California legislators have passed a first-in-the-nation bill to crack down on understaffed chain pharmacies and cut down on medication dispensing errors.
After passing in the Senate Sept. 13 on a vote of 30-9 with one senator not voting, Assembly Bill (AB) 1286 dubbed the “Stop Dangerous Pharmacies Act,” authored by Assemblyman Matt Haney (D-San Francisco), passed the Assembly on a 59-8 vote— with 13 members abstaining—the following day and is now awaiting Gov. Gavin Newsom’s signature.
The measure would authorize a pharmacist-in-charge to make staffing decisions and notify store management of any conditions that present an immediate risk of death, illness, or irreparable harm to pharmacy customers.
It also requires store management to take immediate and reasonable action to resolve the conditions and authorizes the California State Board of Pharmacy to close a pharmacy if the conditions aren’t resolved.
The bill also requires chain pharmacies to be staffed with at least one clerk or pharmacy technician fully dedicated to performing pharmacy-related services, and authorizes trained technicians under supervision to administer flu and COVID-19 shots, epinephrine, and collect specimens for lab tests.
If signed by the governor, the law would require such pharmacies to report medication errors, and requires consulting pharmacists to complete a self-assessment every two years, among other provisions.
Several concerns were ironed out during hearings on the measure, according to Mr. Haney.
“We worked a lot on this bill in the Senate and addressed the overwhelming majority of opposition concerns including the pharmacy closures, which were taken out of the bill,” Mr. Haney said in the Assembly before the Sept. 14 vote. “Senate amendments also addressed a number of the opposition’s other concerns, which includes providing more flexibility in the medication error reporting process.”
The bill will give more autonomy to pharmacy staff, he said in a statement included in the bill’s legislative analysis.
“Community chain pharmacies and the pharmacists who work for them are instrumental in delivering care to Californians,” Mr. Haney said. “However, recent news reports have highlighted alarming medication errors in this setting—including errors that have led to death. The root cause of medication errors in the community chain setting can be tied to pharmacy working conditions, like insufficient staffing, unsanitary conditions, or lack of autonomy to make clinical decisions in the best interest of the patient.”
Since 2021, Walmart and CVS announced plans to close some stores and reduce pharmacy hours this year because of a lack of workers and to lower costs, according to news reports.
In November 2022, a survey by the National Community Pharmacists Association reported 76 percent of such pharmacists said they experienced staff shortages in the latter half of that year, with almost 90 percent saying they had difficulty filling positions for pharmacy technicians.
A 2022 workforce survey conducted by the Pharmacy Technician Certification Board, a national certification organization, found 71 percent of those who responded reported volume and workload contributed to their decision to leave the profession. Also, 68 percent said staffing shortages were the reason they left.
The California Pharmacists Association, the largest state association representing the pharmacy profession, supported the bill and believes it will ensure patient safety, according to the association’s executive director.
“We believe it will help us ensure patient safety going forward and it will provide us with good data so we can continue to ensure patient safety,” the association’s CEO Susan Bonilla told The Epoch Times. “For pharmacists, patient safety really is their No 1 priority.”
The association said it also believes the measure will address some issues related to current working conditions, she added.
“We know that our pharmacists are very overworked,” Ms. Bonilla said. “I think everyone is aware of that. With the [COVID-19] pandemic, there was a big increase in the workload for pharmacists. We’re also entering flu season again.”
The United Food and Commercial Workers Western States Council also supported the legislation.
“This bill is one of the most important public health bills pending this year,” the the organization said in a statement included in the bill’s legislative analysis. “It is based on careful study, is proportional, and, according to the expert regulator, urgently needed.”
The California Community Pharmacy Coalition, however, opposed the bill, asserting it would negatively affect patient access to pharmacies.
“AB 1286 (Haney) as currently written, will have a detrimental impact on patient access to pharmacy services,” the coalition wrote in an opposition statement. “Instead the bill should be modified to expand the pharmacist to pharmacy technician ration, have the Board of Pharmacy work collaboratively with pharmacists and pharmacy companies to develop plans and perimeters to address situations where a pharmacy might need to limit services or close during emergencies, and lasty to address medication errors through a more reasonable approach to reporting.”
