CSSB 79(HSS): "An Act relating to the prescription of opioids; relating to voluntary nonopioid directives; relating to the controlled substance prescription database; relating to the practice of dentistry; relating to the practice of pharmacy; 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; relating to the duties of the Board of Pharmacy; relating to pharmacists; relating to the definition of 'practitioner'; providing for an effective date by repealing the effective date of sec. 73, ch. 25, SLA 2016; and providing for an effective date."
00 CS FOR SENATE BILL NO. 79(HSS) 01 "An Act relating to the prescription of opioids; relating to voluntary nonopioid 02 directives; relating to the controlled substance prescription database; relating to the 03 practice of dentistry; relating to the practice of pharmacy; relating to the practice of 04 medicine; relating to the practice of podiatry; relating to the practice of osteopathy; 05 relating to the practice of nursing; relating to the practice of optometry; relating to the 06 practice of veterinary medicine; relating to the duties of the Board of Pharmacy; 07 relating to pharmacists; relating to the definition of 'practitioner'; providing for an 08 effective date by repealing the effective date of sec. 73, ch. 25, SLA 2016; and providing 09 for an effective date." 10 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 11 * Section 1. AS 08.36.070(a), as amended by sec. 5, ch. 25, SLA 2016, is amended to read: 12 (a) The board shall
01 (1) provide for the examination of applicants and the credentialing, 02 registration, and licensure of those applicants it finds qualified; 03 (2) maintain a registry of licensed dentists, licensed dental hygienists, 04 and registered dental assistants who are in good standing; 05 (3) affiliate with the American Association of Dental Boards and pay 06 annual dues to the association; 07 (4) hold hearings and order the disciplinary sanction of a person who 08 violates this chapter, AS 08.32, or a regulation of the board; 09 (5) supply forms for applications, licenses, permits, certificates, 10 registration documents, and other papers and records; 11 (6) enforce the provisions of this chapter and AS 08.32 and adopt or 12 amend the regulations necessary to make the provisions of this chapter and AS 08.32 13 effective; 14 (7) adopt regulations ensuring that renewal of a license, registration, or 15 certificate under this chapter or a license, certificate, or endorsement under AS 08.32 16 is contingent on [UPON] proof of continued professional competence; the 17 regulations must require that a licensee receive not less than two hours of 18 education in pain management and opioid use and addiction in the two years 19 preceding an application for renewal of a license, unless the licensee has 20 demonstrated to the satisfaction of the board that the licensee does not currently 21 hold a valid federal Drug Enforcement Administration registration number; 22 (8) at least annually, cause to be published on the Internet and in a 23 newspaper of general circulation in each major city in the state a summary of 24 disciplinary actions the board has taken during the preceding calendar year; 25 (9) issue permits or certificates to licensed dentists, licensed dental 26 hygienists, and dental assistants who meet standards determined by the board for 27 specific procedures that require specific education and training; 28 (10) require that a licensed dentist who has a federal Drug 29 Enforcement Administration registration number register with the controlled substance 30 prescription database under AS 17.30.200(o). 31 * Sec. 2. AS 08.36.110(a) is amended to read:
01 (a) An applicant for a license to practice dentistry shall 02 (1) provide certification to the board that the applicant 03 (A) is a graduate of a dental school that, at the time of 04 graduation, is approved by the board; 05 (B) has successfully passed a written examination approved by 06 the board; 07 (C) has not had a license to practice dentistry revoked, 08 suspended, or voluntarily surrendered in this state or another state; 09 (D) is not the subject of an adverse decision based on [UPON] 10 a complaint, investigation, review procedure, or other disciplinary proceeding 11 within the five years immediately preceding application, or of an unresolved 12 complaint, investigation, review procedure, or other disciplinary proceeding, 13 undertaken by a state, territorial, local, or federal dental licensing jurisdiction; 14 (E) is not the subject of an unresolved or an adverse decision 15 based on [UPON] a complaint, investigation, review procedure, or other 16 disciplinary proceeding, undertaken by a state, territorial, local, or federal 17 dental licensing jurisdiction or law enforcement agency that relates to criminal 18 or fraudulent activity, dental malpractice, or negligent dental care and that 19 adversely reflects on the applicant's ability or competence to practice dentistry 20 or on the safety or well-being of patients; 21 (F) is not the subject of an adverse report from the National 22 Practitioner Data Bank or the American Association of Dental Boards 23 Clearinghouse for Board Actions that relates to criminal or fraudulent activity, 24 or dental malpractice; 25 (G) is not impaired to an extent that affects the applicant's 26 ability to practice dentistry; 27 (H) has not been convicted of a crime that adversely reflects on 28 the applicant's ability or competency to practice dentistry or that jeopardizes 29 the safety or well-being of a patient; 30 (2) pass, to the satisfaction of the board, written, clinical, and other 31 examinations administered or approved by the board; and
01 (3) meet the other qualifications for a license established by the board 02 by regulation, including education in pain management and opioid use and 03 addiction in the two years preceding the application for a license, unless the 04 applicant has demonstrated to the satisfaction of the board that the applicant 05 does not currently hold a valid federal Drug Enforcement Administration 06 registration number; approved education may include dental school coursework. 07 * Sec. 3. AS 08.36.315 is amended to read: 08 Sec. 08.36.315. Grounds for discipline, suspension, or revocation of license. 09 The board may revoke or suspend the license of a dentist, or may reprimand, censure, 10 or discipline a dentist, or both, if the board finds, after a hearing, that the dentist 11 (1) used or knowingly cooperated in deceit, fraud, or intentional 12 misrepresentation to obtain a license; 13 (2) engaged in deceit, fraud, or intentional misrepresentation in the 14 course of providing or billing for professional dental services or engaging in 15 professional activities; 16 (3) advertised professional dental services in a false or misleading 17 manner; 18 (4) received compensation for referring a person to another dentist or 19 dental practice; 20 (5) has been convicted of a felony or other crime that affects the 21 dentist's ability to continue to practice dentistry competently and safely; 22 (6) engaged in the performance of patient care, or permitted the 23 performance of patient care by persons under the dentist's supervision, regardless of 24 whether actual injury to the patient occurred, 25 (A) that did not conform to minimum professional standards of 26 dentistry; or 27 (B) when the dentist, or a person under the supervision of the 28 dentist, did not have the permit, registration, or certificate required under 29 AS 08.32 or this chapter; 30 (7) failed to comply with this chapter, with a regulation adopted under 31 this chapter, or with an order of the board;
01 (8) continued to practice after becoming unfit due to 02 (A) professional incompetence; 03 (B) addiction or dependence on alcohol or other drugs that 04 impair the dentist's ability to practice safely; 05 (C) physical or mental disability; 06 (9) engaged in lewd or immoral conduct in connection with the 07 delivery of professional service to patients; 08 (10) permitted a dental hygienist or dental assistant who is employed 09 by the dentist or working under the dentist's supervision to perform a dental procedure 10 in violation of AS 08.32.110 or AS 08.36.346; 11 (11) failed to report to the board a death that occurred on the premises 12 used for the practice of dentistry within 48 hours; 13 (12) falsified or destroyed patient or facility records or failed to 14 maintain a patient or facility record for at least seven years after the date the record 15 was created; 16 (13) prescribed or dispensed an opioid in excess of the maximum 17 dosage authorized under AS 08.36.355; or 18 (14) procured, sold, prescribed, or dispensed drugs in violation of 19 a law, regardless of whether there has been a criminal action or harm to the 20 patient. 21 * Sec. 4. AS 08.36 is amended by adding a new section to read: 22 Sec. 08.36.355. Maximum dosage for opioid prescriptions. (a) A licensee 23 may not issue 24 (1) an initial prescription for an opioid that exceeds a seven-day supply 25 to an adult patient for outpatient use; 26 (2) a prescription for an opioid that exceeds a seven-day supply to a 27 minor; at the time a licensee writes a prescription for an opioid for a minor, the 28 licensee shall discuss with the parent or guardian of the minor why the prescription is 29 necessary and the risks associated with opioid use. 30 (b) Notwithstanding (a) of this section, a licensee may issue a prescription for 31 an opioid that exceeds a seven-day supply to an adult or minor patient if, in the
01 professional judgment of the licensee, more than a seven-day supply of an opioid is 02 necessary for 03 (1) the patient's chronic pain management; the licensee may write a 04 prescription for an opioid for the quantity needed to treat the patient's medical 05 condition or chronic pain; the licensee shall document in the patient's medical record 06 the condition triggering the prescription of an opioid in a quantity that exceeds a 07 seven-day supply and indicate that a nonopioid alternative was not appropriate to 08 address the medical condition; or 09 (2) a patient who is unable to access a practitioner within the time 10 necessary for a refill of the seven-day supply because of a logistical or travel barrier; 11 the licensee may write a prescription for an opioid for the quantity needed to treat the 12 patient for the time that the patient is unable to access a practitioner; the licensee shall 13 document in the patient's medical record the reason for the prescription of an opioid in 14 a quantity that exceeds a seven-day supply and indicate that a nonopioid alternative 15 was not appropriate to address the medical condition; in this paragraph, "practitioner" 16 has the meaning given in AS 11.71.900. 17 (c) In this section, 18 (1) "adult" means 19 (A) a individual who has reached 18 years of age; or 20 (B) an emancipated minor; 21 (2) "emancipated minor" means a minor whose disabilities have been 22 removed for general purposes under AS 09.55.590; 23 (3) "minor" means an individual under 18 years of age who is not an 24 emancipated minor. 25 * Sec. 5. AS 08.36.370 is amended by adding a new paragraph to read: 26 (10) "opioid" includes the opium and opiate substances and opium and 27 opiate derivatives listed in AS 11.71.140 and 11.71.160. 28 * Sec. 6. AS 08.64.107 is amended to read: 29 Sec. 08.64.107. Regulation of physician assistants and intensive care 30 paramedics. The board shall adopt regulations regarding the licensure of physician 31 assistants and registration of mobile intensive care paramedics, and the medical
01 services that they may perform, including the 02 (1) educational and other qualifications, including education in pain 03 management and opioid use and addiction; 04 (2) application and registration procedures; 05 (3) scope of activities authorized; and 06 (4) responsibilities of the supervising or training physician. 07 * Sec. 7. AS 08.64.200(a) is amended to read: 08 (a) Except for foreign medical graduates as specified in AS 08.64.225, each 09 physician applicant shall 10 (1) submit a certificate of graduation from a legally chartered medical 11 school accredited by the Association of American Medical Colleges and the Council 12 on Medical Education of the American Medical Association; 13 (2) submit a certificate from a recognized hospital or hospitals 14 certifying that the applicant has satisfactorily performed the duties of resident 15 physician or intern for a period of 16 (A) one year if the applicant graduated from medical school 17 before January 1, 1995, as evidenced by a certificate of completion of the first 18 year of postgraduate training from the facility where the applicant completed 19 the first year of internship or residency; and 20 (B) two years if the applicant graduated from medical school 21 on or after January 1, 1995, as evidenced by a certificate of completion of the 22 first year of postgraduate training from the facility where the applicant 23 completed the first year of internship or residency and a certificate of 24 successful completion of one additional year of postgraduate training at a 25 recognized hospital; 26 (3) submit a list of negotiated settlements or judgments in claims or 27 civil actions alleging medical malpractice against the applicant, including an 28 explanation of the basis for each claim or action; [AND] 29 (4) not have a license to practice medicine in another state, country, 30 province, or territory that is currently suspended or revoked for disciplinary reasons; 31 and
01 (5) receive education in pain management and opioid use and 02 addiction, unless the applicant has demonstrated to the satisfaction of the board 03 that the applicant does not currently hold a valid federal Drug Enforcement 04 Administration registration number; an applicant may include past professional 05 experience or professional education as proof of professional competence. 06 * Sec. 8. AS 08.64.205 is amended to read: 07 Sec. 08.64.205. Qualifications for osteopath applicants. Each osteopath 08 applicant shall meet the qualifications prescribed in AS 08.64.200(a)(3) - (5) 09 [AS 08.64.200(a)(3) AND (4)] and shall 10 (1) submit a certificate of graduation from the legally chartered school 11 of osteopathy approved by the board; 12 (2) submit a certificate from a hospital approved by the American 13 Medical Association or the American Osteopathic Association that certifies that the 14 osteopath has satisfactorily completed and performed the duties of intern or resident 15 physician for 16 (A) one year if the applicant graduated from a school of 17 osteopathy before January 1, 1995, as evidenced by a certificate of completion 18 of the first year of postgraduate training from the facility where the applicant 19 completed the first year of internship or residency; or 20 (B) two years if the applicant graduated from a school of 21 osteopathy on or after January 1, 1995, as evidenced by a certificate of 22 completion of the first year of postgraduate training from the facility where the 23 applicant completed the first year of internship or residency and a certificate of 24 successful completion of one additional year of postgraduate training at a 25 recognized hospital; 26 (3) take the examination required by AS 08.64.210 or be certified to 27 practice by the National Board of Examiners for Osteopathic Physicians and 28 Surgeons; 29 (4) receive education in pain management and opioid use and 30 addiction, unless the applicant has demonstrated to the satisfaction of the board 31 that the applicant does not currently hold a valid federal Drug Enforcement
01 Administration registration number; an applicant may include past professional 02 experience or professional education as proof of professional competence. 03 * Sec. 9. AS 08.64.209(a) is amended to read: 04 (a) Each applicant who desires to practice podiatry shall meet the 05 qualifications prescribed in AS 08.64.200(a)(3) - (5) [AS 08.64.200(a)(3) AND (4)] 06 and shall 07 (1) submit a certificate of graduation from a legally chartered school of 08 podiatry approved by the board; 09 (2) take the examination required by AS 08.64.210; the State Medical 10 Board shall call to its aid a podiatrist of known ability who is licensed to practice 11 podiatry to assist in the examination and licensure of applicants for a license to 12 practice podiatry; 13 (3) receive education in pain management and opioid use and 14 addiction, unless the applicant has demonstrated to the satisfaction of the board 15 that the applicant does not currently hold a valid federal Drug Enforcement 16 Administration registration number; an applicant may include past professional 17 experience or professional education as proof of professional competence; 18 (4) meet other qualifications of experience or education which the 19 board may require. 20 * Sec. 10. AS 08.64.225(a) is amended to read: 21 (a) Applicants who are graduates of medical colleges not accredited by the 22 Association of American Medical Colleges and the Council on Medical Education of 23 the American Medical Association shall 24 (1) meet the requirements of AS 08.64.200(a)(3) - (5) 25 [AS 08.64.200(a)(3) AND (4)] and 08.64.255; 26 (2) have successfully completed 27 (A) three years of postgraduate training as evidenced by a 28 certificate of completion of the first year of postgraduate training from the 29 facility where the applicant completed the first year of internship or residency 30 and a certificate of successful completion of two additional years of 31 postgraduate training at a recognized hospital; or
01 (B) other requirements establishing proof of competency and 02 professional qualifications as the board considers necessary to ensure the 03 continued protection of the public adopted at the discretion of the board by 04 regulation, including education in pain management and opioid use and 05 addiction, unless the applicant has demonstrated to the satisfaction of the 06 board that the applicant does not currently hold a valid federal Drug 07 Enforcement Administration registration number; an applicant may 08 include past professional experience or professional education as proof of 09 professional competence; and 10 (3) have passed examinations as specified by the board in regulations. 11 * Sec. 11. AS 08.64.250 is amended to read: 12 Sec. 08.64.250. License by credentials. The board may waive the examination 13 requirement and license by credentials if the physician, osteopath, or podiatry 14 applicant meets the requirements of AS 08.64.200, 08.64.205, or 08.64.209, submits 15 proof of continued competence as required by regulation, pays the required fee, and 16 has 17 (1) an active license from a board of medical examiners established 18 under the laws of a state or territory of the United States or a province or territory of 19 Canada issued after thorough examination; or 20 (2) passed an examination as specified by the board in regulations. 21 * Sec. 12. AS 08.64.250 is amended by adding a new subsection to read: 22 (b) The board shall adopt regulations under (a) of this section that require an 23 applicant demonstrate professional competence in pain management and addiction 24 disorders. An applicant may include past professional experience or professional 25 education as proof of professional competence. 26 * Sec. 13. AS 08.64.312 is amended to read: 27 Sec. 08.64.312. Continuing education requirements. (a) The board shall 28 promote a high degree of competence in the practice of medicine, osteopathy, and 29 podiatry by requiring every licensee of medicine, osteopathy, and podiatry 30 [PHYSICIAN LICENSED] in the state to fulfill continuing education requirements. 31 (b) Before a license may be renewed, the licensee shall submit evidence to the
01 board or its designee that continuing education requirements prescribed by regulations 02 adopted by the board have been met. Continuing education requirements must 03 include not less than two hours of education in pain management and opioid use 04 and addiction for every 40 hours of education received, unless the licensee 05 demonstrates to the satisfaction of the board that the licensee's practice does not 06 include pain management and opioid treatment or prescribing. 07 (c) The board or its designee may exempt a physician, osteopath, or 08 podiatrist from the requirements of (b) of this section upon an application by the 09 physician, osteopath, or podiatrist giving evidence satisfactory to the board or its 10 designee that the physician, osteopath, or podiatrist is unable to comply with the 11 requirements because of extenuating circumstances. However, a person may not be 12 exempted from more than 15 hours of continuing education in a five-year period; a 13 person may not be exempted from the requirement to receive at least two hours 14 of education in pain management and opioid use and addiction unless the person 15 has demonstrated to the satisfaction of the board that the person does not 16 currently hold a valid federal Drug Enforcement Administration registration 17 number. 18 * Sec. 14. AS 08.64.326(a) is amended to read: 19 (a) The board may impose a sanction if the board finds after a hearing that a 20 licensee 21 (1) secured a license through deceit, fraud, or intentional 22 misrepresentation; 23 (2) engaged in deceit, fraud, or intentional misrepresentation while 24 providing professional services or engaging in professional activities; 25 (3) advertised professional services in a false or misleading manner; 26 (4) has been convicted, including conviction based on a guilty plea or 27 plea of nolo contendere, of 28 (A) a class A or unclassified felony or a crime in another 29 jurisdiction with elements similar to a class A or unclassified felony in this 30 jurisdiction; 31 (B) a class B or class C felony or a crime in another jurisdiction
01 with elements similar to a class B or class C felony in this jurisdiction if the 02 felony or other crime is substantially related to the qualifications, functions, or 03 duties of the licensee; or 04 (C) a crime involving the unlawful procurement, sale, 05 prescription, or dispensing of drugs; 06 (5) 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; 08 (6) intentionally or negligently permitted the performance of patient 09 care by persons under the licensee's supervision that does not conform to minimum 10 professional standards even if the patient was not injured; 11 (7) failed to comply with this chapter, a regulation adopted under this 12 chapter, or an order of the board; 13 (8) has demonstrated 14 (A) professional incompetence, gross negligence, or repeated 15 negligent conduct; the board may not base a finding of professional 16 incompetence solely on the basis that a licensee's practice is unconventional or 17 experimental in the absence of demonstrable physical harm to a patient; 18 (B) addiction to, severe dependency on, or habitual overuse of 19 alcohol or other drugs that impairs the licensee's ability to practice safely; 20 (C) unfitness because of physical or mental disability; 21 (9) engaged in unprofessional conduct, in sexual misconduct, or in 22 lewd or immoral conduct in connection with the delivery of professional services to 23 patients; in this paragraph, "sexual misconduct" includes sexual contact, as defined by 24 the board in regulations adopted under this chapter, or attempted sexual contact with a 25 patient outside the scope of generally accepted methods of examination or treatment of 26 the patient, regardless of the patient's consent or lack of consent, during the term of the 27 physician-patient relationship, as defined by the board in regulations adopted under 28 this chapter, unless the patient was the licensee's spouse at the time of the contact or, 29 immediately preceding the physician-patient relationship, was in a dating, courtship, 30 or engagement relationship with the licensee; 31 (10) has violated AS 18.16.010;
01 (11) has violated any code of ethics adopted by regulation by the 02 board; 03 (12) has denied care or treatment to a patient or person seeking 04 assistance from the physician if the only reason for the denial is the failure or refusal 05 of the patient to agree to arbitrate as provided in AS 09.55.535(a); [OR] 06 (13) has had a license or certificate to practice medicine in another 07 state or territory of the United States, or a province or territory of Canada, denied, 08 suspended, revoked, surrendered while under investigation for an alleged violation, 09 restricted, limited, conditioned, or placed on probation unless the denial, suspension, 10 revocation, or other action was caused by the failure of the licensee to pay fees to that 11 state, territory, or province; or 12 (14) prescribed or dispensed an opioid in excess of the maximum 13 dosage authorized under AS 08.64.363. 14 * Sec. 15. AS 08.64 is amended by adding a new section to article 3 to read: 15 Sec. 08.64.363. Maximum dosage for opioid prescriptions. (a) A licensee 16 may not issue 17 (1) an initial prescription for an opioid that exceeds a seven-day supply 18 to an adult patient for outpatient use; 19 (2) a prescription for an opioid that exceeds a seven-day supply to a 20 minor; at the time a licensee writes a prescription for an opioid for a minor, the 21 licensee shall discuss with the parent or guardian of the minor why the prescription is 22 necessary and the risks associated with opioid use. 23 (b) Notwithstanding (a) of this section, a licensee may issue a prescription for 24 an opioid that exceeds a seven-day supply to an adult or minor patient if, in the 25 professional medical judgment of the licensee, more than a seven-day supply of an 26 opioid is necessary for 27 (1) the patient's acute medical condition, chronic pain management, 28 pain associated with cancer, or pain experienced while the patient is in palliative care; 29 the licensee may write a prescription for an opioid for the quantity needed to treat the 30 patient's medical condition, chronic pain, pain associated with cancer, or pain 31 experienced while the patient is in palliative care; the licensee shall document in the
01 patient's medical record the condition triggering the prescription of an opioid in a 02 quantity that exceeds a seven-day supply and indicate that a nonopioid alternative was 03 not appropriate to address the medical condition; 04 (2) a patient who is unable to access a practitioner within the time 05 necessary for a refill of the seven-day supply because of a logistical or travel barrier; 06 the licensee may write a prescription for an opioid for the quantity needed to treat the 07 patient for the time that the patient is unable to access a practitioner; the licensee shall 08 document in the patient's medical record the reason for the prescription of an opioid in 09 a quantity that exceeds a seven-day supply and indicate that a nonopioid alternative 10 was not appropriate to address the medical condition; in this paragraph, "practitioner" 11 has the meaning given in AS 11.71.900; or 12 (3) the treatment of a patient's substance abuse or opioid dependence; 13 the licensee may write a prescription for an opioid approved for the treatment of 14 substance abuse or opioid dependence for the quantity needed to treat the patient's 15 substance abuse or opioid dependence; the licensee shall document in the patient's 16 medical record the reason for the prescription of an opioid approved for the treatment 17 of substance abuse or opioid dependence in a quantity that exceeds a seven-day supply 18 and indicate that a nonopioid alternative was not appropriate for the treatment of 19 substance abuse or opioid dependence. 20 (c) In this section, 21 (1) "adult" means 22 (A) an individual who has reached 18 years of age; or 23 (B) an emancipated minor; 24 (2) "emancipated minor" means a minor whose disabilities have been 25 removed for general purposes under AS 09.55.590; 26 (3) "minor" means a individual under 18 years of age who is not an 27 emancipated minor. 28 * Sec. 16. AS 08.64.364(c) is amended to read: 29 (c) The board may not impose disciplinary sanctions on a physician for 30 prescribing, dispensing, or administering a prescription drug that is a controlled 31 substance or botulinum toxin if the requirements under (a) of this section and
01 AS 08.64.363 are met and the physician prescribes, dispenses, or administers the 02 controlled substance or botulinum toxin when an appropriate licensed health care 03 provider is present with the patient to assist the physician with examination, diagnosis, 04 and treatment. 05 * Sec. 17. AS 08.64.380 is amended by adding a new paragraph to read: 06 (7) "opioid" includes the opium and opiate substances and opium and 07 opiate derivatives listed in AS 11.71.140 and 11.71.160. 08 * Sec. 18. AS 08.68.100(a), as amended by sec. 10, ch. 25, SLA 2016, is amended to read: 09 (a) The board shall 10 (1) adopt regulations necessary to implement this chapter, including 11 regulations 12 (A) pertaining to practice as an advanced practice registered 13 nurse, including requirements for an advanced practice registered nurse to 14 practice as a certified registered nurse anesthetist, certified clinical nurse 15 specialist, certified nurse practitioner, or certified nurse midwife; regulations 16 for an advanced practice registered nurse who holds a valid federal Drug 17 Enforcement Administration registration number must address training 18 in pain management and opioid use and addiction; 19 (B) necessary to implement AS 08.68.331 - 08.68.336 relating 20 to certified nurse aides in order to protect the health, safety, and welfare of 21 clients served by nurse aides; 22 (C) pertaining to retired nurse status; and 23 (D) establishing criteria for approval of practical nurse 24 education programs that are not accredited by a national nursing accrediting 25 body; 26 (2) approve curricula and adopt standards for basic education programs 27 that prepare persons for licensing under AS 08.68.190; 28 (3) provide for surveys of the basic nursing education programs in the 29 state at the times it considers necessary; 30 (4) approve education programs that meet the requirements of this 31 chapter and of the board, and deny, revoke, or suspend approval of education
01 programs for failure to meet the requirements; 02 (5) examine, license, and renew the licenses of qualified applicants; 03 (6) prescribe requirements for competence before a former registered, 04 advanced practice registered, or licensed practical nurse may resume the practice of 05 nursing under this chapter; 06 (7) define by regulation the qualifications and duties of the executive 07 administrator and delegate authority to the executive administrator that is necessary to 08 conduct board business; 09 (8) develop reasonable and uniform standards for nursing practice; 10 (9) publish advisory opinions regarding whether nursing practice 11 procedures or policies comply with acceptable standards of nursing practice as defined 12 under this chapter; 13 (10) require applicants under this chapter to submit fingerprints and the 14 fees required by the Department of Public Safety under AS 12.62.160 for criminal 15 justice information and a national criminal history record check; the department shall 16 submit the fingerprints and fees to the Department of Public Safety for a report of 17 criminal justice information under AS 12.62 and a national criminal history record 18 check under AS 12.62.400; 19 (11) require that a licensed advanced practice registered nurse 20 [PRACTITIONER] who has a federal Drug Enforcement Administration registration 21 number register with the controlled substance prescription database under 22 AS 17.30.200(o). 23 * Sec. 19. AS 08.68.270 is amended to read: 24 Sec. 08.68.270. Grounds for denial, suspension, or revocation. The board 25 may deny, suspend, or revoke the license of a person who 26 (1) has obtained or attempted to obtain a license to practice nursing by 27 fraud or deceit; 28 (2) has been convicted of a felony or other crime if the felony or other 29 crime is substantially related to the qualifications, functions, or duties of the licensee; 30 (3) habitually abuses alcoholic beverages, or illegally uses controlled 31 substances;
01 (4) has impersonated a registered, advanced practice registered, or 02 practical nurse; 03 (5) has intentionally or negligently engaged in conduct that has 04 resulted in a significant risk to the health or safety of a client or in injury to a client; 05 (6) practices or attempts to practice nursing while afflicted with 06 physical or mental illness, deterioration, or disability that interferes with the 07 individual's performance of nursing functions; 08 (7) is guilty of unprofessional conduct as defined by regulations 09 adopted by the board; 10 (8) has wilfully or repeatedly violated a provision of this chapter or 11 regulations adopted under this chapter or AS 08.01; 12 (9) is professionally incompetent; 13 (10) denies care or treatment to a patient or person seeking assistance 14 if the sole reason for the denial is the failure or refusal of the patient or person seeking 15 assistance to agree to arbitrate as provided in AS 09.55.535(a); 16 (11) has prescribed or dispensed an opioid in excess of the 17 maximum dosage authorized under AS 08.68.705; or 18 (12) has procured, sold, prescribed, or dispensed drugs in violation 19 of a law, regardless of whether there has been a criminal action or harm to the 20 patient. 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. The board shall 25 adopt regulations for renewal of a license of an advanced practice registered 26 nurse. The regulations must require that a licensee receive not less than two 27 hours of education in pain management and opioid use and addiction in the two 28 years preceding an application for renewal of a license unless the licensee has 29 demonstrated to the satisfaction of the board that the licensee does not currently 30 hold a valid federal Drug Enforcement 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 may not issue 03 (1) an initial prescription for an opioid that exceeds a seven-day supply 04 to an adult patient for outpatient use; 05 (2) a prescription for an opioid that exceeds a seven-day supply to a 06 minor; at the time an advanced practice registered nurse writes a prescription for an 07 opioid for a minor, the advanced practice registered nurse shall discuss with the parent 08 or guardian of the minor why the prescription is necessary and the risks associated 09 with opioid use. 10 (b) Notwithstanding (a) of this section, an advanced practice registered nurse 11 may issue a prescription for an opioid that exceeds a seven-day supply to an adult or 12 minor patient if, in the professional judgment of the advanced practice registered 13 nurse, more than a seven-day supply of an opioid is necessary for 14 (1) the patient's acute medical condition, chronic pain management, 15 pain associated with cancer, or pain experienced while the patient is in palliative care; 16 the advanced practice registered nurse may write a prescription for an opioid for the 17 quantity needed to treat the patient's medical condition, chronic pain, pain associated 18 with cancer, or pain experienced while the patient is in palliative care; the advanced 19 practice registered nurse shall document in the patient's medical record the condition 20 triggering the prescription of an opioid in a quantity that exceeds a seven-day supply 21 and indicate that a nonopioid alternative was not appropriate to address the medical 22 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 (c) This section does not authorize an advanced practice registered nurse to 02 prescribe a controlled substance if the 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 (d) In this section, 06 (1) "adult" means 07 (A) an individual 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 an individual 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 and 11.71.160. 16 * Sec. 23. AS 08.72.140 is amended to read: 17 Sec. 08.72.140. Qualifications for licensure. An applicant for licensure as an 18 optometrist 19 (1) shall be a graduate of a school or college of optometry recognized 20 by the board; 21 (2) may not have committed an act in any jurisdiction that would have 22 constituted a violation of this chapter or regulations adopted under this chapter at the 23 time the act was committed; 24 (3) may not have been disciplined by an optometry licensing entity in 25 another jurisdiction and may not be the subject of a pending disciplinary proceeding 26 conducted by an optometry licensing entity in another jurisdiction; however, the board 27 may consider the disciplinary action and, in the board's discretion, determine if the 28 person is qualified for licensure; 29 (4) shall have successfully completed 30 (A) the written and practical portions of an examination on 31 ocular pharmacology approved by the board that tests the licensee's or
01 applicant's knowledge of the characteristics, pharmacological effects, 02 indications, contraindications, and emergency care associated with the 03 prescription and use of pharmaceutical agents; 04 (B) a nontopical therapeutic pharmaceutical agent course of at 05 least 23 hours approved by the board or an examination approved by the board 06 on the treatment and management of ocular disease; and 07 (C) an optometry and nontopical therapeutic pharmaceutical 08 agent injection course of at least seven hours approved by the board or 09 equivalent training acceptable to the board; and 10 (5) shall meet other qualifications for licensure as established under 11 this chapter and regulations adopted by the board under AS 08.72.050; the 12 regulations must include qualifications for licensees who hold a valid federal 13 Drug Enforcement Administration registration number that address training in 14 pain management and opioid use and addiction. 15 * Sec. 24. AS 08.72.170 is amended to read: 16 Sec. 08.72.170. Licensure by credentials. The board shall issue a license by 17 credentials to an applicant who 18 (1) is a graduate of a school or college of optometry recognized by the 19 board; 20 (2) has passed a written examination approved by the board that is 21 designed to test the applicant's knowledge of the laws of Alaska governing the practice 22 of optometry and the regulations adopted under those laws; 23 (3) holds a current license to practice optometry in another state or 24 territory of the United States or in a province of Canada that has licensure 25 requirements that the board determines are equivalent to those established under this 26 chapter; 27 (4) at some time in the past, received a license to practice optometry 28 from another state or territory of the United States or from a province of Canada that 29 required the person to have passed the National Board of Examiners in Optometry 30 examination to qualify for licensure; 31 (5) was engaged in the active licensed clinical practice of optometry in
01 a state or territory of the United States or in a province of Canada for at least 3,120 02 hours during the 36 months preceding the date of application under this section; 03 (6) has not committed an act in any jurisdiction that would have 04 constituted a violation of this chapter or regulations adopted under this chapter at the 05 time the act was committed; [AND] 06 (7) has not been disciplined by an optometry licensing entity in another 07 jurisdiction and is not the subject of a pending disciplinary proceeding conducted by 08 an optometry licensing entity in another jurisdiction; however, the board may consider 09 the disciplinary action and, in the board's discretion, determine whether [IF] the 10 person is qualified for licensure; and 11 (8) has received education in pain management and opioid use and 12 addiction adequate for the practice of optometry, unless the applicant has 13 demonstrated to the satisfaction of the board that the applicant does not 14 currently hold a valid federal Drug Enforcement Administration registration 15 number; an applicant may include past professional experience or professional 16 education as proof of professional competence. 17 * Sec. 25. AS 08.72.181(d) is amended to read: 18 (d) Before a license may be renewed, the licensee shall submit to the board 19 evidence that, in the two [FOUR] years preceding the application for renewal, the 20 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. 26. 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 that [WHICH] 10 affects the 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 that [WHICH] 13 does not conform to minimum professional standards regardless of whether actual 14 injury to the 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 that [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 harm to the 30 patient. 31 * Sec. 27. AS 08.80.030(b), as amended by sec. 12, ch. 25, SLA 2016, is amended to read:
01 (b) In order to fulfill its responsibilities, the board has the powers necessary 02 for implementation and enforcement of this chapter, including the power to 03 (1) elect a president and secretary from its membership and adopt rules 04 for the conduct of its business; 05 (2) license by examination or by license transfer the applicants who are 06 qualified to engage in the practice of pharmacy; 07 (3) assist the department in inspections and investigations for 08 violations of this chapter, or of any other state or federal statute relating to the practice 09 of pharmacy; 10 (4) adopt regulations to carry out the purposes of this chapter; 11 (5) establish and enforce compliance with professional standards and 12 rules of conduct for pharmacists engaged in the practice of pharmacy; 13 (6) determine standards for recognition and approval of degree 14 programs of schools and colleges of pharmacy whose graduates shall be eligible for 15 licensure in this state, including the specification and enforcement of requirements for 16 practical training, including internships; 17 (7) establish for pharmacists and pharmacies minimum specifications 18 for the physical facilities, technical equipment, personnel, and procedures for the 19 storage, compounding, and dispensing of drugs or related devices, and for the 20 monitoring of drug therapy; 21 (8) enforce the provisions of this chapter relating to the conduct or 22 competence of pharmacists practicing in the state, and the suspension, revocation, or 23 restriction of licenses to engage in the practice of pharmacy; 24 (9) license and regulate the training, qualifications, and employment of 25 pharmacy interns and pharmacy technicians; 26 (10) issue licenses to persons engaged in the manufacture and 27 distribution of drugs and related devices; 28 (11) establish and maintain a controlled substance prescription 29 database as provided in AS 17.30.200; 30 (12) establish standards for the independent administration by a 31 pharmacist of vaccines and related emergency medications under AS 08.80.168,
01 including the completion of an immunization training program approved by the board; 02 (13) establish standards for the independent dispensing by a 03 pharmacist of an opioid overdose drug under AS 17.20.085, including the completion 04 of an opioid overdose training program approved by the board; 05 (14) require that a licensed pharmacist [WHO HAS A FEDERAL 06 DRUG ENFORCEMENT ADMINISTRATION REGISTRATION NUMBER] 07 register with the controlled substance prescription database under AS 17.30.200(o). 08 * Sec. 28. AS 08.80 is amended by adding a new section to article 3 to read: 09 Sec. 08.80.345. Prescription for an opioid; voluntary request for lesser 10 quantity. (a) A pharmacist filling a prescription for an opioid that is a schedule II or 11 III controlled substance under federal law may, at the request of the individual for 12 whom the prescription is written, dispense the prescribed opioid in a lesser quantity 13 than prescribed. 14 (b) Nothing in this section shall be construed to prevent substitution of an 15 equivalent drug under AS 08.80.295. 16 * Sec. 29. AS 08.98.050(a) is amended to read: 17 (a) The board shall 18 (1) establish examination requirements for eligible applicants for 19 licensure to practice veterinary medicine; 20 (2) examine, or cause to be examined, eligible applicants for licensure 21 or registration; 22 (3) approve the issuance of licenses and student permits to qualified 23 applicants; 24 (4) establish standards for the practice of veterinary medicine by 25 regulation; 26 (5) conduct disciplinary proceedings in accordance with this chapter; 27 (6) adopt regulations requiring proof of continued competency before a 28 license is renewed; 29 (7) as requested by the department, monitor the standards and 30 availability of veterinary services provided in the state and report its findings to the 31 department;
01 (8) collect, or cause to be collected, data concerning the practice of 02 veterinary technology by veterinary technicians in the state and submit the data to the 03 department for maintenance; 04 (9) establish, by regulation, educational and training requirements for 05 (A) the issuance of student permits; and 06 (B) the delegation of duties by veterinarians licensed under this 07 chapter to veterinary technicians; 08 (10) require that a licensee who has a federal Drug Enforcement 09 Administration registration number register with the controlled substance 10 prescription database under AS 17.30.200(o); 11 (11) identify resources and develop educational materials to assist 12 licensees to identify an animal owner who may be at risk for abusing or misusing 13 an opioid. 14 * Sec. 30. AS 08.98.235 is amended to read: 15 Sec. 08.98.235. Grounds for imposition of disciplinary sanctions. After a 16 hearing, the board may impose a disciplinary sanction on a person licensed under this 17 chapter when the board finds that the person 18 (1) secured a license through deceit, fraud, or intentional 19 misrepresentation; 20 (2) engaged in deceit, fraud, or intentional misrepresentation in the 21 course of providing professional services or engaging in professional activities; 22 (3) advertised professional services in a false or misleading manner; 23 (4) has been convicted of a felony or other crime which affects the 24 person's ability to continue to practice competently and safely; 25 (5) intentionally or negligently engaged in or permitted the 26 performance of animal care by the person's supervisees which does not conform to 27 minimum professional standards regardless of whether actual injury to the animal 28 occurred; 29 (6) failed to comply with this chapter, with a regulation adopted under 30 this chapter, or with an order of the board; 31 (7) continued to practice after becoming unfit due to
01 (A) professional incompetence; 02 (B) addiction or severe dependency on alcohol or other drugs 03 which impairs the person's ability to practice safely; 04 (C) physical or mental disability; 05 (8) engaged in lewd or immoral conduct in connection with the 06 delivery of professional service; 07 (9) procured, sold, prescribed, or dispensed drugs in violation of a 08 law, regardless of whether there has been a criminal action. 09 * Sec. 31. AS 11.71.900(19) is amended to read: 10 (19) "practitioner" means 11 (A) a physician, dentist, advanced practice registered nurse, 12 veterinarian, scientific investigator, or other person licensed, registered, or 13 otherwise permitted to distribute, dispense, conduct research with respect to, or 14 to administer or use in teaching or chemical analysis a controlled substance in 15 the course of professional practice or research in the state; 16 (B) a pharmacy, hospital, or other institution licensed, 17 registered, or otherwise permitted to distribute, dispense, conduct research with 18 respect to, or to administer a controlled substance in the course of professional 19 practice or research in the state; 20 * Sec. 32. AS 13 is amended by adding a new chapter to read: 21 Chapter 55. Voluntary Nonopioid Directive Act. 22 Sec. 13.55.010. Nonopioid directive; revocation; other requirements. (a) 23 An individual who is 18 years of age or older may execute a voluntary nonopioid 24 directive stating that an opioid may not be administered or prescribed to the 25 individual. The directive must be in a format prescribed by the department and 26 available in an electronic format. 27 (b) The commissioner of health and social services shall adopt regulations to 28 implement this chapter. The regulations must 29 (1) include verification by a health care provider and comply with the 30 written consent requirements under 42 U.S.C. 290dd-2(b); 31 (2) provide standard procedures for an individual to submit a voluntary
01 nonopioid directive to a health care provider or hospital; 02 (3) include appropriate exemptions for emergency medical personnel; 03 (4) ensure the confidentiality of a voluntary nonopioid directive; 04 (5) ensure exemptions for an opioid used for treatment of substance 05 abuse or opioid dependence. 06 (c) An individual may revoke a voluntary nonopioid directive at any time in 07 writing or orally. An individual's guardian, conservator, or other person appointed by 08 the individual or a court to manage the individual's health care 09 (1) may revoke an individual's voluntary nonopioid directive at any 10 time, in writing or orally; 11 (2) may not execute a voluntary nonopioid directive on behalf of the 12 individual. 13 (d) An individual may submit a voluntary nonopioid directive to a health care 14 provider or a hospital. 15 Sec. 13.55.020. Obligations of health care providers and hospitals. A health 16 care provider, a hospital, or an employee of a health care provider or hospital may not 17 be subject to disciplinary action by the health care provider's or the employee's 18 professional licensing board or held civilly or criminally liable for failure to 19 administer, prescribe, or dispense an opioid, or for inadvertent administration of an 20 opioid, to an individual who has executed a voluntary nonopioid directive. 21 Sec. 13.55.030. Prescriptions presumed valid. A prescription presented to a 22 pharmacy is presumed to be valid, and a pharmacist may not be subject to disciplinary 23 action by the pharmacist's professional licensing board or held civilly or criminally 24 liable for dispensing a controlled substance in contradiction to an individual's 25 voluntary nonopioid directive. 26 Sec. 13.55.040. Effect of this chapter. Nothing is this chapter shall be 27 construed to 28 (1) alter an advance health care directive under AS 13.52 (Health Care 29 Decisions Act); 30 (2) limit the prescribing, dispensing, or administering of an opioid 31 overdose drug;
01 (3) limit an authorized health care provider or pharmacist from 02 prescribing, dispensing, or administering an opioid for the treatment of substance 03 abuse or opioid dependence. 04 Sec. 13.55.100. Definitions. In this chapter, unless the context otherwise 05 requires, 06 (1) "department" means the Department of Health and Social Services; 07 (2) "health care provider" has the meaning given in AS 09.65.340; 08 (3) "hospital" has the meaning given in AS 13.52.268; 09 (4) "opioid" includes the opium and opiate substances and opium and 10 opiate derivatives listed in AS 11.71.140 and 11.71.160; 11 (5) "opioid overdose drug" has the meaning given in AS 09.65.340. 12 Sec. 13.55.110. Short title. This chapter may be known as the Voluntary 13 Nonopioid Directive Act. 14 * Sec. 33. AS 17.30.200(a), as amended by sec. 21, ch. 25, SLA 2016, is amended to read: 15 (a) The controlled substance prescription database is established in the Board 16 of Pharmacy. The purpose of the database is to contain data as described in this 17 section regarding every prescription for a schedule II, III, or IV controlled substance 18 under federal law dispensed in the state to a person other than under the 19 circumstances described in (u) of this section [THOSE ADMINISTERED TO A 20 PATIENT AT A HEALTH CARE FACILITY]. 21 * Sec. 34. AS 17.30.200(b), as amended by sec. 23, ch. 25, SLA 2016, is amended to read: 22 (b) The pharmacist-in-charge of each licensed or registered pharmacy, 23 regarding each schedule II, III, or IV controlled substance under federal law dispensed 24 by a pharmacist under the supervision of the pharmacist-in-charge, and each 25 practitioner who directly dispenses a schedule II, III, or IV controlled substance under 26 federal law other than those dispensed or administered under the circumstances 27 described in (u) of this section [ADMINISTERED TO A PATIENT AT A HEALTH 28 CARE FACILITY], shall submit to the board, by a procedure and in a format 29 established by the board, the following information for inclusion in the database on at 30 least a weekly basis: 31 (1) the name of the prescribing practitioner and the practitioner's
01 federal Drug Enforcement Administration registration number or other appropriate 02 identifier; 03 (2) the date of the prescription; 04 (3) the date the prescription was filled and the method of payment; this 05 paragraph does not authorize the board to include individual credit card or other 06 account numbers in the database; 07 (4) the name, address, and date of birth of the person for whom the 08 prescription was written; 09 (5) the name and national drug code of the controlled substance; 10 (6) the quantity and strength of the controlled substance dispensed; 11 (7) the name of the drug outlet dispensing the controlled substance; 12 and 13 (8) the name of the pharmacist or practitioner dispensing the controlled 14 substance and other appropriate identifying information. 15 * Sec. 35. AS 17.30.200(b), as amended by sec. 34 of this Act, is amended to read: 16 (b) The pharmacist-in-charge of each licensed or registered pharmacy, 17 regarding each schedule II, III, or IV controlled substance under federal law dispensed 18 by a pharmacist under the supervision of the pharmacist-in-charge, and each 19 practitioner who directly dispenses a schedule II, III, or IV controlled substance under 20 federal law other than those dispensed or administered under the circumstances 21 described in (u) of this section, shall submit to the board, by a procedure and in a 22 format established by the board, the following information for inclusion in the 23 database on at least a daily [WEEKLY] basis: 24 (1) the name of the prescribing practitioner and the practitioner's 25 federal Drug Enforcement Administration registration number or other appropriate 26 identifier; 27 (2) the date of the prescription; 28 (3) the date the prescription was filled and the method of payment; this 29 paragraph does not authorize the board to include individual credit card or other 30 account numbers in the database; 31 (4) the name, address, and date of birth of the person for whom the
01 prescription was written; 02 (5) the name and national drug code of the controlled substance; 03 (6) the quantity and strength of the controlled substance dispensed; 04 (7) the name of the drug outlet dispensing the controlled substance; 05 and 06 (8) the name of the pharmacist or practitioner dispensing the controlled 07 substance and other appropriate identifying information. 08 * Sec. 36. AS 17.30.200(d), as amended by sec. 25, ch. 25, SLA 2016, is amended to read: 09 (d) The database and the information contained within the database are 10 confidential, are not public records, and are not subject to public disclosure [, AND 11 MAY NOT BE SHARED WITH THE FEDERAL GOVERNMENT]. The board shall 12 undertake to ensure the security and confidentiality of the database and the 13 information contained within the database. The board may allow access to the 14 database only to the following persons, and in accordance with the limitations 15 provided and regulations of the board: 16 (1) personnel of the board regarding inquiries concerning licensees or 17 registrants of the board or personnel of another board or agency concerning a 18 practitioner under a search warrant, subpoena, or order issued by an administrative law 19 judge or a court; 20 (2) authorized board personnel or contractors as required for 21 operational and review purposes; 22 (3) a licensed practitioner having authority to prescribe controlled 23 substances or an agent or employee of the practitioner whom the practitioner has 24 authorized to access the database on the practitioner's behalf, to the extent the 25 information relates specifically to a current patient of the practitioner to whom the 26 practitioner is prescribing or considering prescribing a controlled substance; the agent 27 or employee must be licensed or registered under AS 08; 28 (4) a licensed or registered pharmacist having authority to dispense 29 controlled substances or an agent or employee of the pharmacist whom the pharmacist 30 has authorized to access the database on the pharmacist's behalf, to the extent the 31 information relates specifically to a current patient to whom the pharmacist is
01 dispensing or considering dispensing a controlled substance; the agent or employee 02 must be licensed or registered under AS 08; 03 (5) federal, state, and local law enforcement authorities may receive 04 printouts of information contained in the database under a search warrant or order 05 issued by a court establishing probable cause for the access and use of the information; 06 (6) an individual who is the recipient of a controlled substance 07 prescription entered into the database may receive information contained in the 08 database concerning the individual on providing evidence satisfactory to the board that 09 the individual requesting the information is in fact the person about whom the data 10 entry was made and on payment of a fee set by the board under AS 37.10.050 that 11 does not exceed $10; 12 (7) a licensed pharmacist employed by the Department of Health and 13 Social Services who is responsible for administering prescription drug coverage for 14 the medical assistance program under AS 47.07, to the extent that the information 15 relates specifically to prescription drug coverage under the program; 16 (8) a licensed pharmacist, licensed practitioner, or authorized 17 employee of the Department of Health and Social Services responsible for utilization 18 review of prescription drugs for the medical assistance program under AS 47.07, to the 19 extent that the information relates specifically to utilization review of prescription 20 drugs provided to recipients of medical assistance; 21 (9) the state medical examiner, to the extent that the information 22 relates specifically to investigating the cause and manner of a person's death; 23 (10) an authorized employee of the Department of Health and Social 24 Services may receive information from the database that does not disclose the identity 25 of a patient, prescriber, dispenser, or dispenser location, for the purpose of identifying 26 and monitoring public health issues in the state; however, the information provided 27 under this paragraph may include the region of the state in which a patient, prescriber, 28 and dispenser are located and the specialty of the prescriber; and 29 (11) a practitioner, pharmacist, or clinical staff employed by an Alaska 30 tribal health organization, including commissioned corps officers of the United States 31 Public Health Service employed under a memorandum of agreement; in this
01 paragraph, "Alaska tribal health organization" has the meaning given to "tribal health 02 program" in 25 U.S.C. 1603. 03 * Sec. 37. AS 17.30.200(e), as amended by sec. 27, ch. 25, SLA 2016, is amended to read: 04 (e) The failure of a pharmacist-in-charge or a [,] pharmacist [, OR 05 PRACTITIONER] to register or submit information to the database as required under 06 this section is grounds for the board to take disciplinary action against the license or 07 registration of the pharmacy or pharmacist. The failure of a practitioner to register 08 or review the database as required under this section is grounds for the 09 practitioner's [OR FOR ANOTHER] licensing board to take disciplinary action 10 against the [A] practitioner. 11 * Sec. 38. AS 17.30.200(p), enacted by sec. 34, ch. 25, SLA 2016, is amended to read: 12 (p) The board shall promptly notify the State Medical Board, the Board of 13 Nursing, the Board of Dental Examiners, [AND] the Board of Examiners in 14 Optometry, and the Board of Veterinary Examiners when a practitioner registers 15 with the database under (o) of this section. 16 * Sec. 39. AS 17.30.200(q), enacted by sec. 34, ch. 25, SLA 2016, is amended to read: 17 (q) The board is authorized to provide unsolicited notification to a pharmacist, 18 practitioner's licensing board, or practitioner if a patient has received one or more 19 prescriptions for controlled substances in quantities or with a frequency inconsistent 20 with generally recognized standards of safe practice. An unsolicited notification to a 21 practitioner's licensing board under this section 22 (1) must be provided to the practitioner; 23 (2) is confidential; 24 (3) may not disclose information that is confidential under this 25 section; 26 (4) may be in a summary form sufficient to provide notice of the 27 basis for the unsolicited notification. 28 * Sec. 40. AS 17.30.200(r), enacted by sec. 34, ch. 25, SLA 2016, is amended to read: 29 (r) The board shall update the database on at least a daily [WEEKLY] basis 30 with the information submitted to the board under (b) of this section. 31 * Sec. 41. AS 17.30.200(n) is amended by adding a new paragraph to read:
01 (5) "opioid" includes the opium and opiate substances and opium and 02 opiate derivatives listed in AS 11.71.140 and 11.71.160. 03 * Sec. 42. AS 17.30.200 is amended by adding new subsections to read: 04 (t) Notwithstanding (q) of this section, the board may issue to a practitioner 05 periodic unsolicited reports that detail and compare the practitioner's opioid 06 prescribing practice with other practitioners of the same occupation and similar 07 specialty. A report issued under this subsection is confidential and the board shall 08 issue the report only to a practitioner. The board may adopt regulations to implement 09 this subsection. The regulations may address the types of controlled substances to be 10 included in an unsolicited report, the quantities dispensed, the medication strength, 11 and other factors determined by the board. 12 (u) A practitioner or a pharmacist is not required to comply with the 13 requirements of (a) and (b) of this section if a controlled substance is 14 (1) administered to a patient at 15 (A) a health care facility; or 16 (B) a correctional facility; 17 (2) dispensed to a patient for an outpatient supply of 24 hours or less at 18 a hospital 19 (A) inpatient pharmacy; or 20 (B) emergency department. 21 * Sec. 43. AS 18.05.040(a) is amended to read: 22 (a) The commissioner shall adopt regulations consistent with existing law for 23 (1) the time, manner, information to be reported, and persons 24 responsible for reporting for each disease or other condition of public health 25 importance on the list developed under AS 18.15.370; 26 (2) cooperation with local boards of health and health officers; 27 (3) protection and promotion of the public health and prevention of 28 disability and mortality; 29 (4) the transportation of dead bodies, except that the commissioner 30 may not require that a dead body be embalmed unless the body is known to carry a 31 communicable disease or embalmment is otherwise required for the protection of the
01 public health or for compliance with federal law; 02 (5) carrying out the purposes of this chapter; 03 (6) the conduct of its business and for carrying out the provisions of 04 laws of the United States and the state relating to public health; 05 (7) establishing the divisions and local offices and advisory groups 06 necessary or considered expedient to carry out or assist in carrying out a duty or power 07 assigned to it; 08 (8) the voluntary certification of laboratories to perform diagnostic, 09 quality control, or enforcement analyses or examinations based on recognized or 10 tentative standards of performance relating to analysis and examination of food, 11 including seafood, milk, water, and specimens from human beings submitted by 12 licensed physicians and nurses for analysis; 13 (9) the regulation of quality and purity of commercially compressed 14 oxygen sold for human respiration; 15 (10) establishing confidentiality and security standards for information 16 and records received under AS 18.15.355 - 18.15.395; 17 (11) implementation of AS 13.55 (Voluntary Nonopioid Directive 18 Act). 19 * Sec. 44. Sections 22, 24, 26, 28, 30, 32, 52, and 73, ch. 25, SLA 2016, are repealed. 20 * Sec. 45. The uncodified law of the State of Alaska is amended by adding a new section to 21 read: 22 TRANSITION: REGULATIONS. (a) The Department of Health and Social Services 23 may adopt regulations necessary to implement the changes made by secs. 32 and 43 of this 24 Act. The regulations take effect under AS 44.62 (Administrative Procedure Act), but not 25 before the effective date of the relevant provision of this Act implemented by the regulation. 26 (b) The Department of Commerce, Community, and Economic Development and a 27 board that regulates an occupation that includes a practitioner required to register with the 28 controlled substance prescription database under AS 17.30.200 shall adopt regulations to 29 implement the changes made by AS 17.30.200(b), as amended by sec. 35 of this Act, and 30 AS 17.30.200(r), as amended by sec. 40 of this Act. The regulations take effect under 31 AS 44.62 (Administrative Procedure Act), but not before the effective date of the relevant
01 provision of secs. 35 and 40 of this Act implemented by the regulation. In this subsection, 02 (1) "board" has the meaning given in AS 08.01.110; 03 (2) "occupation" has the meaning given in AS 08.01.110; 04 (3) "practitioner" has the meaning given in AS 11.71.900. 05 (c) The Board of Dental Examiners may adopt regulations necessary to implement the 06 changes made by secs. 1 and 2 of this Act. The regulations take effect under AS 44.62 07 (Administrative Procedure Act), but not before the effective date of the relevant provision of 08 secs. 1 and 2 of this Act implemented by the regulation. 09 (d) The State Medical Board may adopt regulations necessary to implement the 10 changes made by secs. 6 - 13 of this Act. The regulations take effect under AS 44.62 11 (Administrative Procedure Act), but not before the effective date of the relevant provision of 12 secs. 6 - 13 of this Act implemented by the regulation. 13 (e) The Board of Nursing may adopt regulations necessary to implement the changes 14 made by secs. 18 and 20 of this Act. The regulations take effect under AS 44.62 15 (Administrative Procedure Act), but not before the effective date of the relevant provision of 16 secs. 18 and 20 of this Act implemented by the regulation. 17 (f) The Board of Examiners in Optometry may adopt regulations necessary to 18 implement the changes made by secs. 23 - 25 of this Act. The regulations take effect under 19 AS 44.62 (Administrative Procedure Act), but not before the effective date of the relevant 20 provision of secs. 23 - 25 of this Act implemented by the regulation. 21 * Sec. 46. Section 27 of this Act takes effect on the effective date of sec. 12, ch. 25, SLA 22 2016. 23 * Sec. 47. Section 33 of this Act takes effect on the effective date of sec. 21, ch. 25, SLA 24 2016. 25 * Sec. 48. Section 34 of this Act takes effect on the effective date of sec. 23, ch. 25, SLA 26 2016. 27 * Sec. 49. Section 36 of this Act takes effect on the effective date of sec. 25, ch. 25, SLA 28 2016. 29 * Sec. 50. Section 37 of this Act takes effect on the effective date of sec. 27, ch. 25, SLA 30 2016. 31 * Sec. 51. Sections 38 and 39 of this Act take effect on the effective date of sec. 34, ch. 25,
01 SLA 2016. 02 * Sec. 52. Section 42 of this Act takes effect on the effective date of secs. 21 and 23, ch. 25, 03 SLA 2016. 04 * Sec. 53. Sections 1, 2, 6 - 13, 18, 20, 23 - 25, 35, and 40 of this Act take effect July 1, 05 2018. 06 * Sec. 54. Sections 32 and 43 of this Act take effect July 1, 2019. 07 * Sec. 55. Except as provided in secs. 46 - 54 of this Act, this Act takes effect immediately 08 under AS 01.10.070(c).