BILL ANALYSIS Ó
AB 507
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Date of Hearing: April 26, 2011
ASSEMBLY COMMITTEE ON HEALTH
William W. Monning, Chair
AB 507 (Hayashi) - As Amended: April 13, 2011
SUBJECT : Pain management.
SUMMARY : Repeals provisions in existing law which permit the
Department of Justice (DOJ) to employ a physician to interview
and examine any patient in connection with the prescription
possession or use of a controlled substance, require the patient
to submit to the interview and examination, and permit the
physician to testify in prescribed administrative proceedings.
Makes technical and conforming changes to existing law related
to severe chronic intractable pain and to the California
Intractable Pain Treatment Act (CIPT Act).
EXISTING LAW :
1)Permits DOJ 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 permits the physician to
testify in prescribed administrative proceedings.
2)Permits a physician and surgeon to prescribe for, or dispense
or administer to, a person under their 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.
FISCAL EFFECT : This bill has not been analyzed by a fiscal
committee.
COMMENTS :
1)PURPOSE OF THIS BILL . According to the author, pain is the
most common reason Americans access the health care system and
is a leading contributor to health care costs. The costs of
pain and suffering, both emotional and financial, are
enormous. Unrelieved pain is the second leading cause of
medically-related work absenteeism and causes over $61 billion
dollars in lost productivity annually. According to the
National Center for Health Statistics, in 2006, 76.2 million
people suffered from pain in the United States. In a recent
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California HealthCare Foundation survey, pain topped the list
of concerns people face when they think about dying. The
author states that California has led the nation in making
many important legislative and regulatory changes related to
pain management. These previous reforms made great strides to
improve the legal and regulatory landscape for pain management
by promulgating the idea of balance between the legitimate
need to protect public safety and public health through
efforts to reduce drug abuse and diversion, and the imperative
to address the public health problem of unrelieved pain.
However, the author states that some ambiguities and
inconsistencies remain in the law surrounding pain practice,
and that these outdated practice standards, as identified by
the Pain and Policy Studies Group (PPSG), can unduly restrict
healthcare practice and interfere with patient access to
effective pain treatment. The author states that this bill
will remove remaining legal barriers to optimal pain
management for patients with cancer, HIV/AIDs and other
diseases or conditions causing pain by eliminating ambiguities
and inconsistencies in the CIPT Act that negatively affect
appropriate clinical interpretation.
2)Pain and Policy Study Group . According to the sponsor of this
bill, the American Cancer Society (ACS), the changes to
statute that this bill proposes were identified by PPSG, which
reviewed every state's adherence to this principle of balance
using a peer reviewed evaluation. PPSG collaborates with
organizations such as the Alliance of State Pain Initiatives,
the American Academy of Pain Medicine, the ACS Cancer Action
Network, the American Pain Foundation, the American Pain
Society, the American Society of Addiction Medicine, the
Federation of State Medical Boards, the National Association
of Attorney's General, and the U.S. Drug Enforcement
Administration. According to PPSG, its U.S. program is
primarily involved in the collection and evaluation of state
policies that govern pain management, especially prescribing
controlled substances to treat chronic moderate to severe
pain. PPSG identified potential barriers to adequate patient
pain care, as well as language that promotes safe and
effective treatment.
3)PREVIOUS LEGISLATION . AB 2198 (Houston), Chapter 350,
Statutes of 2006, revises the laws governing the use of drugs
to treat pain to clarify that health care professionals that
have a medical basis, including the treatment of pain, for
prescribing, furnishing, dispensing, or administering
dangerous drugs or prescription controlled substances, are
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permitted to do so without being subject to disciplinary
action or prosecution.
AB 487 (Aroner), Chapter 518, Statutes of 2001, requires all
physicians to complete a mandatory continuing education course
in the subjects of pain management and the treatment of
terminally ill and dying patients. AB 487 also requires the
Board of Pharmacy to develop standards by June 1, 2002, to
assure the competent review in cases concerning the
management, including, but not limited to, the
under-treatment, under-medication, and overmedication of a
patient's pain; and permitted the Board of Pharmacy to consult
with specified entities to develop the standards utilizing, to
the extent they are applicable, current authoritative clinical
practice guidelines.
4)SUPPORT . ACS writes that California's policy landscape is
fairly good in looking at this balance, but there are few
remaining components in the codes that are inconsistent with
current best practices in pain management and may impede the
appropriate treatment of pain and that this bill removes or
amends the offending language. ACS states that removing these
last remaining components of policy that could erect barriers
to needed pain treatment will allow the field to focus on
other reasons that pain is under-treated.
5)DOUBLE REFERRED . This bill is double referred. Should it
pass out of this committee, it will be referred to the
Assembly Committee on Business, Professions & Consumer
Protection.
REGISTERED SUPPORT / OPPOSITION :
Support
American Cancer Society (sponsor)
California Academy of Physician Assistants
Opposition
None on file.
Analysis Prepared by : Melanie Moreno / HEALTH / (916)
319-2097
AB 507
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