Board committee weighs changes to 'duty to consult', clarifies hospital CAMR reporting

The Board’s Enforcement & Compounding Committee spent substantial time reviewing 'duty to consult' requirements and hospital reporting obligations.

Deputy Executive Officer Julie Ansell walked members through CCR §1707.2 and committee discussions that flagged operational barriers — chiefly lack of reimbursement and competing workflow demands — that make meaningful oral consultation difficult in some retail settings. Several board members favored moving toward a less prescriptive, standard‑of‑care approach that empowers pharmacists to use professional judgment; members also asked staff to consider limited exemptions for white‑bagging or closed‑door pharmacies and to research reimbursement pathways with DHCS and commercial payers.

Public commenters and industry representatives reiterated practical concerns. Laurie Walmsley (Walgreens) generally supported allowing technician offers to counsel in appropriate workflows. John Gray (Kaiser Permanente) and other hospital representatives asked the board to be cautious about mandating consultation where it could be paternalistic; several hospital commenters asked for clarity about CAMR (medication error reporting) obligations for inpatient hospital pharmacies.

On CAMR, the committee recommended a targeted regulatory amendment to CCR §1710 to explicitly reflect prior board intent: hospital pharmacies meeting subdivision (a) are not to be treated as community pharmacies required to register for CAMR. The committee asked staff to bring draft language and the possible motion to the full board; staff noted attachment materials with proposed text.

What happens next: The committee will continue work, draft proposed regulatory edits for CCR §1710 and draft FAQ/education materials clarifying consultation expectations and CAMR applicability. Staff also flagged ongoing outreach to payers and technology stakeholders to address documentation and reimbursement barriers.

Key public comments

• Multiple pharmacists and system safety officers urged preserving consultation but making compliance operationally feasible; several recommended better documentation tools and payer engagement. • CPHA (Sean Kim) urged alignment with AB1503 implementation and the standard‑of‑care transition.

Closing note: The committee will continue the topic in future meetings and may propose rulemaking or guidance depending on staff recommendations.