BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 418
                                                                  Page  1

          Date of Hearing:   April 28, 2009

                   ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
                                 Mary Hayashi, Chair
                   AB 418 (Emmerson) - As Amended:  April 13, 2009
           
          SUBJECT  :   Pharmacy technicians:  licensure requirements.

           SUMMARY  :   Requires a pharmacy technician (PT) applicant to pass  
          a national PT examination for licensure.  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)Requires the board to adopt regulations for PT training  
            courses.


          4)Is scheduled to take effect on January 1, 2013. 


           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  :   







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           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  
          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 retail 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 prohibits 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  







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          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.

          This bill is primarily supported by hospital-based PT  
          organizations.  A majority of larger chain drug store operators  
          are in opposition because they currently provide supplementary  
          onsite PT training to ensure competency in the retail setting.   
          These operators are concerned that additional qualifications  
          would create a barrier to entry, complicating their ability to  
          attracted qualified personnel.  The chain drugstores argue that  
          hospitals are free to establish additional training requirements  
          if they feel current practices are insufficient to the hospital  
          environment.            

           Arguments in support  .  Health Care Patient Advocates write,  
          "Without standardization [of PT licensure], the continued  
          problems that result in potential or actual harm will remain.   
          Health Care Patient Advocates believes that the root cause of  
          these potential or actual negative outcomes is the variety of  
          training programs that are available?. We believe that  
          standardization is needed and evidenced by the increasing  
          numbers of elderly individuals, the introduction of new  
          medications for administration, as well as our rapidly changing  
          health care system."  

           Arguments in opposition  .  The California Retailers Association  
          and the National Association of Chain Drug Stores state, "AB 418  
          - as amended - would still significantly and unnecessarily alter  
          the training and certification procedures for pharmacy  
          technicians.  While the stated goal of AB 418 is admirable, the  
          fact is that no safety issues have been identified in California  
          related to the training of pharmacy technicians?.  It should be  
          noted that, by definition, PTs cannot be responsible for medical  
          errors.  Pharmacy technicians can only perform non-discretionary  
          tasks.  It is the pharmacist who is responsible for checking the  
          work of the PT and the pharmacist who is charged with protecting  
          patient safety."  
            
           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          California Society of Health System Pharmacists (sponsor)
          American Society of Health-System Pharmacists 







                                                                  AB 418
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          American University of Health Sciences
          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
          Health Care Patient Advocates
          Inland Society of Health System Pharmacists
          Loma Linda Student Chapter, Society of Health System Pharmacists
          Mothers Against Medical Error
          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 Association of Private Postsecondary Schools (CAPPS)
          California Labor Federation
          California Retailers Association
          CVS/Caremark
          National Association of Chain Drug Stores
          Rite Aid
          Target
          United Food and Commercial Workers Union, Western States Council
          Walgreens







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          Analysis Prepared by  :    Sarah Huchel / B. & P. / (916) 319-3301