Miss. Board of Pharmacy adjusts Technician Ratio to 3:1

The Mississippi Board of Pharmacy (MBOP) has updated the pharmacy regulations to allow for the greater use of technicians in all pharmacy practice settings.  The official update reads as follows:


Revisions to the Pharmacy Practice Regulations regarding the increase in Pharmacy Technician/Pharmacist ratios have been completed and effective August 1, 2016, the ratio is three Pharmacy Technicians to one Pharmacist. This ratio applies to all practice settings. Please bear in mind that, regardless of the ratio, that those tasks authorized to be conducted by Pharmacy Technicians may only be performed under the direct and immediate supervision of a Pharmacist. It is the responsibility of the Pharmacist-In-Charge as well as supervising pharmacists to provide supervision of duties of the pharmacy technician and to prevent pharmacy technicians from performing those functions relative to dispensing which are functions based on a judgement for which the pharmacy technician has not been prepared by education or authorized by law or regulation. The Pharmacist-In-Charge (PIC) is responsible for assuring that all personnel are properly registered with the Board. If you have questions concerning ratios or approved tasks of a Pharmacy Technician please contact the office of the Board.

The Board’s adjustment comes at a time when most pharmacies are struggling to stay in business or at least make their individual department within the company profitable. I doubt seriously that any pharmacy is ‘profitable’ in the traditional sense of the word in 2016.  Most, if not all, are simply a means to draw customers into the store for other reasons and will use creative accounting techniques to claim that their pharmacies actually turn a profit and justify exorbitant bonuses to a select few company ‘associates.’

I imagine most large chains (Walgreens, CVS)  and mass merchandisers (Fred’s, Wal-Mart) will take advantage of the new ratio to reduce the number of pharmacists on staff at any given time and, consequently, save on labor costs.  The claim has always been that using technicians will allow the pharmacist more time to spend with the patient and/or giving immunizations.  We’ll see.  I have heard that line in one form of the other for 25 years now and it never works out in the pharmacist’s favor.  My experience has been that any time there is a claim to free up the pharmacist to “do more of this” or “more of that” it turns out later on to simply be a way to demand that the pharmacist (or the pharmacy ‘associates’ to use the corporate speak gobbledygook)  process more “output” with fewer resources.  It may be that the MBOP has finally recognized that this ratio has probably been the norm for many years now and it really can’t justify assessing fines because nobody is following the rule.  At least now, those who were trying to follow the rule but really struggled to keep up with the demands of their corporate ‘bosses’ can release a general sigh of relief.  What is to say a 4 to 1 ratio is reasonable?  5 to 1? Why do we need prescriptions anyway?  Do other first world nations have such a dis-functional prescription drug distribution apparatus in place?

Follow the money.

James P. Tinsley, RPh, J.D.

Djibouti Now Processing Yemeni Visa Applicants

Explosion outside the Capital of Yemen, Sana’a.
Sana’a, Yemen.

The US has not had any diplomatic presence in Yemen since 11 Feb 2015.  All diplomatic personnel were physically relocated outside the country.  The resulting diplomatic vacuum has made pending immigrant visa applications and interviews difficult to coordinate.  Recently, USCIS is almost universally issuing requests for evidence (RFE) if a Petitioner only submits birth certificates and marriage contracts without additional documentation and proof of the marriage or familial relationship.  This most commonly can be done by submitting additional documents and undergoing DNA testing from an AABB approved lab.  However, at this moment, no DNA testing can be done inside Yemen for obvious reasons: the colossal humanitarian disaster that is in the making.

Recently, the consulate in Djibouti is now scheduling and processing immigrant visa applications and interviews for Yemenis without requiring the applicant to be physically present in Djibouti.  This means your relative can schedule his or her interview before departing Yemen and arriving in Djibouti for the interview.  Many Yemenis who are waiting for their interview were not able to afford housing in Djibouti while waiting for the interview.  Coordinating DNA testing is still a challenge, but this new policy should help with the housing expense for Yemenis waiting for an immigrant visa interview.  Below is the latest from the IV Yemen website at the Department of state:

Information for Yemeni Citizens Applying for Petition-Based Immigrant Visas

Updated April 28, 2016

Beginning with appointments in June 2016, the U.S. Department of State is scheduling immigrant visa appointments for Yemeni applicants at the U.S. Embassy in Djibouti instead of the U.S. Embassy in Algeria in order to prevent delays and move more applicants to the interview stage. The U.S. Embassy in Djibouti no longer requires applicants to be physically present in the country prior to transferring their case. Interviews are being scheduled in order of the date the case became documentarily qualified and eligible for scheduling.

The U.S. Department of State previously scheduled visa interviews for Yemeni citizens in Algiers; however, as of March 23, 2016, the Government of Algeria requires Yemeni nationals to have a visa to enter Algeria. While some applicants have successfully obtained Algerian visas, this is preventing many applicants from attending interviews scheduled at the U.S. Embassy in Algiers. There is additional information on the U.S. Embassy in Algiers’s website.

If your relative has a pending case from Yemen and you have questions about what to do next with his/her case, please contact my office to see if we can help. We have been coordinating DNA testing for other Yemeni clients when such testing has been requested from USCIS.  In the absence of other documents, DNA testing may be your only option to overcome a RFE and have your relative’s case move forward to the interview stage in Djibouti.

James P. Tinsley, Esq., 143 C Willowbrook Drive, Saltillo, MS 38866.  (662) 350-3971; james@tinsleylaw.net

Mississippi Senate Bill 2306 tells your Sheriff how to do his job

Bouc émissaire, Juden…

Here we go again. Phil Bryant (PB) and his cronies have all the answers on how to end illegal immigration.  With all the grandstanding and the dubious participation by the “Guvener” in United States v. Texas (without approval or consent of Mississippi’s top elected attorney, Jim Hood, as far as we know), the temptation to find a scapegoat for all of Mississippi’s problems knows no limits.

Senate Bill 2306, introduced by Senator Sean Tindell for Gulfport, requires all law enforcement agencies (LEA) to affirmatively notify “federal immigration authorities” (whoever that may be, there are at least five different federal agencies that could be, but who really cares anyway) that someone in their jail is “not legally present in the United States.”  I’ll call them FIAs for short, but the lack of precision in this is stunning.  I guess if you sent President Obama an email that a guy named José is in the Newton county jail that would count as notifying a FIA.  Who knows for sure.

Despite the lack of precision, this bill places a specific legal duty on your county sheriff, chief of police, state trooper, etc. to somehow let FIAs know that a person is not here in the US “legally.”  So now, the agency has to determine if someone is not legally in the US.  Last time I checked that was something that those vaguely identified FIAs had the sole authority to determine pursuant to federal law, and, by the way, the Constitution of the United States.  (like Professor Cochran used to say: Who needs a constitution among friends anyway? It just makes life harder.)

So I am at a loss as to how the LEA is supposed to determine if a person is not legally in the US.  Of course, the detainee can tell you.  But in the absence of that, how will the LEA know when and when not to “notify” the FIAs?  Doesn’t speak English?  Has darker colored skin? Doesn’t have any identification?  Has a weird last name?  Exercises his 5th amendment right to remain silent? Can’t tell you who won the World Series last year? Doesn’t celebrate Confederate Pride Month (CPM) in April?  I simply don’t know.

Then the bill goes on to require the LEA to “fully honor” a detainer placed by FIAs.  Again the lack of precision makes this bill fertile ground for abuse.  I suspect that the word “detainer” refers to DHS Form I-247, Immigration Detainer-Notice of Action that requests a LEA to “Maintain Custody of Alien for a Period not to exceed 48 hours.”  Federal case law as well as precedent from SCOTUS has held that Form I-247 is merely a request and is not mandatory. See, Galarza v. Szalczyk, 745 F.3d 634 (3d Cir. 2014) (citing, Printz v. United States, 521 U.S. 898 (1997) that struck down most of the Brady Bill as violating the 10th amendment).  To hold otherwise would be tantamount to the federal government nationalizing the state police.  I doubt PB would go for that given his love for President Obama and Attorney General Loretta Lynch.

So, this bill scuttles the distinction between the federal and state spheres of authority over the detention of criminal defendants in county jails and effectively deputizes state LEAs as extensions of the Federal Government.  So, now your local sheriff is no longer allowed to exercise his/her professional judgment as to whom to keep in his/her jail.  The sheriff is now a de facto immigration officer thanks to this unnecessary piece of political theater.

Of course, SB 2306 will be enforced consistent with federal law and “protecting the civil rights of all persons.”  Why is this in there?  Isn’t that always the case?  Do LEAs need to be reminded that they are sworn to protect the civil rights and dignity of ALL persons?  Have we become such a police state that we have to legislate what the constitution already requires?  My thought is that there is a perception out there that persons who are not “legally present” in the US have no rights whatsoever and cannot complain later if they are not treated the same as others.  “Those” illegals have no rights!  There illegal!  The Constitution doesn’t apply to them!  Thanks for reinforcing that idea, PB and Senator Tindell.

Under federal law, a LEA is only required to keep a suspected alien for 48 hours if it chooses to do so.  If a LEA detains a person beyond this time, the LEA and the individual officers are subject to liability for violating federal civil rights statutes, even if the detainee is not legally present in the US.  So, despite the dubious need for this legislation, if a LEA detains someone beyond 48 hours, it does so at its peril and SB 2306 will not immunize the LEA against liability despite its attempt to do so in section 4 of the bill.

The last clause of section three states: “and respecting the privileges and immunities of United States citizens.”  What the ___ does this mean?  Oh, I guess it would not be good if a FIA deported a US citizen.  That never happens because LEAs are provided with so much guidance on how to determine if someone is legally present in the good ole USA.

Reality check:  FIAs deport as many as 4000 US citizens each year.  FIAs have deported US citizens despite clear and obvious evidence of US citizenship.  The FIAs and the LEAs have been sued and paid out large settlements for their blatant disregard for basic human rights.  It is hard to distinguish between incompetence and outright willfulness in those cases, but SB 2306 certainly doesn’t provide any guidance on the issue.

If you want to protect your basic human rights you must protect the basic human rights of all persons, citizens and non-citizens.  History is replete with politicians finding a venerable group to blame for all that is wrong.  Mississippi has bigger problems than illegal immigration.  The story is different for border states like Texas and Arizona, but Mississippi’s foray into this issue is simply political scapegoating and the use fear as a means of political power.  Beware the politician selling fear.  She is selling snake oil that doesn’t cure anything.  Likewise, SB 2306 does nothing to solve the problem of illegal immigration.  Violent criminals who are US citizens are let out of jail all the time and go on to commit other heinous crimes as well.  The connection between illegal immigration and violent crime in general is the very definition of a non sequitur.

Mississippi has a dreadful history with regard to human rights and therefore has a special duty to be exceedingly vigilant guarding those rights of all people.  In 2016, poverty is rampant in large parts of the state, on par with many third world countries.  I have been told by immigrants from Mexico that they would rather live in Mexico than live in certain parts of Mississippi because the standard of living is higher in Mexico.  Not something to be proud of folks.

So, maybe our time would be better spent regulating fantasy football or celebrating CPM?


James P. Tinsley, Esq.