BILL ANALYSIS �
SB 62
Page 1
SENATE THIRD READING
SB 62 (Lieu)
As Amended September 3, 2013
Majority vote
SENATE VOTE :39-0
BUSINESS & PROFESSIONS 9-4 APPROPRIATIONS 12-1
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|Ayes:|Gordon, Bocanegra, |Ayes:|Gatto, Bocanegra, |
| |Campos, Dickinson, | |Bradford, |
| |Bonilla, Holden, Mullin, | |Ian Calderon, Campos, |
| |Skinner, Ting | |Eggman, Gomez, Hall, |
| | | |Holden, Pan, Quirk, Weber |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Jones, Hagman, |Nays:|Bigelow |
| |Maienschein, Wilk | | |
| | | | |
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SUMMARY : Requires a coroner to report to the Medical Board of
California (MBC) when he or she receives information indicating
that a death was caused by a Schedule II, III, or IV drug, as
specified, until January 1, 2018. Specifically, this bill :
1)Deletes the requirement that the pathologist reaching or
approving the findings indicating potential gross negligence
or incompetence be board-certified or California licensed.
2)Deletes the requirement that the pathologist be
board-certified or California licensed in order to avoid
liability for damages in a civil action as a result of
providing information in compliance with this law.
3)Requires a coroner's report indicating gross negligence or
incompetence of specified licensees to also name any attending
physician assistants.
4)Requires a coroner's report indicating gross negligence or
incompetence of specified licensees to be filed with MBC as
soon as possible, or within 90 days, once the coroner's final
report of investigation is complete.
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5)States that when a coroner receives information based on
findings that were reached by, or documented and approved by,
a pathologist indicating that the cause of death is due to a
Schedule II, III, or IV drug, the information regarding the
death of the decedent, including whether the decedent was
undergoing treatment for a terminal illness or chronic
condition, if known, shall be provided by the coroner to MBC.
6)Requires the coroner to submit the report on a form provided
by MBC which shall be developed in consultation with the
California State Coroner's Association; requires the form to
be submitted within 90 days, or as soon as possible, once the
coroner's investigation is complete; and permits the form to
be submitted electronically.
7)Deems that a coroner's report detailing findings that a death
is the result of specified licensees' negligence or misconduct
and the report required by this bill are confidential; and
states that no coroner, physician and surgeon, pathologist or
medical examiner, nor any authorized agent, shall be liable
for damages in any civil action as a result of filing either
report in compliance with the law.
8)Requires MBC to follow existing law regarding quality of care
complaints before referring the report to a field office for
further investigation if the coroner's report required by this
bill is treated as a complaint.
9)Sunsets the provisions of this bill on January 1, 2018, with
the exception of the provisions of 1) and 2) above pertaining
to the deletion of the requirement that pathologists be
board-certified or California licensed, as specified.
10)Makes technical and conforming changes.
11)States that if the Commission on State Mandates determines
that this act contains costs mandated by the state,
reimbursement to local agencies and school districts for those
costs shall be made, as specified.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, the overall fiscal effect of this bill is difficult
to predict, but given reasonable assumptions about the number of
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reports and costs based on current MBC statistics, estimates for
ongoing costs are as follows, through calendar year 2017:
1)$700,000 annually to the MBC (Contingent Fund of the MBC) to
handle increased workload related to review and investigate
approximately 700 new reports.
2)$1.8 million to the Department of Justice to handle
approximately 50 new cases per year (charged to the Contingent
Fund of the MBC).
3)Potential state-reimbursable mandate costs in the range of
$100,000 General Fund (GF) annually to county coroner's
offices for new required reports.
COMMENTS :
1)Purpose of this bill . This bill requires coroners to report
prescription drug deaths to MBC in order to aid in MBC's
oversight of physicians and surgeons and help reduce the
overprescribing of dangerous drugs. This bill is
author-sponsored.
2)LA Times series on prescription drug overdoses . A Los Angeles
Times investigative series in Fall 2012 entitled "Dying for
Relief" analyzed coroners' reports for over 3,000 deaths
occurring in four counties (Los Angeles, Orange, Ventura and
San Diego) where the cause of death was overdose by
prescription drugs.
The analysis found that in nearly half of these cases, the drug
that caused the overdose had been prescribed directly to the
decedent, as opposed to drugs that were stolen or diverted
from another patient. The report also found that more than 80
of the doctors whose names were listed on prescription bottles
related to the decedent had been the prescribing physician for
three or more dead patients, including one doctor who was
linked to as many as 16 dead patients.
3)MBC sunset report . Current law requires a coroner to report
to the appropriate regulatory board within DCA when the
coroner determines that a death may be the result of gross
negligence or incompetence by a physician and surgeon,
podiatrist or physician assistant. While this reporting is
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mandatory under existing law, it is not strictly enforced:
only four reports were received by MBC in Fiscal Year 2011-12,
and only one of those reports indicated a drug-related death.
While it is quite likely that more than one death in
California during 2011-12 was due to grossly negligent or
incompetent prescribing, MBC is not receiving the required
reports because coroners may be hesitant to declare the deaths
to be caused by negligent or incompetent prescribing because
of a lack of information about the case. Coroners are not
privy to a decedent's medical record or history, so a
determination about whether or not the physician's care could
be highly speculative.
In order to avoid the problem of underreporting because of the
coroners' unwanted responsibility to make difficult causation
determinations, this bill simply requires all deaths related
to prescription drug overdoses to be reported to MBC for
further investigation. This would allow MBC to determine
whether a prescriber was acting inappropriately.
4)Understanding drug schedules . Drugs and other substances that
are considered controlled substances under the Controlled
Substances Act are divided into five schedules by the United
States Drug Enforcement Agency. Substances are placed in
their respective schedules based on whether they have a
currently accepted medical use in treatment in the United
States, their relative abuse potential, and likelihood of
causing dependence when abused.
Schedule I drugs have been deemed to have "no currently
accepted medical use in the United States, a lack of accepted
safety for use under medical supervision, and a high potential
for abuse." Examples of Schedule I drugs include heroin, LSD,
marijuana and Ecstasy.
On the opposite end of the spectrum, Schedule V drugs have a
low potential for abuse, and consist primarily of drugs
containing limited quantities of certain narcotics. Schedule
V substances would include over-the-counter cough syrups like
Robitussin AC.
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Analysis Prepared by : Sarah Huchel / B.,P. & C.P. / (916)
319-3301
FN: 0002257