The Senate was ready to pass a bill modifying the state’s controversial prescription drug monitoring program but Senate Majority Leader Diane Rosenbaum, D-Portland, pulled the bill unexpectedly after some Democrats objected to provisions that would have allowed public health officials to receive identifiable prescription information about Oregon patients, including their names.
Even one of the chief sponsors of Senate Bill 626, Republican Sen. Jeff Kruse of Roseburg, was surprised at the move: “Their caucus has issues with it. I’m not quite sure [the problem],” Kruse said. “Hopefully we can resolve the issues.”
Another chief sponsor, Sen. Alan Bates, D-Medford, told The Lund Report he wanted his own bill sent back to the Senate Health Committee to strip SB 626 of the language that could create a privacy breach, admitting he had not read the bill closely before it passed the committee last week.
Bates said he wanted county and state public health officials to get information from the program that broke data down by gender, age, race and locality but did not want anything that could expose private health information to a non-provider like an epidemiologist.
“That’s the camel’s nose under the tent -- pretty soon it’s out there,” Bates said. “I don’t want somebody checking on their brother or sister or starting some witch hunt.”
While the details of the bill escaped Bates, they did not miss the attention of the American Civil Liberties Union of Oregon, which has long been a critic of the program and has opposed regular attempts to expand the program.
“We can think of no legitimate interest that local public health officers would have to get such private information about their neighbors with whom they have no healthcare relationship,” said David Fidanque, the executive director of the state ACLU, in written testimony.
In her testimony, Oregon Medical Association lobbyist Courtni Dresser said that the identifiable information was sought to help county officials investigate possible drug overdose deaths, but she said her organization was concerned how the Oregon Health Authority would limit the use of such data.
Bates said that the patient privacy concerns were a key element when he helped draft the legislation implementing the system in 2009. The prescription drug monitoring program was established to help doctors flag patients who are abusing addictive drugs by shopping around to different providers, but the Oregon program has stronger firewalls than other states, which use their databases to police prescription drug activity. Oregon’s law requires police and law enforcement to get a warrant before accessing patient information.
The federal Drug Enforcement Administration has disregarded the state law requiring a warrant and lost a court case with the Oregon Department of Justice a year ago over the privacy breach, but the feds have appealed the judge’s decision to the 9th Circuit Court of Appeals.
Portland District Judge Ancer Haggerty ruled that forcing the DEA and police to get a warrant protected citizens against “invasive investigations on a hunch” -- as opposed to being based on probable cause of a drug violation.
Besides altering the information available to public health officials, SB 626 shortens the time frame for which pharmacists must enter data about controlled substances they dispense from one week to three days. The eventual goal is to provide real-time information to the database, but pharmacists have argued that the technology is not yet there to implement such a system.
Under objections from the Oregon Medical Association, the Health Committee had already stripped out a provision from the original SB 626 that would have required health practitioners to check the database before prescribing any scheduled drugs like opiates or benzodiazepines.
“The OMA does not support the mandatory use of the PDMP due to the PDMP’s complicated registration process and non-streamlined application in the physician’s workflow,” Dresser said.
SB 626 will return to the Senate Health Committee for amendments, and could be back on the Senate’s docket as early as next week.
How are drug adverse events tracked in Oregon? Is there one system for people on government-subsidized medical care and a different system for those who are not? The public at large has an interest in not paying for harm, is this correct? When auditing entities look at statistics for hospitals, what happens to that information? It used to be that some information was disclosed for nursing homes but very little for hospitals, for fear of hospitals' initiating lawsuits against the auditers. I cannot think of anywhere else in Oregon to ask this, other than of The Lund Report.
Mary Saunders