BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 507|
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THIRD READING
Bill No: AB 507
Author: Hayashi (D)
Amended: 8/16/11 in Senate
Vote: 21
SENATE BUSINESS, PROF. & ECON. DEV. COMMITTEE : 8-1,
6/27/11
AYES: Price, Emmerson, Corbett, Correa, Hernandez, Negrete
McLeod, Vargas, Wyland
NOES: Walters
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
ASSEMBLY FLOOR : 55-20, 5/19/11 - See last page for vote
SUBJECT : Pain management
SOURCE : American Cancer Society
DIGEST : This bill repeals existing law provisions that
authorize the Department of Justice to employ a physician
to interview any patient for whom any controlled substance
classified as Schedule I, II, or III has been prescribed or
to whom any such controlled substance has been furnished or
administered, or who is an habitual user of such controlled
substance, or who has a previous addiction record to a
substance listed as controlled substance, as specified.
This bill makes technical changes to the Pain Patient's
Bill of Rights.
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ANALYSIS : Existing law:
1. Establishes the Pain Patient's Bill of Rights, which
includes provisions governing the treatment of patients
suffering from severe chronic intractable pain,
including access to proper treatment, the use of opiates
or any or all modalities to relieve severe intractable
pain. (Health and Safety Code ÝHSC] Sections
124960-124961)
2. States legislative findings and declarations that a
patient's physician may refuse to prescribe opiate
medication for a patient who requests the treatment for
severe chronic intractable pain. States that a
physician who refuses shall inform the patient that
there are physicians who specialize in the treatment of
severe chronic intractable pain with methods that
include the use of opiates. (HSC Section 124961)
3. Establishes the Uniform Controlled Substances Act, which
among other provisions, specify certain Schedule for
Controlled Substances, and establishes the Controlled
Substance Utilization Review and Evaluation System
administered by the Department of Justice (DOJ) for the
electronic monitoring of the prescribing and dispensing
of specified controlled substances by all practitioners
authorized to prescribe or dispense controlled
substances. (HSC Section 11100 et. seq.)
4. Authorizes a physician and surgeon to prescribe for, or
dispense, or administer to a person, under his/her
treatment for a medical condition, dangerous drugs or
prescription controlled substances for the treatment of
pain or a condition causing pain, including, but not
limited to, intractable pain. (Business and Professions
Code Section 2241.5)
5. Provides that no physician and surgeon shall be subject
to disciplinary action for prescribing, dispensing, or
administering dangerous drugs or prescription controlled
substances, as specified. (Id.)
6. Authorizes the DOJ to employ a physician to interview
any patient for whom any controlled substance classified
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as Schedule I, II, or III has been prescribed or to whom
any such controlled substance has been furnished or
administered, or who is an habitual user of such
controlled substance, or who has a previous addiction
record to a substance listed as controlled substance, as
specified. (HSC Section 11453)
This bill:
1. Repeals existing law that authorizes the DOJ to employ a
physician to interview any patient for whom any
controlled substance classified in Schedule I, II, or
III has been prescribed, or to whom any such controlled
substance has been furnished or administered, or who is
an habitual user of such controlled substance, or who
has a previous addiction record to a substance, as
specified. Repeals certain requirements for a patient
who is the subject of an interview and for physicians
employed to conduct an interview.
2. Makes changes to existing provisions of the Pain
Patient's Bill of Rights, and makes other technical,
non-conforming changes.
Background
Existing law establishes the Pain Patient's Bill of Rights
which includes provisions governing the treatment of
patients suffering from severe chronic intractable pain,
including access to proper treatment, the ability to
request or reject the use of any or all modalities in order
to relieve severe chronic intractable pain, and the use of
opiates or any or all modalities to relieve severe
intractable pain. Provisions dealing with the prescription
of opiates are included in the Pain Patient's Bill of
Rights. Existing law defines "opiate" as any substance
having an addiction-forming or addiction-sustaining
liability similar to morphine or being capable of
conversion into a drug having addiction-forming or
addiction-sustaining liability. Additionally, the law
allows physicians and surgeons to prescribe for, or
dispense, or administer to a person, under his/her
treatment a for medical condition, dangerous drugs or
prescription controlled substances for the treatment of
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pain, or a condition causing pain, including but not
limited to, intractable pain. A physician and surgeon that
furnish a prescription pursuant to specified conditions are
not subject to disciplinary action. However, existing law
allows the DOJ to employ a physician to interview and
examine any patient for whom an opiate has been prescribed,
furnished or administered, or who is a habitual user of
such a controlled substance, or who has a previous
addiction record, as specified. This bill removes these
provisions allowing the DOJ to employ or interview patients
who have been prescribed specific scheduled substances.
Prior 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 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 over medication 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.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
SUPPORT : (Verified 8/15/11)
American Cancer Society (source)
American Chronic Pain Association
American Society for Pain Management Nursing
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California Academy of Physician Assistants
Feinberg Medical Group
For Grace
Hollywood Presbyterian Medical Center
Medical Board of California
Southern California Cancer Pain Initiative
University of Southern California - Keck School of Medicine
- CARE Team/Palliative Medicine Department
ARGUMENTS IN SUPPORT : According to the sponsor, the
American Cancer Society (ACS), this bill is necessary to
deal with inconsistencies in pain management practice and
to update the approach to pain management. The ACS points
out that pain often accompanies cancer, and it often
continues even after cancer treatment. The ACS points out
that cancer pain is a problem for up to 60 percent or more
of patients who are undergoing active treatment, for more
than 60 percent of patients with the advanced disease, and
for at least 30 percent of patients after treatment
concludes. Addressing pain in all these instances is
imperative for improving the quality of life of cancer
patients and survivors. However, the ACS points out there
remains many reasons for the under treatment of pain,
underlying many of them is a chilling factor created by the
policy environment for the treatment of pain. The state
has an interest in both ensuring that pain is adequately
treated while also deterring diversion of controlled
substances. According to the ACS, the proposed changes in
this bill were highlighted by the Pain Policy Studies
Group, which reviews every state's pain policies, and
indicated that there is a need to improve California's pain
policy.
ASSEMBLY FLOOR : 55-20, 5/19/11
AYES: Allen, Ammiano, Atkins, Beall, Block, Blumenfield,
Bonilla, Bradford, Brownley, Buchanan, Butler, Charles
Calderon, Campos, Carter, Cedillo, Chesbro, Cook, Davis,
Dickinson, Eng, Feuer, Fletcher, Fong, Fuentes, Furutani,
Galgiani, Gatto, Gordon, Halderman, Hall, Hayashi, Roger
Hernández, Hill, Huber, Hueso, Huffman, Lara, Bonnie
Lowenthal, Mendoza, Mitchell, Monning, Norby, Pan, Perea,
V. Manuel Pérez, Portantino, Skinner, Smyth, Solorio,
Swanson, Torres, Wieckowski, Williams, Yamada, John A.
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Pérez
NOES: Achadjian, Conway, Donnelly, Beth Gaines, Garrick,
Grove, Hagman, Harkey, Jeffries, Jones, Knight, Logue,
Mansoor, Miller, Morrell, Nielsen, Olsen, Silva, Valadao,
Wagner
NO VOTE RECORDED: Alejo, Bill Berryhill, Gorell, Ma,
Nestande
JJA:kc 8/15/11 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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