02/08/1993 03:00 PM House HES

  HB 114:  EXTEND TOURISM MARKETING COUNCIL                                    
                                                                               
  Number 064                                                                   
                                                                               
  REP. CYNTHIA TOOHEY testified as sponsor of HB 114.  She                     
  related the story of an Anchorage nurse practitioner who                     
  asked the state licensing bureau why she was not allowed to                  
  dispense medication, as most nurse practitioners are                         
  advanced registered nurses operating in the Bush and they                    
  are able to prescribe medicines, but are not allowed to                      
  dispense them.  She said the bill would allow advanced nurse                 
  practitioners (ANPs) to dispense medicines when there is no                  
  pharmacy available.  She cited 126 letters from advanced                     
  nurse practitioners about the bill, and a letter from state                  
  pharmacists showing no opposition.  She said the Indian                      
  Health Service uses many advanced nurse practitioners in                     
  villages, and to bar them from dispensing would do damage to                 
  the state.                                                                   
                                                                               
  Number 108                                                                   
                                                                               
  PATRICIA HONG, PRESIDENT OF THE ALASKA NURSES ASSOCIATION,                   
  testified from Anchorage in support of HB 114.  She urged                    
  support so that advanced nurse practitioners could continue                  
  the proven valuable services they provide to rural and                       
  indigent patients.                                                           
                                                                               
  DARYL YOUNG, DIRECTOR OF STUDENT HEALTH AT THE UNIVERSITY OF                 
  ALASKA-ANCHORAGE, testified from Anchorage in support of                     
  HB 114.  He said ANPs often need to dispense medications                     
  when there is no accessible pharmacy, or when clients cannot                 
  pay for medications and dispensation.  When ANPs can                         
  dispense medications, patients are more likely to obtain and                 
  take their medications.  The university student health                       
  center has 8,000 potential patients, many of them lacking                    
  money, health insurance, time and inclination to comply with                 
  medical orders.  Giving ANPs dispensary privileges, even in                  
  urban areas, will dramatically increase prompt and proper                    
  compliance with medical orders, he said.  He also noted that                 
  the drugs dispensed at the student health center are                         
  premeasured and prepackaged, and none are compounded                         
  on-site.                                                                     
                                                                               
  Number 183                                                                   
                                                                               
  CHAIR BUNDE noted that the Matanuska-Susitna Legislative                     
  Information Office (LIO) was on-line.  He asked witnesses to                 
  limit testimony to two minutes to save time.                                 
  Number 186                                                                   
                                                                               
  DR. DIXIE LIGHT, A FAMILY NURSE-PRACTITIONER, testified from                 
  the Mat-Su LIO.  She said her patients in the Mat-Su valley                  
  and north along the Parks Highway have little access to                      
  drugstores and therefore may wait days before going to town                  
  to fill the prescription, possibly too late.  The ability to                 
  prescribe supports her simple, rural practice, serving low-                  
  income patients with medical care and information.                           
                                                                               
  Number 202                                                                   
                                                                               
  SUE ANN JENKENSON, A MEMBER OF THE ALASKA NURSE PRACTITIONER                 
  ASSOCIATION (transmission partially unintelligible)                          
  testified from Anchorage in support of HB 114.  She said the                 
  change was necessary to provide complete care to patients                    
  too poor to buy medicines or live in rural areas far from                    
  pharmacies.  Nurse practitioners in Alaska have been able to                 
  practice independently since 1984, and to prescribe since                    
  1985, and dispensing would complement these abilities.                       
                                                                               
  Number 222                                                                   
                                                                               
  GAIL McGUILL, EXECUTIVE SECRETARY FOR THE ALASKA BOARD OF                    
  NURSING, testified from Anchorage in support of HB 114.  She                 
  said ANP dispensing does occur around the state.  A November                 
  1992 survey of nurse practitioners in Alaska showed that 55                  
  percent of the state's nurse practitioners dispense                          
  medicine, with 25 percent of nurse practitioners working in                  
  areas without pharmacies, and 22 percent in areas without                    
  physicians.  Ms. McGuill stated HB 114 would help prevent                    
  degradation of such services.  She said the Boards of                        
  Nursing and Pharmacy have cooperated to set parameters for                   
  ANP dispensing, and the parameters of ANP dispensation will                  
  be defined by Board of Nursing regulation.                                   
                                                                               
  Number 248                                                                   
                                                                               
  KAY LAHDENPERA, OF THE MUNICIPALITY OF ANCHORAGE, testified                  
  from Anchorage in support of HB 114.  She said the                           
  municipality has employed and used nurse practitioners since                 
  1984 and would be glad to see them win dispensing authority,                 
  the better to serve their clients.                                           
                                                                               
  Number 264                                                                   
                                                                               
  DR. PETER NAKAMURA, DIRECTOR OF THE DIVISION OF PUBLIC                       
  HEALTH, testified in support of HB 114.  He said it aids in                  
  access and cost containment.                                                 
                                                                               
  Number 272                                                                   
                                                                               
  CHAIR BUNDE closed public testimony and asked the will of                    
  the committee.                                                               
                                                                               
  REP. AL VEZEY moved passage of HB 114 from the committee                     
  with individual recommendations.                                             
                                                                               
  Hearing no objections to the motion, CHAIR BUNDE declared                    
  HB 114 PASSED WITH INDIVIDUAL RECOMMENDATIONS.