Legislature(2017 - 2018)BUTROVICH 205

03/13/2017 01:30 PM HEALTH & SOCIAL SERVICES

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
*+ SB 91 EXTEND DISASTER EMERGENCY:OPIOID EPIDEMIC TELECONFERENCED
Heard & Held
-- Public Testimony --
*+ SB 53 INSURANCE COVERAGE FOR CONTRACEPTIVES TELECONFERENCED
Heard & Held
-- Public Testimony --
        SB 91-EXTEND DISASTER EMERGENCY: OPIOID EPIDEMIC                                                                    
                                                                                                                                
1:56:58 PM                                                                                                                    
CHAIR WILSON announced the consideration of SB 91.                                                                              
                                                                                                                                
1:57:17 PM                                                                                                                    
DR. JAY BUTLER,  Chief Medical Officer, Department  of Health and                                                               
Social Services  (DHSS), Juneau, Alaska, provided  an overview of                                                               
SB 91 as follows:                                                                                                               
                                                                                                                                
     In  late 2016,  DHSS  competed for  and  was awarded  a                                                                    
     five-year  grant by  the  Federal  Substance Abuse  and                                                                    
     Mental  Health Services  Administration  to support  an                                                                    
     opioid  overdose prevention  program that  included the                                                                    
     distribution   of  Naloxone,   a  drug   that  can   be                                                                    
     lifesaving  when   administered  to  someone   who  has                                                                    
     stopped breathing due to an opioid overdose.                                                                               
                                                                                                                                
     The grant  funds have  been used  to acquire  the nasal                                                                    
     spray form  of the drug  that is  part of a  rescue kit                                                                    
     distributed   through  Alaska   Project  HOPE,   "HOPE"                                                                    
     standing for,  "harm reduction overdose  prevention and                                                                    
     education." We worked with law  enforcement in terms of                                                                    
     how they might  be able to best carry the  kits to best                                                                    
     administer   them  if   needed   during  an   emergency                                                                    
     situation.                                                                                                                 
                                                                                                                                
     Project  HOPE has  prioritized partnerships  with staff                                                                    
     of organizations  that do  not have  medical direction,                                                                    
     meaning that they would have  someone who could issue a                                                                    
     prescription  for  the  drug and  those  who  are  most                                                                    
     likely to  be present when  an overdose occurs  such as                                                                    
     for certain  first responders  and persons  involved in                                                                    
     recovery support.                                                                                                          
                                                                                                                                
     To  provide the  kits under  a standing-medical  order,                                                                    
     the department  explored a number  of options.  We were                                                                    
     advised by the attorney  general's office that the best                                                                    
     option would be for  the state-medical officer to issue                                                                    
     a  standing order  and the  authority for  the standing                                                                    
     order  would require  a disaster  declaration. Governor                                                                    
     Walker issued  the declaration on  February 14  with an                                                                    
     anticipated  legislative   concurrent  resolution  that                                                                    
     would extend  the declaration for  longer than  the 30-                                                                    
     day deration defined by Alaska statute.                                                                                    
                                                                                                                                
     No state  funds are  required to support  Project HOPE.                                                                    
     Since  the declaration,  12 organizations  have already                                                                    
     received   the  training   including  some   that  have                                                                    
     received training-the-trainer training  and are able to                                                                    
     provide  the  kits  and  nearly   800  kits  have  been                                                                    
     dispensed so  far. This past Thursday  we returned that                                                                    
     the  opinion of  Legislative Legal  is that  a bill  is                                                                    
     required to extend the declaration  and to continue the                                                                    
     distribution of the kits under the standing order.                                                                         
                                                                                                                                
2:00:15 PM                                                                                                                    
DR. BUTLER addressed the sectional analysis of SB 91 as follows:                                                                
                                                                                                                                
Section 1:                                                                                                                  
Includes the findings of the  extent of the public-health threat.                                                               
Acknowledges and  describes the governor's  disaster declaration,                                                               
and the need for legislation to extend the declaration.                                                                         
                                                                                                                                
Section 2:                                                                                                                  
Extends the February 14, 2017  disaster declaration for 1 year to                                                               
February 14, 2018.                                                                                                              
                                                                                                                                
Section 3:                                                                                                                  
Makes the effective  date retroactive to March 15,  2017 when the                                                               
current disaster declaration expires.                                                                                           
                                                                                                                                
SENATOR  MICCICHE asserted  that  he is  an  active supporter  of                                                               
dealing the  state's opioid crisis.  He asked for  an explanation                                                               
of  the emergency  declaration's criteria  under federal  law. He                                                               
inquired if the emergency declaration was actually appropriate.                                                                 
                                                                                                                                
2:01:36 PM                                                                                                                    
STACY KRALY, Chief Assistant  Attorney General, Alaska Department                                                               
of Law, Juneau, Alaska, addressed  the emergency declaration from                                                               
SB 91 as follows:                                                                                                               
                                                                                                                                
     This is  a state  emergency declaration, not  a federal                                                                    
     declaration.  Under current  state statute  there is  a                                                                    
     mechanism under the  public-health authorizations under                                                                    
     Title  18  and also  under  the  Military and  Veterans                                                                    
     Affair  statutory authorizations  under  Title 26  that                                                                    
     provides  for  the  issuance of  a  declaration  of  an                                                                    
     emergency.                                                                                                                 
                                                                                                                                
     If you look in particular  under AS 18.15.390 which are                                                                    
     the  powers  of  the   department  in  a  public-health                                                                    
     disaster, the  department can work with  the Department                                                                    
     of Military and Veterans  Affairs to initiate a public-                                                                    
     health  emergency under  the  auspices and  authorities                                                                    
     that  Military   and  Veterans  Affairs  as   under  AS                                                                    
     26.23.020;  so they  kind of  work in  conjunction with                                                                    
     each  other generally  and under  emergency declaration                                                                    
     are done for flooding, that's  the most recent one that                                                                    
     happened, ice jams and flooding  and that sort of thing                                                                    
     so there would be  an emergency declaration through the                                                                    
     Department of Veterans and  Military Affairs that would                                                                    
     provide   the  department   authorization  to   provide                                                                    
     certain services  and funding in many  cases to address                                                                    
     this emergency, an earthquake or something like that.                                                                      
                                                                                                                                
     What has  also happened though is  that the Legislature                                                                    
     through the  public health statutes, like  I said under                                                                    
     Title  18, has  given the  department the  authority to                                                                    
     use  the  mechanisms  of  a  disaster  declaration  for                                                                    
     purposes of a public-health  emergency and that is what                                                                    
     we have done under this  context; so they work together                                                                    
     a little bit  different. We use the  same framework and                                                                    
     format   under  the   emergency  declaration   for  the                                                                    
     Veterans and  Military Affairs,  but it  is used  for a                                                                    
     public  health emergency  which is  what we've  done in                                                                    
     this context.                                                                                                              
                                                                                                                                
SENATOR MICCICHE asked if the federal grants that are funding                                                                   
the program requires a disaster declaration.                                                                                    
                                                                                                                                
2:04:19 PM                                                                                                                    
MS. KRALY answered no. She continued as follows:                                                                                
                                                                                                                                
     What we  were very  clear in the  emergency declaration                                                                    
     when we  crafted it for  the governor's office  is that                                                                    
     there were  going to be  no additional funds  that were                                                                    
     going to  be administered  generally when  an emergency                                                                    
     happens  like  I  was explaining  previously;  say  the                                                                    
     flood,  there's   a  need  for  an   expenditure,  some                                                                    
     financial  outlay by  the Legislature  to help  address                                                                    
     the  emergency.  This grant  was  applied  for and  was                                                                    
     received long before this  declaration was received, so                                                                    
     there's  no addition  fiscal  outlay  or request  being                                                                    
     made as a result of this declaration.                                                                                      
                                                                                                                                
CHAIR WILSON stated the following:                                                                                              
                                                                                                                                
     Our offices looked  into this a little  bit and working                                                                    
     with the department and the  state as well and first we                                                                    
     want  to thank  the governor  for raising  awareness to                                                                    
     this  issue. We  all want  here  to save  lives and  we                                                                    
     understand, but I  do want to put  this in perspective,                                                                    
     if we  will have  a conversation to  make sure  we have                                                                    
     clearness upon what  is needed and what  is being asked                                                                    
     for.                                                                                                                       
                                                                                                                                
CHAIR WILSON asked if Alaska has already received the $4                                                                        
million.                                                                                                                        
                                                                                                                                
DR. BUTLER answered yes.                                                                                                        
                                                                                                                                
CHAIR  WILSON asked  him to  verify that  the declaration  is not                                                               
needed for the expenditure of the $4 million.                                                                                   
                                                                                                                                
DR. BUTLER answered correct.                                                                                                    
                                                                                                                                
CHAIR WILSON summarized as follows:                                                                                             
                                                                                                                                
     Really  what is  being asked  for is  that the  medical                                                                    
     director could  have these  special privileges  to help                                                                    
     dispense  Naloxone  throughout the  Alaska  communities                                                                    
     and this  would allow  him to do  that both  allow this                                                                    
     position  to do  that for  the one  year until  the end                                                                    
     date of this declaration.                                                                                                  
                                                                                                                                
2:06:11 PM                                                                                                                    
DR. BUTLER answered correct.                                                                                                    
                                                                                                                                
CHAIR WILSON  asked if  a bill  could be  drafted rather  than an                                                               
emergency declaration.                                                                                                          
                                                                                                                                
DR. BUTLER  answered that  he supported  any means  in addressing                                                               
opioid overdose prevention.                                                                                                     
                                                                                                                                
CHAIR WILSON noted that Dr.  Butler had the emergency declaration                                                               
privilege  within the  30 days.  He asked  if SB  91 extends  the                                                               
privilege for  30 days  or would  the bill be  a stop-gap  if the                                                               
Legislature does not act within the 30-day timeframe.                                                                           
                                                                                                                                
DR. BUTLER answered as follows:                                                                                                 
                                                                                                                                
     The current  disaster declaration will expire  on March                                                                    
     15, so if there is a  gap period it means we would stop                                                                    
     the  dispensing  of   the  kit  until  we   can  get  a                                                                    
     resolution for this issue.                                                                                                 
                                                                                                                                
SENATOR VON  IMHOF asked  him to verify  that the  state received                                                               
the   federal  Substance   Abuse  and   Mental  Health   Services                                                               
Administration (SAMHSA) grant of $4.1 million.                                                                                  
                                                                                                                                
DR. BUTLER answered correct.                                                                                                    
                                                                                                                                
SENATOR VON IMHOF assumed that  the program's success required as                                                               
many caregivers as  possible to have access to the  kits in order                                                               
to deliver Naloxone.                                                                                                            
                                                                                                                                
DR. BUTLER  specified that the  persons who may  be administering                                                               
Naloxone did not have to be a health-care provider.                                                                             
                                                                                                                                
2:08:21 PM                                                                                                                    
SENATOR  VON IMHOF  asked  to confirm  that  Naloxone requires  a                                                               
doctor's approval of some sort  in order to administer, something                                                               
that  is not  always time  efficient and  not always  possible in                                                               
emergency situations.                                                                                                           
                                                                                                                                
DR. BUTLER answered correct.                                                                                                    
                                                                                                                                
SENATOR VON IMHOF stated that  one way to circumvent the doctor's                                                               
approval  is by  claiming  an emergency  disaster.  She asked  if                                                               
circumventing  approval  by  a  doctor  was  the  intent  of  the                                                               
emergency disaster declaration.                                                                                                 
                                                                                                                                
DR.  BUTLER specified  that the  disaster declaration  allows the                                                               
standing order  to be  created to  be able  to provide  that pre-                                                               
existing  prescriptive  authority  so  that  the  kits  could  be                                                               
available to people who are most likely to be present.                                                                          
                                                                                                                                
SENATOR VON  IMHOF asked him  to verify that a  blanket authority                                                               
would  be extended  to  the  on-the-ground health-care  providers                                                               
that are in the emergency situation                                                                                             
                                                                                                                                
DR. BUTLER answered correct.                                                                                                    
                                                                                                                                
SENATOR  VON  IMHOF replied  that  she  understood the  reasoning                                                               
behind  getting  800  kits  out and  distributed  as  quickly  as                                                               
possible  without  having  the cumbersome  aspect  of  having  an                                                               
individual  doctor's  approval each  time.  She  stated that  the                                                               
question remained if an emergency  declaration is required versus                                                               
the statute  process. She  asked Dr. Butler  if he  would support                                                               
extending the declaration  30 days to buy time  for the committee                                                               
to write up a statute for a 1-year authority period.                                                                            
                                                                                                                                
2:10:08 PM                                                                                                                    
DR.  BUTLER reiterated  that he  supported however  the authority                                                               
can be  established to distribute  the kits. He pointed  out that                                                               
the  funding is  for five  years  and asked  if the  prescriptive                                                               
authority can be considered for a longer period.                                                                                
                                                                                                                                
SENATOR GIESSEL quoted the statute  that cited the declaration of                                                               
disaster under AS 26.23.020 and commented as follows:                                                                           
                                                                                                                                
      "This emergency declaration allows the allocation of                                                                      
     medicine or supplies to address the emergency;" it is                                                                      
     only for 30 days, it is  a standing order as Dr. Butler                                                                    
     has pointed out. The medication  in the overdose kit is                                                                    
     a  prescription  medication,  consequently he,  as  the                                                                    
     state's   medical   officer,   can  write   a   blanket                                                                    
     prescription  allowing the  training  of personnel,  of                                                                    
     citizens  in the  proper  use of  these,  it's a  nasal                                                                    
     spray, but it does  require the prescription. To extend                                                                    
     this  only for  30  days does  not  really address  the                                                                    
     problem and the state  medical director has provided us                                                                    
     with some  information about the  size of  this problem                                                                    
     and  it will  take more  than just  another 30  days to                                                                    
     address it properly.                                                                                                       
                                                                                                                                
SENATOR BEGICH  asked to  confirm that  the legislation  would do                                                               
what Senator Giessel referenced in statute.                                                                                     
                                                                                                                                
SENATOR GIESSEL answered yes.                                                                                                   
                                                                                                                                
2:12:54 PM                                                                                                                    
CHAIR WILSON  asked Dr.  Butler to explain  the numbers  that are                                                               
referenced in the bill on page 1, lines 9-13.                                                                                   
                                                                                                                                
DR.  BUTLER confirmed  that  heroin-associated  deaths more  than                                                               
quadrupled  from 2009  to 2015,  from 7  deaths to  38 deaths  in                                                               
2015.                                                                                                                           
                                                                                                                                
CHAIR  WILSON  noted that  in  2014  approximately 500  doses  of                                                               
Naloxone was given  out. He asked Dr. Butler if  he knew how many                                                               
kits are planned to be administered for the first year.                                                                         
                                                                                                                                
DR. BUTLER replied that the goal is to distribute 5,000 kits.                                                                   
                                                                                                                                
2:16:32 PM                                                                                                                    
CHAIR WILSON  noted constituency concerns that  wide availability                                                               
of Naloxone may  have a negative impact on society  as a "Get out                                                               
of death  for free card." He  asked if there is  concern that the                                                               
$4 million  will just  be used for  Naloxone rather  than putting                                                               
funds further upstream to get to people before they use opioids.                                                                
                                                                                                                                
DR. BUTLER specified that Naloxone can  save a life, but does not                                                               
cure the  addiction. He concurred  that Naloxone is not  the only                                                               
approach  to  address the  opioid  epidemic.  He set  forth  that                                                               
access  to  treatment  and  the   stigma  often  associated  with                                                               
addiction  must also  be addressed.  He  added that  how pain  is                                                               
being  managed  with  opioids  is   another  area  that  must  be                                                               
assessed.                                                                                                                       
                                                                                                                                
2:20:51 PM                                                                                                                    
SENATOR  MICCICHE asked  how other  states are  dealing with  the                                                               
opioid epidemic.                                                                                                                
                                                                                                                                
DR.  BUTLER  replied that  like  Alaska,  other states  are  also                                                               
taking a multi-faceted approach  that includes allowing the state                                                               
medical  officer   to  issue  a  standing   order,  address  drug                                                               
monitoring programs, continued medical  education to providers on                                                               
pain management and addiction, and  limiting the number of opioid                                                               
pills that can be dispensed.                                                                                                    
                                                                                                                                
SENATOR MICCICHE  asked if there  is a "good samaritan"  law that                                                               
covers someone administering Naloxone.                                                                                          
                                                                                                                                
2:24:06 PM                                                                                                                    
MS.  KRALY replied  that she  would take  a look  at the  general                                                               
"good  samaritan"  laws  of  the  statutes  and  provide  a  more                                                               
thorough answer of how those would apply.                                                                                       
                                                                                                                                
CHAIR WILSON asked  if training certificates will  be provided to                                                               
show that a  person was well trained  for administering Naloxone.                                                               
He  opined that  certification  would apply  to "good  samaritan"                                                               
laws that a person was trained  within the authority of what they                                                               
do.                                                                                                                             
                                                                                                                                
DR.  BUTLER explained  that the  kits have  pre-packaged Naloxone                                                               
nasal spray to simplify administering  the drug. He detailed that                                                               
training  is fairly  simple and  provided a  step-by-step process                                                               
for administering Naloxone.                                                                                                     
                                                                                                                                
SENATOR  MICCICHE asked  if  the  state was  in  the right  place                                                               
"mechanically" in training for administering Naloxone.                                                                          
                                                                                                                                
2:28:05 PM                                                                                                                    
ANDREW   JONES,  Section   Chief,   Emergency  Programs:   Health                                                               
Emergency  Response  Operations,  EMS  and  Trauma,  Division  of                                                               
Public  Health,   Department  of  Health  and   Social  Services,                                                               
Anchorage, Alaska, announced his  availability to address how the                                                               
overdose kits are administered.                                                                                                 
                                                                                                                                
CHAIR  WILSON  asked  Mr. Jones  to  address  Senator  Micciche's                                                               
inquiry on Naloxone.                                                                                                            
                                                                                                                                
MR. JONES  explained that  Health Emergency  Response Operations,                                                               
Emergency Medical  Services (EMS)  and the  Trauma System  have a                                                               
comprehensive and  customized training program to  meet the needs                                                               
of Alaskans.  He detailed that  training is  hands-on, one-on-one                                                               
that is similar  to CPR training. He noted  that individuals that                                                               
receive training  get a card to  show that they were  trained. He                                                               
revealed  that training-on-training  has  an application  process                                                               
and the thorough training takes a few hours to complete.                                                                        
                                                                                                                                
He explained that the intent of  the program was to compliment SB                                                               
23  and one  of  the parts  of  the bill  says,  "An employer  or                                                               
volunteer of  the overdose program  with training  can administer                                                               
the lifesaving  drug." He said  the intent  was for the  state to                                                               
create an umbrella-program  with a goal to get the  kits into the                                                               
hands of  the non-profits, the  peer-recovery groups,  the people                                                               
who  are in  connection  with individuals  who  are either  going                                                               
through recovery or may actually be using on a day-to-day basis.                                                                
                                                                                                                                
He addressed  Senator Micciche  regarding a  disaster declaration                                                               
and specified  that the two  things that are always  analyzed and                                                               
asked is:  loss of  life, and  loss of property.  He said  the $4                                                               
million  federal grant  will assist  with getting  the medication                                                               
out in an efficient and quick manner to save lives.                                                                             
                                                                                                                                
2:30:36 PM                                                                                                                    
CHAIR WILSON  asked if  DHSS would  come back  in 2018  after the                                                               
declaration is done and ask  the Legislature to issue the medical                                                               
director's position  the same clearance to  authorize dispensing.                                                               
He asked if responding to the  request would be best done through                                                               
a bill process or continue a year-to-year process.                                                                              
                                                                                                                                
DR. BUTLER opined  that the most efficient response  would be the                                                               
bill process.                                                                                                                   
                                                                                                                                
SENATOR VON IMHOF said she was  pleased the state received the $4                                                               
million   SAMHSA  grant;   however,  she   posed  that   using  a                                                               
declaration of disaster emergency  to implement the program opens                                                               
the door to  potential risk of open-ended funding  in the future.                                                               
She  noted that  legal opinion  was sought  and pointed  out that                                                               
there  is a  risk. She  said as  a person  sitting on  the Senate                                                               
Finance Committee,  she acknowledged  the risk and  asserted that                                                               
she  would like  to explore  an  alternative option  if the  same                                                               
thing can be accomplished.                                                                                                      
                                                                                                                                
2:33:27 PM                                                                                                                    
DR.  BUTLER reiterated  that  his objective  is  to maintain  the                                                               
program and save lives in whatever way that is optimal.                                                                         
                                                                                                                                
MS.  KRALY  explained that  the  emergency  declaration that  was                                                               
signed  by   Governor  Walker  was   very  narrowly   crafted  to                                                               
specifically address the concerns  that Senator von Imhof raised.                                                               
She revealed that  an emergency declaration was  the quickest way                                                               
to get the kits into Alaska's communities.                                                                                      
                                                                                                                                
2:36:42 PM                                                                                                                    
SENATOR  GIESSEL noted  that the  Mat-Su has  an opioid  response                                                               
team, a  community group  that has come  together to  address the                                                               
issue  in the  Mat-Su  Valley. She  disclosed  that Anchorage  is                                                               
forming a  similar group. She  asked Mr. Jones  if he knows  if a                                                               
response team is formulating in Fairbanks.                                                                                      
                                                                                                                                
MR. JONES  answered that a Fairbanks  has a collation as  well as                                                               
numerous collations throughout  the state. He said  the intent is                                                               
to provide  tools and capabilities  to empower communities  for a                                                               
long-term response.                                                                                                             
                                                                                                                                
SENATOR GIESSEL asked Mr. Jones  what Naloxone's side effects are                                                               
and the result if the  drug is mistakenly administered to someone                                                               
that is not having an opioid overdose.                                                                                          
                                                                                                                                
MR. JONES answered that the  side effects are minimal, unless the                                                               
person  is allergic  specifically to  Naloxone, a  situation that                                                               
has very few cases of occurrence in  the U.S. He said most of the                                                               
times what ends  up happening if an individual  is overdosing and                                                               
it is  not an  opioid, the  person probably  will not  wakeup and                                                               
that's when CPR is administered.                                                                                                
                                                                                                                                
SENATOR  GIESSEL  asked Mr.  Jones  if  he  knew much  about  the                                                               
state's  "good  samaritan" laws  in  reference  to liability  for                                                               
Naloxone.                                                                                                                       
                                                                                                                                
2:39:21 PM                                                                                                                    
MR. JONES revealed  that one of the statutes as  a result of last                                                               
year's  legislation  from SB  23  addressed  liability and  gross                                                               
negligence. He explained  that gross negligence would  occur if a                                                               
person had  an overdose kit  but did not administer  Naloxone. He                                                               
added  that   administering  CPR  is  covered   under  the  "good                                                               
samaritan" law, as long as gross negligence is not applied.                                                                     
                                                                                                                                
SENATOR  GIESSEL  asked  Dr.  Butler if  he  could  elaborate  on                                                               
Naloxone's  side  effects  and  liability related  to  the  "good                                                               
samaritan" law.                                                                                                                 
                                                                                                                                
DR. BUTLER concurred  with Mr. Jones that nothing  will happen to                                                               
a person that  is administered Naloxone if the  individual is not                                                               
experiencing  an opioid  overdose.  He detailed  that the  person                                                               
will  not   wake  up,  but   9-1-1  should  be  called   and  CPR                                                               
administered by someone that is trained.                                                                                        
                                                                                                                                
2:41:17 PM                                                                                                                    
CHAIR WILSON opened public testimony.                                                                                           
                                                                                                                                
2:41:47 PM                                                                                                                    
KARA  NELSON,   representing  self,  Juneau   Recovery  Community                                                               
Organization, Juneau, Alaska, testified in  support of SB 91. She                                                               
said the  opioid epidemic is  an emergency and people  are dying.                                                               
She asserted that  Naloxone is needed. She revealed  that she has                                                               
been  trained  in  administering  Naloxone and  has  done  so  in                                                               
overdose situations.                                                                                                            
                                                                                                                                
2:44:55 PM                                                                                                                    
MICHAEL CARSON, Vice President,  MyHouse Mat-Su, Wasilla, Alaska,                                                               
testified  in support  of SB  91. He  noted that  he is  also the                                                               
chairman  of  the Mat-Su  Opioid  Task  Force. He  detailed  that                                                               
MyHouse is  one of  the non-profits that  would benefit  from the                                                               
wide  distribution  of  Naloxone  kits.  He  concurred  that  the                                                               
state's heroine increase has, "Gone up through the roof."                                                                       
                                                                                                                                
2:48:27 PM                                                                                                                    
MIKE  COONS,  representing  self, Palmer,  Alaska,  testified  in                                                               
opposition of SB  91. He revealed that he was  a paramedic for 22                                                               
years. He  opined that  distributing Naloxone  will be  a failure                                                               
and  may even  add to  increased  deaths of  opioids by  enabling                                                               
addicts. He said  he objected to the use of  federal funds to pay                                                               
for the $4.1 million grant to the state for disaster relief.                                                                    
                                                                                                                                
CHAIR WILSON clarified that the  $4.1 million comes from a SAMHSA                                                               
grant.                                                                                                                          
                                                                                                                                
MR.  COONS  replied that  the  grant  still comes  from  taxpayer                                                               
dollars.                                                                                                                        
                                                                                                                                
2:51:27 PM                                                                                                                    
JOHN GREEN,  representing himself, Wasilla, Alaska,  testified in                                                               
support  of SB  91. He  revealed that  his daughter  died from  a                                                               
heroin addiction. He set forth  that recovery resources should be                                                               
made available in order to save lives.                                                                                          
                                                                                                                                
2:54:12 PM                                                                                                                    
CHAIR WILSON closed public testimony.                                                                                           
                                                                                                                                
He asked  Dr. Butler about  the "after effect." He  remarked that                                                               
the   possible  side   effects   from   receiving  Naloxone   was                                                               
overlooked. He asked Dr. Butler  if an individual's state of mind                                                               
and behavior is affected from Naloxone.                                                                                         
                                                                                                                                
DR.  BUTLER replied  that Naloxone  does not  cure addiction.  He                                                               
emphasized  that addiction  is  a chronic  health condition  that                                                               
requires management. He noted that  the community coalitions play                                                               
an important role in addiction recovery.                                                                                        
                                                                                                                                
CHAIR  WILSON asked  Dr. Butler  to address  the effects  of what                                                               
happens to a person right after receiving Naloxone.                                                                             
                                                                                                                                
2:56:55 PM                                                                                                                    
DR.  BUTLER  replied  that  the  effects  are  dependent  on  the                                                               
situation.                                                                                                                      
                                                                                                                                
CHAIR WILSON  inquired if  there is  a risk  of the  person being                                                               
aggressive  after being  administered Naloxone.  He asked  if the                                                               
effects  from  Naloxone  and  the  risks  are  being  covered  in                                                               
training.                                                                                                                       
                                                                                                                                
DR. BUTLER explained that the  acute effects that are experienced                                                               
by the  person who receives  the Naloxone  is going to  be driven                                                               
somewhat by  the dose and strength  of the opioid. He  added that                                                               
the amount of  Naloxone administered is important  to get someone                                                               
to  start  breathing  again,  but   to  avoid  going  into  acute                                                               
withdrawal.  He  pointed  out   that  acute  withdrawal  is  very                                                               
unpleasant with the possibility for vomiting.                                                                                   
                                                                                                                                
SENATOR BEGICH noted  that typically a "findings  section" is not                                                               
included  in  legislation and  recommended  that  the section  be                                                               
eliminated from the bill.                                                                                                       
                                                                                                                                
2:59:59 PM                                                                                                                    
CHAIR  WILSON  detailed  that  his   intent  is  to  introduce  a                                                               
committee substitute  at the next  committee meeting. He  said he                                                               
hoped to  get the bill  out of committee  as soon as  possible so                                                               
that the work  of DHSS is not hindered. He  commented on the bill                                                               
as follows:                                                                                                                     
                                                                                                                                
     I  don't think  anyone  here in  the committee  doesn't                                                                    
     think that  every life is  valuable to be saved  and we                                                                    
     thank  the administration  for putting  this forth  and                                                                    
     this plan together. I think  that we've all had our own                                                                    
     experiences with this issue one  way or another, but we                                                                    
     just want to  make sure that we are looking  at this as                                                                    
     a whole. It is my  viewpoint that we are addressing not                                                                    
     just down-the-river, but we can  go further upstream as                                                                    
     possible.                                                                                                                  
                                                                                                                                
CHAIR WILSON held SB 91 in committee for future consideration.                                                                  

Document Name Date/Time Subjects
SB053 verA.PDF SHSS 3/13/2017 1:30:00 PM
SB 53
SB053 Sponsor Statement.pdf SHSS 3/13/2017 1:30:00 PM
SB 53
SB053 Supporting Document - Guttmacher Institute Alaska Specific.pdf SHSS 3/13/2017 1:30:00 PM
SB 53
SB053 Supporting Document - Guttmacher Institute Cost of Unintended Pregnacies.pdf SHSS 3/13/2017 1:30:00 PM
SB 53
SB053 Supporting Document - Contraceptives Dispensed and Unintended Pregnancies.pdf SHSS 3/13/2017 1:30:00 PM
SB 53
SB053 Letter of Opposition - NFIB.pdf SHSS 3/13/2017 1:30:00 PM
SB 53
SB053 Letter of Support - AK Pharmacists Association.pdf SHSS 3/13/2017 1:30:00 PM
SB 53
SB053 Letter of Support - Alaska Nurses Association.pdf SHSS 3/13/2017 1:30:00 PM
SB 53
SB053 Letter of Support - Planned Parenthood.pdf SHSS 3/13/2017 1:30:00 PM
SB 53
SB 53 Public 1.PDF SHSS 3/13/2017 1:30:00 PM
SB 53
SB053 Sectional Analysis.pdf SHSS 3/13/2017 1:30:00 PM
SB 53
SB 91 Version A.pdf SHSS 3/13/2017 1:30:00 PM
SB 91
SB 91 Transmittal Letter and Declaration.PDF SHSS 3/13/2017 1:30:00 PM
SB 91
SB 91 Fiscal Note.PDF SHSS 3/13/2017 1:30:00 PM
SB 91
SB 91 Sectional Analysis Version A.pdf SHSS 3/13/2017 1:30:00 PM
SB 91
SB 53 FNs.pdf SHSS 3/13/2017 1:30:00 PM
SB 53
SB 53 Public 2.pdf SHSS 3/13/2017 1:30:00 PM
SB 53
SB 53 Public 3.pdf SHSS 3/13/2017 1:30:00 PM
SB 53
SB 91 Public 1.pdf SHSS 3/13/2017 1:30:00 PM
SB 91