BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 679|
|Office of Senate Floor Analyses | |
|(916) 651-1520 Fax: (916) | |
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THIRD READING
Bill No: AB 679
Author: Travis Allen (R)
Amended: 9/10/15 in Senate
Vote: 27 - Urgency
PRIOR VOTES NOT RELEVANT
SENATE BUS., PROF. & ECON. DEV. COMMITTEE: 8-0, 9/11/15
AYES: Hill, Bates, Berryhill, Block, Hernandez, Jackson,
Mendoza, Wieckowski
NO VOTE RECORDED: Galgiani
SUBJECT: Controlled substances
SOURCE: Author
DIGEST: This bill extends the date by which specified health
care practitioners and pharmacists must register with the
Controlled Substance Utilization Review and Evaluation System
(CURES) Prescription Drug Monitoring Program (PDMP) by six
months, from January 1, 2016 to July 1, 2016. This measure
contains an urgency clause.
ANALYSIS:
Existing law:
1) Establishes the Medical Practice Act which provides for the
licensing and regulation of physicians and surgeons by the
Medial Board of California (MBC) within the Department of
Consumer Affairs (DCA). (Business and Professions Code (BPC)
§§ 2000 et seq.)
2) Establishes the Nursing Practice Act which provides for the
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certification and regulation of registered nurses, nurse
practitioners and advanced practice nurses by the Board of
Registered Nursing within DCA. (BPC §§ 2700 et seq.)
3) Authorizes a certified nurse-midwife to furnish or order
drugs or devices, including controlled substances, if
furnished or ordered incidentally to the provision of family
planning services, routine health care or perinatal care, or
care rendered consistent with the certified nurse-midwife's
practice; occurs under physician and surgeon supervision; and
is in accordance with standardized procedures or protocols as
specified. (BPC § 2746.51)
4) Authorizes a nurse practitioner to furnish or order drugs or
devices, including controlled substances if it is consistent
with a nurse practitioner's educational preparation or for
which clinical competency has been established and
maintained; occurs under physician and surgeon supervision;
and is in accordance with standardized procedures or
protocols, as specified. (BPC § 2836.1)
5) Establishes the Physician Assistant Practice Act which
provides for the licensing of physician assistants by the
Physician Assistant Committee, under the MBC, within the DCA.
(BPC §§ 3500 et seq.)
6) Authorizes a physician assistant under the supervision of a
physician and surgeon to administer or provide medication to
a patient, or transmit orally or in writing a drug order
under specified conditions and protocols adopted by the
supervising physician and surgeon. (BPC § 3502.1)
7) Defines "dispense" as the furnishing of drugs or devices
upon a prescription from a physician, dentist, optometrist,
podiatrist, veterinarian, or naturopathic doctor or upon an
order to furnish drugs or transmit a prescription from a
certified nurse-midwife, nurse practitioner, physician
assistant, naturopathic doctor, or pharmacist acting within
the scope of his or her practice. Dispense also means and
refers to the furnishing of drugs or devices directly to a
patient by a physician, dentist, optometrist, podiatrist, or
veterinarian, or by a certified nurse-midwife, nurse
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practitioner, naturopathic doctor, or physician assistant
acting within the scope of his or her practice. (BPC § 4024)
8) Classifies controlled substances in five schedules according
to their danger and potential for abuse. (Health and Safety
Code (HSC) §§ 11054-11058)
9) Establishes CURES to monitor Schedule II, III and IV
controlled substance prescriptions. CURES provides for the
electronic transmission of information related to the
prescription of Schedule II, III and IV controlled substances
to the Department of Justice (DOJ). (HSC § 11165)
10)Requires the dispensing pharmacy, clinic, or other dispenser
to report specified information to CURES as soon as
reasonably possible, but not more than seven days after the
date a controlled substance is dispensed, in a format
specified by the DOJ. (HSC § 11165)
11)Requires a health care practitioner eligible to prescribe
Schedule II, III or IV controlled substances, and a
pharmacist, to apply to participate in the CURES PDMP by
January 1, 2016. (HSC § 11165.1)
This bill:
1)Requires that a healthcare practitioner authorized to
prescribe, order, administer, furnish, or dispense Schedule
II, Schedule III, or Schedule IV controlled substances submit
an application to the DOJ to obtain approval to access CURES
before July 1, 2016, or upon receipt of a federal Drug
Enforcement Administration registration, whichever occurs
later.
2)Requires a pharmacist to submit an application to the DOJ to
obtain approval to access to CURES before July 1, 2016, or
upon licensure, whichever occurs later.
3)Contains an urgency clause, stating that its immediate effect
is necessary to ensure that health care practitioners and
pharmacists are not out of compliance with the requirement to
apply to access data contained in the CURES PDMP on January 1,
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2016.
Background
CURES. With rising levels of abuse, PDMPs have become a
critical tool in assisting law enforcement and regulatory bodies
with their efforts to reduce drug abuse.
The California PDMP maintains the CURES database. CURES allows
authorized users, including licensed healthcare prescribers
eligible to prescribe controlled substances, pharmacists
authorized to dispense controlled substances, law enforcement,
and regulatory boards, to access patient controlled substance
history information maintained in CURES. CURES is committed to
assisting in the reduction of pharmaceutical drug diversion
without affecting legitimate medical practice or patient care.
Pharmacists are required to report information relating to
dispensing Schedules II-IV controlled substances at least
weekly, but use of CURES by prescribers and dispensers for
prescription abuse prevention and intervention is voluntary.
CURES' predecessor, the California Triplicate Prescription
Program was created in 1939 and was replaced by CURES in 1998.
In 2009, the PDMP system was introduced as a searchable,
client-facing component of CURES. The California Budget Act of
2011 eliminated all General Fund support of CURES and PDMP,
which included funding for system support, staff support and
related operating expenses. SB 809 (DeSaulnier, Chapter 400,
Statutes of 2013) established a funding mechanism to update and
maintain CURES, required all prescribing health care
practitioners to apply to access CURES information, and
established processes and procedures for regulating prescribing
licensees through CURES and securing private information.
DOJ is currently in the process of modernizing CURES to more
efficiently serve prescribers, pharmacists and regulatory
entities. DOJ originally anticipated that the new CURES 2.0
system would be operational on July 1, 2015, but among other
functionalities, the streamlined registration process is now
expected to be ready by July 1, 2016.
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This bill delays licensee registration requirements to align
statutory mandates with the ready date of the new system,
although there has been no indication from regulatory bodies
that licensees were in danger of prosecution during those six
months.
FISCAL EFFECT: Appropriation: No Fiscal
Com.:YesLocal: No
SUPPORT: (Verified9/11/15)
California Medical Association
OPPOSITION: (Verified9/11/15)
None received
ARGUMENTS IN SUPPORT: Supporters argue that an important
component of SB 809 (DeSaulnier) related to the application
process for CURES has not yet come to fruition. In addition to
the requirement for covered health care practitioners to apply
for CURES, SB 809 required the DOJ, in conjunction with the DCA
and the relevant licensing boards and commissions, to establish
a streamlined application to help facilitate the application of
the thousands of licenses who are required to meet the mandate.
This streamlined application process was originally estimated to
be available to licensees in the summer of 2015, which would
have allowed six months for licensees to utilize the new process
for their application. Though supporters expect a new,
automated application process very soon, it is not yet
available.
The new application process will represent great progress toward
establishing, as envisioned in SB 809, a system that meets the
needs of health care providers and patients. However,
supporters are concerned that the roll out of a new process in
the few months before the application deadline will create
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unnecessary confusion among licensees. Extending the deadline
to enroll by six months will allow time for the new process to
be implemented and the changes to be fully communicated to the
licensee community. A smooth enrollment process will help
reinforce efforts to improve the CURES database and encourage
its increased use.
Prepared by:Sarah Huchel and Mark Mendoza / B., P. & E.D. /
(916) 651-4104
9/11/15 14:06:22
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