5.2 Impaired Practitioner Reporting and Programs

Why impairment is its own MPJE leaf

NABP Area 1.2.3 tests inability to practice with reasonable skill and safety, diversion, the duty not to work impaired, and alternative-to-discipline programs. Connecticut does not handle those facts only under § 20-579(a)(5)–(6) and (b). P.A. 23-204 (effective October 1, 2023) added CGS §§ 20-638 to 20-638c, modeled on the Department of Public Health professional-assistance statutes in §§ 19a-12a to 19a-12e, and expanded the assistance program definition in § 19a-12a so it expressly covers pharmacists and pharmacy interns.

Quick Answer: If you have information that a pharmacist or pharmacy intern is or may be unable to practice with reasonable skill or safety, you shall petition DCP within 30 days—unless, for chemical dependency, emotional or behavioral disorder, or physical or mental illness, you refer that person to the assistance program, which satisfies the petition duty. Illegal diversion still belongs in a DCP petition. The statute says “assistance program,” not a brand name; HAVEN (Health Assistance InterVention Education Network) is the organization that publicly operates Connecticut’s confidential program and lists pharmacists and pharmacy interns as of October 2023.

Duty not to practice impaired

Two statutes describe the same public-safety idea from opposite sides.

• § 20-579(a)(6) and (b) make abuse or excessive use of drugs, including alcohol, and any condition that would interfere with practice, grounds for Commission action.
• § 20-638a(e) requires the assistance program to refer the participant to DCP if the person is unable to practice with skill and safety or poses a threat, and does not refrain from practicing or fails to participate in recommended rehabilitation, or refuses the program’s terms.

There is no Connecticut safe harbor for “I was the only pharmacist scheduled.” An intoxicated pharmacist who starts a shift is practicing while a § 20-579(b) condition would interfere. Colleagues who watch it happen acquire § 20-638b information the same night.

Mandatory versus discretionary reporting — CGS § 20-638b

Who must file. Any health care professional, hospital, pharmacy, pharmacist, or pharmacy intern shall, and any other person may, file a petition with DCP when that person has any information that appears to show that a pharmacist or pharmacy intern is, or may be, unable to practice with reasonable skill or safety for any of these reasons:

• (A) physical illness or loss of motor skill, including deterioration through aging;
• (B) emotional disorder or mental illness;
• (C) abuse or excessive use of drugs, including alcohol, narcotics, or other chemicals;
• (D) illegal, incompetent, or negligent conduct in the practice of the profession;
• (E) possession, use, prescription for use, or distribution of controlled substances or legend drugs, except for therapeutic or other medically proper purposes;
• (F) misrepresentation or concealment of a material fact in obtaining or reinstating a license or registration; or
• (G) violation of Chapter 400j or a regulation adopted under it.

When. Not later than thirty days after obtaining the information. The petition is filed with DCP, in a form and manner the commissioner prescribes—not with the Commission as a first stop, and not with the Department of Public Health. DPH’s parallel § 19a-12e petition is for DPH-licensed professions. Pharmacists are a DCP profession; use § 20-638b.

What a HAVEN / assistance-program referral does—and does not—do. § 20-638b(b) is the alternative-to-discipline valve: a health care professional, hospital, pharmacy, pharmacist, or intern that refers the pharmacist or intern to the assistance program for intervention is deemed to have satisfied subsection (a) with respect to inability to practice due to chemical dependency, emotional or behavioral disorder, or physical or mental illness. That sentence is narrow. It does not say that a HAVEN call wipes out a duty to report illegal oxycodone diversion, incompetent sterile compounding, or a false license application. Those remain DCP petition facts under (D), (E), (F), and (G).

Self-reporting an arrest. A pharmacist or intern who has been arrested on an allegation of possession, use, prescribing, or distribution of alcohol, a controlled substance, or a legend drug shall, not later than 30 days after the arrest, send notice to DCP. Seeking assistance-program intervention during that 30-day period is deemed to satisfy the notice. § 20-638b(d) separately requires the pharmacist or intern to report out-of-state discipline similar in nature to § 20-579 to DCP within 30 days; failure may constitute grounds for discipline.

Immunity. Filers and the assistance program are not liable for damage to the pharmacist or intern without a showing of malice (§ 20-638b(e)).

What the assistance program actually is

CGS § 20-638(1) defines “assistance program” by cross-reference to § 19a-12a(a): the program established to provide education, prevention, intervention, referral assistance, rehabilitation, or support services to health care professionals, pharmacists, and pharmacy interns who have a chemical dependency, emotional or behavioral disorder, or physical or mental illness. § 19a-12a(b) requires it to be an alternative, voluntary, and confidential opportunity for rehabilitation, with mandatory, periodic evaluations of each participant’s ability to practice with skill and safety.

Chapter 400j never uses the letters HAVEN. Do not invent a statutory rename. HAVEN publicly describes itself as Connecticut’s confidential monitoring program for licensed health professionals and states that pharmacists and pharmacy interns were added as of October 2023, which matches the October 1, 2023 effective date of P.A. 23-204. If an item asks for the statutory name, answer assistance program / pharmacy professional assistance program. If it asks who currently operates that confidential track, HAVEN is the published operator; DCP’s Chapter 400j text still will not contain the acronym.

CGS § 20-638c creates the pharmacy professional assistance program account in the General Fund. The Commissioner of Consumer Protection pays the assistance program from that account. (The intern-application add-on taught in Chapter 3 is one of the deposits.)

Pharmacy technicians are not in §§ 20-638 to 20-638c. The assistance program admits pharmacists and pharmacy interns. A technician who is diverting oxycodone is a § 20-579 registration case (especially (a)(5) illegal possession/diversion) plus DCP Drug Control and, if Schedule II is missing, DEA Form 106 theft/loss reporting. Do not send the MPJE down a fictitious “HAVEN for techs” path.

Confidential admission versus public discipline

§ 20-638a(c) is the eligibility screen. A medical review committee shall not admit a pharmacist or intern who:

1. has pending disciplinary charges, prior disciplinary action, or a consent order from any professional licensing, registering, or disciplinary body;
2. has been charged with or convicted of a Connecticut felony, or an out-of-state offense that would be a felony here; or
3. is alleged to have harmed a patient.

Those people are referred to DCP with the committee’s records. § 20-638a(f) then lets DCP decide whether the person may still participate, and whether participation remains confidential. If DCP agrees the person is an appropriate confidential candidate and the person complies, the entire referral and investigation record stays confidential for the duration of participation and after successful completion, except at the participant’s request.

§ 20-638a(h) keeps assistance-program information confidential in civil, criminal, and administrative proceedings unless the participant waives, disclosure is required by law, or the program is disclosing in an administrative proceeding after it has referred the person to DCP. Annual reports to the Commission/DCP give counts and purposes, not names.

DCP investigates each § 20-638b petition under § 21a-11, may order a physical or mental examination by a physician or APRN from an approved list, and may petition Hartford Superior Court if the person refuses the exam or a hearing (§ 20-638b(f)–(h)). License restriction still requires notice and hearing (§ 20-638b(i)).

Realistic Connecticut scenarios

The closing pharmacist in Stamford sees the technician drop oxycodone IR 15 mg tablets into a coat pocket and later finds the CII perpetual inventory short. Waiting for “the Commission’s next Wednesday meeting” is not a reporting plan. § 20-638b’s mandatory petition is written around an impaired pharmacist or intern, so it does not convert the technician into a HAVEN client. The technician’s registration is still in play under § 20-579(a)(5). The pharmacist who watched diversion and stayed silent also faces (a)(16) negligent work, Drug Control investigation, DEA Form 106 if the loss is a theft, and CGS § 21a-322 “failure to maintain effective controls against diversion” against the controlled-substance registration. Referring only the technician to an employee-assistance counselor, and never telling DCP, does not satisfy Connecticut pharmacy law.

The same night, the pharmacist-in-charge smells alcohol on the staff pharmacist, hears slurred counseling, and watches that pharmacist start verifying prescriptions. That is inability to practice with reasonable skill and safety due to abuse or excessive use of alcohol. The PIC shall petition DCP within 30 days or refer the pharmacist to the assistance program, which does satisfy § 20-638b(b) for chemical dependency. Letting the pharmacist “sleep it off in the break room and finish the shift” is practicing while impaired. The intoxicated pharmacist who refuses to clock out is the person § 20-638a(e) later sends to DCP if a program is already involved.

Official anchors

• CGS §§ 20-638 to 20-638c — assistance-program definitions, admission, petitions, account.
• CGS § 19a-12a — statutory assistance-program definition covering pharmacists and interns.
• HAVEN — who we help — operating program; pharmacists and pharmacy interns listed.