BILL ANALYSIS Ó SB 809 Page 1 Date of Hearing: August 21, 2013 ASSEMBLY COMMITTEE ON APPROPRIATIONS Mike Gatto, Chair SB 809 (DeSaulnier) - As Amended: August 5, 2013 Policy Committee: Business and Professions Vote: 14-0 Public Safety 7-0 Urgency: Yes State Mandated Local Program: No Reimbursable: SUMMARY This bill creates a funding mechanism to update and maintain the Department of Justice (DOJ) Controlled Substance Utilization Review and Evaluation System (CURES) Prescription Drug Monitoring Program (PDMP). Specifically, this bill: 1)Assesses an annual $6 fee on the following licensees to pay the reasonable costs associated with operating and maintaining CURES for the purpose of regulating these licensees: Physicians, dentists, podiatrists, veterinarians, naturopathic doctors, pharmacists, registered nurse, certified nurse-midwives, nurse practitioners, physician assistants, and optometrists, as specified; wholesalers and nonresident wholesalers of dangerous drugs, as specified; nongovernmental clinics, nonprofit clinics, and free clinics, as specified; and nongovernmental pharmacies, as specified. 2)Requires the fee to be collected at the time of the licensee's license renewal and be deposited into the CURES Fund, created by this bill, to be available, upon appropriation, to the Department of Consumer Affairs (DCA) to reimburse DOJ. 3)Permits DOJ to seek voluntarily contributed private funds from insurers, health care service plans, and qualified manufacturers for the purpose of supporting CURES, as specified. Requires DOJ to annually report to the Legislature, and make public the amount and source of funds it receives for support of CURES. SB 809 Page 2 4)Requires DOJ, in conjunction with DCA and the appropriate boards and committees, to implement a streamlined application and approval process to provide access to the CURES PDMP database for licensed health care practitioners. 5)Requires the Medical Board to "periodically develop and disseminate" information and educational material regarding the risk of abusing controlled substances, as well as information relating to CURES, to licensed physicians, surgeons and acute care hospitals. FISCAL EFFECT Ongoing special fund costs in the $1.5 million range, fully covered by the proposed fee structure, to staff and maintain the upgraded PDMP. The related costs to upgrade the PDMP database - almost $3 million - received funding in the 2013-14 budget bill. COMMENTS 1)Rationale . Sponsored by DOJ, this bill provides a funding scheme for the ongoing operations of the CURES PDMP. According to the author, "SB 809 provides essential funding to continue and strengthen the CURES PDMP, a vital resource for medical professionals and law enforcement to detect and prevent prescription drug abuse and addiction, and save lives. Without dedicated funding, the CURES program will be suspended and California will join Missouri as the only state in the nation without a PDMP. "Prescription drug abuse is the Nation's fastest-growing drug problem and has been classified as a public health epidemic by the Centers for Disease Control and Prevention. One hundred people die from drug overdoses every day in the United States and prescription painkillers are responsible for 75% of these deaths, claiming more lives than heroin and cocaine combined, and fueling a doubling of drug-related deaths in the United States over the last decade." 2)CURES/PDMP Background. To combat prescription drug abuse, the California Triplicate Prescription Program (TPP) was created in 1939. It was replaced by CURES in 1997, and in 2009, the PDMP system was implemented as a searchable database component of CURES. The database contains more than 100 million entries of controlled substance drugs dispensed in California. In SB 809 Page 3 2012, the program responded to more than 800,000 requests. Pharmacists are required to report dispensations of Schedules II, III and IV controlled substances at least weekly; PDMP by prescribers and dispensers for prescription abuse prevention/intervention is voluntary. The 2011-12 budget bill eliminated GF support of CURES/PDMP. DOJ struggled to keep the program operative, cobbling together temporary staff and student interns. This bill is the result of a lengthy and collaborative effort to establish a stable and ongoing funding scheme. 3)Support includes a lengthy and varied list of organizations, including the Attorney General, the American and CA Medical Associations, Association of CA Insurance Companies, CA Department of Insurance, CA Hospital Association, CA Labor Federation, CA Police Chiefs Association, CA Retailers Association, CA State Sheriffs Association, MBC, and UC. According to the Attorney General's (AG's) Office, The majority of the CURES funding was cut during the Fiscal Year 2011-12 budget and CURES and the PDMP have since been staffed by a single AG employee. Additionally, the current PDMP is a dated, unstable program that has needed an upgrade to meet the needs of prescribers and pharmacists. 4)"The current budget funds the upgrade of the PDMP, and this legislation is necessary to provide the ongoing funding to operate and maintain the program." 5)There is no confirmed opposition . Analysis Prepared by : Geoff Long / APPR. / (916) 319-2081