BILL ANALYSIS
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|SENATE RULES COMMITTEE | SB 490|
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THIRD READING
Bill No: SB 490
Author: Alpert (D)
Amended: 4/24/03
Vote: 21
SENATE HEALTH & HUMAN SERV. COMMITTEE : 7-1, 4/2/03
AYES: Ortiz, Alarcon, Chesbro, Florez, Kuehl,
Vasconcellos, Vincent
NOES: Battin
SENATE BUSINESS & PROFESSIONS COMMITTEE : 4-2, 4/28/03
AYES: Figueroa, Cedillo, Machado, Murray
NOES: Aanestad, Brulte
SENATE APPROPRIATIONS COMMITTEE : 7-5, 5/29/03
AYES: Alpert, Bowen, Burton, Escutia, Karnette, Machado,
Murray
NOES: Battin, Aanestad, Ashburn, Johnson, Poochigian
SUBJECT : Pharmacy: emergency contraception drug therapy
SOURCE : Public Health Institute
DIGEST : This bill authorizes a licensed pharmacist to
initiate emergency contraception drug therapy in accordance
with a standardized procedure approved by the Board of
Pharmacy and the Medical Board of California.
ANALYSIS : Existing law:
1.Regulates the practice of pharmacy by the California
CONTINUED
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State Board of Pharmacy.
2.Prohibits a pharmacist from furnishing a dangerous drug
except upon the prescription of a physician, dentist,
podiatrist, optometrist, or veterinarian.
3.Allows a pharmacist to administer, orally or topically,
drugs and biologicals pursuant to a prescriber's order.
4.Authorizes a pharmacist to initiate emergency
contraception drug therapy in accordance with
standardized protocols developed by the pharmacist and an
authorized prescriber acting within his or her scope of
practice.
This bill:
1.Authorizes a pharmacist to furnish emergency
contraception drug therapy in accordance with a
standardized procedure or protocol developed and approved
by the Medical Board of California and Board of Pharmacy,
in consultation with the American College of
Obstetricians and Gynecologists and other appropriate
entities.
2.Specifies that both the board and the Medical Board of
California shall have authority to ensure compliance, and
both boards are specifically charged with the enforcement
of the provision with respect to their respective
licensees. Provides that nothing in these provisions
shall be construed to expand the authority of a
pharmacist to prescribe any prescription medication.
3.Requires a pharmacist, prior to furnishing emergency
contraception, to receive training regarding the
appropriate use and indications for emergency
contraception.
Comments
SB 1169 (Alpert, Chapter 900, Statutes of 2001) created
authority for a pharmacist to initiate emergency
contraception drug therapy in accordance with standardized
procedures or protocols developed by the pharmacist and an
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authorized prescriber acting within their scope of
practice. Emergency contraception therapy is a drug
regimen that reduces the chance of pregnancy significantly
if administered within 72 hours of unprotected intercourse.
SB 1169 requires a pharmacist, prior to initiating
emergency contraception drug therapy, to complete a
training program on emergency contraception, covering the
conduct of sensitive communications, quality assurance,
referral to additional services, and documentation. For
each therapy regimen initiated by the pharmacist, the
pharmacist must provide the recipient of the emergency
contraception services with a standardized fact sheet,
developed by the Board of Pharmacy, that includes the
indications for the drug, the appropriate method for using
the drug, the need for medical follow-up, and other
information.
SB 490 adds a second process under which pharmacists can
provide emergency contraception therapy that is
standardized and does not require pharmacists to develop
their own protocol in conjunction with authorized
prescribers.
The American Medical Association and the American College
of Obstetricians and Gynecologists have recommended that
emergency contraception be granted over-the-counter status
by the Food and Drug Administration.
Related legislation
SB 545 (Speier), currently in the Senate Business and
Professions Committee and scheduled to be referred to
Senate Health and Human Services Committee, would remove
the training requirement for pharmacists who wish to
provide emergency contraception. The bill would also
prohibit pharmacists from charging a separate consultation
fee if they provide emergency contraception and limit the
dispensing fee charged for emergency contraception drugs to
the Medi-Cal dispensing fee.
Prior legislation
SB 1169 (Alpert), Chapter 900, Statutes of 2001
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AB 261 (Lempert) Chapter 375, Statutes of 1999
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
According to the Senate Appropriations Committee:
Fiscal Impact (in thousands)
Major Provisions 2003-04 2004-05
2005-06 Fund
Standardized procedure and -- minor
-- Special*
Protocol
* Pharmacy Board Contingent Fund and Contingent Fund of the
Medical
Board of California
SUPPORT : (Verified 5/29/03)
Public Health Institute (source)
American College of Obstetricians and Gynecologists
American Federation of State, County & Municipal Employees
California Abortion and Reproductive Rights Action League
California Commission on the Status of Women
California Family Health Council
California Medical Association
California National Organization for Women
California Pharmacists Association
Institute for Health Policy Studies
League of Women Voters of California
Napa County Office of Education
New Generation Health Center
Planned Parenthood Affiliates of California
Planned Parenthood, Los Angeles
Planned Parenthood, San Diego & Riverside
Planned Parenthood, Santa Barbara, Ventura & San Luis
Obispo Counties
San Francisco Health Plan
The Permanente Medical Group, Inc.
UCSF, Institute for Health Policy Studies, School of
Medicine
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ARGUMENTS IN SUPPORT : According to proponents, SB 490
will further expand access to emergency contraception,
thereby reducing unintended pregnancies in California.
According to the author's office and proponents, although
SB 1169 of 2001 allows pharmacists to provide emergency
contraception to patients under a protocol developed by the
pharmacist and an authorized prescriber, the current system
is cumbersome and presents significant barriers to
pharmacists. In addition, few physicians have participated
in the development of protocols for pharmacist
administration of emergency contraception due to
malpractice concerns. As a result, only about 14 percent
of all retail pharmacies in the state provide emergency
contraception. This bill would address these problems by
establishing a standard protocol under which pharmacists
may provide emergency contraception to patients.
According to the author's office, New Mexico currently
permits its Board of Pharmacy to develop a standard
protocol for emergency contraception.
CP:nl 5/29/03 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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