession of the pharmacist-manager. Any media that contains confidential patient health information should be kept securely and accounted for to prevent any breech of confidential information.
- Prior to evacuation, computers should be shut down and covered with waterproof material. If flooding is expected the computer should be disconnected from the terminals and moved to a safe area.
- When the situation is stabilized the pharmacy personnel should be notified to take steps to restore the integrity of the pharmacy setting.
- If controlled substances are lost in a disaster the pharmacist-manager needs to contact the Regional DEA offices for Florida.
- Schedule II drugs should be moved to a locked, secure place. A safe may be used but is not required. Other products such as prescription drugs should be moved, if possible, above the floor level and covered with waterproof materials.
- It may be necessary to complete a loss form – DEA 106 and/or disposal form DEA 41.
Pharmacies are also required to report within one business day the theft or significant loss of controlled substances to the Board of Pharmacy according to 465.022 (11) (b).
The mailing address for the Board of Pharmacy is 4052 Bald Cypress Way, Bin C-04, Tallahassee, FL 32399-3258. The fax number is (850) 413-6982. It is recommended that anything sent to the Board include a confirmation of receipt.
- If prescriptions have been dispensed while the computer is disconnected please note that the code of federal regulations for controlled substances has policy on what needs to happen. That policy defined in CFR 1306.22 states as follows:
“In the event that a pharmacy which employs such a computerized application experiences system down-time, the pharmacy must have an auxiliary procedure which will be used for documentation of refills of Schedule III and IV controlled substance prescription orders. This auxiliary procedure must ensure that refills are authorized by the original prescription order, that the maximum number of refills has not been exceeded, and that all of the appropriate data are retained for online data entry as soon as the computer system is available for use again.”
Regional DEA Offices
2100 North Commerce Parkway
Weston, FL 33326
Diversion Number: (954) 306-4650
Diversion Fax: (954) 306-5351
Diversion Program Manager Fax: (954) 306-5352
Diversion Program Manager - Susan C. Langston, (954) 306-4651
GS Gayle W. Lane, (954) 306-4654
TDS ASAC Kevin L. Stanfill, (954) 660-4611
TDS GS Jeannette G. Moran, (954) 660-4654
Jurisdiction: Broward, Charlotte, Collier, Glades, Hendry, Lee, Miami-Dade, and Monroe
JACKSONVILLE DISTRICT OFFICE (reports to Tallahassee RO)
4077 Woodcock Drive, Suite 210
Jacksonville, FL 32207
Diversion Number: (904) 348-7415
Diversion Fax: (904) 348-7433
GS Steve Utt, (850) 350-7355
Jurisdiction: Baker, Clay, Duval, Flager, Nassau, Putnam, and Saint Johns
ORLANDO DISTRICT OFFICE
Heathrow Business Center
300 International Parkway, Suite 424
Heathrow, FL 32746
Diversion Number: (407) 333-7046
Diversion Fax: (407) 333-7056
GS Linda A. Stocum, (407) 333-7006
TDS ASAC Jeffrey T. Walsh, (407) 333-7096
TDS GS Jae W. Chung, (407) 333-7007
Jurisdiction: Alachua, Bradford, Brevard, Columbia, Dixie, Gilchrist, Hamilton, Lafayette, Lake, Levy, Marion, Orange, Osceola, Seminole, Sumter, Suwannee, Union, and Volusia
TALLAHASSEE RESIDENT OFFICE
1510 Commonwealth Business Drive
Tallahassee, FL 32303-3170
Diversion Number: (850) 350-7350
Diversion Fax: (850) 575-0724
GS Stephen L. Utt, (850) 350-7355
Jurisdiction: Bay, Calhoun, Escambia, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Okaloosa, Santa Rosa, Taylor, Wakulla, Walton, and Washington
TAMPA DISTRICT OFFICE
4950 W. Kennedy Blvd, Suite 400
Tampa, FL 33609
Diversion Number: (813) 287-5160
Diversion Fax: (813) 287-4766
GS Roberta E. Goralczyk, (813) 287-4767
TDS ASAC James F. DiCaprio, (813) 287-4777
Acting TDS GS Steven Genevish, (813) 282-4462
Jurisdiction: Citrus, DeSoto, Hardee, Hernando, Hillsborough, Manatee, Pasco, Pinellas, Polk, and Sarasota
WEST PALM BEACH RESIDENT OFFICE
444 West Railroad Avenue, Suite 500
West Palm Beach, FL 33401
Diversion Number: (561) 653-4050
Diversion Fax: (561) 832-9016
GS Heather A. McMurry, (561) 656-5809
TDS Number: (561) 656-5842
TDS Fax: (561) 656-5802
TDS ASAC John J. McKenna, (954) 489-1995
TDS GS Thomas Redpath, (561) 656-5851
Jurisdiction: Highlands, Indian River, Martin, Okeechobee, Palm Beach and St. Lucie Counties
Important FL Statutes for Emergency Preparedness and Natural Disasters
465.0275 - Emergency prescription refill
252.358 - Emergency-preparedness prescription medication refills
465.019 (2) (b) and (4) - Support by institutional pharmacies during a declared state of emergency