Legislature(2017 - 2018)BARNES 124

02/05/2018 03:15 PM LABOR & COMMERCE

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Audio Topic
03:15:47 PM Start
03:16:58 PM HB323
03:43:02 PM SB64
04:33:31 PM Presentation: State Residential Building Codes
05:08:07 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
*+ HB 323 EXTEND: BOARD OF PHARMACY TELECONFERENCED
Heard & Held
-- Public Testimony --
+ SB 64 ADOPT UNIFORM ENVIRONMENTAL COVENANTS ACT TELECONFERENCED
Moved HCS SB 64(L&C) Out of Committee
-- Public Testimony --
+ Presentation: State Residential Building Codes TELECONFERENCED
by Jim Dunlap, President, AK Home Building Assoc.
+ Bills Previously Heard/Scheduled TELECONFERENCED
+= HB 278 EXTEND:CERT. REAL ESTATE APPRAISERS BOARD TELECONFERENCED
Scheduled but Not Heard
-- Public Testimony --
+= HB 279 EXTEND: REAL ESTATE COMMISSION TELECONFERENCED
Scheduled but Not Heard
-- Public Testimony --
+= HB 280 EXTEND: BOARD OF MARITAL & FAMILY THERAPY TELECONFERENCED
Scheduled but Not Heard
-- Public Testimony --
                HB 323-EXTEND: BOARD OF PHARMACY                                                                            
                 [Contains discussion of SB 37]                                                                                 
                 [Contains discussion of HB 9]                                                                                  
                                                                                                                                
                                                                                                                              
3:16:58 PM                                                                                                                    
                                                                                                                                
CHAIR KITO announced that the first order of business would be                                                                  
HOUSE BILL NO. 323, "An Act extending the termination date of                                                                   
the Board of Pharmacy; and providing for an effective date."                                                                    
                                                                                                                                
3:17:24 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE    COLLEEN    SULLIVAN-LEONARD,    Alaska    State                                                               
Legislature, presented HB 323 as  prime sponsor.  She paraphrased                                                               
the  sponsor   statement,  which   reads  as   follows  [original                                                               
punctuation provided]:                                                                                                          
                                                                                                                                
     House  Bill 323  extends the  termination date  for the                                                                    
     Board  of  Pharmacy  to  June  30,  2022.  Pursuant  to                                                                    
     A.S.?08.03.010(  c)(16),  this  Board is  scheduled  to                                                                    
     sunset on June  30th, 2018 if the  legislature does not                                                                    
     pass legislation extending it.                                                                                             
                                                                                                                                
     Legislative Audit  reviewed the Board's  operations and                                                                    
     determined  that it  is  in the  best  interest of  the                                                                    
     state   to  extend   this   Board  considering   recent                                                                    
     statutory    changes    that   expand    the    Board's                                                                    
     responsibilities   in   relation  to   the   controlled                                                                    
     substance     prescription     database.     Therefore,                                                                    
     recommendation  is  made to  extend  this  Board for  4                                                                    
     years or through June 30, 2022.                                                                                            
                                                                                                                                
     The  Board of  Pharmacy  is composed  of  7 members;  5                                                                    
     licensed pharmacists  actively engaged in  the practice                                                                    
     of  pharmacy in  the  State  for a  period  of 3  years                                                                    
     immediately preceding their  appointments and 2 members                                                                    
     of the public.                                                                                                             
     The Board  also regulates  admission into  the practice                                                                    
     of pharmacy,  establishes and enforces  compliance with                                                                    
     professional  standards  and  adopts regulations.    It                                                                    
     also establishes  and maintains a  controlled substance                                                                    
     prescription  database  and establishes  standards  for                                                                    
     the  independent  administration  by  a  pharmacist  of                                                                    
     vaccines,  related  emergency  medications  and  opioid                                                                    
     overdose drugs.                                                                                                            
                                                                                                                                
     The  Board  also  oversees licensing  for  pharmacists,                                                                    
     pharmacy  interns,  pharmacy  technicians,  pharmacies,                                                                    
     wholesale drug  distributors located inside  the state,                                                                    
     licenses  drug   rooms  located   inside  institutional                                                                    
     facilities  and   also  registers   pharmacies  located                                                                    
     outside  of the  State if  a pharmacy  ships, mails  or                                                                    
     delivers  prescription  drugs   to  consumers  of  that                                                                    
     state.                                                                                                                     
                                                                                                                                
     These  regulations  control   various  aspects  of  the                                                                    
     field, including but not limited to controlling and                                                                        
     regulating   the  practice   of  pharmacy   in  Alaska.                                                                    
     A.S.?08.80.005  mandates  that  effective  control  and                                                                    
     regulation  is  necessary   to  promote,  preserve  and                                                                    
     protect the public's health, safety and                                                                                    
     welfare.                                                                                                                   
                                                                                                                                
3:21:08 PM                                                                                                                    
                                                                                                                                
KRIS  CURTIS, Legislative  Auditor,  Legislative Audit  Division,                                                               
Legislative  Agencies and  Offices, reported  August 2017  sunset                                                               
audit  findings related  to HB  323.   She stated  the board  was                                                               
licensing  effectively   and  was  conducting  its   meetings  in                                                               
accordance  with the  laws.   She underlined  the board  was also                                                               
amending regulations to  improve the industry.   She informed the                                                               
board had  3,747 active licenses in  March 2017 for a  33 percent                                                               
increase  in licensees  since the  previous audit  in 2009.   The                                                               
board had a  surplus of just over [$]275  thousand and management                                                               
within DCBPL had  communicated that it would be  performing a fee                                                               
analysis  at  the  end  of  2017.   She  explained  the  division                                                               
recommended  only a  4-year extension  in  recognition of  recent                                                               
statutory  changes that  expand the  board's responsibilities  in                                                               
relation  to  the   controlled  substance  prescription  database                                                               
(CSPD).                                                                                                                         
                                                                                                                                
MS.   CURTIS  described   the  2008   bill   [Senate  Bill   196]                                                               
establishing the  database.  She paraphrased  the audit document,                                                               
entitled  "A  Sunset  Review  of   the  Department  of  Commerce,                                                               
Community, and  Economic Development, Board of  Pharmacy (board)"                                                               
[included in committee packet],  which reads as follows [original                                                               
punctuation provided]:                                                                                                          
                                                                                                                                
     The  statute  requires  each dispenser  submit  to  the                                                                    
     board, by electronic  means, information regarding each                                                                    
     prescription dispensed for  a controlled substance. The                                                                    
     database electronically  collects information  from in-                                                                    
       state and out-of-state pharmacies as well as other                                                                       
     dispensers of controlled substance prescriptions.                                                                          
     The  database allows  pharmacists and  practitioners to                                                                    
     review  prescription history  prior  to prescribing  or                                                                    
     dispensing  a  controlled  substance. The  database  is                                                                    
     also to be used to:                                                                                                        
        • monitor prescribing practices and patterns of                                                                         
          prescribing or dispensing;                                                                                            
        • identify practitioners who prescribe controlled                                                                       
          substances in an unprofessional or unlawful                                                                           
          manner;                                                                                                               
        • identify individuals   who    may   be   abusing                                                                      
          controlled substances; and                                                                                            
        • identify individuals who present forgeries or                                                                         
          otherwise false or altered prescriptions to a                                                                         
          pharmacy.                                                                                                             
                                                                                                                                
3:23:40 PM                                                                                                                    
                                                                                                                                
MS.  CURTIS identified  that there  were many  problems with  the                                                               
2008 statute,  including that it  did not provide the  ability to                                                               
identify  all dispensers  that must  submit information  so DCBPL                                                               
staff could  not monitor completeness or  identify which specific                                                               
dispensers  were not  submitting the  required information.   She                                                               
added   that   regulations    required   monthly   reporting   of                                                               
information;  however, monthly  reporting was  not effective  for                                                               
monitoring prescription practices.                                                                                              
                                                                                                                                
MS.  CURTIS  presented  that  the  second  issue  with  the  2008                                                               
legislation was  that there was  no requirement that  a dispenser                                                               
or  practitioner   check  the   database  prior   to  dispensing,                                                               
prescribing,  or  administering  medication.     She  added  that                                                               
according to  DCBPL staff,  information in  the database  was not                                                               
analyzed  by   the  board  and  forwarded   to  practitioners  or                                                               
pharmacists because  the Department of  Law advised that  the law                                                               
did  not  allow  the  agency  or  board  to  provide  unsolicited                                                               
reports.                                                                                                                        
                                                                                                                                
MS.  CURTIS  described how  the  law  had  been changed  so  that                                                               
currently   pharmacists  who   dispense  and   practitioners  who                                                               
prescribe,  administer,  or  dispense controlled  substances  are                                                               
required to register with the  database and the board must notify                                                               
the  applicable occupational  boards when  practitioners register                                                               
with the database, thereby allowing  a check for completeness and                                                               
the ability  to identify noncompliance.   She  underlined failure                                                               
to  register is  grounds for  disciplinary action  and dispensers                                                               
are  required   to  report  weekly   and  this   requirement  was                                                               
subsequently changed to report daily.                                                                                           
                                                                                                                                
MS. CURTIS  stated that  access to the  database was  expanded to                                                               
include  dispensers, dispenser  delegates, and  other persons  or                                                               
entities with a valid business  need and the board was authorized                                                               
to   provide  unsolicited   notification  to   a  pharmacist   or                                                               
practitioner if a patient has  received one or more prescriptions                                                               
for controlled substances  inconsistent with generally recognized                                                               
standards of  safe practice.   She added unsolicited  reports may                                                               
also  be  issued to  a  practitioner's  licensing board  and  new                                                               
performance  measures   must  be  reported  to   the  legislature                                                               
annually  including   measures  regarding   the  impact   of  the                                                               
database.    She  stated dispensers  and  practitioners  are  now                                                               
required to check the database  prior to dispensing, prescribing,                                                               
or administering medication, with specific exclusions.                                                                          
                                                                                                                                
MS.  CURTIS said  the audit  states  that with  the changes,  the                                                               
board was empowered to serve  the public interest; however, DCBPL                                                               
does not believe  this board should be  proactively analyzing the                                                               
database as it  is not traditionally the role  of an occupational                                                               
board.   She  added that  DCCED had  stated additional  resources                                                               
would  be needed  if the  legislature  intends for  the board  to                                                               
analyze the data.                                                                                                               
                                                                                                                                
3:26:30 PM                                                                                                                    
                                                                                                                                
MS.  CURTIS presented  the  two recommendations.    She said  the                                                               
first recommendation  was that DCBPL's chief  investigator should                                                               
work   with   the  director   to   improve   the  timeliness   of                                                               
investigations, and  the second was that  DCBPL's director should                                                               
improve procedures to ensure  required licensure documentation is                                                               
appropriately obtained and retained.                                                                                            
                                                                                                                                
MS. CURTIS  informed the Office  of the Governor agreed  with the                                                               
4-year extension but had not  commented on the database concerns;                                                               
the  department   agreed  with   both  recommendations   and  had                                                               
indicated it had implemented new  procedures to ensure timeliness                                                               
of investigations  and did state that  additional resources would                                                               
be  required;   and  the  board   chair  had  agreed   with  both                                                               
recommendations.                                                                                                                
                                                                                                                                
3:29:10 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KNOPP  asked when  the  previous  audit had  been                                                               
carried out.                                                                                                                    
                                                                                                                                
MS. CURTIS  answered the previous  audit had been carried  out in                                                               
2009.   She pointed  to a  timeline in the  audit document.   She                                                               
added there are  new reporting requirements on the  status of the                                                               
database.                                                                                                                       
                                                                                                                                
REPRESENTATIVE KNOPP surmised  it would be four  years before the                                                               
next report on the database.                                                                                                    
                                                                                                                                
MS. CURTIS answered it would probably be in 2021.                                                                               
                                                                                                                                
3:30:44 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE BIRCH remarked pharmacies do  not have a way to be                                                               
compensated  for their  expertise  and said  he  thought that  in                                                               
other places pharmacies  could be paid for some  level of medical                                                               
support services.   He asked  whether it would be  appropriate to                                                               
solicit  the board  for recommendations  for  advancement of  the                                                               
pharmacy profession.                                                                                                            
                                                                                                                                
MS. CURTIS answered  the type of audit was unique  in that the 11                                                               
criteria used  were set out in  statute.  She added  unless there                                                               
are  specific  complaints  heard  at  a  board  meeting  or  news                                                               
article, other issues would not be addressed in the audit.                                                                      
                                                                                                                                
3:33:53 PM                                                                                                                    
                                                                                                                                
LEIF HOLM,  Chair, Board of  Pharmacy, Division  of Corporations,                                                               
Business  and  Professional   Licensing  (DCBPL),  Department  of                                                               
Commerce, Community, and  Economic Development (DCCED), testified                                                               
in support of HB 323.   He testified the board concurred with the                                                               
4-year  board extension  as it  was understood  that the  board's                                                               
duties were expanding further.                                                                                                  
                                                                                                                                
REPRESENTATIVE BIRCH said he supported  the bill proposal but had                                                               
concerns regarding  pharmacists receiving compensation  for their                                                               
expertise.   He  asked where  the  board chairman  would turn  to                                                               
remedy the situation for pharmacists in the state.                                                                              
                                                                                                                                
MR. HOLM  answered it was  a complicated question  and underlined                                                               
the board tries to stay  away from matters of financial interest.                                                               
He emphasized he  does not speak as a board  member when speaking                                                               
to PBMs  and auditing practices.   He said  he knows there  is an                                                               
active push for pharmacies to  get provider status at the federal                                                               
level  to receive  payment for  their  services.   He stated  the                                                               
interest of the board is patient safety.                                                                                        
                                                                                                                                
3:37:08 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE    KNOPP   spoke    to   the    board's   database                                                               
responsibilities  and  asked how  the  board  could maintain  the                                                               
database with no part- or full-time employees.                                                                                  
                                                                                                                                
MR. HOLM  answered it had  not been  working well, and  the board                                                               
has not had  the time or manpower.   He added the  board had been                                                               
actively pursuing  a bill to license  out-of-state wholesalers in                                                               
the state  and had attached  an executive  administrator position                                                               
but had  not been  able to get  the bill passed.   He  added that                                                               
with  Senate  Bill   74,  the  board  was  allowed   to  hire  an                                                               
administrator  for  the   Prescription  Drug  Monitoring  Program                                                               
(PDMP) as  well as a  board assistant,  but he surmised  that the                                                               
position would be solely focused on the PDMP.                                                                                   
                                                                                                                                
3:39:10 PM                                                                                                                    
                                                                                                                                
CHAIR  KITO spoke  to concerns  about implementing  the PDMP  and                                                               
asked  for  Mr. Holm's  thoughts  regarding  how the  legislature                                                               
could assist the board.                                                                                                         
                                                                                                                                
MR. HOLM testified that since the  board hired someone to work on                                                               
the PDMP progress was being made.                                                                                               
                                                                                                                                
3:41:05 PM                                                                                                                    
                                                                                                                                
CHAIR KITO opened public testimony on HB 323.                                                                                   
                                                                                                                                
3:41:18 PM                                                                                                                    
                                                                                                                                
RICHARD  HOLT,  Vice  Chair,  Board   of  Pharmacy,  Division  of                                                               
Corporations,  Business   and  Professional   Licensing  (DCBPL),                                                               
Department  of  Commerce,  Community,  and  Economic  Development                                                               
(DCCED), testified  in support of HB  323.  He said  he concurred                                                               
with  what Mr.  Holm had  stated in  his testimony  regarding the                                                               
legislative audit.  He mentioned  other legislation would aid the                                                               
board in its duties, such as SB 37 and HB 9.                                                                                    
                                                                                                                                
CHAIR KITO held over HB 323.                                                                                                    
                                                                                                                                

Document Name Date/Time Subjects
SB064 Fiscal Note DNR-MLW 2.2.18.pdf HL&C 2/5/2018 3:15:00 PM
SB 64
SB064 Sectional Analysis ver. J 1.19.2018.pdf HL&C 2/5/2018 3:15:00 PM
SB 64
SB064 Sponsor Statement 1.19.2018.pdf HL&C 2/5/2018 3:15:00 PM
SB 64
SB064 Support Doc - DEC Response to DoD 1.19.2018.pdf HL&C 2/5/2018 3:15:00 PM
SB 64
SB064 Support Doc - DEC Response to DoD Supplemental 1.19.2018.pdf HL&C 2/5/2018 3:15:00 PM
SB 64
SB064 Opposition Letter - DoD 1.19.2018.pdf HL&C 2/5/2018 3:15:00 PM
SB 64
SB064 Support Doc - DoL Uniform Law Conference Report 1.19.2018.pdf HL&C 2/5/2018 3:15:00 PM
SB 64
SB064 Support Doc - Fact Sheet 1.19.2018.pdf HL&C 2/5/2018 3:15:00 PM
SB 64
SB064 Opposition Letter - DoD Supplemental 1.19.2018.pdf HL&C 2/5/2018 3:15:00 PM
SB 64
SB064 Support Doc - Uniform Law Commission Fact Sheet 1.19.2018.pdf HL&C 2/5/2018 3:15:00 PM
SB 64
SB064 Support Letters 1.19.2018.pdf HL&C 2/5/2018 3:15:00 PM
SB 64
SB064 Ver. J 1.19.2018.pdf HL&C 2/5/2018 3:15:00 PM
SB 64
SB064 Fiscal Note DEC-SPAR 2.2.18.pdf HL&C 2/5/2018 3:15:00 PM
SB 64
ASHBA Letter to HLAC 1.29.18.pdf HL&C 2/5/2018 3:15:00 PM
Building Codes
HB323 Sectional Analysis 2.2.18.pdf HL&C 2/5/2018 3:15:00 PM
HB 323
HB323 Version D.PDF HL&C 2/5/2018 3:15:00 PM
HB 323
HB323 Legislative Audit 2.2.18.pdf HL&C 2/5/2018 3:15:00 PM
HB 323
HB323 Fiscal Note DCCED-CBPL 2.2.18.pdf HL&C 2/5/2018 3:15:00 PM
HB 323
HB323.SponsorStatement.verD.2.2.18.pdf HL&C 2/5/2018 3:15:00 PM
HB 323
HB323 Support Letter 2.5.18.pdf HL&C 2/5/2018 3:15:00 PM
HB 323