BILL ANALYSIS �
AB 399
Page 1
Date of Hearing: May 11, 2011
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
AB 399 (Bonnie Lowenthal) - As Introduced: February 14, 2011
Policy Committee: Business and
Professions Vote: 9-0
Health
Urgency: No State Mandated Local Program:
No Reimbursable:
SUMMARY
This bill:
1)Requires, rather than authorizes, the California Department of
Corrections and Rehabilitation (CDCR) to incorporate specified
components into its pharmacy services program
2)Requires, rather than authorizes, CDCR to license its
pharmacies and centralized pharmacy distribution center (CPDC)
and meet all applicable regulations.
FISCAL EFFECT
No new net costs or savings as this bill essentially codifies
current CDCR/federal medical receivership practice and planning.
COMMENTS
1)Rationale . This bill mandates protocols adopted by the
California Prison Health Care Receiver, which the author and
proponents believe is necessary to show the federal court the
state will remain in compliance should the receivership ever
cease.
A 2010-11 budget trailer bill codified the provisions
referenced in this bill, but they are permissive and operate
more as guidelines for the development of the centralized
program.
AB 399
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According to the receivership, while this bill is not
necessary for implementation of the ongoing pharmacy services
program, it is important to "to ensure the sustainability of a
cost-effective prison health care system once the Receivership
has returned control of prison health care back to some State
entity. By codifying these nationally recognized standards of
effective medicine, the legislature will establish additional
oversight of the State prison health care system in order to
ensure that it does not once again backslide to an
unconstitutional level in the future."
The CDCR pharmacy services problem, as stated by the
receivership in its October 2009 Utilization Management
Project Charter, is a decentralized pharmacy ordering system
with significant waste due to overstock, expiration and a
general inability to effectively track and route medications.
Centralized pharmacy distribution will reduce costs by taking
advantage of economies of scale, ensuring only necessary
medications are stocked, while increasing patient utilization.
2)Background . The California Prison Health Care Receivership is
a non-profit organization created to house the activities of
the federal Receiver. The Receivership was established by U.S.
District Court Judge Thelton E. Henderson as the result of a
2001 class action law suit (Plata v. Schwarzenegger) over the
quality of medical care in the state's 33 prisons. The court
found that the care violated the Eighth Amendment of the U.S.
Constitution, which forbids cruel and unusual punishment of
the incarcerated.
In 2006, the court appointed the receiver to oversee the
delivery of inmate medical care within CDCR. According to the
Department of Finance (DOF) in a 2010-11 budget change
proposal, since 2006 the receiver has significantly increased
the number of clinical staff, clinician pay, access to CDCR
clinicians, and referrals to specialists and contracted
providers, which has resulted in the cost of inmate medical
services increasing from $883 million in 2005-06 to $2 billion
in 2008-09 with a moderate reduction in expenditures
anticipated in 2009-10 and 2010-11.
3)Related Legislation .
a) AB 1628 (Budget Committee), Statutes of 2010, is the
Public Safety Trailer Bill containing provisions to
AB 399
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implement the 2010-11 budget, including authorizing CDCR to
maintain a comprehensive pharmacy services program.
b) AB 2747 (B. Lowenthal), 2010, which was similar to AB
399, was vetoed. Gov. Schwarzenegger stated, "CDCR is
currently under federal receivership for its health care
services. The Receiver has the authority to conduct the
provisions of AB 2747 and is currently in the process of
implementing the CPDC. It would be premature for me to
sign a bill when the successfulness of the CPDC has yet to
be determined."
Analysis Prepared by: Geoff Long / APPR. / (916) 319-2081