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AB-1048 Health care: pain management and Schedule II drug prescriptions.(2017-2018)

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Date Published: 04/27/2017 09:00 PM
AB1048:v96#DOCUMENT

Amended  IN  Assembly  April 27, 2017
Amended  IN  Assembly  April 19, 2017
Amended  IN  Assembly  March 21, 2017

CALIFORNIA LEGISLATURE— 2017–2018 REGULAR SESSION

Assembly Bill No. 1048


Introduced by Assembly Member Arambula

February 16, 2017


An act to add Section 4052.10 to the Business and Professions Code, and to amend Section 1254.7 of the Health and Safety Code, relating to health care.


LEGISLATIVE COUNSEL'S DIGEST


AB 1048, as amended, Arambula. Health care: pain management and Schedule II drug prescriptions.
(1) The Pharmacy Law provides for the licensing and regulation of pharmacists by the California State Board of Pharmacy in the Department of Consumer Affairs. The law specifies the functions pharmacists are authorized to perform, including to administer, orally or topically, drugs and biologicals pursuant to a prescriber’s order, and to administer immunizations pursuant to a protocol with a prescriber. A violation of the Pharmacy Law is a crime.
This bill would authorize a pharmacist to dispense a Schedule II controlled substance as a partial fill if requested by the patient or the prescriber. The bill would require the pharmacy to retain the original prescription, with a notation of how much of the prescription has been filled, until the prescription has been fully dispensed, and would impose notification requirements on the pharmacy. The bill would require the pharmacy to collect the copayment, if any, for the entire prescription at the time of the first partial fill and would prohibit a pharmacy from charging an additional fee, service fee, or a higher rate or copayment for prescriptions that are dispensed as partial fills. By creating a new crime, this bill would impose a state-mandated local program.
(2) Existing law provides for the licensure and regulation of health facilities by the State Department of Public Health. Existing law requires a health facility, as a condition of licensure, to include pain as an item to be assessed at the same time vital signs are taken and to ensure that pain assessment is performed in a consistent manner that is appropriate to the patient.
This bill would remove the requirement that pain be assessed at the same time as vital signs.
(3) The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: YES  

The people of the State of California do enact as follows:


SECTION 1.

 Section 4052.10 is added to the Business and Professions Code, to read:

4052.10.
 (a) A pharmacist may dispense a Schedule II controlled substance, as listed in Section 11055 of the Health and Safety Code, as a partial fill if requested by the patient or the prescriber.
(b) If a pharmacist dispenses a partial fill on a prescription pursuant to this section, the pharmacy shall retain the original prescription, with a notation of how much of the prescription has been filled, until the prescription has been fully dispensed. The total quantity dispensed shall not exceed the total quantity prescribed.
(c) Subsequent fills, until the original prescription is completely dispensed, shall occur at the pharmacy where the original prescription was partially filled. The full prescription shall be dispensed not more than 30 days after the first partial fill. Thirty-one days after the initial partial fill on a prescription, the prescription shall expire and no more of the drug shall be dispensed without a subsequent prescription.
(d) The pharmacist shall record in the state prescription drug monitoring program only the actual amounts of the drug dispensed.
(e) The pharmacist shall notify the prescriber that the prescription was partially filled and the amount of the drug that was dispensed in one of the following ways:
(1) A notation in the patient’s interoperable electronic health record.
(2) An electronic or facsimile transmission.
(3) A notation in the patient’s record at the pharmacy that is available to the prescriber upon request.
(f) (1) A pharmacy shall collect the copayment, if any, for the entire prescription at the time of the first partial fill. No additional money shall be collected for later dispensing, up to the full prescription amount.
(2) A pharmacist shall not charge an additional fee, service fee, or a higher rate or copayment for prescriptions that are dispensed as partial fills.
(g) This section is not intended to conflict with or supersede any other requirement established for the prescription of a Schedule II controlled substance.
(h) For purposes of this section, the following definitions apply:
(1) “Original prescription” means the prescription presented by the patient to the pharmacy or submitted electronically to the pharmacy.
(2) “Partial fill” means a part of a prescription filled that is of a quantity less that than the entire prescription.

SEC. 2.

 Section 1254.7 of the Health and Safety Code is amended to read:

1254.7.
 (a)  It is the intent of the Legislature that pain be assessed and treated promptly, effectively, and for as long as pain persists.
(b)  A health facility licensed pursuant to this chapter shall, as a condition of licensure, include pain as an item to be assessed. The health facility shall ensure that pain assessment is performed in a consistent manner that is appropriate to the patient. The pain assessment shall be noted in the patient’s chart.

SEC. 3.

 No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.