Legislature(2009 - 2010)CAPITOL 106
04/01/2010 08:00 AM House STATE AFFAIRS
| Audio | Topic |
|---|---|
| Start | |
| SCR14 | |
| SB261 | |
| SB215 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | HB 420 | TELECONFERENCED | |
| + | SCR 14 | TELECONFERENCED | |
| + | SB 261 | TELECONFERENCED | |
| + | SB 215 | TELECONFERENCED | |
| + | SB 244 | TELECONFERENCED | |
| + | TELECONFERENCED |
SB 215-PIONEERS HOME RX DRUG BENEFIT
[Contains mentioned of HB 284.]
9:48:46 AM
CHAIR LYNN announced that the next order of business was SENATE
BILL NO. 215, "An Act requiring the Department of Health and
Social Services to accept federal prescription drug benefits or
to provide comparable benefits for residents of the Alaska
Pioneers' Home."
9:49:40 AM
SENATOR WIELECHOWSKI, Alaska State Legislature, as co-prime
sponsor, noted that HB 284 is a companion bill. He offered a
history of the problem, which SB 215 proposes to address. He
noted that in April 2009, veterans living in the Alaska Pioneer
Homes, who were not able to administer their own medications,
stopped receiving the free or low-cost medications they earned
through the Veterans Administration and were forced to purchase
their medication through the Alaska Pioneer Homes' pharmacies.
The problem, Senator Wielechowski explained, is that the Alaska
Pioneer Homes' pharmacies prepare medication in blister packs,
and the Veterans' Administration does not have the equipment to
do so. The staff at the Alaska Pioneer Homes refused to
administer drugs from bottles, and was not able to put the
medication in blister packs.
SENATOR WIELECHOWSKI said the Department of Health & Social
Services, the Alaska Pioneer Homes, the Veterans Administration,
veterans' advocates, and several members of the legislature
worked together for several months to solve the problem. The
Alaska Pioneer Homes were cooperative, and the chief pharmacist
of the Alaska Veterans Association and chief of staff conducted
in-service visits to the Alaska Pioneer Homes to ensure that the
nurses were properly administering medications directly from the
original bottles from the Veterans Association.
SENATOR WIELECHOWSKI stated that SB 215 seeks to ensure that
this problem does not surface in the future. He stated his
understanding that "this isn't the first time that this has
happened." He said the change of administrations could be a
time when this happens, and that is why "we're seeking to codify
this." Senator Wielechowski related that the bill has a zero
fiscal note and no known opposition. The proposed legislation
is supported by the Office of Veteran Affairs and is a top
legislative priority for the Vietnam Veterans of America. He
offered to answer questions from the committee.
9:53:10 AM
REPRESENTATIVE JOHNSON stated his understanding that the reason
for using blister packs is to eliminate the possibility of
dosing error. He asked if the state would be subjecting itself
to liability by saying it's okay to use bottles.
9:55:00 AM
SENATOR WIELECHOWSKI responded that those who administer
medications at the Alaska Pioneer Homes were concerned about the
possibility of error, but after consideration have decided that
they can administer medication safely from bottles, which is why
they are "supportive of this compromise." He noted that there
are only about a dozen people to which the proposed the
legislation would apply.
9:56:26 AM
REPRESENTATIVE SEATON said when the committee heard the
companion bill, HB 284, he had relayed that he has a relative
who "was in this situation." He expressed concern that the
proposed legislation would be "putting things in statute that
are already taken care of." He said one issue that has not been
addressed is the waste resulting in using blister packs. He
explained that blister packs are made for 31 days, and those
medications not used during months with fewer days are thrown
out, and the value of those discarded medications is not
reimbursed to the person in whose name the prescription is
written.
9:57:20 AM
REPRESENTATIVE P. WILSON said as a nurse, she has "dispensed
drugs like this." She said veterans deserve the free drugs from
the Veterans Association; they should not have to pay for the
same drug because it's in a blister pack. She said she thinks
SB 215 is a good bill.
9:58:38 AM
REPRESENTATIVE GRUENBERG echoed Representative Johnson's concern
about possible liability to the state under SB 215.
9:59:22 AM
SENATOR WIELECHOWSKI responded that "anyone can sue for any
reason at all." He stated, "At some point you have to put some
… confidence in the professionals that are working at the
[Alaska Pioneer] Homes - the nurses that are working there."
Regarding whether or not there would be increased liability, he
said, "I guess someone could administer the wrong blister pack."
9:59:54 AM
REPRESENTATIVE GRUENBERG asked the bill sponsor if he thinks the
legal aspect of the bill had been sufficiently addressed.
10:00:03 AM
SENATOR WIELECHOWSKI responded:
Personally, … as an attorney myself, I don't see it as
burdensome. I don't see it as an additional,
potential liability. You have a professional nurse in
a professional organization who's been working with
the [Alaska Pioneer] Homes, whose working with the
Department of Health & Social Services to figure out a
method to do this. It really is just a matter of
taking a pill out of a bottle and giving it to the
person. And so, obviously if a nurse doesn't do that
correctly, there's potential liability there. I don't
think there's any way you can get around that. If …
they give the person the wrong medicine from a blister
pack, there's potential liability there.
REPRESENTATIVE GRUENBERG expressed satisfaction with Senator
Wielechowski's answer.
10:01:09 AM
VERDIE BOWEN, Director, Office of Veteran Affairs, Department of
Military & Veterans' Affairs (DMVA), testified in support of SB
215. He said several times last year patients had to stop
receiving their medication from the VA. He stated, "Each time a
solution was brought forward, then something new would creep up
from some administrative order or something that would not allow
the patient to receive the medication." Mr. Bowen said what
made the situation worse was that many of the patients involved
could not speak up for themselves because they had Alzheimer's
and dementia, and so their families had to go to their defense.
He affirmed that Senator Wielechowski was correct that the
number of patients affected last year was about a dozen. Mr.
Bowen stated that the intent of the bill is to prevent this
situation from happening again years from now. He credited
Commissioner Hogan as the person who "stood up" and "put forth
the fixes in place." Regarding bottled medicine, Mr. Bowen
explained that the pills are taken out of the bottle and placed
into "ready packs," which he said look like blister packs, but
are packaged for Monday through Sunday. He said he does not
know what liability there would be to the state, but does know
that "this is something that those people have earned and should
continue to receive."
10:03:16 AM
CHAIR LYNN closed public testimony.
10:03:24 AM
REPRESENTATIVE PETERSEN said he thinks it is unfortunate that
some veterans were denied their medication last year, and he
stated his support of SB 215.
10:04:02 AM
CHAIR LYNN reopened public testimony.
10:04:15 AM
DAVE COTE, Director, Central Office, Division of Alaska Pioneer
Homes, stated that the department is neutral regarding SB 215,
because "we are basically already doing this anyway." Regarding
safety, he relayed that while certified nurses' aides are
allowed to dispense from the blister packs, the department has
asked that only nurses dispense the VA and Indian Health
Services medications. Mr. Cote stated that those people who
were charged for the period of May through November were all
refunded and credited back all the money that they were charged.
Mr. Cote, in response to Representative Johnson, said blister
packs increase the amount of money and time required for
dispensing medication and "the VA doesn't do that." In response
to a follow-up question, he said the state uses the blister
packs for safety reasons.
10:07:12 AM
MR. CODY, regarding Representative Seaton's concern about the
wasted medication in a 31-day blister pack, indicated that there
are rules related to whether or not medications can be returned
to pharmacies. He indicated that important factors are whether,
since its release from the pharmacy, the medication stayed at
the proper temperature and was not damaged or tampered with in
any way. He said the department and the pharmacies believe
"this is the right way to go with this."
10:08:11 AM
REPRESENTATIVE GRUENBERG moved to report SB 215 out of committee
with individual recommendations and the accompanying zero fiscal
notes. There being no objection, SB 215 was reported out of the
House State Affairs Standing Committee.
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