California Governor Gavin Newsom signed Assembly Bill 1286 into law on October 8, 2023, introducing groundbreaking requirements aimed at reducing medication errors and pharmacist fatigue. Sponsored by Assembly Member Matt Haney and supported by the California Board of Pharmacy, the law grants the pharmacist in charge (PIC) the authority to make staffing decisions, ensuring adequate staff to prevent fatigue or distraction. Pharmacists must promptly notify store management of conditions posing an immediate risk, and the Board may issue a cease and desist order if issues aren't resolved.

Chain community pharmacies are mandated to have dedicated pharmacy staff during regular business hours, with exceptions for low prescription volumes, unless immunizations and CLIA-waived tests are offered. Technicians, certified for the task, can administer flu and COVID-19 vaccines, prepare and administer epinephrine, collect specimens for tests, and handle prescription transfers and clarifications.

Pharmacies must report medication errors confidentially to the Board within 14 days. The law defines medication error as any unauthorized variation from a prescription. The Board may publish a deidentified summary of the data. Additionally, the law deems it "unprofessional conduct" to subvert compliance and prohibits time guarantees for prescription fills unless mandated by law or contract. Despite these significant changes, the Board of Pharmacy has yet to provide additional guidance on the implementation of the new law. The nationwide impact and potential adoption by other states remain uncertain, particularly in addressing pharmacist workload concerns.