Pharmacist’s ‘dispensing’ at heart of investigation

Re: Advocate article: Pharmacist suspended, Feb. 2, 2012 Posted online Feb. 1, 2012: Red Deer pharmacist suspended for overbilling patients by about $1 million

Re: Advocate article: Pharmacist suspended, Feb. 2, 2012

Posted online Feb. 1, 2012: Red Deer pharmacist suspended for overbilling patients by about $1 million

I am the lawyer representing Michael Tweedy in relation to the hearing conducted by the College of Pharmacists. The headline posted online is incorrect. Mr. Tweedy has never overbilled patients, nor was it ever alleged that he did.

The issue arose in relation to billing practices for Kentwood Place and had nothing to do with any patients that had their prescriptions filled at the pharmacy. The headline and the article itself were misleading.

At issue with the college and Alberta Blue Cross was the interpretation of “dispensing” as it relates to billing, i.e. weekly or daily, and the duties of a pharmacist when dispensing to patients in community settings who are mentally or physically incapable of safely securing and managing their own medications. Dispensing is not clearly defined in the legislation or the pharmacy standards.

It is unfortunate that your reporter did not take the time to learn more about Kentwood Place, its history and residents, as it relates specifically to the issues that confronted Mr. Tweedy.

When Kentwood Place opened in 2007, there were no transitional programs for chronic poorly managed schizophrenic patients in Red Deer. The health region was happy to move long-term psychiatric patients from Ponoka Centennial Place, closed health region operated group homes, and discharged patients from the psychiatric unit of the hospital directly to Kentwood Place. Kentwood Place also provided a home and stability for schizophrenics who were living on the streets.

During the time that Mr. Tweedy was involved with Kentwood Place, he made repeated requests to the health region to have a contract setting out responsibilities for overseeing and managing these vulnerable high-risk patients. There were gaps in the legislation and there were inconsistencies in the interpretation of the pharmacy standards for legal responsibility for safely securing medications in homelike settings where patients do not have the mental or physical capacity to manage their own medications and are at high-risk for overdosing, suicide and harming others. Kentwood Place was in essence a home-care setting, and there were no legislated requirements as to responsibility for safely securing medications.

I argued that these patients were at increased risk if their medications were not secured safely and that Mr. Tweedy was at all times acting in their best interests.

The college and Alberta Blue Cross focused on whether the medications were dispensed as ordered by the physicians.

The college found that Mr. Tweedy’s practise of delivering the medications to a locked cabinet and attending Kentwood on a daily basis was not sufficient to fit within the definition of daily dispensing.

The college found that he should have delivered the medications on a weekly or monthly basis as ordered by the physicians. The college did not make a ruling on responsibility for safely securing the medications and this was irrelevant to Alberta Blue Cross.

Kentwood Place has now been sold and the government of Alberta has passed legislation to address the issue of “supportive living” and defining responsibilities where there are both health and accommodation needs in community, non-health related facilities, such as Kentwood Place. The legislation also makes available increased funding for supportive living residential services for AISH recipients. The legislated and funding gap that existed when Mr. Tweedy opened Kentwood Place no longer exists.

You reported that Mr. Tweedy was fined for “falsely declaring that he attended a professional development course.” This is incorrect. Mr. Tweedy has always maintained his professional continuing competency requirements. The tribunal accepted Mr. Tweedy’s evidence that an unsigned document was filed incorrectly and that when he discovered the error the correct document was filed.

Mr. Tweedy accepts the board’s findings and intends to comply with all recommendations and requirements now and in the future.

Gayle A. Langford

Nurse and lawyer

Red Deer

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