BILL ANALYSIS Ó Senate Appropriations Committee Fiscal Summary Senator Kevin de León, Chair SB 493 (Hernandez) - Pharmacy practice. Amended: April 24, 2013 Policy Vote: B&P 9-0 Urgency: No Mandate: Yes Hearing Date: May 13, 2013 Consultant: Brendan McCarthy This bill meets the criteria for referral to the Suspense File. Bill Summary: SB 493 would expand the scope of practice of pharmacists, by authorizing pharmacists to administer certain medications and furnish immunizations, hormonal contraceptives and certain other drugs. The bill would establish advance practice pharmacist recognition and allow such pharmacists to perform specified activities. Fiscal Impact: One-time costs of about $200,000 to adopt new regulations and upgrade the existing system for processing license applications (Pharmacy Board Contingent Fund). Ongoing costs of about $300,000 per year for licensing and enforcement (Pharmacy Board Contingent Fund). Background: Under current law, pharmacists are licensed and regulated by the Board of Pharmacy. Current law authorizes pharmacists to perform certain health care functions, such as dispensing medications upon the prescription of a physician and administer immunizations pursuant to a protocol with a prescriber (such as a physician). In addition, pharmacists may take certain actions, under protocols authorized by a physician, such as ordering tests and administering drugs. Proposed Law: SB 493 would expand the scope of practice of pharmacists. Specifically, the bill would authorize pharmacists to: Furnish self-administered hormonal contraceptives, in accordance with procedures developed by the Board of Pharmacy and the California Medical Board; Furnish smoking cessation drugs and drugs recommended for people travelling outside the United States; SB 493 (Hernandez) Page 1 Order and interpret tests for the purpose of managing drug therapies; Administer certain vaccines. The bill would establish advance practice pharmacist recognition, with specified licensing and training requirements. The bill would authorize advance practice pharmacists to: Perform patient assessments; Order and interpret tests; Refer patients to other providers; Initiate, adjust, or discontinue drug therapy (similar to authority already granted in law for pharmacists in licensed health care facilities). The bill requires the Board of Pharmacy to adopt regulations to establish the means of documenting completion of the requirements for advance practice pharmacy. Related Legislation: SB 352 (Pavley) authorizes certain medical professionals to supervise medical assistants. That bill is in the Assembly. SB 491 (Hernandez) would expand the scope of practice for nurse practitioners. That bill will be heard in this committee. SB 492 (Hernandez) would authorize an optometrist to diagnose and treat certain medical conditions. That bill will be heard in this committee. Staff Comments: The only costs that may be incurred by a local agency relate to crimes and infractions. Such costs are not reimbursable by the state under the California Constitution.