Legislature(2017 - 2018)CAPITOL 106

01/30/2018 03:00 PM HEALTH & SOCIAL SERVICES

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+= HB 54 TERMINALLY ILL: ENDING LIFE OPTION TELECONFERENCED
Moved CSSSHB 54(HSS) Out of Committee
-- Public Testimony Closed April 6, 2017 --
+= HB 162 DHSS CENT. REGISTRY;LICENSE;BCKGROUND CHK TELECONFERENCED
Heard & Held
-- Public Testimony --
*+ HB 268 OPIOID PRESCRIPTION WARNINGS TELECONFERENCED
Heard & Held
-- Testimony <Invitation Only> --
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
      HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                     
                        January 30, 2018                                                                                        
                           3:04 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Ivy Spohnholz, Chair                                                                                             
Representative Bryce Edgmon, Vice Chair                                                                                         
Representative Sam Kito                                                                                                         
Representative Geran Tarr                                                                                                       
Representative David Eastman                                                                                                    
Representative Jennifer Johnston                                                                                                
Representative Colleen Sullivan-Leonard                                                                                         
                                                                                                                                
Representative Dan Saddler (alternate)                                                                                          
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Representative Matt Claman (alternate)                                                                                          
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
SPONSOR SUBSTITUTE FOR HOUSE BILL NO. 54                                                                                        
"An  Act  providing  an end-of-life  option  for  terminally  ill                                                               
individuals; and providing for an effective date."                                                                              
                                                                                                                                
     - MOVED CSSSHB 54(HSS) OUT OF COMMITTEE                                                                                    
                                                                                                                                
HOUSE BILL NO. 162                                                                                                              
"An Act relating  to criminal and civil  history requirements and                                                               
a registry  regarding certain licenses,  certifications, appeals,                                                               
and  authorizations  by  the  Department  of  Health  and  Social                                                               
Services; and providing for an effective date."                                                                                 
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
SPONSOR SUBSTITUTE FOR HOUSE BILL NO. 268                                                                                       
"An Act relating to the  prescription of opioids; relating to the                                                               
Department  of  Health  and  Social  Services;  relating  to  the                                                               
practice  of dentistry;  relating  to the  practice of  medicine;                                                               
relating to  the practice of  podiatry; relating to  the practice                                                               
of osteopathy; relating to the  practice of nursing; and relating                                                               
to the practice of optometry."                                                                                                  
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: HB 54                                                                                                                   
SHORT TITLE: TERMINALLY ILL: ENDING LIFE OPTION                                                                                 
SPONSOR(s): REPRESENTATIVE(s) DRUMMOND                                                                                          
                                                                                                                                
01/18/17       (H)       READ THE FIRST TIME - REFERRALS                                                                        
01/18/17       (H)       HSS, JUD                                                                                               
03/14/17       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
03/14/17       (H)       <Bill Hearing Canceled>                                                                                
03/27/17       (H)       SPONSOR SUBSTITUTE INTRODUCED                                                                          
03/27/17       (H)       READ THE FIRST TIME - REFERRALS                                                                        
03/27/17       (H)       HSS, JUD                                                                                               
03/28/17       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
03/28/17       (H)       Heard & Held                                                                                           
03/28/17       (H)       MINUTE(HSS)                                                                                            
04/06/17       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
04/06/17       (H)       Heard & Held                                                                                           
04/06/17       (H)       MINUTE(HSS)                                                                                            
01/30/18       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
BILL: HB 162                                                                                                                  
SHORT TITLE: DHSS CENT. REGISTRY;LICENSE;BCKGROUND CHK                                                                          
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR                                                                                    
                                                                                                                                
03/08/17       (H)       READ THE FIRST TIME - REFERRALS                                                                        
03/08/17       (H)       HSS, JUD                                                                                               
01/23/18       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
01/23/18       (H)       Heard & Held                                                                                           
01/23/18       (H)       MINUTE(HSS)                                                                                            
01/30/18       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
BILL: HB 268                                                                                                                  
SHORT TITLE: OPIOID PRESCRIPTION WARNINGS                                                                                       
SPONSOR(s): GARA                                                                                                                
                                                                                                                                
01/12/18       (H)       PREFILE RELEASED 1/12/18                                                                               
01/16/18       (H)       READ THE FIRST TIME - REFERRALS                                                                        
01/16/18       (H)       HSS, L&C                                                                                               
01/22/18       (H)       SPONSOR SUBSTITUTE INTRODUCED                                                                          
01/22/18       (H)       READ THE FIRST TIME - REFERRALS                                                                        
01/22/18       (H)       HSS, FIN                                                                                               
01/30/18       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
REPRESENTATIVE HARRIET DRUMMOND                                                                                                 
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented HB 54 as the sponsor of the bill.                                                              
                                                                                                                                
STACIE KRALY, Chief Assistant Attorney General                                                                                  
Statewide Section Supervisor                                                                                                    
Human Services Section                                                                                                          
Civil Division (Juneau)                                                                                                         
Department of Law                                                                                                               
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified and answered questions during                                                                  
discussion of HB 162.                                                                                                           
                                                                                                                                
KATE BURKHART, Ombudsman                                                                                                        
Juneau Office                                                                                                                   
Office of the Ombudsman                                                                                                         
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified during discussion of HB 162.                                                                   
                                                                                                                                
CHARLES McKEE                                                                                                                   
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified during discussion of HB 162.                                                                   
                                                                                                                                
REPRESENTATIVE LES GARA                                                                                                         
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented HB 268 as the sponsor of the                                                                   
bill.                                                                                                                           
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
3:04:59 PM                                                                                                                    
                                                                                                                                
CHAIR IVY SPOHNHOLZ  called the House Health  and Social Services                                                             
Standing   Committee    meeting   to    order   at    3:04   p.m.                                                               
Representatives  Spohnholz,  Sullivan-Leonard, Johnston,  Saddler                                                               
(alternate), Eastman, Kito, and Tarr  were present at the call to                                                               
order.   Representative  Edgmon  arrived as  the  meeting was  in                                                               
progress.                                                                                                                       
                                                                                                                                
            HB 54-TERMINALLY ILL: ENDING LIFE OPTION                                                                        
                                                                                                                                
3:06:37 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ announced that the  first order of business would                                                               
be SPONSOR  SUBSTITUTE FOR HOUSE  BILL NO. 54, "An  Act providing                                                               
an  end-of-life  option  for   terminally  ill  individuals;  and                                                               
providing for an effective date."                                                                                               
                                                                                                                                
3:07:00 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  HARRIET   DRUMMOND,  Alaska   State  Legislature,                                                               
paraphrased  from the  Sponsor  Statement  [Included in  members'                                                               
packets, which read in part:                                                                                                    
                                                                                                                                
     This  bill allows  patients to  have important  end-of-                                                                    
     life  discussions with  the doctors  they already  know                                                                    
     and  trust.   Without  this   discussion,  well-meaning                                                                    
     doctors are  faced with prescribing  painful procedures                                                                    
     even when the  patient does not want them  and there is                                                                    
     little  or  no  hope   for  success.  People  in  these                                                                    
     conditions  have already  lost their  health and  often                                                                    
     much, much more.  This bill at least  lets them control                                                                    
     the last and most important decision they have left.                                                                       
                                                                                                                                
     House Bill  54 allows  terminally ill patients  to ease                                                                    
     their suffering  and hasten  an inevitable  and certain                                                                    
     death.  This  bill  preserves dignity  and  a  person's                                                                    
     right to  live, and die,  on their own  terms according                                                                    
     to they own desires and beliefs.                                                                                           
                                                                                                                                
REPRESENTATIVE DRUMMOND offered  an update of the  bill since the                                                               
last  hearing during  the spring  of 2017.   She  relayed that  a                                                               
survey had been conducted of  more than 600 Alaskans which showed                                                               
that more than 70 percent of  voting Alaskans supported an end of                                                               
life option,  "such that  this bill allows."   She  declared that                                                               
community  support  was also  rising,  directing  attention to  a                                                               
Kodiak  Island  Borough assembly  resolution  in  support of  the                                                               
proposed bill.  She encouraged support of the proposed bill.                                                                    
                                                                                                                                
3:08:52 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD asked  for more information about                                                               
the survey.                                                                                                                     
                                                                                                                                
REPRESENTATIVE DRUMMOND  explained that this survey  by a private                                                               
group was  offered regularly on  a quarterly basis  and questions                                                               
could be  added.  In  response, she said  that the cost,  paid by                                                               
her office account, was between $1600 - $1800.                                                                                  
                                                                                                                                
CHAIR SPOHNHOLZ pointed out that Representative Saddler,                                                                        
although present, was a committee alternate, and would not be                                                                   
needed to participate as a committee member.                                                                                    
                                                                                                                                
3:10:02 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ moved to adopt Amendment 1, labeled 30-                                                                         
LS0254\O.1, Laffen/Bannister, 1/29/18, which read:                                                                              
                                                                                                                                
     Page 2, line 21, following "request":                                                                                      
          Insert "and a written request"                                                                                        
                                                                                                                                
     Page 2, following line 28:                                                                                                 
          Insert a new subsection to read:                                                                                      
          "(c)  Notwithstanding (a) of this section, if a                                                                       
     qualified individual  is not physically able  to sign a                                                                    
     written  request, the  qualified individual  may direct                                                                    
     another   individual   to   sign  for   the   qualified                                                                    
     individual."                                                                                                               
                                                                                                                                
     Page 2, line 31, following "request":                                                                                      
          Insert "and the written request"                                                                                      
                                                                                                                                
     Page 3, following line 4:                                                                                                  
     Insert new sections to read:                                                                                               
          "Sec. 13.55.050. Written request requirements.                                                                      
     (a)  A  written  request   for  medication  under  this                                                                    
     chapter must be in  substantially the form described in                                                                    
     AS 13.55.060,  signed   and  dated  by   the  qualified                                                                    
     individual,  and  witnessed  by   at  least  two  other                                                                    
     individuals.  The attending  physician may  not witness                                                                    
     the request.  The witnesses shall,  in the  presence of                                                                    
     the qualified  individual, attest that, to  the best of                                                                    
     their  knowledge and  belief, the  qualified individual                                                                    
     is  capable, acting  voluntarily, and  not under  undue                                                                    
     influence to sign the request.                                                                                             
          (b) Only one witness may be                                                                                           
               (1) a relative of the qualified individual                                                                       
     by blood, marriage, or adoption;                                                                                           
               (2) an individual who, at the time the                                                                           
     qualified  individual  signs   the  request,  would  be                                                                    
     entitled to  a portion of  the estate of  the qualified                                                                    
     individual at  death under  a will  or by  operation of                                                                    
     law; or                                                                                                                    
               (3) an owner, operator, or employee of a                                                                         
     health care facility where  the qualified individual is                                                                    
     receiving medical treatment or is a resident.                                                                              
          (c) If  the qualified  individual is  an inpatient                                                                    
     in  a  long-term  care   facility  when  the  qualified                                                                    
     individual  signs the  request,  one  of the  witnesses                                                                    
     shall be  an individual designated by  the facility who                                                                    
     has  the qualifications  established by  the department                                                                    
     by  regulation.  In  this subsection,  "long-term  care                                                                    
     facility" includes  an assisted living home  as defined                                                                    
     in AS 47.32.900  and a nursing  facility as  defined in                                                                    
     AS 47.32.900.                                                                                                              
          Sec.  13.55.060.  Form   for  written  request.  A                                                                  
     request for a medication under  this chapter must be in                                                                    
     substantially the following form:                                                                                          
                 REQUEST FOR MEDICATION TO END MY LIFE                                                                          
          I, _________________, am an adult of sound mind.                                                                      
          I  am  suffering  from _______________,  which  my                                                                    
     attending  physician  has   determined  is  a  terminal                                                                    
     disease  and which  has been  medically confirmed  by a                                                                    
     consulting physician.                                                                                                      
          I  have  been  fully  informed  of  my  diagnosis,                                                                    
     prognosis,  the   nature  of   the  medication   to  be                                                                    
     prescribed   and   potential  associated   risks,   the                                                                    
     expected   result,  and   the  feasible   alternatives,                                                                    
     including   comfort  care,   hospice  care,   and  pain                                                                    
     control.                                                                                                                   
          I  request that  my attending  physician prescribe                                                                    
     medication  that  will end  my  life  in a  humane  and                                                                    
     dignified manner.                                                                                                          
          INITIAL ONE OF THE FOLLOWING:                                                                                         
          _____  I have  informed my  family of  my decision                                                                    
     and taken their opinions into consideration.                                                                               
          _____ I  have decided not  to inform my  family of                                                                    
     my decision.                                                                                                               
          _____ I have no family to inform of my decision.                                                                      
          I  understand that  I have  the  right to  rescind                                                                    
     this request at any time.                                                                                                  
          I understand the full import  of this request, and                                                                    
     I  expect to  die  when  I take  the  medication to  be                                                                    
     prescribed.  I further  understand that,  although most                                                                    
     deaths  occur within  three hours,  my  death may  take                                                                    
     longer,  and my  attending physician  has counseled  me                                                                    
     about this possibility.                                                                                                    
          I  make  this   request  voluntarily  and  without                                                                    
     reservation,  and I  accept  full moral  responsibility                                                                    
     for my actions.                                                                                                            
          Signed: _____________________                                                                                         
          Dated: ______________________                                                                                         
                       DECLARATION OF WITNESSES                                                                                 
        We declare that the person signing this request                                                                         
               (1) is personally known to us or has                                                                             
     provided proof of identity;                                                                                                
               (2) in our presence signed or directed                                                                           
     another person to sign this request;                                                                                       
               (3) is not an individual for whom either of                                                                      
     us is the attending physician; and                                                                                         
               (4) to the best of our knowledge and belief,                                                                     
               (A) has the ability to make and communicate                                                                      
     health care decisions to health care providers; and                                                                        
               (B) is acting voluntarily and not under                                                                          
     undue influence.                                                                                                           
         _______________________ Witness 1 Date: _____                                                                          
         _______________________ Witness 2 Date: _____                                                                          
          NOTE: One witness may not be a relative (by                                                                           
     blood,  marriage,   or  adoption)  of   the  individual                                                                    
     signing this request, may not  be entitled to a portion                                                                    
     of the individual's  estate on death, and  may not own,                                                                    
     operate,  or  be employed  at  a  health care  facility                                                                    
     where the person  is an individual or  resident. If the                                                                    
     individual is  an inpatient at a  health care facility,                                                                    
     one of the witnesses  shall be an individual designated                                                                    
     by the facility."                                                                                                          
                                                                                                                                
     Page 3, line 5:                                                                                                            
          Delete "Sec. 13.55.050"                                                                                             
          Insert "Sec. 13.55.070"                                                                                             
                                                                                                                                
     Page 3, line 22:                                                                                                           
          Delete "AS 13.55.070"                                                                                                 
          Insert "AS 13.55.090"                                                                                                 
                                                                                                                                
     Page 4, line 2:                                                                                                            
          Delete "AS 13.55.110"                                                                                                 
          Insert "AS 13.55.130"                                                                                                 
                                                                                                                                
     Page 4, line 20:                                                                                                           
          Delete "Sec. 13.55.060"                                                                                             
          Insert "Sec. 13.55.080"                                                                                             
                                                                                                                                
     Page 4, line 26:                                                                                                           
          Delete "Sec. 13.55.070"                                                                                             
          Insert "Sec. 13.55.090"                                                                                             
                                                                                                                                
     Page 5, line 2:                                                                                                            
          Delete "Sec. 13.55.080"                                                                                             
          Insert "Sec. 13.55.100"                                                                                             
                                                                                                                                
     Page 5, line 7:                                                                                                            
          Delete "Sec. 13.55.090"                                                                                             
          Insert "Sec. 13.55.110"                                                                                             
                                                                                                                                
     Page 5, line 10:                                                                                                           
          Delete "Sec. 13.55.100"                                                                                             
          Insert "Sec. 13.55.120"                                                                                             
                                                                                                                                
     Page 5, line 13, following "prescription":                                                                                 
          Insert "and more than 48 hours have elapsed                                                                           
     between the qualified individual's written request and                                                                     
     the writing of the prescription"                                                                                           
                                                                                                                                
     Page 5, line 14:                                                                                                           
          Delete "Sec. 13.55.110"                                                                                             
          Insert "Sec. 13.55.130"                                                                                             
                                                                                                                                
     Page 5, following line 18:                                                                                                 
     Insert a new paragraph to read:                                                                                            
               "(2)  all written requests by a qualified                                                                        
     individual for medication under this chapter;"                                                                             
                                                                                                                                
     Renumber the following paragraphs accordingly.                                                                             
                                                                                                                                
     Page 6, line 2:                                                                                                            
          Delete "Sec. 13.55.120"                                                                                             
          Insert "Sec. 13.55.140"                                                                                             
                                                                                                                                
     Page 6, line 6:                                                                                                            
          Delete "Sec. 13.55.130"                                                                                             
          Insert "Sec. 13.55.150"                                                                                             
                                                                                                                                
     Page 6, line 19:                                                                                                           
          Delete "Sec. 13.55.140"                                                                                             
          Insert "Sec. 13.55.160"                                                                                             
                                                                                                                                
     Page 6, line 28:                                                                                                           
          Delete "Sec. 13.55.150"                                                                                             
          Insert "Sec. 13.55.170"                                                                                             
                                                                                                                                
     Page 7, line 5:                                                                                                            
          Delete "Sec. 13.55.160"                                                                                             
          Insert "Sec. 13.55.180"                                                                                             
                                                                                                                                
     Page 7, line 9:                                                                                                            
          Delete "Sec. 13.55.170"                                                                                             
          Insert "Sec. 13.55.190"                                                                                             
          Delete "AS 13.55.130"                                                                                                 
          Insert "AS 13.55.150"                                                                                                 
          Delete "13.55.140"                                                                                                    
          Insert "13.55.160"                                                                                                    
                                                                                                                                
     Page 7, line 10:                                                                                                           
          Delete "AS 13.55.150"                                                                                                 
          Insert "AS 13.55.170"                                                                                                 
                                                                                                                                
     Page 7, line 11:                                                                                                           
          Delete "AS 13.55.160"                                                                                                 
          Insert "AS 13.55.180"                                                                                                 
                                                                                                                                
     Page 7, line 27:                                                                                                           
          Delete "Sec. 13.55.180"                                                                                             
          Insert "Sec. 13.55.200"                                                                                             
                                                                                                                                
     Page 8, line 12:                                                                                                           
          Delete "Sec. 13.55.190"                                                                                             
          Insert "Sec. 13.55.210"                                                                                             
                                                                                                                                
     Page 8, line 14:                                                                                                           
          Delete "Sec. 13.55.200"                                                                                             
          Insert "Sec. 13.55.220"                                                                                             
                                                                                                                                
     Page 8, line 18:                                                                                                           
          Delete "Sec. 13.55.210"                                                                                             
          Insert "Sec. 13.55.230"                                                                                             
                                                                                                                                
     Page 9, line 2:                                                                                                            
          Delete "Sec. 13.55.220"                                                                                             
          Insert "Sec. 13.55.240"                                                                                             
                                                                                                                                
     Page 9, line 12:                                                                                                           
          Delete "Sec. 13.55.230"                                                                                             
          Insert "Sec. 13.55.250"                                                                                             
                                                                                                                                
     Page 9, line 20:                                                                                                           
          Delete "Sec. 13.55.240"                                                                                             
          Insert "Sec. 13.55.260"                                                                                             
                                                                                                                                
     Page 9, line 26:                                                                                                           
          Delete "Sec. 13.55.250"                                                                                             
          Insert "Sec. 13.55.270"                                                                                             
                                                                                                                                
     Page 10, line 1:                                                                                                           
          Delete "AS 13.55.220"                                                                                                 
          Insert "AS 13.55.240"                                                                                                 
                                                                                                                                
     Page 11, line 11:                                                                                                          
          Delete "AS 13.55.150"                                                                                                 
          Insert "AS 13.55.170"                                                                                                 
                                                                                                                                
     Page 11, line 13:                                                                                                          
          Delete "AS 13.55.150"                                                                                                 
          Insert "AS 13.55.170"                                                                                                 
                                                                                                                                
3:10:28 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR objected for discussion.                                                                                    
                                                                                                                                
CHAIR  SPOHNHOLZ  explained  that   proposed  Amendment  1  would                                                               
include  in   statute  a  requirement   that  a   terminally  ill                                                               
individual's desire  for life ending  medication be  written down                                                               
and witnessed by  two individuals.  Of those two,  only one could                                                               
be related to  an individual entitled to a portion  of the estate                                                               
of the  individual whose life would  be ending or be  employed by                                                               
the  health care  facility  where the  individual  was living  or                                                               
receiving treatment.   She clarified that  two interested parties                                                               
could  not sign  off  on this.    She shared  that  there was  an                                                               
exemption to  the written requirement  if the individual  did not                                                               
possess the  capacity to physically  sign the document.   In that                                                               
case,  the individual  could  direct another  person  to sign  on                                                               
their  behalf.   She  reported that  pages 2  and  3 of  proposed                                                               
Amendment 1 spelled  out the form of the written  request and the                                                               
witnessing aspect.   She directed attention to page 5,  lines 1 -                                                               
2, of  proposed Amendment  1, where  the written  request waiting                                                               
period  was   outlined.    On  page   5,  lines  10  -   11,  the                                                               
documentation requirement was outlined.                                                                                         
                                                                                                                                
3:11:38 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR removed her objection.                                                                                      
                                                                                                                                
3:11:47 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD objected.                                                                                       
                                                                                                                                
REPRESENTATIVE EASTMAN  asked about  a request for  medication by                                                               
an  individual as  an  option, as  they may  be  unsure of  their                                                               
decision.  He  asked if these witnesses would have  to be present                                                               
during the administration of the medicine.                                                                                      
                                                                                                                                
CHAIR SPOHNHOLZ said no.                                                                                                        
                                                                                                                                
3:12:35 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE JOHNSTON directed attention to  Page 2, line 7 and                                                               
asked if the "by regulation"  referenced the facility and not the                                                               
person.                                                                                                                         
                                                                                                                                
CHAIR SPOHNHOLZ replied, "correct."                                                                                             
                                                                                                                                
REPRESENTATIVE  EASTMAN   acknowledged  that  the   concerns  for                                                               
coercion had  been raised in  the last year.   He asked  if there                                                               
were concerns  for coercion regarding an  individual, and whether                                                               
that would  prohibit the  written request  from going  through or                                                               
would it not have an effect.                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ offered  her belief that the  written request was                                                               
to document and insure that coercion was not in place.                                                                          
                                                                                                                                
REPRESENTATIVE  EASTMAN asked  if a  situation of  coercion would                                                               
prohibit this as a second attempt.                                                                                              
                                                                                                                                
CHAIR  SPOHNHOLZ  questioned  whether  the  reference  of  second                                                               
attempt  was toward  an individual  choosing to  end their  life.                                                               
She opined that the individual  would still have the autonomy for                                                               
choice.                                                                                                                         
                                                                                                                                
3:14:24 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD maintained her objection.                                                                       
                                                                                                                                
3:14:33 PM                                                                                                                    
                                                                                                                                
A  roll   call  vote  was  taken.     Representatives  Spohnholz,                                                               
Johnston,  Edgmon, Kito,  and  Tarr voted  in  favor of  proposed                                                               
Amendment 1.  Representatives  Sullivan-Leonard and Eastman voted                                                               
against it.   Therefore, Amendment 1  was adopted by a  vote of 5                                                               
yeas - 2 nays.                                                                                                                  
                                                                                                                                
3:15:27 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  EASTMAN  asked what  would  appear  on the  death                                                               
certificate if someone went through this process.                                                                               
                                                                                                                                
REPRESENTATIVE  DRUMMOND  offered   her  understanding  that  the                                                               
diagnosis on the death certificate  would be the terminal illness                                                               
which would have killed the person.                                                                                             
                                                                                                                                
REPRESENTATIVE EASTMAN  mused that, from a  legal perspective, it                                                               
would appear  that the  person had not  engaged entirely  in this                                                               
process, and they had died of natural causes.                                                                                   
                                                                                                                                
REPRESENTATIVE DRUMMOND replied, "I think so."                                                                                  
                                                                                                                                
REPRESENTATIVE  SADDLER   (alternate)  asked  to   clarify  that,                                                               
although he was not allowed to  vote on the proposed bill, he was                                                               
not allowed to debate the issue, as well.                                                                                       
                                                                                                                                
CHAIR SPOHNHOLZ offered her belief  that "an alternate is to make                                                               
sure  that you  caucus is  properly represented  and that  you're                                                               
here for informational purposes."                                                                                               
                                                                                                                                
3:17:59 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  TARR  moved  to   report  SSHB  54,  Version  30-                                                               
LS0254\O,   as  amended,   out  of   committee  with   individual                                                               
recommendations and the accompanying fiscal notes.                                                                              
                                                                                                                                
3:18:13 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  EASTMAN objected.   He  shared that  his concerns                                                               
were "squarely on the side of  what happens when what is supposed                                                               
to happen  doesn't happen."   He  declared that  a chief  role of                                                               
government was  to protect an  individual's right to life  and he                                                               
expressed his  concern that within  this intention of  creating a                                                               
path for things  to happen, there would be abuse.   He stated his                                                               
concern that,  if there was  no requirement for any  witnesses to                                                               
be present  when the  drugs were administered,  it would  be very                                                               
difficult  for  law  enforcement   to  investigate  if  something                                                               
criminal and illegal did take  place which resulted in the death.                                                               
He  declared that  this  was not  a fulfillment  of  the role  to                                                               
protect an  individual's right to  life, or to  prosecute someone                                                               
who took  a life criminally.   He expressed his concern  that the                                                               
age requirement for this process was very young.                                                                                
                                                                                                                                
3:20:46 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   SULLIVAN-LEONARD   echoed    the   comments   of                                                               
Representative Eastman  and stated that  she did not  support the                                                               
proposed bill.   She stated that she believed in  the sanctity of                                                               
life, from beginning  to end.  She shared a  personal anecdote of                                                               
death  within her  family.   She declared  that this  was a  very                                                               
controversial bill.                                                                                                             
                                                                                                                                
3:21:44 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR  referenced the  sad stories  shared earlier.                                                               
She  declared that  each individual  had the  right to  make this                                                               
decision.   She  expressed her  concern for  the more  vulnerable                                                               
populations,  including   seniors  and  those   individuals  with                                                               
disabilities.  She directed attention to  page 2, line 7, that an                                                               
individual   did   not  qualify   solely   because   of  age   or                                                               
disabilities.  She  noted that many elders did  feel themselves a                                                               
burden on  family, especially as their  health deteriorated, they                                                               
had more significant  needs, and they did not  have the resources                                                               
or access to  good health care.  She offered  her belief that, as                                                               
the language  of the  proposed bill  was restrictive,  the issues                                                               
had been addressed  sufficiently.  She stated her  support of the                                                               
proposed bill.  She acknowledged  that the witness aspect was "an                                                               
interesting  component" and  she  expressed her  desire that  the                                                               
bill sponsor further address this as the bill moved forward.                                                                    
                                                                                                                                
3:24:11 PM                                                                                                                    
                                                                                                                                
CHAIR  SPOHNHOLZ offered  her belief  that it  was a  fundamental                                                               
right  for an  individual to  make  the decisions  for their  own                                                               
body.   She  allowed  that the  proposed  bill included  numerous                                                               
safeguards, including the written requirement.   She said that it                                                               
was important  to document the  process.  She  directed attention                                                               
to  page  7, line  27,  which  established  AS 13.55.180,  a  new                                                               
section  establishing criminal  penalties  for anyone  committing                                                               
the  crime of  abuse of  life ending  process of  a person.   She                                                               
pointed  out  that this  was  equivalent  to  murder and  may  be                                                               
punished similarly.   She  declared that  this proposed  bill was                                                               
not  legalizing  anything other  than  giving  an individual  the                                                               
right to make their own choices  with their bodies.  This did not                                                               
give anyone else the right to choose to end another's life.                                                                     
                                                                                                                                
3:26:32 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE EASTMAN maintained his objection.                                                                                
                                                                                                                                
3:26:37 PM                                                                                                                    
                                                                                                                                
A  roll   call  vote  was  taken.     Representatives  Spohnholz,                                                               
Johnston,  Edgmon, Kito,  and Tarr  voted  in favor  of SSHB  54.                                                               
Representatives  Sullivan-Leonard and  Eastman voted  against it.                                                               
Therefore, CSSSHB  54, Version 30-LS0254\O,  was reported  out of                                                               
the  House Health  and Social  Services Standing  Committee by  a                                                               
vote of 5 yeas - 2 nays.                                                                                                        
                                                                                                                                
3:27:19 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 3:27 p.m. to 3:30 p.m.                                                                       
                                                                                                                                
        HB 162-DHSS CENT. REGISTRY;LICENSE;BCKGROUND CHK                                                                    
                                                                                                                                
3:30:03 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ announced  that the next order  of business would                                                               
be HOUSE  BILL NO. 162,  "An Act  relating to criminal  and civil                                                               
history requirements  and a registry regarding  certain licenses,                                                               
certifications, appeals, and authorizations  by the Department of                                                               
Health  and  Social  Services; and  providing  for  an  effective                                                               
date."                                                                                                                          
                                                                                                                                
3:30:15 PM                                                                                                                    
                                                                                                                                
STACIE  KRALY,   Chief  Assistant  Attorney   General,  Statewide                                                               
Section  Supervisor,  Human   Services  Section,  Civil  Division                                                               
(Juneau), Department  of Law, characterized the  proposed bill as                                                               
a  legislative  fix   to  existing  statutes  found   in  AS  47,                                                               
specifically the background  check found in AS  47.05.300 and the                                                               
licensing statutes found  in AS 47.32.  She declared  that HB 162                                                               
was a  technical fix which arose  out of a number  of issues over                                                               
the  past  15 years  to  identify  a  number of  gaps,  overlaps,                                                               
redundancies, and "squishy language."                                                                                           
                                                                                                                                
3:31:27 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ opened public testimony.                                                                                        
                                                                                                                                
3:31:52 PM                                                                                                                    
                                                                                                                                
KATE   BURKHART,  Ombudsman,   Juneau  Office,   Office  of   the                                                               
Ombudsman,  reported that  her office  was  an independent,  non-                                                               
partisan,   and   objective   organization   which   investigated                                                               
complaints about  state government.   When those  complaints were                                                               
found to be justified, the  office would make recommendations for                                                               
the  improvement  of  government  policies  and  programs.    She                                                               
emphasized  that this  was not  an advocacy  role and  would only                                                               
include comment  on issues that  directly affected work  or where                                                               
work might  provide information  that would  inform deliberations                                                               
with  some  context.    She  reported  that  the  Office  of  the                                                               
Ombudsman had developed an understanding  of the background check                                                               
program  based  on  an extensive  investigation  which  had  been                                                               
concluded  and then  reported in  2016.   She declared  that this                                                               
information was  relevant to some  of the provisions  in proposed                                                               
HB  162.   She offered  her comments  for use  as the  bill moved                                                               
forward,  pointing  out that  she  was  not advocating  that  the                                                               
previous recommendations should be taken  in lieu of those in the                                                               
proposed bill.   She pointed out that, as there  was not a unique                                                               
registry  associated  with  the  background  check  program,  the                                                               
proposed  bill  offered  an   opportunity  for  clarification  in                                                               
statute.   The  bill, as  written, referred  to a  civil registry                                                               
which was in fact a  program that checked pre-existing registries                                                               
held  in other  places.    Prior to  2012,  the background  check                                                               
program  used the  standard for  civil  barriers, which  included                                                               
substantiated  reports  of child  maltreatment  and  harm to  the                                                               
Office  of Children's  Services (OCS).   In  2012, the  Office of                                                               
Children's Services began  use of a "more  robust standard" which                                                               
looked to  findings from the  court in a  "child in need  of aid"                                                               
proceeding.  The recommendations  from the Ombudsman's office had                                                               
been  to use  the more  robust standard  of adjudicated  findings                                                               
which also provided an opportunity  for due process in the court;                                                               
whereas the  substantiated report  of harm  did not  always offer                                                               
this opportunity.   She stated that the  background check program                                                               
was  an   essential  component  to   the  systems   which  served                                                               
vulnerable  Alaskans   and  that  proposed  HB   162  offered  an                                                               
opportunity  to strengthen  the  program.   She  relayed that  if                                                               
there was a  decision to use a substantiated report  of harm as a                                                               
basis for  a civil  barrier under  the background  check program,                                                               
which was a policy decision, then  the notice to the people about                                                               
whom  a report  had been  substantiated needed  to be  very clear                                                               
because this could  affect them for up to 10  years.  She pointed                                                               
out that, currently, this notice was  not clear.  She stated that                                                               
an express provision in the  proposed bill, which required that a                                                               
person be  put on  notice for inclusion  in the  child protection                                                               
registry,  could have  effects on  their ability  to take  a care                                                               
giving job, or to become a  relative placement for a child in OCS                                                               
custody.  She opined that this  was an important program and that                                                               
the  proposed bill  provided the  opportunity  to strengthen  the                                                               
program.   She  reiterated that  these comments  were offered  to                                                               
inform the process moving forward.                                                                                              
                                                                                                                                
3:37:20 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ stated that the bill would be held.                                                                             
                                                                                                                                
3:37:46 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SULLIVAN-LEONARD  directed  attention to  the  12                                                               
recommendations  addressing allegations  with  the Department  of                                                               
Health and  Social Services listed on  page 2 of the  letter from                                                               
the Office  of the Ombudsman,  and that there had  been agreement                                                               
for implementation to 3 of  those recommendations.  She asked for                                                               
a general outline  of the 12 recommendations,  with more specific                                                               
details to those 3 agreed upon recommendations.                                                                                 
                                                                                                                                
MS. BURKHART directed  attention to page 35 of  the report, which                                                               
presented the  response by  the Department  of Health  and Social                                                               
Services.  She explained the  Ombudsman process, which began with                                                               
a confidential preliminary report to  a state agency.  The agency                                                               
then had  a chance to  respond before  a final report  was issued                                                               
and  an executive  summary  was  published if  the  issue was  of                                                               
public interest.   She  pointed to the  Department of  Health and                                                               
Social Services (DHSS)  response on page 35.   She explained that                                                               
DHSS was  in the  midst of  a regulatory process  as well  as the                                                               
proposal of a  bill similar to HB  162.  She opined  that part of                                                               
the intention  was to  implement recommendations  9 &  10 through                                                               
the regulatory process, as noted on page 42.                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ  pointed out that  the committee members  did not                                                               
have this report.                                                                                                               
                                                                                                                                
MS.  BURKHART  explained  recommendations  4 &  5  although,  she                                                               
reported, these were not relevant to HB 162.                                                                                    
                                                                                                                                
3:41:38 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR asked about recommendations 9 & 10.                                                                         
                                                                                                                                
MS. BURKHART  explained that recommendation  9 reviewed  the need                                                               
for another look at whether really  old findings in child in need                                                               
of aid  cases should be a  permanent bar to an  appointment.  She                                                               
reported that proposed HB 162  maintained for the current method,                                                               
that  the only  permanent  bar related  to  child protection  was                                                               
termination  of  parental  rights.    She  reiterated  that  this                                                               
recommendation was "not necessarily  super relevant to [HB] 162."                                                               
She  directed  attention  to recommendation  10  which  suggested                                                               
implementation of a tiered response  system, and that regulations                                                               
adopted   last   year   included  a   tiered   response   system,                                                               
particularly with criminal barriers.                                                                                            
                                                                                                                                
3:43:22 PM                                                                                                                    
                                                                                                                                
MS. KRALY stated that there  had been significant and substantial                                                               
communication  with  the Office  of  the  Ombudsman about  moving                                                               
forward with the proposed bill and improving the process.                                                                       
                                                                                                                                
CHAIR  SPOHNHOLZ  pointed  out  that there  would  be  additional                                                               
meetings   between  Ms.   Kraly   and  Ms.   Burkhart  to   offer                                                               
recommendations for possible inclusion in the proposed bill.                                                                    
                                                                                                                                
3:44:33 PM                                                                                                                    
                                                                                                                                
CHARLES McKEE shared some personal experiences.                                                                                 
                                                                                                                                
3:47:26 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ left public testimony open.                                                                                     
                                                                                                                                
[HB 162 was held over.]                                                                                                         
                                                                                                                                
              HB 268-OPIOID PRESCRIPTION WARNINGS                                                                           
                                                                                                                                
3:47:40 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ announced that the  final order of business would                                                               
be SPONSOR  SUBSTITUTE FOR HOUSE  BILL NO. 268, "An  Act relating                                                               
to the  prescription of  opioids; relating  to the  Department of                                                               
Health  and   Social  Services;  relating  to   the  practice  of                                                               
dentistry; relating to the practice  of medicine; relating to the                                                               
practice  of podiatry;  relating to  the practice  of osteopathy;                                                               
relating  to  the  practice  of  nursing;  and  relating  to  the                                                               
practice of optometry."                                                                                                         
                                                                                                                                
3:48:32 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  LES GARA,  Alaska State  Legislature, paraphrased                                                               
from the  Sponsor Statement [Include in  members' packets], which                                                               
read:                                                                                                                           
                                                                                                                                
     House  Bill  268  seeks  to  help  address  the  opioid                                                                    
     addiction  crisis in  Alaska, by  making sure  patients                                                                    
     are  advised  of  the potential  addictive  dangers  of                                                                    
     these   prescription   drugs.  Opioid   drugs   include                                                                    
     oxycodone, hydrocodone, and  other pain reducing drugs.                                                                    
     In many cases  these drugs are needed  to address acute                                                                    
     physical pain, but the facts  show that these drugs can                                                                    
     also  have  powerful  addictive  effects.  Furthermore,                                                                    
     studies show  many heroin users started  as opioid drug                                                                    
     users.  The   relatively  low  cost  of   heroin  as  a                                                                    
     substitute  drug can  lead to  the  transition by  many                                                                    
     Americans and  Alaskans to heroin. Obviously,  this can                                                                    
     occur when  a medical  provider will no  longer provide                                                                    
     additional   prescription  medication.   A  small   but                                                                    
     troubling percentage  of people who become  addicted to                                                                    
     opioid drugs later become heroin addicts.                                                                                  
                                                                                                                                
     These  addictions  can   destroy  families,  destroy  a                                                                    
     person's  ability  to   hold  employment,  and  destroy                                                                    
     lives.  Addiction treatment  is  costly for  consumers,                                                                    
     who pay  indirect insurance costs,  as well as  for the                                                                    
     state,  which  often  covers  and  pays  for  addiction                                                                    
     treatment.  In the  worst  case,  overdose deaths  also                                                                    
     result from opioid use. According  to the Department of                                                                    
     Health and Social Services,  14,000 Americans died from                                                                    
     opioid  use in  2014 and  91 Americans  die every  day.                                                                    
     Alaska's per  capita death rate  is twice  the national                                                                    
     average.  According to  the  Department, between  2009-                                                                    
     2015, 774 Alaskans died from opioid overdose.                                                                              
                                                                                                                                
     This bill recognizes a reality.  Since 1999, the number                                                                    
     of  opioid prescriptions  has  tripled. More  Americans                                                                    
     and Alaskans  have been prescribed these  often useful,                                                                    
     but potentially dangerous drugs.                                                                                           
                                                                                                                                
     House  Bill  268  is a  patient  information  bill.  It                                                                    
     requires  prescribers to  let patients  know about  the                                                                    
     potentially  addictive qualities  of  these drugs  when                                                                    
     they  are prescribed,  and  that  they can  potentially                                                                    
     lead  to opioid  abuse  and  addiction. Providers  must                                                                    
     also  offer  information  about   opioid  use  being  a                                                                    
     potential  risk  factor  for future  heroin  addiction.                                                                    
     Patients   can  then   use  this   knowledge  to   help                                                                    
     themselves  and  their  family  members  guard  against                                                                    
     overuse and abuse when prescribed these medications.                                                                       
                                                                                                                                
     To keep the requirements flexible, and as non-                                                                             
     burdensome   as   feasible,  while   still   protecting                                                                    
     patients, medical  providers who prescribe  these drugs                                                                    
     will be  required to provide this  information to their                                                                    
     patients in their "own words".                                                                                             
                                                                                                                                
     The  bill also  requires the  Department of  Health and                                                                    
     Social Services  to prepare a  very short  handout with                                                                    
     some facts on the dangers  of opioid addiction, and the                                                                    
     potential  association  between  opioid  addiction  and                                                                    
     heroin  use.   To  increase   the  chances   that  this                                                                    
     information  will  be  presented  in  a  form  that  is                                                                    
     useful, it is  required to be concise,  and may include                                                                    
     graphics.   The  handout   is   Important  because   it                                                                    
     recognizes  that  the patient-provider  discussion  may                                                                    
     not  be  long  and  detailed, and  a  patient  may  not                                                                    
     remember what is told to  them by a medical provider in                                                                    
     this   regard.  It   also  serves   to  reinforce   the                                                                    
     information.                                                                                                               
                                                                                                                                
     This bill  does not create opportunities  for new civil                                                                    
     lawsuits   against  providers,   thus  protecting   the                                                                    
     patient-provider  relationship.   Instead  of  imposing                                                                    
     civil liability,  and raising the specter  of lawsuits,                                                                    
     the  enforcement  mechanism  in  the  bill  allows  the                                                                    
     providers' Board  to consider sanctions  for "habitual"                                                                    
     violations  of this  statute that  occur without  "good                                                                    
     cause".                                                                                                                    
                                                                                                                                
     Exceptions to the  legislation's requirements, borrowed                                                                    
     from a  similar statute  passed in New  Jersey, include                                                                    
     medical services  where opioids  may be  necessary such                                                                    
     as for opioid addiction treatment and hospice care.                                                                        
                                                                                                                                
REPRESENTATIVE GARA declared that  this was a world-wide problem,                                                               
and opined that, as heroin was  cheap, it could be substituted if                                                               
the prescription opiates were no  longer available from a doctor.                                                               
He relayed his  request that the Department of  Health and Social                                                               
Services  put a  link on  its website  for physicians  to use  to                                                               
download a concise  handout.  He offered his  own experience with                                                               
opioid prescriptions, that he had  never been told that they were                                                               
potentially  addictive  or  any   link  between  opioid  use  and                                                               
eventual heroin use.                                                                                                            
                                                                                                                                
3:54:34 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD  asked about offering  the choice                                                               
of  another  pain relieving,  non-narcotic  based  product.   She                                                               
shared  that pharmaceutical  representatives had  tried to  offer                                                               
this  to doctors,  but the  response had  been that  the patients                                                               
wanted quick relief.                                                                                                            
                                                                                                                                
REPRESENTATIVE GARA  expressed his agreement, and  he pointed out                                                               
that the proposed bill required  that a reasonable alternative to                                                               
the opioid must be mentioned to the patient.                                                                                    
                                                                                                                                
3:55:49 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE JOHNSTON asked  if the proposed bill  was just for                                                               
written prescriptions as a patient may not be able to read.                                                                     
                                                                                                                                
REPRESENTATIVE  GARA explained  that  the bill  was intended  for                                                               
written prescriptions.   He reported  that there was  some opioid                                                               
use that  was not prescription  use, and  he cited examples  of a                                                               
hospice care center  or a heroin addiction treatment  center.  He                                                               
stated that the  proposed bill did not affect these  centers.  He                                                               
explained  that  the proposed  bill  was  a requirement  for  any                                                               
prescription from an authorized provider.                                                                                       
                                                                                                                                
3:57:36 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOHNSTON said  that  she was  thinking of  trauma                                                               
cases in emergency rooms.                                                                                                       
                                                                                                                                
REPRESENTATIVE GARA  expressed his  agreement that it  should not                                                               
affect emergency rooms and immediate care facilities.                                                                           
                                                                                                                                
CHAIR SPOHNHOLZ pointed out that  there were times when you could                                                               
and could not give consent.                                                                                                     
                                                                                                                                
3:58:12 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR  directed attention to  page 11, line  6, and                                                               
suggested that the mechanism of  action with opioid use needed to                                                               
be  described  to  a  patient to  better  understand  the  health                                                               
effects, even after  the end of the prescription use.   She asked                                                               
if the  Department of Health  and Social Services  would consider                                                               
this, absent  legislation, as there  would be  immediate positive                                                               
effect.                                                                                                                         
                                                                                                                                
REPRESENTATIVE  GARA offered  his belief  that the  Department of                                                               
Health   and   Social   Services  would   not   require   medical                                                               
practitioners to  read a  statement or  provide a  handout, hence                                                               
the need  for legislation to  make this a  mandatory requirement.                                                               
He  pointed out  that should  a  warning become  too long,  there                                                               
would be  resistance from physicians.   He acknowledged  that any                                                               
appropriate  additional  information  could be  included  in  the                                                               
written handout.                                                                                                                
                                                                                                                                
4:01:18 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR  asked if the department  would put something                                                               
on its website more immediately.                                                                                                
                                                                                                                                
REPRESENTATIVE  GARA replied  that  it was  already  on the  DHSS                                                               
website.                                                                                                                        
                                                                                                                                
4:01:53 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ  added that  the Office  of Substance  Misuse and                                                               
Addiction  Prevention  had a  lot  of  information and  resources                                                               
available to the public and health care practitioners.                                                                          
                                                                                                                                
4:02:09 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SADDLER (alternate)  asked  about  the extent  of                                                               
impingement  on  a  professional's  judgement and  who  made  the                                                               
determination  for "without  good cause"  for failing  to provide                                                               
information.                                                                                                                    
                                                                                                                                
REPRESENTATIVE GARA  replied that the  goal of the  proposed bill                                                               
was  to be  non-burdensome on  medical practitioners  and not  to                                                               
create  a hostile  litigation  relationship  between patient  and                                                               
provider.  He  pointed out that the discipline  for providers was                                                               
very relaxed, noting that there  was no lawsuit liability created                                                               
by the  bill.   He explained that  the enforcement  mechanism was                                                               
for habitual violators of the provisions  of the bill who did not                                                               
have good cause.                                                                                                                
                                                                                                                                
REPRESENTATIVE  SADDLER asked  who  defined good  cause and  what                                                               
constituted habitual.                                                                                                           
                                                                                                                                
4:03:56 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  GARA replied  that it  was only  habitual if  the                                                               
person was not following the law on a consistent basis.                                                                         
                                                                                                                                
REPRESENTATIVE KITO asked how a  violation was determined and who                                                               
would determine these violations.                                                                                               
                                                                                                                                
REPRESENTATIVE GARA explained that  the regulatory board for each                                                               
profession  would  determine  the  violations and  the  need  for                                                               
punishment.  He  stated that the legal standard  for habitual was                                                               
determined by the dictionary definition.                                                                                        
                                                                                                                                
4:04:54 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KITO asked  how the board members  were made aware                                                               
of the violation.                                                                                                               
                                                                                                                                
REPRESENTATIVE  GARA   replied  that  "somebody  would   have  to                                                               
complain to them" and he opined  that it would be rare as medical                                                               
practitioners would not want to violate the law.                                                                                
                                                                                                                                
4:05:37 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ said the bill would be held over.                                                                               
                                                                                                                                
4:05:58 PM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no further business before the committee, the House                                                                 
Health and Social Services Standing Committee meeting was                                                                       
adjourned at 4:05 p.m.                                                                                                          

Document Name Date/Time Subjects
SSHB268 Sectional Analysis ver O 1.24.18.pdf HHSS 1/30/2018 3:00:00 PM
HHSS 2/22/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HHSS 3/6/2018 3:00:00 PM
HB 268
SSHB268 Sponsor Statement 1.24.18.pdf HHSS 1/30/2018 3:00:00 PM
HHSS 2/22/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HHSS 3/6/2018 3:00:00 PM
HB 268
SSHB268 Supporting Document-AK DHSS Opioid Addiction and Treatment Factsheet 1.24.18.pdf HHSS 1/30/2018 3:00:00 PM
HHSS 2/22/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HHSS 3/6/2018 3:00:00 PM
HB 268
SSHB268 Supporting Document-AK DHSS Opioid Infographic 1.24.18.pdf HHSS 1/30/2018 3:00:00 PM
HHSS 2/22/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HHSS 3/6/2018 3:00:00 PM
HB 268
SSHB268 Supporting Document-AK DHSS Heroin Use Infographic 1.24.18.pdf HHSS 1/30/2018 3:00:00 PM
HHSS 2/22/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HHSS 3/6/2018 3:00:00 PM
HB 268
SSHB268 Supporting Document-AK DHSS Pain Treatment Handout 1.24.18.pdf HHSS 1/30/2018 3:00:00 PM
HHSS 2/22/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HHSS 3/6/2018 3:00:00 PM
HB 268
SSHB268 Supporting Document-AMA Study 1.24.18.pdf HHSS 1/30/2018 3:00:00 PM
HHSS 2/22/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HHSS 3/6/2018 3:00:00 PM
HB 268
SSHB268 Supporting Document-Article ADN AK Gov. Opioid Declaration 1.24.18.pdf HHSS 1/30/2018 3:00:00 PM
HHSS 2/22/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HHSS 3/6/2018 3:00:00 PM
HB 268
SSHB268 Supporting Document-Article ADN AK Heroin Problem 1.24.18.pdf HHSS 1/30/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HHSS 3/6/2018 3:00:00 PM
HB 268
SSHB268 Supporting Document-Article Huffington Post 1.24.18.pdf HHSS 1/30/2018 3:00:00 PM
HHSS 2/22/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HHSS 3/6/2018 3:00:00 PM
HB 268
SSHB 268 Fiscal Note DCCED-CBPL 01.29.18.pdf HHSS 1/30/2018 3:00:00 PM
HHSS 2/22/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HHSS 3/6/2018 3:00:00 PM
HB 268
SSHB268 Supporting Document-STUFF Online Article on Alternative Pain Treatment in NZ 1.24.18.pdf HHSS 1/30/2018 3:00:00 PM
HHSS 2/22/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HHSS 3/6/2018 3:00:00 PM
HB 268
SSHB268 Supporting Document-Report CDC Long Term Opioid Use 1.24.18.pdf HHSS 1/30/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HHSS 3/6/2018 3:00:00 PM
HB 268
SSHB268 Supporting Document-NJAFP Notice RE New Jersey Opioid Law 1.24.18.pdf HHSS 1/30/2018 3:00:00 PM
HHSS 2/22/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HB 268
SSHB268 Supporting Document-New Jersey Legislature Relevant Opioid Statutes Doc 1.24.18.pdf HHSS 1/30/2018 3:00:00 PM
HHSS 2/22/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HHSS 3/6/2018 3:00:00 PM
HB 268
SSHB268 Supporting Document-CDC Patient Opioid Fact Sheet 1.24.18.pdf HHSS 1/30/2018 3:00:00 PM
HHSS 2/22/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HB 268
SSHB268 Supporting Document-Article VOX 1.24.18.pdf HHSS 1/30/2018 3:00:00 PM
HHSS 2/22/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HHSS 3/6/2018 3:00:00 PM
HB 268
SSHB268 Supporting Document-Article The Star Press Opioids and Foster Care Indiana 1.24.18.pdf HHSS 1/30/2018 3:00:00 PM
HHSS 2/22/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HHSS 3/6/2018 3:00:00 PM
HB 268
SSHB268 Supporting Document-Article NIDA 1.24.18.pdf HHSS 1/30/2018 3:00:00 PM
HHSS 2/22/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HHSS 3/6/2018 3:00:00 PM
HB 268
SSHB268 Supporting Document-Article New Yorker 1.24.18.pdf HHSS 1/30/2018 3:00:00 PM
HHSS 2/22/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HHSS 3/6/2018 3:00:00 PM
HB 268
SSHB268 Supporting Document-CDC Checklist for Opioid Prescribers 1.24.18.pdf HHSS 1/30/2018 3:00:00 PM
HHSS 2/22/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HHSS 3/6/2018 3:00:00 PM
HB 268
SSHB 54 Supporting Document--End of Life Survey 1.29.2018.pdf HHSS 1/30/2018 3:00:00 PM
HB 54
SSHB 54 Supporting Document--Girdwood Board Of Supervisors.pdf HHSS 1/30/2018 3:00:00 PM
HB 54
SSHB54 Supporting Document - Medical Aid in Dying Kodiak Times.pdf HHSS 1/30/2018 3:00:00 PM
HB 54
SSHB 54 Fiscal Note--DHSS-DPH 1.29.2018.pdf HHSS 1/30/2018 3:00:00 PM
HB 54
SSHB 54 Fiscal Note--DOL-CJL 1.29.2018.pdf HHSS 1/30/2018 3:00:00 PM
HB 54