The state board that oversees the licensing of pharmacies and pharmacists is one of the most important professional licensure agencies in Alabama, a group of lawmakers said Thursday.
“So many lives are at stake based on what (drug) is dispensed and how it’s dispensed,” said Sen. Sam Givhan, R-Huntsville, a member of the Legislature’s Joint Sunset Committee.
And a recent report about the finances and actions of the Alabama Board of Pharmacy is one of the most concerning Givhan and other sunset committee members have seen.
“I would recommend the board start working post-haste to remedy these issues, because the best scenario I see right now is a one-year review,” Givhan said about the future of the board.
The sunset committee has the authority to extend for multiple years the authority of dozens of state licensing boards that regulate various professions around the state, from athletic trainers to geologists.
The panel relies on reports from the Alabama Department of Examiners of Public Accounts, which regularly reviews the finances of state agencies. This week, the department’s review of the Alabama Board of Pharmacy highlighted 14 significant issues.
Those include charging some licensees higher fees than what’s authorized by law and using “deferral agreements” to allow pending violations to be dropped if the licensees pay higher fines. Others include violations of open meeting laws and a switch in 2023 to reporting money collected from fees and fines as miscellaneous income.
Committee co-chair Rep. Margie Wilcox, R-Mobile, said it will have more board hearings over the coming months and then meet to make recommendations to the Legislature on agency. Wilcox has been on the committee for four years and told Alabama Daily News she’s heard privately from people with concerns about the pharmacy board.
“Some committees it seems like we’re being real tough on, but when you have this many citizens contacting us, some of them scared to make themselves known publicly, that gives rise to concern,” she said.
The board regulates and collects fees and fines from more than 29,000 pharmacists, pharmacies and drug distributors.
Donna Yeatman, the board’s contracted executive secretary, said it had already begun working on the issues in the report.
“But I completely understand your sentiment,” she told Givhan. At various times during the more than 90-minute hearing, Yeatman invoked the office of the Alabama Attorney General, saying it had OK’d some of the board’s practices.
While the sunset committee has existed for decades, in the last year it flexed some authority, moving to disband the state massage therapy board because of significant management issues.
“I know this is the sunset committee, but there is a lack of sunlight in your program, in your department and in your board with the deferred prosecutions,” Rep. Matt Simpson, R-Daphne, said.
“Allowing for off-the-books resolutions of violations doesn’t give the public an accurate depiction of pharmacies and professionals. We have a duty to let the public be aware of what’s happening. Unfortunately, you guys are the front lines of facing the mental health problem and the opioid addiction and the problems that so many of our communities have. We rely on you to be able to protect the public.”
Yeatman said the deferred prosecutions were used when a violation wasn’t a public danger. For example, if a pharmacist failed to report a move to a different business within the required 10-day period, he or she could be fined $500. But instead of getting a permanent mark on their license, the pharmacist could instead pay $1,000 through a deferral process.
Yeatman said that process and others had been approved by the attorney general.
Rep. Kerry Underwood, R-Tuscumbia, asked about another finding in the report. It said the board was charging some companies amounts beyond set application fees during their application processes. Underwood said that didn’t look right.
“The optics are a pay-to-play kind of thing,” he said.
Yeatman said that often applies to out-of-state entities that have had violations elsewhere or a “facility where we have serious concerns about whether they will be safe.”
That vetting process is time consuming for the board, she said.
“I can assure you that every time we are looking at these, it is absolutely from the standpoint of, if it were my child or my grandmother who was going to receive (medication from this business), are they acceptable to do that? Do they have the qualifications and processes in place to take care of patients?”
The more than 90-minute hearing Thursday included public comments from nine people, five of whom asked the committee for more oversight of the board and four of whom spoke favorably about it.
James Jones, a pharmacist from Prattville, called the board “proactive in the profession.”
“(They are) always professional, always courteous and always nice to us,” Jones said.
“… This board is driven by a moral compass.”
Joseph Kreps, a Birmingham attorney who has spent several years filing open records requests with the board to obtain financial information, accused it of retaliating against him and his clients.
“Reforming this board’s composition is crucial for maintaining proper checks and balances,” Kreps told lawmakers.
Wilcox asked Yeatman about a decrease in pharmacists passing required exams after college. Wilcox asked other boards Thursday about barriers to employment would-be professionals have, especially if they’d paid for a college degree in the field.
Pharmacy graduates are required to take the North American Pharmacist Licensure Examination. Passage rates for graduates at both Auburn and Samford universities have decreased significantly since 2020.
“Do you have any insights into what’s happened from 2020 … to 2023,” Wilcox said?
Yeatman said both schools have “changed their process in how they teach” and that might be affecting the rates.
She also said remote learning during COVID-19 likely impacted students.
“Both schools are very invested in these numbers and are working very hard,” Yeatman said.
Speaker Pro Tem Chris Pringle, R-Mobile, asked the pharmacy board why it had no minority members. He asked similar questions to other boards that came before the committee on Thursday.
“I think boards need to do more to recruit minority people,” Pringle said.
Alabama Daily News’ Alexander Willis contributed to this report.