BILL ANALYSIS
AB 2747
Page 1
ASSEMBLY THIRD READING
AB 2747 (Bonnie Lowenthal)
As Amended April 26, 2010
Majority vote
HEALTH 16-0 APPROPRIATIONS 16-0
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|Ayes:|Monning, Carter, Conway, |Ayes:|Fuentes, Conway, Ammiano, |
| |Caballero, Emmerson, Eng, | |Bradford, Coto, Davis, |
| |Gaines, Hayashi, | |Hill, Hall, Harkey, |
| |Hernandez, Jones, Bonnie | |Miller, Nielsen, Norby, |
| |Lowenthal, Nava, V. | |Skinner, Solorio, |
| |Manuel Perez, Salas, | |Torlakson, Torrico |
| |Smyth, Audra Strickland | | |
| | | | |
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SUMMARY : Requires the California Department of Corrections and
Rehabilitation (CDCR) to maintain and operate a pharmacy
services program, as specified, and authorizes CDCR to operate
and maintain a centralized pharmacy distribution center.
Specifically, this bill :
1)Requires CDCR to maintain and operate a comprehensive pharmacy
services program for facilities under the jurisdiction of CDCR
that, at a minimum, contain all of the following:
a) A statewide pharmacy administration system with direct
authority and responsibility for program administration and
oversight;
b) Medically necessary pharmacy services using qualified
pharmacists, as specified, and written procedures and
operational practices pertaining to the delivery of
pharmaceutical services;
c) A statewide multidisciplinary Pharmacy and Therapeutics
(P&T) Committee responsible for developing and managing a
department formulary, and standardizing the strengths and
dosage forms for specified medications; maintaining and
monitoring a system for the review and evaluation of
corrective actions related to errors in prescribing,
dispensing, and administering medications; conducting
regular therapeutic category reviews for medications listed
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in the formulary; and, evaluating medication therapies and
developing the disease management guidelines;
d) A requirement for the use of generic medications, when
available, unless an exception is reviewed and approved in
accordance with an established nonformulary approval
process; and,
e) Use of an enterprise-based pharmacy operating system
that provides management with information on prescription
workloads, medication utilization, prescribing data, and
other key pharmacy information.
2)Authorizes CDCR to operate and maintain a centralized pharmacy
distribution center to provide specified cost advantages, and
increased public safety.
3)Requires the centralized pharmacy distribution center to
include systems to order and package bulk pharmaceuticals,
prescription, and stock orders for all facilities, as
specified; label medications as required to meet state and
federal prescription requirements; provide barcode validation
matching the drug to the specific prescription or floor stock
order, and sort completed orders for shipping and delivery to
department facilities.
4)Authorizes the centralized pharmacy distribution center to
package bulk pharmaceuticals into both floor stock and
patient-specific packs, and reclaim, for reissue, unused and
unexpired medications, and distribute packaged products, as
specified.
5)Requires the centralized pharmacy distribution center to
maintain a system of quality control checks on each process
used to package, label, and distribute medications, and
requires the quality control system to include a regular
process of random checks by a licensed pharmacist.
6)Authorizes CDCR to investigate and initiate potential
systematic improvements to provide for the safe and efficient
distribution, control, and accountability of drugs within
CDCR's statewide pharmacy administration system, which take
into account factors unique to the correctional environment.
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7)Requires CDCR to ensure that there is a program providing for
the regular inspection of all specified pharmacies to verify
compliance with applicable law, rules, regulations, and other
applicable standards to achieve specified health outcomes.
8)Requires specified corrective actions to be documented in
writing and monitored by CDCR for compliance.
9)On March 1, 2012, and each March 1 thereafter, requires CDCR
to report the following to specified legislative committees:
a) The extent to which the P&T Committee has achieved
specified objectives, as well as the most significant
reasons for achieving or not achieving those objectives;
b) The extent to which CDCR is achieving the objective of
operating a fully functioning and centralized pharmacy
distribution center, as specified;
c) The extent to which the centralized pharmacy center is
achieving specified cost savings;
d) A description of planned or implemented initiatives to
accomplish the next 12 months' objectives for achieving the
goals as specified; and,
e) The costs for prescription pharmaceuticals for the
previous fiscal year, both statewide and at each adult
prison under the jurisdiction of CDCR, and a comparison of
the costs with those costs of the prior fiscal year.
10)Makes the specified requirements for submitting a report
inoperative on March 1, 2016.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, no new net costs or savings as this bill essentially
codifies current CDCR/federal medical receivership practice and
planning.
COMMENTS : According to the author, this bill is part of a
package of bills that is sponsored by the federal Receiver to
reduce prison health care costs and bring the health care system
back to constitutional levels. This bill will ensure that
pharmacy improvements achieved by the Receivership are
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maintained by creating a centrally administered and professional
pharmacy practice with an active P&T Committee. Additionally,
this bill ensures a continued focus on patient safety,
evidence-based practices, and cost-effective decision making.
The author believes that this bill will provide long-term cost
savings in both staffing costs and medication inventory through
the establishment of a central fill pharmacy system.
According to the California Prison Health Care Services,
pharmacy services are provided through onsite pharmacies staffed
by CDCR pharmacists and pharmacy technicians at each prison.
The pharmacists review and label each prescription and provide
the medication to nursing staff who administer the medications
to the inmate-patients. CDCR currently spends $188 million a
year on prescription drugs for inmates and wrote about 608,000
prescriptions per month in 2009. Actual spending on medications
between 2000 and 2008 has more than doubled. The federal
Receiver states that the current prison pharmacy program did not
meet minimal patient care standards and wasted millions of
dollars of taxpayer money.
Analysis Prepared by : Martin Radosevich / HEALTH / (916)
319-2097
FN: 0004368