txt

HB 268: "An Act relating to the prescription of opioids; relating to the Department of Health and Social Services; 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; and relating to the practice of optometry."

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