Maine Drug Law PL488: A Multitude of Problems…Part 3

Maine Drug Law PL488: A Multitude of Problems…Part 3

HIPAA is a privacy law enacted, passed by Congress and signed by President Clinton in 1996. A state (Maine) cannot implement the law at will to supersede federal because federal laws take priority over state laws due to the supremacy clause of our Constitution.

Under the Privacy Law there are Covered Entities and Business Entities; however, neither list includes veterinarians. The American Medical Association’s web page has this description of HIPAA on it today. Note, this description is on the website of the American Medical Association, which represents human medicine,  not the American Veterinarian Association (AVMA) which represents that of animals. Plus neither veterinarians nor their designated staff is bound by HIPAA regulations. How can pet owners who agree to have their personal prescriptions reviewed by someone from a veterinary practice be assured that whatever is seen will remain confidential? They can’t. Whereas in human medicine any HIPAA violations are dealt with appropriately. I think this places an extra burden on a practice, especially a small one. Plus I believe they are as uncomfortable viewing a humans prescriptions as we are knowing the law requires them to.

That gives rise to the question, how can Maine residents be sure their personal data is safe? On March 22, 2017, it was announced that a hacker had breached the Maine Department of Labor’s Job Link, a job matching service. While the service was outsourced to a Kansas company in July 2016, it was reported that the Maine DOL’s computer system is antiquated therefore indirectly played a part in the breach. Officials say the hacker was able to view names, social security numbers, and birth dates of site users. Since July, over 12,000 Maine residents have utilized the site and to date the number of users affected is unknown. So how do we know if the Maine PMP is secure? It’s disturbing alone that a veterinary practice staff member is required to look at consenting humans drug records and that a 5-year window of prescription activity is accessible on the PMP. Now we must also wonder about the security of the electronic system.


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Email sent by Maine DOL on March 24


Secondly, the state is mandating that veterinarians operate outside their scope of practice since pharmacology is often vastly different between the species. They are expected to make a judgment call when reviewing the owner’s (or anyone picking up the animal) prescription drugs on the PMP database and determining if prescribing a controlled drug for the animal would enable the owner to “potentially” exceed the mandated daily limit of 100 MME. This alone is requiring a doctor trained in animal physiology to understand human physiology. Would you expect your dentist to prescribe medications for your cat’s seizures? Or expect your veterinarian to know how much Vicodin you need following major orthopedic surgery? What if a veterinarian makes the wrong judgment call simply based on the numbers? A pet could be denied much-needed medication. Do legislators really have the power to make such laws where one’s medical privacy is violated and their pet possibly left in pain or distress?The inclusion of veterinarians in this hasty bill is not the answer to the opiate epidemic. Perhaps stricter sentencing should be considered. Recently in my Maine community, during the same court session, a drug trafficker was given a suspended sentence and allowed to freely exit the building whereas someone who embezzled money was sentenced to jail hence escorted out by deputies. The drug he trafficked was Suboxone which is both addictive and has the potential to be fatal  if combined with certain other drugs. While I’m certainly not defending someone who embezzled money, as a nurse who worked in a large city teaching hospital, I’ve never heard of someone dying because of it. The stark contrast in sentencing was disturbing and reinforced my belief that including veterinarians in PL 488 is not going to stem the opiate epidemic; appropriate sentencing is.

As a Maine resident who refuses to allow my HIPAA rights to be violated, and as an animal owner who does not want my pet to suffer, I  reached out to my elected officials and Augusta, the state capital, multiple times since February 2017 in an attempt to express my concern. My communications have been completely ignored with the exception of Senator Thomas Saviello who was initially helpful but once I began asking more focused questions regarding PL 488, he no longer responds. This is certainly not the reaction I expected from my elected officials nor is it one I’ve experienced while living in other states.

Next ~ Who else is adversely affected by Maine’s PL488?

Veterinary Visits In Maine Just Got Complicated…

Veterinary Visits In Maine Just Got Complicated…

Like nearly every state, Maine is dealing with an opiate and heroin epidemic. In 2015, Maine experienced 272 overdose related fatalities. In January 2017 one of Maine’s media outlets, WMTW, did an outstanding feature entitled Goodnight moon, goodnight mum,’ ‘Chronicle’ investigates Maine’s heroin epidemic. Anchor David Charns did a phenomenal job detailing the pain and heartache of addiction through a series of interviews and videos including one with Oxford County Sheriff’s Office Sgt. Matthew Baker Sergeant who, moments after arriving home from work in February 2015, discovered his 23-year-old daughter Ronni near death in the upstairs bathroom. Despite CPR from her father and several doses of Narcan by paramedics, she died, leaving behind an 11-month-old daughter Claire. Ronni’s daughter, now 2, lives with her grandparents and is the source of the name of the WMTW article:

When Claire asks for her mother, she and her grandfather look up, past that second-floor bathroom, to the sky. “I’ve always told her that that full moon is mum,” Baker said. “We go outside, and she says, ‘Goodnight moon and goodnight mum.'”

In an effort to combat the Maine opiate epidemic, the Maine Legislature enacted Public Law 488 which became effective January 1, 2017. PL488 affects nearly all facets of healthcare except in this law, veterinarians are included. I didn’t have all the exact data on PL488 so reached out to my State Senator, Thomas Saviello. I must tell you, he is the only government official to respond during the two weeks I called and emailed various agencies, elected officials including the State House. A sad indictment against them but a huge kudos for Senator Saviello. 

What I do know about PL488 and its impacts on veterinarians is such. If an owner takes their pet to be seen and the veterinarian feels it necessary to prescribe a narcotic or benzodiazepine for your pet, they must first do a check on the owner with DHHS to determine if the owner is taking a controlled substance. As I previously mentioned I still need to clarify the parameters but the fact that a veterinarian or perhaps his staff has the power to access a person’s prescriptions is a huge HIPAA violation. But I digress. Let’s use a hypothetical situation. The owner has an anxiety disorder for which he takes Valium on a daily
basis. He also has a severe back issue (long-term) so is on hydrocodone for pain control. His cat is hit by a car and taken to the vet where she undergoes successful emergency surgery but because her injuries are severe, the vet prescribes a pain medication; hydrocodone. Would the fact that the owner is on hydrocodone prohibit the vet from prescribing it for the cat’s postoperative pain? If so, would he be allowed to prescribe a different pain medication such as tramadol which also falls in the opiate category? Is
he is prohibited from prescribing any narcotic because the owner is on two (2)?  Or is it only if the owner is on the same drug? If his prescriptive powers are limited
because the owner is taking a controlled substance, what criteria is used to determine if the animal can or cannot get a prescription?

Whilst I understand the opiate epidemic our country is tackling, how can a veterinarian or anyone for that matter be absolutely certain that a person who is taking several controlled drugs is abusing or trafficking? Plus the thought that an innocent animal might have to suffer needlessly because his owner is prescribed a controlled substance is not only abhorrent but inhumane.  I want to know if it’s possible for the check to be done during non-business hours when DHHS is closed. Does the veterinarian’s office have to speak directly to a DHHS employee or is the information accessible online? And if it is accessible online, how can we, the human patient, be assured it’s secure? If the drug check on the owner can’t be done when DHHS is closed, then what happens to the animal who is in pain?  Any pet owner knows that many accidents happen at night, weekends or holidays when government agencies like DHHS are closed; what then?  Going back to HIPAA, who has authority within the veterinary practice to request the DHHS information? Can a receptionist do it? A vet tech? Or only the veterinarian? Finally, I do not understand how PL488, a state law, can override HIPAA, a federal law enacted in 1996 by Congress and signed into effect by then-President Bill Clinton. Under HIPAA an individual’s medical and other health information including prescriptions is private and protected. The Privacy Law sets limits on who can look at and receive our health information such as covered entities and their business associates. As a nurse and former Union representative, I am extremely familiar with HIPAA. In light of PL488, however, I reviewed it once again and nowhere did I find where veterinarians, veterinary technicians, or veterinary employees of any type are entitled to our records in any form. Additionally, PL488 is, in essence, requiring veterinarians to understand human medication dosages compared to animals which often differ greatly.hipaa_violations_by_type_-_pie_chart

I chose a veterinary team for my German Shepherd based on their reputations and expertise in animal physiology, not human. I value all members of her team despite being in different practices because of their knowledge. Having said that, I expect they keep current with the newest modalities of treatment for my dog. They work long hours yet now the State of Maine expects them to undertake additional training in order to understand and monitor the Prescription Monitoring Program (PMP)?  A program historically used only for humans?

This is ludicrous. There has to be a middle ground, a way the government, human healthcare providers, and law enforcement can work together in an effort to reduce the rampant drug abuse without violating a person’s rights or including veterinarians where there is potential for an animal to suffer because “something” raises a red flag when in reality it could be legitimate.

Once I have all the specifics, I’ll revisit this in a future post.


Update on Luke Stribling, Puppy Killer…

Update on Luke Stribling, Puppy Killer…

Ever since I launched my petition something has bothered me  ~ the media discrepancies in some Florida outlets. It didn’t make sense (yes I’m one of THOSE people who needs an answer) that two media reports would give a completely different version than other media sources about a single event; the first time Luke Stribling took  his puppy Julian to a vet for a broken leg on June 12. Since I wrote the petition, it was extremely important that it be accurate. So I went back the other day to look at the two original  media articles and to my shock they had been changed. Gone was all the damning indictments against both the first veterinarian and animal services for allowing Luke to take an abused puppy home. If I hadn’t archived the original stories I would have thought I definitely lost my marbles. So I emailed each reporter to subtly ask why the change yet neither responded. Hmmmmm.

I contacted Orlando Animal Services to put in a records request under FOIA. They hit my in box the next day. Impressive! Then I reached out to the first veterinary practice and was finally able to connect with the practice manager. You see, the two media reports said that when Stribling brought his puppy in for a broken leg the treating vet became suspicious, did an MRI which revealed even more fractures. Both stories went on to say that the veterinary practice notified authorities but there was “insufficient evidence to seize the puppy” so little Julian went home with Stribling. Not sure if it was over zealous reporting, misinformation, or misconstruing information received but the first veterinary practice never became suspicious because the story Luke told was plausible; Julian caught his leg in the dock slot as he was being walked. They didn’t do an MRI and in fact the practice doesn’t even have an MRI machine. No additional fractures were found and they never called animal services. It bothered me that the two initial media reports gave such detailed yet erroneous information because  what they reported is the type of thing that can tarnish reputations. So I edited my petition today and explained why.

Sadly, everything that occurred when Stribling brought his dead puppy to the vet on June 26 is true. In fact, its even worse than reported.  Reading that poor baby’s necropsy report was difficult for I could actually visualize his last minutes of life and it was disturbing. Forget that I’m a nurse who’s seen more than my share of “gruesome”. Forget that I’m a volunteer disaster nurse with DHHS and have been activated to several equally gruesome disasters. Sitting in a chair reading that report brought tears to my eyes ~ a lot of them


Even though I’ve survived brutality, I’ve never understood why people feel the need to inflict harm. Do they have mutated chromosomes? Or is their gene pool deficient? And how the hell did this pollutant of life, Stribling, manage to reach age 20 without anyone noticing his low frustration tolerance  or propensity for anger? Anger that in an innocent puppy’s case led to a violent death? Frustration and anger are related emotions, but they’re not identical. Some people are able to control anger or frustration and channel these feelings to nondestructive outlets. I get angry sometimes with automated phone systems that seem like an endless merry go round i.e. press this for that, press that for this only to wind up reaching the persons voice mail, leave a message and never get a callback. Frustrating and invokes anger. Yet I don’t throw the phone at the wall or scream when I finally reach a human. Well ~ there WAS that one time after I’d hung up that I threw the phone at the fireplace mantle but we’ll chalk that up to cabin fever as I was homebound. Alone with a broken leg in a wheelchair. In Maine where there’s still snow in April. I actually broke my leg in a terrible snowstorm on wait for it………….April 1!

But all joking aside, why did I toss a phone in an isolated event rooted in frustration while others, like several of the gunmen who committed mass murders, kill people?  Why does someone like Luke Stribling  exhibit a frightening lack of control because his little 7 1/2 pound puppy tinkled on the floor? Such a loss of control that  he punched, kicked and slapped Julian and till he eventually killed him. The necropsy report indicates the severity of the puppy’s injuries and that they’d been going on for some time. He lived in virtual fear of his owner yet no one noticed? No one saw that Luke had anger management issues? Well that is other than Luke’s friends who told investigators AFTER Julian’s death that Luke punched and kicked the puppy for tinkle accidents.


Luke Stribling Beat His Shiba Inu Puppy To Death.

Luke Stribling Beat His Shiba Inu Puppy To Death.

I really thought I did a post on this because of my outrage but apparently I didn’t. Since I wrote and launched a petition today I thought I’d share. Maybe after reading one of you might have some insight as to what would cause college students to commit these egregious acts (there are (2) more cases within the post)…

Luke Stribling, 20, of Orange County, Florida is a student majoring in Jazz at the University of Central Florida. He also willingly and maliciously beat, punched, kicked and tortured  his 17- week- old Shiba Inu puppy named Julian  to death. He was arrested on September 30, 2016 by the Orlando County Sheriff’s Dept for “tormenting, mutilating and ultimately killing his 17-week-old Shiba Inu puppy, Julian“. Deputies arrested Stribling on (2) charges of animal cruelty under Florida Animal Cruelty law: 828.12. Cruelty to animals and booked into Orange County Jail on both felony counts of cruelty to animals. Although the extended period of abuse took place last summer, authorities had to wait for the necropsy results to become available before they could charge. Incidently, a necropsy (same as an autopsy but usually refers to animals) takes at best (3) days but at least he was charged.

Media Video of Luke Stribling Upon Release From Orange County Jail

For those of you not familiar with the Shiba Inu breed I’ve hyperlinked. The abuse started long before little Julian’s death on June 26, 2016. At the time of death Julian was 17-weeks-old and would have weighed approximately 8-10 pounds.

Orange County Sheriff’s Office Facebook Photo of Luke Stribling

Luke Stribling originally brought Julian to the  East Orlando Animal Hospital on June 12, 2016, where he told the veterinarians that Julian had fallen down a flight of stairs and had trouble walking for two days. According to a statement by the examining vet, during the examination Julian literally shook because of severe pain which prompted the veterinarian to ask Stribling why he let his dog suffer for two days with a broken leg; Stribling did not respond to the question. Suspicious of Stribling’s behavior, the vet staff performed a full body MRI scan and found several other fractures all over Julian’s tiny body. Julian was also nervous in Stribling’s presence which indicated signs of abuse. Based on Julian’s pain and fear, the medical findings, and Stribling’s evasive answers, the clinic staff notified Animal Services.  Unfortunately, there wasn’t enough evidence to seize Julian and he was released back into Stribling’s custody.

I’m having an issue for lack of a better word with the absence of intervention reported in the media because nearly every mainstream outlet has a slightly different spin. For example, if Animal Services did not have enough evidence to intervene, what does Click Orlando mean in their article dated September 30:

Records show Stribling took a four-hour course on responsible pet ownership at Orange County Animal Services earlier this month. He also paid a $256 fine.

On June 26, Luke Stribling brought the deceased Julian to a different animal facility, Waterford Lakes Animal Clinic, still wearing the cast on his tiny leg. X-rays found Julian had a fractured rib, sternum and abdomen and had been beaten to death. Waterford Lakes Animal Clinic contacted Animal Control. Upon questioning by investigators, Stribling admitted that he “hit and kicked the dog multiple times because he was frustrated” with Julian for urinating in his student house.

A necropsy indicated the puppy suffered severe internal injuries, traumatic lesions including a hemorrhaging eye, liver and brain and head injuries.

Stribling’s friends  told investigators he punched and kicked Julian for urinating inside his University of Central Florida-area apartment. So a tiny, defenseless puppy suffered  prolonged abuse and trauma because this pathetic waste of oxygen failed as a responsible pet owner? He was negligent and incompetent in housebreaking Julian and for that reason alone the puppy endured endless abuse.

This is the third college male in the US that has recently been in the news for abusing an animal. A football player at Baylor University in Texas abused his own dog to the point of making it scream in pain and the video of the abuse went on Snapchat! His punishment to date? He had to sit out (3) football games. Yep, next Michael Vick right there.


The other football player abused his neighbor’s dog, Luca,  who he was supposed to be watching. The 42 pound dog was bleeding and the student just opened the door and let him run off. The owner located her dog because of an urgent plea on social media. Luca had to have emergency surgery because his jaw wasn’t broken ~ it was shattered. He lost (6) teeth and had numerous stitches. At least his college has suspended him from playing football.


Both of the football players are over 6’ tall and over 220 pounds. Luke Stribling appears to be of slight to regular build. Oh yes! In his LinkedIn profile he lists that he cares about “Animal Welfare”.

One doesnt have to be an animal lover, a vegan, vegetarian or even an animal activist to reaize that the death of an innocent puppy at the very hands of the person who was supposed to love and take care of him is inherintly wrong. Any  person with an ounce of humanity will surely agree that it takes a dark and evil mind to inflict such torment, pain and death upon an innocent puppy.

My words to Stribling if given the opportunity?

Malevolent as you are to the world, I am surprised you actually have friends.

If you feel that Julian the puppy deserves justice, please sign and share my petiton.


✦Links to the other (2) petitions are included with my pictures with text that I tweeted but I’ll add then below just in case.

BaylorUniversity TX  Ishmael Zamora    💙Justice4Rottie💙

Missouri State  Breck Ruddick    💙Justice4Luca💙

Let’s see the weasel one more time!