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HB 89: "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 relating to the practice of pharmacy."

00                              HOUSE BILL NO. 89                                                                          
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 relating to the practice of pharmacy."                                                                   
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 on proof of continued professional competence; the regulations must                                       
04 require that a licensee receive not less than two hours of education in pain                                            
05 management and opioid use and addiction in the two years preceding an application                                       
06 for renewal of a license, unless the licensee has demonstrated to the satisfaction of the                               
07 board that the licensee does not currently hold a valid federal Drug Enforcement                                        
08       Administration registration number;                                                                               
09 (8)  at least annually, cause to be published on the Internet and in a                                                  
10 newspaper of general circulation in each major city in the state a summary of                                           
11       disciplinary actions the board has taken during the preceding calendar year;                                      
12 (9)  issue permits or certificates to licensed dentists, licensed dental                                                
13 hygienists, and dental assistants who meet standards determined by the board for                                        
14       specific procedures that require specific education and training;                                                 
15 (10)  require that a licensed dentist who has a federal Drug                                                            
16 Enforcement Administration registration number register with the controlled substance                                   
17       prescription database under AS 17.30.200(o);                                                                  
18 (11)  adopt regulations requiring a licensee to advise patients, using                                              
19 oral and written information, before prescribing an opioid, of the potential                                        
20 dangers of opioid addiction, and alternatives to the opioid prescription the                                        
21 provider considers reasonable; the board may determine which classes of                                             
22 patients may be reasonably exempted from the information requirement and                                            
23 may allow an exemption from the requirement for violations the board considers                                      
24 to be unintentional, periodic accidental violations, and for good cause, including                                  
25 when a licensee needs to attend to the perceived immediate health care of another                                   
26       patient.                                                                                                      
27    * Sec. 3. AS 08.64.101(a) is amended to read:                                                                      
28            (a)  The board shall                                                                                         
29 (1)  except as provided in regulations adopted by the board under (b) of                                                
30       this section, examine and issue licenses to applicants;                                                           
31 (2)  develop written guidelines to ensure that licensing requirements are                                               
01       not unreasonably burdensome and the issuance of licenses is not unreasonably                                      
02       withheld or delayed;                                                                                              
03                 (3)  after a hearing, impose disciplinary sanctions on persons who                                      
04       violate this chapter or the regulations or orders of the board;                                                   
05                 (4)  adopt regulations ensuring that renewal of licenses is contingent on                               
06       proof of continued competency on the part of the licensee;                                                        
07 (5)  under regulations adopted by the board, contract with private                                                      
08 professional organizations to establish an impaired medical professionals program to                                    
09 identify, confront, evaluate, and treat persons licensed under this chapter who abuse                                   
10       alcohol, other drugs, or other substances or are mentally ill or cognitively impaired;                            
11 (6)  adopt regulations that establish guidelines for a physician who is                                                 
12 rendering a diagnosis, providing treatment, or prescribing, dispensing, or                                              
13 administering a prescription drug to a person without conducting a physical                                             
14 examination under AS 08.64.364; the guidelines must include a nationally recognized                                     
15 model policy for standards of care of a patient who is at a different location than the                                 
16       physician;                                                                                                        
17 (7)  require that a licensee who has a federal Drug Enforcement                                                         
18 Administration registration number register with the controlled substance prescription                                  
19       database under AS 17.30.200(o);                                                                               
20 (8)  adopt regulations requiring a licensee to advise patients, using                                               
21 oral and written information, before prescribing an opioid, of the potential                                        
22 dangers of opioid addiction, and alternatives to the opioid prescription the                                        
23 provider considers reasonable; the board may determine which classes of                                             
24 patients may be reasonably exempted from the information requirement and                                            
25 may allow an exemption from the requirement for violations the board considers                                      
26 to be unintentional, periodic accidental violations, and for good cause, including                                  
27 when a licensee needs to attend to the perceived immediate health care of another                                   
28       patient.                                                                                                      
29    * Sec. 4. AS 08.68.100(a) is amended to read:                                                                      
30            (a)  The board shall                                                                                         
31 (1)  adopt regulations necessary to implement this chapter, including                                                   
01       regulations                                                                                                       
02 (A)  pertaining to practice as an advanced practice registered                                                          
03 nurse, including requirements for an advanced practice registered nurse to                                              
04 practice as a certified registered nurse anesthetist, certified clinical nurse                                          
05 specialist, certified nurse practitioner, or certified nurse midwife; regulations                                       
06 for an advanced practice registered nurse who holds a valid federal Drug                                                
07 Enforcement Administration registration number must address training in pain                                            
08            management and opioid use and addiction;                                                                     
09 (B)  necessary to implement AS 08.68.331 - 08.68.336 relating                                                           
10 to certified nurse aides in order to protect the health, safety, and welfare of                                         
11            clients served by nurse aides;                                                                               
12                      (C)  pertaining to retired nurse status; and                                                       
13 (D)  establishing criteria for approval of practical nurse                                                              
14 education programs that are not accredited by a national nursing accrediting                                            
15            body;                                                                                                        
16 (2)  approve curricula and adopt standards for basic education programs                                                 
17       that prepare persons for licensing under AS 08.68.190;                                                            
18 (3)  provide for surveys of the basic nursing education programs in the                                                 
19       state at the times it considers necessary;                                                                        
20 (4)  approve education programs that meet the requirements of this                                                      
21 chapter and of the board, and deny, revoke, or suspend approval of education                                            
22       programs for failure to meet the requirements;                                                                    
23                 (5)  examine, license, and renew the licenses of qualified applicants;                                  
24 (6)  prescribe requirements for competence before a former registered,                                                  
25 advanced practice registered, or licensed practical nurse may resume the practice of                                    
26       nursing under this chapter;                                                                                       
27 (7)  define by regulation the qualifications and duties of the executive                                                
28 administrator and delegate authority to the executive administrator that is necessary to                                
29       conduct board business;                                                                                           
30                 (8)  develop reasonable and uniform standards for nursing practice;                                     
31 (9)  publish advisory opinions regarding whether nursing practice                                                       
01 procedures or policies comply with acceptable standards of nursing practice as defined                                  
02       under this chapter;                                                                                               
03 (10)  require applicants under this chapter to submit fingerprints and the                                              
04 fees required by the Department of Public Safety under AS 12.62.160 for criminal                                        
05 justice information and a national criminal history record check; the department shall                                  
06 submit the fingerprints and fees to the Department of Public Safety for a report of                                     
07 criminal justice information under AS 12.62 and a national criminal history record                                      
08       check under AS 12.62.400;                                                                                         
09 (11)  require that a licensed advanced practice registered nurse who has                                                
10 a federal Drug Enforcement Administration registration number register with the                                         
11       controlled substance prescription database under AS 17.30.200(o);                                             
12 (12)  adopt regulations requiring a licensee to advise patients, using                                              
13 oral and written information, before prescribing an opioid, of the potential                                        
14 dangers of opioid addiction, and alternatives to the opioid prescription the                                        
15 provider considers reasonable; the board may determine which classes of                                             
16 patients may be exempted from the information requirement and may allow an                                          
17 exemption from the requirement for violations the board considers to be                                             
18 unintentional, periodic accidental violations, and for good cause, including when                                   
19 a licensee needs to attend to the perceived immediate health care of another                                        
20       patient.                                                                                                      
21    * Sec. 5. AS 08.72.050 is amended to read:                                                                         
22            Sec. 08.72.050. Regulations. The board shall adopt regulations                                             
23                 (1)  necessary for the proper performance of its duties;                                                
24                 (2)  governing the applicants and applications for licensing;                                           
25                 (3)  for the licensing of optometrists;                                                                 
26 (4)  necessary to govern the practice of optometry, including the                                                       
27       prescription and use of pharmaceutical agents for the treatment of eye disease;                                   
28 (5)  prescribing requirements that a person licensed under this chapter                                                 
29       must meet to demonstrate continued professional competency;                                                       
30                 (6)  developing uniform standards for the practice of optometry;                                    
31 (7)  requiring a licensee to advise patients, using oral and written                                                
01 information, before prescribing an opioid, of the potential dangers of opioid                                       
02 addiction and alternatives to the opioid prescription the provider considers                                        
03 reasonable; the board may determine which classes of patients may be exempted                                       
04 from the information requirement and may allow an exemption from the                                                
05 requirement for violations the board considers to be unintentional, periodic                                        
06 accidental violations, and for good cause, including when a licensee needs to                                       
07       attend to the perceived immediate health care of another patient.                                             
08    * Sec. 6. AS 08.80.030(b) is amended to read:                                                                      
09 (b)  In order to fulfill its responsibilities, the board has the powers necessary                                       
10       for implementation and enforcement of this chapter, including the power to                                        
11 (1)  elect a president and secretary from its membership and adopt rules                                                
12       for the conduct of its business;                                                                                  
13 (2)  license by examination or by license transfer the applicants who are                                               
14       qualified to engage in the practice of pharmacy;                                                                  
15 (3)  assist the department in inspections and investigations for                                                        
16 violations of this chapter, or of any other state or federal statute relating to the practice                           
17       of pharmacy;                                                                                                      
18                 (4)  adopt regulations to carry out the purposes of this chapter;                                       
19 (5)  establish and enforce compliance with professional standards and                                                   
20       rules of conduct for pharmacists engaged in the practice of pharmacy;                                             
21 (6)  determine standards for recognition and approval of degree                                                         
22 programs of schools and colleges of pharmacy whose graduates shall be eligible for                                      
23 licensure in this state, including the specification and enforcement of requirements for                                
24       practical training, including internships;                                                                        
25 (7)  establish for pharmacists and pharmacies minimum specifications                                                    
26 for the physical facilities, technical equipment, personnel, and procedures for the                                     
27 storage, compounding, and dispensing of drugs or related devices, and for the                                           
28       monitoring of drug therapy;                                                                                       
29 (8)  enforce the provisions of this chapter relating to the conduct or                                                  
30 competence of pharmacists practicing in the state, and the suspension, revocation, or                                   
31       restriction of licenses to engage in the practice of pharmacy;                                                    
01                 (9)  license and regulate the training, qualifications, and employment of                               
02       pharmacy interns and pharmacy technicians;                                                                        
03                 (10)  issue licenses to persons engaged in the manufacture and                                          
04       distribution of drugs and related devices;                                                                        
05                 (11)  establish and maintain a controlled substance prescription                                        
06       database as provided in AS 17.30.200;                                                                             
07 (12)  establish standards for the independent administration by a                                                       
08 pharmacist of vaccines and related emergency medications under AS 08.80.168,                                            
09 including the completion of an immunization training program approved by the board;                                     
10 (13)  establish standards for the independent dispensing by a                                                           
11 pharmacist of an opioid overdose drug under AS 17.20.085, including the completion                                      
12       of an opioid overdose training program approved by the board;                                                     
13 (14)  require that a licensed pharmacist register with the controlled                                                   
14       substance prescription database under AS 17.30.200(o);                                                            
15 (15)  establish the qualifications and duties of the executive                                                          
16 administrator and delegate authority to the executive administrator that is necessary to                                
17       conduct board business;                                                                                           
18 (16)  license and inspect the facilities of wholesale drug distributors,                                                
19 third-party logistics providers, and outsourcing facilities located outside the state                                   
20       under AS 08.80.159;                                                                                           
21 (17)  adopt regulations requiring a licensee to advise patients, using                                              
22 oral and written information, before prescribing an opioid, of the potential                                        
23 dangers of opioid addiction, and alternatives to the opioid prescription the                                        
24 provider considers reasonable; the board may determine which classes of                                             
25 patients may be reasonably exempted from the information requirement and                                            
26 may allow an exemption from the requirement for violations the board considers                                      
27 to be unintentional, periodic accidental violations, and for good cause, including                                  
28 when a licensee needs to attend to the perceived immediate health care of another                                   
29       patient.                                                                                                      
30    * Sec. 7. 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.