BILL ANALYSIS                                                                                                                                                                                                    �



                                                                      



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          |SENATE RULES COMMITTEE            |                  AB 2369|
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                                 THIRD READING


          Bill No:  AB 2369
          Author:   Valadao (R)
          Amended:  6/14/12 in Senate
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  9-0, 6/20/12
          AYES:  Hernandez, Harman, Alquist, Anderson, Blakeslee, De 
            Le�n, DeSaulnier, Rubio, Wolk

           SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8

           ASSEMBLY FLOOR  :  60-5, 5/25/12 - See last page for vote


           SUBJECT  :    Prisoners:  pharmacy services

           SOURCE  :     Author


           DIGEST  :    This bill requires the pharmacy services program 
          (pharmacy program) under the Department of Corrections and 
          Rehabilitation (CDCR) to use less expensive medication as 
          achieved by the statewide prescription drug bulk purchasing 
          program, as defined, unless an exception is approved or the 
          prescriber has indicated "dispense as written" on the 
          prescription.

           ANALYSIS  :    Existing law:

          1.Permits CDCR to maintain and operate a comprehensive 
            pharmacy program for those facilities under its 
            jurisdiction that is both cost effective and efficient.
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          2.Permits the pharmacy program to incorporate a statewide 
            Pharmacy and Therapeutics Committee responsible, among 
            other tasks, for developing and managing a department 
            formulary and conducting regular therapeutic category 
            reviews for medication listed in the department 
            formulary.

          3.Permits the pharmacy program to incorporate 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.

          4.Permits the Department of General Services (DGS) to enter 
            into contracts with manufacturers and suppliers of 
            single-source or multisource drugs for purposes of a 
            statewide prescription drug bulk purchasing program. 
            Requires CDCR, the Department of Mental Health (DMH), and 
            the Department of Developmental Services (DDS) to 
            participate in this bulk purchasing program. Permits any 
            other state or local government entity to elect to 
            participate in the purchasing program.

          5.Permits DGS, in consultation with CDCR, DMH, or DDS, to 
            investigate and implement other options and strategies to 
            achieve the greatest savings on prescription drugs with 
            prescription drug manufacturers and wholesalers.

          This bill requires the comprehensive pharmacy program, 
          operated by CDCR, to use less expensive medications as 
          achieved by DGS' statewide pharmaceutical bulk purchasing 
          program, as specified, when those medications are 
          available, unless an exception is reviewed and approved in 
          accordance with an established nonformulary approval 
          process, or unless the prescriber has indicated on the 
          prescription "dispense as written."

           Background
           
           Medical Receivership for CDCR  .  On June 30, 2005, in a 
          class-action lawsuit filed four years earlier, the United 
          States District Court for the Northern District of 
          California established a Receivership to take control of 

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          the delivery of medical services to all California state 
          prisoners confined by CDCR. The court order establishing 
          the Receivership provides that the Receivership, "shall 
          cease as soon as the Court is satisfied, and so finds in 
          consultation with the Receiver, that Defendants have the 
          will, capacity, and leadership to maintain a system of 
          providing constitutionally adequate medical health care 
          services to class members."

          The judge in the case issued an order in January 2012 
          stating that because of the progress to date, "the end of 
          the Receivership appears to be in sight, and the Court 
          seeks to get the parties' and the Receiver's views on when 
          the Receivership should be terminated and how this case 
          should progress after the Receivership has ended." The 
          judge ordered that the parties meet and confer on 
          post-Receivership planning as soon as possible and filed a 
          joint report on their meet-and-confer on or before April 
          30, 2012.

          On May 30, 2012, in response to the report filed jointly by 
          the State and the Receiver, the judge issued a new order 
          outlining a transition plan for transferring authority from 
          the Receiver to the state. As part of this gradual 
          transition of authority, the court ordered the Receiver and 
          the state to identify and secure appropriate revisions or 
          additions to state law and regulations, as well as to 
          CDCR's operations manual, that institutionalize changes 
          made during the Receivership and eliminate the need for any 
          waivers of state law following the termination of the 
          Receivership. The Court ordered the parties to consider the 
          Court's proposal, to file opposition briefs or statements 
          of non-opposition by June 29, 2012, and to file any reply 
          briefs no later than July 20, 2012.

           Comments
           
          According to the author's office, as management of prison 
          health care services transitions out of the control of the 
          federal Receiver and back to the jurisdiction of CDCR, it 
          is critical that fiscal responsibility is maintained while 
          upholding quality patient care. Utilizing the less 
          expensive prescriptions on the formulary is an excellent 
          way to maintain fiscal responsibility. In addition, AB 2369 

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          would strengthen the physician's ability to make the 
          patient care decisions by continuing the current 
          nonformulary approval process, as well as adding a 
          provision to allow the physician to "dispense as written" 
          when prescribing for their patient.

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


           ASSEMBLY FLOOR  :  60-5, 05/25/12
          AYES:  Achadjian, Alejo, Allen, Block, Blumenfield, 
            Bradford, Brownley, Buchanan, Butler, Charles Calderon, 
            Campos, Carter, Chesbro, Conway, Cook, Dickinson, 
            Donnelly, Eng, Feuer, Fong, Fuentes, Beth Gaines, 
            Galgiani, Garrick, Gatto, Gordon, Gorell, Hagman, 
            Halderman, Harkey, Hayashi, Roger Hern�ndez, Huber, 
            Hueso, Jeffries, Jones, Lara, Logue, Bonnie Lowenthal, 
            Mansoor, Mendoza, Miller, Monning, Morrell, Nestande, 
            Nielsen, Norby, Olsen, Pan, Portantino, Skinner, Smyth, 
            Solorio, Swanson, Torres, Valadao, Wagner, Williams, 
            Yamada, John A. P�rez
          NOES:  Ammiano, Beall, Cedillo, Hill, Huffman
          NO VOTE RECORDED:  Atkins, Bill Berryhill, Bonilla, Davis, 
            Fletcher, Furutani, Grove, Hall, Knight, Ma, Mitchell, 
            Perea, V. Manuel P�rez, Silva, Wieckowski


          CTW:n  7/2/12   Senate Floor Analyses 

                       SUPPORT/OPPOSITION:  NONE RECEIVED

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