BILL NUMBER: AB 2018 AMENDED BILL TEXT AMENDED IN ASSEMBLY APRIL 5, 2000 INTRODUCED BY Assembly Members Thomsonand Runner, Runner, and Migden (Coauthors: Assembly Members Aanestadand Aroner, Aroner, Bates, Cardenas, Cox, Honda, and Strom-Martin ) (Coauthor: Senator Bowen) FEBRUARY 18, 2000 An act to amend Sections11164 and 1116511158, 11164, 11165, 11167, and 11167.5 of, and to repeal Sections11161, 11167, 11167.511159.2, 11161, 11162, 11162.5, 11163, 11168 , and 11169 of, the Health and Safety Code, relating to controlled substances. LEGISLATIVE COUNSEL'S DIGEST AB 2018, as amended, Thomson. Controlled substances: Schedule II: triplicate prescription. (1) Existing law provides that no person shall prescribe a controlled substance, nor shall any person fill, compound, or dispense such a prescription unless it complies with specified requirements, one of which is that prescriptions for Schedule II controlled substances shall be prepared in triplicate. The Department of Justice is required to issue these triplicate prescriptions to any practitioner authorized to write a prescription for Schedule II controlled substances. Existing law also imposes specified printing and distribution requirements on prescription blanks, provides that it is a crime to counterfeit or knowingly possess official prescription blanks, limits the number of prescription blank groups issued to an individual prescriber by the Department of Justice, requires the retention of a prescriber's prescription book for 3 years, and provides that, subject to a specified alternate procedure and related requirements, a prescription for a Schedule II drug for use by a terminally ill patient is exempt from specified reporting requirements. This bill would eliminate the triplicate prescription requirement for Schedule II controlled substances. The bill would make conforming changes to related provisions and would repeal specified printing and distribution requirements applicable to prescription blanks for Schedule II and other drugs, provisions making it a crime to counterfeit or knowingly possess prescription blanks, the 3-year recordkeeping requirement, and the alternate Schedule II prescribing procedure applicable to terminally ill patients . (2) Existing law provides for the electronic monitoring of the prescribing and dispensing of Schedule II controlled substances pursuant to the Controlled Substance Utilization Review and Evaluation System (CURES) program, as specified. The program is scheduled to become inoperative on July 1, 2003. This bill would continue the program indefinitely by repealing its repeal date. Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. Section 11158 of the Health and Safety Code is amended to read: 11158. (a) Except as provided in Section 11159 or in subdivision (b) of this section, no controlled substance classified in Schedule II shall be dispensed without a prescription meeting the requirements of this chapter. Except as provided in Section 11159 or when dispensed directly to an ultimate user by a practitioner, other than a pharmacist or pharmacy, no controlled substance classified in Schedule III, IV, or V may be dispensed without a prescription meeting the requirements of this chapter. (b) A practitioner specified in Section 11150 may dispense directly to an ultimate user a controlled substance classified in Schedule II in an amount not to exceed a 72-hour supply for the patient in accordance with directions for use given by the dispensing practitioner only where the patient is not expected to require any additional amount of the controlled substance beyond the 72 hours.Practitioners dispensing drugs pursuant to this subdivision shall meet the requirements of subdivision (f) of Section 11164.(c) Except as otherwise prohibited or limited by law, a practitioner specified in Section 11150, may administer controlled substances in the regular practice of his or her profession. SEC. 2. Section 11159.2 of the Health and Safety Code is repealed.11159.2. (a) Notwithstanding any other provision of law, a prescription for a Schedule II controlled substance for use by a patient who has a terminal illness shall not be subject to Section 11164. (b) (1) The prescription shall be signed and dated by the prescriber and shall contain the name of the person for whom the controlled substance is prescribed, the name and quantity of the controlled substance prescribed, and directions for use. The signature, date, and information required by this paragraph shall be wholly written in ink or indelible pencil in the handwriting of the prescriber. (2) The prescription shall also contain the address of the person for whom the controlled substance is prescribed, as provided in paragraph (3) of subdivision (b) of Section 11164, and shall contain the name, address, telephone number, category of professional licensure, and federal controlled substance registration number of the prescriber, as provided in paragraph (2) of subdivision (b) of Section 11164. (3) The prescription shall also indicate that the prescriber has certified that the patient is terminally ill by the words "11159.2 exemption." (c) A pharmacist may fill a prescription pursuant to this section when there is a technical error in the certification required by paragraph (3) of subdivision (b), provided that he or she has personal knowledge of the patient's terminal illness, and subsequently returns the prescription to the prescriber for correction within 72 hours. (d) For purposes of this section, "terminally ill" means a patient who meets all of the following conditions: (1) In the reasonable medical judgment of the prescribing physician, the patient has been determined to be suffering from an illness that is incurable and irreversible. (2) In the reasonable medical judgment of the prescribing physician, the patient's illness will, if the illness takes its normal course, bring about the death of the patient within a period of one year. (3) The patient's treatment by the physician prescribing a Schedule II controlled substance pursuant to this section primarily is for the control of pain, symptom management, or both, rather than for cure of the illness.SEC. 3. Section 11161 of the Health and Safety Code is repealed.SEC. 2.SEC. 4. Section 11162 of the Health and Safety Code is repealed.11162. The prescription blanks shall be printed on distinctive paper, the serial number of the group being shown on each form, and each form being serially numbered. The prescription blanks shall bear the preprinted name, address, and category of professional licensure of the practitioner to whom they are issued, and the federal registry number for controlled substances.SEC. 5. Section 11162.5 of the Health and Safety Code is repealed.11162.5. (a) Every person who counterfeits a prescription blank purporting to be an official prescription blank prepared and issued pursuant to Section 11161, or knowingly possesses more than three such counterfeited prescription blanks, shall be punished by imprisonment in the state prison or by imprisonment in the county jail for not more than one year. (b) Every person who knowingly possesses three or fewer counterfeited prescription blanks purporting to be official prescription blanks prepared and issued pursuant to Section 11161, shall be guilty of a misdemeanor punishable by imprisonment in the county jail not exceeding six months, or by a fine not exceeding one thousand dollars ($1,000), or by both.SEC. 6. Section 11163 of the Health and Safety Code is repealed.11163. Not more than one such prescription group shall in any case be issued or furnished by the Department of Justice to the same prescriber at one time.SEC. 7. Section 11164 of the Health and Safety Code is amended to read: 11164. Except as provided in Section 11167, no person shall prescribe a controlled substance, nor shall any person fill, compound, or dispense such a prescription unless it complies with the requirements of this section. (a) Each prescription for a controlled substance classified in Schedule II, III, IV, or V, except as authorized by subdivision(c)(b) , shall be subject to the following requirements: (1) The prescription shall be signed and dated by the prescriber and shall contain the name of the person for whom the controlled substance is prescribed, the name and quantity of the controlled substance prescribed, and directions for use.With respect to prescriptionsPrescriptions for controlled substances classified in SchedulesIII and IV,II, III, and IV shall include the signature, date, and information required by this paragraph , and shall be wholly written in ink or indelible pencil in the handwriting of the prescriber. (2) In addition, the prescription shall contain the name, address, telephone number, category of professional licensure, and federal controlled substance registration number of the prescriber. The information required by this paragraph shall be either preprinted upon the prescription blank, typewritten, rubber stamped, or printed by hand. Notwithstanding any provision in this section, the prescriber's address, telephone number, category of professional licensure, or federal controlled substances registration number need not appear on the prescription if that information is readily retrievable in the pharmacy. (3) The prescription shall also contain the address of the person for whom the controlled substance is prescribed. If the prescriber does not specify this address on the prescription, the pharmacist filling the prescription or an employee acting under the direction of the pharmacist shall write or type the address on the prescription or maintain this information in a readily retrievable form in the pharmacy. (b) Any controlled substance classified in ScheduleII,III, IV, or V may be dispensed upon an oral or electronically transmitted prescription, which shall be reduced to writing by the pharmacist filling the prescription or by any other person expressly authorized by provisions of the Business and Professions Code. The date of issue of the prescription and all the information required for a written prescription by subdivision(b)(a) shall be included in the written record of the prescription. The pharmacist need not reduce to writing the address, telephone number, license classification, or federal registry number of the prescriber or the address of the patient if that information is readily retrievable in the pharmacy. Pursuant to authorization of the prescriber, any employee of the prescriber on behalf of the prescriber may orally or electronically transmit a prescription for a controlled substance classified in ScheduleII,III, IV, or V, if in these cases the written record of the prescription required by this subdivision specifies the name of the employee of the prescriber transmitting the prescription. (c) The use of commonly used abbreviations shall not invalidate an otherwise valid prescription. (d) Notwithstanding any provision of subdivisions (a) and (b), prescriptions for a controlled substance classified in Schedule V may be for more than one person in the same family with the same medical need.SEC. 3.SEC. 8. Section 11165 of the Health and Safety Code is amended to read: 11165. (a) To assist law enforcement and regulatory agencies in their efforts to control the diversion and resultant abuse of Schedule II controlled substances, and for statistical analysis, education, and research, the Department of Justice shall, contingent upon the availability of adequate funds, establish the Controlled Substance Utilization Review and Evaluation System (CURES) for the electronic monitoring of the prescribing and dispensing of Schedule II controlled substances by all practitioners authorized to prescribe or dispense these controlled substances. (b) The CURES Program shall operate under existing provisions of law to safeguard the privacy and confidentiality of patients. Data obtained from CURES shall only be provided to appropriate state, local, and federal persons or public agencies for disciplinary, civil, or criminal purposes and to other agencies or entities, as determined by the Department of Justice, for the purpose of educating practitioners and others in lieu of disciplinary, civil, or criminal actions. Data may be provided to public or private entities, as approved by the Department of Justice, for educational, peer review, statistical, or research purposes, provided that patient information, including any information that may identify the patient, is not compromised. Further, data disclosed to any individual or agency as described in this subdivision, shall not be disclosed, sold, or transferred to any third party.(c) The sum of one million fifty thousand dollars ($1,050,000) is hereby appropriated from the Pharmacy Board Contingent Fund to the Board of Pharmacy for the purpose of entering into an interagency agreement with the Department of Justice for the implementation, operation, and evaluation of CURES.SEC. 4. Section 11167 of the Health and Safety Code is repealed. SEC. 5. Section 11167.5 of the Health and Safety Code is repealed. SEC. 6.SEC. 9. Section 11167 of the Health and Safety Code is amended to read: 11167. Notwithstanding subdivision (a) of Section 11164, in an emergency where failure to issue a prescription may result in loss of life or intense suffering, an order for a Schedule II controlled substance may be dispensed on an oral, written,or electronic data transmission order, subject to all of the following requirements: (a) The order contains all information required by subdivision (a) of Section 11164. (b)Any written order is signed and dated by the prescriber in indelible pencil or ink, and theThe pharmacy reduces any oral or electronic data transmission order to writing prior to actually dispensing the controlled substance. (c) The prescriber provides atriplicatewritten prescription, completed as provided by subdivision (a) of Section 11164, by the seventh day following the transmission of the initial order; a postmark by the seventh day following transmission of the initial order shall constitute compliance. (d) If the prescriber fails to comply with subdivision (c), the pharmacy shall so notify the Bureau of Narcotic Enforcement in writing within 144 hours of the prescriber's failure to do so and shall make and retain a written, readily retrievable record of the prescription, including the date and method of notification of the Bureau of Narcotic Enforcement. SEC. 10. Section 11167.5 of the Health and Safety Code is amended to read: 11167.5. (a) An order for a controlled substance classified in Schedule II in a licensed skilled nursing facility, an intermediate care facility, or a licensed home health agency providing hospice care may be dispensed upon an oral or electronically transmitted prescription. Prior to filling the prescription, the pharmacist shall reduce it to writing in ink or indelible pencil in the handwriting of the pharmacistupon an official prescription form issued by the Department of Justice for that purpose. The prescriptions shallbe prepared in triplicate and shallcontain the date the prescription was orally or electronically transmitted by the prescriber, the name of the person for whom the prescription was authorized, the name and address of the licensed facility or home health agency providing hospice care in which that person is a patient, the name and quantity of the controlled substance prescribed, the directions for use, and the name, address, category of professional licensure, and federal controlled substance registration number of the prescriber. Theduplicateprescription shall be retained by the pharmacist, andthe triplicate shall be forwarded to the prescriber by the end of the month in which the prescription was issued. The originalshall be properly endorsed by the pharmacist with the pharmacy's state license number, the signature of the pharmacist, the name and address of the pharmacy, and the signature of the person who received the controlled substances for the licensed facility or home health agency providing hospice careand shall be forwarded by the pharmacist to the Department of Justice at the end of the month in which the prescription was filled. A skilled nursing facility, intermediate care facility, or licensed home health agency providing hospice care shall forward to the dispensing pharmacist a copy of any signed telephone orders, chart orders, or related documentation substantiating each oral or electronically transmitted prescription transaction under this section. (b) For the purposes of this section, "hospice care" means interdisciplinary health care which is designed to alleviate the physical, emotional, social, and spiritual discomforts of an individual who is experiencing the last phases of a terminal disease and to provide supportive care for the primary care person and the family of the patient under hospice care. SEC. 11. Section 11168 of the Health and Safety Code is repealed.11168. The prescription book containing the prescriber's copies of prescriptions issued shall be retained by the prescriber which shall be preserved for three years.SEC. 12. Section 11169 of the Health and Safety Code is repealed.