Unpredictable Weather and Predictable Obstacles

Erin Mullen

Dr. Erin Mullen is the Director of Programming for Rx Response. She is a pharmacist, emergency manager, and disaster responder.


It seems like this winter weather will never end! Today, we have 4 states under a declaration of emergency, it’s snowing outside of my office, and there will be more snow, ice, and cold coming for the weekend across much of the country.  It’s a relief that while there have been some transportation problems, things seem to be clearing up without too much worry about medicine deliveries on a regional scale.

But, to continue on the theme that we started in last week’s blog, there is still quite a bit of variability in how states respond to disasters. With this set of declarations, we can see that, appropriately, there is a primary concern about transportation and the need to ensure that emergency vehicles and relief supplies can get to where they are needed. But what isn’t necessarily clear is the recognition that disruptions in power and transportation can lead to disruptions in patient care – specifically patients being able to get refill authorizations for chronic care medicines, and, except in South Carolina, there isn’t any specific information to guide pharmacists on providing emergency refills during a declared emergency.

Out of the 4 states, only South Carolina has clear language that directs pharmacists to be able to provide an emergency supply of medicine, of up to a 15 days’ supply. The best part about this legislation is that it is automatically triggered by the Governor’s declaration, and is readily available on the Board of Pharmacy’s website, so pharmacists and patients both can be assured that the proper procedures are being followed. Other states have tackled this problem at the time of the declaration, inserting the authorization within the declaration itself. Many states are not so clear.

While we don’t expect Winter Storm Remus (or even the next set of storms) to be catastrophic, it still is reassuring for patients and pharmacists to know what to expect. When circumstances such as those following a disaster are unusual, there remain predictable obstacles which can be avoided if the right actions have taken place. In this case, a pre-existing authorization that allows pharmacists to dispense critical medicines to ensure patients can continue to effectively treat their chronic conditions should be in place.

Links to Emergency Declarations for Winter Storm “Remus”

  • Alabama: includes transportation waiver for disaster relief supplies
  • Georgia: includes ransportation waiver for delivery of essential supplies, including medicines
  • North Carolina: transportation waiver for delivery of essential supplies, including medicines
  • South Carolina:
    • Emergency declaration mobilizing national guard
    • Emergency Prescription refill of 15 days permitted
      • Refill authorizations may be difficult or impossible to obtain. If the Governor declares a State of Emergency within your county, pharmacists may utilize the S.C. State of Emergency Laws (Section 40-43-170) that allows for a one-time emergency refill of up to a 15-day supply of a prescribed medication if:o    § The pharmacist has all prescription information necessary in order to accurately refill the prescription and;o    § In the pharmacist’s professional opinion the medication is essential to the maintenance of life or to the continuation of therapy and;o    § The pharmacist reduces the information to a written prescription marked “Emergency Refill”, files the prescription as required by law and notifies the prescribing physician within 15 days of the emergency refill and;§ The prescription is not for a controlled substance
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