allowed a speaker picard and place it to the right of the podium. it will appear on the july 12 agenda unless otherwise stated. >> i know many of you are here for a number of things. why don't we call an item number one. >> hearing on the standards, projects that may cause environmental health impact. >> this is an item that i introduced and let's make it very clear what the purpose of this item is. it is an item that will involve a general discussion of the standards and procedures that are followed in the department of public health as they provide a review of land use projects or other projects that come before the board that require their expertise in terms of analyzing and the environmental health impacts of those projects. there may be members. the focus of this presentation and this discussion is for us to hear from the department of public health generally speaking on standards and procedures, the ethical guidelines that they follow. i thought it was important for us to have this discussion because anybody that follows the board of superviso

. >> reporter: jeff picard is the director of pharmacy operations for children's national medical center. >> if a child needs certain electrolytes in his iv and those are short, we are really scrambling. >> reporter: drugs for cancer treatments, infections, heart disease, diabetes, even adhd are experiencing shortages. 211 last year. perhaps as many as # hundred medications by the end of 2011. >> there were problems with production in terms of keeping up with quality issues. >> reporter: there are fewer manufacturers to pick approximate up the slack in a company goes offline. some drugs are discontinued if they are not profitable to make. others get hung up in the regulatory process. usually, alternatives are available but doctors say it complicates how they treat their patients. >> that is definitely a major issue when they're admitting someone who is very ill. >> it does come caught things because we get a little bit out of our standard of care and we have to be a little more vigilant for unusual things that we wouldn't usually be looking for. >> reporter: in the pharmacy at children's

. >> jeff picard is the director of pharmacy operations for children's national medical center. >> if a child needs certain electrolytes in his iv and those are short, we're really scrambling. >> reporter: drug for cancer treatments, infections, heart disease, diabetes, even adhd are experiencing shortages. # 11 last year and perhaps as many as 300 medications by the end of 2011. -- 311 last year and perhaps as many as 300 medications -- 211 last year and perhaps as many as 300 medications by the end of twoiive. >> reporter: there are fewer manufacturers to pick up the slack if the company goes offline. some drug are discontinue if the they are not profitable to make. others get hung up in the regulatory process. usually, alternatives are available but doctors say it complicates how they treat their patients. >> that is definitely a major issue when they're admitting someone who is very ill. >> the doctor specializes in pediatric unif he can schuss dises. >> it does complicate things because we get out of the standard of care and we have to be a little bit more vigilant for unusual th