BILL ANALYSIS                                                                                                                                                                                                    



                                                          AB 141
                                                          Page  1

ASSEMBLY THIRD READING
AB 141 (Knox)
As Amended May 28, 1999
Majority vote 

  HEALTH              14-0        APPROPRIATIONS      15-6        
  
 ----------------------------------------------------------------- 
|Ayes:|Gallegos, Baugh,          |Ayes:|Migden, Cedillo, Davis,   |
|     |Aanestad, Bates, Corbett, |     |Hertzberg, Kuehl,         |
|     |Firebaugh, Kuehl,         |     |Maldonado, Papan, Romero, |
|     |Steinberg, Strickland,    |     |Shelley, Steinberg,       |
|     |Thomson, Vincent, Wayne,  |     |Thomson, Wesson, Wiggins, |
|     |Wildman, Zettel           |     |Wright, Aroner            |
|     |                          |     |                          |
|-----+--------------------------+-----+--------------------------|
|     |                          |Nays:|Brewer, Ashburn, Battin,  |
|     |                          |     |Pescetti, Runner, Zettel  |
|     |                          |     |                          |
 ----------------------------------------------------------------- 
  SUMMARY  :  Requires the Board of Pharmacy (Board) to conduct a  
study of the incidence of medication errors in pharmacies and to  
issue a report of its findings from the study to the Legislature  
by December 1, 2002.  Specifically,  this bill  : 

1)Requires the Board to conduct a study of the incidence of  
  medication errors in pharmacies in California, employing a  
  methodology that uses "test" prescriptions, as defined,  
  distributed to a statistically significant cross section of  
  pharmacies in the state.

2)Defines "test" prescription to be a prescription that is  
  prepared solely for the purposes of this study and not for the  
  actual medical needs of a patient, and requires all "test"  
  prescription drugs, after examination for purposes of the  
  study, to be forwarded to the Board to remain in the Board's  
  custody until destroyed.

3)Requires the Board to ensure that the study is based on sound  
  scientific and analytic principles, and permits the Board to  
  contract with outside entities to design the study, collect  
  and analyze data results, and disseminate findings.

4)States that the purpose of the study is to measure the  
  frequency and describe the type of medication errors occurring  








                                                          AB 141
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  in California, to improve patient safety, and to identify  
  broader issues that may become the basis for instituting  
  profession-wide standards and changes.

5)Specifies that the information collected and produced in the  
  course of the study shall be used for research purposes only  
  and shall be disclosed for the sole purpose of determining the  
  validity and propriety of the study.

6)Requires the identity of individual pharmacists and pharmacies  
  to remain confidential and shall not be disclosed to any  
  person or private, public, or other governmental entity.

7)Prohibits information derived from the study from being used  
  for disciplinary purposes by the Board or any other government  
  agency, and prohibits the information, records, and reports  
  received or generated in connection with the study from being  
  subject to disclosure or discovery in connection with any  
  administrative, civil or criminal investigation or proceeding.

8)Authorizes up to $600,000 to be expended from the Pharmacy  
  Board Contingent Fund by the California State Board of  
  Pharmacy for the purpose of conducting the study, and requires  
  the Board to reimburse the Pharmacy Board Contingent Fund in  
  an amount equal to any private funding obtained by the Board  
  for these purposes.

9)Requires the Board to issue a report of its findings from the  
  study to the Legislature by December 1, 2002, and sunsets the  
  provisions of this bill on January 1, 2003.

  EXISTING LAW  establishes the Board of Pharmacy within the  
Department of Consumer Affairs, and charges the Board with the  
administration and enforcement of laws pertaining to the  
practice of pharmacy.

  FISCAL EFFECT  :  According to the Assembly Appropriations  
Committee analysis, the cost of the study would depend on its  
scope, but would likely be in the range of $500,000 to $1  
million on a one-time basis from the Pharmacy Board Contingent  
Fund.  This bill authorizes up to $600,000 from this fund.

  COMMENTS  :  The author introduced this bill at the request of the  
Engineers and Scientists of California (ESC), the Region 8  
States Council of the United Food and Commercial Workers (UFCW),  








                                                          AB 141
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and the California Pharmacists Association (CPhA).  According to  
ESC and UFCW, there is strong evidence that prescription error  
rates have increased dramatically, and point to a study  
published in the February 1998 issue of the journal  Lancet  .   
This study found that deaths due to medication errors in the  
United States more than doubled between 1983 and 1993.  CPhA  
argues in support that this bill would focus the concern of the  
Board on the issue of prescription errors in California.  CPhA  
states that while studies exist reinforcing evidence that  
prescription error rates are increasing, it is important to  
specifically examine the degree of this problem in California.

The Consumer Federation of California states in support that  
this bill will require the Board to be more cognizant of the  
existence and causes of increasing prescription error rates in  
California, and that consumers will ultimately benefit from  
increased awareness of prescription error rates in California.   
The California Nurses Association also supports this bill,  
arguing that reducing medication errors to a minimum should be  
one of the prime regulatory objectives of the Board.

A similar bill requiring a study of prescriptions errors, AB  
1889 (Knox), was vetoed in 1998.  Among the points raised in the  
veto message, the Governor stated that AB 1889's reference to  
"placebo" prescriptions was inappropriate, and that a study  
should use "fictitious," rather than "placebo," prescriptions.   
This bill addresses that concern by using "test" prescriptions,  
rather than the "placebo" prescriptions of AB 1889.  The  
Governor also suggested that a study of this problem could be  
done by national organizations rather than the Board of  
Pharmacy.


  Analysis Prepared by  :  Vincent D. Marchand / HEALTH / (916)  
319-2097 


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