No On 46 Campaign: New Video Raises Troubling Questions About Whether Gov't Website Will Be Ready To Meet Prop 46 Mandate

SACRAMENTO, Calif., Sept. 3, 2014 /PRNewswire/ -- Today, the statewide coalition opposed to the deeply flawed Proposition 46 released a video underscoring the numerous problems with the state-run prescription-drug database that physicians and pharmacists would have to consult under Proposition 46. The concerns were voiced in recent testimony by the state expert charged with overseeing the glitch-plagued website.

See the video here:  http://www.noon46.com/terrible-joke/

Under Proposition 46, starting the day after the November 2014 election, physicians and pharmacists will be required to consult the Controlled Substance Utilization Review and Evaluation System (CURES) database before prescribing certain medications. Physicians who do not comply will be presumed negligent.

By all accounts, CURES does not have the capacity to handle the additional traffic generated by Proposition 46. Under legislation passed in 2013, SB 809 (DeSaulnier), some upgrades to the system are expected, but not until summer 2015 at the earliest – months after the Proposition 46 mandate would kick in.

This "CURES mandate flaw" puts physicians in the untenable position of either breaking their Hippocratic Oath or breaking the law.  
Background: On July 24, 2014, in testimony before the California Medical Board, the state staff person in charge of CURES repeatedly made clear that the database will not be adequate or fully functional until mid-2015 at the earliest. California Department of Justice staffer Mike Small, who administers CURES, discussed the current status of the system and the progress towards creating a 'CURES 2.0,' which is scheduled to go live in July 2015.

Since Article 2, Section 10 of the California Constitution requires the CURES provisions of Proposition 46 to go into effect the day after the election, the current system described by Small is the system doctors would be forced to use or be presumed negligent.

Below are transcribed highlights of Small's presentation, taken from video available at: https://www.youtube.com/watch?v=hEtRhk1mXas#t=12747

Small describing the current CURES system: "It has proven one thing unquestionably- that it is not robust enough, it is not sufficient enough to carry out the mission that we need…..In budget year 2011 the Legislature and the Governor did defund CURES, so we've been really running on unofficial status, recognizing that it is an important public health and public safety program, we've been trying to sustain. And as a consequence, we are unable to satisfactorily respond to the important constituencies, particularly the practitioners. We've been unable to answer phone calls in a timely basis and we've been taking far too long to process applications that we get for new registrants and new users.

Asked how long it takes today for individual practitioners to register with CURES: Right now, we have approximately a 5-6 week backlog to process the application.

Asked if the necessary fixes to CURES' registration process can occur in 2014 (if Proposition 46's mandate were to take effect): I….I don't know. I really don't know, because you know, I don't like to blow smoke up you, so….it's going to be around winter or spring, but, when exactly? Because we haven't kicked into gear with the vendor, I'd just be speculating.

Asked if the current system will be fixed before the new one is ready: "When I came on in December 2011, it was made clear to me that changes to the existing system were frozen because there was not staff funding on the program side to do anything to it. Therefore, all I can do is recognize that it is not the best system in the universe. It is not the friendliest system by any means. I get kicked out myself and it doesn't tell me 'oh, your password expired,' it kind of leaves it to your imagination. And my joke to my colleagues is 'if I tried as hard as I can to build a terrible system, I don't think I could meet this'. So yes, are we saddled with something? Absolutely. Can I do something about it? No."

On how Proposition 46 would affect the registration system: "I think our first goal is to effectuate a registration process that could accommodate any eventuality. Because I am with the Attorney General's office, and the Attorney General does title and summary for all the public initiatives, I can't comment too much on any specific situation that may force a contracted enrollment period except to say I'm going to do my darned best to meet anything that comes down the road."

Asked how long it takes for a registered user to get a response from CURES: "It can be anywhere from – and I have to be honest with you, because I ran some people that law enforcement was looking at, and they had extremely long, over 50-page histories – and the system's actually crashed on me trying to get that back. So I'm not going to give you any one firm time, but usually in the existing system it could be anywhere from moments to never. What can even be worse is trying to sign in. I think the biggest problem doctors face is that in the darn system, your password seems to expire every second breath, and then it's harder than heck to get the thing re-established. That to me is the most frustrating part.

Asked if CURES 2.0 will operate in real time: "No. In the sense that real time is real time ingestion of data, processing, and making it available; if we have legislation that only allows us to accept (data) every 7 days at the max, we cannot possibly have a real time system, even if we plan for it."

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SOURCE No On 46 Campaign