BILL ANALYSIS
AB 977
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ASSEMBLY THIRD READING
AB 977 (Skinner)
As Amended January 25, 2010
Majority vote
BUSINESS & PROFESSIONS 10-0 HEALTH 17-0
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|Ayes:|Hayashi, Emmerson, |Ayes:|Jones, Adams, Ammiano, |
| |Conway, Hernandez, Nava, | |Block, Skinner, Conway, |
| |Niello, | |De La Torre, |
| |John A. Perez, Price, | |De Leon, Emmerson, |
| |Ruskin, Smyth | |Gaines, Hall, Fuentes, |
| | | |Bonnie Lowenthal, Nava, |
| | | |V. Manuel Perez, Salas, |
| | | |Audra Strickland |
|-----+--------------------------+-----+--------------------------|
| | | | |
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BUSINESS & PROFESSIONS 11-0 APPROPRIATIONS 15-0
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|Ayes:|Hayashi, Emmerson, |Ayes:|De Leon, Ammiano, |
| |Conway, Eng, Hernandez, | |Bradford, |
| |Hill, Nava, Niello, | |Charles Calderon, Coto, |
| |John A. Perez, Ruskin, | |Davis, Fuentes, Hall, |
| |Smyth | |Miller, Nielsen, |
| | | |John A. Perez, Skinner, |
| | | |Solorio, |
| | | |Audra Strickland, |
| | | |Torlakson |
|-----+--------------------------+-----+--------------------------|
| | | | |
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SUMMARY : Creates a pilot project that will permit a pharmacist
to administer an influenza immunization pursuant to a
standardized protocol developed by 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 a pharmacist may administer
an influenza immunization pursuant to a standardized protocol
developed and approved by MBC to any person 18 years or older.
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2)Requires that the protocol 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
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 provide:
a) The patient or the patient's agent with the appropriate
Vaccine Information Statement (VIS), produced by the CDC,
for each immunization administered;
b) 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) Documentation of administration of the immunization to
the appropriate immunization registry.
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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.
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 Board of Pharmacy (BOP) to evaluate the
pilot program's effectiveness and for the BOP to report back
to the relevant Senate and Assembly committees by January 1,
2014.
12)Makes legislative findings and declarations.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, one-time fee-supported special fund fiscal impact to
the MBC and the California Board of Pharmacy (CBP) likely in the
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range of $50,000 to $100,000, combined, to establish the pilot
in 2011. Ongoing absorbable costs until 2015 to provide pilot
oversight. Fee-supported special fund costs of approximately
$50,000 to complete the evaluation to be submitted to the
Legislature.
COMMENTS : 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."
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; record keeping and
documentation procedures
This bill would permit a pharmacist to administer the influenza
vaccine pursuant to a protocol developed by the MBC. Sponsors
of this bill argue that this protocol is essential for public
health by expanding access to immunizations. However, the CDC
currently recommends that certain individuals should not be
vaccinated for influenza without first consulting a physician.
Analysis Prepared by : Sarah Huchel / B. & P. / (916) 319-3301
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FN: 0003627