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