Legislative Updates for CSHP Members
CSHP is excited to introduce a new feature to our AdvocacySource Newsletter and to our membership! CSHP's lobbying firm, the Weideman Group, will author a guest column, CSHP at the Capitol, twice monthly to give CSHP members a window into the Capitol and highlight CSHP's advocacy efforts in Sacramento.
CSHP has utilized the Weideman Group for several years now as part of the society's government affairs program. The principal of Weideman Group, Mark Weideman, was CSHP's lobbyist during the passage of SB 493 and played a pivotal role in the bill's ultimate success. Mark Weideman has also been CSHP's chief advocate for bills like SB 1039 and AB 486 and will continue to represent CSHP in the legislature in 2017.
Another key Weideman Group advocate for CSHP is Tim Valderrama, who was Senator Hernandez's Chief of Staff for more than six years, including the period when the senator authored and passed SB 493 in 2013. Valderrama has been at the center of California's healthcare policymaking for many years and brings a wealth of expertise to CSHP. This includes Valderrama working closely with Senator Hernandez on California's successful implementation of the Affordable Care Act, the startup of Covered California, and the expansion of Medi-Cal coverage.
We hope you'll enjoy these guest columns from Weideman Group, and join us in 2017 as CSHP continues to advance its mission of promoting "wellness, patient safety and the optimal use of medication" through advocacy efforts at the Capitol!
September 25, 2017
Each year, the California Legislature considers thousands of legislative bills dealing with nearly every subject, including pharmacy-related issues. CSHP's Government Affairs Advisory Committee, Board of Directors, and staff review legislation, formulate responses and actively engage in the legislative process. GAAC reviewed more than 40 bills and took positions on more than half of those.
The first year of the two-year 2017-2018 legislative session ended on September 15. The Legislature is now officially on recess until it reconvenes on January 3, 2018. Governor Brown has until October 15 to act on legislation.
Information and updates on key 2017 legislative bills in which CSHP advocated on behalf of CSHP members can be accessed on the CSHP website below.
AB 40 (Santiago): Requires the Department of Justice to make the electronic history of controlled substances dispensed to an individual under a health care practitioner’s care, based on data contained in the CURES database, available to practitioners through EMR systems. CSHP supports this bill as it will improve provider access and workflow to critically important CURES data. AB 40 has passed out of the Legislature and is awaiting action from the Governor.
AB 315 (Wood): Requires a PBM to be registered with the Department of Managed Health Care and, among other requirements, periodically disclose information regarding the amount of rebates and discounts a PBM receives in connection with prescription drug benefits related to a purchaser. CSHP supports this bill as it will potentially help provide greater transparency around drug pricing. AB 315 was made a 2-year bill in the Senate to give the author time to work on language with the Administration. CSHP will continue to engage on this measure when the Legislature reconvenes in January.
AB 401 (Aguiar-Curry): Allows the California State Board of Pharmacy to issue a remote dispensing site pharmacy license for locations where there is no pharmacy within 10 miles, with the dispensing location to be staffed by a pharmacy technician and supervised by a pharmacist through a telepharmacy software system up to 150 miles away. CSHP has an oppose unless amended position due to concerns that the bill could result in two levels of pharmacy care in many areas of the state since the bill would allow remote dispensing sites to remain in operation even if a full-fledged pharmacy is established in a previously designated medically underserved area (MUA). CSHP is also concerned with AB 401 as it could place an unsafe workload on a pharmacist-in-charge. AB 401 has passed out of the Legislature and is awaiting action from the Governor. Please click here to send a pre-written letter to the Governor if you’re personally concerned about potential negative impacts associated with AB 401.
AB 1589 (Bocanegra): increases the ratio of pharmacy technicians to pharmacists to 4 to 1. The bill was made into a two-year bill earlier this year and will be considered again in 2018.
SB 17 (Hernandez): Requires health plans, insurers and drug manufacturers to report information related to drugs costs, including information related to the most frequently prescribed drugs, the most costly drugs by total annual spending, and drugs with the highest year-over-year increase in total annual spending, as well as percentage of premium increases attribute to prescription drug costs and other information to help increase drug pricing transparency. CSHP supported SB 17 given the increasing burden of drug costs and the need for greater drug pricing transparency. SB 17 has passed out of the Legislature and is awaiting action from the Governor.
SB 133 (Hernandez): Ensures continuity of care through stipulating that certain covered health coverage benefits should be maintained for a newly covered enrollee if that enrollee had coverage terminated by his/her previous insurer due to a plan’s withdrawal from the market. CSHP was able to work with Senator Hernandez on a set of amendments to fix a potentially harmful situation identified by CSHP members. We feel confident that the final version of the bill will help ensure continuity of care, including for patients that require medication regimens. SB 133 has passed out of the Legislature and is awaiting action from the Governor.
SB 351 (Roth): Establishes a “hospital satellite compounding pharmacy" licensure designation, and would also allow a general acute care hospital to have multiple pharmacies on its campus by eliminating reference to the consolidated license in the definition of a hospital pharmacy. The bill is sponsored by the California State Board of Pharmacy and is supported by CSHP. SB 351 has passed out of the Legislature and is awaiting action from the Governor.
SB 419 (Portantino): Prohibits the prescribing of oxycodone to patients under 18 years of age, except under certain circumstances. According to the author’s office, the bill is in response to increasing levels of prescription drug abuse by minors and young adults. The bill was made into a two-year bill earlier this year and will be considered again in 2018.
SB 443 (Hernandez): Authorizes the use of an emergency medical services automated drug delivery system for use within an EMS provider agency, subject to certain restrictions. CSHP supported the concept of the bill and worked with Senator Hernandez’s office to make technical amendments to the language. SB 443 has passed out of the Legislature and is awaiting action from the Governor.
August 15, 2017
Telepharmacy services represents an opportunity to expand access to pharmaceutical care in underserved areas. CSHP policy supports expanded access to care with safeguards for patient safety, quality, and outcomes.
AB 401 Telepharmacy (Aguiar-Curry) would authorize the California Board of Pharmacy (BOP) to issue a remote dispensing site pharmacy license to specific medically-underserved areas. Pharmacy technicians staff the remote dispensing site while the supervising pharmacist monitors those technicians through a telepharmacy system and conducts patient consultations though video chat.
AB 401 is currently under consideration in the legislature with its next stop in the Senate Committee on Appropriations to be heard on August 21, 2017. Several key points in the bill include:
- Requires a designated pharmacist-in-charge (PIC) from the supervising pharmacy
- Allows up to two pharmacy technicians at the remote pharmacy to be supervised by the PIC, in addition to the technician(s) at the supervising pharmacy.
- Allows for establishment of a telepharmacy in a medically-underserved area, defined as 10 or more road miles from an existing pharmacy but within 150 miles from the supervising pharmacy
- Requires a remote dispensing site pharmacy dispensing more than 300 prescriptions per day to close with the option of converting to a full-service pharmacy
- Requires pharmacist consultation using telepharmacy software and equipment
Safety components of the bill include:
- Controlled substances received by a pharmacy technician must be stored separately from other inventory until a pharmacist can review and countersign. This shall also be captured on video and made accessible to the supervising pharmacy.
- Outlines specific tasks and actions the pharmacy technician cannot do
- Qualifications for the pharmacy technician working at a remote dispensing site shall be promulgated by the BOP
CSHP Government Affairs Advisory Committee (GAAC) members, lobbyist and staff have met on several occasions with the author’s staff. CSHP has identified issues of concern such as patient safety, avoiding two levels of care, pharmacist work load, pharmacy technician training, pharmacist-to-tech ratio, distance from the next pharmacy, diversion of medications, maximum prescriptions filled remotely per day, and more. Amendments have been made to the bill from CSHP’s efforts, and CSHP will continue to press for changes in interest of patient safety and the pharmacy profession.
CSHP shares the author’s intention and ultimate goal and remains optimistic that we can strike an appropriate policy balance on AB 401 that will expand access to care without impacting patient safety.
June 12, 2017
CSHP’s top legislative priority this year is SB 716 (Hernandez), which seeks to add a pharmacy technician to the California State Board of Pharmacy. Given the large numbers of these professionals practicing in California and the increasingly complex procedures they are being asked to perform, patient safety would improve by ensuring the Board of Pharmacy has pharmacy technician representatives that clearly understands the practice demands for this profession.”
Thanks to the hard work of CSHP’s leadership and government affairs team, SB 716 has made significant progress in advancing through the legislature. Here is a summary of that progress as well as a glimpse of what lies next.
Similar to prior years, CSHP has had the great privilege of partnering with Senator Hernandez, a highly respected healthcare thought leader, to tackle this issue. SB 716 was introduced on February 17. CSHP worked closely with Senator Hernandez’s team to address some concerns about the revised composition of the Board of Pharmacy. Those concerns were resolved with minor amendments that helped lead to a unanimous vote on April 24 in the Senate Business and Professions Committee.
SB 716 was a featured theme of this year’s legislative day in Sacramento, held on April 25. Dozens of CSHP members met with their local legislators to urge support for SB 716. Thanks to that advocacy and the work of our government affairs team, SB 716 then passed unanimously off the Senate floor on May 15 – a major victory!
What’s next? The bill now moves to the Assembly, where it will go through a similar process of being heard in the Assembly’s Business and Professions Committee and then receive a floor vote. While a tremendous amount of work has already gone into the bill, we are less than half way through the legislative process. The Assembly will have their own policy perspectives and overall legislative agenda priorities that we will have to carefully navigate. If we clear committee and floor votes in the Assembly, we will then need to go back to the Senate for a concurrence vote and then work to obtain the governor’s signature.
For questions or more information about ways to get involved at CSHP, please contact Megan Page at email@example.com.
May 22, 2017
Our Government Affairs team often gets asked what CSHP members can do to directly advance their profession and help support CSHP advocacy in the Legislature. One of the most powerful ways to do so is by making a contribution to CSHP's Political Action Committees, or PACs. CSHP's PACs represent a core element of its strategy to build long term political power to support our legislative advocacy.
A political action committee, or PAC, authorizes an organization to pool campaign contributions from its members and then donate those funds to campaign accounts for candidates or ballot initiatives. Most politically engaged organizations in Sacramento have at least one PAC, and sometimes multiple PACs, and often have total annual contributions in the hundreds of thousands of dollars. For example, the California Medical Association regularly spends six figures on its political contributions to legislators in order to build power and advance its agenda. CSHP uses its PACs to make political contributions to legislators that are committed to protecting patients and empowering pharmacy professionals.
CSHP made a strategic decision in 2009 to form its own political action committees. CSHP currently has two political action committees that it can draw upon to make political contributions. - the Pharmacy Professionals of California Political Action Committee (PPC-PAC) and the Pharmacy Professionals of California Small Contributors Committee (PPC-SCC). A portion of each CSHP member's dues automatically goes to the PPC-SCC, although CSHP may members may choose to opt out and instead redirect their contribution elsewhere, such as to the CSHP Foundation. CSHP members may additionally choose to make direct contributions to the PPC-PAC. Strong donations to the PPC-PAC gives CSHP the bandwidth to build relationships with a broad cross-section of the Legislature, educating legislators on the pharmacy profession and the role of pharmacy professionals in patient care.
CSHP's PACs are governed by an independent Board of Directors comprised of CSHP members. The PAC Board of Directors has typically worked in conjunction with CSHP staff and CSHP government affairs representation in order to determine legislative targets, contribution amounts and timing. Because of limited resources, CSHP has historically targeted its giving towards Chairs and members of key committees that have jurisdiction over pharmacy-related legislation - primarily the Health Committees and the Business and Professions Committees. However, the greater the level of contributions to CSHP's PACs, the more legislators CSHP can target to build relationships that are key to legislative success.
So are you looking for a way to support CSHP advocacy and advance your profession in California? Making a donation to CSHP's PAC is a powerful way to do so. Want to know how? You can make a contribution anytime by clicking here. CSHP also holds an annual PAC fundraiser at its annual Seminar. Attending the Seminar PAC fundraiser is a great way to directly meet legislators while networking with like-minded pharmacy professionals. Whichever option you may choose (or if you choose both!), know that your contribution and engagement is vital to our success -- thank you!
April 25, 2017
It has been an exciting couple of days for CSHP in Sacramento!
CSHP's top legislative priority this year is SB 716, which would add a pharmacy technician member to the California State Board of Pharmacy. Yesterday SB 716 (Hernandez) passed out of its first committee, the Senate Business and Professions Committee, on a strong 8-0 vote. CSHP's advocacy team held multiple meetings with legislative staff to secure this successful outcome. This is the first of many votes for SB 716, but we are off to a strong start.
Then today, CSHP and CphA hosted the annual California Pharmacy Legislative Day in Sacramento. Pharmacy professionals from throughout California heard from legislative and regulatory speakers in the morning, and held meetings throughout the afternoon with legislators in at the Capitol to personally advocate for their profession. Thank you to everyone who participated and made your voice heard in the Capitol.
Even if you were unable to attend this year's Legislative Day, there are still opportunities for you to advocate on behalf of our pharmacy profession. For example, in the coming weeks, CSHP will be asking you to send in letters of support for SB 716. We will also be penning a future column on ways to engage with your local legislator within the context of your community -- travel to Sacramento not required! Finally, we cannot emphasize enough the importance of engaging within your professional association, whether it be volunteering for a CSHP committee/task force or supporting CSHP's PPC-PAC with a contribution.
However you choose to engage, remember that your partnership with CSHP will lead the evolution in pharmacy!
April 10, 2017
California has made remarkable progress in recent years in enacting forward-thinking pharmacy practice laws. SB 493 (Hernandez, 2013) declared that pharmacists were healthcare providers and established new protocols that dramatically expanded access to care. Follow-up legislation expanded upon that initial success by focusing on other key aspects of the pharmacy ecosystem, such as addressing needed Title XXII reforms.
We know more work still needs to be done. One such area relates to pharmacy technicians. Pharmacy technicians play a critical role in the delivery of quality patient care and the optimal use of medications. However, despite having progressive pharmacy practice laws in other areas, California lags behind many states when it comes to pharmacy technician laws.
For example, despite their increasingly important role in the healthcare delivery system, pharmacy technicians currently do not have direct representation on the California State Board of Pharmacy. Several other states recognize the need to include pharmacy technicians in regulatory oversight proceedings and have pharmacy technicians on their respective governing boards. For example, Oregon, Washington, Arizona, and Texas each have one or two pharmacy technicians on their pharmacy boards along with pharmacist and consumer members.
With this in mind, CSHP has turned to our longtime partner and ally, Senator Hernandez, to author SB 716. This bill would increase the number of members on the California Board of Pharmacy to 14 by adding one pharmacy technician appointed by the Governor. This change will give pharmacy technicians a voice on their governing regulatory board. Adding a pharmacy technician member to the Board will also help continue the trend of empowering the pharmacy technician profession, which is important as pharmacists continue to play an ever-greater role in direct patient care.
As in years past, CSHP will be calling upon its members in the coming weeks and months to engage in support of SB 716. The bill is scheduled for its first hearing on April 17 in the Senate Business and Professions Committee, so stay tuned for more information about how to make your voice heard in support. We look forward to partnering with you to take this next step in advancing the practice of pharmacy in California.
March 20, 2017
As discussed in the last column, CSHP’s Government Affairs Advisory Committee and the Weideman Group are working through many bills that have been introduced in the legislature to identify those that are pertinent to the pharmacy profession, and to recommend legislative positions and priorities to help guide CSHP advocacy this year. While this process is ongoing, here is a sneak peak at some of the many bills that have been introduced, and that CSHP will be analyzing and potentially engaging on in the coming weeks and months.
AB 401 (Aguiar-Curry): Requires the Board of Pharmacy to issue a remote dispensing site pharmacy license and authorizes the board to establish, by regulation, locations eligible for a remote dispensing site pharmacy. The bill would also authorize a pharmacy located in California to serve as a supervising pharmacy to provide telepharmacy services for up to 3 remote dispensing site pharmacies and would require a pharmacist from the supervising pharmacy to, among other things, be capable of being on site at the remote dispensing pharmacy within 6 hours.
AB 1589 (Salas): This bill, which is likely to be amended in the future to contain further potential changes to pharmacy law, would require the Board of Pharmacy to review California’s pharmacy technician ratio on a biennial basis and require the Board to provide a report to the Legislature with recommendations if it deems changes are necessary. There has been significant interest from a variety of stakeholders, including some retail pharmacy chains, about wanting to be able to expand the pharmacy technician ratio.
SB 351 (Roth): Establishes a “hospital satellite compounding pharmacy" licensure designation, which the bill currently defines as an area licensed by the Board to perform sterile compounding that is separately licensed by the Board to perform that compounding and located outside of the hospital in another physical plant that is regulated as a general acute care hospital.
SB 419 (Portantino): Prohibits the prescribing of oxycodone to patients under 21 years of age. According to the author’s office, the bill is in response to increasing levels of prescription drug abuse by minors and young adults.
A central benefit provided to members of CSHP is our advocacy efforts in Washington D.C. and Sacramento on policy issues that affect our profession. CSHP will be closely monitoring these issues and will be engaging with policy makers on your behalf throughout the year. Stay tuned!
February 28, 2017
Each year, the California Legislature introduces and acts on thousands of legislative bills touching practically every topic under the sun. A certain number of those each year impact, or have the potential to impact, the profession of pharmacy. Advancing and supporting legislation that empowers pharmacists and improves patient health is a core function of CSHP and its government affairs team. Conversely, educating lawmakers and pushing back on misguided or potentially harmful legislative proposals remains a core part of the work CSHP undertakes in Sacramento each year.
As of the bill introduction deadline on February 17, the Legislature had introduced a total of 2,623 bills this year, 1,751 in the Assembly and 872 in the Senate. A small but significant number of those have the ability to affect your profession.
In response, CSHP’s lobbying firm (the Weideman Group) and CSHP’s Government Affairs Advisory Committee (GAAC) have already started working through that mountain of legislation to identify proposals that have potential to impact the pharmacy profession. After identifying bills germane to the pharmacy profession, the GAAC and the Weideman Group recommend positions and priorities to CSHP’s Board of Directors to focus and prioritize CSHP’s legislative involvement. CSHP’s Board makes additional changes as necessary and then approves CSHP’s legislative agenda for the year, which helps guide CSHP engagement as we move forward through the year.
How can you get involved in the coming months? Many of you already have by supporting the federal provider status legislation, HR 592 and S 109. CSHP will call on its members to engage on additional priority legislation in the coming months. Additionally, CSHP is planning the 2017 California Pharmacy Legislative Day, to take place Tuesday, April 25th, in Sacramento. In addition to making a difference on behalf of your profession and patients, CSHP members who have participated in prior legislative days will tell you the experience is rewarding and incredibly educational. More information is coming soon, so stay tuned! Finally, consider getting involved in a CSHP committee or task force. Committees like the GAAC play a direct role in guiding CSHP engagement in the Legislature. A call for volunteers will occur in March. New members are added to the committees each year, so contact the CSHP office to learn more!
February 10, 2017
Did you know that CSHP advocates for policies that empower pharmacists and improve patient safety and the optimal use of medicine at both the state and federal levels?
In partnership with the American Society of Health-System Pharmacists (ASHP), CSHP is currently supporting House of Representatives bill HR 592 and Senate bill S 109. These bills will authorize pharmacists to provide Medicare beneficiaries the same services they are already empowered to provide through their state pharmacy practice acts.
In California, we have been very successful with legislation such as SB 493, but we need to continue to advocate for additional policies that help advance the practice of pharmacy and optimal use of medicine for our patients, at both the state and federal levels. And as always, you can play a direct role in making that happen by calling on your California Senators and local Congressional Representative.
CSHP has put together a template support letter to help facilitate making your voice heard – simply click visit our website, input your name and address information, and we will do the rest!
Thank you for being a part of the CSHP advocacy team.
January 17, 2017
Legislative policy committees are an integral component of how a bill becomes law. Each legislative committee (and there are many) focuses on a specific issue area, and then hears and votes on bills germane to their subject matter area of expertise. Each legislative committee may hear hundreds of bills during the legislative session. Last week, committee chairs in the Assembly and Senate were finalized by legislative leadership in the respective houses. Committee chairs preside over hearings with each chair wielding significant influence on bills passing through his or her committee.
Most legislative bills related to the profession of pharmacy pass through four committees: the Assembly and Senate Health Committees and the Assembly and Senate Business and Professions Committees. CSHP regularly engages on bills moving through these four committees, and as such works directly with the chairs of those committees and their staff. You will be hearing more about these four committees as we move through the year, so today we’d like to share some background information on the chairs of these important committees. CSHP looks forward to working with all four chairs in 2017.
Senator Ed Hernandez, Chair, Senate Health Committee
Senator Ed Hernandez is a familiar name for members of CSHP. Hernandez represents the 22nd Senate District in Los Angeles. Hernandez was first elected to the Assembly in 2006 before being elected to the Senate in 2010. Hernandez is an optometrist by trade and owns his private practice. Hernandez is currently running for Lieutenant Governor in 2018.
As CSHP members know, Hernandez was the author of SB 493 in 2013. Hernandez has been a champion of expanding access to healthcare for Californians and was a chief implementer of the Affordable Care Act in California. Hernandez has been a strong supporter of empowering pharmacists, nurse practitioners, optometrists and other healthcare professionals to be able to do more to provide needed primary care services. Hernandez remains a legislative champion for CSHP and a partner in improving access and care for our patients.
Assemblymember Jim Wood, Chair, Assembly Health Committee
Assemblymember Wood represents the 2nd Assembly District encompassing a stretch of California’s northern coast. Wood was first elected to the Assembly in 2014, is a dentist and owns his dental practice. He is also a forensic dentistry expert.
Wood was named chair of the Assembly Health Committee last year and has done a good job learning the issues in a short period. He has been a proponent of seeking innovative ways to expand access to care, which is a challenge in his largely rural district. In the coming year, we will work to educate Assemblyman Wood about the profession and explore ways to collaborate with him on issues of expanding access to care in rural portions of the state.
Senator Jerry Hill, Chair, Senate Business and Professions Committee
Senator Hill represents Senate District 13 in the Bay Area, which includes Silicon Valley. Hill was elected to the Assembly in 2008 and then to the Senate in 2012, and was chair of the Senate Business and Professions Committee last legislative session and he remains the chair in the new 2017-2018 legislative session.
One of the issues Senator Hill has championed is microbial stewardship in responding to rising rates of antibiotic resistance. CSHP has been supportive of efforts in the past, including those led by Senator Hill, to address microbial stewardship through efforts such as improving education about the usage of antibiotics in the livestock sector or requirements around microbial stewardship plans for hospitals. He is also very interested in policy related to diversion and has been an advocate of strengthening California’s CURES database.
Assemblymember Rudy Salas, Chair, Assembly Business and Professions Committee
Assemblymember Salas represents the 32nd Assembly District in the South San Joaquin Valley. Salas was elected to the Assembly in 2012 and has been chair of the Assembly Business and Professions Committee since 2016.
Kern County, which Salas represents, faces many severe challenges related to healthcare including provider shortages, high poverty and health morbidity rates. CSHP members from Kern County participated in the development of SB 493 and brought valuable perspectives about the benefits of empowering pharmacists in rural areas. CSHP lobbyists and GAAC members will be working with Assemblyman Salas this year to strengthen his understanding of the role pharmacists play in our healthcare delivery system.
December 20, 2016
California Democrats were successful in securing supermajorities in both the Assembly and the Senate. However, the diverse Democratic caucus and a large contingent of moderate Democrats may prove challenging to legislative leadership, particularly on issues related to taxes and climate. The new legislature was officially sworn in on December 5th. Numerous bills were also introduced that day, with multiple high-profile bills related to immigration, transportation and infrastructure leading the way.
In the world of healthcare, a flurry of activity will occur in the coming days to push back on President-elect Trump and Congress's desire to repeal the Affordable Care Act without a replacement plan in place. Drug pricing is expected to be an issue of concern for many members of the legislature - the effort will be led by Senator Hernandez's bill (SB 17) to bring greater transparency to drug pricing and to provide purchasers with advanced notification of price increases. Other hot topics include the implementation of the Medicaid Managed Care rule, how to spend revenue generated by Proposition 55 which is the tax extension to fund education and healthcare and Proposition 56; the cigarette tax to fund healthcare, as well as increased access to care monitoring required by the Medi-Cal waivers. A proposal to revisit the pharmacy technician supervising ratio is expected, which will be addressed in subsequent issues of this publication as details emerge.
Additional advocacy highlights and updates from the Government Affairs Advisory Committee (GAAC) will be shared with members in the New Year!