BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 2660
                                                                  Page  1

          Date of Hearing:   April 21, 2004

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                   Judy Chu, Chair

                    AB 2660 (Leno) - As Amended:  April 12, 2004 

          Policy Committee:                              HealthVote:16-0
                        Business and Professions              13-0

          Urgency:     No                   State Mandated Local Program:  
          Yes    Reimbursable:              No

           SUMMARY  

          This bill makes several changes relating to pharmacists issuing  
          drug orders.  Specifically, this bill:

          1)Revises the definition of "prescription" by including a drug  
            order issued by a pharmacist under specified conditions. 

          2)Requires a pharmacist authorized to issue an order to initiate  
            or adjust a controlled substance therapy under existing law to  
            personally register with the federal Drug Enforcement  
            Administration (DEA). 

          3)Authorizes a person to possess a controlled substance  
            furnished under a drug order by a pharmacist under specified  
            conditions.

          4)Authorizes the Board of Pharmacy to issue or renew a license  
            to conduct a pharmacy that is owned and operated by a  
            pharmacist authorized to issue a drug order under specified  
            conditions.  Current law prohibits the Board from issuing or  
            renewing a license to conduct a pharmacy to a person  
            authorized to prescribe or write a prescription.

           FISCAL EFFECT  

          Minor, if any, costs to the Board of Pharmacy.

           COMMENTS  

           1)Purpose  .  This bill is sponsored by the Kaiser Permanente  
            Medical Care Program to make the appropriate changes to  








                                                                  AB 2660
                                                                  Page  2

            qualify pharmacists to register for a DEA number and therefore  
            initiate or adjust controlled substance drug therapy. 

           2)Background  .  The California Pharmacy Law allows pharmacists to  
            initiate or adjust the drug regimen of a patient under an  
            order or authorization by the patient's prescriber in  
            accordance with policies, procedures or protocols.  This  
            authority under state law 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.  The  
            DEA issues registration numbers to mid-level practitioners, in  
            accordance with state law.  Without DEA numbers, pharmacists  
            cannot assist physicians with drug therapy involving  
            controlled substances, although they are still authorized to  
            initiate or adjust drug therapy involving non-controlled  
            substances.  

          The DEA issued registration numbers to qualified California  
            pharmacists prior to the passage of SB 816 (Escutia) Chapter  
            749, Statutes of 1999.  SB 816 specifically designated  
            certified nurse-midwives, nurse practitioners and physician  
            assistants as mid-level practitioners authorized to order  
            prescription drugs, but left out pharmacists.  This exclusion  
            resulted in the DEA categorizing pharmacists apart from other  
            health providers who otherwise are permitted to initiate or  
            adjust controlled or non-controlled substances.  As a result,  
            pharmacists have been denied DEA registration numbers have  
            been unable to assist physicians in managing controlled  
            substance drug therapies. 


           Analysis Prepared by  :    Scott Bain / APPR. / (916) 319-2081