Legislature(2015 - 2016)BARNES 124

02/27/2015 03:15 PM LABOR & COMMERCE

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
*+ HB 32 WORKERS COMP: CONTROLLED SUBSTANCES TESTS TELECONFERENCED
Heard & Held
*+ HB 116 EXTEND ALCOHOLIC BEVERAGE CONTROL BOARD TELECONFERENCED
Moved HB 116 Out of Committee
        HB 32-WORKERS COMP: CONTROLLED SUBSTANCES TESTS                                                                     
                                                                                                                                
3:18:32 PM                                                                                                                    
                                                                                                                                
CHAIR OLSON announced  that the first order of  business would be                                                               
HOUSE BILL  NO. 32,  "An Act  relating to  employer-required drug                                                               
testing;  requiring the  Alaska  Workers'  Compensation Board  to                                                               
adopt  regulations relating  to  the  prescription of  controlled                                                               
substances  to employees;  and relating  to  the prescription  of                                                               
controlled substances to employees."                                                                                            
                                                                                                                                
3:19:03 PM                                                                                                                    
                                                                                                                                
KONRAD JACKSON,  Staff, Representative  Kurt Olson,  Alaska State                                                               
Legislature, on behalf of the  prime sponsor, Representative Kurt                                                               
Olson,  stated that  HB 32  is  intended to  address opioid  use,                                                               
which is one of the factors  leading to the high cost of workers'                                                               
compensation  insurance  in Alaska.    The  sponsor introduced  a                                                               
similar  bill last  legislature on  the  same topic.   This  bill                                                               
would allow  for drug testing  for workers'  compensation patient                                                               
opioid  use   under  very  specific  circumstances   by  limiting                                                               
prescriptions  for opioids  to  a  30-day supply.    He said  the                                                               
bill's focus  is aimed to help  reduce the high cost  of workers'                                                               
compensation in Alaska  by addressing the epidemic  use of opioid                                                               
use  and abuse  of  prescription drugs  by workers'  compensation                                                               
patients.                                                                                                                       
                                                                                                                                
MR. JACKSON  gave a brief  section-by-section analysis of  HB 32,                                                               
relating that Section  1 would authorize drug  testing of injured                                                               
workers  if  the  employees have  been  prescribed  a  controlled                                                               
substance  for over  90  days.   He said  a  negative test  could                                                               
result in denial of future  payments for the controlled substance                                                               
by the employer,  although negative or positive  test results may                                                               
not  result  in  any  adverse employment  action.    He  directed                                                               
attention to  the "may"  language, which  is permissive  since it                                                               
does not mandate a test after 90 days.                                                                                          
                                                                                                                                
MR.  JACKSON   stated  that  Section  2   requires  the  Workers'                                                               
Compensation  Board  to  adopt   regulations  pertaining  to  the                                                               
provisions in Section 3 of HB 32.                                                                                               
                                                                                                                                
3:20:53 PM                                                                                                                    
                                                                                                                                
MR.  JACKSON  stated  Section  3   will  limit  prescriptions  of                                                               
controlled substances  listed in schedule  IA, IIIA, or VA  in AS                                                               
11.71 to  a 30-day  supply; however, an  employer or  insurer may                                                               
use an  employee's negative test  result under AS 23.10  to claim                                                               
that the  employee may  not be eligible  for future  payments for                                                               
schedule IA controlled substance  prescription.  Again, this bill                                                               
is designed to  limit and discourage use of  long-term opioids by                                                               
restricting prescriptions  to controlled  substances to  30 days,                                                               
he  said.    He  reported   statistics  that  show  one  in  four                                                               
prescriptions  is  being  used  by   someone  who  has  not  been                                                               
prescribed the  medication that employers are  paying for, either                                                               
directly or through insurer premiums.                                                                                           
                                                                                                                                
3:22:06 PM                                                                                                                    
                                                                                                                                
MR. JACKSON  emphasized that the  drugs in question are  not mild                                                               
drugs, but are  opioids, which are a synthetic  version of opium-                                                               
derived drugs  as defined in AS  11.  Higher usage  and dosage of                                                               
opioids  over  long  periods  of  time  can  lead  to  addiction,                                                               
increased disability  or work loss,  and potentially  even death.                                                               
He reported  that deaths from  overdoses have  grown dramatically                                                               
and  in many  states  have now  exceeded  deaths from  automobile                                                               
crashes.   He concluded by  stating that prescription  drug abuse                                                               
has been declared an epidemic  by the Centers for Disease Control                                                               
(CDC).                                                                                                                          
                                                                                                                                
3:23:45 PM                                                                                                                    
                                                                                                                                
CHAIR OLSON asked whether patients  can obtain a new prescription                                                               
so long as they see their doctor.                                                                                               
                                                                                                                                
MR. JACKSON  answered yes.   The bill proposes reducing  a 90-day                                                               
prescription of controlled  substances to 30 days.   Patients can                                                               
obtain refills  by visiting their  physicians, who  can prescribe                                                               
an additional  30-day refill, if  deemed necessary.   The overall                                                               
goal is  to reduce workers'  compensation costs, but also  to get                                                               
workers  healthy and  back to  work as  quickly as  possible, and                                                               
proper pain management is a key component.                                                                                      
                                                                                                                                
3:24:42 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  HUGHES asked  for  further  clarification if  the                                                               
drug test  is negative and the  opioids are not in  the patient's                                                               
system,  whether  it  is  possible  that  these  drugs  might  be                                                               
diverted  and  are  being  illegally sold.    She  further  asked                                                               
whether  the  statistics for  overdoses  are  for patients  being                                                               
prescribed  the  drugs or  by  people  illegally buying  diverted                                                               
prescription drugs.                                                                                                             
                                                                                                                                
MR. JACKSON replied that a negative  test may result in denial of                                                               
a  prescription refill  for controlled  substances, noting  these                                                               
costs are being  passed on to the insurer or  the employer.  Thus                                                               
if the patients do not  need the medication, their employers need                                                               
to stop  paying for  it.   He clarified that  this bill  does not                                                               
accuse   workers'   compensation   patients  of   selling   their                                                               
prescription  drugs,  in fact,  patients  may  simply be  putting                                                               
their prescriptions  in the medicine  cabinet.  This  bill allows                                                               
the  drug testing  to occur  to ensure  that patients  are taking                                                               
their medications.  If patients  have been consciously attempting                                                               
to wean themselves off their  pain medication, and some have done                                                               
so,  they must  do  so in  conjunction with  their  doctors.   He                                                               
reiterated that  this bill  does not intend  to harm  the injured                                                               
worker.    He  directed  attention  to some  of  the  reports  in                                                               
members'  packets that  provide  information  on drug  overdoses,                                                               
although he did not specifically recall the figures.                                                                            
                                                                                                                                
3:27:48 PM                                                                                                                    
                                                                                                                                
CHAIR  OLSON said  that he  has heard  that one-third  of Alaskan                                                               
workers  are subject  to random  UAs (urine  analysis) with  more                                                               
stringent  actions  allowed for  positive  tests.   For  example,                                                               
North Slope workers will lose their  jobs if they have a negative                                                               
test.   Employees of many  industries, including ones  related to                                                               
transportation, maritime,  and the military currently  subject to                                                               
drug testing, he reported.                                                                                                      
                                                                                                                                
3:28:28 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE HUGHES  said it  is a good  bill and  she supports                                                               
it.     She  emphasized  the  importance   of  reducing  workers'                                                               
compensation costs  in Alaska.   She asked whether  any employers                                                               
are  subject to  rules  regarding administering  random UAs,  for                                                               
example, whether employees are forewarned.                                                                                      
                                                                                                                                
MR. JACKSON answered that this  bill specifically addresses Title                                                               
23, which relates to workers'  compensation and does not apply to                                                               
other workers.   He clarified  that this bill applies  to injured                                                               
workers who have been taking  prescriptions opioids for more than                                                               
90 days.   However, this bill would not apply  to patients taking                                                               
prescription drugs  for opioids for  less than 90  days; instead,                                                               
the trigger  for drug testing  of workers'  compensation patients                                                               
is  for patients  have been  taking prescription  opioids for  90                                                               
days or longer.   He stated that the details  for testing will be                                                               
laid out in regulation upon passage of HB 32.                                                                                   
                                                                                                                                
3:30:44 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE COLVER asked  who can order the  tests, whether it                                                               
is the employer or the workers' compensation carrier.                                                                           
                                                                                                                                
MR. JACKSON answered that it is  not spelled out in the bill, but                                                               
it will be  established in regulation.  He  directed attention to                                                               
Section 1, which  allows the employer, or  essentially the claims                                                               
manager to  order the  testing.   He deferred  to Mr.  Monagle to                                                               
further address this during his testimony.                                                                                      
                                                                                                                                
3:31:49 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KITO said  this is the first time he  has seen the                                                               
bill.    He expressed  concern  that  the state  would  establish                                                               
different classes  of care for people.   He offered if  the state                                                               
believes  that it  needs  to  assure that  there  isn't abuse  of                                                               
scheduled drugs, the statutes should  apply to everyone, not just                                                               
those  receiving workers'  compensation.   However,  if there  is                                                               
further  concern   about  keep  people  from   illegally  selling                                                               
narcotics, it  is already illegal  to do  so.  He  suggested that                                                               
there  should  be  other  ways   to  investigating  whether  that                                                               
activity is  taking place.  He  did not think that  doctors could                                                               
provide evidence  to an investigator  as to whether a  patient is                                                               
potentially selling narcotics.                                                                                                  
                                                                                                                                
3:33:09 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KITO asked  how  long it  takes for  prescription                                                               
drugs listed  in schedule  IA to  clear a  patient's bloodstream.                                                               
He wondered  when workers' compensation patients  will have clear                                                               
urine analysis  tests.   He further asked  for the  percentage of                                                               
cases that  this would apply  to in  Alaska, for example,  if the                                                               
state has 100  workers' compensation cases, how  many cases would                                                               
involve prescriptions  for narcotics  beyond 30  days.   He asked                                                               
whether the  doctor will need  to refill the  prescriptions after                                                               
30 days for patients who have prescriptions for narcotics.                                                                      
                                                                                                                                
MR. JACKSON answered he is  absolutely correct that it is illegal                                                               
for anyone  to resell  prescriptions that  are not  prescribed to                                                               
them.   Thus  only pharmacies  can sell  prescription drugs.   In                                                               
terms  of the  length of  time for  opioids to  leave a  person's                                                               
system, he  surmised that it  would depend  on the body  mass and                                                               
the  drug; however,  he  was not  certain.   He  deferred to  Mr.                                                               
Monagle, but also offered to research the matter.                                                                               
                                                                                                                                
3:35:42 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KITO felt  it was important to  know what workers'                                                               
compensation   patients  were   being  testing   for  and   if  a                                                               
prescription  drug clears  in one  day or  seven days  would mean                                                               
different things.                                                                                                               
                                                                                                                                
MR. JACKSON provided  some statistics for Alaska,  noting that in                                                               
2011,  prescription  drugs comprised  almost  20  percent of  the                                                               
medical costs of  workers' compensation claims.   Over 90 percent                                                               
of  the time,  injured  workers  missing one  or  more weeks  had                                                               
prescriptions covered  by workers' compensation, of  which, 60 to                                                               
90 percent received opioids or narcotics.                                                                                       
                                                                                                                                
3:36:42 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KITO asked  for further  clarification if  he was                                                               
indicating 60 percent of 90 percent  of the 20 percent of medical                                                               
costs were for workers' compensation claims.                                                                                    
                                                                                                                                
MR. JACKSON answered yes.                                                                                                       
                                                                                                                                
3:37:09 PM                                                                                                                    
                                                                                                                                
CHAIR OLSON asked whether that  amounted to 11 percent of injured                                                               
workers.                                                                                                                        
                                                                                                                                
MR. JACKSON deferred to Chair Olson on the math.                                                                                
                                                                                                                                
3:37:20 PM                                                                                                                    
                                                                                                                                
MR. JACKSON,  referring to  the 30-day  renewal, stated  that the                                                               
sponsor's  hope  was to  encourage  a  stronger and  more  robust                                                               
communication  between doctors  and injured  workers, which  will                                                               
allow  for 30-day  refills of  prescriptions  for opioids,  which                                                               
could encourage a conversation between  doctors and patients that                                                               
could  mean  patients  don't need  prescriptions  for  additional                                                               
drugs.                                                                                                                          
                                                                                                                                
3:38:11 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   JOSEPHSON  asked   for   clarification  on   the                                                               
statistics.                                                                                                                     
                                                                                                                                
MR. JACKSON  responded that  20 percent of  the medical  costs in                                                               
workers'  compensation  claims  were for  prescription  drugs  in                                                               
2011.   Ninety percent of the  injured workers who missed  a week                                                               
or more received workers'  compensation prescriptions, with 60-90                                                               
percent of them receiving opioids.                                                                                              
                                                                                                                                
3:39:25 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE JOSEPHSON  said that the statistics  tell him that                                                               
injured workers  are prescribed lots  of drugs.   He contemplated                                                               
how  best  to   use  that  information  and   whether  this  bill                                                               
represents the right means to reduce costs.                                                                                     
                                                                                                                                
CHAIR OLSON  added that  HB 32  will provide one  tool to  do so.                                                               
Ultimately, he hoped that the  best practices for pain management                                                               
will be completed in the next year  or two.  Although he is not a                                                               
doctor,  it  seemed to  him  that  prescribing drugs  to  injured                                                               
workers  that were  intended  as  end of  life  drugs for  cancer                                                               
patients  without  first trying  other  options  can create  some                                                               
problems.    For  example,  after  several  months  of  being  on                                                               
opioids, injured workers are much  less likely to return to their                                                               
jobs.  He offered to  provide statistics, but reiterated that the                                                               
longer  injured workers  are on  drugs like  oxycodone, the  less                                                               
likely they are to return to work.                                                                                              
                                                                                                                                
3:41:04 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOSEPHSON   asked  whether  any  study   or  data                                                               
supported  that legislation  of  this type  in  other states  has                                                               
achieved  results, in  other  words if  premium  costs were  then                                                               
reduced.                                                                                                                        
                                                                                                                                
MR. JACKSON related that Florida,  Washington, Colorado and Texas                                                               
have initiated  reforms and Texas  and Washington have  also seen                                                               
significant reductions in deaths from  opioid use.  Other states,                                                               
including Florida have restricted  physicians from dispensing and                                                               
all of those  measures have contributed to a  reduction in deaths                                                               
and  abuse  of  prescription  opioids.    He  did  not  have  the                                                               
statistics on hand, he said.                                                                                                    
                                                                                                                                
3:42:42 PM                                                                                                                    
                                                                                                                                
CHAIR OLSON recalled  that the committee has  a relatively recent                                                               
national study from the  Workers' Compensation Research Institute                                                               
it can distribute to members.                                                                                                   
                                                                                                                                
3:43:55 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  TILTON related  her understanding  that long-term                                                               
use leads to addiction.   She asked whether workers' compensation                                                               
covers rehabilitation.                                                                                                          
                                                                                                                                
MR. JACKSON deferred  to Mr. Monagle to respond.   He referred to                                                               
a study  in members' packets  by the Lockton  Companies entitled,                                                               
"Opioids  Wreak  Havoc  on   Workers'  Compensation  Costs"  that                                                               
highlighted the addiction and  other problems observed throughout                                                               
the country.   He added  that members' packets also  include some                                                               
charts that show the number of deaths attributed to overdoses.                                                                  
                                                                                                                                
3:45:19 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TILTON asked whether  any information is available                                                               
on   prescription   paid   medicines   prescribed   in   workers'                                                               
compensation claims that have been seized in investigations.                                                                    
                                                                                                                                
MR. JACKSON  answered that he  was unsure whether  the Department                                                               
of  Public Safety  (DPS) tracks  the  source, but  he offered  to                                                               
check.    He stated  the  DPS  provided information  in  members'                                                               
packets on hydrocodone seized in 2011-2013.                                                                                     
                                                                                                                                
REPRESENTATIVE  TILTON suggested  it  may be  difficult to  track                                                               
that type of information, but it could be useful information.                                                                   
                                                                                                                                
CHAIR OLSON offered to request  any information that is available                                                               
from the department.                                                                                                            
                                                                                                                                
3:46:54 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KITO pointed  to the earlier statistics.   He said                                                               
he was surprised only 20  percent of workers' compensation claims                                                               
involve prescriptions,  but it  seemed as though  about 1  or 1.2                                                               
people  per hundred  were using  opioids.   He asked  for further                                                               
clarification on  whether there are any  anticipated cost savings                                                               
by implementing this bill.                                                                                                      
                                                                                                                                
MR.  JACKSON  answered that  not  have  the figures,  which  were                                                               
calculated  by the  National  Council  on Compensation  Insurance                                                               
(NCCI).  He  anticipated that it may take time  to quantify costs                                                               
and  savings that  may be  realized from  passage of  HB 32.   He                                                               
offered to try to obtain the information.                                                                                       
                                                                                                                                
3:48:24 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KITO  asked for  further clarification  on whether                                                               
the information would be nationwide or applicable to Alaska.                                                                    
                                                                                                                                
MR.  JACKSON  answered  that  the   estimated  savings  would  be                                                               
specific to Alaska, assuming that this bill passes.                                                                             
                                                                                                                                
3:48:46 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KITO  expressed  an  interest  in  identifying  a                                                               
ballpark figure of  cost savings.  He reiterated  his interest in                                                               
how  much  money  Alaska  insurers  stand  to  save  on  workers'                                                               
compensation  costs.   He suggested  that if  the state  hopes to                                                               
save money it would be good to identify any savings.                                                                            
                                                                                                                                
MR.  JACKSON  emphasized  that  he  agreed  it  is  important  to                                                               
determine  savings, plus,  another  benefit in  passing the  bill                                                               
could be the  number of people that may never  abuse narcotics or                                                               
have prescription drugs diverted and found by children.                                                                         
                                                                                                                                
3:50:17 PM                                                                                                                    
                                                                                                                                
CHAIR  OLSON  stated  that approximately  half  the  states  have                                                               
enacted  similar   legislation.     He  offered  to   obtain  the                                                               
information  on  the  number  of  states  that  have  implemented                                                               
measures of this  type.  He offered his belief  that other states                                                               
have seen significant savings.                                                                                                  
                                                                                                                                
3:50:45 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE HUGHES offered her belief  that it is important to                                                               
have  a  foundation  on  this  issue.    She  asked  for  further                                                               
clarification,  in  terms  of  protection   of  privacy,  of  how                                                               
employers  become  aware of  their  employees  being on  workers'                                                               
compensation.                                                                                                                   
                                                                                                                                
MR. JACKSON deferred to Mr. Monagle to respond.                                                                                 
                                                                                                                                
REPRESENTATIVE  HUGHES asked  for  further  clarification on  the                                                               
information that employers are provided.                                                                                        
                                                                                                                                
3:52:33 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOSEPHSON agreed  this could  be in  the workers'                                                               
best interests;  however, he imagined  that injured  workers will                                                               
be taking painkillers  and not be getting a flu  shot.  He looked                                                               
forward to a discussion on the  nature of employer being privy to                                                               
this type of medical information.                                                                                               
                                                                                                                                
3:53:51 PM                                                                                                                    
                                                                                                                                
MICHAEL MONAGLE,  Director, Central Office, Division  of Workers'                                                               
Compensation,  Department   of  Labor  &   Workforce  Development                                                               
(DLWD), said as he  consider the bill, he does not  look at it in                                                               
terms of  cost savings  to employers, but  in terms  of returning                                                               
someone back to work and  preventing people from destroying their                                                               
lives by long-term opioid use.   He recalled an instance in which                                                               
an injured  worker reached a  point of medical recovery,  but due                                                               
to extensive  use of  opioids for several  years, the  worker had                                                               
developed such  cognitive and other  impairments that  the doctor                                                               
classified the worker  as permanently disabled.  He  said that it                                                               
was those types  of concerns that this  legislation will address.                                                               
The 90  days is  identified by medical  studies as  the threshold                                                               
when the  physical problems begin to  develop.  He said  that the                                                               
curve for  employees who return  to work drops off  sharply after                                                               
90 days  on prescription pain  killers.  He explained  that under                                                               
the bill,  injured employees  under workers'  compensation claims                                                               
would  obtain  a  30-day  supply of  medication,  followed  by  a                                                               
consultation  with   their  physician   who  can   determine  the                                                               
effectiveness and necessity of  prescribing an additional 30-days                                                               
prescription  for  opioids.    In  many  cases  there  isn't  any                                                               
functional  improvement  and  the  patients  become  addicted  to                                                               
opioids and  continue to use  them.  Nationwide, the  emphasis is                                                               
to work to  wean patients off opioids after 90  days in the hopes                                                               
that patients can  discontinue these drugs and learn  how to deal                                                               
with their pain management in more constructive ways.                                                                           
                                                                                                                                
3:56:29 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE JOSEPHSON  asked for further clarification  on how                                                               
employee privacy and the employer's right to know would work.                                                                   
                                                                                                                                
MR. MONAGLE  said that typically  what was meant in  referring to                                                               
the  term  "employer" in  workers'  compensation  matters is  the                                                               
employer,  the insurance  company, or  the claims  administrator.                                                               
Unless  the  entities are  self-insured,  most  employers do  not                                                               
interact with an injured worker;  instead that contact is done by                                                               
the  insurance company  or the  contracted claims  administrator.                                                               
The  claims administrator  or  claims  adjustor provides  regular                                                               
contact with the  injured worker, who reviews  the medical bills,                                                               
authorizes  payment  of  medical  bills,  and  issues  disability                                                               
checks to the  injured worker.  He reiterated  that the employer,                                                               
the insurance company,  or the claims administrator  are the ones                                                               
who  will have  access  to the  information  on the  prescription                                                               
drugs since  they are the ones  who have access to  the frequency                                                               
that  the  injured  worker  is  using  prescription  drugs.    He                                                               
suggested the  claims administrator  would initiate any  check on                                                               
the prescription, not the employer.                                                                                             
                                                                                                                                
3:58:03 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOSEPHSON  asked  whether  the  claims  adjustors                                                               
confer to  inquiries by  small employers  and if  these adjustors                                                               
use some discretion.                                                                                                            
                                                                                                                                
MR.  MONAGLE answered  that  workers'  compensation was  excluded                                                               
from HIPAA  [Health Insurance Portability and  Accountability Act                                                               
of 1996] law  so the health care concerns between  a provider and                                                               
the  patient  does  not apply  in  workers'  compensation  cases.                                                               
Second, the provision of the  Workers' Compensation Act says that                                                               
parties to  workers' compensation  cases are  entitled to  any of                                                               
the  information about  that case,  which includes  the employer,                                                               
the injured worker and their  representatives, such as the claims                                                               
administrator or  legal counsel.   Thus any of the  parties would                                                               
have access to the information, he said.                                                                                        
                                                                                                                                
3:59:26 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOSEPHSON  asked  whether  any  current  statutes                                                               
requires drug  testing other than  for those  employees operating                                                               
heavy equipment or for commercial carriers.                                                                                     
                                                                                                                                
MR.  MONAGLE answered  that  AS  23.10.600-699 outlines  employer                                                               
drug testing.   First, drug testing  is a voluntary system  so it                                                               
is not mandatory  for any employer to test.   Drug testing is not                                                               
administered by  the state, but  is left open to  private action.                                                               
He  suggested  that if  employees  feel  their rights  have  been                                                               
violated, their  recourse is civil.   It goes  on to say  that an                                                               
employer  must meet  certain requirements  in order  to put  in a                                                               
policy for drug  testing, for example, providing  employees a 30-                                                               
day  notice prior  to implementing  a plan,  as well  as advising                                                               
them of the conditions of  testing, including the substances that                                                               
will be tested.   These statutes also provide  remedies for those                                                               
whose confidentiality  has been  violated or  who suffer  a false                                                               
positive test  that occurred  through negligence  on the  part of                                                               
the employer or the person doing the testing for the employer.                                                                  
                                                                                                                                
4:01:41 PM                                                                                                                    
                                                                                                                                
AESHA  PALLESEN,  Assistant  Attorney   General,  Labor  &  State                                                               
Affairs Section,  Civil Division  (Anchorage), Department  of Law                                                               
(DOL), agreed that  provisions are generally set out  in AS 23.10                                                               
for drug  testing and  that Section  1 of this  bill would  add a                                                               
section to that  drug testing regime for a  negative drug testing                                                               
in workers' compensation cases.                                                                                                 
                                                                                                                                
4:02:19 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KITO recalled Mr.  Monagle mentioned a patient who                                                               
was on  opioids for a  long period  of time; however,  he offered                                                               
his belief  that this bill would  not do anything about  that and                                                               
would only  allow an action to  be taken if someone  had not been                                                               
taking prescribed opioids.                                                                                                      
                                                                                                                                
REPRESENTATIVE  KITO  expressed  concern   about  what  would  be                                                               
accomplished by  the bill  if the  only denial  is in  regards to                                                               
those who are not taking their prescribed medication.                                                                           
                                                                                                                                
CHAIR OLSON  stated that  part of  the bill  was aimed  at having                                                               
workers' compensation injured employees  see their doctor monthly                                                               
and not  refilling potent drugs via  the pharmacy.  He  said that                                                               
this  action may  result in  additional  costs, but  it may  also                                                               
result  in ultimate  savings; however,  the ultimate  goal is  to                                                               
assist in getting injured workers back to work.                                                                                 
                                                                                                                                
4:05:06 PM                                                                                                                    
                                                                                                                                
SCOTT JORDAN,  Director, Division of Risk  Management, Department                                                               
of Administration  (DOA), in  response to  a question  on privacy                                                               
issues,   stated   that    Health   Insurance   Portability   and                                                               
Accountability   Act  (HIPAA)   does   not   apply  to   workers'                                                               
compensation  cases  so the  state,  which  is self-insured,  can                                                               
share these  records.   He reported that  he obtains  a quarterly                                                               
report of the workers' compensation individuals on opioid drugs.                                                                
                                                                                                                                
4:06:05 PM                                                                                                                    
                                                                                                                                
CHAIR OLSON asked  for further clarification on  how many injured                                                               
employees are taking scheduled drugs.                                                                                           
                                                                                                                                
MR.  JORDAN answered  that 67  employees of  900 open  claims, or                                                               
less than 1 percent are  prescribed opioids.  He characterized it                                                               
as a low amount.                                                                                                                
                                                                                                                                
4:06:31 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOSEPHSON asked  for  further clarification  that                                                               
these are injured Alaska state employees.                                                                                       
                                                                                                                                
MR. JORDAN answered yes.                                                                                                        
                                                                                                                                
4:07:09 PM                                                                                                                    
                                                                                                                                
LORI   WING-HEIER,  Director,   Division   of  Insurance   (DOI),                                                               
Anchorage Office,  Department of  Commerce, Community  & Economic                                                               
Development  (DCCED), stated  that  from  the DOI's  perspective,                                                               
after all  is said and done,  the data comes to  the division and                                                               
the DOI  sets the  rates for employers,  including rates  for the                                                               
State of Alaska.   These rates have gone up,  and while they have                                                               
stabilized somewhat  in the past  year, the rates are  still very                                                               
high.  The division was proud  that the state fell off the number                                                               
one spot  in the nation;  however, these rates still  represent a                                                               
very high  cost to  employers across  the state.   Any  impact to                                                               
bring down the cost of  workers' compensation will be considered,                                                               
and this  is one approach  to do so.   As a former  risk manager,                                                               
she can attest to the fact  that the cost of rehabilitation is an                                                               
expensive  part  of most  workers'  compensation  claims when  it                                                               
involves pulling someone back from being  on an opioid for a long                                                               
period time.   She  reported that  it increases  the cost  of the                                                               
claim, which  goes back into  the workers' compensation  rate and                                                               
is shared by all employers.                                                                                                     
                                                                                                                                
4:08:52 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOSEPHSON related  his  understanding that  there                                                               
would normally  be some type of  tracking by the prescriber.   He                                                               
asked whether that  information would be shared to  ensure that a                                                               
drug contract  was followed.   He asked whether  that information                                                               
would make its way back to the adjuster.                                                                                        
                                                                                                                                
MS. WING-HEIER answered  that the adjuster will have  a record of                                                               
prescriptions   being  prescribed   to   the  injured   employee.                                                               
However,  this bill  would require  the employees  to touch  base                                                               
with the  physician every 30  days.  In  fact, it isn't  meant to                                                               
try to  take the painkiller  or narcotic away, but  just requires                                                               
patients to  touch bases  with their  physicians to  help prevent                                                               
overprescribing.                                                                                                                
                                                                                                                                
REPRESENTATIVE  JOSEPHSON  referred  to  Section 1  of  the  bill                                                               
related to  testing.  He  asked whether there is  some redundancy                                                               
if the prescriber  already doing some testing.   He recalled that                                                               
in his  experience as  an attorney, that  evidence he  saw during                                                               
trial  and  drug  contracts.    He  asked  whether  an  insurance                                                               
adjuster will know those facts.                                                                                                 
                                                                                                                                
MS.  WING-HEIER   answered  that  the  adjuster   will  know  the                                                               
prescriptions  were  issued,  but  she  was  unsure  whether  the                                                               
adjuster will know  if any prescriptions were not  being used and                                                               
of the patient might be stockpiling the medication.                                                                             
                                                                                                                                
4:10:59 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE JOSEPHSON asked whether  costs can be reported for                                                               
the 67 of 900 injured employees.   He recalled that 20 percent of                                                               
the cost is for prescription drugs  so he wondered how much money                                                               
is being spent.                                                                                                                 
                                                                                                                                
MS. WING-HEIER  said she has  cumulative data for the  state, but                                                               
not the State of  Alaska data.  She deferred to  Mr. Jordan.  She                                                               
did  not  have  the  itemized  costs for  the  67  injured  state                                                               
workers.                                                                                                                        
                                                                                                                                
4:12:17 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KITO  offered  that  not  all  of  the  67  total                                                               
scheduled drug  use cases will have  prescriptions for controlled                                                               
scheduled  drugs  over 90  days  or  that  all  of them  will  be                                                               
violation cases.   Thus  it seemed  as though out  of 67,  a very                                                               
small number might be subject to  this law.  He asked whether she                                                               
had any idea of the number of cases this would affect.                                                                          
                                                                                                                                
MS.  WING-HEIER answered  that  she does  not  have the  specific                                                               
information related to the state's  plan; however, she agreed not                                                               
every case  would be for  injured workers with  prescriptions for                                                               
controlled  substances for  over  30  days.   She  was unsure  of                                                               
whether the 67  of 900 were for prescriptions of  over 90 days or                                                               
if that was the current total  for the state's claim record.  She                                                               
offered  to   provide  some  state   statistical  data   for  all                                                               
employers.                                                                                                                      
                                                                                                                                
4:13:51 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KITO  asked for  further clarification  on whether                                                               
this  applies  to all  employers.  He  expressed an  interest  in                                                               
seeing the data for all employers.                                                                                              
                                                                                                                                
MS. WING-HEIER offered to provide it.                                                                                           
                                                                                                                                
4:14:31 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOSEPHSON  related  his  understanding  that  the                                                               
state  does not  write workers'  compensation checks  to insurers                                                               
since the state is self-insured.                                                                                                
                                                                                                                                
MR.  JORDAN agreed  that  is  correct.   In  further response  to                                                               
Representative  Josephson, he  clarified that  the division  does                                                               
not pay a premium  and he was unsure of the  source of the $1,400                                                               
premium since the state is self-insured.                                                                                        
                                                                                                                                
CHAIR OLSON answered that the  $1,400 refers to the monthly major                                                               
medical health  insurance cost  for state  employees.   This bill                                                               
would  not  affect  those  premiums since  it  isn't  related  to                                                               
workers' compensation.                                                                                                          
                                                                                                                                
4:15:25 PM                                                                                                                    
                                                                                                                                
CHAIR  OLSON opened  public testimony  on HB  32 and  held public                                                               
testimony open.                                                                                                                 
                                                                                                                                
[HB 32 was held over.]                                                                                                          
                                                                                                                                

Document Name Date/Time Subjects
HB32 verA .pdf HL&C 2/27/2015 3:15:00 PM
HB 32
HB32 Sponsor Statement.pdf HL&C 2/27/2015 3:15:00 PM
HB 32
HB32 Sectional Analysis.pdf HL&C 2/27/2015 3:15:00 PM
HB 32
HB32 Fiscal Note-DOLWD-WC-02-21-15.pdf HL&C 2/27/2015 3:15:00 PM
HB 32
HB32 Fiscal Note-DOA-DRM-02-20-15.pdf HL&C 2/27/2015 3:15:00 PM
HB 32
HB32 Supporting Documents-2013 DPS Prescription Drug Statistics.pdf HL&C 2/27/2015 3:15:00 PM
HB 32
HB32 Supporting Documents-AKDrug Overdose Deaths 2008-12.pdf HL&C 2/27/2015 3:15:00 PM
HB 32
HB32 Supporting Documents-Health Partners Opiate Drug Screens.pdf HL&C 2/27/2015 3:15:00 PM
HB 32
HB32 Supporting Documents-Letter NFIB 02-13-2015.PDF HL&C 2/27/2015 3:15:00 PM
HB 32
HB32 Supporting Documents-Letter PCI 02-3-2015.pdf HL&C 2/27/2015 3:15:00 PM
HB 32
HB32 Supporting Documents-Report Lockton & Associates 08-2012.pdf HL&C 2/27/2015 3:15:00 PM
HB 32
HB32 Supporting Documents-Report Workers Compensation 2012 Issues Report by Joseph Paduda.pdf HL&C 2/27/2015 3:15:00 PM
HB 32
HB32 Supporting Documents-Letter AK State Chamber 02-26-2015.pdf HL&C 2/27/2015 3:15:00 PM
HB 32
HB116 ver A.PDF HL&C 2/27/2015 3:15:00 PM
HB 116
HB116 Sponsor Statement.pdf HL&C 2/27/2015 3:15:00 PM
HB 116
HB116 Fiscal Note-DCCED-ABC-02-20-15.pdf HL&C 2/27/2015 3:15:00 PM
HB 116
HB116 Supporting Documents-Legislative Audit 05-30-14.pdf HL&C 2/27/2015 3:15:00 PM
HB 116