EXECUTIVE ORDER
17-18

WHEREAS, the Centers for Disease Control and Prevention has declared a national opioid epidemic, which poses a grave danger to Missouri; and

WHEREAS, Missouri is facing a public health crisis of epidemic proportions from the unlawful distribution and misuse of opioids ("Opioid Public Health Crisis"); and

WHEREAS, one cause of Missouri's Opioid Public Health Crisis is the overabundance of prescription opioids, with evidence showing that at least half of opioid overdose deaths involve prescription opioids. In Missouri, there are approximately 89,000 prescriptions for narcotics for every 100,000 Missourians; and

WHEREAS, Missouri's Opioid Public Health Crisis is impacting Missouri families and communities every day. It is estimated that two Missourians die from narcotic overdose and two babies are born with narcotic withdrawal every day somewhere in Missouri; and

WHEREAS, in 2016, more than 900 Missourians died from an opioid overdose; and

WHEREAS, deaths that are the result of opioid overdose are preventable; and

WHEREAS, Missouri's Opioid Public Health Crisis is overwhelming law enforcement, health care, and social services providers; and

WHEREAS, Missouri is the only State in the country that does not have a system to monitor prescription drug activity; and

WHEREAS, despite Missouri's Opioid Public Health Crisis, the 99th General Assembly failed to pass legislation instituting a prescription drug monitoring program; and

WHEREAS, Missouri's Opioid Public Health Crisis necessitates the marshalling of all appropriate resources to combat the harmful effects of opioids on Missouri families and communities.

NOW THEREFORE, I, ERIC R. GREITENS, GOVERNOR OF THE STATE OF MISSOURI, by virtue of the authority vested in me by the Constitution and the laws of the State of Missouri, hereby declare, order, and direct the following:

  1. The Department of Health and Senior Services ("DHSS") shall implement a multi-phase prescription drug monitoring program ("PDMP").
  2. To implement the first phase of the PDMP, DHSS shall enter into contracts with pharmacy benefit management organizations to analyze prescriber and pharmacy prescription and dispensing data for schedule II-IV controlled substances, which includes opioids.
    1. DHSS shall use the analyses for the purpose of identifying activity indicating that controlled substances are being inappropriately prescribed, dispensed, or obtained; investigating such activity; and making referrals regarding such activity to appropriate government officials, including law enforcement and professional licensing boards.
    2. Prescription and dispensation information received by DHSS shall be confidential and shall be disclosed only as provided by section 195.042, RSMo.
  3. For the second phase of the PDMP, DHSS shall promulgate a rule pursuant to Chapter 195, RSMo, requiring dispensers to submit controlled substance prescription and dispensation information to DHSS or its designee for the purpose of identifying activity indicating that controlled substances are being inappropriately obtained, prescribed, or dispensed; investigating such activity; and making referrals regarding such activity to appropriate government officials, including law enforcement and professional licensing boards. Prescription and dispensation information shall be confidential and shall be disclosed only as provided by section 195.042, RSMo.
  4. Finally, DHSS shall work with private companies, government entities, or others to purchase and utilize innovative technology and software to effectively and efficiently monitor controlled substance prescription information sent to DHSS or its designee under a prescription drug monitoring program. Prescription and dispensation information shall be confidential and shall be disclosed only as provided by section 195.042, RSMo.

IN WITNESS WHEREOF, I have hereunto set my hand and caused to be affixed the Great Seal of the State of Missouri, in the City of Jefferson, on this 17th day of July, 2017.

[Eric R. Greitens's signature]
Eric R. Greitens
Governor

ATTEST:

[Jay Ashcroft's signature]
John R. Ashcroft
Secretary of State

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