LEGISLATIVE STEERING COMMITTEE AGENDA - Wacounties.org

POLICY FACT SHEET
current practice is that an RN fulfills this role by assessing the patient and any relevant laboratory results; may or may not consult
with the physician Health Officer while the patient is there or after the fact; determines if the patient meets criteria establish by
the physician Health Officer; if so, implements treatment protocols developed by the physician Health Officer; and provides the
patient with a prescription signed by the physician Health Officers for the patient to take to a pharmacy or calls in a prescription
to a local pharmacy on behalf of the physician Health Officer or pursuant to a valid prescription signed by the physician Health
Officer, selects medications from the clinic stock, adds the patient name, and gives them to the patient with instructions for use.
Currently in some cases, some or all of these steps may also be executed by a Disease Investigation Specialist (DIS) or other
public health professionals.
This problem is not unique to public health. It is prevalent through the healthcare system
Problem 2 – Dispensing in the public health context
In RCW 18.64.011, the definitions for “dispense” and “distribute” are less than clear. Well intended health professionals in
different fields may construe them differently and as a result they are not applied uniformly.
Timely access to pharmaceuticals is an important component in achieving the public health goals of prevention, early detection
and swift response to communicable and infectious disease and other health threats. In the public health context, assuring that
patients receive medications at the time of their visit (encounter with the public health system) is essential to minimizing
treatment failure and thus providing the most protection to the patient and the public. This will prevent more disease and more
unintended pregnancies than approaches that delay access to pharmaceuticals and risk treatment failure due to lack of patient
follow-through and patients never beginning treatment.
This dispensing problem is unique to public health because of the “immediacy” – the need to give patients medications at the
time they are seen in order to protect the health of the public; because if a patient is sent away to a pharmacy and they don’t go
or for some other reason don’t get or complete the treatment, this endangers the health of the public.
Solution:
Clear statutory authority that provides consistency for pharmaceutical prescribing and dispensing in public health agencies.
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