AB 486 (Bonilla)
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Governor Brown Signs AB 486!

The California Society of Health-System Pharmacists is pleased to report that our Assembly Bill 486 was signed by Governor Brown. CSHP collaborated with the Board of Pharmacy to develop AB 486 in an effort to give centralized hospital packaging pharmacies the flexibility to work with existing technology and adapt to new technology as it becomes available. AB 486 also clarifies that this technology can be used for multiple purposes and at multiple locations within the hospital, improving patient safety. The end result will be better, smarter and more efficient care.

 Business and Professions Code to be Amended…

AB 486 amends Business and Professions Code section 4128 to be clearer than the original law enacted by AB 377 (Solorio, 2012), of which CSHP was a sponsor along with the California Hospital Association. This bill would make technical amendments by replacing the word “retrievable” with more clarifying language about barcode medication administration software capabilities. This gives centralized hospital packaging pharmacies greater flexibility to work with existing technology and adapt to new technology as it becomes available. AB 486 also clarifies that this technology can be used for multiple purposes and at multiple locations within the hospital, improving patient safety.

As you know, in Fall 2012, the California pharmacy community celebrated the passage of AB 377 (Solorio). CSHP has introduced AB 486, making key, clarifying updates to the existing language, allowing centralized hospital packaging pharmacies to better utilize the new law!

Background

Supported by the California Society of Health-System Pharmacists, the California Hospital Association and the Board of Pharmacy, AB 377 created a new licensure category under the Board of Pharmacy – the “Centralized Hospital Packaging Pharmacy”.
 
The bill has allowed hospitals the opportunity to create centralized hospital packaging pharmacies, which then serve multiple institutions under common ownership. This was a positive policy change, allowing hospitals to establish these special pharmacies offsite and to purchase and place large robotic packing/filling tools, which often are not usable in hospitals simply due to space restrictions. These tools dramatically decrease medication errors and save lives.
 
The bill has also required all medications prepared within the centralized hospital pharmacy to be barcoded for scanning at the hospital bedside, helping ensure patients are receiving the right medication at the right time.

Overall, the passage of AB 377 was an important step forward for health-systems and patients in California, enhancing medication preparation and delivery, implementing barcode medication administration assistance, decreasing medication errors and improving medication safety.

The Problem

The Board of Pharmacy, tasked with inspecting the proper implementation of the new law, is faced with the challenge of interpreting and enforcing the word “retrievable” in section 4128.4 of the Business & Professions code, making it difficult for organizations to utilize the law. This section refers to elements that have to be on the medication barcode.

The intent of the word “retrievable” by the bill author was not that the elements be immediately readable upon being scanned, but that instead, the elements would be ‘retrievable’ through a sequential, hierarchical process. However, the Board of Pharmacy feels, given the way the language reads, bound to interpreting this section as requiring the elements to be immediately readable upon being scanned. Current technology does not allow for this. To comply, hospital technology vendors would need to completely modify existing systems to make all elements listed in 4128.4 immediately readable upon scan.

The Solution

The Board of Pharmacy supported AB 377 and wants to see it implemented. Board members have started granting waivers to bypass 4128.4, but this is a temporary fix. CSHP has collaborated with the Board of Pharmacy to develop and implement a more permanent, long-term solution.

That solution is AB 486, amending section 4128 to be less proscriptive than the original language and giving centralized hospital packaging pharmacies the flexibility to work with existing technology and adapt to new technology as it becomes available. AB 486 also clarifies that this technology can be used for multiple purposes and at multiple locations within the hospital, improving patient safety. Thanks to Assemblymember Bonilla, the end result will be better, smarter and more efficient care.

Fact Sheet

Read the Fact Sheet

Contacts

California Society of Health-System Pharmacists
1314 H Street, Suite 200
Sacramento, CA 95814
Office: (916) 447-1033
Fax: (916) 447-2396
Email: info@cshp.org
Hours: M-F 8:00am – 5:00pm

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