Hospice Doctors Seek Exemption From Florida’s Drug Database Requirement

Jan 14, 2019

Some hospice and palliative doctors are seeking a drug database exemption for terminally ill patients.

A Florida law that requires healthcare providers to check a statewide database before prescribing opioids went into effect last year.

House Bill 21 (HB 21), which went into effect last July, aims to control the use of drugs labeled schedule II or higher. These controlled substances include opioids, as well as painkillers that are deemed to have a high potential for abuse like OxyContin.

The law places a legal requirement on medical providers to check the Electronic-Florida Online Controlled Substances Evaluation Program (E-FORSCE) before prescribing a controlled substance to any patient over the age of 16.  

Dr. Ana Sanchez, Chief Medical Officer of Community Hospice & Palliative Care, is among those who want lawmakers to give doctors who care for dying patients an exemption from the database. She said she’s concerned it’s taking time away from patient care.

“It’s not about the burden of the process,” she said. “It is just precious time we need to dedicate to these vulnerable, fragile patients”

The state drug database is not new. The Florida Legislature first created the Florida Prescription Drug Monitoring Program (PDMP) in 2009.

PDMP required controlled prescribers to report to the database within seven days, but they didn’t have to check the database beforehand. HB 21 changed that.  

“Each time there is a change with that patient - the same patient, with the same provider - you’re still required by law to look up and query that date and query that database,” said Sanchez.

Sanchez said she acknowledges the opioid crisis, but said hospice and palliative care patients are not contributing to the problem. She said her patients are not vulnerable to physician shopping or diverting medication, which are some of the issues HB 21 is attempting the solve.

Sanchez said she does not have a problem with the database itself.  

“It’s wonderful to have that database, to go in and look at histories, prescribing histories, which is happening anyway,” she said. “But to have a delay when I am prescribing a medication that may be needed urgently by a patient is inappropriate for an end of life patient.   

Community Hospice & Palliative Care has about 1,300 patients on any given day, said Sanchez. The Jacksonville-based organization also serves 16 counties throughout Northeast and North Central Florida.

So imposing a legal requirement on prescribers to check the database every time takes away from patients who need urgent care, said Sanchez.  

“And if you fail to do so, it can be a misdemeanor,” said she said.

That is in part why Sanchez has joined a growing number of hospice and palliative care doctors that are asking lawmakers to give their terminally ill patients an exemption.