BILL ANALYSIS
AB 2660
Page 1
Date of Hearing: April 13, 2004
ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
Lou Correa, Chair
AB 2660 (Leno) - As Amended: April 12, 2004
SUBJECT : Prescriptions: issuance by a pharmacist.
SUMMARY : Amends existing law to reinstate pharmacists'
authority to register with the US Drug Enforcement Agency (DEA)
and therefore initiate or adjust controlled substance drug
therapy under specified conditions. Specifically, this bill :
1)Authorizes a pharmacist to initiate and adjust prescription
drug therapies using controlled substances under specific
physician protocols;
2)Requires a pharmacist initiating or adjusting controlled
substances to register with the DEA;
3)Authorizes the Board of Pharmacy to issue new or renewal
licenses to pharmacists who initiate or adjust drug therapies
under specific circumstances; and,
4)Makes other nonsubstantive technical changes.
EXISTING LAW :
1)Defines "prescription" and sets requirements on how medication
is dispensed and who is authorized to issue a prescription.
2)Makes specific requirements for issuing prescriptions for a
controlled substance, and requires a copy of the prescription
to be submitted to the Department of Justice at the end of the
month in which the prescription was filled.
3)Authorizes pharmacists to furnish, transmit, and administer
prescription medication. Authorizes them to perform routine
drug therapy-related patient assessment procedures, including
temperature, pulse and respiration, ordering drug
therapy-related lab tests, administering drugs and biologicals
by injection, and initiating or adjusting the drug regimen of
a patient pursuant to an order or authorization made by the
patient's prescriber. Allows pharmacists to furnish emergency
contraception drug therapy as long as the pharmacist completes
a training program on emergency contraception drug therapy.
AB 2660
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4)Allows certified nurse-midwives, nurse practitioners, and
physician assistants to order or furnish drugs or devises
under the supervision of a physician and surgeon.
5)Allows a pharmacist, under physician supervision, who is
functioning as part of a multidisciplinary group in a clinical
setting, to initialize or adjust a drug therapy.
6)Precludes any person from possessing a controlled substance,
unless the person has a valid prescription for that drug.
AB 2660
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7)Existing federal law requires any person who dispenses or
proposes to dispense any controlled substance to obtain a
registration number from the Attorney General annually.
FISCAL EFFECT : Unknown
COMMENTS :
The California Pharmacist Practice Act allows specifically
authorized and specially qualified pharmacists to initiate and
adjust prescription drug therapy under protocols jointly
developed by physicians and pharmacists. This authority applies
to both controlled and non-controlled substances. Controlled
substances are also regulated by federal law, which requires
anyone handling controlled substances to have a DEA registration
number. DEA issues registration numbers to mid-level
practitioners, in accordance with state law. Without DEA
numbers, qualified pharmacists cannot assist physicians with
drug therapy involving controlled substances, although they are
still permitted to initiate or adjust drug therapy involving
non-controlled substances.
DEA used to issue registration numbers to qualified California
pharmacists because they were considered mid-level
practitioners. In 1999, the Legislature passed SB 816 (Escutia),
Chapter 749, Statutes of 1999, which specifically designated
certified nurse-midwives, nurse practitioners and physician
assistants as mid-level practitioners, but left out pharmacists.
This legislation was unrelated to pharmacists and no one
thought to include pharmacists or knew that this would prevent
pharmacists from assisting physicians with drug therapy
involving controlled substances. As a result, pharmacists have
been denied DEA registration numbers and have been unable to
assist physicians in managing controlled substance drug
therapies.
Without DEA numbers, qualified pharmacists are no longer allowed
to assist physicians with drug therapy involoving controlled
substances. This, in turn, unnecessarily burdens physicians,
who are required to personally approve even the slightest
adjustment to any controlled substance therapy. According to
the author's office, this is particularly problematic in
managing pain therapy, which a qualified pharmacist could assist
with under this bill.
Pharmacists were overlooked in 1999, although they had
AB 2660
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previously been allowed to adjust controlled substance drug
therapy. This bill simply rectifies this oversight and
re-establishes the ability of qualified pharmacists to work
under a physician in adjusting controlled substance drug
therapy.
REGISTERED SUPPORT / OPPOSITION :
Support
Kaiser Permanente Medical Care Program (sponsor)
California Association for Nurse Practitioners
California Association of Physician Groups
California Pharmacists Association
Opposition
None on file.
Analysis Prepared by : Rene? L. Brooks / B. & P. / (916)
319-3301