BILL ANALYSIS �
AB 2369
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REPLACE: 5/18/2012
ASSEMBLY THIRD READING
AB 2369 (Valadao)
As Introduced February 24, 2012
Majority vote
BUSINESS & PROFESSIONS 6-0HEALTH 19-0
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|Ayes:|Hayashi, Bill Berryhill, |Ayes:|Monning, Logue, Ammiano, |
| |Butler, Hagman, Ma, Smyth | |Atkins, Bonilla, Eng, |
| | | |Garrick, Gordon, Hayashi, |
| | | |Roger Hern�ndez, |
| | | |Bonnie Lowenthal, |
| | | |Mansoor, Mitchell, |
| | | |Nestande, Pan, |
| | | |V. Manuel P�rez, Silva, |
| | | |Smyth, Williams |
|-----+--------------------------+-----+--------------------------|
| | | | |
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APPROPRIATIONS 16-1
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|Ayes:|Fuentes, Harkey, | | |
| |Blumenfield, Bradford, | | |
| |Charles Calderon, Campos, | | |
| |Davis, Donnelly, Gatto, | | |
| |Hall, Lara, Mitchell, | | |
| |Nielsen, Norby, Solorio, | | |
| |Wagner | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Hill | | |
| | | | |
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SUMMARY : Requires the California Department of Corrections and
Rehabilitation's (CDCR) pharmacy program to require the use of
generic medications, when available, unless an exception is
reviewed and approved in accordance with an established
nonformulary approval process.
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EXISTING LAW :
1)Authorizes the CDCR to maintain and operate a comprehensive
pharmacy services program for those facilities under the
jurisdiction of the department that is both cost effective and
efficient.
2)Allows the CDCR pharmacy program to incorporate a number of
components, including 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.
FISCAL EFFECT : According to Assembly Appropriations Committee,
negligible state fiscal effect.
COMMENTS : According to the author, "As management of prison
health care services transitions out of the control of the
federal Receiver (Receiver) and back to the jurisdiction of
CDCR, it is critical that fiscal responsibility is maintained
while upholding quality patient care. Generic medications are
an excellent way to maintain fiscal responsibility as they have
the equivalent active ingredient as the brand name versions and
must work under the same safety and effectiveness standards as
approved by the Food and Drug Administration, yet the cost is
significantly less. However, there is no current requirement to
use generic medications within the penal code."
CDCR provides for the custody and care of approximately 167,000
inmates, which includes pharmacy services at each of the 33
adult prisons. Between 2000 and 2005, CDCR's management of its
pharmacies was the focus of several audits and reviews, all of
which identified major issues that impeded pharmacy operations
and drove up costs.
Delivery of medical services - including pharmacy services - for
prisoners in California has been under the control of the
Receiver for nearly four years, as a result of a 2006 federal
court case that determined inadequate medical care in
California's prisons violated the Eighth Amendment of the U.S.
Constitution forbidding cruel and unusual punishment. The court
found CDCR prison pharmacy operations, in particular, to be
"unbelievably poor."
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The Receiver is charged with taking over the operations of the
state's prison medical care system and bringing it up to
constitutional levels. In January 2007, the Receiver entered
into an agreement with Maxor National Pharmacy Services (Maxor)
to assist in implementing an action plan it had created to
improve CDCR's pharmacy operations. The Receiver retains
overall responsibility for pharmacy operations and Maxor is
responsible for providing guidance to facility level pharmacy
staff in order to implement the objectives contained in the
agreement.
According to a 2010 report on CDCR's pharmacy system by the
Office of the Inspector General, "For the fiscal year 2009-2010
Governor's budget, CDCR proposed to spend close to $2 billion to
provide medical, dental and mental health care services to
California's inmates. Almost 10% of that amount, $190 million,
is allocated for pharmaceuticals.
"In comparing California with other large correctional
operations for fiscal years 2006-2007 and 2007-2008, we find
that the daily pharmaceutical cost per inmate is significantly
higher at CDCR, (which) spends more than two times the amount
that the Federal Bureau of Prisons spends per inmate per day on
medications, and more than three times the amount spent by the
Texas Department of Corrections."
Current law provides that CDCR's pharmacy program may include a
number of components, including a requirement for the use of
generic medications.
This bill requires, rather than allows, the CDCR pharmacy
program to require the use of generic medications, when
available, unless an exception is reviewed and approved in
accordance with an established non-formulary approval process.
Analysis Prepared by : Angela Mapp / B.,P. & C.P. / (916)
319-3301
FN: 0003543
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