SHAC granted necessary licenses to dispense drugs

After being shut down for unlawful medication handling in January, the Portland State Student Health and Counseling Center is now operating under an interim plan for legally dispensing medication to students.

The plan allows for some medications to be dispersed by registered nurses, though doctors or nurse practitioners must still dispense other medications. A nurse practitioner is a registered nurse who has completed at least one academic year of a practitioner training program, according to the Oregon State Board of Nursing’s Nurse Practice Act.

The Center for Student Health and Counseling (SHAC) dispensary’s method of handing out medication was brought under legal review in January because nurses were dispensing medications that are illegal to distribute without a family planning or county health license.

Interim Director of SHAC Mary Beth Collins said that the clinic has since filed for and been granted both licenses, and that SHAC is currently retraining their nursing staff in accordance to the new licenses.

SHAC has also hired a consulting pharmacist, Susan Bliss, to fulfill family planning license requirements as well as to manage policy changes and nurse retraining. The current plan is only temporary, Collins said, and SHAC may decide to have doctors directly dispense some medications that regular nurses cannot during appointments.

“For now, our nurses can dispense the bulk of what we order to the clinic,” Collins said. “I’m hopeful that we’ll have a regular plan for our entire formulary in place by fall term.”

A formulary is the list of medication that a clinic orders and is allowed to dispense. Medications that cannot be dispensed by nurses include drugs prescribed for psychological and antidepressant purposes, Collins said.

“There are definitely some things on our formulary that can never be dispensed by our nurses, but other drugs just need to be available for students,” said Ashley Cooley, nurse practitioner and SHAC assistant director of health services. “It’s always been our intent to serve the students as timely and helpfully as possible.”

“Birth control in particular is something that we’ve kept in mind for students as we reorganize our policies about the dispensary, since that’s a drug that needs to be filled in a timely manner,” Collins said.

Collins said that medications for ADHD treatment and pain medications, such as Percocet and oxycontin, have never been carried by SHAC. Cooley said that SHAC isn’t likely to ever carry or dispense that sort of medication.

Collins said that the legal issues haven’t been a large concern, but she said that since the limiting of dispensary hours to two hours per day in January, SHAC has only handed out about two-thirds as many prescribed medications.

Currently, the dispensary window is open from 12 p.m. to 1 p.m. on weekdays.

Collins also said that she is concerned about the cost of medication for students, and that SHAC is able to help students save on a lot of common medications that may cost more through other clinics. Being a part of the university, Collins said, SHAC is able to order medication drugs at low costs through government health organizations.

“We like to pass our savings on to our student clientele,” Collins said. “There are some significant changes that we’ve made and we’re currently working out the concerns as best we can, but we still want to help students save money.”

Collins said SHAC recommends that if students cannot visit the dispensary window during the limited hours, they should visit a Safeway pharmacy, because they offer a matching policy on the cost of medication.

SHAC’s dispensary window is keeping limited hours during the summer for nurses to dispense some medication such as birth control and antibiotics, Cooley said. She also said that SHAC’s family planning license allows nurses to dispense those medications as long as a doctor or physician has prescribed them.

The family planning and county health licenses were granted in early June, Cooley said. The three boards that oversee SHAC–the state Board of Nursing, the state Board of Pharmacy and the Oregon Medical Board–all met with SHAC staff, once in January and once in April, before the interim plan was approved, Collins said.

“The concerns are more of a pharmacy thing, but (SHAC) seems to be doing well from a nursing standpoint,” said Barbara Holtry, public information officer for the state Board of Nursing. “The nursing practices at PSU’s clinic seem to be up to scratch.”

Collins said that no further concerns about SHAC’s practices have been raised at the Board of Pharmacy since the initial complaints, and the board has been very cooperative of the interim plan. Gary Miner, compliance director at the state Board of Pharmacy, was unavailable by press time.

“We’ve worked out the problems that we had and I’m hopeful that we’ll be back on track this fall,” Collins said.

“The boards have all been very supportive and easy to work with,” Cooley said. “I think we have a great relationship with all three boards.”