Legislature(2021 - 2022)GRUENBERG 120

04/16/2021 08:00 AM House LABOR & COMMERCE

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08:08:51 AM Start
08:09:32 AM SB87
08:12:56 AM HB145
08:48:54 AM HB149
09:17:40 AM HB125
09:44:03 AM Alaska Workers' Compensation Board
09:44:34 AM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
-- Please Note Time & Location Change --
+= SB 87 REINSURANCE; CREDITS TELECONFERENCED
Moved SB 87 Out of Committee
-- Public Testimony --
+= HB 145 EXPAND PHARMACIST AUTHORITY TELECONFERENCED
Moved HB 145 Out of Committee
-- Public Testimony --
+= HB 149 CHILD CARE PROVIDER COLLECTIVE BARGAINING TELECONFERENCED
Heard & Held
-- Public Testimony --
+ HB 125 MILITARY AND FAMILY EMPLOYMENT PREFERENCE TELECONFERENCED
Heard & Held
+ Bills Previously Heard/Scheduled TELECONFERENCED
               HB 145-EXPAND PHARMACIST AUTHORITY                                                                           
                                                                                                                                
8:12:56 AM                                                                                                                    
                                                                                                                                
CO-CHAIR FIELDS announced  that the next order  of business would                                                               
be  HOUSE  BILL  NO.  145,  "An Act  relating  to  the  Board  of                                                               
Pharmacy;   relating  to   health  care   services  provided   by                                                               
pharmacists  and  pharmacy  technicians;   and  relating  to  the                                                               
practice of pharmacy."                                                                                                          
                                                                                                                                
8:13:11 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SNYDER  reminded the  committee that  the proposed                                                               
legislation  is  intended  to clearly  define  the  patient  care                                                               
services that  can be  provided by pharmacists.   She  noted that                                                               
the  COVID-19 pandemic  particularly highlighted  those services,                                                               
and that  HB 145  would help  ensure regulation  by the  Board of                                                               
Pharmacy as  well as contain  a component  ensuring reimbursement                                                               
by  insurance  providers.   She  noted  Representative  Kaufman's                                                               
concern  regarding  the  term   "general  health  and  wellness,"                                                               
expressed during the  April 12, 2021, meeting of  the House Labor                                                               
and  Commerce  Standing  Committee,   which  she  said  would  be                                                               
addressed during this hearing.                                                                                                  
                                                                                                                                
8:14:20 AM                                                                                                                    
                                                                                                                                
CO-CHAIR FIELDS opened public testimony on HB 145.                                                                              
                                                                                                                                
8:14:32 AM                                                                                                                    
                                                                                                                                
ANGELA JAGLOWICZ, PharmD, testified in  support of HB 145, noting                                                               
that she  is a practicing  primary care pharmacist  and certified                                                               
diabetes education  specialist.   She described  working directly                                                               
with primary  care providers (PCPs)  in caring for  patients with                                                               
chronic  diseases,  ensuring  that medications  are  employed  to                                                               
provide the  best possible health  outcome for the patient.   She                                                               
pointed out  that the  care she provides  is easily  accessed and                                                               
provides continuity  of care  while freeing  up the  schedules of                                                               
busy PCPs for more urgent situations.   She said that as a result                                                               
of  ongoing  visits,  her  patients   are  able  to  develop  the                                                               
knowledge   needed  to   manage  their   own  health   care  more                                                               
effectively.                                                                                                                    
                                                                                                                                
8:16:19 AM                                                                                                                    
                                                                                                                                
DAN  NELSON,   PharmD,  Director   of  Pharmacy,   Tanana  Chiefs                                                               
Conference,  testified in  support  of HB  145,  noting that  the                                                               
COVID-19 pandemic required  an "all hands on  deck" situation for                                                               
healthcare professionals.   He characterized pharmacists  as some                                                               
of  the most  accessible healthcare  professionals and  that they                                                               
have rapidly  responded to Alaska's  healthcare needs.   He urged                                                               
the committee's support for HB 145.                                                                                             
                                                                                                                                
8:17:35 AM                                                                                                                    
                                                                                                                                
JAY FLYNN,  MD, testified in  support of HB 145,  explaining that                                                               
doctors can't  always get to  patients with  lifesaving vaccines.                                                               
He said  pharmacists' contribution  allows the  medical community                                                               
to have a stronger impact in the Norton Sound area.                                                                             
                                                                                                                                
8:18:56 AM                                                                                                                    
                                                                                                                                
KYLIE GOFF  testified in support  of HB 145.   She said  that the                                                               
medical   community   relies   heavily  on   the   expertise   of                                                               
pharmacists,   who  have   been  leaders   in  organizing   child                                                               
immunizations and well-child checkups.   She said that the impact                                                               
of pharmacists  is felt  more in communities  with a  shortage of                                                               
primary care providers.                                                                                                         
                                                                                                                                
8:21:17 AM                                                                                                                    
                                                                                                                                
BARRY  CHRISTENSEN, RPh,  Legislative Committee  Co-Chair, Alaska                                                               
Pharmacists  Association, testified  in support  of HB  145.   He                                                               
noted the  changes within  the profession  in recent  decades and                                                               
said today's  pharmacists are in  a better position to  help meet                                                               
their  patients' pharmaceutical  needs.   In order  for community                                                               
pharmacies to survive and serve  patients, he said, the statutory                                                               
language in HB 145 is necessary.                                                                                                
                                                                                                                                
8:23:05 AM                                                                                                                    
                                                                                                                                
NATALIE MCCAY testified in support of HB  145.  She said she is a                                                               
certified  pharmacy technician  and expressed  that the  proposed                                                               
legislation   would  be   especially  important   to  rural   and                                                               
underserved areas such as Petersburg.   Pharmacists are often the                                                               
first stop when  patients have questions, she  said, and allowing                                                               
pharmacists  and their  support staff  to provide  certain health                                                               
care services would increase access to health care.                                                                             
                                                                                                                                
8:24:01 AM                                                                                                                    
                                                                                                                                
DOUGLAS BARTKO testified in support of  HB 145.  He discussed the                                                               
problem  of claim  rejection experienced  by pharmacists,  saying                                                               
they need to be paid for the services they provide.                                                                             
                                                                                                                                
8:25:43 AM                                                                                                                    
                                                                                                                                
JUSTIN RUFFRIDGE,  PharmD, testified  on behalf  of the  Board of                                                               
Pharmacy in support of HB 145.                                                                                                  
                                                                                                                                
8:26:21 AM                                                                                                                    
                                                                                                                                
MARK  BOHRER, RPh,  Pharmacy  Practice  Coordinator, Fred  Meyer,                                                               
testified in  support of  HB 145  as the  supervisor of  all Fred                                                               
Meyer pharmacy  locations in  Alaska.  He  said he  has practiced                                                               
pharmacy in  Alaska for  31 years  and described  how pharmacists                                                               
have  "stepped  up"  during   the  COVID-19  pandemic,  providing                                                               
testing and vaccinations.                                                                                                       
                                                                                                                                
8:27:55 AM                                                                                                                    
                                                                                                                                
DIRK WHITE,  RPh, testified in support  of HB 145.   He expressed                                                               
that the  practice of pharmacy has  changed in the past  35 years                                                               
and statutes  need to evolve into  the new century.   He said his                                                               
pharmacy has started offering strep  tests and COVID-19 tests but                                                               
because  he  and his  employees  are  not classified  as  medical                                                               
providers, they're not  able to bill insurance  companies and are                                                               
forced to charge patients directly.   Passage of HB 145, he said,                                                               
would improve  the profession and  allow pharmacists  to increase                                                               
access to healthcare in all parts of Alaska.                                                                                    
                                                                                                                                
8:30:24 AM                                                                                                                    
                                                                                                                                
TALETHIA BOGART testified in support of  HB 145.  She shared that                                                               
she is  in her 3rd year  of pharmacy school and  previously was a                                                               
high school  science teacher and  pharmacy technician.   She said                                                               
she understands  the shortage of  health care services  in Alaska                                                               
and  that she  believes  HB  145 would  alleviate  some of  those                                                               
issues, primarily in primary care  settings.  She said that she's                                                               
being  prepared to  handle many  areas of  health care  including                                                               
primary care,  critical care,  emergency medicine,  and community                                                               
pharmacy, and  pointed out that  she's seen firsthand  the impact                                                               
of  her  training   in  remote  communities.     She  said  she's                                                               
participated in COVID-19  vaccine clinics, administering hundreds                                                               
of vaccines and providing general health care information.                                                                      
                                                                                                                                
8:33:00 AM                                                                                                                    
                                                                                                                                
JACOB JORDAN testified  in support of HB 145.   He shared that he                                                               
is  a  pharmacy student  in  his  third year,  having  previously                                                               
served  nine years  in  the military  after  graduating from  the                                                               
United States Military  Academy at West Point.   He described the                                                               
intense training to  become a Doctor of  Pharmacy, including four                                                               
years  of education  on medication  use, safety,  and monitoring,                                                               
with a focus  on chronic disease management,  health and wellness                                                               
support,  and   providing  preventative  health  services   in  a                                                               
community  setting.   He said  he's required  to have  over 2,000                                                               
hours  of  clinical  experience,   culminating  in  his  clinical                                                               
training during his fourth year in  the program, as well as three                                                               
years of  classroom-based training.  Students  within the program                                                               
have taken independent healthcare  initiatives, he said, with his                                                               
class  training  over  60  volunteers  each  year  to  assist  in                                                               
community  health care.   He  said  HB 145  would help  modernize                                                               
Alaska's  pharmacy  practice  statutes and  resolve  longstanding                                                               
regulatory  issues,  thereby  allowing patients  more  access  to                                                               
pharmacy healthcare services.                                                                                                   
                                                                                                                                
8:35:09 AM                                                                                                                    
                                                                                                                                
MARGARET  SODEN,  RPh, testified  in  support  of  HB 145.    She                                                               
pointed out  how pharmacists, pharmacy technicians,  and pharmacy                                                               
students  helped during  the COVID-19  pandemic.   She  described                                                               
some  of  the  changes  in  the profession  since  she  took  her                                                               
licensing exam in  1965, when the practical exam  tested how well                                                               
one could fold  papers for containing powder.  She  said that all                                                               
areas  of   medicine,  including   pharmacy,  have   become  more                                                               
sophisticated  and  it's  important   to  empower  the  Board  of                                                               
Pharmacy to recognize the changes.                                                                                              
                                                                                                                                
8:37:00 AM                                                                                                                    
                                                                                                                                
KAREN MILLER, RPh,  testified in support of HB  145, sharing that                                                               
she's been  a pharmacist  at Fairbanks  Memorial Hospital  for 27                                                               
years.  She  described helping with hospice,  long-term care, and                                                               
patient discharges,  noting that oftentimes the  pharmacist is in                                                               
the background ensuring direct and  affordable drug therapy.  She                                                               
said  pharmacists often  struggle to  get reimbursement  and that                                                               
she believes HB 145 would be beneficial.                                                                                        
                                                                                                                                
8:38:24 AM                                                                                                                    
                                                                                                                                
AMY TAUL testified in support of  HB 145, sharing that she is the                                                               
clinical  faculty   pharmacist  at  Providence   Family  Medicine                                                               
Center.   She  said that  the primary  resource for  treatment is                                                               
medication, and  medical school graduates often  receive only one                                                               
semester of  pharmacology.   She described  supporting physicians                                                               
and patients  through medication and chronic  disease management,                                                               
working   alongside  physicians   to  assist   in  choosing   the                                                               
appropriate medication.   She talked about  working directly with                                                               
patients  in general  health care  and disease  management, often                                                               
counseling patients  and making the  appropriate recommendations.                                                               
Utilizing clinical  pharmacists, she said, would  make physicians                                                               
available to treat more patients.                                                                                               
                                                                                                                                
8:41:36 AM                                                                                                                    
                                                                                                                                
SUSAN WHEELER,  PharmD, testified in  support of HB  145, sharing                                                               
that  she   is  a  pharmacist   at  the   Yukon-Kuskokwim  Health                                                               
Corporation.   She  said that  pharmacists  are fully  integrated                                                               
with  other healthcare  professionals but  are unable  to receive                                                               
compensation  for their  services  due to  the  absence of  their                                                               
ability to  enroll as  billing providers.   She  said pharmacists                                                               
are often  the most  readily available  healthcare professionals,                                                               
but are the  only providers not currently listed  in the provider                                                               
anti-discrimination  statute, meaning  they  do  not receive  the                                                               
same  compensation as  another  professional  providing the  same                                                               
service.   She said the  lack of compensation makes  it difficult                                                               
to sustain and provide the  services pharmacists are qualified to                                                               
provide,  which  may  prevent   patients  from  obtaining  needed                                                               
healthcare.                                                                                                                     
                                                                                                                                
8:43:32 AM                                                                                                                    
                                                                                                                                
RENEE ROBINSON, PharmD,  testified in support of  HB 145, sharing                                                               
that she  is an associate  professor at the University  of Alaska                                                               
Anchorage/Idaho  State  University  College  of  Pharmacy.    She                                                               
described  her  extensive  experience  working  with  underserved                                                               
populations.    She  said  HB   145  would  resolve  longstanding                                                               
regulatory issues that impede progress  while supporting Board of                                                               
Pharmacy oversight.                                                                                                             
                                                                                                                                
8:45:34 AM                                                                                                                    
                                                                                                                                
CO-CHAIR FIELDS,  after ascertaining that  no one else  wished to                                                               
testify, closed public testimony on HB 145.                                                                                     
                                                                                                                                
8:45:59 AM                                                                                                                    
                                                                                                                                
CO-CHAIR SPOHNHOLZ moved  to report HB 145 out  of committee with                                                               
individual  recommendations and  the  accompanying fiscal  notes.                                                               
There being  no objection, HB 145  was reported out of  the House                                                               
Labor and Commerce Standing Committee.