Cass County will participate in cooperative prescription-drug monitoring program

Cass County has joined dozens of other Missouri counties and cities in a cooperative program designed to prevent prescription-drug abuse.

The Cass County Commission approved an ordinance Nov. 9 starting a prescription drug monitoring program as well as an ordinance approving a three-year intergovernmental cooperative agreement with St. Louis County on a 2-1 vote at its recent meeting.

The county said it wants “to enact the development and administration of a program for monitoring the prescribing and dispensing of schedule II, III, and IV controlled substances by professionals licensed to prescribe or dispense such substances within Cass County,” according to the ordinance.

The drug-monitoring program the county has entered an agreement with is connected to the St. Louis County Department of Health, which has been operating and maintaining the program since April.

Cass County’s approval of the program to help combat misuse of prescription drugs comes four months after Gov. Eric Greitens signed an executive order to establish a state prescription-drug monitoring program. However, as The Kansas City Star reported this month, Missouri remains the only state without a database to track prescription drugs.

The Star also reported over the summer that Cass County had the highest rate of morphine milligrams dispensed per capita among counties near Kansas City, according to 2015 data from the Centers for Disease Control and Prevention.

Cass County Health Department Director Amanda Prough said this week in an email that Cass County has not yet received a “go-live” date from St. Louis County to start the drug-monitoring program. Prough said once the user agreement has been signed, it would take an average of three months for the program to be up and running.

“As a subscriber to the St. Louis PDMP, the Cass County Health Department will recruit providers through community outreach and engagement and we will be sent reports based on the data that is collected via the PDMP,” Prough said in an email. “We will not have access to any individual or any identifiable data.”

Cass County Commissioner Jimmy Odom, who brought the issue before the commission, said the county anticipates receiving grant funding to cover part of the cost of the prescription-drug monitoring program. Cass Regional Medical Center, which offered to pay the cost, estimates that the county’s participation in the program could cost between $5,000 to $7,000 per year.

Before its passage Nov. 9, more than two dozen speakers at the meeting voiced support and opposition to the prescription-drug monitoring program during the two-hour meeting.

The concerns of a group of citizens who spoke against the ordinances centered on individual privacy and governmental overreach with the implementation of a database tracking prescriptions. Some citizens also challenged the effectiveness of drug-monitoring programs currently operating in other states.

“I’m deeply concerned about our citizens’ constitutional rights to privacy to keep your medical information between you and the doctors,” John Webb said. “I’m in the computer business, that’s what I do professionally, and collecting of data creates your first problem as far as security goes.”

Those who spoke in favor of a prescription-drug monitoring program included CEOs and other representatives of Cass Regional Medical Center and Belton Regional Medical Center, a director with the Cass County Health Department, a newspaper reporter, a pastor, the county prosecutor, the county auditor, a retired registered nurse, a trooper of the Missouri State Highway Patrol, and a captain with the sheriff’s office.

A letter signed by U.S. Rep. Vicky Hartzler in June, which encouraged Cass County to register with St. Louis County’s existing prescription-drug monitoring program, was included in the agenda packet from the Nov. 9 meeting.

Cass Regional Medical Center CEO Chris Lang addressed commissioners during the meeting in support of a prescription-drug monitoring program on behalf of the hospital, the hospital’s board, and medical staff

“While this information is being gathered by your pharmacies, that is correct,” Lang said. “Your pharmacies already do have this information. What this is intending to do is set up an entity, an entity that is contracted that will bring the information together in one database that then the providers ... can then access with a protected password to basically gather that information and to determine in the best interest of that patient what should be done from that standpoint of those medications.

“And If you don’t think we have an opioid issue in Cass County, I would (invite) you to look at some of the statistics that are out there. ... Something has to be done if we’re going to address this crisis.”

Odom and fellow Cass County Commissioner Monty Kisner voted to pass both ordinances, while Presiding Commissioner Jeff Cox voted no.

Cox explained why he planned to vote against the ordinances.

“The crux of it for me is I do not see taking and collecting prescription drug information from our citizens and putting it into a government database — I don’t see that as within the scope of what county government is supposed to be doing,” Cox said.

In his comments before the vote, Cox also referenced a lawsuit filed in St. Charles County by United for Missouri and two St. Charles County residents. The lawsuit, which was filed in August, challenges the prescription-drug monitoring program as a violation of citizens’ privacy rights and as an unreasonable search and seizure, according to a report from the Associated Press.

This story was originally published November 16, 2017 at 1:08 PM with the headline "Cass County will participate in cooperative prescription-drug monitoring program."