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Official Newsjournal of the Illinois Council of Health-System Pharmacists

Government Affairs Report
Proposed Chicago City Ordinance Gets Pharmacies Fired Up!

by Jim Owen and Scott Meyers

A proposed Chicago City ordinance has the pharmacy world in a dither and for good reason! The ordinance, proposed by Finance Chairman and long-time City Council Member, Ed Burke, would limit the number of prescriptions a pharmacist could fill to ten per hour. It would also limit the pharmacist’s work-day to an eight hour shift that would include two mandatory 15-minute breaks and a 30-minute uninterrupted lunch period. Now the breaks and lunch seem reasonable enough, but a pharmacist with any experience knows that 10 prescriptions an hour is a very low limit, except for those real winners that can take an hour all by themselves! And an eight-hour work day is fairly restrictive as many pharmacists prefer the four 10-hour days a week or even the three 12-hour shifts. And pharmacists working the night shift at the 24-hour stores would probably rather quit than give up their 7-on/7-off schedules!

And we say the pharmacists at the stores because the ordinance exempts these restrictions for hospital, health-system and nursing home operated pharmacies. We’re not sure what that means for a pharmacy operated in a hospital, health-system or nursing home by an outside contractor, but we’re guessing it wouldn’t necessarily be good!

So the chains and the independent pharmacy owners are doing all they can to fight this regulatory burden, and to be honest, ICHP is right there with them. Here are the reasons why:

The ordinance is unconstitutional, at least in our opinion and those of our attorneys. The Illinois Pharmacy Practice Act expressly prohibits local governments from exercising any type of regulatory power. A rarely read section of the Act states this clearly:
(225 ILCS 85/38) (from Ch. 111, par. 4158)
(Section scheduled to be repealed on January 1, 2020)
Sec. 38. It is declared to be the public policy of this State, pursuant to paragraphs (h) and (i) of Section 6 of Article VII of the Illinois Constitution of 1970, that any power or function set forth in this Act to be exercised by the State is an exclusive State power or function. Such power or function shall not be exercised concurrently, either directly or indirectly, by any unit of local government, including home rule units, except as otherwise provided in this Act. (Source: P.A. 85-796.)
The Illinois General Assembly has extended the Pharmacy Practice Act for two-short years, rather than the usual ten-years and has established the Collaborative Pharmaceutical Task Force with a charge of discussing and establishing solutions to the current pharmacist work load issues first described by the Chicago Tribune in December of last year and then frequently thereafter whenever any pharmacy regulatory activity has occurred. The Task Force will represent all facets of pharmacist practice including organized labor, the Illinois State Medical Society and the Illinois Hospital Association. The Task Force has two-years to come up with proposals to ensure patient safety and reduce work load and stress for the practicing pharmacists of the State.
The proposed limits are extremely unreasonable. As mentioned before, most pharmacists will have no problem filling a larger number of prescriptions per hour than the 10 per hour limit proposed. The problem is that there will be times when one prescription is too many in an hour. So regulating workload in this fashion just doesn’t make sense.
The ordinance is opposed on another constitutional level. If the City of Chicago is allowed to begin this type of regulation, what will prevent every home-rule and even non-home-rule municipalities from creating their own pharmacy regulations in the future? It is bad enough that we have 50 different State Pharmacy Practice Acts, can you imagine what it would be like to have multiple municipalities in multiple State, each with their very own rules and regs? If that happens, my response will be “I’m glad I don’t have to take the MPJE now!”

While some of our members have questioned our loyalty to the frontline pharmacist, our response has always been what makes the most sense. This ordinance is far from that. We need and will look at ways to decrease the workload to a safe level. We will work on solutions that are reasonable for both the pharmacist and the pharmacy, but most importantly for the patient. We will make sure that pharmacy practice is not further restricted by cumbersome rules that don’t improve patient care but rather bog down the pharmacist as he or she tries to make sure the patient makes the best use of their medications.

We have asked our members with Chicago addresses to call or e-mail their aldermen and women to urge them to vote “No” on this ordinance. We suggested that the City Council let the Collaborative Pharmaceutical Task Force do its job over the next two years to create comprehensive and Statewide regulations that will benefit all parties involved. We believe that implementation of this type of ordinance will restrict access to medications for patients around the City which could result in additional illness and health care costs.

This is just another example of why pharmacists, pharmacy technicians, and pharmacy students need to belong to a statewide pharmacy organization. One like ICHP! And this is why these same individuals need to stay informed and establish active relationships with their City and State elected officials. The more colleagues that follow these suggestions, the more informed our State and local government officials will be and the less vulnerable our profession and our patients will be.