BILL ANALYSIS                                                                                                                                                                                                    �



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          SENATE THIRD READING
          SB 360 (DeSaulnier)
          As Amended  July 7, 2011
          Majority vote 

           SENATE VOTE  :39-0  
           
           PUBLIC SAFETY       7-0         APPROPRIATIONS      17-0        
           
           ----------------------------------------------------------------- 
          |Ayes:|Ammiano, Knight, Cedillo  |Ayes:|Fuentes, Harkey,          |
          |     |Hagman, Hill, Mitchell,   |     |Blumenfield, Bradford,    |
          |     |Skinner                   |     |Charles Calderon, Campos, |
          |     |                          |     |Davis, Donnelly, Gatto,   |
          |     |                          |     |Hall, Hill, Lara,         |
          |     |                          |     |Mitchell, Nielsen, Norby, |
          |     |                          |     |Solorio, Wagner           |
          |-----+--------------------------+-----+--------------------------|
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Makes changes to the Controlled Substance Utilization 
          Review and Evaluation System (CURES) and the Prescription Drug 
          Monitoring Program (PDMP).  Specifically,  this bill  :

          1)Expands the requirements imposed on security-printer 
            applicants to print prescription forms for controlled 
            substance prescriptions to include the names and addresses of 
            any individual owner, partner, corporate officer, manager, 
            agent, representative, employee or subcontractor with direct 
            access to, management of, or control over controlled substance 
            prescription forms; a signed statement regarding any prior 
            criminal convictions for these parties, and fingerprints for 
            the same.

          2)Clarifies that the fee assessed by the Department of Justice 
            (DOJ) to process the application of a security printer shall 
            be sufficient to cover inspections of security printers in 
            addition to the other costs specified by statutes.

          3)Requires that controlled substance forms shall be provided in 
            person only to established customers.  

          4)Requires a security printer to obtain the customer's photo 
            identification and log the information.  








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          5)Limits the mailing of controlled substance only to an address 
            verified by the Drug Enforcement Agency or Medical Board of 
            California.

          6)Requires a security printer to report the theft or loss of 
            controlled substance prescription forms to DOJ within 24 hours 
            of its occurrence.

          7)Requires DOJ to impose sanctions on security printers who 
            violate applicable statutes and regulations, including failure 
            to comply with guidelines, failure to take reasonably 
            precautions to prevent dishonest or illegal actions with 
            regard to the access and control of security prescription 
            forms, and the theft or fraudulent use of a prescriber's 
            identity to obtain forms.

          8)Specifies that the sanctions for a violation of applicable 
            statutes and regulations are a fine of up to $1,000 for a 
            first violation, a fine of up to $2,500 for a second or 
            subsequent violation; disciplinary proceedings for suspension 
            or revocation of security printer status for third or 
            subsequent violations.

          9)Modifies the PDMP to include the following features:  

             a)   Allows any practitioner licensed to prescribe controlled 
               substances of Schedules II-IV or any pharmacist to apply to 
               participate in the PDMP, as specified; and,

             b)   Gives the program participant Internet access to view 
               the electronic history of controlled substances dispensed 
               to an individual under his or her case based on data 
               contained in CURES.

          10)Provides that a PDMP application may be denied, or a 
            subscriber suspended from the program for material 
            falsification of an application, failure to maintain effective 
            controls for access to the patient activity report, a 
            suspended or revoked DEA registration, an arrest for a drug 
            offense, or accessing information for any reason other than 
            patient care.

          11)Requires an authorized subscriber to notify DOJ within 10 








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            days of any changes to the subscriber account.

          12)Allows, until July 12, 2012, a health care practitioner or 
            pharmacist to make a written request for controlled substance 
            history information about a person under the care of the 
            practitioner or pharmacist, in order to provide sufficient 
            time for subscribers to apply for access to PDMP.    

          13)Authorizes DOJ to audit the PDMP system and its users.

          14)Authorizes DOJ to establish regulations for a system to issue 
            citations for unauthorized use of the CURES data by 
            subscribers with PDMP access, and provides for orders or 
            abatement, fines of up to $2,500 per violation, and a hearing 
            process if a subscriber is in violation of the CURES-PDMP 
            statutes or corresponding regulations.

          15)Requires citations issued by DOJ to be in writing, to 
            particularly describe the violation including a specific 
            citation to the statute or regulation violated, and to notify 
            the subscriber of the opportunities to request a hearing 
            and/or an informal conference, and the deadlines for 
            requesting them.

          16)Provides that the failure of a subscriber to pay a fine 
            within 30 days, or to comply with an abatement order within 
            the time subscribed, may result in disciplinary action unless 
            the citation is being appeal.

          17)Provides that any administrative fines collected shall be 
            deposited in the CURES Program Special Fund.

          18)Specifies that the sanctions authorized pursuant to this bill 
            shall be separate and in addition to any other administrative, 
            civil or criminal remedies, but that a criminal action may not 
            be initiated for a specific offense if a citation has been 
            issued for that matter, and that if a criminal action has been 
            filed, a citation cannot be issued for the same offense.  
            Notwithstanding this provision, nothing shall prevent DOJ from 
            prosecuting a suspension or revocation of a subscriber.

          19)Requires an affected PMDP prescriber to immediately report 
            the theft or loss of controlled substance prescription forms 
            to DOJ, and specifies the reporting shall be done no later 








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            than three days after the discovery of the theft of loss.

           FISCAL EFFECT  :   According to the Assembly Appropriations 
          Committee:

          1)Unknown significant annual General Fund costs, in the range of 
            $150,000, for developing regulations, conducting PDMP audits, 
            and holding citation conferences and hearings, offset to some 
            degree by dedicated citation revenue. 

          DOJ states a willingness and ability to absorb the cost of 
            regulations.  Moreover, DOJ does not anticipate a significant 
            number of audits, citations or hearings, contending the 
            deterrent value of the enforcement mechanism will suffice in 
            most cases.    

          2)Unknown, likely minor and absorbable administrative costs to 
            DOJ for security printer process changes, offset to an unknown 
            degree by increased fines. 

           COMMENTS  :   According to the author, "Due to the rise in 
          prescription drug abuse, controlled drugs prescription history 
          information is available and maintained by DOJ's CURES program.  
          In 2009, the DOJ launched an automated PDMP.  The program allows 
          licensed health care practitioners eligible to prescribe 
          controlled substances access to patient controlled substance 
          prescription information.  Prescribers and pharmacists can now 
          make informed decisions about patient care and detect patients 
          who may be abusing controlled substances by obtaining multiple 
          prescriptions from various practitioners.  However, current 
          efforts at maintaining privacy and control of CURES data are 
          inadequate to protect confidential patient information and to 
          deter its misuse.

          "SB 360 will help to prevent the misuse of confidential 
          information collected through the CURES and ensure the integrity 
          of the program and process for practitioners and pharmacists to 
          appropriately use patient's controlled substances history 
          information.

          "The DOJ manages the California Security Prescription Printer 
          Program.  While the DOJ has established guidelines for the 
          security of prescription forms, current law lacks sufficient 
          safeguards against theft and fraudulent use of prescription pads 








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          and the DOJ has seen an increase in criminal enterprises 
          involved in prescription form theft and fraud.  SB 360 provides 
          additional requirements and sanctions for Security Printers to 
          deter fraudulent use of prescription pads and the illegal 
          distribution of controlled substances."

          Please see the policy committee analysis for a full discussion 
          of this bill.
           

          Analysis Prepared by  :    Sandy Uribe / PUB. S. / (916) 319-3744 


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