Tougher State Oversight Could Spur Progress at Rite Aid

There’s lots to be said for appropriate regulatory enforcement by state government bureaucracies, especially when it comes to health and safety issues.

Often, the state’s actions encourage a firm to deal with its shortcomings more quickly and forthrightly, protecting the public.

But in California, over considerable time, these bureaucracies haven’t been as tough or well-staffed as they should be.

The main subject here is the state Board of Pharmacy and its dealings with the Rite Aid drugstore chain.

I’m not saying Rite Aid’s 640 stores in California aren’t trying to cope with their problems, three years after moving into the old Thrifty Payless stores.

To the contrary, my discussions with Rite Aid officials demonstrate, I think, a willingness to modernize and improve customer service.

But maybe they aren’t proceeding with the urgency the situation requires.

After I wrote about Rite Aid last week, I received 140 readers’ calls, letters and e-mails, and only five were favorable to the firm.

The critical messages varied: Five expressed anger at Rite Aid because its stores don’t sell Coca-Cola. More complained of unavailable advertised items. But far more significant were assertions that Rite Aid pharmacies have long lines, lack adequate personnel, are curt with customers, and occasionally make prescription errors.

Kathleen Tuttle, an L.A. County deputy district attorney in consumer protection, remarked to me two weeks ago that Rite Aid does not seem well-attuned to California laws.

This week, she suggested that enforcement of those laws “may have to be ratcheted up” before Rite Aid responds satisfactorily.

Patricia Harris, executive officer of the state Board of Pharmacy--which gets 800 to 1,000 complaints of all kinds each year--released records showing that in fiscal 1997-98, the board received 67 complaints against Rite Aid, of which 35 claimed prescription errors.

In 1998-99, the number rose. There were 179 complaints against Rite Aid, 91 involving alleged prescription errors.

Yet, Harris acknowledged, the Pharmacy Board hasn’t gone to the state attorney general to seek a single penalty against the firm.

This contrasts with the pharmacy boards in Washington and Oregon. Both forced settlements in which Rite Aid paid penalties, $50,000 and $60,000, respectively.

I asked Harris about some of the specific complaints I’d received. Would they, if officially brought to the board, merit investigation?

* Natalie Lum of Los Angeles took Rite Aid an antibiotic prescription for her 5-year-old, who had an ear infection. She said the pharmacist told her the doctor had prescribed too high a dose of the drug. Without consulting the physician, he only issued the boy half the dose.

* Deborah Gorra of the Inland Empire said she found out that a prescription had been left on Rite Aid’s shelf without refrigeration for 24 to 36 hours, despite a notice it had to be refrigerated. On the advice of the drug’s producer, she refused it.

Harris said these cases, and others I mentioned to her, would all merit investigations.

But she added that she is short of inspectors to do them. She has 21 such positions authorized, but has had only 10 inspectors since 1994.

As a result, the Pharmacy Board has had to abandon most of its random inspections and cut back enforcement, she said.

One problem is that the state doesn’t pay the inspectors, who are all pharmacists themselves, as much as private industry pays its pharmacists. There is about a $20,000 gap, so it is hard to recruit inspectors.

A bill is pending in the Legislature to authorize the board to pay the same as University of California pharmacists get, but the Wilson administration killed a similar bill last year, and Gov. Gray Davis has yet to take a position this year. Board members are nervous.

Summing up the board’s situation, Harris, nine years in her post, said, “It’s pretty frustrating. . . . I’m pretty much crippled.”

The board did act quickly in one case. Russell Lubrani, a pharmacist, told me he called the board anonymously to say his Rite Aid store in Costa Mesa had no pharmacist-in-charge, as required by law.

Lubrani says the Pharmacy Board contacted Rite Aid the next day and the position was filled in a few days. But he says that his role in the matter was discovered and Rite Aid fired him. He is now suing the firm in Orange County Superior Court for wrongful termination.

In three of the state agencies and boards assigned to regulate health care--the Department of Corporations, the Medical Board and the Pharmacy Board--little has been done to stiffen oversight since Davis took over from Pete Wilson in January.

In an April 1 column, I quoted Davis’ press secretary, Michael Bustamante, as saying that the governor planned to move HMO regulation out of the Department of Corporations, which has often been timid and very slow. Four months later, that hasn’t taken place, and while Bustamante says it still will, he allows that it is “weeks” away.

Despite what we hear about the evils of Big Government, stringent medical and pharmaceutical regulation is terribly important to millions of Californians.

Rite Aid claims it is moving ahead with improvements. Its vice president for pharmacy operations, Michael Podgurski, says, “We are looking for any way to improve efficiency in our pharmacies.”

Already, he said, Rite Aid has installed the first 52 automated prescription-filling machines in its 275 metropolitan Southern California stores.

It sounds good. But when I thought about all the negative messages I received in the last week, I still suspect we need tough, timely regulation to be sure Rite Aid perseveres.

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Ken Reich can be contacted with your accounts of true consumer adventures at (213) 237-7060 or by e-mail at: ken.reich@latimes.com