BILL ANALYSIS
AB 977
Page 1
Date of Hearing: January 12, 2010
ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
Mary Hayashi, Chair
AB 977 (Skinner) - As Amended: January 6, 2010
SUBJECT : Pharmacists: immunization protocols with physicians.
SUMMARY : Creates a pilot project that will permit pharmacists
to administer influenza immunizations pursuant to standardized
protocols developed and approved by both the Board of Pharmacy
(BOP) and the Medical Board of California (MBC) in consultation
with public health officers, to any person 18 years or older.
Specifically , this bill:
1)Creates a pilot project in which pharmacists may administer
influenza immunizations pursuant to standardized protocols
developed and approved by both BOP and MBC, in consultation
with public health officers, to any person 18 years or older.
2)Requires that the protocols be consistent with protocols
developed by the Advisory Committee on Immunizations Practices
of the federal Centers for Disease Control and Prevention
(CDC).
3)Requires a pharmacist initiating and administering any
immunization pursuant to the pilot to:
a) Complete the American Pharmacists Association's
Pharmacy-Based Immunization Delivery Certificate Training
Program or another pharmacy-based immunization training
certificate program endorsed by the CDC or the
Accreditation Council for Pharmaceutical Education;
b) Complete three hours of immunization-related continuing
education coursework annually, which may be applied to the
existing continuing education requirement; and,
c) Be certified in basic life support.
4)States that if a pharmacist fails to satisfy the three hours
of immunization-related continuing education coursework
annually, the pharmacist must, in addition to any other
applicable disciplinary action, retake the immunization
AB 977
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training certificate program in addition to the three hours of
immunization-related continuing education coursework prior to
initiating any further immunizations.
5)Requires a pharmacist, at the time of immunization
administration, to:
a) Provide the patient or the patient's agent with the
appropriate Vaccine Information Statement (VIS), produced
by the CDC, for each immunization administered;
b) Provide documentation of administration of the
immunization to the patient and the patient's physician or
primary care provider, if one can be identified; and,
c) Provide documentation of administration of the
immunization to the appropriate immunization registry.
6)Requires a pharmacist to maintain an immunization
administration record, which shall include, but not be limited
to:
a) The name of the vaccine;
b) Vaccine's expiration date;
c) Date of administration;
d) The manufacturer and lot number;
e) The administration site and route;
f) The VIS date; and,
g) The name and title of the person administering the
vaccination, for 10 years from the date of administration.
7)Permits a pharmacist initiating and administering vaccines to
initiate and administer epinephrine by injection for severe
allergic reactions.
8)Requires any adverse event be reported to the Vaccine Adverse
Event Reporting System within the United States Department of
Health and Human Services.
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9)States that, upon receipt, a pharmacist is responsible for
ensuring that proper temperatures are maintained during the
subsequent storage and handling of the vaccine to preserve its
potency.
10)Sunsets the pilot project on January 1, 2015.
11)Requires the MBC and BOP complete an evaluation of the pilot
program's effectiveness and report back to the relevant Senate
and Assembly committees by January 1, 2012.
12)Makes Legislative findings and declarations.
FISCAL EFFECT : Unknown
COMMENTS :
Purpose of this bill . According to the author's office, "In
1995, pharmacy law allowed a pharmacist to administer
immunizations pursuant to a protocol with a physician. Since
that time, pharmacists have safely initiated and administered
thousands of immunizations to Californians. However, the full
impact of pharmacist delivered vaccines has not been realized.
Many pharmacists are unable to obtain a prescriber's signature
on their vaccination protocol, making them unable to administer
vaccines. Even after extensive education of physicians
regarding the minimal liability incurred, many remain
apprehensive and choose not to sign immunization protocols with
pharmacists. Further, independent pharmacies are the hardest
hit by the need for a prescriber protocol. These small
businesses often serve low-income, ethnically diverse
communities in suburban and rural locations throughout
California."
Background . Currently, 49 states including California allow a
pharmacist to administer immunizations pursuant to a protocol
with a prescriber. A protocol typically identifies:
The individual who has delegated activity
The pharmacist authorized to administer vaccine
Types of vaccines pharmacist is authorized to administer
Procedures, decision criteria, or the plan a pharmacist should
follow, including when to refer a patient
Procedure for emergency situations
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Record keeping and documentation procedures
This bill would permit pharmacists to administer one vaccine
without a protocol. There is concern that this protocol is
essential for public health. The CDC currently recommends that
certain individuals should not be vaccinated for influenza
without first consulting a physician.
Some argue that immunizations are a key entry point into the
doctor's office for children, especially teenagers. Permitting
pharmacists to provide immunizations would result in missed
opportunities to see a doctor and get other preventive care.
REGISTERED SUPPORT / OPPOSITION :
Support
California Board of Pharmacy (sponsor)
Opposition
None on file.
Analysis Prepared by : Sarah Huchel / B. & P. / (916) 319-3301