BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 418
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          Date of Hearing:   March 31, 2009

                   ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
                                 Mary Hayashi, Chair
                AB 418 (Emmerson) - As Introduced:  February 23, 2009
          
          SUBJECT  :   Pharmacy technicians.

           SUMMARY  :   Increases qualification and continuing education  
          requirements for a pharmacy technician (PT) license.   
          Specifically,  this bill  :  


          1)Eliminates the option for a PT to obtain licensure by  
            certification by the PT Certification Board.


          2)Requires an applicant to pass a PT examination recognized by  
            the National Organization for Competency Assurance and  
            approved by the Pharmacy Board (board).


          3)Permits the completion of a course of training offered by a  
            program accredited by an accreditation agency approved by the  
            board as one of the options for PT licensure.


          4)Requires the board to adopt regulations that include criteria  
            for approving an accreditation agency. 


          5)Requires the board to adopt regulations for approving an  
            accreditation agency and the licensure of PTs under the new  
            qualification requirements. 


          6)Prohibits the board from renewing a PT license unless the  
            applicant submits proof satisfactory to the board that he or  
            she has successfully completed 20 hours of approved courses of  
            continuing PT education as specified during the two years  
            preceding the application for renewal.


          7)Prohibits the board from requiring any other continuing  
            education requirements than specified for the first renewal of  
            a PT license.







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          8)Specifies that if an applicant for renewal of a PT license  
            submits the renewal application and payment of the renewal fee  
            but does not submit proof satisfactory to the board that the  
            licensee has completed 20 hours of continuing pharmacy  
            education, the board shall not renew the license and shall  
            issue the applicant an inactive PT license. 


          9)Specifies that any PT license that is not renewed within three  
            years following its expiration may not be renewed and shall be  
            canceled by operation of law at the end of the three-year  
            period.


          10)Grandfathers in current PTs' education credentials for  
            initial licensure, but requires them to complete the new  
            continuing education requirements upon their second and  
            subsequent renewals. 


          11)Is scheduled to take effect on January 1, 2011. 


           EXISTING LAW  :
           
           1)Establishes the Pharmacy Law, which provides for the licensure  
            and regulation of pharmacists and pharmacy technicians by the  
            board. 

          2)Authorizes the board to issue a PT license to an individual if  
            that individual is a high school graduate or possesses a  
            general educational development certificate equivalent and has  
            either obtained a specified associate's degree, completed a  
            specified course of training, graduated from a specified  
            school of pharmacy, or is certified by the PT Certification  
            Board. 

           FISCAL EFFECT  :   Unknown

           COMMENTS  :   

           Purpose of this bill  .  According to the author's office,  
          "Pharmacists rely heavily on pharmacy technicians so that they  
          may optimally perform tasks to protect and provide for  







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          Californians in need of prescriptions.  Unfortunately, there is  
          a shortage of licensed pharmacists in California and an ever  
          increasing amount of patients as the population grows.  As there  
          is no single standard for PT training and licensure beyond being  
          a high school graduate or having an equivalent degree, pharmacy  
          technicians have a broad range of minimum competencies,  
          experience, education, and training.  Such varied levels of  
          training in combination with the ever increasing pharmacist  
          workload places patients at undue risk of medication errors."   

           Background  :  According to a 2003 workforce analysis by the  
          Center for Health Professions (CHF) at the University of  
          California, San Francisco, the PT profession is experiencing  
          rapid change, mirroring changes in the pharmacy profession and  
          in pharmaceutical treatment.  PTs arose from the U.S. military  
          classification, "pharmacy specialists" developed in the  
          mid-1940s. Between 1968 and 1975, the U.S. Department of Health,  
          Education and Welfare and professional pharmacy associations  
          studied and defined tasks and roles that could be played by  
          technicians, and established, in 1975, the American Society of  
          Health-System Pharmacists (ASHP) education guidelines for  
          hospital pharmacy technicians.  These guidelines were formalized  
          in 1982 as accreditation standards. Between 1994 and 1996, a  
          national task force completed a task analysis of technician jobs  
          and reported findings and recommendations advocating uniform  
          national education and training standards. In 1997, several  
          national associations collaborated to write the ASHP Model  
          Curriculum.

          PTs operating in hospital and community pharmacies are typically  
          responsible for maintaining inventory, preparing unit-dose  
          packaging, packaging and labeling, entering prescription  
          information and checking patients' profile information, and  
          various clerical duties.  California law requires prohibit PTs  
          from performing any task requiring a pharmacist's professional  
          judgment.  PTs work closely with pharmacists, and in a 2002  
          summit on the profession, pharmacists indicated that their  
          attitudes about working with technicians have become more  
          favorable in recent years: many considered technicians an asset  
          and supported developing the profession through improved  
          training and education.  However, the CHF study noted that the  
          more stringent requirements will likely have a significant  
          impact on training and recruiting PTs, since historically, most  
          technicians have trained on-the-job.  The California Labor  
          Market Information Division projects a 39.8% increase in  
          pharmacy technician positions in California through 2010.







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           Arguments in support  .  The American Society of Health-System  
          Pharmacists writes in support, "This bill is a vital piece of  
          patient safety legislation.  The lack of appropriate education,  
          training, and certification requirements for pharmacy  
          technicians has received national media attention, with USA  
          Today, Good Morning America, 20/20, and World News Tonight all  
          reporting on the tragic and deadly results of medication errors  
          involving pharmacy technicians.  The benefit of accredited  
          training and education is that it serves as an educational basis  
          for all practice settings.  Taken together with national  
          certification, as through the PT Certification Board, such  
          legislation reflects the understanding that what a PT does is  
          just as important as how it is done.  Accredited education  
          programs provide the baseline skills that are required for an  
          effective PT.  National certification reflects a competency and  
          understanding of the basic knowledge that is required for those  
          who work on the pharmacy front-lines."  

           Arguments in opposition  .  CVS/Caremark writes, "We fully support  
          adequate training, supervision and registration of pharmacy  
          technicians.  There are currently in place very specific  
          regulations and statutes governing the training content,  
          qualifications, and registration of PTs?. [Furthermore,] the  
          sponsor has yet to identify specific safety problems or other  
          gaps that have occurred in California because of current PT  
          training and registration requirements."  
            
           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          California Society of Health System Pharmacists (sponsor)
          American Society of Health-System Pharmacists 
          California Hospital Association 
          California Society of Health System Pharmacists, Central Valley  
          Chapter
          California Society of Health System Pharmacists, Pacific Student  
          Chapter
          California Society of Health System Pharmacists, San Gabriel  
          Valley Chapter
          California Society of Health System Pharmacists, Western  
          University Chapter
          Diablo Chapter of the California Society of Health System  
          Pharmacists
          Golden Gate Society of Health System Pharmacists







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          Inland Society of Health System Pharmacists
          Loma Linda Student Chapter, Society of Health System Pharmacists
          Orange County Society of Health System Pharmacists
          Sacramento Valley Society of Health System Pharmacists
          San Diego Society of Health System Pharmacists
          San Fernando Valley Society of Health System Pharmacists
          Sierra Society of Health System Pharmacists
          Society of Health System Pharmacists, Student Chapter Society,  
          Touro 
          South Bay/Long Beach - Society of Health System Pharmacists
          Southern California Society of Health System Pharmacists
          The Quaid Foundation
          University of California, San Diego Student Chapter, Society of  
          Health System Pharmacists
          University of California, San Francisco Student Chapter, Society  
          of Health System Pharmacists
          University of Southern California Society of Health System  
          Pharmacists
          Numerous individuals

           Opposition 
           
          California Retailers Association
          CVS/Caremark
          National Association of Chain Drug Stores
          Rite Aid
          Target
          United Food and Commercial Workers Union, Western States Council
           
          Analysis Prepared by  :    Sarah Huchel / B. & P. / (916) 319-3301