BILL ANALYSIS �
SB 62
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Date of Hearing: August 14, 2013
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Mike Gatto, Chair
SB 62 (Price) - As Amended: June 27, 2013
Policy Committee: Business and
Professions Vote: 9-4
Urgency: No State Mandated Local Program:
Yes Reimbursable: Yes
SUMMARY
This bill requires a coroner to file a report with the Medical
Board of California (MBC) when he or she receives information
that indicates that cause of death is due to a Schedule II, III,
or IV drug.
This bill also makes minor changes to an existing requirement
that coroners file a report with the MBC in cases of gross
negligence or incompetence on the part of a physician.
FISCAL EFFECT
The overall fiscal effect of this bill is difficult to predict,
given inexperience with the new reporting system and data source
this bill creates. Costs will depend on the number of reports
actually filed and the proportion that require extensive review,
investigation, and/or legal trials. Costs may be higher or
lower in early years as the reporting and review systems are
refined. Given reasonable assumptions about the number of
reports and costs based on current MBC statistics, estimates for
ongoing costs are as follows:
$700,000 annually to the MBC (Contingent Fund of the MBC) to
handle increased workload related to review and investigation of
approximately 700 new reports.
$1.8 million to the Department of Justice to handle
approximately 50 new cases per year (charged to the Contingent
Fund of the MBC).
Potential state-reimbursable mandate costs in the range of
SB 62
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$100,000 GF annually to county coroner's offices for new
required reports.
COMMENTS
1)Rationale . This bill seeks to improve the MBC's ability to
identify and investigate medical providers whose patients die
from prescription drug overdose. The MBC proposed such a
coroner reporting requirement in its sunset review report as
an issue for the legislative consideration in response to an
LA Times series finding numerous individual providers,
primarily pain specialists, were each linked to multiple
prescription drug overdose deaths. This bill is
author-sponsored and supported by the MBC.
2)Background . Coroners are currently required to determine the
circumstances, manner, and cause of certain types of death,
including violent, sudden, unusual, and unattended deaths, as
well as those related to drug addiction. Drugs categorized as
II-IV on the federal Drug Enforcement Agency's schedule are
drugs with currently accepted medical use as well as some
potential for abuse and/or addiction, ranging from limited
(IV) to severe (II).
Coroners are currently required to report to the MBC deaths
that indicate a physician's gross negligence or incompetence.
The MBC indicates only four such reports were received in FY
2011/12, and only one of the reports indicated a drug-related
death. This bill seeks to increase reporting for prescription
drug overdoses by requiring reports be filed when the
coroner's stated cause of death includes prescription drugs, a
criteria that does not require a subjective judgment by a
coroner.
3)Opposition . The California Medical Association believes this
bill is costly and has numerous policy flaws, including that
the bill will require numerous reports to be filed that have
no connection with the physician-patient relationship, that it
could have a chilling effect on physician willingness to
appropriately prescribe needed pain medication and treat
patients suffering from chronic pain and/or addiction, and
that the toxicology tests relied upon to make a determination
of an overdose do not reliably indicate inappropriate
prescribing.
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4)Related legislation . SB 670 (Steinberg), among other
provisions, authorizes MBC to inspect medical records of a
deceased patient and declares it unprofessional conduct for a
licensee who is under investigation by the MBC to fail to
attend an interview, as specified. SB 670 is currently
pending in the Business and Professions committee.
SB 809 (DeSaulnier and Steinberg) is an urgency measure that
makes various changes to the funding and operation of the
Controlled Substances Utilization Review and Evaluation System
(CURES) Prescription Drug Monitoring Program. SB 809 is
currently pending in the Business and Professions committee.
Analysis Prepared by : Lisa Murawski / APPR. / (916) 319-2081