02/13/2003 03:07 PM House HES
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+ teleconferenced
= bill was previously heard/scheduled
ALASKA STATE LEGISLATURE
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES
STANDING COMMITTEE
February 13, 2003
3:07 p.m.
MEMBERS PRESENT
Representative Peggy Wilson, Chair
Representative Carl Gatto, Vice Chair
Representative Cheryll Heinze
Representative Paul Seaton
Representative Kelly Wolf
Representative Sharon Cissna
MEMBERS ABSENT
Representative Mary Kapsner
COMMITTEE CALENDAR
HOUSE BILL NO. 25
"An Act relating to health care decisions, including do not
resuscitate orders and the donation of body parts, and to powers
of attorney relating to health care, including the donation of
body parts; and providing for an effective date."
- HEARD & HELD
HOUSE BILL NO. 51
"An Act requiring pharmacists to include generic drug
information on containers in which brand-name prescription drug
orders are dispensed."
- MOVED CSHB 51(HES) OUT OF COMMITTEE
PREVIOUS ACTION
BILL: HB 25
SHORT TITLE:HEALTH CARE SERVICES DIRECTIVES
SPONSOR(S): REPRESENTATIVE(S)WEYHRAUCH
Jrn-Date Jrn-Page Action
01/21/03 0038 (H) PREFILE RELEASED (1/10/03)
01/21/03 0038 (H) READ THE FIRST TIME -
REFERRALS
01/21/03 0038 (H) HES, JUD, FIN
01/21/03 0038 (H) REFERRED TO HES
02/13/03 (H) HES AT 3:00 PM CAPITOL 106
BILL: HB 51
SHORT TITLE:LABELING OF PRESCRIBED DRUGS
SPONSOR(S): REPRESENTATIVE(S)SEATON
Jrn-Date Jrn-Page Action
01/21/03 0045 (H) PREFILE RELEASED (1/17/03)
01/21/03 0045 (H) READ THE FIRST TIME -
REFERRALS
01/21/03 0045 (H) HES, L&C
01/24/03 0065 (H) COSPONSOR(S): MEYER
01/27/03 0079 (H) COSPONSOR(S): GARA
02/10/03 0173 (H) COSPONSOR(S): CROFT
02/13/03 (H) HES AT 3:00 PM CAPITOL 106
WITNESS REGISTER
REPRESENTATIVE BRUCE WEYHRAUCH
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: As sponsor of HB 25, testified on the
purpose of the bill and answered questions from the members.
MARIA WALLINGTON, M.D.
Providence Health System
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 25, recommended
minor changes in the bill, and answered questions from the
members.
PAUL MALLEY, President
Aging with Dignity
Tallahassee, Florida
POSITION STATEMENT: Testified in support of HB 25 and provided
the committee with information about Five Wishes.
MARK JOHNSON, Chief
Community Health and Emergency Medical Services
Division of Public Health
Department of Health and Social Services
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 25.
MARIE DARLIN, Coordinator
Capitol City Task Force
AARP
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 25.
ACTION NARRATIVE
TAPE 03-13, SIDE A
Number 0001
CHAIR PEGGY WILSON called the House Health, Education and Social
Services Standing Committee meeting to order at 3:07 p.m.
Representatives Wilson, Gatto, Heinze, and Seaton were present
at the call to order. Representatives Wolf and Cissna arrived
as the meeting was in progress.
HB 25-HEALTH CARE SERVICES DIRECTIVES
Number 0051
CHAIR WILSON opened the hearing on HOUSE BILL NO. 25, "An Act
relating to health care decisions, including do not resuscitate
orders and the donation of body parts, and to powers of attorney
relating to health care, including the donation of body parts;
and providing for an effective date." Chair Wilson said the
committee will hear testimony on the bill today, and take
questions on the bill next week.
Number 0132
REPRESENTATIVE BRUCE WEYHRAUCH, Alaska State Legislature,
sponsor, told the committee that HB 25, on health care
directives, is a bill that was passed by the House last year.
He noted that Representatives Cissna, Kapsner, and Wilson worked
on that bill, and he wants the committee to know that HB 25 is
identical to that legislation. He said he is glad that there
are a number of people present to testify because it will give
the new members of the committee an opportunity to understand
the purpose of the bill.
Number 0229
REPRESENTATIVE WEYHRAUCH shared personal reasons for wanting to
see this legislation pass. He said his father passed away
recently, and health care directives were a significant part of
end-of-life decisions that his mother, along with her seven
children, had to make on behalf of his father. He told the
committee that as an attorney, he believes no matter what a
lawyer does to make end-of-life decisions clean, neat, and
legal, it never quite works that way. Anyone who has had to
deal with death and dying knows that the decisions never are
quite as clear as one would like.
Number 0277
REPRESENTATIVE WEYHRAUCH said he believes it is very important
to do whatever can be done to make the end-of-life a time when
dying people are surrounded by love. It should be a time when
the family is there to nurture them, to show they care for them,
and want their life to be as good as possible in that situation.
The last thing families need is to be faced with a lot of
stressful decisions on what someone they love may or may not
want to do at the end-of-life phases. Representative Weyhrauch
said the nightmare end-of-life existence his father had made him
realize that there are some things worse in life than death.
Number 0336
REPRESENTATIVE WEYHRAUCH explained that the bill offers a
comprehensive, simplified alternative in making end-of-life
decisions. He said he was asked to sponsor this bill by
individuals he respects who deal with end-of-life issues, senior
issues, care issues, nursing issues, and medical issues. These
people have been deeply touched by end-of-life experiences and
want to see an expansion of options for people who want to
prepare themselves for when they can no longer speak or act on
their own behalf.
Number 0535
REPRESENTATIVE WEYHRAUCH explained that this bill puts all of
these legal issues under one title. He mentioned an analogy
that might help in understanding the purpose of this bill. He
asked members to think of the frustrations many feel when trying
to do something that requires going from one agency to another,
one building to another, and one city to another to meet the
requirements of a permit. Representative Weyhrauch said this
kind of frustration has led to discussions in the legislature
about streamlining the permitting process.
REPRESENTATIVE WEYHRAUCH said this bill would bring under one
chapter the kinds of end-of-life decisions people have to make.
It is a way to make it as easy as possible for the public at a
time that is the most stressful, critical phase of life. This
bill would address the organ donor program, DNR [do not
resuscitate] program or comfort program, living will program,
and health care durable power of attorney. While this allows
people to make a statement at the end-of-life, it also serves as
a guiding protocol in the case of an accident when emergency
medical technicians are called. The bill takes all the current
provisions related to end-of-life, and puts them in a critical
one-stop look for these kinds of decisions. Representative
Weyhrauch said he would be available to the committee should
they require any additional information before the next meeting.
Number 0629
REPRESENTATIVE GATTO asked about the sectional analysis, page 3,
section 13.52.050(a). He asked about the wording "to promptly
communicate a health care decision to the patient." His concern
is the ability to do that. If a patient is unresponsive, it is
not possible to do that. Representative Gatto asked for
clarification on this.
Number 0779
CHAIR WILSON offered her experience as a nurse. One of the
first things that a hospital tries to do as an individual is
admitted into the hospital is to communicate with the patient on
preferences for medical treatment. The problem is that while
all hospitals have to do that, they probably do it differently.
Number 0817
REPRESENTATIVE WEYHRAUCH responded that the bill says "if
possible." The law is intended to be read in a commonsense way.
He said it is absolutely absurd to communicate with an
unconscious person. If a health care directive has been made
for a patient, and the patient is unable to communicate, then
the intent is to communicate with someone who can be trusted
with fiduciary duty in watching over the patient's interest. If
the patient has fulfilled some sort of health care directive in
advance, then that directive is there for the health care
professionals.
Number 0876
REPRESENTATIVE GATTO suggested that the language "when possible"
be inserted [Sec. 13.52.050(a)] as a simple fix in the language
to make this as clear as possible.
Number 0930
REPRESENTATIVE WEYHRAUCH said that in the bill [page 6, line 4]
it says "if possible."
REPRESENTATIVE GATTO responded that "if" is fine and he sees no
reason to change the language.
Number 0962
REPRESENTATIVE CISSNA asked about merging a number of
departmental regulations or provisions under this bill. If so,
she asked, what are those changes?
Number 1029
REPRESENTATIVE WEYHRAUCH explained that when he referred to
"department" it was in an analogous situation in referring to
permitting when someone may be frustrated because of having to
get one permit from one department, another agency, and another
town. He said there was no intent in his reference to that to
imply that somehow there are multiple departments involved in
this legislation. What this bill is intended to do is to bring
together under one statute the end-of-life health care
decisions. He reiterated that the intent and language is the
same as last year's bill.
Number 1084
REPRESENTATIVE CISSNA asked what are the changes and additions
to existing law.
Number 1116
REPRESENTATIVE WEYHRAUCH said it takes current provisions
related to the end-of-life and puts them in one chapter. Among
those decisions are the organ donor program, living will
program, "Comfort One" program or DNR program, and the expanded
health care durable power of attorney.
Number 1157
REPRESENTATIVE CISSNA asked if there are actually specific
changes to existing law.
Number 1165
REPRESENTATIVE WEYHRAUCH said in order to meet the chair's
schedule, he will provide the committee with a list of what the
law is now and what the law will be.
Number 1209
REPRESENTATIVE HEINZE asked about page 7, lines 1 through 4,
where it talks about a health care provider's declining to
comply with an individual instructions. She inquired about
Jehovah's Witnesses who will not accept blood transfusions.
REPRESENTATIVE WEYHRAUCH responded that it is an individual
decision on the part of a patient and a health care provider.
If an institution does not want to comply with an individual's
health care instruction that requires a medically ineffective
decision, for example, the provider is not forced to comply. If
a Jehovah's Witness or Christian Science believer who just wants
to live life without medical intervention is not in agreement
with treatment options, then he or she might not be in the right
facility. The patient may need to go somewhere else where the
kind of care that person wants is available, such as home care
or a hospice facility.
Number 1249
REPRESENTATIVE HEINZE asked Representative Weyhrauch to clarify
whether the health care provider may decline to follow the
instructions of a patient. For example, if the child of a
Jehovah's Witness came into a facility and was dying, but a
transfusion would save the child, then the provider does have
the right to override the wishes of the patient.
Number 1256
REPRESENTATIVE WEYHRAUCH responded that health care institutions
may decline to comply with an instruction or direction on a
decision that someone else has made.
Number 1311
MARIA WALLINGTON, M.D., Providence Health System, read the
following statement regarding HB 25:
I am a physician who practiced pediatric cardiology
and pediatric intensive care here in Anchorage for 20
years. Three years ago I completed a Master's in
Ethics and began working for the Providence Health
System in Alaska as their medical ethicist. One of my
duties is to help patients, families, and health care
providers who are faced with challenging decisions at
the end-of-life. In this capacity I have encountered
families and physicians whose efforts to do the right
thing for patients has been complicated by lack of
clear, unambiguous, supportive laws.
I would like to point out to you that Alaska, along
with three other states, received the lowest possible
grade on this part of a national report evaluating
states on the care provided to residents near the end-
of-life. Last November, Last Acts, a coalition of
more than 1000 organizations such as the AMA [American
Medical Association] and the American Hospital
Association, issued a report card for all 50 states on
how end-of-life care is encouraged in each state.
Alaska received the lowest possible grade on "State
Advance Directive Policies." They found, as many of
my colleagues and I have, that Alaska's current laws
do not support good advance-care planning. Of the six
criteria that were evaluated, Alaska's current laws
only [provide] for one. That is the out-of-hospital
Do-Not-Resuscitate order protocol of Comfort One. The
passage of HB 25 will provide for top marks in all of
the criteria.
Those criteria, which follow the recommendations for
state policies contained in the federal Uniform Health
Care Decisions Act, are:
1. To recommend a single, comprehensive advance
directive, which reduces confusion. Currently, the
power of attorney [POA] and living will laws are not
connected in any way.
2. Avoid mandatory forms or language for medical
powers of attorney or combined living wills/medical
powers of attorney, giving residents the freedom to
express their wishes in their own way. Current POA
forms are complex and difficult.
3. Give precedence to the agent's authority or most
recent directive over the living will, recognizing
that an agent has the advantage of being able to weigh
all the facts and medical opinions in light of the
patient's wishes at the time a decision needs to be
made.
4. Authorize default surrogates - typically, next of
kin - to make health care decisions, including
decisions about life support if the patient has not
named someone. No current support in Alaska law
[exists] for surrogates.
5. Include "close friend" in the list of permissible
default surrogates, recognizing that family in today's
world often extends beyond the nuclear family.
Currently no clear statement for decisionmaking.
6. Have a statewide, non-hospital DNR order protocol
for emergency medical service [EMS] personnel to
ensure that EMS personnel can follow the wishes of
terminally ill patients out in the community. This is
handled through the Comfort One protocol.
The current Alaska Statutes covering living will and
power of attorney are limited and confusing, and can,
in fact, discourage people from making a living will.
This means patients' wishes are often not documented
for those who would be called upon to make decisions
for them. I was delighted last year when I discovered
this bill making its way through the legislature. It
would have handled so many of the issues that were
troubling me. I was very disappointed time ran out so
it only made it through the House and did not get
acted on in the Senate. It solves several of the
troubling issues involving end-of-life decision making
that have been causing problems for families and
health care providers.
Specifically, I particularly like the example of
Advance Health Care Directive provided in the bill,
Page 12. It encourages individuals to think through
some of the difficult decisions that might need to be
made and to provide guidance on how to make those
decisions on their behalf. The current living will
law only addresses whether or not to prolong one's
dying process. Often direction is needed for
patient's unable to communicate desires but the
patient is not dying. This directive will help make
those preferences known.
Secondly, it ties the appointment of an agent for
health care decision making to the patient's wishes
for how those decisions should be made. It also
expressly tells the agent what criteria should be used
for making decisions. (Page 3 line 12 (h) and Page 15
line 25 (4) Agent's Obligation). The agent's
obligation is to decide on the behalf of the patient
as the patient would have decided for himself, to the
extent known. This form of the Advance Directive
encourages the individual to make those wishes known.
Sometimes we have decisionmakers requesting what they
want instead of what they know the patient would have
wanted.
Number 1444
DR. WALLINGTON continued:
The other major problem that as health care providers
we have struggled with, which this legislation will
solve, is the problem of surrogate decisionmakers for
patients without a legal guardian or a power of
attorney. Most of our unconscious patients fall into
this category. Currently there is no statute to
support the common practice of using a relative or,
sometimes a good friend, to give consent for
treatment. This legislation corrects that shortage by
legalizing the use of surrogates and delineating how
they are identified and how they may act on a
patient's behalf. This act will give surrogates legal
support for doing this very difficult job.
As it stands, this is a good bill. However, it can be
an excellent bill with a few minor changes. The first
is very simple. On page 22, in the definitions, lines
12 and 20, which are A through D under "health care",
actually belong under "health care decision". They
represent decisions that need to be made, not care or
treatment.
Number 1502
The second issue is a little more complex. On the
bottom of page 4, top of page 5 under "decisions by
surrogate" a class of surrogates and all classes with
less priority are disqualified from making a decision
if there are an even number of members in that class
and they are evenly divided on a decision. For
instance, consider an elderly widow who has had a
stroke, cannot communicate, and needs decisions made
for her on where she will be cared for long term. She
has two adult children who cannot agree despite the
best efforts of the health care professional to get
agreement. Who makes the decision? After giving us
surrogates, this section takes them away again and
does not give any guidance for what the health care
provider can do. Please consider authorizing the
primary physician to break the tie by siding with the
surrogate who, in his/her professional judgment, is
acting in the best interest of the patient.
One of the most challenging duties anyone can ever be
called on to undertake is to make difficult medical
decisions for another person. One of the best gifts
we can give those who shoulder this burden on our
behalf is having in place a good, informative advance
health care directive. HB 25 will allow individuals
to do this job of preparing for these end-of-life
challenges better and will help health care providers
better serve patients and their families when these
challenges occur.
In conclusion, as a medical professional who daily
experience the reality of life and death, as an
ethicist, and as a representative of Providence Health
System in Alaska, I urge that you help all Alaskans
who will someday face difficult health care decisions
by supporting HB 25. Thank you for your attention.
CHAIR WILSON thanked Dr. Wallington and told her the committee
would take her comments into consideration.
Number 1580
PAUL MALLEY, President, Aging with Dignity, testified in support
of HB 25 and provided the committee with background information
about the organization and the development of the "Five Wishes"
advance directive [a legal document]. He told the committee
that his is a private nonprofit organization that works
nationally. He told the committee the group was founded by Jim
Towey in 1986. When Mr. Towey was appointed by President Bush
to direct the Office of Faith-Based and Community Initiatives,
he was asked to serve as president of the organization. Mr.
Towey developed this document called "Five Wishes," which is
circulating all over the country in all 50 states; 5,000
organizations have distributed over 2,000,000 copies to
individuals.
Number 1628
MR. MALLEY said Mr. Towey wrote Five Wishes based primarily on
his experiences in working with Mother Teresa in Calcutta,
India. He was her legal counsel for twelve years and also
worked in her homes for the dying in India, Mexico, and
Washington, D.C. He saw how people were cared for at the end-
of-life, where their full needs were met, not just their medical
needs. During their last moments of life, they had people by
their side holding their hand and praying for them if that is
what they wanted. He contrasted that with the way he saw people
dying in America, where they are often hooked up to tubes and
machines, when they would rather not be. Many are dying and
being treated as if it were purely another medical moment, when
it is so much more. Mr. Towey wrote Five Wishes as a way for
people to put down in writing and communicate with their
families what is important to them.
Number 1664
MR. MALLEY told the committee there were three goals that his
organization had in mind when writing this document. First, the
organization wanted to make it easy to understand so that people
could fill it out in their living rooms and not have to wait
until they go to a hospital or go to an attorney to do it. It
includes more than just the medical issues, because in all the
national research that has been done when people are asked what
is important to them at the end-of-life, the most common
response is, "I want to be in my home, and I want my family to
be with me," for example. So that is important when talking
about advanced-care planning. The third thing the organization
wanted to facilitate is communication. It was important to help
people talk with their families and there health care providers
to make sure that all the questions are answered, that they know
what kind of care that individual would want. "We" have 5,000
organizations that are distributing Five Wishes. These groups
include hospices, hospitals, and work places that are giving it
to their employees, such as, the U.S. Department of State, the
U.S. Department of Justice, the U.S. Food and Drug
Administration.
Number 1715
MR. MALLEY said in Florida, Governor Bush has been a big
supporter of the organization's work and is actually giving
copies of Five Wishes to every state employee. When Five Wishes
was developed the organization got the support of the Robert
Wood Johnson Foundation and had legal counsel from the American
Bar Association. The organization wanted it to be a legally
valid document in as many states as possible. He told the
committee that today it is valid in 35 states, according to the
American Bar Association. That count does not include Alaska;
hopefully, it will by the end of the year. The reason it is not
legal is due to the mandatory form requirement and the Alaska
durable power of attorney for health care. Alaska's current
statute requires that residents of Alaska use that form, and
that form only. Mr. Malley said he cannot say, without a doubt,
that Five Wishes meets the legal requirement, and that is why
the work the committee is doing today is so important. This
bill will make the statutes more streamlined by putting them all
together, and allowing residents to express their own wishes, in
their own words, to talk about what is important to them.
Number 1800
MR. MALLEY said he would like to share with the committee
something that happened two weeks ago. He met a woman in a
small town in New England after he had just given a
presentation. She came up to him with a tear in her eye. She
told him the story of her husband, who had died a year ago. He
had been in a coma for the last 28 days of his life; however,
before he went into a coma he filled out his Five Wishes.
During the time that he was sick and his family was with him,
his Five Wishes were placed on the nightstand beside his bed in
the hospital. When the family came in, they did not know what
to do, but they picked up his Five Wishes, and knew he wanted to
have pictures of his grandkids by him; he wanted his favorite
afghan brought in; he wanted his church notified so his pastor
would come in and pray with him. This helped them care for
their loved one the way he wanted to be. When the 28th day
came, and the doctor said it is not likely he will be able to
recover, one son refused to allow his dad to be taken off life-
support treatment. She said they told him this was your
father's decision to make and he made it. She showed him his
father's wishes in his father's own writing and his own
signature. So the son said if that is what dad wants, that is
what should be done. He was able to follow his father's wishes.
Beyond that, on wish number 5, the father had wished that his
family members would make peace with each other if they could
before his death. The woman told him that two of her sons had
not spoken for five years, and they spoke on that day, and have
been great friends ever since. It is something that would not
have happened if this conversation about advanced care had not
happened.
MR. MALLEY said in closing, he would like to assist or answer
any questions that might be helpful.
Number 1893
REPRESENTATIVE SEATON asked Representative Weyhrauch if passing
this law would preempt or make invalid the durable powers of
attorney that are currently on file. He asked if he could
provide an answer on this issue at the next hearing of the bill.
Number 1930
MARK JOHNSON, Chief, Community Health and Emergency Medical
Services, Division of Public Health, Department of Health and
Social Services (DHSS), testified in support of HB 25. He said
the Department of Health and Social Services' interest in the
bill is with section 13.52.060, which is on page 7 of the draft
bill and deals with the DNR [do not resuscitate] protocol and
identification requirements. He said that DHSS adopted
regulations in 1996 based on legislation that was passed in 1994
which mandated that the department do this, and as a result the
"Comfort One" program was adopted. He said the Comfort One
program procedure identifies and respects the wishes of patients
in the out-of-hospital environment who do not want life-saving
measures such as CPR [cardiopulmonary resuscitation] performed
on them when their breathing and heart stops. He told the
committee a Comfort One participant can be identified through
the use of an enrollment form, wallet card, and optional
bracelet, which are obtained from a physician and serve to alert
health care providers that the patient has been issued a valid
DNR order and that CPR should not be performed. If the patient
has made an anatomical gift and is in the hospital, the DNR
order will not take effect until the donated organ can be
evaluated to see if it is suitable for donation. This bill is
consistent with that procedure and the department is supportive.
Number 2006
MARIE DARLIN, Coordinator, Capitol City Task Force, AARP,
testified in support of HB 25. She told the committee she
represents [AARP's] 71,000 Alaskan members. She said the task
force includes representatives from other senior and retiree
organizations who have similar concerns. She asked the
committee to review the letter in the bill packet from Alaska
AARP in support of HB 25. She said considerable time was spent
last year on this health directives legislation. While the bill
passed the House, the Senate ran out of time to pass the bill.
In a 2002 survey of AARP members in Alaska, health care was
listed as one of their top legislative concerns; therefore, this
advanced directives legislation is one of AARP's priorities.
She urged support of HB 25.
Number 2080
REPRESENTATIVE GATTO asked Ms. Darlin if she has ever met anyone
who opposes this legislation or the concept of this legislation.
Number 2090
MS. DARLIN said there were Senators who had questions on some
aspects of the bill last year; however, she said she feels that
all the questions were answered.
Number 2105
REPRESENTATIVE GATTO asked if she is aware of even one person
who is opposed to the concept of the bill.
MS. DARLIN replied not that she can remember.
[HB 25 was held over]
CHAIR WILSON called a brief at ease at 3:50 p.m. She called the
committee back to order at 3:52 p.m.
HB 51-LABELING OF PRESCRIBED DRUGS
Number 2127
CHAIR WILSON announced that the next bill the committee will
hear is HOUSE BILL NO. 51, "An Act requiring pharmacists to
include generic drug information on containers in which brand-
name prescription drug orders are dispensed."
Number 2148
REPRESENTATIVE SEATON, sponsor of HB 51, explained that the bill
was generated from a public health and safety concern for many
people across Alaska, especially senior citizens, who are having
trouble with medications labeling. Representative Seaton told
the members that prescription medications can be a brand name or
generic name, and while the medication itself is the same, it
does not have labeling which reflects that. He said that when
an individual gets medication filled from a pharmacy and it is
filled with a generic medication, the generic name will be on
the label. However, most often, if the prescription is filled
with a brand name, only the brand name will appear on the label.
Representative Seaton told the committee that often individuals
are double filling the medication because they do not notice the
medications are the same. He said if an individual were only
taking one pill with chronic illnesses it would not be as great
a problem, but what has happened now is medicines have become
much more prolific to treat specific parts of diseases, so
people end up taking six, seven, eight, or more medications to
treat their conditions.
Number 2230
REPRESENTATIVE SEATON said that he has talked to people who have
double dosed their children who have chronic illnesses. He said
the bill requires that any prescription that has a brand name
must also have the generic name on the label to protect
consumers by ensuring they can tell it is the same medicine. He
said any brand name would also have the generic name on the
label.
Number 2250
REPRESENTATIVE SEATON asked the members to review the letters of
support in the bill packet from groups such as AARP, Pioneer
Homes' pharmacists, Aetna Insurance Company, senior citizen
centers, and many more.
Number 2267
REPRESENTATIVE SEATON pointed out research done by the
Legislative Research Services, which found under the Institute
for Safe Medicine Practices (ISMP) that 15 percent of reported
medication errors are due to confusion because of drug names
[found in the Joint Commission on Accreditation of Healthcare
Organizations]. Representative Seaton said that according to
the U.S. Food and Drug Administration the number of medication
errors can be greatly reduced by doing 15 things, and one of
those is to provide brand and generic names on all medication
labels.
Number 2290
REPRESENTATIVE GATTO asked about the drug labeling print size.
REPRESENTATIVE SEATON said the size of the label is not
addressed in the bill. He said the labels used as examples are
actual copies of prescription labels. He said whenever the
brand name of a medication is used, the generic name would also
appear on the label.
TAPE 03-13, SIDE B
Number 2335
REPRESENTATIVE GATTO asked Representative Seaton what "W/F"
means?
Number 2328
REPRESENTATIVE SEATON said he does not know.
Number 2321
CHAIR WILSON told the committee Representative Seaton has
requested a friendly amendment, to his bill. Chair Wilson read
the requested amendment, which said:
on page 1, line 11, delete the word "below", and add
the word "near."
REPRESENTATIVE SEATON spoke to the amendment by saying the
reason for this friendly amendment is to accommodate some
computer programs that already have a space designated for the
generic name when using a brand-name medication. That space may
be above, below, or beside the brand name. The intent in the
bill is to make sure the consumers have the information, and it
is not necessary that it conform to a particular format.
Number 2259
REPRESENTATIVE GATTO moved to adopt the foregoing as Amendment
1. There being no objection, it was so ordered.
Number 2234
REPRESENTATIVE HEINZE moved to report HB 51, as amended, out of
committee with individual recommendations and a zero fiscal
note. There being no objection, CSHB 51 (HES) was reported from
the House Health, Education and Social Services Standing
Committee.
ADJOURNMENT
Number 2205
There being no further business before the committee, the
Health, Education and Social Services Standing Committee meeting
was adjourned at 4:00 p.m.
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