Sen. Kohl Says Pain
Relief Will Soon Be More Available to Senior Citizens in Nursing Homes
Chair of
Committee on Aging releases his hold on nomination of DEA head after
help from attorney general
Dec. 22, 2010
The chairman of the Senates Special Committee on Aging says he has
received assurances from Attorney General Eric Holder that the
administration will help in changes to the Controlled Substances Act
that will allow faster delivery of pain medication to nursing home
patients. Sen. Herb Kohl (D-WI) says he will now stop blocking the
nomination of a new head for the Drug Enforcement Agency.
Sen. Kohl
released his hold on the nomination of Michelle Leonhart, tapped to lead
the DEA.
Earlier this
year, Kohl brought attention to the unintended consequences of the
DEA's heightened scrutiny of prescribing practices in long-term care
settings at an Aging Committee hearing on the topic.
According to
sources within the long-term care industry, vulnerable patients have at
times been left to languish in pain as nursing home nurses and doctors
strive to adhere to the Controlled Substances Act. After numerous
failed attempts to work with the DEA on the issue, Kohl placed a hold on
Ms. Leonhart's nomination earlier this month.
"Attorney
General Holder assured me that he would be personally responsible for
promptly seeing this matter through the review process both at the
Justice Department and administration-wide, said Kohl.
Based on our
agreement, I am releasing the hold on Michele Leonhart's nomination, and
I look forward to introducing a mutually acceptable legislative fix in
the opening days of the 112th Congress. Time is of the essence for
nursing home residents who need immediate pain relief.
As part of the
agreement with General Holder, the Department of Justice (DOJ) will
deliver draft legislation to Senator Kohl in January outlining certain
changes to the Controlled Substances Act.
The legislation
will deem certain nurses or other licensed health care professionals,
who are designated by the nursing home as agents of DEA-licensed
practitioners (practitioners being the resident's attending physician or
specialist), as authorized to transmit the practitioner's order for a
controlled substance, specifically Schedule II drugs, to DEA-licensed
pharmacies, either orally or by fax.
In exchange,
nursing homes, practitioners, and pharmacies will be required to take
certain steps to verify their accountability.
Background on
the dispute
An Aging
Committee investigation earlier this year found widespread confusion
among nursing home providers, who are trying to change their protocols
to adhere to DEA's expectations with little to no compliance assistance
from the agency.
More
disturbingly, according to Kohls office, the Committee has received
numerous reports from throughout the country of actual harm to nursing
home residents who remained in unrelieved pain for hours or even days.
At an Aging
Committee hearing in March (click
to a report on the hearing), panelists detailed a recent enforcement
initiative launched by the DEA that has caused many nursing home
patients to experience serious delays in receiving the medication they
need to control their pain. A number of pharmacies, including several
in the Midwest, are facing huge administrative fines from DEA because
they dispensed drugs based on doctors' verbal orders, instead of
obtaining written prescriptions directly from the physicians.
At Ms.
Leonhart's nominating hearing before the Judiciary Committee in
November, Kohl expressed his disappointment that the DEA had not
followed through on the pledges it made to the Aging panel, and stated
that he would like to see significant progress on the issue prior to her
final confirmation.
Kohl said he
also mentioned to Ms. Leonhart that he had requested comments from DEA
on draft legislation back in August, and had yet to receive a response.
Senator Sheldon Whitehouse (D-RI) joined Senator Kohl in calling for a
more robust response from the DEA. Kohl and Whitehouse first reached
out to the DEA on the delivery of pain medication in nursing homes in an
October 2009
letter.
"At hearing, the
Deputy Assistant Administrator of the DEA assured me that your agency
would act quickly to solve this problem. And, when I met with you in
early May, you assured me that this was a priority and that you also
would address the problem swiftly," Kohl said at the nomination
hearing.
"It appears that
DEA is putting paperwork before pain relief. I would like to see much
more progress made on this issue before you are confirmed."
Kohl
acknowledged that due to his continuous pressure, the DEA finally
released new guidelines in October intended to reduce the delay that
some nursing home residents face in receiving painkillers.
Under the new
rule, physicians may now authorize nurses employed by long-term care
facilities to phone in their oral prescriptions for certain medications
to pharmacies. Unfortunately, the changes still do not give nurses the
ability to transmit prescriptions for other important medications,
including morphine.
Senator Kohl has
been working to craft legislation that would grant nurses, who are
charged with the day-to-day care of residents in nursing homes, with the
authority to call in orders for pain relief medication to pharmacies as
necessary following consultation with the resident's doctor, who in most
cases is on-site only periodically.
In other words,
nurses would be considered "agents" of doctors when placing orders for
controlled substances, including Schedule II drugs. The bill would also
create a federal registration category for nursing homes under the
jurisdiction of DEA, and would require nursing homes to certify that all
staff members have received anti-diversion training.
Nursing Home Abuse, Medical Malpractice? Contact a lawyer.
click here
Keep up with the latest news for senior citizens, baby
boomers
Dec. 22, 2010
The chairman of the Senates Special Committee on Aging says he has
received assurances from Attorney General Eric Holder that the
administration will help in changes to the Controlled Substances Act
that will allow faster delivery of pain medication to nursing home
patients. Sen. Herb Kohl (D-WI) says he will now stop blocking the
nomination of a new head for the Drug Enforcement Agency.