BILL ANALYSIS
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|SENATE RULES COMMITTEE | SB 545|
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UNFINISHED BUSINESS
Bill No: SB 545
Author: Speier (D), et al
Amended: 9/3/03
Vote: 21
SENATE BUSINESS & PROFESSIONS COMMITTEE : 4-1, 4/7/03
AYES: Figueroa, Cedillo, Machado, Vincent
NOES: Aanestad
NO VOTE RECORDED: Brulte, Murray
SENATE APPROPRIATIONS COMMITTEE : 7-5, 6/4/03
AYES: Alpert, Burton, Escutia, Karnette, Machado, Murray,
Speier
NOES: Battin, Aanestad, Ashburn, Johnson, Poochigian
NO VOTE RECORDED: Bowen
SENATE FLOOR : 21-15, 6/5/03
AYES: Alarcon, Alpert, Burton, Cedillo, Chesbro, Dunn,
Escutia, Figueroa, Karnette, Kuehl, Machado, Murray,
Ortiz, Perata, Romero, Scott, Sher, Soto, Speier,
Torlakson, Vasconcellos
NOES: Aanestad, Ackerman, Ashburn, Battin, Brulte, Denham,
Hollingsworth, Johnson, Knight, Margett, McClintock,
McPherson, Morrow, Oller, Poochigian
NO VOTE RECORDED: Bowen, Ducheny, Florez, Vincent
ASSEMBLY FLOOR : 48-29, 9/5/03 - See last page for vote
SUBJECT : Emergency contraception drug therapy
SOURCE : The American College of Obstetricians and
Gynocologists
CONTINUED
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DIGEST : This bill caps the administrative fee charged to
patients for emergency contraception at $10 for prescribers
of telephone or electronic prescriptions and for
pharmacists.
Assembly Amendments
1.Require the pharmacist, prior to furnishing an emergency
contraception, to complete a training program consisting
of at least one hour of approved continuing education on
emergency contraception drug therapy.
2.Provide that no more than a $10 administrative fee may be
charged for prescribers of telephone or electronic
prescriptions and for pharmacists.
3.Prohibit a pharmacist from requiring a patient to provide
individually identifiable medical information except as
specified.
4.Require a pharmacist, upon request, to disclose the total
retail drug price for emergency contraception drug
therapy.
5.Incorporate additional changes to Section 4052 of the
Business and Professions Code proposed by SB 490 (Alpert)
that becomes operative only if SB 490 and this bill are
both enacted and become effective on or before January 1,
2004, and this bill is enacted last.
ANALYSIS :
This bill:
1.Prohibits an individual authorized to prescribe emergency
contraception who issues a prescription or order for
emergency contraception (EC) drug therapy as a result of
a patient contract by telephone or electronic means from
charging an administrative fee or fees totaling more than
$10 for EC services.
2.Prohibits a pharmacist, pharmacist's employer, or
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pharmacist's agent from directly charging a separate
consultation fee to a patient for emergency contraception
drug therapy services that is initiated, but permits a
pharmacists to charge an administrative fee of up to $10
above the retail cost
3.Repeals a requirement that a pharmacist, prior to
furnishing EC, have completed a training program on EC,
which includes, but is not limited to, conduct of
sensitive communications, quality assurance, referral to
additional services, and documentation, and, instead,
requires a pharmacist, prior to furnishing EC, to
complete a training program on EC consisting of at least
one hour of approved continuing education on EC drug
therapy.
4.Prohibits a pharmacist from requiring a patient to
provide specified individually identifiable medication
information beyond what is contained in a specified
regulation before initiating EC.
Comments
Emergency contraception therapy is a drug regimen that
reduces the change of pregnancy significantly if
administered within 72 hours of unprotected intercourse
(sometimes referred to as "morning after pills"). SB 1169
(Alpert), Chapter 900, Statutes of 2001, authorized a
pharmacist to initiate EC drug therapy in accordance with
standardized protocols developed by the pharmacist and an
authorized prescriber acting within his or her scope of
practice. SB 1169 requires a pharmacist, prior to
initiating emergency contraception drug therapy, to
complete a training program on emergency contraception that
covers the conduct of sensitive communications, quality
assurance, referral to additional services, and
documentation. The pharmacist must also provide each
recipient of the emergency contraception services with a
standardized fact sheet, developed by the Pharmacy Board,
that includes the indications for the drug, the appropriate
method for using the drug, the need for medical follow-up,
and other information. Pharmacists must also sign
"protocol" agreements with individual physicians so that
the pharmacist can dispense the drugs as directed.
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Current law does not limit the amount a pharmacist or
prescriber can charge a private-pay patient for EC, or the
amount of the consulation/dispensing fee. This bill does
not cap the amount that can be charged for EC (e.g., the
bills), but caps the administrative fee at $10.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
According to the Assembly Appropriations Committee, minor
and absorbable costs to the Medical Board and the Pharmacy
Board. The Medical Board operating costs are funded from
physician licensing fees deposited in the Medical Board
Contingency Fund, and Pharmacy Board operating costs are
funded from pharmacist licensing fees deposited in the
Pharmacy Board Contingent Fund.
SUPPORT : (Verified 9/3/03)
American College of Obstetricians and Gynecologists
(source)
American Association of University Women
American Civil Liberties Union
California Abortion Rights Action League
California Commission on the Status of Women
California Medical Association
California National Organization for Women
California Nurses Association
California Nurses Midwives Association
California Women Lawyers
Planned Parenthood Affiliates of California
Planned Parenthood Golden Gate
Santa Barbara Women's Political Committee
The American Nurses Association of California
OPPOSITION : (Verified 9/3/03)
California Catholic Conference
California Grocers Association
California Retailers Association
California Society of Health-System Pharmacists
Rite Aid
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ARGUMENTS IN SUPPORT : In their letters of support, many
proponents of this bill argue that the current system of
dispensing EC drug therapy is impeding public access to a
critical and time sensitive emergency drug therapy. They
state that some pharmacists are charging a consultation fee
that in some cases is greater than the actual cost of the
drug.
In their letter of support, the California Medical
Association states that EC drug therapy is safe and
recommends that it should be made available to consumes
over-the-counter. The California National Organization for
Women (CANOW) also states that EC drug therapy is safe.
CANOW maintains that when EC drug therapy is dispensed to a
patient, the pharmacist is required to provide the patient
with a state-developed fact sheet that explains the use of
the drug, appropriate methods for its use, need for medical
follow-up with their personal physician and other relevant
patient information.
The California Nurses Association (CNA) states that the
provisions of this bill remove the barriers to access of EC
drugs. CNA supports increasing availability to EC drug
therapy and has always been an advocate for ensuring access
to these types of contraception drugs.
ARGUMENTS IN OPPOSITION : The California Catholic
Conference argues that because EC is currently available at
pharmacies without a prior physical examination of the
requesting patient, or prescription from a physician, it
would seem that a minimum standard of care should be to
require the dispensing pharmacists to complete appropriate
training concerning dispensing EC drug therapy to insure
that the pharmacist is able to adequately consult patients
concerning emergency contraception.
ASSEMBLY FLOOR :
AYES: Berg, Bermudez, Calderon, Canciamilla, Chan, Chavez,
Chu, Cohn, Corbett, Correa, Daucher, Diaz, Dutra,
Dymally, Frommer, Goldberg, Hancock, Jerome Horton,
Shirley Horton, Jackson, Kehoe, Koretz, Laird, Leno,
Levine, Lieber, Liu, Longville, Lowenthal, Montanez,
Mullin, Nakano, Nation, Negrete McLeod, Nunez, Oropeza,
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Parra, Pavley, Reyes, Ridley-Thomas, Salinas, Simitian,
Steinberg, Vargas, Wiggins, Wolk, Yee, Wesson
NOES: Aghazarian, Bates, Benoit, Bogh, Campbell, Cogdill,
Cox, Dutton, Garcia, Harman, Haynes, Houston, Keene, La
Malfa, La Suer, Leslie, Maddox, Matthews, Maze, McCarthy,
Mountjoy, Nakanishi, Pacheco, Plescia, Runner, Samuelian,
Spitzer, Strickland, Wyland
CP:cm 9/11/03 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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