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CSSSHB 268(FIN): "An Act relating to the prescription of opioids; 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; and providing for an effective date."

00            CS FOR SPONSOR SUBSTITUTE FOR HOUSE BILL NO. 268(FIN)                                                        
01 "An Act relating to the prescription of opioids; relating to the practice of dentistry;                                 
02 relating to the practice of medicine; relating to the practice of podiatry; relating to the                             
03 practice of osteopathy; relating to the practice of nursing; relating to the practice of                                
04 optometry; and providing for an effective date."                                                                        
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       OPIOID ADDICTION: LEGISLATIVE FINDINGS. The legislature finds that                                                
09            (1)  the state has a considerable moral, public health, and financial interest in                            
10 reducing opioid and heroin addiction in the state;                                                                      
11            (2)  it is medically documented that opioid prescription drugs are addictive and                             
12 that opioid addiction is harmful and expensive to address;                                                              
13            (3)  as of 2017, accepted evidence shows that a significant percentage of                                    
14 people who become addicted to heroin were initially addicted to opioid prescription drugs;                              
01            (4)  opioid prescription drug and heroin addiction interferes with an addict's                               
02 ability to work and provide for a stable and healthy family;                                                            
03            (5)  the state's opioid epidemic damages the health of families and children and                             
04 affects the chances that a child will receive a healthy upbringing;                                                     
05            (6)  the opioid epidemic increases crime in the state, and the presence of heroin                            
06 dealers in the state poses a public safety threat;                                                                      
07            (7)  the opioid epidemic costs the state and other entities excessive amounts of                             
08 money, which is especially problematic in lean budget times;                                                            
09            (8)  policies that reduce the number of people who become addicted to opioids                                
10 and heroin will better serve citizens of the state and foster healthier families;                                       
11 (9)  patients are not always advised of the addictive effects of opioid                                                 
12 prescription drug use or that opioid prescription drug use may lead to opioid prescription drug                         
13 and heroin addiction; and                                                                                               
14 (10)  requiring medical providers to inform patients of the risks associated with                                       
15 opioid prescription drug use can help to reduce opioid prescription drug and heroin addictions                          
16 in the state.                                                                                                           
17    * Sec. 2. AS 08.36.070(a) is amended to read:                                                                      
18            (a)  The board shall                                                                                         
19 (1)  provide for the examination of applicants and the credentialing,                                                   
20       registration, and licensure of those applicants it finds qualified;                                               
21 (2)  maintain a registry of licensed dentists, licensed dental hygienists,                                              
22       and registered dental assistants who are in good standing;                                                        
23 (3)  affiliate with the American Association of Dental Boards and pay                                                   
24       annual dues to the association;                                                                                   
25 (4)  hold hearings and order the disciplinary sanction of a person who                                                  
26       violates this chapter, AS 08.32, or a regulation of the board;                                                    
27 (5)  supply forms for applications, licenses, permits, certificates,                                                    
28       registration documents, and other papers and records;                                                             
29 (6)  enforce the provisions of this chapter and AS 08.32 and adopt or                                                   
30 amend the regulations necessary to make the provisions of this chapter and AS 08.32                                     
31       effective;                                                                                                        
01                 (7)  adopt regulations ensuring that renewal of a license, registration, or                             
02       certificate under this chapter or a license, certificate, or endorsement under AS 08.32                           
03       is contingent upon proof of continued professional competence;                                                    
04                 (8)  at least annually, cause to be published on the Internet and in a                                  
05       newspaper of general circulation in each major city in the state a summary of                                     
06       disciplinary actions the board has taken during the preceding calendar year;                                      
07                 (9)  issue permits or certificates to licensed dentists, licensed dental                                
08       hygienists, and dental assistants who meet standards determined by the board for                                  
09       specific procedures that require specific education and training;                                                 
10 (10)  require that a licensed dentist who has a federal Drug                                                            
11 Enforcement Administration registration number register with the controlled substance                                   
12       prescription database under AS 17.30.200(o);                                                                  
13 (11)  adopt regulations requiring a licensee to advise patients, using                                              
14 oral and written information, before prescribing an opioid, of the potential                                        
15 dangers of opioid addiction, and alternatives to the opioid prescription the                                        
16 provider considers reasonable; the board may determine which classes of                                             
17 patients may be reasonably exempted from the information requirement and                                            
18 may allow an exemption from the requirement for violations the board considers                                      
19 to be unintentional, periodic accidental violations, and for good cause, including                                  
20 when a licensee needs to attend to the perceived immediate health care of another                                   
21       patient.                                                                                                      
22    * Sec. 3. AS 08.64.101 is amended to read:                                                                         
23            Sec. 08.64.101. Duties. The board shall                                                                    
24                 (1)  examine and issue licenses to applicants;                                                          
25 (2)  develop written guidelines to ensure that licensing requirements are                                               
26 not unreasonably burdensome and the issuance of licenses is not unreasonably                                            
27       withheld or delayed;                                                                                              
28 (3)  after a hearing, impose disciplinary sanctions on persons who                                                      
29       violate this chapter or the regulations or orders of the board;                                                   
30 (4)  adopt regulations ensuring that renewal of licenses is contingent on                                               
31       proof of continued competency on the part of the licensee;                                                        
01 (5)  under regulations adopted by the board, contract with private                                                      
02 professional organizations to establish an impaired medical professionals program to                                    
03 identify, confront, evaluate, and treat persons licensed under this chapter who abuse                                   
04       alcohol, other drugs, or other substances or are mentally ill or cognitively impaired;                            
05 (6)  adopt regulations that establish guidelines for a physician who is                                                 
06 rendering a diagnosis, providing treatment, or prescribing, dispensing, or                                              
07 administering a prescription drug to a person without conducting a physical                                             
08 examination under AS 08.64.364; the guidelines must include a nationally recognized                                     
09 model policy for standards of care of a patient who is at a different location than the                                 
10       physician;                                                                                                        
11 (7)  require that a licensee who has a federal Drug Enforcement                                                         
12 Administration registration number register with the controlled substance prescription                                  
13       database under AS 17.30.200(o);                                                                               
14 (8)  adopt regulations requiring a licensee to advise patients, using                                               
15 oral and written information, before prescribing an opioid, of the potential                                        
16 dangers of opioid addiction, and alternatives to the opioid prescription the                                        
17 provider considers reasonable; the board may determine which classes of                                             
18 patients may be reasonably exempted from the information requirement and                                            
19 may allow an exemption from the requirement for violations the board considers                                      
20 to be unintentional, periodic accidental violations, and for good cause, including                                  
21 when a licensee needs to attend to the perceived immediate health care of another                                   
22       patient.                                                                                                      
23    * Sec. 4. AS 08.68.100(a) is amended to read:                                                                      
24            (a)  The board shall                                                                                         
25 (1)  adopt regulations necessary to implement this chapter, including                                                   
26       regulations                                                                                                       
27 (A)  pertaining to practice as an advanced practice registered                                                          
28 nurse, including requirements for an advanced practice registered nurse to                                              
29 practice as a certified registered nurse anesthetist, certified clinical nurse                                          
30            specialist, certified nurse practitioner, or certified nurse midwife;                                        
31 (B)  necessary to implement AS 08.68.331 - 08.68.336 relating                                                           
01            to certified nurse aides in order to protect the health, safety, and welfare of                              
02            clients served by nurse aides;                                                                               
03                      (C)  pertaining to retired nurse status; and                                                       
04                      (D)  establishing criteria for approval of practical nurse                                         
05            education programs that are not accredited by a national nursing accrediting                                 
06            body;                                                                                                        
07                 (2)  approve curricula and adopt standards for basic education programs                                 
08       that prepare persons for licensing under AS 08.68.190;                                                            
09                 (3)  provide for surveys of the basic nursing education programs in the                                 
10       state at the times it considers necessary;                                                                        
11 (4)  approve education programs that meet the requirements of this                                                      
12 chapter and of the board, and deny, revoke, or suspend approval of education                                            
13       programs for failure to meet the requirements;                                                                    
14                 (5)  examine, license, and renew the licenses of qualified applicants;                                  
15 (6)  prescribe requirements for competence before a former registered,                                                  
16 advanced practice registered, or licensed practical nurse may resume the practice of                                    
17       nursing under this chapter;                                                                                       
18 (7)  define by regulation the qualifications and duties of the executive                                                
19 administrator and delegate authority to the executive administrator that is necessary to                                
20       conduct board business;                                                                                           
21                 (8)  develop reasonable and uniform standards for nursing practice;                                     
22 (9)  publish advisory opinions regarding whether nursing practice                                                       
23 procedures or policies comply with acceptable standards of nursing practice as defined                                  
24       under this chapter;                                                                                               
25 (10)  require applicants under this chapter to submit fingerprints and the                                              
26 fees required by the Department of Public Safety under AS 12.62.160 for criminal                                        
27 justice information and a national criminal history record check; the department shall                                  
28 submit the fingerprints and fees to the Department of Public Safety for a report of                                     
29 criminal justice information under AS 12.62 and a national criminal history record                                      
30       check under AS 12.62.400;                                                                                         
31 (11)  require that a licensed advanced nurse practitioner who has a                                                     
01 federal Drug Enforcement Administration registration number register with the                                           
02       controlled substance prescription database under AS 17.30.200(o);                                             
03 (12)  adopt regulations requiring a licensee to advise patients, using                                              
04 oral and written information, before prescribing an opioid, of the potential                                        
05 dangers of opioid addiction, and alternatives to the opioid prescription the                                        
06 provider considers reasonable; the board may determine which classes of                                             
07 patients may be exempted from the information requirement and may allow an                                          
08 exemption from the requirement for violations the board considers to be                                             
09 unintentional, periodic accidental violations, and for good cause, including when                                   
10 a licensee needs to attend to the perceived immediate health care of another                                        
11       patient.                                                                                                      
12    * Sec. 5. AS 08.72.050 is amended to read:                                                                         
13            Sec. 08.72.050. Regulations. The board shall adopt regulations                                             
14                 (1)  necessary for the proper performances of its duties;                                               
15                 (2)  governing the applicants and applications for licensing;                                           
16                 (3)  for the licensing of optometrists;                                                                 
17 (4)  necessary to govern the practice of optometry, including the                                                       
18       prescription and use of pharmaceutical agents for the treatment of eye disease;                                   
19 (5)  prescribing requirements that a person licensed under this chapter                                                 
20       must meet to demonstrate continued professional competency;                                                       
21                 (6)  developing uniform standards for the practice of optometry;                                    
22 (7)  requiring a licensee to advise patients, using oral and written                                                
23 information, before prescribing an opioid, of the potential dangers of opioid                                       
24 addiction and alternatives to the opioid prescription the provider considers                                        
25 reasonable; the board may determine which classes of patients may be exempted                                       
26 from the information requirement and may allow an exemption from the                                                
27 requirement for violations the board considers to be unintentional, periodic                                        
28 accidental violations, and for good cause, including when a licensee needs to                                       
29       attend to the perceived immediate health care of another patient.                                             
30    * Sec. 6. AS 47.37.040 is amended by adding a new paragraph to read:                                               
31 (24)  post on the department's Internet website, and provide access to a                                                
01       printable version of, a written statement, which may include graphics, that provides                              
02       easily understandable information on opioids, including the potentially addictive and                             
03       harmful qualities of opioids.                                                                                     
04    * Sec. 7. The uncodified law of the State of Alaska is amended by adding a new section to                          
05 read:                                                                                                                   
06 TRANSITION: REGULATIONS. (a) The Department of Health and Social Services                                               
07 may adopt regulations necessary to implement the changes made by sec. 6 of this Act. The                                
08 regulations take effect under AS 44.62 (Administrative Procedure Act), but not before the                               
09 effective date of sec. 6 of this Act.                                                                                   
10 (b)  The Board of Dental Examiners, the State Medical Board, the Board of Nursing,                                      
11 and the Board of Examiners in Optometry may adopt regulations necessary to implement the                                
12 changes made by secs. 2 - 5 of this Act. The regulations take effect under AS 44.62                                     
13 (Administrative Procedure Act), but not before the effective date of secs. 2 - 5 of this Act.                           
14       (c)  The Board of Dental Examiners, the State Medical Board, the Board of Nursing,                                
15 and the Board of Examiners in Optometry shall implement regulations required by secs. 2 - 5                             
16 of this Act on or before October 1, 2019.                                                                               
17    * Sec. 8. Sections 7(a) and (b) of this Act take effect immediately under AS 01.10.070(c).