Health Department Reveals Ambitious Plan to Regulate Pain Clinics

The Sarasota County Health & Human Services Department hosted a meeting in the Fruitville Public Library on Wednesday evening to gather input on a bold set of ordinances intended to combat abuse of prescription drugs.

The meeting came just as the county’s one-year moratorium on new pain management clinics is set to expire on June 8. Wayne Applebee, Criminal Justice Policy Coordinator at the Health Department, explained that the moratorium was enacted in June 2010 as a temporary solution, while statewide initiatives developed. With those plans set back by legal challenges, the Board of County Commissioners tasked the Health Department with drafting new ordinances in their March 1, 2011 meeting.

The county's health department then . The ordinance, however, was delayed because commissioners felt the ordinance would only hurt legal clinics and not deter illegal activity. The BCC then said the county should extended the moratorium another six months while the county gets input from the public and has time to sift through new state pain management laws. 

Physicians, the families of prescription drug abuse victims and representatives from the sheriff’s office were among the event's 30-plus attendees Wednesday night. Participants were asked to write comments on notes that they would then stick to the wall. There was no public session, however, and participants were largely left to discuss concerns amongst themselves -- leading to heated exchanges in several instances.

Applebee explained that the floor was closed in an effort to prevent arguments, due to the contentious nature of the subject.

The proposed ordinances will be presented to the Board for approval at their June 7, 2011 meeting. The public will have the opportunity to present comments at that meeting. County staff is requesting a continuance to June 28 for a decision about the extension of the temporary moratorium on new occupational licenses/business tax receipts for new pain management clinics.

The Ordinances

As drafted, the ordinances grant the BCC the right to put pain clinics on probation -- though the nature of this probation is not defined -- or to revoke their licenses.

A wide set of criteria is defined, including the following:

• “Any person with authority to issue prescriptions” at a clinic being convicted of a crime.
• Failure to allow Code enforcement officers to inspect, and to provide newly required personnel and operational records.
• Neglecting to confirm the identity of each patient seen
• Failure to prohibit loitering on the clinic’s premises, including neighboring properties, and the failure to prohibit the cueing of vehicles.

Code enforcement offices are empowered to seek warrants, subpoenas, injunctions, or issue citations, with no limits specified.

Pain management clinics are also prohibited from occupying the same property as pharmacies, as well as accepting cash only. Proposed limits would prevent clinics from operating on Sundays and staying open past noon on Saturdays.

Bones of Contention

Dr. Jack L. LeFrock of Above & Beyond Pain Management & Laser Center worried that the proposed record-keeping measures are not going to truly solve the problem. What is really needed, he said, are more ambitious measures such as MRI requirements before prescribing methadone, and global databases based on identification numbers.

A number of other comments were submitted, though many were tacked to the wall immediately before the meeting’s end in order to avoid public scrutiny.

The Problem

The Health Department notes that Florida is the largest of the 16 states that have not adopted a prescription drug-monitoring program. Sarasota ranks 8th in the state for unintentional poisoning deaths, and the county mortality rate for residents aged 20-24 is 2.5 times greater than the state rate. Sarasota’s Addictions Receiving Facility indicated a 147 percent increase in benzo/opiate related patient admittance. In 2009, prescription drugs accounted for 86% of drugs identified as a cause of death by the District 12 Medical Examiner.