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AB-1343 Controlled substances: CURES database.(2021-2022)

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Date Published: 02/20/2021 04:00 AM
AB1343:v99#DOCUMENT


CALIFORNIA LEGISLATURE— 2021–2022 REGULAR SESSION

Assembly Bill
No. 1343


Introduced by Assembly Member Cooper

February 19, 2021


An act to amend Section 11165.4 of the Health and Safety Code, relating to controlled substances.


LEGISLATIVE COUNSEL'S DIGEST


AB 1343, as introduced, Cooper. Controlled substances: CURES database.
Existing law classifies certain controlled substances into Schedules I to V, inclusive. Existing law requires the Department of Justice to maintain the Controlled Substances Utilization Review and Evaluation System (CURES) for the electronic monitoring of the prescribing and dispensing of Schedule II, Schedule III, and Schedule IV controlled substances by a health care practitioner authorized to prescribe, order, administer, furnish, or dispense a Schedule II, Schedule III, or Schedule IV controlled substance. Existing law requires an authorized health care practitioner to consult the CURES database to review a patient’s controlled substance history before prescribing a Schedule II, Schedule III, or Schedule IV controlled substance to the patient for the first time and, on or before July 1, 2021, at least once every 6 months thereafter, as specified. Existing law makes exceptions for the requirement to consult the CURES database, including if a health care practitioner prescribes, orders, administers, or furnishes a controlled substance to a patient as part of the patient’s treatment for surgical, radiotherapeutic, therapeutic, or diagnosed procedure, as specified.
This bill would create an additional exception to the requirement to consult the CURES database for a health care practitioner who is employed by a substance use disorder treatment clinic or program who is treating patients who are enrolled in substance abuse disorder treatment with regularly prescribed or furnished controlled substances if there have been consultations in the CURES database within the previous 6 months.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

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


SECTION 1.

 Section 11165.4 of the Health and Safety Code, as added by Section 10 of Chapter 677 of the Statutes of 2019, is amended to read:

11165.4.
 (a) (1) (A) (i) A health care practitioner authorized to prescribe, order, administer, or furnish a controlled substance shall consult the patient activity report or information from the patient activity report obtained from the CURES database to review a patient’s controlled substance history for the past 12 months before prescribing a Schedule II, Schedule III, or Schedule IV controlled substance to the patient for the first time and at least once every six months thereafter if the prescriber renews the prescription and the substance remains part of the treatment of the patient.
(ii) If a health care practitioner authorized to prescribe, order, administer, or furnish a controlled substance is not required, pursuant to an exemption described in subdivision (c), to consult the patient activity report from the CURES database the first time the health care practitioner prescribes, orders, administers, or furnishes a controlled substance to a patient, the health care practitioner shall consult the patient activity report from the CURES database to review the patient’s controlled substance history before subsequently prescribing a Schedule II, Schedule III, or Schedule IV controlled substance to the patient and at least once every six months thereafter if the prescriber renews the prescription and the substance remains part of the treatment of the patient.
(iii) A health care practitioner who did not directly access the CURES database to perform the required review of the controlled substance use report shall document in the patient’s medical record that they reviewed the CURES database generated report within 24 hours of the controlled substance prescription that was provided to them by another authorized user of the CURES database.
(B) For purposes of this paragraph, “first time” means the initial occurrence in which a health care practitioner, in their role as a health care practitioner, intends to prescribe, order, administer, or furnish a Schedule II, Schedule III, or Schedule IV controlled substance to a patient and has not previously prescribed a controlled substance to the patient.
(2) A health care practitioner shall review a patient’s controlled substance history that has been obtained from the CURES database no earlier than 24 hours, or the previous business day, before the health care practitioner prescribes, orders, administers, or furnishes a Schedule II, Schedule III, or Schedule IV controlled substance to the patient.
(b) The duty to consult the CURES database, as described in subdivision (a), does not apply to veterinarians or pharmacists.
(c) The duty to consult the CURES database, as described in subdivision (a), does not apply to a health care practitioner in any of the following circumstances:
(1) If a health care practitioner prescribes, orders, or furnishes a controlled substance to be administered to a patient in any of the following facilities or during a transfer between any of the following facilities, or for use while on facility premises:
(A) A licensed clinic, as described in Chapter 1 (commencing with Section 1200) of Division 2.
(B) An outpatient setting, as described in Chapter 1.3 (commencing with Section 1248) of Division 2.
(C) A health facility, as described in Chapter 2 (commencing with Section 1250) of Division 2.
(D) A county medical facility, as described in Chapter 2.5 (commencing with Section 1440) of Division 2.
(E) Another medical facility, including, but not limited to, an office of a health care practitioner and an imaging center.
(F) A correctional clinic, as described in Section 4187 of the Business and Professions Code, or a correctional pharmacy, as described in Section 4021.5 of the Business and Professions Code.
(2) If a health care practitioner prescribes, orders, administers, or furnishes a controlled substance in the emergency department of a general acute care hospital and the quantity of the controlled substance does not exceed a nonrefillable seven-day supply of the controlled substance to be used in accordance with the directions for use.
(3) If a health care practitioner prescribes, orders, administers, or furnishes a controlled substance to a patient as part of the patient’s treatment for a surgical, radiotherapeutic, therapeutic, or diagnostic procedure and the quantity of the controlled substance does not exceed a nonrefillable seven-day supply of the controlled substance to be used in accordance with the directions for use, in any of the following facilities:
(A) A licensed clinic, as described in Chapter 1 (commencing with Section 1200) of Division 2.
(B) An outpatient setting, as described in Chapter 1.3 (commencing with Section 1248) of Division 2.
(C) A health facility, as described in Chapter 2 (commencing with Section 1250) of Division 2.
(D) A county medical facility, as described in Chapter 2.5 (commencing with Section 1440) of Division 2.
(E) A place of practice, as defined in Section 1658 of the Business and Professions Code.
(F) Another medical facility where surgical procedures are permitted to take place, including, but not limited to, the office of a health care practitioner.
(4) If a health care practitioner prescribes, orders, administers, or furnishes a controlled substance to a patient who is terminally ill, as defined in subdivision (c) of Section 11159.2.
(5) (A) If all of the following circumstances are satisfied:
(i) It is not reasonably possible for a health care practitioner to access the information in the CURES database in a timely manner.
(ii) Another health care practitioner or designee authorized to access the CURES database is not reasonably available.
(iii) The quantity of controlled substance prescribed, ordered, administered, or furnished does not exceed a nonrefillable seven-day supply of the controlled substance to be used in accordance with the directions for use and no refill of the controlled substance is allowed.
(B) A health care practitioner who does not consult the CURES database under subparagraph (A) shall document the reason they did not consult the database in the patient’s medical record.
(6) If the CURES database is not operational, as determined by the department, or cannot be accessed by a health care practitioner because of a temporary technological or electrical failure. A health care practitioner shall, without undue delay, seek to correct the cause of the temporary technological or electrical failure that is reasonably within the health care practitioner’s control.
(7) If the CURES database cannot be accessed because of technological limitations that are not reasonably within the control of a health care practitioner.
(8) If consultation of the CURES database would, as determined by the health care practitioner, result in a patient’s inability to obtain a prescription in a timely manner and thereby adversely impact the patient’s medical condition, provided that the quantity of the controlled substance does not exceed a nonrefillable seven-day supply if the controlled substance were used in accordance with the directions for use.
(9) If a health care practitioner is employed by a substance use disorder treatment clinic or program and is treating patients who are enrolled in substance abuse disorder treatment with regularly prescribed or furnished controlled substances and there have been consultations with the CURES database within the previous six months.
(d) (1) A health care practitioner who fails to consult the CURES database, as described in subdivision (a), shall be referred to the appropriate state professional licensing board solely for administrative sanctions, as deemed appropriate by that board.
(2) This section does not create a private cause of action against a health care practitioner. This section does not limit a health care practitioner’s liability for the negligent failure to diagnose or treat a patient.
(e) All applicable state and federal privacy laws govern the duties required by this section.
(f) The provisions of this section are severable. If any provision of this section or its application is held invalid, that invalidity shall not affect other provisions or applications that can be given effect without the invalid provision or application.
(g) This section shall become operative on July 1, 2021, or upon the date the department promulgates regulations to implement this section and posts those regulations on its internet website, whichever date is earlier.