BILL NUMBER: AB 3049 CHAPTERED 09/15/02 CHAPTER 536 FILED WITH SECRETARY OF STATE SEPTEMBER 15, 2002 APPROVED BY GOVERNOR SEPTEMBER 13, 2002 PASSED THE ASSEMBLY AUGUST 25, 2002 PASSED THE SENATE AUGUST 22, 2002 AMENDED IN SENATE AUGUST 19, 2002 AMENDED IN SENATE JUNE 12, 2002 AMENDED IN SENATE JUNE 5, 2002 INTRODUCED BY Committee on Health (Thomson (Chair), Bates, Cohn, Dickerson, Frommer, Goldberg, Koretz, Negrete McLeod, Runner, Salinas, Strom-Martin, Washington, Wayne, and Zettel) MARCH 14, 2002 An act to amend Sections 11164 and 124595 of, to add Section 1596.799 to, and to repeal Section 130015 of, the Health and Safety Code, and to amend Section 14094.3 of the Welfare and Institutions Code, relating to public health. LEGISLATIVE COUNSEL'S DIGEST AB 3049, Committee on Health. Public health. (1) Existing law requires child day care facilities that are licensed by the State Department of Social Services to require proof of each child's immunizations, including tuberculosis testing, and to maintain files of this proof on the premises. This bill would exempt from these requirements any child day care center that exclusively offers a program of services for which there is no contract or agreement between the parent and the center for the regular care of the child, and there is no prearranged schedule of care for any child. It would require parents to sign a form acknowledging that they understand the center is not required to verify immunizations and tuberculosis testing for any children accepted for care. (2) Existing law, the California Uniform Controlled Substances Act, sets forth the requirements with respect to the form and content of prescriptions for controlled substances, and for filling, compounding, and dispensing those prescriptions. This bill would make a technical, conforming change to the act's requirements for the form of prescriptions for controlled substances. (3) Existing law establishes the American Indian Health Policy Panel, to advise the State Department of Health Services on the level of resources, priorities, criteria, and guidelines necessary to implement provisions for a program of various health services under the American Indian Health Service Program. Existing law specifies the composition of the panel, and requires that, in addition to other members, 4 members be appointed by the Director of Health Services from a list of persons submitted by the California Urban Indian Health Council. This bill would instead, require that 4 members be appointed from a list of persons submitted by the Western Indian Network. (4) Existing law, the Alfred E. Alquist Hospital Facilities Seismic Safety Act of 1983, requires for fiscal years 1994-95 through 1997-98, that an appropriation in the sum of $318,000 be made from the Hospital Building Fund to the Office of Statewide Health Planning and Development, for the purpose of developing specified regulations. This bill would delete the above appropriation. (5) Existing law establishes the California Children's Services (CCS) program in order to provide services to qualified children with disabilities. Existing law also provides for the Medi-Cal program, which is administered by the State Department of Health Services, pursuant to which medical benefits are provided to public assistance recipients and certain other low-income persons. Existing law provides for the department to enter into contracts with managed care systems, hospitals, and prepaid health plans for the provision of various Medi-Cal benefits. Existing law prohibits the CCS covered services from being incorporated into a Medi-Cal managed care contract entered into after August 1, 1994, until August 1, 2005, except with respect to contracts entered into for county organized health systems in specified counties. This bill would add the Counties of Yolo and Marin to those counties excepted from the prohibition against incorporating CCS covered services into Medi-Cal managed care contracts. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. Section 1596.799 is added to the Health and Safety Code, to read: 1596.799. (a) Notwithstanding Section 1597.05 or any other provision of law, any day care center that exclusively offers a program of services for which there is no contract or agreement between any parent and the center for the regular care of any child, and for which there is no prearranged schedule of care for any child, shall not be required to do either of the following: (1) Verify children's immunizations or tuberculosis testing. (2) Maintain files regarding children's immunizations or tuberculosis testing. (b) Upon admission of a child, the parent shall sign an acknowledgment that he or she understands that verification of immunizations and tuberculosis testing is not required for any child accepted in this type of program. (c) This section shall not be construed to exempt a day care center from any other licensing requirement. SEC. 2. Section 11164 of the Health and Safety Code is amended to read: 11164. Except as provided in Section 11167, no person shall prescribe a controlled substance, nor shall any person fill, compound, or dispense a prescription for a controlled substance unless it complies with the requirements of this section. (a) The signature on each prescription for a controlled substance classified in Schedule II shall be wholly written in ink or indelible pencil in the handwriting of the prescriber upon the official prescription form issued by the Department of Justice. Each prescription shall be prepared in triplicate, signed by the prescriber, and shall contain, either typewritten or handwritten by the prescriber or his or her employee, the date, name, and address of the person for whom the controlled substance is prescribed, the name, quantity, and strength of the controlled substance prescribed, directions for use, and the address, category of professional licensure, and the federal controlled substance registration number of the prescriber. The original and duplicate of the prescription shall be delivered to the pharmacist filling the prescription. The duplicate shall be retained by the pharmacist and the original, properly endorsed by the pharmacist with the name and address of the pharmacy, the pharmacy's state license number, the date the prescription was filled and the signature of the pharmacist, shall be transmitted to the Department of Justice at the end of the month in which the prescription was filled. Upon receipt of an incompletely prepared official prescription form of the Department of Justice, the pharmacist may enter on the face of the prescription the address of the patient. A pharmacist may fill a prescription for a controlled substance classified in Schedule II containing an error or errors, if the pharmacist notifies the prescriber of the error or errors and the prescriber approves any correction. The prescriber shall fax or mail a corrected prescription to the pharmacist within seven days of the prescription being dispensed. (b) Each prescription for a controlled substance classified in Schedule III, IV, or V, except as authorized by subdivision (c), shall be subject to the following requirements: (1) The prescription shall be signed and dated by the prescriber and shall contain the name of the person for whom the controlled substance is prescribed, the name and quantity of the controlled substance prescribed, and directions for use. With respect to prescriptions for controlled substances classified in Schedules III and IV, the signature, date, and information required by this paragraph shall be wholly written in ink or indelible pencil in the handwriting of the prescriber. (2) In addition, the prescription shall contain the name, address, telephone number, category of professional licensure, and federal controlled substance registration number of the prescriber. The information required by this paragraph shall be either preprinted upon the prescription blank, typewritten, rubber stamped, or printed by hand. Notwithstanding any provision in this section, the prescriber's address, telephone number, category of professional licensure, or federal controlled substances registration number need not appear on the prescription if that information is readily retrievable in the pharmacy. (3) The prescription shall also contain the address of the person for whom the controlled substance is prescribed. If the prescriber does not specify this address on the prescription, the pharmacist filling the prescription or an employee acting under the direction of the pharmacist shall write or type the address on the prescription or maintain this information in a readily retrievable form in the pharmacy. (c) Any controlled substance classified in Schedule III, IV, or V may be dispensed upon an oral or electronically transmitted prescription, which shall be reduced to writing by the pharmacist filling the prescription or by any other person expressly authorized by provisions of the Business and Professions Code. The date of issue of the prescription and all the information required for a written prescription by subdivision (b) shall be included in the written record of the prescription. The pharmacist need not reduce to writing the address, telephone number, license classification, or federal registry number of the prescriber or the address of the patient if that information is readily retrievable in the pharmacy. Pursuant to authorization of the prescriber, any employee of the prescriber on behalf of the prescriber may orally or electronically transmit a prescription for a controlled substance classified in Schedule III, IV, or V, if in these cases the written record of the prescription required by this subdivision specifies the name of the employee of the prescriber transmitting the prescription. (d) The use of commonly used abbreviations shall not invalidate an otherwise valid prescription. (e) Notwithstanding any provision of subdivisions (b) and (c), prescriptions for a controlled substance classified in Schedule V may be for more than one person in the same family with the same medical need. (f) In addition to the prescriber's record required by Section 11190, any practitioner dispensing a controlled substance classified in Schedule II in accordance with subdivision (b) of Section 11158 shall prepare a written record thereof on the official forms issued by the Department of Justice, pursuant to Section 11161, and shall transmit the original to the Department of Justice in accordance with any rules that the department may adopt for completion and transmittal of the forms. SEC. 3. Section 124595 of the Health and Safety Code is amended to read: 124595. (a) The Indian Health Policy Panel, established by the director pursuant to Section 1520 of Title 17 of the California Administrative Code, is continued in existence and shall be renamed the American Indian Health Policy Panel. The policy panel shall advise the department on the level of resources, priorities, criteria, and guidelines necessary to implement this chapter. The policy panel shall be composed of 10 members, appointed by the director. Four members shall be appointed from a list of persons submitted by the California Rural Indian Health Board, four members shall be appointed from a list of persons submitted by the Western Indian Network, and two members shall represent the public. The persons appointed by the director to represent the public may be consumers, consumer advocates, health service providers, representatives of state or county health agencies, health professionals, or private citizens. The terms of the members shall be established pursuant to bylaws adopted by the policy panel. (b) The director may also seek advice from individuals and groups, other than the policy panel, on program issues. (c) Those persons who are members of the policy panel on December 31, 1983, shall continue to be members for the remainder of their terms and, upon expiration of their terms, shall be eligible for reappointment by the director. SEC. 4. Section 130015 of the Health and Safety Code is repealed. SEC. 5. Section 14094.3 of the Welfare and Institutions Code is amended to read: 14094.3. (a) Notwithstanding this article or Section 14093.05 or 14094.1, CCS covered services shall not be incorporated into any Medi-Cal managed care contract entered into after August 1, 1994, pursuant to Article 2.7 (commencing with Section 14087.3), Article 2.8 (commencing with Section 14087.5), Article 2.9 (commencing with Section 14088), Article 2.91 (commencing with Section 14089), Article 2.95 (commencing with Section 14092); or either Article 2 (commencing with Section 14200), or Article 7 (commencing with Section 14490) of Chapter 8, until August 1, 2005, except for contracts entered into for county organized health systems in the Counties of San Mateo, Santa Barbara, Solano, Yolo, Marin, and Napa. (b) Notwithstanding any other provision of this chapter, providers serving children under the CCS program who are enrolled with a Medi-Cal managed care contractor but who are not enrolled in a pilot project pursuant to subdivision (c) shall continue to submit billing for CCS covered services on a fee-for-service basis until CCS covered services are incorporated into the Medi-Cal managed care contracts described in subdivision (a). (c) (1) The department may authorize a pilot project in Solano County in which reimbursement for conditions eligible under the CCS program may be reimbursed on a capitated basis pursuant to Section 14093.05, and provided all CCS program's guidelines, standards, and regulations are adhered to, and CCS program's case management is utilized. (2) During the time period described in subdivision (a), the department may approve, implement, and evaluate limited pilot projects under the CCS program to test alternative managed care models tailored to the special health care needs of children under the CCS program. The pilot projects may include, but need not be limited to, coverage of different geographic areas, focusing on certain subpopulations, and the employment of different payment and incentive models. Pilot project proposals from CCS program-approved providers shall be given preference. All pilot projects shall utilize CCS program-approved standards and providers pursuant to Section 14094.1. (d) (1) The department shall submit to the appropriate committees of the Legislature an evaluation of pilot projects established pursuant to subdivision (c) based on at least one full year of operation. (2) The evaluation required by paragraph (1) shall address the impact of the pilot projects on outcomes as set forth in paragraph (4) and, in addition, shall do both of the following: (A) Examine the barriers, if any, to incorporating CCS covered services into the Medi-Cal managed care contracts described in subdivision (a). (B) Compare different pilot project models with the fee-for-service system. The evaluation shall identify, to the extent possible, those factors that make pilot projects most effective in meeting the special needs of children with CCS eligible conditions. (3) CCS covered services shall not be incorporated into the Medi-Cal managed care contracts described in subdivision (a) before the evaluation process has been completed. (4) The pilot projects shall be evaluated to determine if: (A) All children enrolled with a Medi-Cal managed care contractor described in subdivision (a) identified as having a CCS eligible condition are referred in a timely fashion for appropriate health care. (B) All children in the CCS program have access to coordinated care that includes primary care services in their own community. (C) CCS program standards are adhered to. (e) For purposes of this section, CCS covered services include all program benefits administered by the program specified in Section 123840 of the Health and Safety Code regardless of the funding source. (f) Nothing in this section shall be construed to exclude or restrict CCS eligible children from enrollment with a managed care contractor, or from receiving from the managed care contractor with which they are enrolled primary and other health care unrelated to the treatment of the CCS eligible condition.