BILL ANALYSIS Ó
SB 809
Page 1
SENATE THIRD READING
SB 809 (DeSaulnier)
As Amended September 3, 2013
Majority vote
SENATE VOTE :39-0
PUBLIC SAFETY 7-0 BUSINESS & PROFESSIONS 14-0
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|Ayes:|Ammiano, Melendez, |Ayes:|Bonilla, Jones, |
| |Jones-Sawyer, Mitchell, | |Bocanegra, Campos, |
| |Quirk, Skinner, Waldron | |Dickinson, Eggman, |
| | | |Gordon, Hagman, Holden, |
| | | |Maienschein, Mullin, |
| | | |Skinner, Ting, Wilk |
|-----+--------------------------+-----+--------------------------|
| | | | |
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APPROPRIATIONS 16-0
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|Ayes:|Gatto, Harkey, Bigelow, | | |
| |Bocanegra, Bradford, Ian | | |
| |Calderon, Campos, Eggman, | | |
| |Gomez, Hall, Holden, | | |
| |Linder, Pan, Quirk, | | |
| |Wagner, Weber | | |
|-----+--------------------------+-----+--------------------------|
| | | | |
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SUMMARY : Establishes a funding mechanism to update and maintain
the Controlled Substance Utilization Review and Evaluation
System (CURES) and Prescription Drug Monitoring Program (PDMP),
requires all prescribing health care practitioners to apply to
access CURES information, and establishes processes and
procedures for regulating prescribing licensees through CURES
and securing private information. 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 those licensees:
a) Physicians, dentists, podiatrists, veterinarians,
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naturopathic doctors, pharmacists, registered nurse,
certified nurse-midwives, nurse practitioners, physician
assistants, and optometrists, as specified;
b) Wholesalers and nonresident wholesalers of dangerous
drugs, as specified;
c) Nongovernmental clinics, nonprofit clinics, and free
clinics, as specified; and,
d) Nongovernmental pharmacies, as specified.
2)Requires, beginning April 1, 2014, the assessed fee to be
billed and collected by the regulating agency of each licensee
at the time of the licensee's license renewal, and states that
if the reasonable regulatory cost of operating and maintaining
CURES is less than $6 per licensee, the Department of Consumer
Affairs (DCA) may, by regulation, reduce the fee to the
reasonable regulatory cost.
3)Requires the fees collected to be deposited in the CURES Fund,
which is created within the State Treasury.
4)Requires moneys in the CURES Fund to be, upon appropriation by
the Legislature, available to DCA to reimburse the Department
of Justice (DOJ) for costs to operate and maintain CURES for
the purposes of regulating the specified licensees.
5)Requires DCA to contract with DOJ on behalf of the Medical
Board of California (MBC), the Dental Board of California, the
California State Board of Pharmacy, the Veterinary Medical
Board, the Board of Registered Nursing, the Physician
Assistant Board of the Medical Board of California, the
Osteopathic Medical Board of California, the Naturopathic
Medicine Committee of the Osteopathic Medical Board, the State
Board of Optometry, and the California Board of Podiatric
Medicine to operate and maintain CURES for the purposes of
regulating licensees.
6)Requires DOJ, in conjunction with DCA and the appropriate
boards and committees, to do all of the following:
a) Identify and implement a streamlined application and
approval process to provide access to the CURES PDMP
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database for pharmacists and licensed health care
practitioners eligible to prescribe, order, administer,
furnish, or dispense Schedule II, Schedule III, or Schedule
IV controlled substances, and requires every reasonable
effort be made to implement a streamlined application and
approval process that a licensed health care practitioner
or pharmacist can complete at the time that he or she is
applying for licensure or renewing his or her license;
b) Identify necessary procedures to enable licensed health
care practitioners and pharmacists with access to the CURES
PDMP to delegate their authority to order reports from the
CURES PDMP; and,
c) Develop a procedure to enable health care practitioners
who do not have a federal Drug Enforcement Administration
(DEA) number to opt out of applying for access to the CURES
PDMP.
7)Requires MBC to periodically develop and disseminate
information and educational material regarding assessing a
patient's risk of abusing or diverting controlled substances
and information relating to CURES to each licensed physician
and surgeon and to each general acute care hospital in this
state; and further requires MBC to consult with the State
Department of Public Health, appropriate boards and
committees, and DOJ in developing the materials to be
distributed.
8)Requires a California pharmacy to report dispensing a Schedule
IV controlled substance issued by a prescriber in another
state for delivery to a patient in another state to CURES.
9)Authorizes pharmacies to dispense Schedule III, IV, and V
controlled substances prescriptions from out-of-state
prescribers as specified.
10)Requires DOJ to maintain CURES to assist health care
practitioners in their efforts to ensure appropriate
prescribing, ordering, administering, furnishing, and
dispensing of controlled substances.
11)Deletes provisions stating that the reporting of Schedules
III and IV controlled substances shall be contingent upon the
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availability of adequate funds from DOJ.
12) Requires DOJ to annually report to the Legislature and make
available to the public the amount and source of funds it
receives for support of CURES.
13)Permits DOJ to seek and use grant funds to pay the costs
incurred by the operation and maintenance of CURES.
14)Requires CURES to comply with all applicable federal and
state privacy and security laws and regulations.
15)Requires DOJ to establish policies, procedures, and
regulations regarding the use, access, evaluation, disclosure,
management, implementation, operation, storage, and security
of the information within CURES.
16)Requires a pharmacy, clinic, or other dispenser to report
specified information, including a prescribers national
provider identifier number, to DOJ as soon as reasonably
possible, but not more than seven days after the date a
controlled substance is dispensed.
17)Permits DOJ to invite stakeholders to assist, advise, and
make recommendations on the establishment of rules and
regulations necessary to ensure the proper administration and
enforcement of the CURES database. All prescriber and
dispenser invitees must be licensees, as specified, in active
practice in California, and a regular user of CURES.
18)Requires DOJ, prior to upgrading CURES, to consult with
prescribers licensed by one of the relevant boards or
committees, the boards or committees themselves, and any other
stakeholders for the purpose of identifying desirable
capabilities and upgrades to the CURES PDMP.
19)Permits DOJ to establish a process to educate authorized
subscribers of the CURES PDMP on how to access and use the
CURES PDMP.
20)Requires a health care practitioner authorized to prescribe,
order, administer, furnish, or dispense Schedule II-IV
controlled substances or a pharmacist to, before January 1,
2016, or upon receipt of a federal Drug Enforcement
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Administration (DEA) registration, whichever occurs later,
submit an application to DOJ to access information online
regarding the controlled substance history of a patient, as
specified.
21)Requires DOJ, upon approval of an application to access
patient information, release to the practitioner or pharmacist
the electronic history of controlled substances dispensed to
an individual under his or her care based on data contained in
the CURES PDMP.
22)States that a health care practitioner authorized to
prescribe Schedules II-IV controlled substances, shall be
deemed to have completed the requirements to access individual
patient information if he or she has applied to access CURES
PDMP at the time he or she applied for licensure or renewal.
23)Requires a pharmacist to submit an application, as specified,
to obtain approval to access CURES PDMP.
24)Permits DOJ to seek voluntarily contributed private funds
from insurers, health care service plans, and qualified
manufacturers for the purpose of supporting CURES. Insurers,
health care service plans, qualified manufacturers, and other
donors may contribute by submitting their payment to the
Controller for deposit into the CURES Fund. Contributions to
the CURES Fund shall be nondeductible for state tax purposes.
25)Defines the following terms:
a) "Controlled substance" means a drug, substance, or
immediate precursor listed in any schedule in Section
11055, 11056, or 11057 of the Health and Safety Code (HSC);
b) "Health care service plan" means an entity licensed
pursuant to the Knox-Keene Health Care Service Plan Act of
1975 (Chapter 2.2 (commencing with Section 1340) of
Division 2 of HSC);
c) "Insurer" means an admitted insurer writing health
insurance, as defined in Section 106 of the Insurance Code,
and an admitted insurer writing workers' compensation
insurance, as defined in Section 109 of the Insurance Code;
and,
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d) "Qualified manufacturer" means a manufacturer of a
controlled substance, but does not mean a wholesaler or
nonresident wholesaler of dangerous drugs, as specified, a
veterinary food-animal drug retailer, as specified, or an
individual regulated by the MBC, the Dental Board of
California, the California State Board of Pharmacy, the
Veterinary Medical Board, the Board of Registered Nursing,
the Physician Assistant Committee of the Medical Board of
California, the Osteopathic Medical Board of California,
the State Board of Optometry, or the California Board of
Podiatric Medicine.
26)Makes clarifying and technical amendments.
27)Makes legislative findings and declarations.
EXISTING LAW :
1)Requires DOJ to maintain CURES for the electronic monitoring
of the prescribing and dispensing of Schedule II, III, and IV
controlled substances by all practitioners authorized to
prescribe or dispense these controlled substances.
2)Requires a dispensing pharmacy or clinic to provide specified
prescription data for each prescription for a Schedule II,
III, or IV controlled substance to DOJ on a weekly basis.
3)Allows a licensed health care practitioner who is eligible to
prescribe Schedule II, III, or IV controlled substances, or a
pharmacist, to make a written request to DOJ for the history
of controlled substances dispensed to an individual under his
or her care, and allows DOJ to provide that information to
that health care practitioner or pharmacist.
4)Provides that the history of controlled substances dispensed
to an individual based on data contained in CURES that is
received by a practitioner or pharmacist from DOJ pursuant to
this section shall be considered medical information subject
to specified confidentiality provisions.
5)Requires every practitioner, other than a pharmacist, who
prescribes or administers a controlled substance classified in
Schedule II, III or IV to record specified information
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relating to the transaction.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, 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 : According to the author, "SB 809 provides essential
funding to continue and strengthen the CURES Prescription Drug
Monitoring Program, 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 Prescription
Drug Monitoring Program.
"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 percent 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. In California, on average,
there are six deaths every day from prescription drug overdose
and1.2 million emergency room visits related to the misuse or
abuse of pharmaceuticals.
"SB 809 provides sufficient and sustainable revenue to maintain
the CURES program operations, sustain full modernization, and
improve program participation and utilization by requiring all
practitioners and pharmacists to enroll in the CURES PDMP."
Please see the policy committee analysis for a full discussion
of this bill.
Analysis Prepared by : Shaun Naidu / PUB. S. / (916) 319-3744
FN: 0002184
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