BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 2131
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          Date of Hearing:   April 8, 2014

              ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER  
                                     PROTECTION
                               Susan A. Bonilla, Chair
                    AB 2131 (Morrell) - As Amended:  April 2, 2014
           
          SUBJECT  :   Pharmacy licenses:  letters of reprimand.

           SUMMARY  :   Permits the Board of Pharmacy (BOP) to issue a  
          pharmacist or pharmacy technician license concurrently with a  
          public letter of reprimand for those applicants who have  
          committed minor violations that BOP deems not to merit a license  
          denial or probationary license.  Specifically,  this bill :  

          1)Permits BOP to issue a license to an applicant who has  
            committed minor violations that BOP deems, in its discretion,  
            to not merit the denial of a license or require probationary  
            status under existing law, and may concurrently issue a public  
            letter of reprimand.

          2)Requires that the letter of reprimand be in writing and  
            describe in detail the nature and facts of the violation,  
            including a reference to the statutes or regulations violated.

          3)Requires the letter of reprimand to inform the licensee that  
            within 30 days of service of the letter of reprimand the  
            licensee may do either of the following:

             a)   Submit a written request to the BOP's executive officer  
               (EO) for an office conference to contest the letter of  
               reprimand; and, 

               i)     Requires the EO or his or her designee to hold an  
                 office conference with the licensee and the licensee's  
                 legal counsel or authorized representative, if any,  
                 within 30 days of receipt of the request. Unless so  
                 authorized by the EO or his or her designee, no  
                 individual other than the legal counsel or authorized  
                 representative of the licensee may accompany the licensee  
                 to the office conference;

               ii)    Permits the licensee to submit to the EO, or his or  
                 her designee, declarations and documents pertinent to the  
                 subject matter of the letter of reprimand prior to or at  








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                 the office conference;

               iii)   States that the office conference is intended to be  
                 an informal proceeding and is not subject to the  
                 provisions of the Administrative Procedure Act (APA) and  
                 formal hearing requirements, as specified;

               iv)    Permits the EO, or his or her designee, to affirm,  
                 modify, or withdraw the letter of reprimand. Requires  
                 that within 14 calendar days from the date of the office  
                 conference, the EO, or his or her designee, to personally  
                 serve or send by certified mail a written decision to the  
                 licensee's address of record. States that this decision  
                 shall be deemed the final administrative decision  
                 concerning the letter of reprimand; 

               v)     Permits judicial review of the decision by filing a  
                 petition for a writ of mandate, as specified, within 30  
                 days of the date the decision was personally served or  
                 sent by certified mail. States that the judicial review  
                 shall determine whether or not there was a prejudicial  
                 abuse of discretion in the issuance of the letter of  
                 reprimand; or,

             b)   The licensee may accept the letter of reprimand without  
               challenge. Requires BOP to inform the licensee that the  
               letter of reprimand shall be purged after three years if no  
               letter of admonishment, citation, notice of correction, or  
               disciplinary action is initiated by BOP within those three  
               years.

          4)Requires that the letter of reprimand be served upon the  
            licensee personally or by certified mail at the applicant's  
            address of record with BOP. If the applicant is served by  
            certified mail, service shall be effective upon deposit in the  
            United States mail.

          5)Requires that a public letter of reprimand issued concurrently  
            with a license be purged three years from the date of issuance  
            if no letter of admonishment, citation, notice of correction,  
            or disciplinary action is initiated by BOP during the three  
            year period.

          6)Requires that a public letter of reprimand be disclosed to an  
            inquiring member of the public and be posted on the board's  








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            Internet Web site.

          7)States that nothing in this bill shall be construed to affect  
            the BOP's authority to issue an unrestricted license. 

           EXISTING LAW  :

          1)Establishes BOP to administer and enforce the Pharmacy Law.   
            (Business and Professions Code (BPC) Section 4001)

          2)Permits BOP to refuse a license to any applicant guilty of  
            unprofessional conduct. (BPC 4300) 

          3)Permits BOP, in its sole discretion, to issue a probationary  
            license to any applicant for a license who is guilty of  
            unprofessional conduct and who has met all other requirements  
            for licensure.  Permits BOP to issue the license subject to  
            any terms or conditions not contrary to public policy  
            including, but not limited to, the following:

             a)   Medical or psychiatric evaluation;

             b)   Continuing medical or psychiatric treatment;

             c)   Restriction of type or circumstances of practice;

             d)   Continuing participation in a BOP-approved  
               rehabilitation program;

             e)   Abstention from the use of alcohol or drugs;

             f)   Random fluid testing for alcohol or drugs; or,

             g)   Compliance with laws and regulations governing the  
               practice of pharmacy.  (BPC 4300)

          4)Permits BOP to initiate disciplinary proceedings to revoke or  
            suspend any probationary certificate of licensure for any  
            violation of the terms and conditions of probation.  Upon  
            satisfactory completion of probation, BOP must convert the  
            probationary license to a regular license, free of conditions.  
             (BPC 4300) 

          5)Requires all BOP disciplinary proceedings to be conducted in  
            accordance with the APA and formal hearing process, as  








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            specified.  (BPC 4300)  

          6)Permits a licensee to contest an order of correction and  
            letter of admonishment through an informal office conference,  
            and allows any person or entity served with a citation, as  
            specified, to appeal to BOP for an APA hearing and an office  
            conference.  (BPC 4083, 4315; California Code of Regulations  
            1775.4) 

           FISCAL EFFECT  :   Unknown

           COMMENTS  :   

           1)Purpose of this bill  .  This bill would allow BOP to issue a  
            pharmacist or pharmacy technician license and concurrently  
            issue a public letter of reprimand for cases in which there  
            have been violations not significant enough to warrant a  
            license denial.   This step would allow the BOP to put the  
            licensee, and potential employers, on notice that there was a  
            question about the licensee's qualifications, while still  
            permitting an otherwise qualified applicant to practice.  The  
            letter would remain public for three years and be expunged if  
            there were no interim disciplinary actions.  This bill is  
            sponsored by BOP.  

          2)Author's statement  .  According to the author's office,  
            "Assembly Bill 2131 would allow the board to issue a license  
            concurrently with a Letter of Reprimand.  The board believes  
            that by issuing a Letter of Reprimand concurrent with a  
            license, the individual would receive the privilege of the  
            license, while the letter of reprimand serves to protect the  
            public and provide notice to an employer of facts and  
            violations about the new licensee. A Letter of Reprimand would  
            also allow the board to document a licensee's history  
            regarding an event that may have happened many years ago, when  
            considering a disciplinary action for misconduct during the  
            first three years of licensure."
                
            3)Probationary licenses  .  Current law affords a procedure for  
            BOP to award a probationary license with practice conditions  
            in lieu of a full license.  However, that process is  
            considered formal discipline and requires a full investigation  
            and formal hearing, which takes 12-18 months to complete.  AB  
            2131 creates an abridged process that would allow BOP to grant  
            a license to an applicant whose case may not be significant  








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            enough to result in a probationary license or license denial,  
            but places a flag on the licensee's license due to prior  
            behavior.  BOP estimates that if this bill passes, this option  
            will likely be used less than a dozen times per year. Current  
            law affords the Medical Board of California a similar process  
            for both the probationary license and public letter of  
            reprimand.    
                 
            4)Office conference  . This bill states that the letter of  
            reprimand is intended to be an informal proceeding and is not  
            subject to the APA or formal hearing process.  The applicant  
            is allowed to appeal the letter, however, via an "office  
            conference."  
                 
             An office conference allows the applicant and his or her legal  
            counsel or authorized representative to meet with BOP's EO, or  
            his or her designee, and dispute the issuance of the public  
            letter of reprimand.  The applicant is allowed to present  
            declarations and documents in support of his or her case, and  
            the EO, or his or her representative, makes a decision within  
            14 calendar days of the hearing.  

            If the applicant disputes the decision, he or she may file a  
            writ of mandate, which is a process by which a court without a  
            jury hears a final decision of an administrative body.  BOP  
            uses the office conference for other lesser violations, such  
            as a letter of admonishment (for minor violations of the  
            Pharmacy Law) and order of correction (a directive to change  
            practices), and as a tandem appeal for formal citations.  

           5)Arguments in support  .  BOP writes, "[AB] 2131 would authorize  
            [BOP] to issue a letter of reprimand, which would describe in  
            detail the nature and facts of an individual's violations.   
            [AB] 2131 would provide the individual the right to contest  
            the Letter of Reprimand, would specify the process and  
            timeframe for the contesting of the letter, and would require  
            that a letter of reprimand be purged three years from the date  
            of issuance.
             
             "[BOP] believes that [AB] 2131 would serve to protect public  
            by licensing individuals who meet minimum qualifications for  
            licensure, but also by documenting and making available  
            information regarding an individual's past so that employers  
            can make informed decisions as to those they are hiring."     









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           6)Prior legislation  . AB 1045 (Chapter 302, Statutes of 2013)  
            Required patients to be notified as soon as possible within 12  
            hours of a recall notice for a sterile compounded drug, and  
            required the automatic cancellation, suspension, or revocation  
            of a California pharmacy license if an out-of-state pharmacy's  
            home state license is canceled, suspended, or revoked.

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          Board of Pharmacy (sponsor) 
          California Pharmacists Association

           Opposition 
           
          None on file.
           
          Analysis Prepared by  :    Sarah Huchel / B.,P. & C.P. / (916)  
          319-3301