BILL ANALYSIS Ó
SB 500
Page 1
SENATE THIRD READING
SB 500 (Lieu)
As Amended May 29, 2014
Majority vote
SENATE VOTE :33-0
BUSINESS & PROFESSIONS 11-0 APPROPRIATIONS 14-0
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|Ayes:|Bonilla, Jones, |Ayes:|Gatto, Bigelow, |
| |Dickinson, Eggman, | |Bocanegra, Bradford, Ian |
| |Gordon, Hagman, Holden, | |Calderon, Eggman, Gomez, |
| |Mullin, Skinner, Ting, | |Holden, Linder, Pan, |
| |Wilk | |Quirk, |
| | | |Ridley-Thomas, Wagner, |
| | | |Weber |
|-----+--------------------------+-----+--------------------------|
| | | | |
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SUMMARY : Requires the Medical Board of California (MBC) to
update pain management case review standards by July 1, 2015,
and every five years thereafter, as specified. Specifically,
this bill :
1)Requires MBC to update pain management case review standards
on or before July 1, 2015, and every five years thereafter.
2)Authorizes MBC to consult with the Osteopathic Medical Board
of California in developing pain management case review
standards.
3)Requires MBC to convene a task force to develop and recommend
the updated standards to the board.
4)Authorizes the task force to consult with entities such as the
American Pain Society, the American Academy of Pain Medicine,
the California Society of Anesthesiologists, the California
Chapter of the American College of Emergency Physicians, the
Osteopathic Medical Board of California, any other medical
entity specializing in pain control therapies, the American
Cancer Society, a physician who treats or evaluates patients
as part of the workers' compensation system, an osteopathic
physician, a physician assistant, and specialists in
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pharmacology and addiction medicine.
5)Makes other technical or nonsubstantive changes.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, minor and absorbable costs to MBC (Contingent Fund of
the MBC) to meet this bill's requirements. The MBC is already
convening a Prescribing Task Force that is in the process of
reviewing pain management standards.
COMMENTS :
1)Purpose of this bill. This bill requires MBC to convene a
task force to update MBC's 2007 pain management case review
standards to ensure the competent review of such cases by July
1, 2015, and every five years thereafter. This bill is author
sponsored.
2)Current MBC standards for pain management. MBC publishes
guidelines for physician's management of patient pain to
educate those physicians who lack knowledge about appropriate
treatment and for those who may fail to treat pain properly
due to fear of discipline by MBC. MBC's Web site states,
"These Guidelines are intended to improve effective pain
management in California, by avoiding under treatment, over
treatment, or other inappropriate treatment of a patient's
pain and by clarifying the principles of professional practice
that are endorsed by the Medical Board so that physicians have
a higher level of comfort in using controlled substances,
including opioids, in the treatment of pain. These Guidelines
are intended to promote improved pain management for all forms
of pain and for all patients in pain."
The guidelines were first adopted in 1994, when MBC outlined
its approach to improving appropriate prescribing for
effective pain management in California in a policy statement.
The statement was the product of one year of research,
hearings and discussions.
The statement was expanded in May 2002 as a result of AB 487
(Aroner), Chapter 518, Statutes of 2001, which called for a
task force to review the 1994 Guidelines and to assist MBC in
"develop[ing] standards to assure the competent review in
cases concerning the management, including, but not limited
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to, the under treatment, under medication, and over medication
of a patient's pain." The task force expanded the scope of the
1994 Guidelines from intractable pain patients to all patients
with pain.
3)Evolving standards of pain control. Pain prescribing
guidelines have evolved over the years. For example, previous
law declared it to be unprofessional conduct for a
practitioner to prescribe pain medications to an addict.
However, the standard of care has evolved, and current law now
permits a physician to prescribe, dispense, or administer
prescription drugs, including prescription controlled
substances, to an addict under his or her treatment for a
purpose other than maintenance on, or detoxification from,
prescription drugs or controlled substances.
Standards of care change due to new information, practices,
and medication. MBC last revised its guidelines for
prescribing controlled substances in 2007. This bill will
ensure that MBC revisits its guidelines every five years to
reflect changing practices.
4)MBC's Prescribing Task Force. MBC established a Prescribing
Task Force in 2013 in response to a board member's suggestion
that MBC further define best practices as it relates to
prescribing controlled substances to aid pain management and
reduce prescription drug overdoses. The Prescribing Task
Force will revisit the pain management guidelines and continue
to meet, although it does not have a deadline for approving
changes.
Analysis Prepared by : Sarah Huchel / B., P. & C.P. / (916)
319-3301
FN: 0004034