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SB-617 Pharmacy technicians: supervision.(2019-2020)

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Date Published: 04/25/2019 09:00 PM
SB617:v97#DOCUMENT

Amended  IN  Senate  April 25, 2019
Amended  IN  Senate  April 10, 2019

CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Senate Bill
No. 617


Introduced by Senator Glazer

February 22, 2019


An act to amend Section 4115 of the Business and Professions Code, relating to healing arts.


LEGISLATIVE COUNSEL'S DIGEST


SB 617, as amended, Glazer. Pharmacy technicians: supervision.
The Pharmacy Law provides for the licensure and regulation of pharmacists, pharmacy technicians, and pharmacies by the California State Board of Pharmacy, which is within the Department of Consumer Affairs. That law authorizes a pharmacy technician to perform packaging, manipulative, repetitive, or other nondiscretionary tasks only while assisting, and while under the direct supervision and control of, a pharmacist. That law prohibits a pharmacy with only one pharmacist from having more than one pharmacy technician performing those tasks and prohibits the ratio of pharmacy technicians performing those tasks to any additional pharmacist from exceeding 2 to 1, except as specified.
This bill would, with certain exceptions, allow an employer and one or more labor organizations representing employees who are pharmacists, pharmacy technicians, or a combination thereof in an employer’s pharmacy to enter into a bona fide collective bargaining agreement providing a ratio of up to 3 to 1 pharmacy technicians per pharmacist, regardless of whether the pharmacy has only one pharmacist or more than one pharmacist, if the employer meets certain requirements, including demonstrating to the board that the employer will, among other things, ensure that each pharmacy technician receives in-service training before the pharmacy technician assumes the pharmacy technician’s duties and responsibilities.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

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


SECTION 1.

 Section 4115 of the Business and Professions Code is amended to read:

4115.
 (a) A pharmacy technician may perform packaging, manipulative, repetitive, or other nondiscretionary tasks only while assisting, and while under the direct supervision and control of, a pharmacist. The pharmacist shall be responsible for the duties performed under the pharmacist’s supervision by a technician.
(b) This section does not authorize the performance of any tasks specified in subdivision (a) by a pharmacy technician without a pharmacist on duty.
(c) This section does not authorize a pharmacy technician to perform any act requiring the exercise of professional judgment by a pharmacist.
(d) The board shall adopt regulations to specify tasks pursuant to subdivision (a) that a pharmacy technician may perform under the supervision of a pharmacist. Any pharmacy that employs a pharmacy technician shall do so in conformity with the regulations adopted by the board.
(e) A person shall not act as a pharmacy technician without first being licensed by the board as a pharmacy technician.
(f) (1) A pharmacy with only one pharmacist shall have no more than one pharmacy technician performing the tasks specified in subdivision (a). The ratio of pharmacy technicians performing the tasks specified in subdivision (a) to any additional pharmacist shall not exceed 2 to 1, except that this ratio shall not apply to personnel performing clerical functions pursuant to Section 4116 or 4117. This ratio is applicable to all practice settings, except for an inpatient of a licensed health facility, a patient of a licensed home health agency, as specified in paragraph (2), an inmate of a correctional facility of the Department of Corrections and Rehabilitation, and for a person receiving treatment in a facility operated by the State Department of State Hospitals, the State Department of Developmental Services, or the Department of Veterans Affairs.
(2) The board may adopt regulations establishing the ratio of pharmacy technicians performing the tasks specified in subdivision (a) to pharmacists applicable to the filling of prescriptions of an inpatient of a licensed health facility and for a patient of a licensed home health agency. Any ratio established by the board pursuant to this subdivision shall allow, at a minimum, at least one pharmacy technician for a single pharmacist in a pharmacy and two pharmacy technicians for each additional pharmacist, except that this ratio shall not apply to personnel performing clerical functions pursuant to Section 4116 or 4117.
(3) A pharmacist scheduled to supervise a second pharmacy technician may refuse to supervise a second pharmacy technician if the pharmacist determines, in the exercise of the pharmacist’s professional judgment, that permitting the second pharmacy technician to be on duty would interfere with the effective performance of the pharmacist’s responsibilities under this chapter. A pharmacist assigned to supervise a second pharmacy technician shall notify the pharmacist in charge in writing of the pharmacist’s determination, specifying the circumstances of concern with respect to the pharmacy or the pharmacy technician that have led to the determination, within a reasonable period, but not to exceed 24 hours, after the posting of the relevant schedule. An entity employing a pharmacist shall not discharge, discipline, or otherwise discriminate against any pharmacist in the terms and conditions of employment for exercising or attempting to exercise in good faith the right established pursuant to this paragraph.
(g) Notwithstanding subdivisions (a) and (b), the board shall by regulation establish conditions to permit the temporary absence of a pharmacist for breaks and lunch periods pursuant to Section 512 of the Labor Code and the orders of the Industrial Welfare Commission without closing the pharmacy. During these temporary absences, a pharmacy technician may, at the discretion of the pharmacist, remain in the pharmacy but may only perform nondiscretionary tasks. The pharmacist shall be responsible for a pharmacy technician and shall review any task performed by a pharmacy technician during the pharmacist’s temporary absence. This subdivision shall not be construed to authorize a pharmacist to supervise pharmacy technicians in greater ratios than those described in subdivision (f).
(h) The pharmacist on duty shall be directly responsible for the conduct of a pharmacy technician supervised by that pharmacist.
(i) In a health care facility licensed under subdivision (a) of Section 1250 of the Health and Safety Code, a pharmacy technician’s duties may include any of the following:
(1) Packaging emergency supplies for use in the health care facility and the hospital’s emergency medical system or as authorized under Section 4119.
(2) Sealing emergency containers for use in the health care facility.
(3) Performing monthly checks of the drug supplies stored throughout the health care facility. Irregularities shall be reported within 24 hours to the pharmacist in charge and the director or chief executive officer of the health care facility in accordance with the health care facility’s policies and procedures.
(j) Notwithstanding any other law, an employer and one or more labor organizations representing employees who are pharmacists, pharmacy technicians, or a combination thereof in an employer’s pharmacy may enter into a bona fide collective bargaining agreement providing a ratio of up to 3 to 1 pharmacy technicians per pharmacist, regardless of whether the pharmacy has only one pharmacist or more than one pharmacist. The ratio of pharmacy technicians performing the tasks specified in subdivision (a) to a pharmacist, under this subdivision, shall not exceed 3 to 1, except that this ratio shall not apply for an inpatient of a licensed health facility, a patient of a licensed home health agency as specified in paragraph (2) of subdivision (f), an inmate of a correctional facility of the Department of Corrections and Rehabilitation, for a person receiving treatment in a facility operated by the State Department of State Hospitals, the State Department of Developmental Services, or the Department of Veterans Affairs, and to personnel performing clinical functions pursuant to Section 4116 or 4117. The board shall approve an application from an employer to use the ratio allowed by this subdivision if all of the following conditions are met:
(1) The employer applies to the board, on a form prescribed by the board, for approval to use the ratio allowed by this subdivision.
(2) The employer demonstrates to the board that, prior to using the ratio allowed by this subdivision, the employer will do all of the following:
(A) Establish written job descriptions, task protocols, and policies and procedures that pertain to the duties performed by a pharmacy technician.
(B) Ensure and document that each pharmacy technician is licensed with the board or working as a pharmacy technician trainee.
(C) Ensure that each pharmacy technician is knowledgeable in the established job descriptions, task protocols, and policies and procedures in the pharmacy setting that the pharmacy technician is to perform the pharmacy technician’s duties.
(D) Ensure that the duties assigned to a pharmacy technician do not exceed the established job descriptions, task protocols, and policies and procedures.
(E) Ensure that each pharmacy technician receives in-service training before the pharmacy technician assumes the pharmacy technician’s duties and responsibilities, and maintains documentation thereof.
(F) Require and maintain a signed or electronically confirmed patient confidentiality statement from each pharmacy technician onsite or in an electronically accessible form.
(G) Provide immediate personal supervision.
(H) Provide the board, upon request, with a copy of the established job descriptions, task protocols, and policies and procedures for all pharmacy technician duties.
(I) Maintain a policies and procedures manual with regard to pharmacy technicians, in an electronic or hard copy, that shall include all of the following:
(i) Supervision by a pharmacist.
(ii) Confidentiality safeguards of patient information.
(iii) Minimum qualifications.
(iv) Documentation of in-service education or ongoing training and demonstration of competency, specific to pharmacy setting and job function.
(v) General duties and responsibilities of pharmacy technicians.
(vi) Retrieval of prescription files, patient files, patient profile information, and other records pertaining to the practice of pharmacy.
(vii) Functions related to prescription processing.
(viii) Functions related to ordering and inventory control of dangerous drugs and devices and controlled dangerous substances.
(ix) Prescription refill and renewal authorization.
(x) Procedures dealing with documentation and records required for controlled dangerous substances and dangerous drugs and devices.
(xi) Procedures dealing with medication errors.
(xii) Pharmacy technician functions related to automated systems.
(xiii) Functions that may not be performed by a pharmacy technician.
(xiv) A form signed by the pharmacy technician, or comparable electronic confirmation, that demonstrates that the manual has been reviewed by the pharmacy technician.
(3) The pharmacist-in-charge shall review the policies and procedures manual at least every two years and, if necessary, amend the manual as needed. Documentation of the review of the manual shall be made available to the board upon request.

(k)Each provision in subdivision (j) stands alone, and if any provision in subdivision (j) has been held, or in the future is held, to be unconstitutional, preempted by federal law, or otherwise invalid by any court, all of the other provisions set forth in subdivision (j) are intended to, and shall remain, fully effective and shall be interpreted to exclude the unconstitutional, preempted, or otherwise invalid provision or provisions.  If any sentence, clause, word, or portion of subdivision (j) is for any reason held to be unconstitutional, preempted by federal law, or otherwise invalid, that holding shall not affect the remaining portions of subdivision (j).  The Legislature hereby declares that it would have enacted subdivision (j) and each sentence, clause, word, or portion in subdivision (j) despite the fact that one or more sentences, clauses, words, or portions of subdivision (j) may be held unconstitutional, preempted by federal law, or otherwise invalid.