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AB-888 Opioid prescriptions: information: nonpharmacological treatments for pain.(2019-2020)

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Date Published: 04/11/2019 09:00 PM
AB888:v97#DOCUMENT

Amended  IN  Assembly  April 11, 2019
Amended  IN  Assembly  March 21, 2019

CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Assembly Bill No. 888


Introduced by Assembly Member Low

February 20, 2019


An act to amend Section 11158.1 of the Health and Safety Code, relating to controlled substances.


LEGISLATIVE COUNSEL'S DIGEST


AB 888, as amended, Low. Opioid prescriptions: information: nonpharmacological treatments for pain.
Existing law requires a prescriber, with certain exceptions, before directly dispensing or issuing for a minor the first prescription for a controlled substance containing an opioid in a single course of treatment, to discuss specified information with the minor, the minor’s parent or guardian, or another adult authorized to consent to the minor’s medical treatment.
This bill would extend that requirement for the prescriber by applying it to any patient, not only a minor, under those circumstances. The bill would also require the prescriber to discuss the availability of nonpharmacological treatments for pain, as defined.
Existing law makes an exception to the requirement for the prescriber in the case of a patient who is being treated for a diagnosis of chronic intractable pain, as specified.
This bill would remove that exception and would instead make an exception in the case of a patient who is currently receiving hospice care.
The bill would require the prescriber, after discussing the information, to offer offer, as deemed appropriate by the prescriber, a referral for a provider of nonpharmacological treatments for pain, and to obtain informed written consent from the patient, a minor patient’s parent or guardian, or another authorized adult, as specified.
Existing federal law, the federal Patient Protection and Affordable Care Act (PPACA), requires a health benefit plan issuer that offers coverage in the small group or individual market to ensure that the coverage includes the essential health benefits package, as defined.
This bill would make legislative findings and declarations relating to addiction associated with overreliance on prescription medication for pain management, and providing that nonpharmacological treatments for pain should be considered during the next update to the state’s essential health benefits benchmark plan.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

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


SECTION 1.

 The Legislature finds and declares all of the following:
(a) The opioid crisis has devastated communities within California, which has prompted an urgent discussion about the risks of addiction associated with overreliance on prescription medication for pain management.
(b) A growing body of research indicates that certain nonpharmacological therapies are proven to be equally effective to treat certain causes of pain as prescription opioids, without placing patients at risk for addiction or overdose.
(c) To this end, awareness of, and access to, nonpharmacological treatments for pain are vitally important to the state’s efforts to combat the opioid crisis, and that coverage of these treatments should be considered during the next update to the state’s essential health benefit benefits benchmark plan pursuant to Section 156.111 of Title 45 of the Code of Federal Regulations.

SEC. 2.

 Section 11158.1 of the Health and Safety Code is amended to read:

11158.1.
 (a) Except when a patient is being treated as set forth in Sections 11159, 11159.2, and 11167.5, and Article 2 (commencing with Section 11215) of Chapter 5, pertaining to the treatment of addicts, or except when a patient is currently receiving hospice care, a prescriber shall discuss all of the following information with the patient, or, if the patient is a minor, the minor, the minor’s parent or guardian, or another adult authorized to consent to the minor’s medical treatment, before directly dispensing or issuing to a patient the first prescription in a single course of treatment for a controlled substance containing an opioid:
(1) The risks of addiction and overdose associated with the use of opioids.
(2) The increased risk of addiction to an opioid for an individual who is suffering from both mental and substance abuse disorders.
(3) The danger of taking an opioid with a benzodiazepine, alcohol, or another central nervous system depressant.
(4) The availability of nonpharmacological treatments for pain.
(5) Any other information required by law.
(b) After discussing the information required by subdivision (a), the prescriber shall do both of the following:
(1) Obtain informed written consent from the patient, a minor patient’s parent or guardian, or another adult authorized to consent to the minor patient’s medical treatment, which shall be placed in the patient’s medical record and shall contain all of the following:
(A) The name and quantity of the controlled substance being prescribed or issued to the patient, and the amount of the initial dose.
(B) A statement certifying that the prescriber discussed with the patient, a minor patient’s parent or guardian, or another adult authorized to consent to the minor patient’s medical treatment, the information required by subdivision (a).
(C) A space for the signature of the patient, a minor patient’s parent or guardian, or another adult authorized to consent to the minor patient’s medical treatment.
(2) Offer Offer, as deemed appropriate by the prescriber, a referral for a provider of nonpharmacological treatments for pain.
(c) This section does not apply in any of the following circumstances:
(1) If the patient’s treatment includes emergency services and care as defined in Section 1317.1.
(2) If the patient’s treatment is associated with, or incidental to, an emergency surgery, regardless of whether the surgery is performed on an inpatient or outpatient basis.
(3) If, in the prescriber’s professional judgment, fulfilling the requirements of subdivision (a) or (b) would be detrimental to the patient’s health or safety, or in violation of the patient’s legal rights regarding confidentiality.
(d) For purposes of this section, “nonpharmacological treatments for pain” include, but are not limited to, acupuncture, chiropractic care, physical therapy, occupational therapy, and licensed mental health provider services.
(e) This section shall not be construed as requiring health care coverage, or changing existing health care coverage requirements, for nonpharmacological treatments for pain.

(e)

(f) Notwithstanding any other law, including Section 11374, failure to comply with this section shall not constitute a criminal offense.