BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 1977|
|Office of Senate Floor Analyses | |
|(916) 651-1520 Fax: (916) | |
|327-4478 | |
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THIRD READING
Bill No: AB 1977
Author: Wood (D) and Waldron (R)
Amended: 4/13/16 in Assembly
Vote: 21
SENATE HEALTH COMMITTEE: 8-0, 6/29/16
AYES: Hernandez, Nguyen, Hall, Mitchell, Monning, Nielsen,
Pan, Roth
NO VOTE RECORDED: Wolk
ASSEMBLY FLOOR: 78-0, 5/9/16 (Consent) - See last page for
vote
SUBJECT: Opioid Abuse Task Force
SOURCE: Author
DIGEST: This bill requires health plan and health insurer
representatives, in collaboration with others, to convene an
Opioid Abuse Task Force.
ANALYSIS: Existing law establishes the California Department
of Public Health (CDPH), which among other activities and
responsibilities convenes the Prescription Opioid Misuse and
Overdose Prevention (POMOP) Workgroup.
This bill:
1)Requires on or before February 1, 2017, health plan and health
AB 1977
Page 2
insurer representatives, in collaboration with advocates,
experts, health care professionals, and other entities and
stakeholders that they deem appropriate, to convene an Opioid
Abuse Task Force (OATF).
2)Requires OATF to develop recommendations regarding the abuse
and misuse of opioids as a serious problem that affects the
health, social welfare, and economic welfare of persons in the
state, and requires OATF to address all of the following:
a) Interventions that have been scientifically validated
and have demonstrated clinical efficacy;
b) Interventions that have measurable treatment outcomes;
c) Collaborative, evidence-based approaches to resolving
opioid abuse and misuse that incorporate both the provider
and the patient into the solution;
d) Education that engages and encourages providers to be
prudent in prescribing opioids and to be proactive in
defining care plans that include a plan to taper and stop
opioid use; and,
e) Review and consideration of medication coverage policies
and formulary management and development of an
interdisciplinary case management program that addresses
quality, fraud, waste, and abuse.
3)Requires on or before December 31, 2017, OATF to submit a
report detailing its findings and recommendations to the
Governor, the President pro Tempore of the Senate, the Speaker
of the Assembly, the Senate Committee on Health, and the
Assembly Committee on Health.
4)Dissolves OATF on June 1, 2018.
AB 1977
Page 3
5)States that a violation of this bill is not subject to a fine
or imprisonment, as specified.
6)Finds and declares that abuse and misuse of opioids is a
serious problem that affects the health, social, and economic
welfare of this state, and after alcohol, prescription drugs
are the most commonly abused substances by Americans over 12
years of age.
7)Finds and declares that almost two million people in the
Unites States suffer from substance use disorders related to
opioid pain relievers and the number of unintentional overdose
deaths has more than quadrupled since 1999.
Comments
1)Author's statement. According to the author, not enough is
being done to curb the growth of opioid abuse, and health care
providers and parents need tools to help guard against the
abuse of opioid medication. The author cites increasing
patient awareness on proper storage and disposal, limiting
initial prescriptions for acute pain, as well as the
development and availability of abuse-deterrent opioids, which
are formulated to prevent manipulation of the drug for the
purpose of misuse, as strategies that should be encouraged to
combat opioid abuse. The CDPH is engaged in efforts to
address this epidemic through the grant funded formation of
the POMOP Workgroup. The author is concerned that CDPH
efforts have not engaged external stakeholders who may have
unique expertise or experience in combating this problem.
Additionally, the OATF in this bill could focus on immediate,
actionable strategies which complement the CDPH workgroup
efforts, which are more comprehensive and appropriately
focused on longitudinal changes in behavior.
2)Opioid abuse. According to a March 2015 federal Department of
Health and Human Services issue brief on Opioid Abuse in the
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U. S., mortality data show that there was a 6% increase in
drug overdose deaths between 2012 and 2013. Approximately 37%
(16,235) of overdose deaths involved prescription opioids, a
number essentially unchanged from 2012. However, the mortality
rate from heroin overdose increased each year from 2010 to
2013. Deaths from heroin overdoses increased by 39% from 2012
to 2013 alone and were approximately 19% (8,257) of all drug
overdose deaths in 2013. According to CDPH in the past,
prescription opioids (such as hydrocodone, oxycodone, morphine
and codeine) were prescribed for relieving short-term (acute)
pain. Today, they are increasingly being used for long-term
(chronic) pain management. As a result, sales of opioid pain
relievers quadrupled in the past 10 years. By 2010, enough
opioid pain relievers were sold to medicate every American
adult (about 240 million people) every four hours for an
entire month. In California, deaths involving opioid
prescription medications have increased 16.5% since 2006. In
2012, there were more than 1,800 deaths from all types of
opioids - 72% involved prescription opioids. Prescription
opioid misuse is a public health problem that can lead to
long-term health consequences, including limitations in daily
activity, impaired driving, mental health problems, trouble
breathing, overdose and death.
3)POMOP. CDPH and its state partners convened POMOP Workgroup in
the spring of 2014. This workgroup is exploring opportunities
to improve collaboration and expand joint efforts among state
departments working to address this epidemic. It has
identified two priorities: expansion and strengthening of
prevention strategies and improvement of monitoring and
surveillance. Initial workgroup discussions have focused on
information sharing about existing efforts and roles,
identification of challenges, and potential opportunities for
partnership. Participants in the Workgroup include: CDPH,
Department of Health Care Services, Department of Justice,
Department of Consumer Affairs, California State Board of
Pharmacy, Medical Board of Californian, Dental Board of
California, Board of Nursing, Emergency Medical Services
Authority, California Department of Education, Department of
Corrections and Rehabilitation, and Division of Workers
Compensation.
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FISCAL EFFECT: Appropriation: No Fiscal
Com.:NoLocal: No
SUPPORT: (Verified 8/1/16)
California Council of Community Behavioral Health Agencies
California Dental Association
California District Attorneys Association
California Health+Advocates
California State Sheriffs' Association
County Health Executives Association of California
L.A. Care Health Plan
Medical Board of California
Mental Health America of California
OPPOSITION: (Verified 8/1/16)
California Department of Public Health
ARGUMENTS IN SUPPORT: L.A. Care Health Plan writes in support
that creating OATF to address widespread opioid abuse is a
logical and necessary first step for California. The California
Council of Community Behavioral Health Agencies writes that the
creation and operation of OATF could go a long way toward
finding solutions to this increasing threat to public health.
The County Health Executives Association of California believes
this bill is a modest, but important, step in addressing a
complicated and rising prescription drug abuse problem. The
California Dental Association writes that this bill will begin
to address this need for interventions to opioid abuse. The
California State Sheriffs' Association believes OATF's work
could prove central to future efforts to deal with this growing
problem. The Medical Board of California indicates that this
bill furthers the Board's mission of consumer protection and is
in line with the Board's work on this important issue.
AB 1977
Page 6
ARGUMENTS IN OPPOSITION: CDPH opposes this bill because CDPH
currently convenes the POMOP Workgroup in collaboration with
over 20 state agencies, and it is expanding this year to include
representatives from federal and local entities, foundations and
academic partners. Part of the current planning of the
Workgroup is outreach to engage health system and health plan
partners. CDPH believes OATF duplicates and significantly
overlaps with the goals of the ongoing POMOP Workgroup, and it
may dilute, divert, or otherwise reduce resources that have been
allocated to the Workgroup, potentially limiting its efficacy,
and result in policy inaction should recommendations from the
groups be misaligned.
ASSEMBLY FLOOR: 78-0, 5/9/16
AYES: Achadjian, Alejo, Travis Allen, Arambula, Atkins, Baker,
Bigelow, Bloom, Bonilla, Bonta, Brough, Brown, Burke,
Calderon, Campos, Chang, Chau, Chávez, Chiu, Chu, Cooley,
Cooper, Dababneh, Dahle, Daly, Dodd, Eggman, Frazier,
Gallagher, Cristina Garcia, Gatto, Gipson, Gomez, Gonzalez,
Gordon, Gray, Grove, Hadley, Harper, Roger Hernández, Holden,
Irwin, Jones, Jones-Sawyer, Kim, Lackey, Levine, Linder,
Lopez, Low, Maienschein, Mathis, Mayes, McCarty, Medina,
Melendez, Mullin, Nazarian, Obernolte, O'Donnell, Olsen,
Patterson, Quirk, Ridley-Thomas, Rodriguez, Salas, Santiago,
Steinorth, Mark Stone, Thurmond, Ting, Wagner, Waldron, Weber,
Wilk, Williams, Wood, Rendon
NO VOTE RECORDED: Beth Gaines, Eduardo Garcia
Prepared by:Teri Boughton / HEALTH / (916) 651-4111
8/4/16 14:34:10
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