Legislature(2015 - 2016)SENATE FINANCE 532

04/02/2015 01:30 PM Senate FINANCE

Note: the audio and video recordings are distinct records and are obtained from different sources. As such there may be key differences between the two. The audio recordings are captured by our records offices as the official record of the meeting and will have more accurate timestamps. Use the icons to switch between them.

Download Mp3. <- Right click and save file as

* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
Presentation: Overview FY17 Operating Budget
+ SB 71 VACCINE CERTIFICATION FOR PHARMACISTS TELECONFERENCED
Heard & Held
+ SB 86 REFINED FUEL SURCHARGE; MOTOR FUEL TAX TELECONFERENCED
Scheduled but Not Heard
+ Bills Previously Heard/Scheduled TELECONFERENCED
+= HB 72 APPROP: OPERATING BUDGET/LOANS/FUNDS TELECONFERENCED
Moved SCS CSHB 72(FIN) Out of Committee
+= HB 73 APPROP: MENTAL HEALTH BUDGET TELECONFERENCED
Moved SCS CSHB 73(FIN) Out of Committee
SENATE BILL NO. 71                                                                                                            
                                                                                                                                
     "An  Act  relating to  the  practice  of pharmacy;  and                                                                    
     relating to the administration  of vaccines and related                                                                    
     emergency medications."                                                                                                    
                                                                                                                                
2:06:27 PM                                                                                                                    
                                                                                                                                
Co-Chair MacKinnon discussed housekeeping.                                                                                      
                                                                                                                                
2:06:51 PM                                                                                                                    
                                                                                                                                
SENATOR CATHY GIESSEL, SPONSOR, provided a sponsor                                                                              
statement:                                                                                                                      
                                                                                                                                
     Currently,  Alaska pharmacists  require oversight  by a                                                                    
     medical doctor  or nurse practitioner to  oversee their                                                                    
     immunization  authority.  SB   71  will  give  already-                                                                    
     trained   and   certified  pharmacists   authority   to                                                                    
     immunize Alaska  adults and children without  having to                                                                    
     contract   with    often   hard-to-find   doctors/nurse                                                                    
     practitioners to oversee their immunization programs.                                                                      
                                                                                                                                
     This  bill  will  particularly  help  rural  pharmacies                                                                    
     increase  their  reach  to populations  who  often  see                                                                    
     their   pharmacist   more    often   than   a   medical                                                                    
     professional.  Consumers would  enjoy more  flexibility                                                                    
     with their schedules and cost  savings by being able to                                                                    
     access    their    local   pharmacist    for    crucial                                                                    
     immunizations.                                                                                                             
     SB  71  expands  authority for  Alaska  pharmacists  to                                                                    
     independently administer all  vaccines and would reduce                                                                    
     burdensome  collaborative practice  agreements. Studies                                                                    
     have  shown  that  states   in  which  pharmacists  are                                                                    
     granted  broad authority  to  administer vaccines  have                                                                    
     higher immunization rates.                                                                                                 
                                                                                                                                
     In  2013 Alaskan  pharmacists administered  over 13,000                                                                    
     flu vaccines  and this legislation  would significantly                                                                    
     improve  access to  additional vaccinations  and public                                                                    
     health as  a result. I  ask for your support  to expand                                                                    
     the   authority   of   pharmacists   to   independently                                                                    
     administer vaccinations.                                                                                                   
                                                                                                                                
Senator  Giessel  added that  SB  71  would provide  already                                                                    
trained,  and   certified,  pharmacists  the   authority  to                                                                    
immunize  Alaska  adults  and children,  without  having  to                                                                    
contract with  physicians or nurse practitioners  to oversee                                                                    
their programs.  She said that  since 2005,  all pharmacists                                                                    
had  been  trained in  immunization  procedures  as part  of                                                                    
their  education program,  pharmacists  who attended  school                                                                    
before  2005,  would be  required  to  take an  immunization                                                                    
training  program approved  by  the Board  of Pharmacy.  She                                                                    
highlighted the  details of the training.  She believed that                                                                    
the bill would be particularly  helpful in rural areas where                                                                    
the  populations encountered  their  pharmacists more  often                                                                    
that  their medical  providers. She  opined that  Alaska had                                                                    
the lowest  immunization rates in  the country;  studies had                                                                    
shown that in states where  pharmacists had the authority to                                                                    
administer medications  immunization rates were  higher. She                                                                    
stated  that   all  of  the   vaccinations  that   would  be                                                                    
administered  by  a  pharmacist  would be  reported  to  the                                                                    
statewide data program, VacTrack.                                                                                               
                                                                                                                                
2:09:50 PM                                                                                                                    
                                                                                                                                
Co-Chair MacKinnon OPENED public testimony.                                                                                     
                                                                                                                                
2:10:29 PM                                                                                                                    
                                                                                                                                
SCOTT WATTS, ALASKA  PHARMACY ASSOCIATION, JUNEAU, testified                                                                    
in support of SB 71. He  related that Alaska was rated below                                                                    
the  national level  for immunizations.  He reiterated  that                                                                    
pharmacists were  trained in  immunizations and  were acting                                                                    
as  a  resource  for   the  public  concerning  immunization                                                                    
accessibility  and  travel   schedules.  He  commented  that                                                                    
increased vaccination rates would  help to lower health care                                                                    
costs  in the  state. He  commented on  the fiscal  note and                                                                    
observed that it was a  one-time cost, which would be easily                                                                    
off-set by the lower health care costs.                                                                                         
                                                                                                                                
2:12:18 PM                                                                                                                    
                                                                                                                                
Senator Olson expressed concern  about adequate training for                                                                    
adverse  reactions  to  vaccinations, such  as  anaphylactic                                                                    
shock.                                                                                                                          
                                                                                                                                
2:14:18 PM                                                                                                                    
                                                                                                                                
Mr.  Watts replied  that  protocol  existed for  epinephrine                                                                    
injections  to halt  anaphylactic reactions.  He added  that                                                                    
the pharmacists that administered  the vaccinations were CPR                                                                    
certified.                                                                                                                      
                                                                                                                                
Senator  Olson clarified  that pharmacists  did not  receive                                                                    
the same  training as physicians.  He said  that pharmacists                                                                    
were not trained in intubation.                                                                                                 
                                                                                                                                
2:15:26 PM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
2:15:59 PM                                                                                                                    
RECONVENED                                                                                                                      
                                                                                                                                
Senator Olson reiterated that most  pharmacists did not have                                                                    
the  same training  as physicians  and were  not trained  on                                                                    
intubation.                                                                                                                     
                                                                                                                                
Mr. Watts responded that he had  not meant to imply that the                                                                    
two had the same training.                                                                                                      
                                                                                                                                
Senator  Olson  spoke  to the  state's  lagging  vaccination                                                                    
numbers.  He said  that there  existed  the perception  that                                                                    
vaccines  delivered  in  multiple  sequences  over  a  short                                                                    
period  of  time could  result  in  adverse reactions,  like                                                                    
Sudden  Infant Death  Syndrome and  Autism,  but noted  that                                                                    
those theories had largely been debunked.                                                                                       
                                                                                                                                
2:17:51 PM                                                                                                                    
                                                                                                                                
MARGARET  SODEN,   SELF,  FAIRBANKS   (via  teleconference),                                                                    
testified  in   support  of  the  bill.   She  related  that                                                                    
pharmacies  in   her  community   were  open   evenings  and                                                                    
weekends, unlike medical  offices; additionally, pharmacists                                                                    
interacted   with    patients   more   often    than   other                                                                    
practitioners  because they  returned to  the pharmacy  on a                                                                    
regular basis.  She felt that  the legislation  would result                                                                    
in more  pharmacies offering vaccinations, which  would lead                                                                    
to more Alaskans being immunized.                                                                                               
                                                                                                                                
2:19:46 PM                                                                                                                    
                                                                                                                                
AMBER   BRIGGS,   SELF,   SOLDOTNA   (via   teleconference),                                                                    
testified in  support of the  legislation. She  related that                                                                    
she   was   a   pharmacist   and   had   administered   many                                                                    
vaccinations. She believed  that not providing immunizations                                                                    
would result in  adverse economic impacts to  the state. She                                                                    
opined that  the rates of  emergency room visits due  to the                                                                    
H1N1  flu  virus increased  when  people  did not  vaccinate                                                                    
against the  flu. She concluded the  allowing pharmacists to                                                                    
independently   administer   vaccinations  would   help   to                                                                    
decrease healthcare costs in the state.                                                                                         
                                                                                                                                
2:22:09 PM                                                                                                                    
                                                                                                                                
RYAN  RUGGLES,  DISTRICT  PHARMACY MANAGER,  CARRS  SAFEWAY,                                                                    
ANCHORAGE (via teleconference), testified  in support of the                                                                    
legislation.  He   echoed  the  comments  of   the  previous                                                                    
testifiers. He  believed that the  bill offered  convent and                                                                    
economical access to vaccinations.  He noted that pharmacies                                                                    
across the state already administered vaccinations.                                                                             
                                                                                                                                
2:24:48 PM                                                                                                                    
                                                                                                                                
Co-Chair MacKinnon  whether shots were administered  on site                                                                    
at Carrs Safeway.                                                                                                               
                                                                                                                                
Mr. Ruggles indicated that  all immunizations were available                                                                    
except for Yellow Fever.                                                                                                        
                                                                                                                                
Co-Chair MacKinnon  asked whether the store  contracted with                                                                    
a doctor.                                                                                                                       
                                                                                                                                
Mr. Ruggles replied  that the store contracted  with a nurse                                                                    
practitioner through a collaborative practice agreement.                                                                        
                                                                                                                                
Co-Chair MacKinnon queried the cost of the contract.                                                                            
Mr.   Ruggles  responded   that  contract   agreements  with                                                                    
providers  varied. He  could not  provide the  specific cost                                                                    
offhand,  but noted  that the  price could  vary drastically                                                                    
between providers.                                                                                                              
2:25:51 PM                                                                                                                    
                                                                                                                                
Co-Chair   MacKinnon   informed   the   committee   that   a                                                                    
representative  of  the  Department  of  Health  and  Social                                                                    
Services was available online for questions.                                                                                    
                                                                                                                                
2:26:08 PM                                                                                                                    
                                                                                                                                
BARRY CHRISTENSEN, CO-CHAIR,  ALASKA PHARMACISTS ASSOCIATION                                                                    
LEGISLATIVE   COMMITTEE,  KETCHIKAN   (via  teleconference),                                                                    
spoke  in favor  of the  legislation. He  believed that  the                                                                    
bill  would  provide  improved access  to  vaccinations  and                                                                    
improve public  health. He felt  that the fiscal  note could                                                                    
be  justified  by  the  healthcare  savings  that  would  be                                                                    
realized  by the  lesser number  of hospitalizations  due to                                                                    
the flu virus. He related  that, according to the Center for                                                                    
Disease Control (CDC), for every  $1 spent on vaccinations -                                                                    
$10 in healthcare  costs were saved. He noted  the letter of                                                                    
support from  the National  Association of  Trade Drugstores                                                                    
in member packets (copy on file).                                                                                               
                                                                                                                                
2:28:26 PM                                                                                                                    
                                                                                                                                
JASON  TAPLEY, SELF,  JUNEAU, testified  in  support of  the                                                                    
bill. He felt that the  legislation would increase access to                                                                    
vaccinations  for those  with disabilities  or other  travel                                                                    
constraints.                                                                                                                    
                                                                                                                                
2:29:39 PM                                                                                                                    
                                                                                                                                
Senator Olson  asked Mr. Tapley  what kind of  resources and                                                                    
equipment were available to the  pharmacists where he worked                                                                    
that addressed adverse reactions to vaccinations.                                                                               
                                                                                                                                
Mr.  Tapley  replied that  most  pharmacists  were train  in                                                                    
basic life  support; most pharmacies were  stocked with epi-                                                                    
pens and  Benadryl, which  could be  used in  the short-term                                                                    
until an ambulance arrived.                                                                                                     
                                                                                                                                
2:31:05 PM                                                                                                                    
                                                                                                                                
Co-Chair MacKinnon CLOSED public testimony.                                                                                     
                                                                                                                                
2:31:22 PM                                                                                                                    
                                                                                                                                
Senator Giessel commented  that the collaborative agreements                                                                    
that were in  place currently had been in  place since 1989.                                                                    
She   asserted  that   healthcare  education   had  evolved,                                                                    
pharmacists were now  required to earn PHD  degrees and were                                                                    
highly educated. She contended  that intubation was a highly                                                                    
refined  skill requiring  repeated practice  and was  a rare                                                                    
necessity.                                                                                                                      
                                                                                                                                
2:32:45 PM                                                                                                                    
                                                                                                                                
Senator Dunleavy queried the fiscal note.                                                                                       
                                                                                                                                
Senator  Giessel  spoke  to  the fiscal  note  1,  from  the                                                                    
Department    of   Commerce,    Community,   and    Economic                                                                    
Development. She  stated that the regulatory  costs would be                                                                    
covered by the licensing fees.  She continued to fiscal note                                                                    
2, from the Department of  Health and Social Services, which                                                                    
reflected  a  capital  budget  cost  of  $50  thousand.  She                                                                    
referred  to  the audit  that  had  been completed  for  the                                                                    
department which  documented the  system deficits  and known                                                                    
non-compliance instances  for many  sections of  the state's                                                                    
Medicaid  management information  services. She  argued that                                                                    
the system used  for enrollment in and  payment for Medicaid                                                                    
needed a complete renovation.                                                                                                   
                                                                                                                                
2:34:31 PM                                                                                                                    
                                                                                                                                
Senator Olson agreed with Senator  Giessel assessment of the                                                                    
immunizations needs of the state.                                                                                               
                                                                                                                                
2:35:03 PM                                                                                                                    
                                                                                                                                
Senator Bishop asked whether there  was data which reflected                                                                    
the number of cases of  adverse reactions to vaccinations in                                                                    
the state.                                                                                                                      
                                                                                                                                
Senator Giessel  commented that  the data  would need  to be                                                                    
gathered.                                                                                                                       
                                                                                                                                
2:36:01 PM                                                                                                                    
                                                                                                                                
Senator Olson asked  whether the sponsor had  heard from any                                                                    
of the Native Health organizations in rural Alaska.                                                                             
                                                                                                                                
Senator Giessel responded in the negative.                                                                                      
Senator  Olson asked  whether  the administration  supported                                                                    
the legislation.                                                                                                                
                                                                                                                                
Senator Giessel replied that she did not know.                                                                                  
Senator Olson asked  whether the sponsor had  heard from the                                                                    
Alaska  State  Medical  Association   of  the  Alaska  State                                                                    
Medical Board.                                                                                                                  
                                                                                                                                
Senator Giessel said that she  had not received any negative                                                                    
feedback from either organization.                                                                                              
                                                                                                                                
2:37:10 PM                                                                                                                    
                                                                                                                                
Co-Chair MacKinnon  commented that there  was representation                                                                    
from the state of Alaska available to answer questions.                                                                         
                                                                                                                                
2:37:45 PM                                                                                                                    
                                                                                                                                
ERIN NARUS, DIVISION OF HEALTH  CARE SERVICES, DEPARTMENT OF                                                                    
HEALTH AND SOCIAL  SERVICES, ANCHORAGE (via teleconference),                                                                    
stated that  the department did  not have a position  on the                                                                    
legislation.                                                                                                                    
                                                                                                                                
Senator  Olson   asked  whether  the  fiscal   notes  seemed                                                                    
accurate.                                                                                                                       
                                                                                                                                
Ms.  Narus replied  that the  request in  fiscal note  2 was                                                                    
necessary in order to comply with federal requirements.                                                                         
                                                                                                                                
SB  71  was   HEARD  and  HELD  in   committee  for  further                                                                    
consideration.                                                                                                                  
                                                                                                                                
2:39:19 PM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
3:30:56 PM                                                                                                                    
RECONVENED                                                                                                                      
                                                                                                                                
Co-Chair MacKinnon handed the gavel over to Co-Chair Kelly.                                                                     
                                                                                                                                

Document Name Date/Time Subjects
SB71 Sectional Analysis.pdf SFIN 4/2/2015 1:30:00 PM
SB 71
SB71 Sponsor Statement.pdf SFIN 4/2/2015 1:30:00 PM
SB 71
SB71 Support AK Pharmacists Assn.pdf SFIN 4/2/2015 1:30:00 PM
SB 71
SB71 Support Bd of Pharmacy.pdf SFIN 4/2/2015 1:30:00 PM
SB 71
SB71 Support Emails 3-19-15.pdf SFIN 4/2/2015 1:30:00 PM
SB 71
SB71 Support Brown 3-13-15.pdf SFIN 4/2/2015 1:30:00 PM
SB 71
SB71 Support Garrison.pdf SFIN 4/2/2015 1:30:00 PM
SB 71
SB71 Support Island Pharmacy.pdf SFIN 4/2/2015 1:30:00 PM
SB 71
SB71 Support NACDS.pdf SFIN 4/2/2015 1:30:00 PM
SB 71
SB71 Support Ron's Apothecary 3-13-15.pdf SFIN 4/2/2015 1:30:00 PM
SB 71
SB71 Support Safeway.pdf SFIN 4/2/2015 1:30:00 PM
SB 71
SB71 Support Soden 3-23-15.pdf SFIN 4/2/2015 1:30:00 PM
SB 71
SB 86 Changes in SB 86 CS.pdf SFIN 4/2/2015 1:30:00 PM
SB 86
SB 86 CS LC Sectional.pdf SFIN 4/2/2015 1:30:00 PM
SB 86
SB 86 Supporting Documents - DEC Active Contaminated Sites.pdf SFIN 4/2/2015 1:30:00 PM
SB 86
SB 86 Supporting Documents - DEC All Products Spilled FY10-14.pdf SFIN 4/2/2015 1:30:00 PM
SB 86
SB 86 Supporting Documents - DEC All Products Spilled FY14.pdf SFIN 4/2/2015 1:30:00 PM
SB 86
HB 72 Amendment 25.pdf SFIN 4/2/2015 1:30:00 PM
HB 72
HB 72 Amendment 26.pdf SFIN 4/2/2015 1:30:00 PM
HB 72
HB 72 Amendment 24.pdf SFIN 4/2/2015 1:30:00 PM
HB 72
SB 86 - Work Draft version F.pdf SFIN 4/2/2015 1:30:00 PM
SB 86
SB 86 Fund Transfer SFC 4-2-15.pdf SFIN 4/2/2015 1:30:00 PM
SB 86