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| DATE | 2014-04-29 |
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Pharmacy board's actions raise questions about ethics, patient privacy,
safety
John Russell, john.russell-at-indystar.com 9:58 p.m. EDT March 30, 2014
INI Walgreens
(Photo: Scott Olson/Getty Images)
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A powerful member of the Indiana Board of Pharmacy was quietly involved
in discussions with state pharmacy regulators about a $100 million
project that benefited his employer — Walgreens pharmacies.
And now a government watchdog group and a labor federation say those
actions not only violated state ethics laws, but have allowed Walgreen
Co. to dramatically remodel dozens of stores across Indiana,
compromising patient privacy and increasing the chance of errors in
filling prescriptions.
One of the groups persuaded the U.S. Department of Health and Human
Services to look into the matter. It recently launched an investigation
into the patient privacy allegations at Walgreen.
Walgreen said it is cooperating with the investigation, and defended the
store layout as safe and effective. "We presented this model to more
than 30 boards of pharmacy around the country," said Michael Polzin, a
company spokesman in Illinois. "We're very proud of the work we have
done."
55_archive
William Cover is a former president of the Indiana pharmacy
board.(Photo: Star archive)
In dozens of emails from 2011 reviewed by The Indianapolis Star, William
J. Cover — then president of the state pharmacy board — played a
key role in connecting state regulators with Walgreen officials months
before the remodeling project became public.
During that time, Cover was corporate manager of pharmacy affairs for
Walgreen — raising questions about whether he should have removed
himself from any involvement with state officials concerning the
project.
It seems clear he didn't.
In one email, the executive director of the pharmacy board asked top
state officials whether board members could travel to Illinois to visit
Walgreen headquarters. "This is a specific request from my Board
President," wrote Phil Wickizer, referring to Cover.
In various emails spanning five months in 2011, Cover arranged two trips
for the Board of Pharmacy to Walgreen sites in Illinois to meet company
officials and inspect the new design. He sent information about the
project to the Board of Pharmacy staff.
Walgreen was proposing a radical departure from most pharmacies, dubbed
the "Well Experience." The plan was to move pharmacists out from behind
the counter to a workstation on the floor, where they could answer
questions from the public and provide health counseling. Indiana was the
pilot site.
Walgreen said it would spend about $100 million in infrastructure, hire
150 new employees and spend millions more in marketing and technology.
According to an email from Wickizer to the Indiana Professional
Licensing Agency on May 11, 2011, "Walgreens wants to partner with the
Board and get your buy-in before making such a commitment." He said the
company wanted to keep the plans confidential.
"I told them this would not be an issue," Wickizer wrote.
The licensing association warned that the meeting in Chicago might
violate Indiana's open doors laws, and in a subsequent email, Wickizer
reported to Walgreen officials that the board would go in two groups to
avoid a quorum, which would require public notice.
Before the trips, Cover asked Wickizer whether other board members were
supporting the project.
"Reaction so far?" Cover wrote on May 11, two months before the vote.
Wickizer responded that three of the other six board members so far
"have responded affirmatively." An hour later, Cover followed up with
Wickizer: "Thanks for all your hard work on this project. It is
certainly appreciated."
In an email three days before Walgreen's project became public at a
Board of Pharmacy meeting, Cover wrote to Wickizer: "Monday will be
fun!!"
On Monday, July 11, 2011, Walgreen officials appeared before the board
to explain the project. The board voted 6-0 to approve it, with Cover
abstaining due to a conflict stemming from his employment at Walgreen.
Wickizer left Indiana government in 2012 to take a job as senior legal
counsel at Express Scripts, a pharmaceutical mail-order operation based
in St. Louis. He referred questions to the Indiana Professional
Licensing Agency.
Cover, who is still on the board but no longer serves as president, did
not return numerous phone calls to his office and home in Middlebury.
Sue Swayze, a spokeswoman for the Indiana Professional Licensing Agency,
defended Cover's conduct, saying he was merely coordinating logistical
and scheduling issues, such as the trip to Chicago, while keeping
himself out of substantive discussions of the project.
"We are sticklers about recusing ourselves from that discussion" when
there are conflicts, she said.
She said it would be up to the state's public access counselor or
inspector general to making a legal ruling.
Two citizens groups say they plan to file a complaint Monday, with the
Indiana inspector general's office. Common Cause Indiana and Change to
Win, a labor-supported activist group, say that Cover's actions violated
the Indiana ethics code. The emails were obtained by Change to Win under
numerous open-records requests.
Julia Vaughn, director of Common Cause, a government watchdog group,
said Cover should have removed himself completely from the matter.
"Under the circumstances, he should have kept himself at arm's length,"
she said. "Looking at the emails, I think more separation was needed,
and that's why we think an investigation is necessary."
Change to Win said it has made more than 100 visits to Well Experience
stores and has found widespread risks to patient privacy and public
health. Pharmacists often leave their desks in a public area of the
store to talk to patients in consulting rooms or to unlock a cabinet in
the dispensing area.
When the pharmacist leaves, the public can look at the computer screens
or at labeled bottles of medicine on their desk, the organization said.
About 80 percent of the stores visited violated privacy laws in this
way, the group alleged.
"No one wants to have their prescription for methadone or Viagra or
their dependence on prescription painkillers sitting out on a desk for
their neighbors or employees to see," said Nell Geiser, an official with
Change to Win in New York.
The watchdog groups say officials' haste in approving the project may
have caused them to inadvertently violate the Indiana pharmacy laws that
existed at that time. Indiana law required pharmacists to provide
"immediate and personal supervision" to other pharmacy staff. Two years
later, in 2013, the Indiana pharmacy regulations were amended to allow
certain types of remote supervision.
Polzin, the Walgreen spokesman, declined to comment on the allegations
against Cover, except to say the company expects all its employees to
follow all laws.
Call Star reporter John Russell at (317) 444-6283. Follow him on
Twitter: -at-johnrussell99.
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