How paramedics get life-saving drugs is changing in Virginia, and some Hampton Roads providers are optimistic that the change will be more efficient.
EMS agencies across the commonwealth have been working fast to set up alternative systems for stocking medications, a result of the new rules included in the Drug Supply Chain Security Act.
At first, creating a new system concerned some EMS agencies.
“I think that now agencies are starting to say ‘Okay, we can do this,’” said Ciera Fenske, EMS battalion chief for the Williamsburg Fire Department. “And the great thing is that now we can be in service faster which makes us available for more calls so that we don't have to use as much mutual aid.”
The 2013 law was crafted to better track controlled substances from “cradle to grave,” and improve the ability to root out expired, contaminated or recalled medications.
It also spelled the end of regional exchange programs between EMS agencies and hospitals that have been supplying medicines since the 1970s.
It wasn’t until late 2023 that EMS agencies were informed the regulations also applied to their operations – and that they had a year to abide by them.
Fenske said, at first, agencies weren’t provided a lot of information. Regional EMS councils have stepped in to help agencies set up systems for ordering supplies and getting licensed.
The U.S. Food and Drug Administration last year pushed its November 2024 deadline to April as some agencies struggled with funding or ran into a licensure bottleneck, according to Peninsulas EMS Council Executive Director Michael Player.
Suffolk Fire & Rescue was one agency that didn’t receive its Drug Enforcement Agency licensure before the original deadline.
“Near every agency in the state is trying to get those and they’re short staffed as it is,” said Suffolk Fire & Rescue Capt. Jeff Matthews.
Suffolk City Council in May approved more than $450,000 in traffic enforcement funds to purchase electronic tracking equipment and software that is specific enough to track individual vials. Both have been fitted into vehicle lockers and medics’ kits and will keep stock of which drugs are used when and by who.
Suffolk secured its DEA and Board of Pharmacy licenses last month and is geared up for the April deadline.
Medics will use their badge and a unique keycode to access a station safe and replenish just the medications used on that call rather than swap the entire kit as was the norm in the exchange program. They also won't spend time at the hospital – and not available for calls – while they wait for staff to help with a kit swap.
While Suffolk was building its system from the ground up, Williamsburg had a head start according to Fenske. It built a pharmacy into Williamsburg Fire Department Headquarters years ahead the FDA said it would be needed.
“Once we found out that we had to do all these other things, it was much easier to build off of the foundation we already had,” Fenske said.
Williamsburg’s costs came in well under Suffolk’s. The city set aside $150,000 to start its program. The department had already been purchasing lower schedule drugs and had its Board of Pharmacy credentials, allowing it to get ahead of many agencies in getting its DEA license.
Williamsburg is also using RFID tracking technology. Unlike Suffolk, battalion chiefs will be in charge of restocking more controlled substances such as morphine, leaving the lower schedule drugs to the medics to restock.
Matthews said Suffolk has been getting hands-on experience with item-for-item rather than kit-for-kit exchanges through new vending machines set up in hospitals such as Sentara Obici. Those machines stock non-controlled substances and supplies such as IV start kits and angiocaths, and are the same machines used to restock medics at Suffolk Fire & Rescue.
“It's been going without a hitch,” he said.
Matthews and Fenske say all that’s left to do is continue training and practicing ahead of April.
