Bill Text: CA AB977 | 2009-2010 | Regular Session | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Pharmacists: immunization protocols.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Engrossed - Dead) 2010-06-14 - In committee: Set, first hearing. Hearing canceled at the request of author. [AB977 Detail]

Download: California-2009-AB977-Amended.html

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BILL NUMBER: AB 977	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  APRIL 13, 2009

INTRODUCED BY   Assembly Member Skinner

                        FEBRUARY 26, 2009

   An act to amend Section 4052 of, and to add Section 4052.8 to, the
Business and Professions Code, relating to pharmacy.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 977, as amended, Skinner. Pharmacists: immunization
administration.
   Existing law, the Pharmacy Law, provides for the licensing and
regulation of pharmacists by the Board of Pharmacy in the Department
of Consumer Affairs. A violation of the Pharmacy Law is a crime.
Existing law, among other things, authorizes a pharmacist to
administer immunizations pursuant to a protocol with a prescriber.
   This bill would  additionally  authorize a pharmacist to
 initiate and administer immunizations pursuant to a protocol
with a prescriber or the recommended Immunization Schedules provided
by the federal Centers for Disease Control and Prevention 
 initiate and administer influenza and pneumococcal immunizations
to any person 7 years of age or older  . The bill would require
a pharmacist, prior to initiating and administering  those 
immunizations, to complete a specified pharmacy-based immunization
delivery training program. The bill would also require a pharmacist
 initiating and administering immunizations  to complete 3
hours of immunization-related continuing education coursework
annually and to be certified in basic life support. The bill would
require  the   a  pharmacist, at the time
of administration of an immunization, to provide the patient with a
Vaccine Information Statement and to provide the patient's physician
with documentation of administration of the immunization. The bill
would also require a pharmacist  administering an immunization
 to maintain a specified immunization administration record,
 report any adverse event and   provide
documentation of administration to the California Immunization
Registry, report any adverse event and assure proper storage and
handling of vaccines. The bill would authorize a pharmacist
initiating and administering vaccines to initiate and 
administer epinephrine for severe allergic reactions  , and
assure proper storage and handling of vaccines  .  The
bill would also require a pharmacist to obtain the consent of a
parent or guardian before administering any immunization to a patient
under 18 years of age. 
   Because this bill would create new requirements under the Pharmacy
Law, the violation of which would be a crime, it would impose a
state-mandated local program.
   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.
State-mandated local program: yes.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

   SECTION 1.    The Legislature finds and declares all
of the following:  
   (a) Vaccines are a safe, effective, and efficient means to prevent
sickness and death from infectious diseases as reported by the
United States Department of Health and Human Services (HHS). 

   (b) The National Vital Statistics Report published by HHS reports
that influenza and pneumonia combined are the eighth leading cause of
death in people of all ages, and the sixth leading cause of death in
people over 65 years of age.  
   (c) The federal Centers for Disease Control and Prevention report
that 220,000,000 persons should get the influenza vaccination
annually, however, fewer than 100,000,000 do.  
   (d) According to the California Health Care Foundation, 6,600,000
Californians are uninsured and may not have access to immunizations.
 
   (e) Pharmacists represent the third largest health professional
group in the United States and are on the front line of preventative
care.  
   (f) Pharmacists are trained to screen, administer, and properly
deal with any adverse events that may arise from vaccines.  

   (g) Therefore, in order to achieve greater access to immunization
and to protect Californians, it is the intent of the Legislature to
provide greater access to lifesaving vaccinations and to ensure that
pharmacists may independently administer influenza and pneumonia
vaccinations. 
   SECTION 1.   SEC. 2.   Section 4052 of
the Business and Professions Code is amended to read:
   4052.  (a) Notwithstanding any other provision of law, a
pharmacist may:
   (1) Furnish a reasonable quantity of compounded drug product to a
prescriber for office use by the prescriber.
   (2) Transmit a valid prescription to another pharmacist.
   (3) Administer, orally or topically, drugs and biologicals
pursuant to a prescriber's order.
   (4) Perform procedures or functions in a licensed health care
facility as authorized by Section 4052.1.
   (5) Perform procedures or functions as part of the care provided
by a health care facility, a licensed home health agency, a licensed
clinic in which there is a physician oversight, a provider who
contracts with a licensed health care service plan with regard to the
care or services provided to the enrollees of that health care
service plan, or a physician, as authorized by Section 4052.2.
   (6) Manufacture, measure, fit to the patient, or sell and repair
dangerous devices or furnish instructions to the patient or the
patient's representative concerning the use of those devices.
   (7) Provide consultation to patients and professional information,
including clinical or pharmacological information, advice, or
consultation to other health care professionals.
   (8) Furnish emergency contraception drug therapy as authorized by
Section 4052.3.
   (9)  Initiate   Administer or initiate 
and administer immunizations pursuant to Section 4052.8.
   (b) A pharmacist who is authorized to issue an order to initiate
or adjust a controlled substance therapy pursuant to this section
shall personally register with the federal Drug Enforcement
Administration.
   (c) Nothing in this section shall affect the requirements of
existing law relating to maintaining the confidentiality of medical
records.
   (d) Nothing in this section shall affect the requirements of
existing law relating to the licensing of a health care facility.
   SEC. 2.   SEC. 3.   Section 4052.8 is
added to the Business and Professions Code, to read:
   4052.8.  (a) A pharmacist may  initiate and administer
immunizations pursuant to   do  either of the
following:
   (1)  A   Administer any immunization pursuant
to a  protocol with a prescriber. 
   (2) The recommended Immunization Schedules for persons aged 7
through 18 years of age and adults provided by the federal Centers
for Disease Control and Prevention, as they may be amended from time
to time.  
   (2) Initiate and administer influenza or pneumococcal
immunizations to any person seven years of age or older. 
   (b) Prior to initiating and administering immunizations, a
pharmacist shall complete the American Pharmacists Association's
Pharmacy-Based Immunization Delivery Certificate Training Program or
another pharmacy-based immunization training certificate program
endorsed by the federal Centers for Disease Control and Prevention or
the Accreditation Council for Pharmaceutical Education.
   (c) (1) A pharmacist initiating and administering any immunization
pursuant to this section shall also complete three hours of
immunization-related continuing education coursework annually.
   (2) If a pharmacist fails to satisfy this requirement, he or she
shall, in addition to any other applicable disciplinary action,
retake the training identified in subdivision (b) and also complete
the three hours of immunization-related continuing education
coursework described in paragraph (1) prior to initiating and
administering any further immunizations.
   (3) The three hours of immunization-related continuing education
may be applied toward the continuing education requirement described
in Section 4231.
   (d) A pharmacist initiating and administering any immunization
pursuant to this section shall at all times be certified in basic
life support. 
   (e) A pharmacist shall obtain the consent of a parent or guardian
before administering an immunization to a patient under 18 years of
age.  
   (e) 
    (f)  At the time of administration of an immunization,
the pharmacist shall do  both   all  of the
following:
   (1) Provide the patient or the patient's agent with the
appropriate Vaccine Information Statement, produced by the Centers
for Disease Control and Prevention, for each immunization
administered.
   (2) Provide documentation of administration of the immunization to
the patient and the patient's physician or primary care provider, if
one can be identified. 
   (3) Provide documentation of administration of the immunization to
the California Immunization Registry (CAIR).  
   (f) 
    (g)  The pharmacist shall maintain an immunization
administration record, which shall include, but not be limited to,
the name of the vaccine, the expiration date, the date of
administration, the manufacturer and lot number, the administration
site and route, the Vaccine Information Statement date, and the name
and title of the person administering, for the longer of the
following periods:
   (1) Ten years from the date of administration.
   (2) If the patient is younger than 18 years of age at the time of
administration, three years beyond the patient's 18th birthday.

   (g) 
    (h)  Any pharmacist initiating and administering
vaccines may initiate and administer epinephrine by injection for
severe allergic reactions. 
   (h) 
    (i)  Any adverse event shall be reported to the Vaccine
Adverse Event Reporting System within the U.S. Department of Health
and Human Services. 
   (i) 
    (j)  Upon receipt of a vaccine as authorized by this
section, a pharmacist is responsible for assuring that proper vaccine
temperatures are maintained during subsequent storage and handling
to preserve the potency of the vaccine.
   SEC. 3.   SEC. 4.   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.
                           ____ CORRECTIONS  Text--Pages 3 and 4.
                                                          ____