03/08/1993 02:20 PM Senate HES

  The first order of business was HB 114 (DRUG DISPENSING:ADV.                 
  NURSE  PRACTITIONERS).     REPRESENTATIVE  CYNTHIA   TOOHEY,                 
  sponsor of the measure, said the bill clarifies  the statute                 
  where  it has been a common practice for nurse practitioners                 
  to  dispense  medication  since  the  early  1980s.    Nurse                 
  practitioners  may examine  and prescribe,  but the  statute                 
  doesn't include  the  word "dispense."   In  many rural  and                 
  urban areas where  there aren't pharmacies, the  legislation                 
  is urgently needed.   Representative Toohey said there is  a                 
  zero  fiscal  note  from  the  Department  of  Commerce  and                 
  Economic  Development.    HB  114   passed  the  House  HESS                 
  Committee, Labor and Commerce Committee, and the House Floor                 
  with a 39-0  vote and an immediate effective date.  The bill                 
                                                                               
                                                                               
  has  the  support of  the  Board  of Nursing,  the  Board of                 
  Pharmacy,  the   Alaska  Nurses   Association,  the   Alaska                 
  Association of Advanced  Nurse Practitioners, advanced nurse                 
  practitioners (ANP) throughout the state, the Department  of                 
  Health and Social  Services, and the Department  of Commerce                 
  and Economic Development.  She urged support for the HB 114.                 
                                                                               
  SENATOR ELLIS asked if the bill would include  dispensing of                 
  any kind.   Representative Toohey said it would  be whatever                 
  they are licensed to dispense.  They must complete a certain                 
  amount of hours of  pharmacology and pass some tests.   They                 
  are  then  given  licensing  to  prescribe  specific  drugs.                 
  Senator  Ellis  asked   if  they  can   dispense  narcotics.                 
  Representative Toohey  indicated that  narcotics are  within                 
  the license of a nurse practitioner.                                         
                                                                               
  Number 084                                                                   
                                                                               
  MARY STROWING, Member, Alaska State  Nursing Board, said the                 
  board  supports HB  114.   The legislation  is necessary  to                 
  provide legal authority for ANPs  to dispense the medication                 
  that they have  prescribed.  Dispensing has  been occurring,                 
  statewide  since  ANPs  began  practicing  in  Alaska  under                 
  regulations established  in 1980  by the  Board of  Nursing.                 
  She said a  July 1992 attorney  general opinion stated  that                 
  there is no legal authority which  allows ANP dispensing.  A                 
  survey done by the Board of  Nursing in November, 1992, with                 
  a 71 percent response rate, revealed that 55 percent of ANPs                 
  working in  Alaska dispense in  their practice.   The survey                 
  further  disclosed  that  25  percent of  the  ANPs  were in                 
  communities  without  pharmacies,  and 22  percent  were  in                 
  communities without physicians.  Ms. Strowing said HB 114 is                 
  needed  to  allow ANPs  to  continue  to dispense  in  their                 
  practice  so  the  care  of  the  communities  will  not  be                 
  adversely impacted.  The  Board of Nursing and the  Board of                 
  Pharmacy have been  working together  on the parameters  for                 
  ANP dispensing  and they  will be  defined by  the Board  of                 
  Nursing's regulations.  The ANP will be required to dispense                 
  in accordance with a practitioners  scope of practice.   She                 
  urged that HB 114 be passed into law.                                        
                                                                               
  There being no  further testimony, SENATOR LEMAN  moved that                 
  HB 114,  be passed  out of  the Senate  HESS Committee  with                 
  individual  recommendations.    Hearing  no  objection,  the                 
  motion passed.