BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 1169
                                                                  Page  1

          Date of Hearing:   August 29, 2001

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                              Carole Migden, Chairwoman

                   SB 1169 (Alpert) - As Amended:  August 20, 2001 

          Policy Committee:                             HealthVote:13-1

          Urgency:     No                   State Mandated Local Program:  
          Yes    Reimbursable:              No

           SUMMARY  

          This bill authorizes pharmacists to initiate emergency  
          contraception drug therapy using protocols developed by the  
          pharmacist and an authorized prescriber.  The pharmacist must  
          complete a training program on emergency contraception and  
          provide the recipient with a standardized fact sheet to be  
          developed by the Board of Pharmacy containing information on  
          using the drug and the need for medical followup.

          The bill also contains provisions to avoid chaptering out AB 826  
          (Cohn).

           FISCAL EFFECT  

          Minor, absorbable costs to the Board of Pharmacy to develop the  
          required fact sheet on emergency contraception.

           COMMENTS  

           1)Purpose  .  This bill, sponsored by the Public Health Institute  
            (PHI), seeks to make emergency contraceptives more widely  
            available to women who are at risk of an unwanted pregnancy.   
            Currently, a woman must have a prescription to obtain these  
            drugs on an outpatient basis, or may obtain them from a  
            pharmacist without a prescription in an inpatient setting  
            based on a facility protocol.

          This bill, modeled after a program in Washington state,  
            authorizes a trained pharmacist to dispense emergency  
            contraceptives without a prescription in outpatient settings,  
            provided a standardized protocol or procedure developed in  
            collaboration with a physician or other authorized prescriber  








                                                                  SB 1169
                                                                  Page  2

            is followed.  The pharmacist must also provide the woman with  
            a standardized fact sheet containing specified information.

          The Board of Pharmacy, American College of Obstetricians and  
            Gynecologists, the California Medical Association and other  
            supporters note this bill will increase women's access to this  
            health service by avoiding the need for an appointment with a  
            physician prior to obtaining the drugs.  For these drugs to be  
            effective, the window of opportunity is very short - within 72  
            hours of intercourse.

           2)Background  .  Emergency contraceptives are designed to prevent  
            pregnancy, not cause an abortion.  There are two types of  
            emergency contraceptive pills.  One type uses estrogen and  
            progestin, the same hormones used in birth control pills, and  
            is about 75% effective in preventing pregnancy.  The other  
            type contains only progestin and reduces the risk of pregnancy  
            by 89%.  Women can start the pills right away or up to 72  
            hours after unprotected sex.  Depending on the time during the  
            menstrual cycle they are taken, the pills may inhibit or delay  
            ovulation, inhibit tubal transport of the egg or sperm,  
            interfere with fertilization, or alter the endometrium to  
            prevent a fertilized egg from being implanted.  If a woman is  
            already pregnant, emergency contraception does not work.  The  
            pills are harmless to the fetus and mother.

           3)Opposition  .  The California Right to Life Committee opposes  
            this bill as another vehicle to promote abortion under the  
            euphemism "emergency contraception drug therapy."

           4)Suggested Amendment  .  Although the bill requires a pharmacist  
            to be trained in emergency contraceptives before issuing them,  
            it does not specify the entity responsible for developing the  
            length and content of the training program.  Should the bill  
            be amended to require the Board of Pharmacy, in collaboration  
            with the Medical Board of California, to develop the training  
            requirements?

           Analysis Prepared by  :    Joyce Iseri / APPR. / (916) 319-2081