00 HOUSE BILL NO. 268 01 "An Act relating to the prescription of opioids; relating to the Department of Health and 02 Social Services; relating to the practice of dentistry; relating to the practice of medicine; 03 relating to the practice of podiatry; relating to the practice of osteopathy; relating to the 04 practice of nursing; and relating to the practice of optometry." 05 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 06  * Section 1. The uncodified law of the State of Alaska is amended by adding a new section 07 to read: 08 SHORT TITLE. This Act may be known as the Consumer Advisory on Potential 09 Heroin Addiction from Opioid Use Act. 10  * Sec. 2. The uncodified law of the State of Alaska is amended by adding a new section to 11 read: 12 OPIOID ADDICTION: LEGISLATIVE FINDINGS. The legislature finds that 13 (1) the state has a considerable moral, public health, and financial interest in 14 reducing opioid and heroin addiction in the state; 01 (2) it is medically documented that opioid prescription drugs are addictive and 02 that opioid addiction is harmful and expensive to address; 03 (3) as of 2017, accepted evidence shows that approximately 80 percent of 04 people who become addicted to heroin were initially addicted to opioid prescription drugs; 05 (4) opioid prescription drug and heroin addiction interferes with an addict's 06 ability to work and provide for a stable and healthy family; 07 (5) the state's opioid epidemic damages the health of families and children and 08 affects the chances that a child will receive a healthy upbringing; 09 (6) the opioid epidemic increases crime in the state, and the presence of heroin 10 dealers in the state poses a public safety threat; 11 (7) the opioid epidemic costs the state and other entities excessive amounts of 12 money in lean budget times; 13 (8) policies that reduce the number of people who become addicted to opioids 14 and heroin will better serve citizens of the state and foster healthier families; 15 (9) many patients are not advised of the addictive effects of opioid 16 prescription drug use or that opioid prescription drug use may lead to opioid prescription drug 17 and heroin addiction; and 18 (10) requiring medical providers to inform patients of the risks associated with 19 opioid prescription drug use can help to reduce opioid prescription drug and heroin addictions 20 in the state. 21  * Sec. 3. AS 08.36.315 is amended to read: 22 Sec. 08.36.315. Grounds for discipline, suspension, or revocation of license.  23 The board may revoke or suspend the license of a dentist, or may reprimand, censure, 24 or discipline a dentist, or both, if the board finds, after a hearing, that the dentist 25 (1) used or knowingly cooperated in deceit, fraud, or intentional 26 misrepresentation to obtain a license; 27 (2) engaged in deceit, fraud, or intentional misrepresentation in the 28 course of providing or billing for professional dental services or engaging in 29 professional activities; 30 (3) advertised professional dental services in a false or misleading 31 manner; 01 (4) received compensation for referring a person to another dentist or 02 dental practice; 03 (5) has been convicted of a felony or other crime that affects the 04 dentist's ability to continue to practice dentistry competently and safely; 05 (6) engaged in the performance of patient care, or permitted the 06 performance of patient care by persons under the dentist's supervision, regardless of 07 whether actual injury to the patient occurred, 08 (A) that did not conform to minimum professional standards of 09 dentistry; or 10 (B) when the dentist, or a person under the supervision of the 11 dentist, did not have the permit, registration, or certificate required under 12 AS 08.32 or this chapter; 13 (7) failed to comply with this chapter, with a regulation adopted under 14 this chapter, or with an order of the board; 15 (8) continued to practice after becoming unfit due to 16 (A) professional incompetence; 17 (B) addiction or dependence on alcohol or other drugs that 18 impair the dentist's ability to practice safely; 19 (C) physical or mental disability; 20 (9) engaged in lewd or immoral conduct in connection with the 21 delivery of professional service to patients; 22 (10) permitted a dental hygienist or dental assistant who is employed 23 by the dentist or working under the dentist's supervision to perform a dental procedure 24 in violation of AS 08.32.110 or AS 08.36.346; 25 (11) failed to report to the board a death that occurred on the premises 26 used for the practice of dentistry within 48 hours; 27 (12) falsified or destroyed patient or facility records or failed to 28 maintain a patient or facility record for at least seven years after the date the record 29 was created; 30 (13) prescribed or dispensed an opioid in excess of the maximum 31 dosage authorized under AS 08.36.355; [OR] 01 (14) procured, sold, prescribed, or dispensed drugs in violation of a 02 law, regardless of whether there has been a criminal action or harm to the patient; or  03 (15) repeatedly and without good cause failed to provide oral and  04 written information on opioids under AS 08.36.357 before prescribing an opioid  05 to a patient. 06  * Sec. 4. AS 08.36 is amended by adding a new section to read: 07 Sec. 08.36.357. Opioid prescription information and warning; relationship  08 to causes of action. (a) Before a licensee prescribes an opioid to a patient, the licensee 09 or an agent of the licensee shall provide to the patient or the person authorized to make 10 health care decisions for the patient 11 (1) an oral statement which, in the licensee's or agent's own words, 12 includes 13 (A) the licensee's reasons for prescribing the opioid; 14 (B) any non-opioid alternatives to the prescription; 15 (C) any advantages or disadvantages of using a prescription for 16 a shorter period; and 17 (D) a warning that 18 (i) the prescription may lead to opioid addiction; 19 (ii) the danger of opioid addiction may begin to increase 20 if a prescription is extended beyond three days; 21 (iii) more than half of all people who are addicted to 22 heroin were initially addicted to opioid prescription drugs; and 23 (iv) heroin and opioid addiction pose a potentially 24 lifelong health danger; and 25 (2) a written statement, which may include graphics, prepared by the 26 Department of Health and Social Services that 27 (A) provides appropriate information conveying the potential 28 addictive and health dangers of opioids; 29 (B) provides that approximately 80 percent of people who are 30 addicted to heroin were initially addicted to opioid prescription drugs; and 31 (C) is not more than six sentences long and uses a font not 01 smaller than 16 points. 02 (b) The information and warning requirements under (a) of this section do not 03 apply to a patient receiving 04 (1) active cancer treatment; 05 (2) hospice or palliative care from a licensed provider or facility; and 06 (3) substance abuse or opioid dependence treatment. 07 (c) Nothing in this section creates a new cause of action or affects an existing 08 cause of action. 09  * Sec. 5. AS 08.64.326(a) is amended to read: 10 (a) The board may impose a sanction if the board finds after a hearing that a 11 licensee 12 (1) secured a license through deceit, fraud, or intentional 13 misrepresentation; 14 (2) engaged in deceit, fraud, or intentional misrepresentation while 15 providing professional services or engaging in professional activities; 16 (3) advertised professional services in a false or misleading manner; 17 (4) has been convicted, including conviction based on a guilty plea or 18 plea of nolo contendere, of 19 (A) a class A or unclassified felony or a crime in another 20 jurisdiction with elements similar to a class A or unclassified felony in this 21 jurisdiction; 22 (B) a class B or class C felony or a crime in another jurisdiction 23 with elements similar to a class B or class C felony in this jurisdiction if the 24 felony or other crime is substantially related to the qualifications, functions, or 25 duties of the licensee; or 26 (C) a crime involving the unlawful procurement, sale, 27 prescription, or dispensing of drugs; 28 (5) has procured, sold, prescribed, or dispensed drugs in violation of a 29 law regardless of whether there has been a criminal action or harm to the patient; 30 (6) intentionally or negligently permitted the performance of patient 31 care by persons under the licensee's supervision that does not conform to minimum 01 professional standards even if the patient was not injured; 02 (7) failed to comply with this chapter, a regulation adopted under this 03 chapter, or an order of the board; 04 (8) has demonstrated 05 (A) professional incompetence, gross negligence, or repeated 06 negligent conduct; the board may not base a finding of professional 07 incompetence solely on the basis that a licensee's practice is unconventional or 08 experimental in the absence of demonstrable physical harm to a patient; 09 (B) addiction to, severe dependency on, or habitual overuse of 10 alcohol or other drugs that impairs the licensee's ability to practice safely; 11 (C) unfitness because of physical or mental disability; 12 (9) engaged in unprofessional conduct, in sexual misconduct, or in 13 lewd or immoral conduct in connection with the delivery of professional services to 14 patients; in this paragraph, "sexual misconduct" includes sexual contact, as defined by 15 the board in regulations adopted under this chapter, or attempted sexual contact with a 16 patient outside the scope of generally accepted methods of examination or treatment of 17 the patient, regardless of the patient's consent or lack of consent, during the term of the 18 physician-patient relationship, as defined by the board in regulations adopted under 19 this chapter, unless the patient was the licensee's spouse at the time of the contact or, 20 immediately preceding the physician-patient relationship, was in a dating, courtship, 21 or engagement relationship with the licensee; 22 (10) has violated AS 18.16.010; 23 (11) has violated any code of ethics adopted by regulation by the 24 board; 25 (12) has denied care or treatment to a patient or person seeking 26 assistance from the physician if the only reason for the denial is the failure or refusal 27 of the patient to agree to arbitrate as provided in AS 09.55.535(a); 28 (13) has had a license or certificate to practice medicine in another 29 state or territory of the United States, or a province or territory of Canada, denied, 30 suspended, revoked, surrendered while under investigation for an alleged violation, 31 restricted, limited, conditioned, or placed on probation unless the denial, suspension, 01 revocation, or other action was caused by the failure of the licensee to pay fees to that 02 state, territory, or province; [OR] 03 (14) prescribed or dispensed an opioid in excess of the maximum 04 dosage authorized under AS 08.64.363; or  05 (15) repeatedly and without good cause failed to provide oral and  06 written information on opioids under AS 08.64.371 before prescribing an opioid  07 to a patient. 08  * Sec. 6. AS 08.64 is amended by adding a new section to read: 09 Sec. 08.64.371. Opioid prescription information and warning; relationship  10 to causes of action. (a) Before a licensee prescribes an opioid to a patient, the licensee 11 or an agent of the licensee shall provide to the patient or the person authorized to make 12 health care decisions for the patient 13 (1) an oral statement which, in the licensee's or agent's own words, 14 includes 15 (A) the licensee's reasons for prescribing the opioid; 16 (B) any non-opioid alternatives to the prescription; 17 (C) any advantages or disadvantages of using a prescription for 18 a shorter period; and 19 (D) a warning that 20 (i) the prescription may lead to opioid addiction; 21 (ii) the danger of opioid addiction may begin to increase 22 if a prescription is extended beyond three days; 23 (iii) more than half of all people who are addicted to 24 heroin were initially addicted to opioid prescription drugs; and 25 (iv) heroin and opioid addiction pose a potentially 26 lifelong health danger; and 27 (2) a written statement, which may include graphics, prepared by the 28 Department of Health and Social Services that 29 (A) provides appropriate information conveying the potential 30 addictive and health dangers of opioids; 31 (B) provides that approximately 80 percent of people who are 01 addicted to heroin were initially addicted to opioid prescription drugs; and 02 (C) is not more than six sentences long and uses a font not 03 smaller than 16 points. 04 (b) The information and warning requirements under (a) of this section do not 05 apply to a patient receiving 06 (1) active cancer treatment; 07 (2) hospice or palliative care from a licensed provider or facility; and 08 (3) substance abuse or opioid dependence treatment. 09 (c) Nothing in this section creates a new cause of action or affects an existing 10 cause of action. 11  * Sec. 7. AS 08.68.270 is amended to read: 12 Sec. 08.68.270. Grounds for denial, suspension, or revocation. The board 13 may deny, suspend, or revoke the license of a person who 14 (1) has obtained or attempted to obtain a license to practice nursing by 15 fraud or deceit; 16 (2) has been convicted of a felony or other crime if the felony or other 17 crime is substantially related to the qualifications, functions, or duties of the licensee; 18 (3) habitually abuses alcoholic beverages, or illegally uses controlled 19 substances; 20 (4) has impersonated a registered, advanced practice registered, or 21 practical nurse; 22 (5) has intentionally or negligently engaged in conduct that has 23 resulted in a significant risk to the health or safety of a client or in injury to a client; 24 (6) practices or attempts to practice nursing while afflicted with 25 physical or mental illness, deterioration, or disability that interferes with the 26 individual's performance of nursing functions; 27 (7) is guilty of unprofessional conduct as defined by regulations 28 adopted by the board; 29 (8) has wilfully or repeatedly violated a provision of this chapter or 30 regulations adopted under this chapter or AS 08.01; 31 (9) is professionally incompetent; 01 (10) denies care or treatment to a patient or person seeking assistance 02 if the sole reason for the denial is the failure or refusal of the patient or person seeking 03 assistance to agree to arbitrate as provided in AS 09.55.535(a); 04 (11) has prescribed or dispensed an opioid in excess of the maximum 05 dosage authorized under AS 08.68.705; [OR] 06 (12) has procured, sold, prescribed, or dispensed drugs in violation of a 07 law, regardless of whether there has been a criminal action or harm to the patient; or  08 (13) has repeatedly and without good cause failed to provide oral  09 and written information on opioids under AS 08.68.710 before prescribing an  10 opioid to a patient. 11  * Sec. 8. AS 08.68 is amended by adding a new section to article 6 to read: 12 Sec. 08.68.710. Opioid prescription information and warning; relationship  13 to causes of action. (a) Before an advanced practice registered nurse prescribes an 14 opioid to a patient, the advanced practice registered nurse or an agent of the advanced 15 practice registered nurse shall provide to the patient or the person authorized to make 16 health care decisions for the patient 17 (1) an oral statement which, in the advanced practice registered nurse's 18 or agent's own words, includes 19 (A) the advanced practice registered nurse's reasons for 20 prescribing the opioid; 21 (B) any non-opioid alternatives to the prescription; 22 (C) any advantages or disadvantages of using a prescription for 23 a shorter period; and 24 (D) a warning that 25 (i) the prescription may lead to opioid addiction; 26 (ii) the danger of opioid addiction may begin to increase 27 if a prescription is extended beyond three days; 28 (iii) more than half of all people who are addicted to 29 heroin were initially addicted to opioid prescription drugs; and 30 (iv) heroin and opioid addiction pose a potentially 31 lifelong health danger; and 01 (2) a written statement, which may include graphics, prepared by the 02 Department of Health and Social Services that 03 (A) provides appropriate information conveying the potential 04 addictive and health dangers of opioids; 05 (B) provides that approximately 80 percent of people who are 06 addicted to heroin were initially addicted to opioid prescription drugs; and 07 (C) is not more than six sentences long and uses a font not 08 smaller than 16 points. 09 (b) The information and warning requirements under (a) of this section do not 10 apply to a patient receiving 11 (1) active cancer treatment; 12 (2) hospice or palliative care from a licensed provider or facility; and 13 (3) substance abuse or opioid dependence treatment. 14 (c) Nothing in this section creates a new cause of action or affects an existing 15 cause of action. 16  * Sec. 9. AS 08.72.240 is amended to read: 17 Sec. 08.72.240. Grounds for imposition of disciplinary sanctions. The board 18 may impose disciplinary sanctions when the board finds after a hearing that a licensee 19 (1) secured a license through deceit, fraud, or intentional 20 misrepresentation; 21 (2) engaged in deceit, fraud, or intentional misrepresentation in the 22 course of providing professional services or engaging in professional activities; 23 (3) advertised professional services in a false or misleading manner; 24 (4) has been convicted of a felony or other crime that affects the 25 licensee's ability to continue to practice competently and safely; 26 (5) intentionally or negligently engaged in or permitted the 27 performance of patient care by persons under the licensee's supervision that does not 28 conform to minimum professional standards regardless of whether actual injury to the 29 patient occurred; 30 (6) failed to comply with this chapter, with a regulation adopted under 31 this chapter, or with an order of the board; 01 (7) continued to practice after becoming unfit due to 02 (A) professional incompetence; 03 (B) failure to keep informed of or use current professional 04 theories or practices; 05 (C) addiction or severe dependency on alcohol or other drugs 06 that impairs the licensee's ability to practice safely; 07 (D) physical or mental disability; 08 (8) engaged in lewd or immoral conduct in connection with the 09 delivery of professional service to patients; 10 (9) failed to refer a patient to a physician after ascertaining the 11 presence of ocular or systemic conditions requiring management by a physician; 12 (10) prescribed or dispensed an opioid in excess of the maximum 13 dosage authorized under AS 08.72.276; 14 (11) procured, sold, prescribed, or dispensed drugs in violation of a 15 law, regardless of whether there has been a criminal action or harm to the patient; or  16 (12) repeatedly and without good cause failed to provide oral and  17 written information on opioids under AS 08.72.277 before prescribing an opioid  18 to a patient. 19  * Sec. 10. AS 08.72 is amended by adding a new section to read: 20 Sec. 08.72.277. Opioid prescription information and warning; relationship  21 to causes of action. (a) Before a licensee prescribes an opioid to a patient, the licensee 22 or an agent of the licensee shall provide to the patient or the person authorized to make 23 health care decisions for the patient 24 (1) an oral statement which, in the licensee's or agent's own words, 25 includes 26 (A) the licensee's reasons for prescribing the opioid; 27 (B) any non-opioid alternatives to the prescription; 28 (C) any advantages or disadvantages of using a prescription for 29 a shorter period; and 30 (D) a warning that 31 (i) the prescription may lead to opioid addiction; 01 (ii) the danger of opioid addiction may begin to increase 02 if a prescription is extended beyond three days; 03 (iii) more than half of all people who are addicted to 04 heroin were initially addicted to opioid prescription drugs; and 05 (iv) heroin and opioid addiction pose a potentially 06 lifelong health danger; and 07 (2) a written statement, which may include graphics, prepared by the 08 Department of Health and Social Services that 09 (A) provides appropriate information conveying the potential 10 addictive and health dangers of opioids; 11 (B) provides that approximately 80 percent of people who are 12 addicted to heroin were initially addicted to opioid prescription drugs; and 13 (C) is not more than six sentences long and uses a font not 14 smaller than 16 points. 15 (b) The information and warning requirements under (a) of this section do not 16 apply to a patient receiving 17 (1) active cancer treatment; 18 (2) hospice or palliative care from a licensed provider or facility; and 19 (3) substance abuse or opioid dependence treatment. 20 (c) Nothing in this section creates a new cause of action or affects an existing 21 cause of action. 22  * Sec. 11. The uncodified law of the State of Alaska is amended by adding a new section to 23 read: 24 TRANSITION: REGULATIONS. The Department of Health and Social Services may 25 adopt regulations necessary to implement the changes made by secs. 4, 6, 8, and 10 of this 26 Act. The regulations take effect under AS 44.62 (Administrative Procedure Act), but not 27 before the effective date of the relevant provision of this Act implemented by the regulation.