The DEA Wants Your Old Meds, No Questions Asked
Medical Board of California could lose investigative powers
Legislators propose turning over investigations of doctors to the state attorney general's office, leaving the board to deal with licensing.
The Medical Board of California would be stripped of its power to investigate physician misconduct under a sweeping reform plan by legislators who say the agency has struggled to hold problem doctors accountable.
The medical board has come under fire for failing to discipline doctors accused of harming patients, particularly those suspected of recklessly prescribing drugs.
Under the proposed legislation, amended Thursday, investigations of doctors would be handled by the California attorney general, leaving the board to deal mostly with licensing doctors.
"I've heard repeated stories of difficulty in sanctioning physicians. It's cumbersome and takes a long period of time," said Sen. Curren Price (D-Los Angeles), who co-authored the proposal with Assemblyman Richard Gordon (D-Menlo Park). "I don't want anybody else to die."
Dying for Relief: A Los Angeles Times investigation
The proposed changes come a month after Price and Gordon wrote a letter to the board president threatening to "dissolve" the board unless it made significant progress in overseeing the state's more than 100,000 doctors.
The letter cited a Los Angeles Times investigative report that detailed cases in which doctors continued to practice despite having prescribed drugs to multiple patients who fatally overdosed. In some instances, the deaths occurred as the doctor was under investigation by the board and the inquiry dragged on for months or years.
Medical board President Sharon Levine, who was participating in a board hearing in Los Angeles, said she had been anticipating the move, but could not comment before the full board discussed the matter Friday.
Lynda Gledhill, a spokeswoman for Atty. Gen. Kamala Harris, said the attorney general was still evaluating the proposal.
The idea of placing investigators in the attorney general's office is not a new one.
A similar plan was proposed in 2004 by a public interest lawyer who was appointed by the Legislature to examine the medical board's oversight of physicians.
The lawyer, Julianne D'Angelo Fellmeth, wrote a report recommending that investigators be transferred to the attorney general's office, where they would work more closely with deputy attorney generals who prosecute cases of physician misconduct. The proposed move was intended to foster cooperation and streamline the process.
The plan was supported by then-Attorney Gen. Bill Lockyer, the medical board, the California Medical Assn. and other key players. Ultimately, however, there was political opposition to the idea and it was dropped from proposed legislation, Fellmeth said.
Gordon said he hoped this time would be different. He said shifting investigative responsibilities away from the medical board would not only improve investigations, it would enhance public confidence in the oversight process.
If the investigators answered to another agency, he said, "it would provide far greater assurance to the public that the medical profession is being regulated in California."
"The way it is now, you could almost look at it and ask: Is this a situation of the fox guarding the henhouse," Gordon said. "Some say they're too cozy."
Price and Gordon's desire to reform the medical board seemed to grow more urgent after a public hearing in March that was part of a review process to renew the medical board's legislative authority. Much of the hearing focused on issues raised in a series of Times articles that found that drugs prescribed by doctors played a role in nearly half of the prescription drug overdose deaths in Southern California from 2006 through 2011. The Times reported that 71 physicians prescribed drugs to three or more patients who later fatally overdosed and several had a dozen or more patients who died. In most cases, the board was unaware of the patients' deaths.
At the hearing, lawmakers heard emotional testimony from parents — many of them wearing matching T-shirts with the word "ENOUGH" — who criticized the medical board for doing little or nothing to stop doctors from harming patients with their prescription pads.
After the hearing, Price and Gordon wrote the letter to Levine urging the board to "be more responsive" and "show significant progress." The lawmakers were critical of the board's hiring record, pace of investigations and failure to more often seek immediate suspensions of doctors in the most egregious cases.
Levine said Thursday that the board "took very seriously" the lawmakers' letter and had responded point by point. She said board officials planned to meet with them May 7 to discuss matters further.
Earlier this month, a broad package of bills aimed at reducing prescription drug abuse and overdose deaths won approval from a key state Senate committee. The package included a bill that would require coroners to report prescription-involved deaths to the Medical Board of California and one that would upgrade the state's prescription drug monitoring program, known as CURES, to help officials improve tracking of overprescribing doctors and drug abusing patients.
Alameda County passes law that makes drugmakers pay for disposing of unused drugs-Tri-Valley Times July 24, 2012
In a vote closely watched by the pharmaceutical industry, Alameda County approved a law making drug companies responsible for the cost of disposing of unused portions of their products. Supervisors voted 5-0 Tuesday during a second reading of the ordinance, delayed for months by industry opposition despite support from law enforcement and environmentalists.
Alameda County is "setting a national precedent" Robert Kennedy Jr., an environmental activist, wrote in a letter to supervisors. State Sen. Loni Hancock said in a statement read during the meeting that she wants to see California adopt a similar policy. And April Rovero, founder of the National Coalition against Prescription Drug Abuse, called it "a pillar of attack on prescription drug abuse epidemic."
Pharmaceutical representatives chose not to comment during Tuesday's meeting. "We are interested in what works," BayBio lobbyist Ritchard Engelhardt said afterward. BayBio is a pharmacy trade group based in South San Francisco that has been vocal in its opposition during past meetings. The industry, he said Tuesday, is opposed to spending money on unproven, ineffective programs like the one in Alameda County.
BayBio has no plans to sue, Engelhardt said, adding that he could not speak for the manufacturers his company represents. Companies could also simply refuse to cooperate -- even though the pharmaceutical industry is paying for a pilot program in San Francisco similar to Alameda County's.
Still, the threat of litigation has made other counties cautious. "We've definitely been watching," said Marilyn Underwood, Contra Costa County's director of environmental health.` Contra Costa County wants to see how the ordinance plays out here before making any decisions about moving forward, she said.
The Alameda County Sheriff's Office operates 28 prescription drug drop-off boxes locally. With the help of the drug companies, the number of boxes could be expanded to include every location where law enforcement is present without passing the cost on to consumers, Undersheriff Richard Lucia told supervisors Tuesday.
Drop boxes are also common in other counties, including San Mateo, Contra Costa and Santa Clara. San Mateo, for example, spent about $94,000 between 2010 and the first six months of 2012 disposing of 56,655 pounds of pharmaceuticals brought to the boxes, according to Dean Peterson, director of environmental health for San Mateo County. San Mateo has been monitoring the drug disposal law but has been hesitant to follow suit because the ordinance excludes controlled substances. "We don't ask, we take them all," Tissier said.
by Jeb Bing
From human trafficking in Livermore to mothers banding together in Pleasanton to fight drug abuse among their teenagers, Alameda County District Attorney Nancy O'Malley kept local real estate professionals on the edge of their seats last Friday as she talked about crime and related issues in the Tri-Valley at a meeting hosted by the Valley Real Estate Network.
Although Oakland and the more densely populated areas of the "North County," as she calls it, get the most attention from her office, this area is not squeaky clean. In fact, of the numerous "human trafficking" cases she handled in Alameda County last year, the biggest one came out of Livermore. Pleasanton has big problems, too, especially with youth drugs. She's quick to add, however, that the reported high numbers are also due to an active adult population that is quick to report abuses rather than ignoring them. Parents here are saying they're just not going to let their kids do drugs and have adopted a "tough love" approach that hits hard at the time. Still, O'Malley credits that effort with saving children from the dire consequences of using or dealing in drugs going forward.
She gave a big "shout out" (her words) to Mothers with a Purpose, a Pleasanton group with 175 members that meets regularly in their homes to talk openly about teenage drug-related problems. With few exceptions, O'Malley said, these are high-achieving, smart kids who started raiding their parents' medicine cabinets, looking for prescription drugs, such as oxycontin. When those pills ran out, many turned to street drugs such as heroin and amphetamines, which she described as the real killers. The Mothers group, formed last year to deal with drug addicted children, has received national attention for its willingness to make other parents aware of the support and solutions to what O'Malley called a national epidemic.
With Oakland now No. 3 in the country in terms of human trafficking, it's become a major focus of the District Attorney's Office. O'Malley said her office handled 34 cases last year involving girls from 11 to 18 years old. Arrests are often made in hotels and motels, including here in the Tri-Valley, where "connections" are made through the Internet and Smart Phones. Her office recently created a program called Human Exploitation in Trafficking (HET) Watch, which encourages anyone suspicious of an illegal sex operation to call her office. It's a robust effort that is having such success that law enforcement agencies around the world have been calling O'Malley for more details.
Terminology among law enforcement agencies has also changed when discussing human trafficking and the commercial sex trade. Pimps are now child abusers, children they coerce or force into prostitution are now victims of child abuse, not prostitutes, and even the term "Johns" is out, with those individuals now called child molesters. After all, O'Malley told the Realtors, her husband's name is John and she recognized a few friends in the audience whose first names are John -- all good people whose names shouldn't be associated with those who buy sex for money, she argued.
The Tri-Valley's population is about 220,000 with Alameda County's now 1.6 million. O'Malley, who was sworn in as district attorney in January 2011, has been in the DA's office since 1984. Although crime this year is down somewhat, arrests are not, with driving while intoxicated charges totaling a new high of 1,500 last year. Police also are seeing more gang-related problems in the Tri-Valley, including several stabbings, shootings and a couple of murders in Livermore that O'Malley said were gang-related. Her office recently started a Youth Justice Leadership program with 21 youths from the Tri-Valley participating in the first phase. Their mission is to work with kids in middle school as peer advisors to help them resist pressure from older gang members to use drugs, drink and eventually join up.
O'Malley also asked Realtors to join her in a shared lookout effort to spot "hot spots" of possible criminal activities, especially in unoccupied foreclosed homes that have become a convenient place for illicit and illegal activities. She said she finds most Realtors have the same "eagle-eye" vision as police officers when driving through neighborhoods. Although on different missions, both can quickly spot something that's wrong. Hers was a message that struck home as real estate professionals agreed with the district attorney that a safe Tri-Valley is a great place to call home.