PURPOSE: This rule establishes guidelines for the operation of the Well-Being Committee, pursuant to section 338.380, RSMo.

1. (1) Definitions.

   1. (A) Board—State Board of Pharmacy.
   2. (B) Committee administrator—The person who is hired by the contractor or the committee to oversee and manage the Well-Being Program.
   3. (C) Contractor—An entity with whom the board contracts for the purpose of creating, supporting, and maintaining the Well-Being Program.
   4. (D) Impairment—An illness, substance abuse, or physical or mental condition suffered by a licensee that is reasonably related to the ability to practice pharmacy.
   5. (E) Licensee—Pharmacist, intern pharmacist, or technician licensed or registered in the state of Missouri or who has applied for licensure or registration in the state of Missouri.
   6. (F) Well-Being Committee—The committee established pursuant to section 338.380, RSMo, for the purpose of promoting the early identification, intervention, treatment, and rehabilitation of pharmacists, intern pharmacists, and technicians who may be impaired by reasons of illness, substance abuse, or as a result of any physical or mental condition.
   7. (G) Well-Being Program—The activities and functions of the Well-Being Committee.
2. (2) The board may contract with a contractor for purposes of creating, supporting, and maintaining the Well-Being Program. The Well-Being Committee may assist the board in the identification, selection, and evaluation of the contractor, as requested by the board. Operational costs of the Well-Being Program may be paid by the board, subject to available funding. All costs of drug screens and professional and administrative services provided to a licensee shall be paid by the licensee.

3. (3) Membership and Organization.

   1. (A) The Well-Being Committee (hereinafter committee) shall be composed of the committee administrator and three (3) appointed members as follows:

      1. 1. One (1) member designated by the

Missouri Pharmacy Association;

1. 2. One (1) member designated by the

Missouri Society of Health-System Pharmacists; and

1. 3. One (1) member designated by the

State Board of Pharmacy.

1. (B) The appointed committee members shall serve staggered three (3)-year terms and may serve as many terms as their respective organizations deem appropriate. The entity designating a member to the committee shall designate a person to finish the three (3)-year term of any member of the committee who becomes unable to serve.
2. (C) The committee shall annually elect a chairperson.
3. (D) The committee shall meet at least two

1. (2) times annually.

   1. (E) The appointed committee members shall serve without compensation other than that allowed by law for service as a board member. Each appointed committee member shall be entitled to reimbursement for travel expenses as deemed appropriate by the board.
   2. (F) The committee administrator shall be a nonvoting member of the committee.
2. (4) An impaired licensee may enter the Well- Being Program voluntarily or by referral of the board pursuant to a settlement agreement or other disciplinary order. Licensees entering the Well-Being Program voluntarily shall be subject to and shall comply with all requirements of this rule.

3. (5) Well-Being Committee Duties.

   1. (A) The committee shall oversee all aspects of the general operation of the contractor including, but not limited to, oversight of the administration, staffing, financial operations, and case management of the Well- Being Program.
   2. (B) The committee shall assist the board in monitoring the impaired licensee’s compliance with the terms of any disciplinary order/agreement.
   3. (C) The committee shall provide the board access to all information and documents pertaining to impaired licensees referred to the Well-Being Program by the board.
   4. (D) The committee shall enter into written contracts with each impaired licensee. The contract between the committee and the impaired licensee shall be a minimum of five

4. (5) years in duration, or the time designated by the board. The contract between the committee and impaired licensee shall include, but shall not be limited to, the following conditions/requirements:

   1. 1. Each impaired licensee shall comply

with all terms, conditions, or treatment identified, required, or recommended by the contractor or the board for the treatment, evaluation, monitoring, or assessment of the impaired licensee;

1. 2. Each impaired licensee shall abstain

from the possession or consumption of legend medication, except as prescribed by a treating prescriber;

1. 3. Each impaired licensee shall abstain

from illegal possession of alcohol, the consumption of alcohol, and the possession or consumption of illegal drugs;

1. 4. Each impaired licensee shall submit

to random drug testing unless otherwise specified by the board, committee, or contractor;

1. 5. Each impaired licensee shall report to

the committee or the contractor all relapses or other breaches of the contractual terms;

1. 6. Each impaired licensee shall report to

or meet with the board, committee, contractor, or the contractor’s appointed designee as may be requested by the board, committee, or contractor;

1. 7. Each impaired licensee shall attend

support meetings as requested by the committee, contractor, or treatment providers;

1. 8. Each impaired licensee referred to the

Well-Being Program by the board shall authorize the committee to release any and all information regarding the impaired licensee to the board;

1. 9. Each impaired licensee voluntarily

enrolled in the Well-Being Program shall authorize the committee to release any and all information regarding the impaired licensee to the board upon a violation of any state or federal drug law or if the licensee breaches or fails to comply with any terms of a Well- Being contract; and

1. 10. Each impaired licensee shall be

financially responsible for all drug screens and any other professional or administrative service rendered on behalf of the impaired licensee.

1. (E) The committee shall provide to the board in writing:

   1. 1. An annual action plan and budget to

be approved by the board. The committee shall report on progress with regard to preparing and implementing the action plan and budget as requested by the board or committee;

1. 2. Progress reports with regard to each

licensee participating in or being assisted by the Well-Being Program. The identity of licensees who voluntarily submit to the Well- Being Program shall remain anonymous to the board for purposes of these reports, except as otherwise provided by this rule. Progress reports shall be provided to the board at board meetings or upon request of the board;

1. 3. Except as otherwise provided by this

rule for voluntary participants, any and all information or documentation with regard to the identification, intervention, treatment, and rehabilitation of any licensee who participates in, or is assisted by, the Well-Being Program;

1. 4. Quarterly income and expense

reports. These reports must be itemized and account for all income from any and every source and each expense to any and every vendor that relates to the Well-Being Program in any way; and

1. 5. Any other report or information

requested by the board, except as otherwise provided by this rule for voluntary participants.

1. (F) In addition to the other requirements of this rule, the committee shall also report, in writing, to the board:

   1. 1. All licensee violations of board disci-

plinary orders/agreements, board statutes or regulations, or other state or federal drug laws which occur after the date of the disciplinary order/agreement or the date the licensee entered the Well-Being Program, whichever occurs first;

1. 2. Any licensee who fails to enter treat-

ment within forty-eight (48) hours following the provider’s determination that the licensee needs treatment;

1. 3. Any licensee who does not comply

with the terms of a Well-Being Program contract or who resumes the practice of pharmacy before the treatment provider has made a clear determination that the licensee is capable of practicing; and

1. 4. Any breach of contract by the Well-

Being Committee or the committee administrator.

1. (G) The identity of licensees who voluntarily submit to the Well-Being Program shall remain anonymous to the board, provided that upon receipt of a Notice of Non-Compliance from the contractor, the committee shall promptly file a complaint with the board against the licensee identified in the notice. The complaint required by this subsection shall include the impaired licensee’s name, license number, and the factual basis for the alleged contractual breach/non-compliance. Upon the filing of a complaint, the committee shall require the committee administrator to supply to the board any information or documentation with regard to the licensee’s identification, intervention, treatment, compliance, and rehabilitation, as requested by the board or their designated representative.
2. (H) The committee shall require the costs of drug screens and professional and administrative services to be paid by the impaired licensee.

1. (6) Committee Administrator Duties.

   1. (A) The committee administrator shall oversee and manage the daily operations of the committee and assist with the administrative duties of the committee.
   2. (B) The committee administrator shall possess a combination of education and experience in the area of addiction counseling and be currently licensed in Missouri as a psychologist, psychiatrist, professional counselor, or clinical social worker. Upon request of the committee, the board may waive the licensure requirements of this subsection for qualified applicants that otherwise possess an equivalent combination of education and experience, as required by this rule.

   3. (C) The committee administrator shall also be familiar with licensees suffering from impairment issues which include, but shall not be limited to, the following:

      1. 1. Dependency;
      2. 2. Alcohol addiction;
      3. 3. Drug addiction;
      4. 4. Other addictive diseases;
      5. 5. Physical issues; and
      6. 6. Mental health issues.

   4. (D) Upon referral, the duties of the committee administrator shall also include, but are not limited to, assisting the committee with the following:

      1. 1. Organizing and carrying out interven-

tions;

1. 2. Referring licensees for appropriate

assessment or evaluation and seeing that treatment recommendations based on the assessment are followed;

1. 3. Monitoring treatment progress and

re-entry contractual compliance;

1. 4. Managing/monitoring random drug

screens;

1. 5. Assisting licensees to re-enter prac-

tice from treatment;

1. 6. Assisting with aftercare issues;
2. 7. Any and all reporting to appropriate

agencies, as requested by the board or the committee;

1. 8. Program development;
2. 9. Outreach education, as requested by

the committee; and

1. 10. Other necessary services as deter-

mined by the committee.

1. (E) Upon request by the committee, the committee administrator shall supply to the committee in writing: 20 CSR 2220-2

   1. 1. Any information or documentation

regarding the operation of the Well-Being Program;

1. 2. All information or documentation

with regard to the identification, intervention, treatment, and rehabilitation of any licensee that is participating in or being assisted by the Well-Being Program or who has participated in or been assisted by the Well-Being Program;

1. 3. Progress reports to the committee

with regard to each licensee participating in the Well-Being Program; and

1. 4. Any reports provided to the board.

2. (F) Upon request, the committee administrator shall supply to the board in writing:

   1. 1. Any information requested by the

board regarding the Well-Being Program or any licensee participating in or being assisted by the Well-Being Program, except as otherwise provided herein for voluntary participants; and

1. 2. Any information or documentation

with regard to the identification, intervention, treatment, rehabilitation, and compliance of any voluntary participant who breaches or fails to comply with the terms of any Well-Being Program contract or violates any state or federal law.

1. (7) Contractor Duties.

   1. (A) Upon referral, the contractor shall be responsible for requiring evaluators to provide written reports which address whether a participant of the Well-Being Program suffers from an impairment, identifies the impairment, provides recommendations for treatment of the impairment, and whether the participant’s practice of pharmacy should be restricted due to the impairment; and

   2. (B) The contractor shall provide services when appropriate to impaired licensees which include, but are not limited to, the following:

      1. 1. Monitoring compliance of the con-

tract between the committee and the impaired licensee;

1. 2. Assisting the impaired licensee in

obtaining evaluation and treatment;

1. 3. Ensuring that treatment recommenda-

tions based on the assessment of the licensee are followed;

1. 4. Monitoring treatment progress and

re-entry contractual compliance;

1. 5. Managing/monitoring random drug

screens;

1. 6. Assisting licensees to re-enter prac-

tice from treatment;

1. 7. Assisting with aftercare issues;
2. 8. Any and all reporting to appropriate

agencies, as requested by the board or the committee;

1. 9. Program development; AND INSURANCE
2. 10. Outreach education, as requested by

the committee;

1. 11. Managing, ensuring, and monitoring

random and scheduled drug screens; and

1. 12. Other necessary services as deter-

mined by the committee.

1. (C) The contractor shall assist the board in monitoring the impaired licensee’s compliance with the terms of any disciplinary order/agreement.
2. (D) The contractor shall obtain a written release from all licensees referred to the Well-Being Program that authorizes the contractor to release to the board, the committee, or the committee administrator all information and documents pertaining to a licensee referred by the board.

3. (E) Voluntary Participants.

   1. 1. Except as otherwise provided in this

subsection, the identity of licensees who voluntarily submit to the Well-Being Program shall remain anonymous to the board.

1. 2. The contractor shall file with the

committee a Notice of Non-Compliance against any voluntary participant who breaches or fails to comply with the terms of any Well-Being Program contract or who violates any state or federal drug law. If a complaint is filed by the committee against the licensee, the contractor shall require the committee administrator to supply to the board any information or documentation with regard to the licensee’s identification, intervention, treatment, compliance, and rehabilitation, as requested by the board.

1. 3. The contractor shall obtain a written

release from all licensees who voluntarily enter the Well-Being Program that authorizes the contractor to release any and all information or documents pertaining to the licensee to the board or the committee in the event the licensee breaches or fails to comply with the terms of any Well-Being Program contract or violates any state or federal drug law.

1. (F) General Reporting.

   1. 1. The contractor shall provide to the

committee in writing:

1. A. An annual action plan and budget

to be approved by the board. The contractor shall report on progress with regard to preparing and implementing the action plan and budget as requested by the board or committee;

1. B. Quarterly income and expense

reports for the Well-Being Program and any other financial report requested by the board or the committee;

1. C. Progress reports with regard to

each licensee participating in or being assisted by the Well-Being Program;

1. D. Any reports provided to the board;
2. E. Any and all information or docu-

mentation with regard to the identification, intervention, treatment, and rehabilitation of any licensee who participates in, or is assisted by, the Well-Being Program;

1. F. Any other report or information

requested by the committee; and

1. G. The information and documenta-

tion required by this subsection shall only be released to the board pursuant to Chapter 338, RSMo, and the rules promulgated thereto.

1. 2. The contractor shall provide to the

board in writing:

1. A. An annual action plan and budget

as directed by the board. The contractor shall report on progress with regard to preparing and implementing the action plan and budget as requested by the board or committee;

1. B. Progress reports with regard to

each licensee participating in or being assisted by the Well-Being Program, provided the identity of licensees who voluntarily submit to the Well-Being Program shall remain anonymous to the board for purposes of these reports, except as otherwise provided by this rule; and

1. C. Any other report or information

requested by the board, except as otherwise provided by this rule for voluntary participants.

1. (G) Violation Reporting. In addition to the other requirements of this rule, the contractor shall report, in writing, to the committee:

   1. 1. All licensee violations of a board dis-

ciplinary order/agreement, any provision of Chapter 338, RSMo, or the board regulations, or any state or federal drug law, which occurs after the date of the disciplinary order/agreement or the date the licensee entered the Well-Being Program, whichever occurs first;

1. 2. Any licensee who fails to enter treat-

ment within forty-eight (48) hours following the provider’s determination that the licensee needs treatment; and

1. 3. Any licensee who does not comply

with the terms of a Well-Being Program contract or who resumes the practice of pharmacy before the treatment provider has made a clear determination that the licensee is capable of practicing.

1. (H) The contractor shall require the costs of drug screens and professional and administrative services to be paid by the impaired licensee.

1. (8) Confidentiality.

   1. (A) The committee and contractor shall provide the board access to all information pertaining to each impaired licensee referred to the committee by the board.
   2. (B) In regards to participants referred by the board and the voluntary participants who have violated or breached their Well-Being Program contracts, the board and committee may exchange privileged and confidential information, interviews, reports, statements, memoranda, and other documents including information on investigations, findings, conclusions, interventions, treatment, rehabilitation, and other proceedings of the board and committee, and other information closed to the public to promote the identification, interventions, treatment, rehabilitation, and discipline (accountability) of licensees who may be impaired.
   3. (C) All privileged and confidential information and other information not considered to be public records or information pursuant to Chapter 610, RSMo, shall remain privileged and confidential and closed to the public after such information is exchanged.

AUTHORITY: section 338.140.1, RSMo 2000 and section 338.380, RSMo Supp. 2009.* Original rule filed Aug. 18, 2009, effective March 30, 2010. *Original authority: 338.140.1, RSMo 1939, amended 1981, 1989, 1997 and 338.380, RSMo 2007.