Joint Subcommittee to Investigate Illegal Use of Ritalin and OxyContin and to Study ADD and ADHD
December 3, 2001, Richmond
At its third and final meeting, the joint subcommittee received an update on the activities of the Attorney Generals Task Force on Prescription Drug Abuse and developed its final recommendations.
Under consideration by the Task Force on Prescription Drug Abuse is a recommendation for the creation of a prescription monitoring system for Virginia to provide a center for data from pharmacies on all controlled substance prescriptions. Data collected would be identical to that already submitted for Medicaid and insurance purposes. The data would be available to law enforcement for open, ongoing investigations, but the system would not be used to identify aberrations or possible infractions. The anticipated start-up cost for such an initiative is over $1 million, with the Department of Health Professions the likely repository for this data. The prescription monitoring systems in Nevada and Kentucky have received particular praise among the various systems currently in place in 18 states. Also under consideration is increasing the penalties for distribution of Schedule III and IV drugs from misdemeanor to Class 6 felony.
Among potential recommendations discussed by the joint subcommittee were (i) amending the Code of Virginia to clarify current law regarding possession and administration of prescription medications in public schools and directing school boards to implement policies regulating student possession of their own prescription and nonprescription medications; (ii) directing school boards to adopt policies consistent with the Virginia School Health Guidelines promulgated by the Virginia Department of Health, in collaboration with the Virginia Department of Education, addressing the dispensing and storage of student prescriptions in the public schools; (iii) amending the Code to prohibit school personnel (or through school board policy) from suggesting that parents seek psychotropic medication for their child; (iv) increasing funding for the Virginia State Police Drug Diversion Unit and for methadone treatment centers; and (v) continuing the joint subcommittee for an additional year.
Recommendation 1: That § 22.1-279.3:1 of the Code of Virginia be amended to require reporting of theft of student prescription medications from students during school hours, on school property, at school-sponsored activities, or from school storage.
Action: Legislation amending the Code; no budget impact.
Testimony before the committee indicated that, at least in some school divisions, the principal decides whether to report a medication theft to law enforcement. These incidents are treated as property thefts. The Department of Educations September 2001 survey indicated thefts of medications had occurred at school; about half of the responding school divisions indicated they have no policy or procedure regarding stolen medications. The Code of Virginia already directs school principals to report criminal conduct involving alcohol and controlled substances to law-enforcement agencies; however, clarifying this provision to include thefts of student prescriptions held by the school may assist in detailing incidents of diversion and abuse.
Recommendation 2: That reimbursement for pediatric specialists at pediatric medical centers through Medicaid and FAMIS be increased.
Action: Budget amendment.
Recommendation 3: That the joint subcommittee endorse the efforts of the Attorney Generals Task Force on Prescription Drug Abuse regarding the implementation of an appropriate prescription monitoring system for the Commonwealth.
Action: Policy statement in final report.
The joint subcommittee applauds the efforts of the Attorney Generals Task Force regarding the feasibility and appropriateness of implementing a prescription monitoring system for controlled substances in the Commonwealth.
Recommendation 4: That the Special Advisory Commission on Mandated Health Insurance Benefits examine and encourage continuing education of third party payers regarding adequate reimbursement for behavioral evaluations and ADHD and study the feasibility and appropriateness of expanding reimbursement for child evaluations to address an appropriate range of mental health services, including comprehensive assessment by clinical psychologists, without tying such reimbursement to a specific, final diagnosis.
Recommendation 5: That the Department of Health, in collaboration with the Departments of Education, Health Professions, and Mental Health, Mental Retardation, and Substance Abuse Services, with the assistance of researchers with public health and education expertise, conduct a statewide epidemiological study examining the prevalence of methylphenidate use and ADHD diagnoses in the Commonwealth; that such study incorporate, among other things, consideration of (i) contributing factors to any such prevalences; (ii) any relevant nutritional and educational issues; and (iii) the identification of age-appropriate behaviors by education and health professionals; and that such study include the input of psychologists, physicians, and other health professionals.
Action: Study resolution and budget amendment.
Recommendation 6: That the governing bodies of the Commonwealths public and private institutions of higher education support increased student prescription drug abuse prevention and education programs on their respective campuses.
Action: Policy statement in final report; possible letter to institutions.