By Ariana Hussing
On January 6, 2025, the California State Board of Pharmacy (Board) submitted its Sunset Review Report Volume 1 and Volume 2, in advance of the Joint Sunset Review Oversight Hearing before the Assembly Business and Professions Committee and the Senate Business, Professions and Economic Development Committee. The Board’s enabling act, section 14001.1 of the Business and Professions Code, is scheduled to sunset on January 1, 2026, if not extended.
The Board’s Sunset Report outlines 22 new issues the Board faces, including licensing IV hydration clinics to improve safety and addressing staffing shortages by increasing the pharmacy technician-to-pharmacist ratio. They propose adding a technician to the Board, renaming the “Advanced Practice Pharmacist” license to “Advanced Pharmacist Practitioner,” enhancing oversight of nonresident and mail-order pharmacies, expanding telehealth authority, and adopting a flexible enforcement model focused on patient outcomes.
In preparation for the March 11 hearing, committee staff released a Background Paper that expressed concerns about the Board’s enforcement capacity, particularly regarding large pharmacy chains and third-party business models that may evade traditional oversight. Key issues include whether the Board has effectively used its authority to hold pharmacy owners accountable for systemic problems across multiple stores. There are also doubts about the Board’s preparedness to regulate new healthcare models like telehealth, which could threaten fair competition and patient safety by limiting access to medication history. Additionally, lawmakers are evaluating the Board’s resources and financial health, especially after recent fee increases that raised licensure costs to maximum limits. Lastly, the paper highlights regulatory gaps related to unlicensed activities, such as rogue compounding and non-compliant pharmacies, prompting legislators to seek clarification on how the Board plans to address these issues.
On March 11, 2025, the Joint Sunset Review Oversight Hearing addressed funding, enforcement delays, and evolving practice models. Legislators expressed concerns about the Board’s disciplinary case processing times and the need for expedited actions. The Board noted improvements, such as an online complaint system, and discussed potential authority for flexible actions on low-risk violations. They showed interest in telepharmacy pilot programs for rural areas. Still, they stressed the need for clear statutory authority for patient safety. Patient advocates called for better communication from the Board on complaint statuses. At the same time, licensee groups supported modernization efforts, like expanding pharmacy technician roles, but raised concerns about regulatory burdens.
To prevent its authority from expiring, the Legislature introduced AB 1503 (Committee on Business and Professions), extending the Board’s sunset date to January 1, 2030. The latest version, introduced on February 24, 2025, proposes renaming the Board to “Advanced Pharmacist Practitioner” but lacks significant reforms. Further amendments may address licensing for IV clinics, technician ratios, and telehealth pharmacy regulation. AB 1503 will have its first policy hearing on April 29, 2025, before the Assembly Business and Professions Committee, where the committee will address amendments and responses to 32 identified issues mentioned in the committee’s Background Paper.
The sunset review process for the Board has enabled legislative oversight and public input. While there has been progress in licensing and enforcement, challenges persist, especially with new pharmacy models. AB 1503 will extend the Board’s authority to 2030 and propose reforms based on this review. Ongoing discussions among lawmakers, stakeholders, and regulators are vital for enhancing California’s pharmacy oversight and healthcare quality.