BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



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          |SENATE RULES COMMITTEE            |                  SB 1390|
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                                 THIRD READING


          Bill No:  SB 1390
          Author:   Corbett (D)
          Amended:  4/26/10
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  9-0, 4/14/10
          AYES:  Alquist, Strickland, Aanestad, Cedillo, Cox, Leno,  
            Negrete McLeod, Pavley, Romero

           SENATE BUSINESS, PROF. & ECON. DEV. COMMITTEE  :  7-0,  
            4/19/10
          AYES:  Negrete McLeod, Wyland, Aanestad, Correa, Oropeza,  
            Walters, Yee
          NO VOTE RECORDED:  Calderon, Florez

           SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8


           SUBJECT  :    Prescription drug labels

           SOURCE  :     California Association of Health Facilities


           DIGEST  :    This bill allows the Board of Pharmacy to exempt  
          from regulations requiring a standardized, patient-centered  
          prescription drug label, those prescriptions dispensed to a  
          patient in a health facility, as defined.  

           ANALYSIS  :    

          Existing law:

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          1. Provides for the licensure and regulation of the  
             practice of pharmacy by the Board of Pharmacy (Board).  

          2. Requires the Board to promulgate regulations that  
             require a standardized, patient-centered, prescription  
             drug label on all prescription medication dispensed to  
             patients in California.  The Board has to promulgate  
             these regulations on or before January 1, 2011.

          This bill:

          1. Allows the Board to exempt from regulations requiring a  
             standardized, patient-centered prescription drug label,  
             those prescriptions dispensed to a patient in a health  
             facility, if the prescriptions are administered by a  
             licensed health care professional.  

             Under this bill, prescriptions dispensed to a patient in  
             a health facility that will not be administered by a  
             licensed health care professional, or prescriptions that  
             are provided to the patient upon discharge from the  
             facility, must still be subject to the prescription drug  
             labeling requirements in existing law and its associated  
             regulations. 

          2. States that the bill will not diminish existing  
             statutory and regulatory informed consent, patients'  
             rights, or pharmaceutical labeling and storage  
             requirements.

           Comments  

          This bill is a follow-up measure to SB 472 (Corbett),  
          Chapter 470, Statutes of 2007, the California Patient  
          Medication Safety Act.  SB 472 required the Board to adopt  
          regulations to create a patient-centered, standard format  
          for prescription drug labels that will take into account  
          the needs of California patients, including seniors and  
          limited-English proficient patients.  

           Background  
          
          The Board held a regulatory meeting on a proposed  
          regulation on January 20, 2010, and revised the  







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          requirements related to font size and the translation  
          requirements contained in the original regulation proposal.  
           Under the proposed regulation, labels on drug containers  
          dispensed to patients in California must meet specified  
          requirements to ensure they are patient-centered.  Under  
          the proposed regulations, the following items must be  
          clustered into one area of the label that comprises at  
          least 50 percent of the label, using at least 10-point font  
          using sans serif typeface, listing these items in the  
          following order:
           
          1. Name of the patient.

          2. Name of the drug and strength of the drug ("name of the  
             drug" means either the manufacturer's trade name, or the  
             generic name and the name of the manufacturer).

          3. Directions for use.

          4. Purpose or condition, if entered onto the prescription  
             by the prescriber, or otherwise known to the pharmacy  
             and its inclusion on the label is requested by the  
             patient. 

          The proposed regulations also require pharmacies to have  
          policies and procedures in place to help patients with  
          limited or no English proficiency understand the  
          information on the label in the patient's language.  The  
          pharmacy's policies and procedures must be specified in  
          writing, and must include, at minimum, the selected means  
          to identify the patient's language, and to provide  
          interpretive services in the patient's language.   
          Pharmacies must provide, at minimum, interpretive services  
          in the patient's language, if interpretive services in such  
          language are available, during all hours that the pharmacy  
          is open, either in person by pharmacy staff or by use of a  
          third-party interpretive service available by telephone at  
          or adjacent to the pharmacy counter.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No

           SUPPORT  :   (Verified  5/18/10)








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          California Association of Health Facilities (source)
          Aging Services of California
          California Pharmacists Association


           ARGUMENTS IN SUPPORT  :    The bill's sponsor, the California  
          Association of Health Facilities (CAHF), writes that SB 472  
          was intended to ensure that labels on prescription  
          containers were readable and understandable to the  
          consumers who obtained and used those medications.  CAHF  
          argues that, while it was clear that SB 472 was intended to  
          provide specific labeling for consumer use, it did not  
          foresee that the new labeling would be required for  
          institutional settings, such as in long-term care  
          facilities.  Prescriptions dispensed to patients for  
          self-administration have been distinguished historically  
          from prescriptions dispensed in institutional settings that  
          are administered by personnel of that facility.  CAHF  
          states these prescriptions are, in practice, treated like  
          those for inpatients in hospitals, where staff are likewise  
          responsible for proper administration of the drugs.  

          CAHF states that skilled nursing facility inpatient  
          medications are administered pursuant to orders in the  
          patient's chart and are packaged in special systems as  
          requested by each facility (for example, unit dose and  
          blister packs).  These medications are not in the  
          possession or control of the patient and are administered  
          to the patient by facility personnel.  CAHF states the  
          Board has expressed concerns that under SB 472, it is not  
          clear that the Board can exempt prescriptions administered  
          in long-term care facilities.  SB 1390 provides this clear  
          authority to the Board, thus allowing long-term care  
          facilities that have licensed health care personnel  
          administer medication to a patient to be exempt from the  
          labeling requirements required by SB 472.


          CTW:mw  5/18/10   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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