BILL ANALYSIS
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|SENATE RULES COMMITTEE | AB 931|
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THIRD READING
Bill No: AB 931
Author: Fletcher (R)
Amended: 6/17/09 in Senate
Vote: 21
SENATE HEALTH COMMITTEE : 11-0, 7/8/09
AYES: Alquist, Strickland, Aanestad, Cedillo, Cox,
DeSaulnier, Leno, Maldonado, Negrete McLeod, Pavley, Wolk
ASSEMBLY FLOOR : 74-0, 5/14/09 - See last page for vote
SUBJECT : Emergency supplies
SOURCE : California Pharmacists Association
DIGEST : This bill increases the limit on the number of
forms of drugs, from 24 to 48, that can be stored in a
secured emergency supplies container (known as an emergency
kit) provided by a pharmacy to a skilled nursing facility
or an intermediate care facility, caps the number of
psychotherapeutic medications in an emergency kit but
allows the number to be increased by the Department of
Public Health (DPH) through a program flexibility request
granted to a facility based on the needs of the facility's
patient population, as specified, and allows DPH to
increase the limit on the number of doses in an emergency
kit from four to 16.
ANALYSIS :
CONTINUED
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Existing law:
1. Requires DPH to license and inspect health facilities,
including skilled nursing facilities (SNFs) and
intermediate care facilities (ICFs).
2. Authorizes, under the Pharmacy Law, a pharmacy to
furnish prescription drugs or devices to a health
facility for storage in a secure emergency
pharmaceutical supplies container that is maintained
within the facility under state regulations.
3. Limits the number of oral dosage form or suppository
form drugs provided by a pharmacy to an SNF or ICF for
storage in a secured emergency supplies container to 24.
4. Permits DPH to limit the number of doses of each drug
available to not more than four doses of any separate
drug dosage form in each emergency supply.
5. Exempts an automated drug delivery system, when a
pharmacist controls access to the drugs, from the limit
on the number and quantity of oral dosage or suppository
form drugs provided by a pharmacy to an SNF or ICF for
storage in a secured emergency supplies container.
6. Defines, through regulation, a psychotherapeutic drug as
a medication to control behavior or to treat thought
disorder processes.
7. Defines a "special treatment program service unit
distinct part" as an identifiable and physically
separate unit of an SNF or an entire SNF that provides
therapeutic programs to an identified mentally
disordered population group.
This bill:
1. Increases the limit on the number of oral dosage form or
suppository form drugs from 24 to 48 that can be stored
in a secured emergency supplies container provided by a
pharmacy to an SNF or an ICF.
2. Caps the number of psychotherapeutic drugs in an
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emergency kit at four of the 48 oral dosage form or
suppository form drugs, but allows DPH to increase the
number of psychotherapeutic drugs in the emergency
supplies container to not more than 10 if the facility
can demonstrate the necessity for an increased number of
drugs based on the needs of the patient population at
the facility.
3. Exempts special treatment program service units of a
distinct part of a SNF from the four psychotherapeutic
drug limit.
4. Allows DPH to increase from four to 16 the numerical
limit on the number of separate drug dosage forms of
each drug available in an emergency kit, but requires
DPH to limit the number of doses of psychotherapeutic
drugs available to not more than four doses.
Comments
Existing law allows a pharmacy to furnish prescription
drugs to an ICF or SNF for storage in a secured emergency
pharmaceutical supplies container. The emergency drug
supply has to be approved by the health facility's patient
care policy committee or pharmaceutical service committee,
and must be readily available to each nursing station.
Existing law limits the number of oral dosage form or
suppository form drugs in these emergency supplies to 24
(DPH indicates this is a total of all forms of drugs).
Existing regulations prohibit more than six emergency
drugs, in solid, oral dosage form or suppository dosage
form for anti-infective, anti-diarrheal, anti-nausea or
analgesic use, from being stored in sealed containers. In
addition, not more than four doses of any drug may be
stored.
Existing regulations also require the emergency drug supply
to be stored in a portable container with a seal that must
be broken to gain access to the drugs. The director of
nursing services or charge nurse is required to notify the
pharmacy when drugs have been used from the emergency kit
or when the seal has been broken. The contents of the
supply must be listed on the outside of the container, and
the supply must be checked at least monthly by the
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pharmacist. Drugs used from the emergency kit must be
replaced within 72 hours and the supply must be resealed by
the pharmacist.
FISCAL EFFECT : Appropriation: No Fiscal Com.: No
Local: No
SUPPORT : (Verified 7/9/09)
California Pharmacists Association (source)
California Association of Health Facilities
ARGUMENTS IN SUPPORT : The California Association of
Health Facilities (CAHF) states emergency kits can be used
for medication orders for patients in need or urgent care,
a disaster situation, or when drugs cannot be readily
accessed from a pharmacy. CAHF argues that it has been 15
years since the last time the number of drugs in emergency
kits was increased, many new and varied medications have
become available to better treat specific ailments, and
that without the change in law proposed by this bill,
patients in an emergency situation may not have access to
the drugs that provide the highest quality of care.
ASSEMBLY FLOOR :
AYES: Adams, Anderson, Arambula, Beall, Bill Berryhill,
Tom Berryhill, Blakeslee, Block, Blumenfield, Brownley,
Buchanan, Caballero, Charles Calderon, Carter, Chesbro,
Conway, Cook, Coto, Davis, De La Torre, De Leon, DeVore,
Duvall, Emmerson, Eng, Evans, Feuer, Fletcher, Fong,
Fuller, Furutani, Galgiani, Garrick, Gilmore, Hagman,
Hall, Harkey, Hayashi, Hernandez, Hill, Huber, Huffman,
Jeffries, Jones, Knight, Krekorian, Lieu, Logue, Bonnie
Lowenthal, Ma, Mendoza, Miller, Monning, Nava, Nestande,
Niello, John A. Perez, V. Manuel Perez, Portantino,
Price, Ruskin, Salas, Silva, Skinner, Solorio, Audra
Strickland, Swanson, Torlakson, Torres, Torrico, Tran,
Villines, Yamada, Bass
NO VOTE RECORDED: Ammiano, Fuentes, Gaines, Nielsen,
Saldana, Smyth
CTW:mw 7/9/09 Senate Floor Analyses
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SUPPORT/OPPOSITION: SEE ABOVE
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