BILL NUMBER: AB 507	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  APRIL 13, 2011
	AMENDED IN ASSEMBLY  MARCH 21, 2011

INTRODUCED BY   Assembly Member Hayashi

                        FEBRUARY 15, 2011

    An act to amend Section 4301 of the Business and
Professions Code, and   An act  to amend Sections
124960 and 124961 of, and to repeal Section 11453 of, the Health and
Safety Code, relating to public health.



	LEGISLATIVE COUNSEL'S DIGEST


   AB 507, as amended, Hayashi. Pain management. 
   (1) Existing law, the Pharmacy Law, provides for the licensure and
regulation of pharmacists and pharmacy technicians by the California
State Board of Pharmacy.  
   Existing law requires the board to take action against any holder
of a license who is guilty of unprofessional conduct, as defined,
including, but not limited to, the clearly excessive furnishing of
controlled substances in violation of prescribed statutory provisions
relating to the prescription of a controlled substance. 

   This bill would exempt from this provision any holder of a license
who has a medical basis for furnishing dangerous drugs or
prescription controlled substances, including for pain or a condition
causing pain.  
   (2) 
    (1)  Existing law authorizes the Department of Justice
to employ a physician to interview and examine any patient in
connection with the prescription  ,  possession  , 
or use of a controlled substance, requires the patient to submit to
the interview and examination, and authorizes the physician to
testify in prescribed administrative proceedings.
   This bill would repeal that provision. 
   (3) 
    (2)  Existing law, the Medical Practice Act, provides
for the licensing and regulation of physicians and surgeons by the
Medical Board of California, and the violation of specified
provisions of the act is a crime. Existing law authorizes a physician
and surgeon to prescribe for, or dispense or administer to, a person
under his or her treatment for a medical condition, drugs or
prescription controlled substances for the treatment of pain or a
condition causing pain, including, but not limited to, intractable
pain.
   This bill would conform findings and declarations and other
references to severe chronic intractable pain and to the California
Intractable Pain Treatment Act.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
   
  SECTION 1.    Section 4301 of the Business and
Professions Code is amended to read:
   4301.  The board shall take action against any holder of a license
who is guilty of unprofessional conduct or whose license has been
procured by fraud or misrepresentation or issued by mistake.
Unprofessional conduct shall include, but is not limited to, any of
the following:
   (a) Gross immorality.
   (b) Incompetence.
   (c) Gross negligence.
   (d) The clearly excessive furnishing of controlled substances in
violation of subdivision (a) of Section 11153 of the Health and
Safety Code. Any holder of a license who has a medical basis for
furnishing dangerous drugs or prescription controlled substances,
including for pain or a condition causing pain, shall not be subject
to disciplinary action pursuant to this section.
   (e) The clearly excessive furnishing of controlled substances in
violation of subdivision (a) of Section 11153.5 of the Health and
Safety Code. Factors to be considered in determining whether the
furnishing of controlled substances is clearly excessive shall
include, but not be limited to, the amount of controlled substances
furnished, the previous ordering pattern of the customer (including
size and frequency of orders), the type and size of the customer, and
where and to whom the customer distributes its product.
   (f) The commission of any act involving moral turpitude,
dishonesty, fraud, deceit, or corruption, whether the act is
committed in the course of relations as a licensee or otherwise, and
whether the act is a felony or misdemeanor or not.
   (g) Knowingly making or signing any certificate or other document
that falsely represents the existence or nonexistence of a state of
facts.
   (h) The administering to oneself, of any controlled substance, or
the use of any dangerous drug or of alcoholic beverages to the extent
or in a manner as to be dangerous or injurious to oneself, to a
person holding a license under this chapter, or to any other person
or to the public, or to the extent that the use impairs the ability
of the person to conduct with safety to the public the practice
authorized by the license.
   (i) Except as otherwise authorized by law, knowingly selling,
furnishing, giving away, or administering, or offering to sell,
furnish, give away, or administer, any controlled substance to an
addict.
   (j) The violation of any of the statutes of this state, of any
other state, or of the United States regulating controlled substances
and dangerous drugs.
   (k) The conviction of more than one misdemeanor or any felony
involving the use, consumption, or self-administration of any
dangerous drug or alcoholic beverage, or any combination of those
substances.
   (l) The conviction of a crime substantially related to the
qualifications, functions, and duties of a licensee under this
chapter. The record of conviction of a violation of Chapter 13
(commencing with Section 801) of Title 21 of the United States Code
regulating controlled substances or of a violation of the statutes of
this state regulating controlled substances or dangerous drugs shall
be conclusive evidence of unprofessional conduct. In all other
cases, the record of conviction shall be conclusive evidence only of
the fact that the conviction occurred. The board may inquire into the
circumstances surrounding the commission of the crime, in order to
fix the degree of discipline or, in the case of a conviction not
involving controlled substances or dangerous drugs, to determine if
the conviction is of an offense substantially related to the
qualifications, functions, and duties of a licensee under this
chapter. A plea or verdict of guilty or a conviction following a plea
of nolo contendere is deemed to be a conviction within the meaning
of this provision. The board may take action when the time for appeal
has elapsed, or the judgment of conviction has been affirmed on
appeal or when an order granting probation is made suspending the
imposition of sentence, irrespective of a subsequent order under
Section 1203.4 of the Penal Code allowing the person to withdraw his
or her plea of guilty and to enter a plea of not guilty, or setting
aside the verdict of guilty, or dismissing the accusation,
information, or indictment.
   (m) The cash compromise of a charge of violation of Chapter 13
(commencing with Section 801) of Title 21 of the United States Code
regulating controlled substances or of Chapter 7 (commencing with
Section 14000) of Part 3 of Division 9 of the Welfare and
Institutions Code relating to the Medi-Cal program. The record of the
compromise is conclusive evidence of unprofessional conduct.
   (n) The revocation, suspension, or other discipline by another
state of a license to practice pharmacy, operate a pharmacy, or do
any other act for which a license is required by this chapter.
   (o) Violating or attempting to violate, directly or indirectly, or
assisting in or abetting the violation of or conspiring to violate
any provision or term of this chapter or of the applicable federal
and state laws and regulations governing pharmacy, including
regulations established by the board or by any other state or federal
regulatory agency.
   (p) Actions or conduct that would have warranted denial of a
license.
   (q) Engaging in any conduct that subverts or attempts to subvert
an investigation of the board.
   (r) The selling, trading, transferring, or furnishing of drugs
obtained pursuant to Section 256b of Title 42 of the United States
Code to any person a licensee knows or reasonably should have known,
not to be a patient of a covered entity, as defined in paragraph (4)
of subsection (a) of Section 256b of Title 42 of the United States
Code.
   (s) The clearly excessive furnishing of dangerous drugs by a
wholesaler to a pharmacy that primarily or solely dispenses
prescription drugs to patients of long-term care facilities. Factors
to be considered in determining whether the furnishing of dangerous
drugs is clearly excessive shall include, but not be limited to, the
amount of dangerous drugs furnished to a pharmacy that primarily or
solely dispenses prescription drugs to patients of long-term care
facilities, the previous ordering pattern of the pharmacy, and the
general patient population to whom the pharmacy distributes the
dangerous drugs. That a wholesaler has established, and employs, a
tracking system that complies with the requirements of subdivision
(b) of Section 4164 shall be considered in determining whether there
has been a violation of this subdivision. This provision shall not be
interpreted to require a wholesaler to obtain personal medical
information or be authorized to permit a wholesaler to have access to
personal medical information except as otherwise authorized by
Section 56 and following of the Civil Code. For purposes of this
section, "long-term care facility" shall have the same meaning given
the term in Section 1418 of the Health and Safety Code. 
   SEC. 2.   SECTION 1.   Section 11453 of
the Health and Safety Code is repealed.
   SEC. 3.   SEC. 2.   Section 124960 of
the Health and Safety Code is amended to read:
   124960.  The Legislature finds and declares all of the following:
   (a) The state has a right and duty to control the illegal use of
opiate drugs.
   (b) Inadequate treatment of acute and chronic pain originating
from cancer or noncancerous conditions is a significant health
problem.
   (c) For some patients, pain management is the single most
important treatment a physician can provide.
   (d) A patient suffering from pain or a condition causing pain,
including, but not limited to, intractable pain should have access to
proper treatment of his or her pain.
   (e) Due to the complexity of their problems, many patients
suffering from pain or a condition causing pain, including, but not
limited to, intractable pain may require referral to a physician with
expertise in the treatment of pain or a condition causing pain,
including, but not limited to, intractable pain. In some cases, pain
or a condition causing pain, including, but not limited to,
intractable pain is best treated by a team of clinicians in order to
address the associated physical, psychological, social, and
vocational issues.
   (f) In the hands of knowledgeable, ethical, and experienced pain
management practitioners, opiates administered for pain or a
condition causing pain, including, but not limited to, intractable
pain can be safe.
   (g) Opiates can be an accepted treatment for patients in pain or a
condition causing pain, including, but not limited to, intractable
pain who have not obtained relief from any other means of treatment.
   (h) A patient suffering from pain or a condition causing pain,
including, but not limited to, intractable pain has the option to
request or reject the use of any or all modalities to relieve his or
her pain.
   (i) A physician treating a patient who suffers from pain or a
condition causing pain, including, but not limited to, intractable
pain may prescribe a dosage deemed medically necessary to relieve
pain as long as the prescribing is in conformance with Section 2241.5
of the Business and Professions Code.
   (j) A patient who suffers from pain or a condition causing pain,
including, but not limited to, intractable pain, has the option to
choose opiate medication for the treatment of the severe chronic
intractable pain as long as the prescribing is in conformance with
the provisions of Section 2241.5 of the Business and Professions
Code.
   (k) The patient's physician may refuse to prescribe opiate
medication for a patient who requests the treatment for pain or a
condition causing pain, including, but not limited to, intractable
pain. However, that physician shall refer the patient to physicians
who treat pain or a condition causing pain, including, but not
limited to, intractable pain with methods that include the use of
opiates.
   SEC. 4.   SEC. 3.   Section 124961 of
the Health and Safety Code is amended to read:
   124961.  Nothing in this section shall be construed to alter any
of the provisions set forth in Section 2241.5 of the Business and
Professions Code. This section shall be known as the Pain Patient's
Bill of Rights.
   (a) A patient suffering from pain or a condition causing pain,
including, but not limited to, intractable pain has the option to
request or reject the use of any or all modalities in order to
relieve his or her pain.
   (b) A patient who suffers from pain or a condition causing pain,
including, but not limited to, intractable pain has the option to
choose opiate medications to relieve that pain without first having
to submit to an invasive medical procedure, which is defined as
surgery, destruction of a nerve or other body tissue by manipulation,
or the implantation of a drug delivery system or device, as long as
the prescribing physician acts in conformance with the provisions of
the California Intractable Pain Treatment Act, Section 2241.5 of the
Business and Professions Code.
   (c) The patient's physician may refuse to prescribe opiate
medication for the patient who requests a treatment for pain or a
condition causing pain, including, but not limited to, intractable
pain. However, that physician shall refer the patient to physicians
who treat pain and whose methods include the use of opiates.
   (d) A physician who uses opiate therapy to relieve pain or a
condition causing pain, including, but not limited to, intractable
pain may prescribe a dosage deemed medically necessary to relieve the
patient's pain, as long as that prescribing is in conformance with
Section 2241.5 of the Business and Professions Code.
   (e) A patient may voluntarily request that his or her physician
provide an identifying notice of the prescription for purposes of
emergency treatment or law enforcement identification.
   (f) Nothing in this section shall do either of the following:
   (1) Limit any reporting or disciplinary provisions applicable to
licensed physicians and surgeons who violate prescribing practices or
other provisions set forth in the Medical Practice Act, Chapter 5
(commencing with Section 2000) of Division 2 of the Business and
Professions Code, or the regulations adopted thereunder.
   (2) Limit the applicability of any federal statute or federal
regulation or any of the other statutes or regulations of this state
that regulate dangerous drugs or controlled substances.