BILL ANALYSIS                                                                                                                                                                                                    Ó



          SENATE COMMITTEE ON APPROPRIATIONS
                             Senator Ricardo Lara, Chair
                            2015 - 2016  Regular  Session

          AB 1386 (Low) - Emergency medical care:  epinephrine  
          auto-injectors
          
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          |Version: June 28, 2016          |Policy Vote: HEALTH 7 - 0, JUD. |
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          |Urgency: No                     |Mandate: Yes                    |
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          |Hearing Date: August 1, 2016    |Consultant: Brendan McCarthy    |
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          This bill meets the criteria for referral to the Suspense File.

          Bill  
          Summary:  AB 1386 would allow a health care provider to issue a  
          prescription for an epinephrine auto-injector to an authorized  
          entity. The bill would authorize a pharmacy to fill such a  
          prescription.


          Fiscal  
          Impact:  
           One-time costs of $50,000 for the development of information  
            technology systems to track information relating to the  
            issuance of certificates and collection of data on usage of  
            epinephrine auto-injectors under the bill by the Emergency  
            Medical Services Authority (General Fund).

           One-time costs of $130,000 over two years for the adoption of  
            regulations by the Emergency Medical Services Authority  
            (General Fund).

           Ongoing costs of $90,000 per year to review training programs,  







          AB 1386 (Low)                                          Page 1 of  
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            issue certificates to participating individuals, and report  
            data on the program by the Emergency Medical Services  
            Authority (General Fund).


          Background:  Under current law, the Emergency Medical Services Authority  
          develops guidelines and standards for emergency medical systems,  
          including standards for training and the scope of practice for  
          emergency medical personnel.

          Under current law, school districts and county offices of  
          education are authorized to designate school personnel to  
          receive training to use an epinephrine auto-injector to render  
          emergency medical care under certain conditions. In addition,  
          current law authorizes prehospital emergency medical personnel,  
          first responders, or lay rescuers to use an epinephrine  
          auto-injector to render emergency medical care, if certain  
          conditions are met, including training requirements.


          Proposed Law:  
            AB 1386 would allow a health care provider to issue a  
          prescription for an epinephrine auto-injector to an authorized  
          entity. The bill would authorize a pharmacy to fill such a  
          prescription.
          Specific provisions of the bill would:
           Authorize a health care provider to issue a prescription for  
            an epinephrine auto-injector to an authorized entity, if  
            certain conditions are met;
           Authorize a pharmacy to fill such a prescription;
           Define authorized entity to include any for-profit, nonprofit,  
            or government entity or organization that employs one person  
            or utilizes a volunteer or agent that has completed a required  
            training course;
           Place certain requirements on an authorized entity, including  
            a requirement to report any use of an epinephrine  
            auto-injector to the Emergency Medical Services Authority;
           Require the Authority to report annually on the use of  
            epinephrine auto injectors under the bill;
           Provide limited immunity from professional review, civil  
            liability or criminal prosecution for prescribers or  
            authorized entities.










          AB 1386 (Low)                                          Page 2 of  
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          Related  
          Legislation:  
           SB 738 (Huff, Statutes of 2015) provides qualified immunity to  
            a physician who prescribes an epinephrine auto-injector to a  
            school district or related entity.
           SB 1266 (Huff, Statutes of 2014) requires school districts and  
            related entities to provide epinephrine auto-injectors to  
            school nurses or trained volunteers.
           SB 669 (Huff, Statutes of 2013) authorizes prehospital  
            emergency medical care personnel, first responders, and lay  
            rescuers to use an epinephrine auto-injector


          Staff  
          Comments:  Current law authorizes the Authority to charge fees  
          for approval of training courses ($500) and individual  
          certification cards ($15). Applicants under this bill would be  
          required to pay those fees as well. However, it is not expected  
          that enough of either type of applicant will apply to generate  
          sufficient fee revenues to offset the additional costs imposed  
          by the bill.
          The only costs that may be incurred by a local agency relate to  
          crimes and infractions. Under the California Constitution, such  
          costs are not reimbursable by the state.


          




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