HEALTH, WELFARE AND STATE INSTITUTIONS. Minutes of Meeting - April 18, '75

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1 HEALTH, WELFARE AND STATE INSTITUTIONS Mnutes of Meetng - Aprl 18, '75 ').,o u,:) The twenty-thrd meetng of the Health, Welfare and State Insttutons Commttee was held on Aprl 18, 1975 at 12:00 p.m. n Room 323. COMMITTEE MEMBERS PRESENT: Charmah Lee E. Walker Sena t.o_t: Neal Senator Gojack -S~nato.rHerr Senator Hlbrecht Senator Schofeld Senator Young A.B Revses chld abuse and neglect statutes. Mr. Orvlle Wahrenbrock requested that Secton 3 be deleted and that the remander of the bll be passed. Senator Gojack moved "Do Pass" as amended, seconded by Senator Herr, moton carred. A.B Apportons dutes respectng medcal or remedal care rates between state welfare board and state welfare admnstrator. Mr. Bll Hadley, State Welfare, advsed that they ntroduced ths bll to brng t.n lne wth other sectons -?bf the law regardng rate settng. Senator Schofeld moved "Do Pass"; seconded by Senator Young; moton carred. S.B Provdes for regulaton of retal sale of convenence drugs. Mr. George Bennett, Secretary for State Board of Pharmacy, advsed that the reason for ths bll s that they fnd durng ther nspectons that many stores such as grocery stores, lquor stores, etc. that sell drugs have these drugs stored mproperly. Mr. Bennett referred to drugs beng stored n drect sunlght or certan drugs requrng refrgeraton beng stored on shelves. Mr. Bennett commented that usually upon contactng the manager of the store and advsng them of mproper storage, they are happy to remove them from the shelves; however, Mr. Bennett further commented that they do not have the money to do ths. Ths bl would protect the consumer and also regulate the people who store and sell these drugs. Mr. Bennett referred to a publcaton enttled "Survey on Pharmacy Law" and provded the commttee wth an excerpt from ths publcaton whch ndcates that 34 states have such a drug lcensng law (see Exhbt A). Senator Walker commented that Secton 7 be deleted from ths bll snce t s contaned n S.B. 460; Mr. Bennett concurred.

2 Health, Welfare and State Insttutons Mnutes of Meetng Aprl 18, 1975 Paqe Two Senator Gojack asked what the total charges would be per year to the store - how many could be overlappng charges to one person. Mr. Bennett repled none. Mr. Bennett advsed that ths would enable them to go back and check the tme, date stamp, etc. Senator Walker asked f they would adopt regulatons that would keep the drugs from beng placed n the sunlght; Mr. Bennett advsed that ths may be done n the way of an nformatve letter to the people who carry drugs. Senator Walker asked what the pror opposton to ths bll wa~; Mr. Bennett repled that the Propretary Assocaton felt that they mght take these drugs off the sundry outlet. Mr. Bennett further stated that they just wanted to carry out ther nspectons and nform people of possbly storage problems. Senator Walker referred to page 1, lne 16, and asked the purpose of ths language. Mr. Bennett repled that t refers to prescrpton drugs, such as narcotcs, whch can't be n such stores anyway. Senator Gojack suggested that page 1, lne 21 be amended to read: " wthout prescrpton" (the remander of the sentence should be deleted).,s'.b Makes varous changes relatng to pharmacsts and pharmacy. Mr. Robert Groves provded the commttee wth proposed amendments to ths bll (see Exhbt B for amendments). Mr. Groves advsed that the bll came out of the bll drafterrs offce wth a number of changes that were not n ther orgnal draft. Senator Walker referred to amendment #1 and felt that perhaps ths would be settng them up as an nvestment agency. Mr. Bennett repled that they don't have that authorty. By June 30th, they have the maxmum amount n the treasury - most of the fees come n wthn two months and these are used up durng the year. They nvest on days. Mr. Bennett agreed that "st~te bonds" may be deleted on lne two of ther proposed amendments. Mr. Bennett referred to page 3, lne 27 and advsed that n the past they have had accounts wth savngs and loan assocatons, but n the last year they have purchased treasury notes for several months -- ths wordng on page 3 would prohbt them from dong ths. Senator SchofelQ asked how much more nterest they receve on treasury notes; Mr. Bennett repled that last summer t was 9.55% on treasury note whle t was 5 1/4% n savngs and loan Senator Walker asked how they handle contnung educaton. Mr. Bennett advsed that they have had consderable expense snce ths began July 1. Mr. Bennett further commented that they do not produce the contnung educaton programs - they merely montor the qualty - ths comes out of the general fund. Ths allows them to do somethng

3 Health, Welfare & State Insttutons Mnutes of Meetng Aprl 18, 1975 Page Three that s suggested by federal legslaton. Mr. Bennett referred to Secton 3, lne 10, page 1, and advsed that they have occason to fnd someone who has psychatrc problem or njured n an accdent, and f that person s able to meet the requrements they have tp relcense hm. They have no authorty to ask that he have an examnaton. At the Board's expense, they would lke to refer hm to a psychatrst. Mr. Groves advsed that there s a provson that an examnng physcan must report and the person beng examned then has the opportunty to seek ndependent medcal examnaton. - Senator Schofeld felt that whenever a pharmacst feels that there s ncompetency, he should be able to show proof of s,1ch ncompetency. 1 Mr. Groves suggested that we put n the requrement of showng "good cause". Senator Walker suggested that n order to conform wth other requrements for fndng of ncompetency that we have, we should also state that once the determnaton for ncompetency has been made, the person should be examned by two physcans. Mr. Bennett agreed. Senator Walker referred to page 2, lnes , and felt that ths determnaton should be left to the mental health authortes; Mr. Bennett repled that the Board does not want to determne mental competency. Senator Herr expressed concern wth the possblty of only one person makng a determnaton and asked f ths would be the only wtness requred. Mr. Bennett advsed that ths would be only hearsay and they would have to nvestgate such reports. Mr. Bennett advsed of the followng techncal changes: Secton 5, page 2, lne 24, change "shall" to "may"; Secton 6, page 2, lne 43, change "shall" to "may";. Secton 7, page 3, lne 8, has been changed from $25 a day because they are now forced to go for hearngs at a specfc place where they cannot use cheaper lodgng. Senator Walker advsed that a bll has been passed that would standardze all travel for all. Mr. Bennett asked f ths was S.B f so, Mr. Bennett feels ths relates to salary only. Senator Walker advsed that he would check on ths. Mr. Bennett referred to Secton 9, page 3, and advsed that the Board lcenses people out of the State of Nevada and some out of the U.S. They are now requred to notfy everyone of a Board meetng and they feel t s an unnecessary burden to have to ncur the expenses of postage. They would lke to gve some type of general notce, such as a notce n the newspaper, a newsletter, etc. Mr. Mdmore requested that the word "regular" on lne 45 be deleted so that ths would apply to specal as well as regular meetngs Wth reference to page 4, lne 22, Mr. Bennett commented that they would lke ths changed to "bennally" n order to conform wth many other states; also, most of ther out-of-state members are from Calforna and ths conforms wth Calforna statutes.

4 Health, Welfare and Stat~ Insttutons Mnutes of Meetng Aprl 18, 1975 Page Four. Mr. Bennett referred to page 4, lne 30, and advsfd.that they, want to set forth n the law what the passng grad\uf are on :ther exam.naton snce there has recently been confuson as to what' -Ls a satsfactory grade to pass. Mr. Bennett advsed t;hat page 4, lne.3.8 has been.cbangaa.n order to conform wth the Natonal J\.ssotlatox of Pharma y;who clvse -l: '5'&&.~. Sharon Greene referred to page 10, subsecton' 3., \and felt th11 sho.uld nclude the wordng ".mmedately after carng for the patent" snce t s not realstc that the nurse would have to sgn the nventory sheet pror to carng for a patent f t were. an emergency. Wth respect to lne 48, pag~ 10, Ms. Green cqmroent.ed that n.y t;,tfbes. there s only one regstered nurse on duty.at one tme '.'"'~.th11 would 1 cause problems f there were two emergency patents n tna.t s~e could. only work on one at a tme. A possble soluton to ths sect.oc would be to add the wordng nunless drected by them", m&b:~ngtbe physcan or regstered nurse. The areas on page 10 that.ms. >G»eene feels need amendng are subsectons 3, 4 add 6. Senator Walker advsee t:hat testmony on s.. B. 459 and s.. a., 46t wll be contnued for Tuesday, Aprl 22, S.B Prohbts denal of hosptal prvleges to certan podatrsts solely because of ther. professon. Senator Schofeld moved "Do Pass 11 Young;.moton carred. and amend; seconded by Sena:f=;or Beng no further busness at ths tme, the meetng was adjourn,ed at 2:00 p.m. APPROVED: -Respectfully submtted, ~ ;Jl.-4,:d«J Sharon w. Maher, Se:cratar,y'_ :.tee E. Walker, Charman

5 . ">'' ~-~ I. LICENSURE DRUG DISTR1 3 t-f.. /;I""':, EQJ IREMENTS FOR (Y-'v"_rv1 u 10N oju Mn mum Stan dards Pharmacy Equp of Permt New Annual ment Re- Permt Fee Requred Fee RenewalR qured Alabama... $50, A 2 Alaska 50. T 1,. 2 Ar_7;<1nj.,...,,., M ~.. ~-.--~ 4'- : 'Jlrllllrsfs... 2::>. 8 '1, 2 Calforna Colorado 100. l, 2 Connectcut E 1, 2 Oela..yare Dst. of Col.... l 5. A Florda... 1 Georga A 1 Hawa Idaho A Illnos Indana Iowa 1, 2 Kansas U Ken~u.cky... Lou,s,ana A 40. A Mane. 1, 2 Maryland B 1. 2 Massachusetts a.p Mchgan I, 2 Mnnesota A Msssspp A Mssour A Montana.... ;20. A Nebraska l, 2 Nevada 50. B New Hampshre.. 1, 2 New Jersey A 100. G 1, 2 New Mexco... 1, 2 New York 60. A 60. F rth Carolna A rth Dakota... I, 2 Oho A , 2 Oklahoma 35. B 1, 2 Oregon B I, 2 Pennsylvana B Puerto Rco... 1, 2 Rhode Island A 20. A South Carolna A South Dakota J, 2 Tennessee A 1, 2 Texas , 2 Utah 5. Vermont A 1, 2 Vrgna A 1, 2 Washngton AH 1 West Vrgna F 1, 2 Wsconsn A Wyomng FOOTNOTES: 1 - Lcense requred to manufacture drugs. 2 - Lcense requred to wholesale drugs. A - t transferable. B - Transfer fee same. C -Transfer fee $1.00 D - Transfer fee $5.00 E -Transfer fee $15.00 F - Transfer fee $25.00 G - Transfer fee $50.00 H - Plus $10 for prophylactc fee I - Only to dealers located remote from a pharmacy. K- Drugs saleable desgnated by law, Arzona $25.00 annual patent and propretary permt; N. M. all pro pretary OTC except controlled stances n Schedule V sub- 21 $ 2.,-5,,fu ~ 50. D 35. lc F x 30. T x x 125. U 40. O x 50, 50.A x T HS x 65, pf-~ Outlets Other than Pharmaces Phar lcensed macy to Sell Inspected Drugs Packaged An Saleab:e Annual nually Drufs Fee lc y xv h "l. K 5. L K L K L K "'~ N K 100. L K L L 5 L 10.T K L 3.H L 15. K Kl K L KL 15. L 15 L - Drugs saleable desgnated by Board, Arzona $5.00 lfetme general dealer permt. M- Examnaton gven applcants. N - Lousana Bd. Health Lcense products of Mfg. o- Mnmum standards of equpment desgnated by Board except n Lousana where t s by law. P - Massachusetts permt fee-bennal R-Average renewal fee "$32.00 S -Addtonal $ Controlled Sub stances Act T-Bennal U - Regstraton under Controlled Sub stances Act ncluded. V - Twce a year. I, l I - l d 334 l, '. lr., I :;., :1 tr ' ' l ( ;,, :,; '.;,:, L.. 1' I:' EHIBIT A -

6 - I. II. rrr. IV. V. VI. VII. VIII. PROPOSED Al'1ENDMEN~S TO S.B Add to Sec. 2, subsecton 1, authorty for.the board to nvest ts moneys n Unted S.tates or state 'bonds- or treasury notes.. Amend Sec. 7, subsecton 4(b), to read as follows: Actual expenses for subsstence, lodgng and transportaton whle travel.ng on busness of the board. Amend Sec. 16, subsec.ton 1, lne 39, to provde that the bennal renewal fee shall be not more than $ The suggested new language to become NRS , subsecton 2, whch appears at page 7, lnes 11 through 14, should be deleted because t s contaned n S.B. 248, whch has been passed and approved. Delete all of Sec. 21, except the new language commencng on page 9, lne 41 through lne 44. Amend Sec. 18 by deletng the words "that he s u7.able properly to perform hs dutes" whch appear on page 8, lnes 8 and 9. Delete Sec. 25. Add a new secton, to read as follows: pharmaceutcal manufacturer's servce representatve or detal man may possess or dstrbute_any prescrpton drug or sample thereof, unless he has frst appled for and obtaned a permt from the board to do so. Add a new secton to make the act effectve upon passage and approval. EHIBIT B