New prescription orders
Prescription orders for individual patients are submitted to the central pharmacy
by completing a prescription order form (LHS-181). The LHS-181 includes space for three separate prescriptions. An LHS-181 must be completed for new prescriptions even if the prescription has been written on the prescriber's prescription blank. When the prescription order is being mailed to the central pharmacy, the LHS-181 is completed and the prescriber's original signed prescription blank is attached to the LHS-181 (unless the LHS-181 was signed by the prescriber).
New prescriptions may also be faxed to the central pharmacy. In this case a completed LHS-181 and the prescriber's prescription blank (if the LHS-181 was not signed by the prescriber) are faxed to the central pharmacy; however, prior to faxing the prescription order containing the prescriber's signature, state pharmacy regulations require that the following information be included within the body of the signed prescription document (the prescriber's prescription blank or the LHS-181 whichever has been signed by the prescriber) - FAXED TO BPS (Pharmacy Services), THE INITIALS OF THE PERSON FAXING THE DOCUMENT, AND THE DATE THAT THE DOCUMENT IS BEING FAXED. Writing this information within the body of the prescription document serves to cancel the prescription so that it can not be presented to another pharmacy. Prescription orders may also be telephoned to the central pharmacy; however, this should be restricted to immediate needs that require special instructions, attention and/or handling.
If the drug is for a Schedule II-V controlled substance, the prescriber's DEA number must be included on the prescription order that contains the prescriber's signature.
When prescriptions are dispensed by the central pharmacy, a copy of the LHS-181 is returned to the health department with the patient's medication. A white sticker containing the prescription number, the date dispensed, the cost of the medication, and the number of remaining refills is attached to the LHS-181.
Prescriptions are normally dispensed and returned to health departments within one to two business days of the date that the orders are received in the central pharmacy. When there is an immediate need, health departments may request next day delivery which insures delivery the next business day; however, this special handling increases the shipping charge.
Health department personnel should document the receipt of medications for individual patients. These medications should be stored in a secure area to await delivery to the patient. When the medication is delivered to the patient, a notation should be made in the patient's record indicating the date of delivery.
Where applicable, payment for medication is handled in accordance with the health department's policies and procedures.
Refilling prescriptions for individual patients
Refillable prescriptions (where the white sticker attached to the LHS-181 indicates that refills remain and legal/program limitations have not been exceeded) may be reordered for patients by submitting (mail/fax) a completed LHS-181 prescription order form that also includes the prescription number in the designated box on the order form. The public health nurse should review the LHS-181 prior to faxing/mailing the order to the central pharmacy and initial the order to confirm that this review has been completed.
Health Department personnel should develop a system of reordering patients' medications that insures that there will be no interruption in a patient's drug therapy.