AB 1902 Hearing Set for Assembly Business and Professions Committee

 

A hearing on AB 1902 before the California Assembly Business and Professions Committee is set for April 9, 2024.  AB 1902 would require a pharmacies to provide an accessible prescription labels upon request of a person who is blind, has low vision or is otherwise print disabled.  

The bill, introduced by Assembly Member Juan Alanis, along with co-authors Assm. Megan Dahle, Dixon, Lackey and Mathis, has already been amended once before the hearing removing references to  notify each person of the availability of accessible labels, removing patient preference and requiring cautions or warnings be on the alternative label.

The amended bill states the labels must be provided at no additional cost to the patient and be affixed to the container. The label must also be available in a timely manner comparable to the wait times of other patients, appropriate to the disability of the patient through the use of audible, large print or braille, or translated, conform to the US Access Board and National CLAS standards, and provide a compatible reading device if one is needed.

You can track AB 1902 here:  https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240AB1902

Testimony can be submitted through the witness portal https://calegislation.lc.ca.gov/Advocates/ or if that is inaccessible to you,
a letter addressed to: "Chair Marc Berman and Members of the Committee" and emailed to BOTH: Christina.Rocha@asm.ca.gov and Robert.Sumner@asm.ca.gov before April 2nd.


Basic Access is Not a Favor - Colorado HB24-1115 Hearing

March 12, 2024--The Colorado House Health and Human Services Committee heard testimony regarding HB24-1115 which would require pharmacies to provide accessible prescription labeling services like audible, large print and Braille labels for those who are living with visual or other print impairments. 

HB24-1115 is sponsored by Representative Mary Young, whose own father has vision loss, Representative Junie Joseph and Senator Steve Fenberg. It has been several years in the making and had much stakeholder engagement on both sides, including patients, disability advocates and pharmacies.

The hearing began with several amendments introduced requested by the pharmacy industry to make compliance easier. The greatest concerns to the pharmacies were the impact it would have on already low margins of profit on prescriptions.  With this in mind one of the amendments was to create a  grant fund of $80,000 to provide pharmacies hardship grants of $1500 to assist with the purchase of necessary equipment to begin offering accessible labeling services.

Pharmacists Kai Davis and Dr Lucas Smith provided testimony regarding the challenges already facing rural pharmacies and a summary of ways they are already helping patients, including QR codes that take you to drug information, compliance strip packaging and two week cartridges with reminder alarms.

During the question time, Representative David Ortiz spoke frankly, "Basic access is not an additional service. Full Stop.  Stop saying that.  Stop couching it in that language.  It is a basic human right.  And you are not "helping us" by doing the bare minimum.  Strike that from your lexicon as you speak about this.  Do you understand how ablest that is?"  At that point the Chair muted the hearing and called the committee back to order.  

Testimony was also provided by Curtis Chung of the National Federation of the Blind of Colorado who demonstrated a ScripTalk audible prescription label using his iphone. "God bless those pharmacies that have already done it.  I've said in other fora in Colorado, it's like the wild west for us blind people in the state of Colorado to get accessible prescriptions labels right now.  So having something that makes it consistently available everywhere would be a huge boon to people who cannot see, or see so badly or have other print disabilities."

Jack Johnson of Disability Law Colorado addressed the rural pharmacy request for a period of time to acquire equipment after a request so they don't have to get equipment until they get a request for accommodation. "We have been very open to working with them.  I think there is a question around how do we do that without it being a pure cure period because cure periods tend to be a problem when it comes to civil rights law. And also how do we address it if a patient has some kind of imminent risk, like they need their medication immediately? This issue should be addressed with another amendment before the floor vote.  

Testimony was also provided by Elizabeth Moran, Executive Director of the ARC of Colorado, whose sister is an individual with a developmental disability and whose father is aging with Alzheimer's. She is heartened by several measures of this bill especially the "no cost to the patient" provision, that pharmacies would provide "sustained, periodic and reasonable efforts to inform the public", and following the best practices of the US Access Board.

Later, during the closing remarks, Rep. Ortiz apologized for his heated remarks earlier, "I apologize for turning what should have been a teachable moment into a scolding; but I’m going to reiterate that teachable moment folks: which is that access—basic access—is not a favor. 

You are not “helping us out.”  It is the law.  Can you imagine if we gave out prescriptions without labels at all? How many people would die?  That’s how you have to think about this.  All you are doing is doing what the law already says you should be doing.  And making sure – it’s not just about independence – making sure that those that are living with visual impairment can access their medications safely. 

No one else talks about cost when we are talking about fire code—when abled bodies are threatened, we just do it. When we are talking about dimensions for stairs, for safety, or everything else we do when it comes to the safety of abled bodies.  We do it. 

That’s what I am trying to advocate for you all to think of when I say ‘basic access’, especially for something as essential and life-saving as medication.”

Representative Wineburg also provided closing comments, "I walked into this an absolute no today and I'll be honest, I've been flipped.  I am a solid Yes.  The demonstration from the gentleman --thank you so much -- plus everything else -- yeah, this is a good bill.  I thank you for presenting it."

The bill passed with a vote of 11 yes with 2 excused.  It heads now to appropriations. 

You can read the full text and track the status of the bill here: https://leg.colorado.gov/bills/hb24-1115

Link to the hearing audio:
HB24-1115 begins at 12:22
Rep Otiz's comments begin at 1:07:33 



Illinios and Colorado Introduce Accessible Labeling Legislation


Colorado state seal and Illinios state seal
In Colorado Representative Mary Young along with Representatives Junie Joseph and Steve Fenberg, introduced HB24-1115 Prescription Drug Label Accessibility Bill at the behest of the National Federation of the Blind of Colorado. A similar pill was introduced and dropped previously in 2020 mid pandemic.

As introduced HB24-1115 bill requires a pharmacy to provide an individual who has difficulty seeing or reading standard printed labels on prescription drug containers with access to the prescription drug label information by:

  • Including an electronic label affixed to the prescription drug container that transmits the prescription drug's label information, directions, and written instructions to an end user's external accessible device, including an individual's compatible prescription drug reader;
  • Providing a prescription drug reader at no cost to the individual;
  • Providing a prescription drug label in braille or large print; or
  • Providing the individual with a method recommended by the United States access board.


The state pharmacy board may exempt from the requirements of the bill a pharmacy that is a sole proprietorship with no more than 2 pharmacists for which, upon request of the pharmacy, the board determines compliance would create an undue burden.

In early stakeholder meetings pharmacy representatives asked for clarification and amendment to the waiver clause to include all independent pharmacies, however NFB of Colorado members said that would allow for so many exemptions, access would still be hindered considerably.

Meanwhile, in Illinois, representative Kevin Olickal, who represents the Skokie and Lincolnwood area, introduced a similar bill HB5055. This is the first bill of it's kind in Illinois.  It is awaiting assignment to committee.