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HB 159: "An Act relating to the prescription of opioids; establishing the Voluntary Nonopioid Directive Act; relating to the controlled substance prescription database; relating to the practice of dentistry; relating to the practice of medicine; relating to the practice of podiatry; relating to the practice of osteopathy; relating to the practice of nursing; relating to the practice of optometry; relating to the practice of veterinary medicine; related to the duties of the Board of Pharmacy; and providing for an effective date."

00                             HOUSE BILL NO. 159                                                                          
01 "An Act relating to the prescription of opioids; establishing the Voluntary Nonopioid                                   
02 Directive Act; relating to the controlled substance prescription database; relating to the                              
03 practice of dentistry; relating to the practice of medicine; relating to the practice of                                
04 podiatry; relating to the practice of osteopathy; relating to the practice of nursing;                                  
05 relating to the practice of optometry; relating to the practice of veterinary medicine;                                 
06 related to the duties of the Board of Pharmacy; and providing for an effective date."                                   
07 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:                                                                
08    * Section 1. AS 13 is amended by adding a new chapter to read:                                                     
09                 Chapter 55. Voluntary Nonopioid Directive Act.                                                        
10 Sec. 13.55.010. Nonopioid directive; revocation; other requirements. (a)                                              
11 An individual 18 years of age or older may execute a voluntary nonopioid directive in                                   
12 a format prescribed by the department and available in an electronic format. The                                        
13 instruction must state the individual's directive that the individual not be administered                               
01       or prescribed an opioid.                                                                                          
02            (b)  Regulations for the implementation of the voluntary nonopioid directive                                 
03       under this section shall                                                                                          
04                 (1)  include verification by a health care provider and comply with the                                 
05       written consent requirements under 42 U.S.C. 290dd-2(b) and 42 C.F.R. Part 2;                                     
06                 (2)  provide standard procedures for an individual to submit a voluntary                                
07       nonopioid directive to a health care provider or hospital;                                                        
08                 (3)  include appropriate exemptions for emergency medical personnel;                                    
09                 (4)  ensure confidentiality of a voluntary nonopioid directive;                                         
10 (5)  ensure exemptions for an opioid used for treatment of substance                                                    
11       abuse or opioid dependence.                                                                                       
12 (c)  An individual may revoke a voluntary nonopioid directive at any time in                                            
13 writing or orally. An individual's guardian, conservator, or other person appointed by                                  
14 the individual or a court to manage the individual's health care may revoke an                                          
15 individual's voluntary nonopioid directive at any time in writing or orally. An                                         
16 individual's guardian, conservator, or other person appointed by the individual or a                                    
17 court to manage the individual's health care may not execute a voluntary nonopioid                                      
18       directive on behalf of the individual.                                                                            
19 (d)  An individual may submit a voluntary nonopioid directive to a health care                                          
20       provider or a hospital.                                                                                           
21 Sec. 13.55.020. Obligations of health care providers and hospitals. A health                                          
22 care provider, a hospital, or an employee of a health care provider or hospital may not                                 
23 be subject to disciplinary action by the health care provider's or the employee's                                       
24 professional licensing board and may not be subject to civil or criminal liability for                                  
25 failure to administer, prescribe, or dispense an opioid to an individual who has                                        
26       executed a voluntary nonopioid directive.                                                                         
27 Sec. 13.55.030. Prescriptions presumed valid. A prescription presented to a                                           
28 pharmacy is presumed to be valid and a pharmacist shall not be subject to discipline                                    
29 by the pharmacist's professional licensing board or held civilly or criminally liable for                               
30 dispensing a controlled substance in contradiction to a person's voluntary nonopioid                                    
31       directive.                                                                                                        
01            Sec. 13.55.040. Effect of this chapter. Nothing is this chapter shall be                                   
02       construed to                                                                                                    
03                 (1)  alter an advance health care directive under AS 13.52 (Health Care                                 
04       Decisions Act);                                                                                                   
05                 (2)  limit prescribing, dispensing, or administering an opioid overdose                                 
06       drug;                                                                                                             
07                 (3)  limit an authorized health care provider or pharmacist from                                        
08       prescribing, dispensing, or administering an opioid for the treatment of substance                                
09       abuse or opioid dependence.                                                                                       
10 Sec. 13.55.100. Definitions. In this chapter, unless the context otherwise                                            
11       requires,                                                                                                         
12                 (1)  "department" means the Department of Health and Social Services;                                   
13                 (2)  "health care provider" has the meaning given in AS 09.65.340;                                      
14                 (3)  "hospital" has the meaning given in AS 13.52.268;                                                  
15 (4)  "opioid" includes the opium and opiate substances and opium and                                                    
16       opiate derivatives listed in AS 11.71.140;                                                                        
17                 (5)  "opioid overdose drug" has the meaning given in AS 09.65.340.                                      
18 Sec. 13.55.110. Short title. This chapter may be known as the Voluntary                                               
19       Nonopioid Directive Act.                                                                                          
20    * Sec. 2. AS 08.36.070(a), as amended by sec. 5, ch. 25, SLA 2016, is amended to read:                             
21            (a)  The board shall                                                                                         
22 (1)  provide for the examination of applicants and the credentialing,                                                   
23       registration, and licensure of those applicants it finds qualified;                                               
24 (2)  maintain a registry of licensed dentists, licensed dental hygienists,                                              
25       and registered dental assistants who are in good standing;                                                        
26 (3)  affiliate with the American Association of Dental Boards and pay                                                   
27       annual dues to the association;                                                                                   
28 (4)  hold hearings and order the disciplinary sanction of a person who                                                  
29       violates this chapter, AS 08.32, or a regulation of the board;                                                    
30 (5)  supply forms for applications, licenses, permits, certificates,                                                    
31       registration documents, and other papers and records;                                                             
01 (6)  enforce the provisions of this chapter and AS 08.32 and adopt or                                                   
02 amend the regulations necessary to make the provisions of this chapter and AS 08.32                                     
03       effective;                                                                                                        
04 (7)  adopt regulations ensuring that renewal of a license, registration, or                                             
05 certificate under this chapter or a license, certificate, or endorsement under AS 08.32                                 
06 is contingent upon proof of continued professional competence; regulations must                                     
07 require that a licensee receive not less than two hours of education in pain                                        
08 management and opioid use and addiction in the two years preceding an                                               
09 application for renewal of a license, unless the licensee has demonstrated to the                                   
10 satisfaction of the board that the licensee does not currently hold a valid federal                                 
11       Drug Enforcement Administration registration number;                                                          
12 (8)  at least annually, cause to be published on the Internet and in a                                                  
13 newspaper of general circulation in each major city in the state a summary of                                           
14       disciplinary actions the board has taken during the preceding calendar year;                                      
15 (9)  issue permits or certificates to licensed dentists, licensed dental                                                
16 hygienists, and dental assistants who meet standards determined by the board for                                        
17       specific procedures that require specific education and training;                                                 
18 (10)  require that a licensed dentist who has a federal Drug                                                            
19 Enforcement Administration registration number register with the controlled substance                                   
20       prescription database under AS 17.30.200(o).                                                                      
21    * Sec. 3. AS 08.36.110(a) is amended to read:                                                                      
22            (a)  An applicant for a license to practice dentistry shall                                                  
23                 (1)  provide certification to the board that the applicant                                              
24 (A)  is a graduate of a dental school that, at the time of                                                              
25            graduation, is approved by the board;                                                                        
26 (B)  has successfully passed a written examination approved by                                                          
27            the board;                                                                                                   
28 (C)  has not had a license to practice dentistry revoked,                                                               
29            suspended, or voluntarily surrendered in this state or another state;                                        
30 (D)  is not the subject of an adverse decision based upon a                                                             
31 complaint, investigation, review procedure, or other disciplinary proceeding                                            
01 within the five years immediately preceding application, or of an unresolved                                            
02 complaint, investigation, review procedure, or other disciplinary proceeding,                                           
03            undertaken by a state, territorial, local, or federal dental licensing jurisdiction;                         
04 (E)  is not the subject of an unresolved or an adverse decision                                                         
05 based upon a complaint, investigation, review procedure, or other disciplinary                                          
06 proceeding, undertaken by a state, territorial, local, or federal dental licensing                                      
07 jurisdiction or law enforcement agency that relates to criminal or fraudulent                                           
08 activity, dental malpractice, or negligent dental care and that adversely reflects                                      
09 on the applicant's ability or competence to practice dentistry or on the safety or                                      
10            well-being of patients;                                                                                      
11 (F)  is not the subject of an adverse report from the National                                                          
12 Practitioner Data Bank or the American Association of Dental Boards                                                     
13 Clearinghouse for Board Actions that relates to criminal or fraudulent activity,                                        
14            or dental malpractice;                                                                                       
15 (G)  is not impaired to an extent that affects the applicant's                                                          
16            ability to practice dentistry;                                                                               
17 (H)  has not been convicted of a crime that adversely reflects on                                                       
18 the applicant's ability or competency to practice dentistry or that jeopardizes                                         
19            the safety or well-being of a patient;                                                                       
20 (2)  pass, to the satisfaction of the board, written, clinical, and other                                               
21       examinations administered or approved by the board; and                                                           
22 (3)  meet the other qualifications for a license established by the board                                               
23 by regulation, including education in pain management and opioid use and                                            
24 addiction in the two years preceding the application for a license, unless the                                      
25 applicant has demonstrated to the satisfaction of the board that the applicant                                      
26 does not currently hold a valid federal Drug Enforcement Administration                                             
27       registration number; approved education may include dental school coursework.                                 
28    * Sec. 4. AS 08.36.315 is amended to read:                                                                         
29 Sec. 08.36.315. Grounds for discipline, suspension, or revocation of license.                                         
30 The board may revoke or suspend the license of a dentist, or may reprimand, censure,                                    
31       or discipline a dentist, or both, if the board finds after a hearing that the dentist                             
01                 (1)  used or knowingly cooperated in deceit, fraud, or intentional                                      
02       misrepresentation to obtain a license;                                                                            
03                 (2)  engaged in deceit, fraud, or intentional misrepresentation in the                                  
04       course of providing or billing for professional dental services or engaging in                                    
05       professional activities;                                                                                          
06                 (3)  advertised professional dental services in a false or misleading                                   
07       manner;                                                                                                           
08                 (4)  received compensation for referring a person to another dentist or                                 
09       dental practice;                                                                                                  
10 (5)  has been convicted of a felony or other crime that affects the                                                     
11       dentist's ability to continue to practice dentistry competently and safely;                                       
12 (6)  engaged in the performance of patient care, or permitted the                                                       
13 performance of patient care by persons under the dentist's supervision, regardless of                                   
14       whether actual injury to the patient occurred,                                                                    
15 (A)  that did not conform to minimum professional standards of                                                          
16            dentistry; or                                                                                                
17 (B)  when the dentist, or a person under the supervision of the                                                         
18 dentist, did not have the permit, registration, or certificate required under                                           
19            AS 08.32 or this chapter;                                                                                    
20 (7)  failed to comply with this chapter, with a regulation adopted under                                                
21       this chapter, or with an order of the board;                                                                      
22                 (8)  continued to practice after becoming unfit due to                                                  
23                      (A)  professional incompetence;                                                                    
24 (B)  addiction or dependence on alcohol or other drugs that                                                             
25            impair the dentist's ability to practice safely;                                                             
26                      (C)  physical or mental disability;                                                                
27 (9)  engaged in lewd or immoral conduct in connection with the                                                          
28       delivery of professional service to patients;                                                                     
29 (10)  permitted a dental hygienist or dental assistant who is employed                                                  
30 by the dentist or working under the dentist's supervision to perform a dental procedure                                 
31       in violation of AS 08.32.110 or AS 08.36.346;                                                                     
01                 (11)  failed to report to the board a death that occurred on the premises                               
02       used for the practice of dentistry within 48 hours;                                                               
03                 (12)  falsified or destroyed patient or facility records or failed to                                   
04       maintain a patient or facility record for at least seven years after the date the record                          
05       was created;                                                                                                  
06                 (13)  prescribed or dispensed an opioid in excess of the maximum                                    
07       dosage authorized under AS 08.36.355; or                                                                      
08                 (14)  procured, sold, prescribed, or dispensed drugs in violation of                                
09       a law,  regardless of whether there has been a criminal action or patient harm.                               
10    * Sec. 5. AS 08.36 is amended by adding a new section to read:                                                     
11 Sec. 08.36.355. Maximum dosage for opioid prescriptions. (a) A licensee                                               
12 may not issue an initial prescription for an opioid that exceeds a seven-day supply to                                  
13       an adult patient for outpatient use.                                                                              
14 (b)  A licensee may not issue a prescription for an opioid that exceeds a seven-                                        
15 day supply to a minor. At the time a licensee writes a prescription for an opioid for a                                 
16 minor, the licensee shall discuss with the parent or guardian of the minor why the                                      
17       prescription is necessary and the risks associated with opioid use.                                               
18 (c)  Notwithstanding (a) and (b) of this section, a licensee may issue a                                                
19 prescription for an opioid that exceeds a seven-day supply to an adult or minor patient                                 
20 if, in the professional judgment of the licensee, more than a seven-day supply of an                                    
21       opioid is necessary for                                                                                           
22 (1)  the patient's chronic pain management; the licensee may write a                                                    
23 prescription for an opioid for the quantity needed to treat the patient's medical                                       
24 condition or chronic pain; the licensee shall document in the patient's medical record                                  
25 the condition triggering the prescription of an opioid in a quantity that exceeds a                                     
26 seven-day supply and indicate that a nonopioid alternative was not appropriate to                                       
27       address the medical condition; or                                                                                 
28 (2)  a patient who is unable to access a practitioner within the time                                                   
29 necessary for a refill of the seven-day supply because of a logistical or travel barrier;                               
30 the licensee may write a prescription for an opioid for the quantity needed to treat the                                
31 patient for the time that the patient is unable to access a practitioner; the licensee shall                            
01 document in the patient's medical record the reason for the prescription of an opioid in                                
02 a quantity that exceeds a seven-day supply and indicate that a nonopioid alternative                                    
03 was not appropriate to address the medical condition; in this paragraph, "practitioner"                                 
04       has the meaning given in AS 11.71.900.                                                                            
05            (d)  In this section,                                                                                        
06                 (1)  "adult" means                                                                                      
07                      (A)  a person who has reached 18 years of age; or                                                  
08                      (B)  an emancipated minor;                                                                         
09                 (2)  "emancipated minor" means a minor whose disabilities have been                                     
10       removed for general purposes  under AS 09.55.590;                                                                 
11 (3)  "minor" means a person under 18 years of age who is not an                                                         
12       emancipated minors.                                                                                               
13    * Sec. 6. AS 08.36.370 is amended by adding a new paragraph to read:                                               
14 (10)  "opioid" includes the opium and opiate substances and opium and                                                   
15       opiate derivatives listed in AS 11.71.140.                                                                        
16    * Sec. 7. AS 08.64.107 is amended to read:                                                                         
17 Sec. 08.64.107. Regulation of physician assistants and intensive care                                                 
18 paramedics. The board shall adopt regulations regarding the licensure of physician                                    
19 assistants and registration of mobile intensive care paramedics, and the medical                                        
20       services that they may perform, including the                                                                   
21 (1)  educational and other qualifications, including education in pain                                              
22       management and opioid use and addiction;                                                                      
23                 (2)  application and registration procedures;                                                           
24                 (3)  scope of activities authorized; and                                                                
25                 (4)  responsibilities of the supervising or training physician.                                         
26    * Sec. 8. AS 08.64.200(a) is amended to read:                                                                      
27 (a)  Except for foreign medical graduates as specified in AS 08.64.225, each                                            
28       physician applicant shall                                                                                         
29 (1)  submit a certificate of graduation from a legally chartered medical                                                
30 school accredited by the Association of American Medical Colleges and the Council                                       
31       on Medical Education of the American Medical Association;                                                         
01 (2)  submit a certificate from a recognized hospital or hospitals                                                       
02 certifying that the applicant has satisfactorily performed the duties of resident                                       
03       physician or intern for a period of                                                                               
04 (A)  one year if the applicant graduated from medical school                                                            
05 before January 1, 1995, as evidenced by a certificate of completion of the first                                        
06 year of postgraduate training from the facility where the applicant completed                                           
07            the first year of internship or residency; and                                                               
08 (B)  two years if the applicant graduated from medical school                                                           
09 on or after January 1, 1995, as evidenced by a certificate of completion of the                                         
10 first year of postgraduate training from the facility where the applicant                                               
11 completed the first year of internship or residency and a certificate of                                                
12 successful completion of one additional year of postgraduate training at a                                              
13            recognized hospital;                                                                                         
14 (3)  submit a list of negotiated settlements or judgments in claims or                                                  
15 civil actions alleging medical malpractice against the applicant, including an                                          
16       explanation of the basis for each claim or action; and                                                            
17 (4)  not have a license to practice medicine in another state, country,                                                 
18       province, or territory that is currently suspended or revoked for disciplinary reasons;                       
19 (5)  receive education in pain management and opioid use and                                                        
20 addiction, unless the applicant has demonstrated to the satisfaction of the board                                   
21 that the applicant does not currently hold a valid federal Drug Enforcement                                         
22 Administration registration number; an applicant may include past professional                                      
23       experience or professional education as proof of professional competence.                                     
24    * Sec. 9. AS 08.64.205 is amended to read:                                                                         
25 Sec. 08.64.205. Qualifications for osteopath applicants. Each osteopath                                               
26 applicant shall meet the qualifications prescribed in AS 08.64.200(a)(3), (4), and (5)                              
27       [AND (4)] and shall                                                                                             
28 (1)  submit a certificate of graduation from the legally chartered school                                               
29       of osteopathy approved by the board;                                                                              
30 (2)  submit a certificate from a hospital approved by the American                                                      
31 Medical Association or the American Osteopathic Association that certifies that the                                     
01 osteopath has satisfactorily completed and performed the duties of intern or resident                                   
02       physician for                                                                                                     
03 (A)  one year if the applicant graduated from a school of                                                               
04 osteopathy before January 1, 1995, as evidenced by a certificate of completion                                          
05 of the first year of postgraduate training from the facility where the applicant                                        
06            completed the first year of internship or residency; or                                                      
07 (B)  two years if the applicant graduated from a school of                                                              
08 osteopathy on or after January 1, 1995, as evidenced by a certificate of                                                
09 completion of the first year of postgraduate training from the facility where the                                       
10 applicant completed the first year of internship or residency and a certificate of                                      
11 successful completion of one additional year of postgraduate training at a                                              
12            recognized hospital;                                                                                         
13 (3)  take the examination required by AS 08.64.210 or be certified to                                                   
14 practice by the National Board of Examiners for Osteopathic Physicians and                                              
15       Surgeons;                                                                                                     
16 (4) receive education in pain management and opioid use and                                                         
17 addiction, unless the applicant has demonstrated to the satisfaction of the board                                   
18 that the applicant does not currently hold a valid federal Drug Enforcement                                         
19 Administration registration number; an applicant may include past professional                                      
20       experience or professional education as proof of professional competence.                                     
21    * Sec. 10. AS 08.64.209(a) is amended to read:                                                                     
22 (a)  Each applicant who desires to practice podiatry shall meet the                                                     
23       qualifications prescribed in AS 08.64.200(a)(3), (4), and (5) [AND (4)] and shall                             
24 (1)  submit a certificate of graduation from a legally chartered school of                                              
25       podiatry approved by the board;                                                                                   
26 (2)  take the examination required by AS 08.64.210; the State Medical                                                   
27 Board shall call to its aid a podiatrist of known ability who is licensed to practice                                   
28 podiatry to assist in the examination and licensure of applicants for a license to                                      
29       practice podiatry;                                                                                                
30 (3)  receive education in pain management and opioid use and                                                        
31 addiction, unless the applicant has demonstrated to the satisfaction of the board                                   
01       that the applicant does not currently hold a valid federal Drug Enforcement                                   
02       Administration registration number; an applicant may include past professional                                
03       experience or professional education as proof of professional competence;                                     
04                 (4)  meet other qualifications of experience or education which the                                 
05       board may require.                                                                                                
06    * Sec. 11. AS 08.64.225(a) is amended to read:                                                                     
07            (a)  Applicants who are graduates of medical colleges not accredited by the                                  
08       Association of American Medical Colleges and the Council on Medical Education of                                  
09       the American Medical Association shall                                                                            
10 (1)  meet the requirements of AS 08.64.200(a)(3), (4), and (5) [AND                                                 
11       (4)] and 08.64.255;                                                                                               
12                 (2)  have successfully completed                                                                        
13 (A)  three years of postgraduate training as evidenced by a                                                             
14 certificate of completion of the first year of postgraduate training from the                                           
15 facility where the applicant completed the first year of internship or residency                                        
16 and a certificate of successful completion of two additional years of                                                   
17            postgraduate training at a recognized hospital; or                                                           
18 (B)  other requirements establishing proof of competency and                                                            
19 professional qualifications as the board considers necessary to ensure the                                              
20 continued protection of the public adopted at the discretion of the board by                                            
21 regulation, including education in pain management and opioid use and                                               
22 addiction, unless the applicant has demonstrated to the satisfaction of the                                         
23 board that the applicant does not currently hold a valid federal Drug                                               
24 Enforcement Administration registration number; an applicant may                                                    
25 include past professional experience or professional education as proof of                                          
26            professional competence; and                                                                             
27 (3) have passed examinations as specified by the board in                                                               
28            regulations.                                                                                                 
29    * Sec. 12. AS 08.64.250 is amended to read:                                                                        
30 Sec. 08.64.250. License by credentials. The board may waive the examination                                           
31 requirement and license by credentials if the physician, osteopath, or podiatry                                     
01       applicant meets the requirements of AS 08.64.200, 08.64.205, or 08.64.209, submits                            
02       proof of continued competence as required by regulation, pays the required fee, and                           
03       has                                                                                                             
04                 (1)  an active license from a board of medical examiners established                                    
05       under the laws of a state or territory of the United States or a province or territory of                         
06       Canada issued after thorough examination; or                                                                      
07                 (2)  passed an examination as specified by the board in regulations.                                    
08     * Sec. 13. AS 08.64.250 is amended by adding a new subsection to read:                                            
09            (b)  Regulations under (a) of this section must require the applicant                                        
10 demonstrate professional competence in pain management and addiction disorders; an                                      
11 applicant may include past professional experience or professional education as proof                                   
12       of professional competence.                                                                                       
13    * Sec. 14. AS 08.64.312 is amended to read:                                                                        
14 Sec. 08.64.312. Continuing education requirements. (a) The board shall                                                
15 promote a high degree of competence in the practice of medicine, osteopathy, and                                    
16 podiatry by requiring every licensee of medicine, osteopathy, and podiatry                                      
17       [PHYSICIAN LICENSED] in the state to fulfill continuing education requirements.                                   
18 (b)  Before a license may be renewed, the licensee shall submit evidence to the                                         
19 board or its designee that continuing education requirements prescribed by regulations                                  
20 adopted by the board have been met, including not less than two hours of education                                  
21 in pain management and opioid use and addiction for every 40 hours of                                               
22 education received, unless the licensee demonstrates to the satisfaction of the                                     
23 board that the licensee's practice does not include pain management and opioid                                      
24       treatment or prescribing.                                                                                     
25 (c)  The board or its designee may exempt a physician, osteopath, or                                                
26 podiatrist from the requirements of (b) of this section upon an application by the                                  
27 physician, osteopath, or podiatrist giving evidence satisfactory to the board or its                                
28 designee that the physician, osteopath, or podiatrist is unable to comply with the                                  
29 requirements because of extenuating circumstances. However, a person may not be                                         
30 exempted from more than 15 hours of continuing education in a five-year period; a                                   
31 person may not be exempted from the requirement to receive at least two hours                                       
01 of education in pain management and opioid use and addiction, unless the person                                     
02 has demonstrated to the satisfaction of the board that the person does not                                          
03 currently hold a valid federal Drug Enforcement Administration registration                                         
04       number .                                                                                                      
05    * Sec. 15. AS 08.64.326(a) is amended to read:                                                                     
06            (a)  The board may impose a sanction if the board finds after a hearing that a                               
07       licensee                                                                                                          
08                 (1)  secured a license through deceit, fraud, or intentional                                            
09       misrepresentation;                                                                                                
10 (2)  engaged in deceit, fraud, or intentional misrepresentation while                                                   
11       providing professional services or engaging in professional activities;                                           
12                 (3)  advertised professional services in a false or misleading manner;                                  
13 (4)  has been convicted, including conviction based on a guilty plea or                                                 
14       plea of nolo contendere, of                                                                                       
15 (A)  a class A or unclassified felony or a crime in another                                                             
16 jurisdiction with elements similar to a class A or unclassified felony in this                                          
17            jurisdiction;                                                                                                
18 (B)  a class B or class C felony or a crime in another jurisdiction                                                     
19 with elements similar to a class B or class C felony in this jurisdiction if the                                        
20 felony or other crime is substantially related to the qualifications, functions, or                                     
21            duties of the licensee; or                                                                                   
22 (C)  a crime involving the unlawful procurement, sale,                                                                  
23            prescription, or dispensing of drugs;                                                                        
24 (5)  has procured, sold, prescribed, or dispensed drugs in violation of a                                               
25       law regardless of whether there has been a criminal action or patient harm;                                   
26 (6)  intentionally or negligently permitted the performance of patient                                                  
27 care by persons under the licensee's supervision that does not conform to minimum                                       
28       professional standards even if the patient was not injured;                                                       
29 (7)  failed to comply with this chapter, a regulation adopted under this                                                
30       chapter, or an order of the board;                                                                                
31                 (8)  has demonstrated                                                                                   
01 (A)  professional incompetence, gross negligence, or repeated                                                           
02 negligent conduct; the board may not base a finding of professional                                                     
03 incompetence solely on the basis that a licensee's practice is unconventional or                                        
04            experimental in the absence of demonstrable physical harm to a patient;                                      
05                      (B)  addiction to, severe dependency on, or habitual overuse of                                    
06            alcohol or other drugs that impairs the licensee's ability to practice safely;                               
07                      (C)  unfitness because of physical or mental disability;                                           
08                 (9)  engaged in unprofessional conduct, in sexual misconduct, or in                                     
09       lewd or immoral conduct in connection with the delivery of professional services to                               
10 patients; in this paragraph, "sexual misconduct" includes sexual contact, as defined by                                 
11 the board in regulations adopted under this chapter, or attempted sexual contact with a                                 
12 patient outside the scope of generally accepted methods of examination or treatment of                                  
13 the patient, regardless of the patient's consent or lack of consent, during the term of the                             
14 physician-patient relationship, as defined by the board in regulations adopted under                                    
15 this chapter, unless the patient was the licensee's spouse at the time of the contact or,                               
16 immediately preceding the physician-patient relationship, was in a dating, courtship,                                   
17       or engagement relationship with the licensee;                                                                     
18                 (10)  has violated AS 18.16.010;                                                                        
19 (11)  has violated any code of ethics adopted by regulation by the                                                      
20       board;                                                                                                            
21 (12)  has denied care or treatment to a patient or person seeking                                                       
22 assistance from the physician if the only reason for the denial is the failure or refusal                               
23       of the patient to agree to arbitrate as provided in AS 09.55.535(a); [OR]                                         
24 (13)  has had a license or certificate to practice medicine in another                                                  
25 state or territory of the United States, or a province or territory of Canada, denied,                                  
26 suspended, revoked, surrendered while under investigation for an alleged violation,                                     
27 restricted, limited, conditioned, or placed on probation unless the denial, suspension,                                 
28 revocation, or other action was caused by the failure of the licensee to pay fees to that                               
29       state, territory, or province; or                                                                             
30 (14)  prescribed or dispensed an opioid in excess of the maximum                                                    
31       dosage authorized under AS 08.64.363.                                                                         
01    * Sec. 16. AS 08.64 is amended by adding a new section to article 3 to read:                                       
02            Sec. 08.64.363. Maximum dosage for opioid prescriptions. (a) A licensee                                    
03       may not issue an initial prescription for an opioid that exceeds a seven-day supply to                            
04       an adult patient for outpatient use.                                                                              
05 (b)  A licensee may not issue a prescription for an opioid that exceeds a seven-                                        
06 day supply to a minor. At the time a licensee writes a prescription for an opioid for a                                 
07 minor, the licensee shall discuss with the parent or guardian of the minor why the                                      
08       prescription is necessary and the risks associated with opioid use.                                               
09            (c)  Notwithstanding (a) and (b) of this section, a licensee may issue a                                     
10 prescription for an opioid that exceeds a seven-day supply to an adult or minor patient                                 
11 if, in the professional medical judgment of the licensee, more than a seven-day supply                                  
12       of an opioid is necessary for                                                                                     
13 (1)  the patient's acute medical condition, chronic pain management,                                                    
14 pain associated with a cancer diagnosis, or pain experienced while the patient is in                                    
15 palliative care; the licensee may write a prescription for an opioid for the quantity                                   
16 needed to treat the patient's medical condition, chronic pain, pain associated with a                                   
17 cancer diagnosis, or pain experienced while the patient is in palliative care; the                                      
18 licensee shall document in the patient's medical record the condition triggering the                                    
19 prescription of an opioid in a quantity that exceeds a seven-day supply and indicate                                    
20       that a nonopioid alternative was not appropriate to address the medical condition;                                
21 (2)  a patient who is unable to access a practitioner within the time                                                   
22 necessary for a refill of the seven-day supply because of a logistical or travel barrier;                               
23 the licensee may write a prescription for an opioid for the quantity needed to treat the                                
24 patient for the time that the patient is unable to access a practitioner; the licensee shall                            
25 document in the patient's medical record the reason for the prescription of an opioid in                                
26 a quantity that exceeds a seven-day supply and indicate that a nonopioid alternative                                    
27 was not appropriate to address the medical condition; in this paragraph, "practitioner"                                 
28       has the meaning given in AS 11.71.900; or                                                                         
29 (3) the treatment of a patient's substance abuse or opioid dependence;                                                  
30 the licensee may write a prescription for an opioid approved for the treatment of                                       
31 substance abuse or opioid dependence for the quantity needed to treat the patient's                                     
01 substance abuse or opioid dependence; the licensee shall document in the patient's                                      
02 medical record the reason for the prescription of an opioid approved for the treatment                                  
03 of substance abuse or opioid dependence in a quantity that exceeds a seven-day supply                                   
04 and indicate that a nonopioid alternative was not appropriate for the treatment of                                      
05       substance abuse or opioid dependence.                                                                             
06            (d)  In this section,                                                                                        
07                 (1)  "adult" means                                                                                      
08                      (A)  a person who has reached 18 years of age; or                                                  
09                      (B)  an emancipated minor;                                                                         
10 (2)  "emancipated minor" means a minor whose disabilities have been                                                     
11       removed for general purposes under AS 09.55.590;                                                                  
12 (3)  "minor" means a person under 18 years of age who is not an                                                         
13       emancipated minor.                                                                                                
14    * Sec. 17. AS 08.64.364(c) is amended to read:                                                                     
15 (c)  The board may not impose disciplinary sanctions on a physician for                                                 
16 prescribing, dispensing, or administering a prescription drug that is a controlled                                      
17 substance or botulinum toxin if the requirements under (a) of this section and                                      
18 AS 08.64.363 are met and the physician prescribes, dispenses, or administers the                                    
19 controlled substance or botulinum toxin when an appropriate licensed health care                                        
20 provider is present with the patient to assist the physician with examination, diagnosis,                               
21       and treatment.                                                                                                    
22    * Sec. 18. AS 08.64.380 is amended by adding a new paragraph to read:                                              
23 (7)  "opioid" includes the opium and opiate substances and opium and                                                    
24       opiate derivatives listed in AS 11.71.140.                                                                        
25    * Sec. 19. AS 08.68.270 is amended to read:                                                                        
26 Sec. 08.68.270. Grounds for denial, suspension, or revocation. The board                                              
27       may deny, suspend, or revoke the license of a person who                                                          
28 (1)  has obtained or attempted to obtain a license to practice nursing by                                               
29       fraud or deceit;                                                                                                  
30 (2)  has been convicted of a felony or other crime if the felony or other                                               
31       crime is substantially related to the qualifications, functions, or duties of the licensee;                       
01                 (3)  habitually abuses alcoholic beverages, or illegally uses controlled                                
02       substances;                                                                                                       
03                 (4)  has impersonated a registered or practical nurse;                                                  
04                 (5)  has intentionally or negligently engaged in conduct that has                                       
05       resulted in a significant risk to the health or safety of a client or in injury to a client;                      
06                 (6)  practices or attempts to practice nursing while afflicted with                                     
07       physical or mental illness, deterioration, or disability that interferes with the                                 
08       individual's performance of nursing functions;                                                                    
09                 (7)  is guilty of unprofessional conduct as defined by regulations                                      
10       adopted by the board;                                                                                             
11 (8)  has wilfully or repeatedly violated a provision of this chapter or                                                 
12       regulations adopted under this chapter or AS 08.01;                                                               
13                 (9)  is professionally incompetent;                                                                     
14 (10)  denies care or treatment to a patient or person seeking assistance                                                
15 if the sole reason for the denial is the failure or refusal of the patient or person seeking                            
16       assistance to agree to arbitrate as provided in AS 09.55.535(a);                                              
17 (11)  prescribed or dispensed an opioid in excess of the maximum                                                    
18       dosage authorized under AS 08.68.705; or                                                                      
19 (12)  has procured, sold, prescribed, or dispensed drugs in violation                                               
20       of a law, regardless of whether there has been a criminal action or patient harm.                             
21    * Sec. 20. AS 08.68.276 is amended to read:                                                                        
22 Sec. 08.68.276. Continuing competence required. A license to practice                                                 
23 nursing may not be renewed unless the nurse has complied with continuing                                                
24 competence requirements established by the board by regulation. Regulations for                                     
25 renewal of a license of an advanced practice registered nurse must require a                                        
26 licensee receive not less than two hours of education in pain management and                                        
27 opioid use and addiction in the two years preceding an application for renewal of                                   
28 a license, unless the licensee has demonstrated to the satisfaction of the board                                    
29 that the licensee does not currently hold a valid federal Drug Enforcement                                          
30       Administration registration number.                                                                           
31    * Sec. 21. AS 08.68 is amended by adding a new section to article 6 to read:                                       
01 Sec. 08.68.705. Maximum dosage for opioid prescriptions. (a) An advanced                                              
02 practice registered nurse licensed in the state may not issue an initial prescription for                               
03       an opioid that exceeds a seven-day supply to an adult patient for outpatient use.                                 
04 (b)  An advanced practice registered nurse licensed in the state may not issue a                                        
05 prescription for an opioid that exceeds a seven-day supply to a minor. At the time an                                   
06 advanced practice registered nurse writes a prescription for an opioid for a minor, the                                 
07 advanced practice registered nurse shall discuss with the parent or guardian of the                                     
08       minor why the prescription is necessary and the risks associated with opioid use.                                 
09 (c)  Notwithstanding (a) and (b) of this section, an advanced practice registered                                       
10 nurse licensed in the state may issue a prescription for an opioid that exceeds a seven-                                
11 day supply to an adult or minor patient if, in the professional judgment of the                                         
12 advanced practice registered nurse, more than a seven-day supply of an opioid is                                        
13       necessary for                                                                                                     
14 (1)  the patient's acute medical condition, chronic pain management,                                                    
15 pain associated with a cancer diagnosis, or pain experienced while the patient is in                                    
16 palliative care; the advanced practice registered nurse may write a prescription for an                                 
17 opioid for the quantity needed to treat the patient's medical condition, chronic pain,                                  
18 pain associated with a cancer diagnosis, or pain experienced while the patient is in                                    
19 palliative care; the advanced practice registered nurse shall document in the patient's                                 
20 medical record the condition triggering the prescription of an opioid in a quantity that                                
21 exceeds a seven-day supply and indicate that a nonopioid alternative was not                                            
22       appropriate to address the medical condition; or                                                                  
23 (2)  a patient who is unable to access a practitioner within the time                                                   
24 necessary for a refill of the seven-day supply because of a logistical or travel barrier;                               
25 the advanced practice registered nurse may write a prescription for an opioid for the                                   
26 quantity needed to treat the patient for the time that the patient is unable to access a                                
27 practitioner; the advanced practice registered nurse shall document in the patient's                                    
28 medical record the reason for the prescription of an opioid in a quantity that exceeds a                                
29 seven-day supply and indicate that a nonopioid alternative was not appropriate to                                       
30 address the medical condition; in this paragraph, "practitioner" has the meaning given                                  
31       in AS 11.71.900.                                                                                                  
01 (e)  This section does not authorize an advanced practice registered nurse to                                           
02 prescribe a controlled substance if that advanced practice registered nurse is not                                      
03 otherwise authorized to prescribe a controlled substance under policies, procedures, or                                 
04       regulations issued or adopted by the board.                                                                       
05            (f)  In this section,                                                                                        
06                 (1)  "adult" means                                                                                      
07                      (A)  a person who has reached 18 years of age; or                                                  
08                      (B)  an emancipated minor;                                                                         
09                 (2)  "emancipated minor" means a minor whose disabilities have been                                     
10       removed for general purposes under AS 09.55.590;                                                                  
11 (3)  "minor" means a person under 18 years of age who is not an                                                         
12       emancipated minor.                                                                                                
13    * Sec. 22. AS 08.68.850 is amended by adding a new paragraph to read:                                              
14 (12)  "opioid" includes the opium and opiate substances and opium and                                                   
15       opiate derivatives listed in AS 11.71.140.                                                                        
16    * Sec. 23. AS 08.72.170 is amended to read:                                                                        
17 Sec. 08.72.170. Licensure by credentials. The board shall issue a license by                                          
18       credentials to an applicant who                                                                                   
19 (1)  is a graduate of a school or college of optometry recognized by the                                                
20       board;                                                                                                            
21 (2)  has passed a written examination approved by the board that is                                                     
22 designed to test the applicant's knowledge of the laws of Alaska governing the practice                                 
23       of optometry and the regulations adopted under those laws;                                                        
24 (3)  holds a current license to practice optometry in another state or                                                  
25 territory of the United States or in a province of Canada that has licensure                                            
26 requirements that the board determines are equivalent to those established under this                                   
27       chapter;                                                                                                          
28 (4)  at some time in the past, received a license to practice optometry                                                 
29 from another state or territory of the United States or from a province of Canada that                                  
30 required the person to have passed the National Board of Examiners in Optometry                                         
31       examination to qualify for licensure;                                                                             
01 (5)  was engaged in the active licensed clinical practice of optometry in                                               
02 a state or territory of the United States or in a province of Canada for at least 3,120                                 
03       hours during the 36 months preceding the date of application under this section;                                  
04 (6)  has not committed an act in any jurisdiction that would have                                                       
05 constituted a violation of this chapter or regulations adopted under this chapter at the                                
06       time the act was committed; and                                                                                   
07 (7)  has not been disciplined by an optometry licensing entity in another                                               
08 jurisdiction and is not the subject of a pending disciplinary proceeding conducted by                                   
09 an optometry licensing entity in another jurisdiction; however, the board may consider                                  
10 the disciplinary action and, in the board's discretion, determine if the person is                                      
11       qualified for licensure;                                                                                      
12 (8)  has received education in pain management and opioid use and                                                   
13 addiction adequate for the practice of optometry, unless the applicant has                                          
14 demonstrated to the satisfaction of the board that the applicant does not                                           
15 currently hold a valid federal Drug Enforcement Administration registration                                         
16 number; an applicant may include past professional experience or professional                                       
17       education as proof of professional competence.                                                                
18    * Sec. 24. AS 08.72.181(d) is amended to read:                                                                     
19 (d)  Before a license may be renewed, the licensee shall submit to the board                                            
20       evidence that, in the four years preceding the application for renewal, the licensee has                          
21 (1)  completed eight hours of continuing education, approved by the                                                     
22       board, concerning the use and prescription of pharmaceutical agents;                                              
23 (2)  completed seven hours of continuing education, approved by the                                                     
24 board, concerning the injection of nontopical therapeutic pharmaceutical agents;                                        
25       [AND]                                                                                                             
26 (3)  completed at least two hours of education in pain management                                                   
27 and opioid use and addiction, unless the applicant has demonstrated to the                                          
28 satisfaction of the board that the applicant does not currently hold a valid federal                                
29       Drug Enforcement Administration registration number; and                                                      
30 (4)  met other continuing education requirements as may be prescribed                                               
31       by regulations of the board to ensure the continued protection of the public.                                     
01    * Sec. 25. AS 08.72.240 is amended to read:                                                                        
02            Sec. 08.72.240. Grounds for imposition of disciplinary sanctions. The board                                
03 may impose disciplinary sanctions when the board finds after a hearing that a licensee                                  
04 (1)  secured a license through deceit, fraud, or intentional                                                            
05       misrepresentation;                                                                                                
06                 (2)  engaged in deceit, fraud, or intentional misrepresentation in the                                  
07       course of providing professional services or engaging in professional activities;                                 
08                 (3)  advertised professional services in a false or misleading manner;                                  
09                 (4)  has been convicted of a felony or other crime which affects the                                    
10       licensee's ability to continue to practice competently and safely;                                                
11 (5)  intentionally or negligently engaged in or permitted the                                                           
12 performance of patient care by persons under the licensee's supervision which does not                                  
13 conform to minimum professional standards regardless of whether actual injury to the                                    
14       patient occurred;                                                                                                 
15 (6)  failed to comply with this chapter, with a regulation adopted under                                                
16       this chapter, or with an order of the board;                                                                      
17                 (7)  continued to practice after becoming unfit due to                                                  
18                      (A)  professional incompetence;                                                                    
19 (B)  failure to keep informed of or use current professional                                                            
20            theories or practices;                                                                                       
21 (C)  addiction or severe dependency on alcohol or other drugs                                                           
22            which impairs the licensee's ability to practice safely;                                                     
23                      (D)  physical or mental disability;                                                                
24 (8)  engaged in lewd or immoral conduct in connection with the                                                          
25       delivery of professional service to patients;                                                                     
26 (9)  failed to refer a patient to a physician after ascertaining the                                                    
27       presence of ocular or systemic conditions requiring management by a physician;                                
28 (10)  procured, sold, prescribed, or dispensed drugs in violation of                                                
29       a law, regardless of whether there has been a criminal action or patient harm.                              
30    * Sec. 26. AS 08.80.030(b), as amended by sec. 12, ch. 25, SLA 2016, is amended to read:                           
31 (b)  In order to fulfill its responsibilities, the board has the powers necessary                                       
01       for implementation and enforcement of this chapter, including the power to                                        
02                 (1)  elect a president and secretary from its membership and adopt rules                                
03       for the conduct of its business;                                                                                  
04                 (2)  license by examination or by license transfer the applicants who are                               
05       qualified to engage in the practice of pharmacy;                                                                  
06                 (3)  assist the department in inspections and investigations for                                        
07       violations of this chapter, or of any other state or federal statute relating to the practice                     
08       of pharmacy;                                                                                                      
09                 (4)  adopt regulations to carry out the purposes of this chapter;                                       
10 (5)  establish and enforce compliance with professional standards and                                                   
11       rules of conduct for pharmacists engaged in the practice of pharmacy;                                             
12 (6)  determine standards for recognition and approval of degree                                                         
13 programs of schools and colleges of pharmacy whose graduates shall be eligible for                                      
14 licensure in this state, including the specification and enforcement of requirements for                                
15       practical training, including internships;                                                                        
16 (7)  establish for pharmacists and pharmacies minimum specifications                                                    
17 for the physical facilities, technical equipment, personnel, and procedures for the                                     
18 storage, compounding, and dispensing of drugs or related devices, and for the                                           
19       monitoring of drug therapy;                                                                                       
20 (8)  enforce the provisions of this chapter relating to the conduct or                                                  
21 competence of pharmacists practicing in the state, and the suspension, revocation, or                                   
22       restriction of licenses to engage in the practice of pharmacy;                                                    
23 (9)  license and regulate the training, qualifications, and employment of                                               
24       pharmacy interns and pharmacy technicians;                                                                        
25 (10)  issue licenses to persons engaged in the manufacture and                                                          
26       distribution of drugs and related devices;                                                                        
27 (11)  establish and maintain a controlled substance prescription                                                        
28       database as provided in AS 17.30.200;                                                                             
29 (12)  establish standards for the independent administration by a                                                       
30 pharmacist of vaccines and related emergency medications under AS 08.80.168,                                            
31       including the completion of an immunization training program approved by the board;                               
01 (13)  require that a licensed pharmacist [WHO HAS A FEDERAL                                                             
02 DRUG ENFORCEMENT ADMINISTRATION REGISTRATION NUMBER]                                                                    
03       register with the controlled substance prescription database under AS 17.30.200(o).                               
04    * Sec. 27. AS 08.80 is amended by adding a new section to read:                                                    
05 Sec. 08.80.340. Prescription for an opioid; voluntary request for lesser                                            
06 quantity. (a) A pharmacist filling a prescription for an opioid that is a schedule II or                              
07 III controlled substance under federal law may, at the request of the individual for                                    
08 whom the prescription is written, dispense the prescribed substance in a lesser quantity                                
09 than prescribed. The remaining quantity in excess of the quantity requested by the                                      
10       individual shall be void.                                                                                       
11 (b)  A pharmacist who dispenses less than the full quantity of a prescribed                                             
12 substance under (a) of this section shall notify the prescribing practitioner within 72                                 
13 hours and submit information as to the amount of the controlled substance prescribed                                    
14 and the amount dispensed in the controlled substance prescription database under                                        
15 AS 17.30; in this section, "opioid" includes the opium and opiate substances and                                        
16       opium and opiate derivatives listed in AS 11.71.140.                                                              
17 (c)  Nothing in this section shall be construed to prevent substitution of an                                           
18       equivalent drug under AS 08.80.295.                                                                               
19    * Sec. 28. AS 08.98.050(a) is amended to read:                                                                     
20            (a)  The board shall                                                                                         
21 (1)  establish examination requirements for eligible applicants for                                                     
22       licensure to practice veterinary medicine;                                                                        
23 (2)  examine, or cause to be examined, eligible applicants for licensure                                                
24       or registration;                                                                                                  
25 (3)  approve the issuance of licenses and student permits to qualified                                                  
26       applicants;                                                                                                       
27 (4)  establish standards for the practice of veterinary medicine by                                                     
28       regulation;                                                                                                       
29 (5)  conduct disciplinary proceedings in accordance with this chapter;                                                  
30 in addition, the board may deny, suspend, or revoke the license of a person who                                     
31 has procured, sold, prescribed, or dispensed drugs in violation of a law,                                           
01       regardless of whether there has been a criminal action;                                                       
02                 (6)  adopt regulations requiring proof of continued competency before a                                 
03       license is renewed;                                                                                               
04                 (7)  as requested by the department, monitor the standards and                                          
05       availability of veterinary services provided in the state and report its findings to the                          
06       department;                                                                                                       
07                 (8)  collect, or cause to be collected, data concerning the practice of                                 
08       veterinary technology by veterinary technicians in the state and submit the data to the                           
09       department for maintenance;                                                                                       
10                 (9)  establish, by regulation, educational and training requirements for                                
11                      (A)  the issuance of student permits; and                                                          
12 (B)  the delegation of duties by veterinarians licensed under this                                                      
13            chapter to veterinary technicians;                                                                       
14 (10)  require that a licensee who has a federal Drug Enforcement                                                    
15 Administration registration number register with the controlled substance                                           
16       prescription database under AS 17.30.200(o);                                                                  
17 (11)  identify resources and develop educational materials to assist                                                
18 licensees to identify an animal owner who may be at risk for abusing or misusing                                    
19       an opioid.                                                                                                    
20    * Sec. 29. AS 17.30.200(a) is amended to read:                                                                     
21 (a)  The controlled substance prescription database is established in the Board                                         
22 of Pharmacy. The purpose of the database is to contain data as described in this                                        
23 section regarding every prescription for a schedule IA, IIA, IIIA, IVA, or VA                                           
24 controlled substance under state law or a schedule I, II, III, IV, or V controlled                                      
25 substance under federal law dispensed in the state to a person other than those                                         
26 administered to a patient at a health care facility or a correctional facility, except                              
27 when prescribing opioids to an inmate at the time of the inmate's release. The                                      
28 Department of Commerce, Community, and Economic Development shall assist the                                            
29       board and provide necessary staff and equipment to implement this section.                                        
30    * Sec. 30. AS 17.30.200(b), as amended by sec. 23, ch. 25, SLA 2016, is amended to read:                           
31 (b)  The pharmacist-in-charge of each licensed or registered pharmacy,                                                  
01 regarding each schedule II, III, or IV controlled substance under federal law dispensed                                 
02 by a pharmacist under the supervision of the pharmacist-in-charge, and each                                             
03 practitioner who directly dispenses a schedule II, III, or IV controlled substance under                                
04 federal law other than those administered to a patient at a health care facility or a                               
05 correctional facility, except when prescribing opioids to an inmate at the time of                                  
06 the inmate's release, shall submit to the board, by a procedure and in a format                                     
07 established by the board, the following information for inclusion in the database on at                                 
08       least a daily [WEEKLY] basis:                                                                                 
09 (1)  the name of the prescribing practitioner and the practitioner's                                                    
10 federal Drug Enforcement Administration registration number or other appropriate                                        
11       identifier;                                                                                                       
12                 (2)  the date of the prescription;                                                                      
13 (3)  the date the prescription was filled and the method of payment; this                                               
14 paragraph does not authorize the board to include individual credit card or other                                       
15       account numbers in the database;                                                                                  
16 (4)  the name, address, and date of birth of the person for whom the                                                    
17       prescription was written;                                                                                         
18                 (5)  the name and national drug code of the controlled substance;                                       
19                 (6)  the quantity and strength of the controlled substance dispensed;                                   
20 (7)  the name of the drug outlet dispensing the controlled substance;                                                   
21       and                                                                                                               
22 (8)  the name of the pharmacist or practitioner dispensing the controlled                                               
23       substance and other appropriate identifying information.                                                          
24    * Sec. 31. AS 17.30.200(d), as amended by sec. 25, ch. 25, SLA 2016, is amended to read:                           
25 (d)  The database and the information contained within the database are                                                 
26 confidential, and are not public records, and are not subject to public disclosure [,                               
27 AND MAY NOT BE SHARED WITH THE FEDERAL GOVERNMENT]. The                                                                 
28 board shall undertake to ensure the security and confidentiality of the database and the                                
29 information contained within the database. The board may allow access to the                                            
30 database only to the following persons, and in accordance with the limitations                                          
31       provided and regulations of the board:                                                                            
01 (1)  personnel of the board regarding inquiries concerning licensees or                                                 
02 registrants of the board or personnel of another board or agency concerning a                                           
03 practitioner under a search warrant, subpoena, or order issued by an administrative law                                 
04       judge or a court;                                                                                                 
05 (2)  authorized board personnel or contractors as required for                                                          
06       operational and review purposes;                                                                                  
07 (3)  a licensed practitioner having authority to prescribe controlled                                                   
08 substances or an agent or employee of the practitioner whom the practitioner has                                        
09 authorized to access the database on the practitioner's behalf, to the extent the                                       
10 information relates specifically to a current patient of the practitioner to whom the                                   
11 practitioner is prescribing or considering prescribing a controlled substance; the agent                                
12       or employee must be licensed or registered under AS 08;                                                           
13 (4)  a licensed or registered pharmacist having authority to dispense                                                   
14 controlled substances or an agent or employee of the pharmacist whom the pharmacist                                     
15 has authorized to access the database on the pharmacist's behalf, to the extent the                                     
16 information relates specifically to a current patient to whom the pharmacist is                                         
17 dispensing or considering dispensing a controlled substance; the agent or employee                                      
18       must be licensed or registered under AS 08;                                                                       
19 (5)  federal, state, and local law enforcement authorities may receive                                                  
20 printouts of information contained in the database under a search warrant, subpoena,                                    
21 or order issued by a court establishing probable cause for the access and use of the                                    
22       information;                                                                                                      
23 (6)  an individual who is the recipient of a controlled substance                                                       
24 prescription entered into the database may receive information contained in the                                         
25 database concerning the individual on providing evidence satisfactory to the board that                                 
26 the individual requesting the information is in fact the person about whom the data                                     
27 entry was made and on payment of a fee set by the board under AS 37.10.050 that                                         
28       does not exceed $10;                                                                                              
29 (7)  a licensed pharmacist employed by the Department of Health and                                                     
30 Social Services who is responsible for administering prescription drug coverage for                                     
31 the medical assistance program under AS 47.07, to the extent that the information                                       
01       relates specifically to prescription drug coverage under the program;                                             
02 (8)  a licensed pharmacist, licensed practitioner, or authorized                                                        
03 employee of the Department of Health and Social Services responsible for utilization                                    
04 review of prescription drugs for the medical assistance program under AS 47.07, to the                                  
05 extent that the information relates specifically to utilization review of prescription                                  
06       drugs provided to recipients of medical assistance;                                                               
07                 (9)  the state medical examiner, to the extent that the information                                     
08       relates specifically to investigating the cause and manner of a person's death;                                   
09                 (10)  an authorized employee of the Department of Health and Social                                     
10 Services may receive information from the database that does not disclose the identity                                  
11 of a patient, prescriber, dispenser, or dispenser location, for the purpose of identifying                              
12 and monitoring public health issues in the state; however, the information provided                                     
13 under this paragraph may include the region of the state in which a patient, prescriber,                                
14       and dispenser are located and the specialty of the prescriber; and                                                
15 (11)  a practitioner, pharmacist, or clinical staff employed by an Alaska                                               
16 tribal health organization, including commissioned corps officers of the United States                                  
17 Public Health Service employed under a memorandum of agreement; in this                                                 
18 paragraph, "Alaska tribal health organization" has the meaning given to "tribal health                                  
19       program" in 25 U.S.C. 1603.                                                                                       
20    * Sec. 32. AS 17.30.200(e) as enacted by sec. 27, ch. 25, SLA 2016, is amended to read:                            
21 (e)  The failure of a pharmacist-in-charge, pharmacist, or practitioner to                                              
22 register, review the database or submit information to the database as required under                               
23 this section is grounds for the board to take disciplinary action against the license or                                
24 registration of the pharmacy or pharmacist or for another licensing board to take                                       
25       disciplinary action against a practitioner.                                                                       
26    * Sec. 33. AS 17.30.200(p), as enacted by sec. 34, ch. 25, SLA 2016, is amended to read:                           
27 (p)  The board shall promptly notify the State Medical Board, the Board of                                              
28 Nursing, the Board of Dental Examiners, [AND] the Board of Examiners in                                                 
29 Optometry, and the Board of Veterinary Examiners when a practitioner registers                                      
30       with the database under (o) of this section.                                                                      
31    * Sec. 34. AS 17.30.200(q), as enacted by sec. 34, ch. 25, SLA 2016, is amended to read:                           
01 (q)  The board is authorized to provide unsolicited notification to a pharmacist,                                   
02 to a practitioner's licensing board, or practitioner if a patient has received one or                               
03 more prescriptions for controlled substances in quantities or with a frequency                                          
04 inconsistent with generally recognized standards of safe practice. An unsolicited                                   
05       notification to a practitioner's licensing board under this section                                           
06                 (1)  also must be provided to the practitioner;                                                     
07                 (2)  is confidential;                                                                               
08                 (3)  may not disclose information confidential under this section;                                  
09                 (4)  may be in a summary form sufficient to provide notice of the                                   
10       basis for the unsolicited notification.                                                                       
11    * Sec. 35. AS 17.30.200(r), as enacted by sec. 34, ch. 25, SLA 2016, is amended to read:                           
12 (r)  The board shall update the database on at least a daily [WEEKLY] basis                                         
13       with the information submitted to the board under (b) of this section.                                            
14    * Sec. 36. AS 17.30.200 is amended by adding new subsections to read:                                              
15 (t)  Notwithstanding (q) of this section, the board may issue to a practitioner                                         
16 periodic unsolicited reports that detail and compare the practitioner's opioid                                          
17 prescribing practice with other practitioners of the same occupation and similar                                        
18 specialty. A report issued under this subsection is confidential and shall be issued only                               
19 to a practitioner. The board may adopt regulations to implement this subsection;                                        
20 regulations may address the types of controlled substances to be included in an                                         
21 unsolicited report, quantities dispensed, medication strength, and other factors                                        
22       determined by the board.                                                                                          
23 (u)  In this section, "opioid" includes the opium and opiate substances and                                             
24       opium and opiate derivatives listed in AS 11.71.140.                                                              
25    * Sec. 37. AS 18.05.040(a) is amended to read:                                                                   
26            (a)  The commissioner shall adopt regulations consistent with existing law for                               
27 (1)  the time, manner, information to be reported, and persons                                                          
28 responsible for reporting for each disease or other condition of public health                                          
29       importance on the list developed under AS 18.15.370;                                                              
30                 (2)  cooperation with local boards of health and health officers;                                       
31 (3)  protection and promotion of the public health and prevention of                                                    
01       disability and mortality;                                                                                         
02 (4)  the transportation of dead bodies, except that the commissioner                                                    
03 may not require that a dead body be embalmed unless the body is known to carry a                                        
04 communicable disease or embalmment is otherwise required for the protection of the                                      
05       public health or for compliance with federal law;                                                                 
06                 (5)  carrying out the purposes of this chapter;                                                         
07                 (6)  the conduct of its business and for carrying out the provisions of                                 
08       laws of the United States and the state relating to public health;                                                
09                 (7)  establishing the divisions and local offices and advisory groups                                   
10 necessary or considered expedient to carry out or assist in carrying out a duty or power                                
11       assigned to it;                                                                                                   
12 (8)  the voluntary certification of laboratories to perform diagnostic,                                                 
13 quality control, or enforcement analyses or examinations based on recognized or                                         
14 tentative standards of performance relating to analysis and examination of food,                                        
15 including seafood, milk, water, and specimens from human beings submitted by                                            
16       licensed physicians and nurses for analysis;                                                                      
17 (9)  the regulation of quality and purity of commercially compressed                                                    
18       oxygen sold for human respiration;                                                                                
19 (10)  establishing confidentiality and security standards for information                                               
20       and records received under AS 18.15.355 - 18.15.395;                                                          
21 (11)  implementation of AS 13.55 (Voluntary Nonopioid Directive                                                     
22       Act).                                                                                                         
23    * Sec. 38. Sections 52 and 73, ch. 25, SLA 2016, are repealed.                                                     
24    * Sec. 39. The uncodified law of the State of Alaska is amended by adding a new section to                         
25 read:                                                                                                                   
26 TRANSITION: REGULATIONS. (a) The Department of Health and Social Services                                               
27 and the Department of Commerce, Community, and Economic Development may adopt                                           
28 regulations necessary to implement the changes made by this Act. The regulations take effect                            
29 under AS 44.62 (Administrative Procedure Act), but not before the effective date of the                                 
30 relevant provision of this Act implemented by the regulation.                                                           
31 (b)  The Department of Commerce, Community, and Economic Development and the                                            
01 board that regulates an occupation that includes a practitioner who is required to register with                        
02 the controlled substance prescription database under AS 17.30.200 shall adopt regulations to                            
03 implement the changes made by AS 08.98.050(a), as amended by sec. 28 of this Act. The                                   
04 regulations take effect under AS 44.62 (Administrative Procedure Act), but not before the                               
05 effective date of sec. 28 of this Act.                                                                                  
06    * Sec. 40. This Act takes effect immediately under AS 01.10.070(c).