It takes so much effort for someone to become a professional pharmacist or pharmacy technician. Pharmacy professionals go through extensive and difficult training, a grueling examination, and a thorough a tedious license application process. So much hard work and dedication is why it is so painful to lose your license after a serious complaint has been reported against you. In severe scenarios, you can lose your ability to work as a pharmacist or continue with your business. If you are in such a situation, you need a professional license attorney to help you protect your license, your livelihood, and reputation. Get in touch with us at The Legal Guardian for top-notch legal services if you are a Long Beach pharmacist or any other healthcare professional facing disciplinary actions from your healthcare professional licensing board.
Professional Roles of Pharmacists and Pharmacy Technicians
Pharmacists and pharmacy technicians are unsung, yet critical members of the healthcare profession. Their services are vital in ensuring that patients get the right medication and advice regarding the drugs that they have been prescribed. Below is a bird’s eye view of the professional roles of both pharmacists and pharmacy technicians.
Dispensing prescription is a role that involves as much clerical work as actually dispensing drugs to patients. Pharmacists are responsible for counting out the correct tablets, properly preparing bottle labels, precise logging & documenting, and carefully handling medications for patients. Pharmacy records are medical records and errors can be very costly.
Communicating with the Prescribers
Sometimes prescribers, specifically doctors and other clinicians, write the wrong prescriptions without their knowledge. When there is any doubt or question, it is the pharmacist's responsibility to confirm with the provider whether the prescribed dosage or formulation is suitable for the patient’s condition. It is simply not enough to fill every prescription that is written. When it comes to the myriad medications that treat, or even cure, the ailments we face today, the pharmacy is the last line of assurance in a very complex healthcare system. Where there is any doubt or a more appropriate – or cost effective – solution, pharmacy professionals have a responsibility to question a particular brand of drug a doctor has prescribed and whether there is a generic equivalent of the name-brand prescription.
Ensuring the Safety of a Patient
Patient safety is, perhaps the most important job of the Pharmacist – or any healthcare provider with a professional license. Pharmacists are responsible for checking every patient's medication whenever they want to get new or refilled prescriptions. Your pharmacy professionals have no margin for error when it comes to knowing how any given prescription may adversely affect every you and making sure that adverse reactions are mitigated if not avoided altogether. This is the best way that healthcare practice prevents potentially dangerous interactions between drugs.
Patients must be informed about the adverse reactions and interactions with other medications, food, beverages, and alcohol. Pharmacists and pharmacy professionals are tasked with the role of counseling patients on when and how they should take their doses, what patients can expect, and what to do in case of an adverse or undesirable reaction. Many pharmacists will even follow up with the patients to confirm whether the prescribed drugs are working and share tips on how to minimize their side effects.
Working with Patients on General Health
Maintaining health requires more than taking prescribed medications. A pharmacist can help patients avoid getting sick by recommending non-prescribed remedies, taking health supplements, and using natural health products depending on their condition. Also, they can advise patients to exercise and maintain a good diet.
Dealing with Insurance Companies
Pharmacists working in chains and independent pharmacies submit insurance claims and work with private insurance companies to ensure that they are paid. They also can resolve coverage denials to avoid having their patients go without medications.
The pharmacist's ultimate role is to ensure that the right drug, right patient, and right dose (popularly known as the "the three Rs") are delivered. Therefore, they commonly oversee or mentor pharmacy technicians, residents, and student interns in their respective tasks. Pharmacy owners and supervisors also have the responsibility for making the right hiring decision and enforcing workplace policies.
Performing Administrative Tasks
Everyone in a pharmacy must keep patient files up to date and ensure that the needed products are stocked and that reports are generated and filed. Pharmacy supervisors and managers may spend as much or more time on administrative tasks and duties as they do dealing directly with patients.
Pharmacy education is an ongoing, never-ending endeavor. Pharmacists have to continue their education courses to maintain and renew their licenses. Every pharmacy professional must constantly keep up to date with drug approvals, product recalls, and medication changes such as dosage and warnings and interactions. Moreover, as frequent as changes are across the entire pharmaceutical spectrum, so too do laws and regulations and rules for Pharmacists change. Federal and state regulatory compliance is a perpetual challenge.
Pharmacy technicians have their own, very specific, responsibilities working so closely with pharmacists and patients. Most pharmacy technicians work under the supervision of pharmacists and, while commonly referred to as pharmacy aides or assistants, they are integral members of a much larger team. Most duties undertaken by pharmacy technicians overlap the responsibilities that pharmacists have, but they primarily perform clerical tasks by helping the pharmacists. Some of the responsibilities of a pharmacy technician are as follows:
- Fill bottles with the prescribed medication, apply labels and directions and other pre-packaging measures
- Handle cash register operations
- Call doctors for prescription or refill
- Resolve complaints made by customers
- Resolve issues related to the insurance coverage of the patients
- Keep detailed records of the medications on stock
- Produce labels for packages
California Disciplinary Guidelines Associated with Pharmacists and Pharmacy Technicians
In California, the Board of Pharmacy is responsible for enforcing statutes and regulations related to pharmacy practice and the regulation of controlled substances. Therefore, the Board serves the public in the following ways:
- Protecting the health, welfare, and safety of the people of California with integrity and honesty
- Advocating the highest quality pharmaceutical care
- Providing the best available information for pharmaceutical care
- Promoting education, wellness, and quality of life
The California State Board of Pharmacy recognizes, and takes very seriously, the importance of ensuring the safe and effective delivery of potentially dangerous drugs and controlled substances for medicinal purposes. When it comes to known abuse, current abuse, and diversion of drugs and controlled substances, the California State Board of Pharmacy takes a very strict view on violations.
The California State Board of Pharmacy, under the California Code of Regulations, has established disciplinary guidelines and a disciplinary process intended to protect the public. The guidelines should be and generally are followed in Board of Pharmacy disciplinary actions. Of course, all actions of the Board are subject to review from the judiciary.
The California State Board of Pharmacy will seek revocation of a pharmacy license when suitable grounds exist. When any discipline, certainly when revocation is sought by the California State Board of Pharmacy, every Respondent is entitled to due process and a hearing before an Administrative Law Judge and there are very specific procedures for making that happen. Pharmacy license revocation will automatically occur when the respondent fails to follow the procedure or file a notice of defense within the allotted time. For that reason alone, it is essential to hire an experienced professional licensure defense lawyer as early in the process as possible.
According to the Board's established guidelines, when a suspension is sought, as opposed to revocation, a thirty day minimum suspension is commonly sought for an individual and at least fourteen days for licensed premises. However, every case is unique and suspension lengths can vary.
Terms of Probation for Individual Licensee (Pharmacists, Advanced Practice Pharmacists, Intern Pharmacists, and Pharmacy Technicians)
The Board has established a minimum three-year probation period for most cases where probation needs to be imposed. If the Board has established that the case involves self-administration or diversion of controlled substances, dangerous drugs, or devices, the probation period could be a minimum of five years. The terms and conditions imposed on the probationers intend to allow him or her to demonstrate rehabilitation.
The conditions for probation are divided into two basic categories. The first category includes all of the standard conditions of probation – the conditions for all probationers. The second category includes the optional conditions, which depend on the nature and circumstances of each specific case.
Categories for Violations and Possible Penalties
The California Pharmacy Law has identified offenses for which the California State Board of Pharmacy should take disciplinary action against the license. There are four categories of violation which have associated recommended minimum and maximum penalties that apply to licenses issued to individuals working in the pharmaceutical industry. The categories are arranged in a particular order, starting with those that attract the least serious penalties and ending with those with the most serious penalties. This means that Category 1 carries the least serious penalties, while category 4 carries the most serious penalties. In a case that involves multiple violations, the appropriate penalty usually increases accordingly. If an individual has committed violations in more than one category, the minimum penalties shall be those recommended in the highest category.
Here is a more detailed view of the four categories that are used by the California State Board of Pharmacy.
A category one violation carries the penalties of revocation of your license and a two-year term of probation. All standard terms and conditions will also be included. The maximum penalty in this category is the outright revocation of your license. The kind of violations included in this category is less serious compared to Category 2 through 4. These violations include:
- Violation of record keeping requirements, inventory control requirements, and scope of practice requirements
- Small or isolated failures to abide by or enforce prescription refill requirements, drug-substitution requirements, or labeling requirements.
- Violating an obligation to supply or update the information to the Board or other enforcement agencies
- Failing to adequately supervise staff or ensuring security and sanitation of premises, dangerous drugs, and devices or controlled substances
- Violating packaging requirements, security control requirements and reporting requirements
- Violations that result from the misuse of their education, license privileges irrespective of whether the violation occurs outside the Board licensed entity
Under this category, the minimum penalty includes the revocation of your license and a three-year term of probation. Probation can be five-years if your case involves self-administration or diversion of controlled substances, a dangerous drug, a dangerous device, or alcohol abuse. All the standard terms and conditions must also apply when appropriate. The maximum penalty in this category is the outright revocation of your license. Category 2 discipline is recommended when there is a severe violation that has serious potential harm and involves a disregard for public safety. It also involves a blatant disregard of regulations regarding the distribution of dangerous drugs, devices, or controlled substances. Finally, it involves violations that reflect the ethics, competence, diligence, and criminal convictions that do not involve alcohol, dangerous drugs, controlled substances, and dangerous devices. These violations might include the following:
- Failing to abide by prohibitions on referral kickbacks or rebates and percentage-based lease agreement
- Violating advertising or marketing limitations, including the use of false or misleading marketing or advertising
- A repeat of serious violations related to record-keeping requirements, inventory control requirements, and scope of practice requirements
- Violating requirements related to controlled substance secure prescription, security requirements, and inventory control
- Failing to meet compliance requirements including pharmacists-in-charge or designated representative
- A small-scale dispensing or furnishing dangerous drugs or dangerous devices through the internet without a valid prescription
- Purchasing, trading, or transferring dangerous drugs or devices to or from an unauthorized person
- Gross immorality or negligence, incompetence, and excessive furnishing of controlled substances
- Criminal violations that do not involve alcohol, dangerous drugs, devices, or controlled substances
A category three violation can carry a revocation of your license, a 90-day suspension, and three to five years of probation. A five-year probationary period will most likely be ordered in cases of self-administration, abusive use of alcohol, and diversion of controlled substances or dangerous drugs. The maximum penalty for category three violation is the outright revocation of your pharmacy license. Category 3 discipline is recommended for violations with significant harm or serious effect compared to Category 2 violations. It also involves violations that involve willfully and knowingly violating laws or regulations related to dispensing or distributing dangerous drugs or controlled substances. Such violations are as follows:
- Violations that involve the creation, manipulation, or perpetuation of drugs shortages
- Failure to deploy or abide by the Drug Supply Chain Security Act requirements and other similar requirements needed for dangerous drugs or devices
- Violating your responsibility to ensure that there is proper prescribing and dispensing of controlled substances
- Dispensing or furnishing drugs without a valid prescription or to an unauthorized person
- Involvement in fraudulent actions that are connected with the licensee practice
- A repeat or serious unlawful possession of a dangerous drug, device, substance, syringes, hypodermic needles, and other drugs paraphernalia
- Forging prescriptions, passing or forging prescriptions or other unlawful means of acquiring dangerous drugs, controlled substances or dangerous drugs
- Failure to maintain records of acquisition or disposal of dangerous drugs or devices
Violation of category four of the disciplinary regulations will lead to the automatic revocation of your pharmacy license. Category four addresses the most serious violations of regulations involving the dispensing or distribution of dangerous drugs, devices, or controlled substances. Violations under this category might include the following:
- Violations that involve the possession, transportation, importation, or unlawful sale of controlled substances
- Repeated serious examples of conducts described in Categories 1, 2, and 3
- Violation of a governed self-administration of a controlled substance that creates a possibility of infection control risk
- Criminal convictions that involve abuse or diversion of alcohol, dangerous drugs, dangerous devices, and controlled substances
Challenging an Accusation by the California State Board of Pharmacy
Once you have been notified about an accusation filed by the California State Board of Pharmacy, you should immediately consult with and, if necessary, hire an experienced professional license defense attorney. It may be possible to negotiate a resolution that would limit the discipline imposed. If you cannot negotiate a settlement, your professional license defense attorney will request an Administrative Hearing before an Administrative Law Judge.
An Administrative Hearing is similar to an action in any other court, where there are lawyers, a judge, and a court reporter. Once the attorney for the California State Board of Pharmacy has presented their case, your professional license defense lawyer will have the chance to cross-examine the witnesses who testified against you and present mitigating or exculpatory evidence in your defense. The Administrative Law Judge is an independent party without any alignment with the California State Board of Pharmacy. As the Petitioner, the Board has the burden to prove that discipline is warranted or that you should not be allowed to retain your license.
Winning Your Administrative Hearing
Winning an Administrative Hearing is something of a moving target; winning is often defined and redefined by the facts and severity of any given case. Winning for one client can be drastically different from another.
Of course, it is possible to have your case dismissed if there is a lack of evidence before or at the hearing. The Administrative Law Judge will consider the following when determining the exact discipline to impose on you:
- Whether the patient or general public suffered any actual harm
- The degree of potential harm that existed because of the violation
- Previous professional discipline on board-issued warning you have received
- The severity of your allegations
- Any criminal record relevant to your ability to perform any professional duties
- Whether your conduct was out of gross negligence, incompetence, or recklessness
- Whether there is any financial benefit that results from the violation
Many professional license defense cases rely more on mitigation than anything else. For example, in cases where the licensee did the thing the Board alleged, mitigating evidence can persuade an Administrative Law Judge to propose a more lenient discipline or, in some cases, none at all.
Examples of mitigating evidence include:
- Written testimony from your coworkers, employer, or manager attesting to your competency; The statement should provide relevant period in which the incident occurred and should be signed under penalty of perjury.
- Letters from a psychologist, counselor, or rehab program administration that show the completion of your rehabilitation or corrective program
- Drugs or alcohol screening results that favor you
- Physical or psychological examinations that show your competency to resume your professional role
- A written statement from your probation or parole officer that shows your compliance with the court-ordered probationary terms.
Such evidence would help you get a license suspension or probation other than losing it. The probation period or conditions might vary, but your attorney can use mitigating material to help secure the most lenient penalties.
After the hearing, the Administrative Law Judge will make a determination about whether the alleged conduct was committed and, if so, whether and what type of discipline is appropriate based on the evidence presented.
Find a Professional License Defense Attorney Near Me
Just because the State of California Board of Pharmacy files an Accusation against you and seeks to revoke your pharmacy license does not mean they are right or that you should just give up without a fight. Consult with a professional license defense attorney and discuss options and possible defense strategies.
At The Legal Guardian, we have built a reputation of offering comprehensive and highly personalized legal services to clients facing disciplinary actions across the spectrum of allied healthcare professions in Long Beach and surrounding areas. For more information, contact us at 866-448-6811, and schedule a consultation.