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  JANUARY 4, 2010
	AMENDED IN ASSEMBLY  APRIL 23, 2009
	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 protocols
with physicians.
   Existing law, the Pharmacy Law, provides for the licensing and
regulation of pharmacists by the California State Board of Pharmacy.
 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  request the California Pharmacists
Association to provide information to specified legislative
committees on the status of immunization protocols between
independent pharmacists and physicians   additionally
authorize a pharmacist to initiate and administer influenza and
pneumococcal immunizations to any person 11 years of age or older
  pursuant to standardized protocols developed and approved
by both the board and the Medical Board of California. 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 a
pharmacist, at the time of administration of an immunization, to
provide the patient with a Vaccine Information Statement and to
provide the patient and the patient's physician with documentation of
administration of the immunization. The bill wo   uld also
require a pharmacist administering an immunization to maintain a
specified immunization record, provide documentation of
administration to the appropriate 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. 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:  no
  yes  . State-mandated local program:  no
  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) Primary care physicians play an integral role in preventative
health care for Californians. This act will provide an adjunct to
that preventative health care.  
   (h) 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 pneumococcal
vaccinations. 
   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) Administer immunizations pursuant to  a protocol with
a prescriber   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. 3.    Section 4052.8 is added to the  
Business and Professions Code   , to read:  
   4052.8.  (a) A pharmacist may do either of the following:
   (1)  Administer any immunization pursuant to a protocol with a
prescriber.
   (2) Administer influenza and pneumococcal immunizations, pursuant
to standardized protocols developed and approved by both the board
and the Medical Board of California in consultation with public
health officers, to any person 11 years of age or older. The
standardized protocols shall be consistent with protocols developed
by the Advisory Committee on Immunization Practices of the federal
Centers for Disease Control and Prevention.
   (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) For any patient under 18 years of age, a pharmacist shall
obtain the consent of a parent or the patient's guardian before
administration.
   (f) At the time of administration of an immunization, the
pharmacist shall do all of the following:
   (1) Provide the patient or the patient's agent with the
appropriate Vaccine Information Statement, produced by the federal
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 appropriate immunization registry.
   (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.
   (h) Any pharmacist initiating and administering vaccines may
initiate and administer epinephrine by injection for severe allergic
reactions.
   (i) Any adverse event shall be reported to the Vaccine Adverse
Event Reporting System within the United States Department of Health
and Human Services.
   (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. 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.  
  SECTION 1.    The California Pharmacists
Association is hereby requested to provide information to the
respective chairpersons of the Committees on Business and Professions
and Health of the Assembly and of the Committees on Business,
Professions and Economic Development and Health of the Senate on the
status of immunization protocols between independent pharmacists and
physicians.