Nevada PDMP Request

Sarah Seymour filed this request with the Nevada Board Of Pharmacy of Reno, NV.
Due Dec. 3, 2019
Est. Completion None
Status
Awaiting Response

Communications

From: Sarah Seymour

To Whom it May Concern,

Northeastern University’s School of Social Justice and Health Equity is interested in the state’s prescription monitoring program, the Nevada Prescription Monitoring Program (NV PMP Aware). Specifically, we want to learn more about law enforcement access to the database, the use of an algorithm that produces a risk assessment score to analyze its contents, and the data access and retention rules governing the system. We understand the algorithm was produced by the corporation Appriss Health.

In order to permit the public to understand how the Nevada State Board of Pharmacy is using the NV PMP Aware and how it impacts public health and civil liberties in Nevada, Northeastern University’s Health in Justice Action Lab is making this request under the Nevada Open Records Act § 239 et seq., for the following records:

1. Any and all records reflecting an agreement for purchase, acquisition, or licensing of, or permission to use, test, or evaluate Appriss’s systems or services, including any product or service offered;

2. Any and all memoranda of understanding between the Nevada State Board of Pharmacy and any outside entity regarding the NV PMP Aware.

3. Any and all records including information about the algorithm that determines risk scores in the NV PMP Aware, including but not limited to its source code, developer documentation, and operator manuals (e.g. Narx Score, Overdose Risk Score);

4. Any and all research, technical reports, or internal audits that define and/or evaluate the NV PMP Aware effectiveness or performance;

5. Any and all research, technical reports, or internal audits that evaluate the Appriss risk assessment tool’s effectiveness or performance;

6. Any document containing a full list of the data fields in the NV PMP Aware;

7. Any and all records of de-identified red flag algorithm outputs (e.g. provider red flag, pharmacy red flag, 40 MED red flag) and patient behavioral red flags (e.g., anxious patient demeanor, distance between prescriber and dispenser) with prescriber/dispenser training documentation on how to address the red flags;

8. Any record showing the number of patients in the NV PMP Aware by quarter and year (2006-present);

9. Any record showing the number of prescribers and pharmacists in the NV PMP Aware by quarter and year (2006-present);

10. Any and all records containing Nevada State Board of Pharmacy analysis of whether and/or how the NV PMP Aware has impacted public health in Nevada (e.g. decrease or increase in overdose rates, “doctor shopping,” prescribing volume, etc.) over time;
11. Any and all records 2006-present of notification to law enforcement about information in the NV PMP Aware Medical Review Group or other channels, including but not limited to how many times law enforcement agencies have been notified about information in the NV PMP Aware, and which agencies have been notified;

12. Any and all internal policy, memoranda, and/or training documentation describing how entities outside of Nevada State Board of Pharmacy, including law enforcement, may obtain access to information in the NV PMP Aware , including but not limited to the rules, regulations, and procedures of the Medical Review Group;

13. The legal authorization for sharing NV PMP Aware information with the law enforcement entities; and

14. Any and all records showing how often law enforcement entities or individuals have requested information or records from the NV PMP Aware, or made electronic queries of the system, including but not limited to what types of information or records have been requested, which agencies have made the requests, the percent of requests that were accepted versus denied, temporal trends, the form of the request (e.g. subpoena, warrant, etc.), and whether the requests were granted or denied.

Because this request involves a matter of public concern and because it is made on behalf of a nonprofit organization, we ask that you waive any fees. If you decide not to waive fees, we request that you permit us to examine, at our election, the responsive documents before deciding which portions to transmit. We prefer the documents in electronic format.

Should you determine that some portion of the documents requested are exempt from disclosure, please release any reasonably segregable portions that are not exempt. In addition, please note the applicable statutory exemption and explain why it applies to the redacted portions. As you know, a custodian of public records shall comply with a request within ten days after receipt.

Thank you for your assistance. We look forward to your response.

Sincerely,
Sarah Seymour

From: Nevada Board Of Pharmacy

Please see attached.

Brett Kandt
General Counsel
Nevada State Board of Pharmacy
775-850-1440
bkandt@pharmacy.nv.gov<mailto:bkandt@pharmacy.nv.gov>

[cid:image001.jpg@01D56E0A.E2AB1990]<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.bing.com_images_search-3Fq-3Dnevada-2Bstate-2Bseal-26view-3Ddetailv2-26-26id-3DBBA9CBA1E320A1DB08579B92167A3DBB884731A6-26selectedIndex-3D1-26ccid-3D92QAGdQw-26simid-3D607997718548448884-26thid-3DJN.QKsw9yMwT9d3nWOCIFRbMw&d=DwMFAg&c=n4nxo_3wbMT6jcMjwPfD0w&r=DOaCwNpActYrq7f38Ovyuy2tMKyGLU0lOTJxNRB30do&m=_BZv4_q49q4OCFwRjskinK8WG_sYcBLzbALdL1KJbII&s=TMKRRDWoWo7YsBcumn-cQxLoAp5lqmUvdjqn5UKEjRQ&e=>

NOTICE: This information is provided as a courtesy on behalf of the Nevada State Board of Pharmacy. This information does not constitute legal advice and does not establish an attorney-client relationship. This information does not override the specific provisions of Nevada law as applied to a particular set of facts.

CONFIDENTIALITY NOTICE: This message and any accompanying documents are intended only for the use of the individual or entity to which they are addressed. They may contain information that is proprietary, privileged, confidential or exempt from disclosure under applicable Federal or State law. If the reader of this message is not the intended recipient, you are hereby notified that you are strictly prohibited from reading, using, sharing or copying this communication or its contents. If you have received this email in error, please notify the sender immediately and destroy the original transmission.

From: Sarah Seymour

Hi Brett,

Thank you for the response and apologies for the delayed follow-up as we have sent requests to all 50 states. You had request clarification for item 1, 2, 4, 5, and 7. Here's a brief clarification for each individual point that we are requesting the most current version of:
1: We are requesting proof of contracting with Appriss (e.g. PDMP training booklet with Appriss analytics system, financial contract for the acquisition of using Appriss's data analytics systems for PDMP reporting or something similar)

2: Agreement with other entities in sharing full NV PDMP data (e.g. PMPi contract, other state corporations)

4: We are requesting a report concerning the general usability of the NV PDMP system - for example how many accounts are there, how actively is the PDMP used, the number of prescriptions administered with the use of the PDMP (generally is it user friendly and are people willing to use it)

5: "Appriss assessment tool" = NarxCare; "effectiveness and performance" = the ability to identify those that are at risk for misuse, diversion, or potential overdose of prescription drug

7: "Red flag algorithmic outputs": threshold reports that cause a patient to be flagged for misuse or diversion of prescription drugs (e.g. MED threshold, more than 5 providers in 365 days)

Let me know if you need any more clarification for these points. Thanks again!

Best,

Sarah Seymour

From: Nevada Board Of Pharmacy

Sarah-

This will acknowledge receipt of your clarifications on your public records request – the Board staff anticipate providing a response by Friday, January 10.

Regards,

Brett Kandt
General Counsel
Nevada State Board of Pharmacy
775-850-1440
bkandt@pharmacy.nv.gov<mailto:bkandt@pharmacy.nv.gov>

[cid:image001.jpg@01D5AF44.86D412E0]<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.bing.com_images_search-3Fq-3Dnevada-2Bstate-2Bseal-26view-3Ddetailv2-26-26id-3DBBA9CBA1E320A1DB08579B92167A3DBB884731A6-26selectedIndex-3D1-26ccid-3D92QAGdQw-26simid-3D607997718548448884-26thid-3DJN.QKsw9yMwT9d3nWOCIFRbMw&d=DwMFAg&c=n4nxo_3wbMT6jcMjwPfD0w&r=DOaCwNpActYrq7f38Ovyuy2tMKyGLU0lOTJxNRB30do&m=_BZv4_q49q4OCFwRjskinK8WG_sYcBLzbALdL1KJbII&s=TMKRRDWoWo7YsBcumn-cQxLoAp5lqmUvdjqn5UKEjRQ&e=>

NOTICE: This information is provided as a courtesy on behalf of the Nevada State Board of Pharmacy. This information does not constitute legal advice and does not establish an attorney-client relationship. This information does not override the specific provisions of Nevada law as applied to a particular set of facts.

CONFIDENTIALITY NOTICE: This message and any accompanying documents are intended only for the use of the individual or entity to which they are addressed. They may contain information that is proprietary, privileged, confidential or exempt from disclosure under applicable Federal or State law. If the reader of this message is not the intended recipient, you are hereby notified that you are strictly prohibited from reading, using, sharing or copying this communication or its contents. If you have received this email in error, please notify the sender immediately and destroy the original transmission.

From: Nevada Board Of Pharmacy

Hello Ms. Seymour,

I wanted to let you know that are working on a response to your request. Our legal counsel has been out sick. The Nevada State Board of Pharmacy’s legal counsel needs to review the documents before it can be sent. You should expect to receive a response to the request by end of next week.

Thank you,

Yenh Long, Pharm.D., BCACP
Nevada State Board of Pharmacy
Email: ylong@pharmacy.nv.gov<mailto:ylong@pharmacy.nv.gov>
985 Damonte Ranch Parkway, Suite 206
Reno, NV 89512
Ph: 775-850-1440
Fax: 775-850-1444

This information is provided as a courtesy on behalf of the Nevada State Board of Pharmacy. This information does not constitute legal advice and does not override the specific provisions of Nevada law as applied to a particular set of facts.

CONFIDENTIALITY NOTICE: This message and any accompanying documents are intended only for the use of the individual or entity to which they are addressed. They may contain information that is proprietary, privileged, confidential or exempt from disclosure under applicable Federal or State law. If the reader of this message is not the intended recipient, you are hereby notified that you are strictly prohibited from reading, using, sharing or copying this communication or its contents. If you have received this email in error, please notify the sender immediately and destroy the original transmission. Thank you.

From: Sarah Seymour

Hi Yenh,

Thank you for following up with us in regards to this request. Looking forward to hearing from your department soon.

Best,

Sarah Seymour

From: Nevada Board Of Pharmacy

Sarah-

Attached please find the Nevada State Board of Pharmacy’s response to your supplemental request.

Regards,

Brett Kandt
General Counsel
Nevada State Board of Pharmacy
775-850-1440
bkandt@pharmacy.nv.gov<mailto:bkandt@pharmacy.nv.gov>

[cid:image001.jpg@01D5C6FA.B13F58A0]<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.bing.com_images_search-3Fq-3Dnevada-2Bstate-2Bseal-26view-3Ddetailv2-26-26id-3DBBA9CBA1E320A1DB08579B92167A3DBB884731A6-26selectedIndex-3D1-26ccid-3D92QAGdQw-26simid-3D607997718548448884-26thid-3DJN.QKsw9yMwT9d3nWOCIFRbMw&d=DwMFAg&c=n4nxo_3wbMT6jcMjwPfD0w&r=DOaCwNpActYrq7f38Ovyuy2tMKyGLU0lOTJxNRB30do&m=_BZv4_q49q4OCFwRjskinK8WG_sYcBLzbALdL1KJbII&s=TMKRRDWoWo7YsBcumn-cQxLoAp5lqmUvdjqn5UKEjRQ&e=>

NOTICE: This information is provided as a courtesy on behalf of the Nevada State Board of Pharmacy. This information does not constitute legal advice and does not establish an attorney-client relationship. This information does not override the specific provisions of Nevada law as applied to a particular set of facts.

CONFIDENTIALITY NOTICE: This message and any accompanying documents are intended only for the use of the individual or entity to which they are addressed. They may contain information that is proprietary, privileged, confidential or exempt from disclosure under applicable Federal or State law. If the reader of this message is not the intended recipient, you are hereby notified that you are strictly prohibited from reading, using, sharing or copying this communication or its contents. If you have received this email in error, please notify the sender immediately and destroy the original transmission.

From: Sarah Seymour

Hi Brett,

Apologies for the late response and thank you for providing these. I wanted to clarify a point and follow-up with another item we requested that seemed to overlooked in the original request.

In clarifying Item 8, We are requesting the number of unique patients within the PDMP, whether that be annually or quarterly. They do not have to be broken down by type of prescription they are receiving or any other dispensing information.

As for Item 7, does your department possess any trainings on how to identify and respond to patient behavioral red flags (e.g., anxious patient demeanor, distance between prescriber and dispenser)?

Let us know when you get a chance if these documents are in your possession. Thank you in advance.

Best,

Sarah Seymour

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