Jack is the V.P. for Pharmacy Services for a drugstore chain whose pharmacies are extremely busy. Some of the chain pharmacies and pharmacists have been fined for not counseling and not following other OBRA ‘90 requirements as adopted by the state. As a result, Jack sent out instructions to all pharmacies that for every new prescription, a clerk or technician must ask the patient if he or she would like counseling. If the patient does want counseling, the clerk must tell the patient that because the pharmacists are very busy, it could be a 10–15-minute wait. If the patient then declines counseling, the clerk must have the patient sign a waiver of counseling. Clerks are instructed to give information forms to patients to be completed, asking for demographic characteristics and significant medical and drug information.

a. In what ways has Jack complied with the requirements of OBRA ‘90? In what ways has Jack failed to comply with the requirements of OBRA ‘90?

b. If you were an employee of one of Jack’s pharmacies, what further changes would you recommend to bring Jack’s pharmacies into compliance with the language and intent of OBRA ‘90?