Legislature(2021 - 2022)BUTROVICH 205
02/16/2021 01:30 PM Senate HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| SB65 | |
| SB70 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SB 65 | TELECONFERENCED | |
| *+ | SB 70 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
February 16, 2021
1:31 p.m.
MEMBERS PRESENT
Senator David Wilson, Chair
Senator Shelley Hughes, Vice Chair
Senator Mia Costello
Senator Lora Reinbold
Senator Tom Begich
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
SENATE BILL NO. 65
"An Act relating to immunity for consulting physicians,
podiatrists, osteopaths, advanced practice registered nurses,
physician assistants, dentists, optometrists, and pharmacists."
- HEARD & HELD
SENATE BILL NO. 70
"An Act relating to opioid overdose drugs; and providing for an
effective date."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: SB 65
SHORT TITLE: LIABILITY CONSULTING HEALTH CARE PROVIDER
SPONSOR(s): SENATOR(s) KIEHL
02/03/21 (S) READ THE FIRST TIME - REFERRALS
02/03/21 (S) HSS, JUD
02/16/21 (S) HSS AT 1:30 PM BUTROVICH 205
BILL: SB 70
SHORT TITLE: OPIOID OVERDOSE DRUGS
SPONSOR(s): SENATOR(s) WILSON
02/05/21 (S) READ THE FIRST TIME - REFERRALS
02/05/21 (S) HSS
02/16/21 (S) HSS AT 1:30 PM BUTROVICH 205
WITNESS REGISTER
SENATOR JESSE KIEHL
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Sponsor of SB 65.
CJ HARRELL, Intern
Senator Jesse Kiehl
Alaska State Legislature
POSITION STATEMENT: Introduced SB 65 for the bill sponsor.
JACOB KELLY, M.D.
Alaska Heart and Vascular Institute
Anchorage, Alaska
POSITION STATEMENT: Testified by invitation in support of SB 65.
ROBERT CRAIG, CEO
Alaska Heart and Vascular Institute
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 65.
STEVEN COMPTON, M.D., Secretary/Treasurer Elect
Alaska State Medical Association
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 65.
JASMINE MARTIN, Staff
Senator David Wilson
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented the sectional analysis for SB 70
on behalf of the sponsor.
THERESA WELTON, Section Chief
Office of Substance Misuse and Addiction Prevention (OSMAP)
Division Public Health
Department of Health and Social Services (DHSS)
Juneau, Alaska
POSITION STATEMENT: Testified on the importance of continuing
the standing medical order to allow distribution of naloxone,
during the hearing on SB 70
KAREN MALCOM-SMITH, founder
David Dylan Foundation
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 70.
KATIE BOTZ, representing self
Juneau, Alaska
POSITION STATEMENT: Testified in support of SB 70.
ACTION NARRATIVE
1:31:00 PM
CHAIR DAVID WILSON called the Senate Health and Social Services
Standing Committee meeting to order at 1:31 p.m. Present at the
call to order were Senators Costello, Hughes, Begich, and Chair
Wilson. Senator Reinbold arrived shortly thereafter.
SB 65-LIABILITY CONSULTING HEALTH CARE PROVIDER
1:31:39 PM
CHAIR WILSON announced the consideration of SENATE BILL NO. 65
"An Act relating to immunity for consulting physicians,
podiatrists, osteopaths, advanced practice registered nurses,
physician assistants, dentists, optometrists, and pharmacists."
He stated his intent to hear an overview of the bill and take
testimony and hold the bill for further consideration. He
invited sponsor Senator Kiehl and his staff to the table.
1:32:13 PM
SENATOR JESSE KIEHL, Alaska State Legislature, Juneau, Alaska,
Sponsor of SB 65, introduced himself.
1:32:29 PM
CJ HARRELL, Intern, Senator Jesse Kiehl, Alaska State
Legislature, Juneau, Alaska, stated that in Alaska and other
states, healthcare providers will seek the knowledge and
expertise of fellow medical professionals to help them
understand how to help their patients in an effective and timely
manner. These conversations can be an official consultation, but
more often than not, medical professionals will have what are
called curbside consultations. This is when a patient's
healthcare provider has an uncompensated, informal consultation
with another medical professional. These consulting medical
professionals are often specialists and do not have any
relationship with the patient under discussion. It is a fast and
effective way of sharing knowledge and expertise and is the
backbone of medical care. Two years ago in Minnesota a
healthcare provider who had no relationship to a patient was
forced to defend themselves against a civil liability case. The
fear is that by not protecting those who have no relationship to
a patient and are sharing their expertise through a curbside
consultation providers will no longer feel comfortable aiding
fellow healthcare providers in that way. SB 65 will allow
curbside consultations to continue, but without the potential to
become subject to civil liability for a patient with whom they
have no actual relationship.
1:33:59 PM
SENATOR BEGICH commented that there had been good conversations
last year about a similar bill. He sees that most of the changes
were incorporated in this version of the bill. He noted he spoke
to Senator Kiehl a bit about the telehealth issues. Now that the
emergency order which extended telehealth is gone, he asked
Senator Kiehl if the bill has any relationship to telehealth
that could be explored.
SENATOR KIEHL replied he doesn't see a hook to telehealth, which
is generally direct patient care and if not face-to-face,
camera-to-camera, which does establish a doctor patient
relationship. There is a duty of care. Curbside consults
frequently involve doctors on the phone, but the consulting
doctor is not seeing the patient.
SENATOR BEGICH clarified that in a three-person scenario, there
is a curbside consult, the doctor who is dealing with the
patient, and the patient.
SENATOR KIEHL responded that in that scenario, the treating
healthcare professional may seek a curbside consult with a
colleague. This bill protects that curbside consult as long as
the consulting physician is not laying hands on the patient,
even virtually. Therefore, they would not be liable.
SENATOR BEGICH asked what the estimated cost is to Alaskans if
this bill did not pass, in terms of things like liability
insurance. He asked if that is what is driving the bill.
SENATOR KIEHL answered that cost of liability is one of the key
drivers. The financial cost would be difficult to figure out.
The potential for increased medical malpractice costs is
significant, although he doesn't have a number for that. The
potential cost to the healthcare system as a whole is much
greater. The potential is the effect on a doctor who might
previously have called a specialist about a transport or a
referral for a workup. When the answer can safely be no, a lot
of money is saved compared to the specialist not being available
for a free consult and saying the patient must be sent. That is
a risk the state needs to avoid.
1:38:03 PM
SENATOR REINBOLD asked if the bill has any protection in regard
to administering the mRNA vaccines.
SENATOR KIEHL replied not directly, but he could see the
potential implication. If a healthcare provider had a patient
who is medically fragile or has complicating medical conditions
and wanted to call a specialist to see if those contraindicted
giving the shot, the state would want them to be able to make
that call and SB 65 would help make that a safe call.
SENATOR REINBOLD asked if the bill protects the person
administering the shot.
SENATOR KIEHL answered that that person lays hands on the
patient and would retain whatever liability that person would
otherwise have if there was a bad reaction that might cause
liability.
SENATOR REINBOLD advised that safety with vaccines will be a top
issue with her. She wanted to make sure there were zero
protections regarding vaccinations. The Judiciary Committee has
talked about informed consent required with emergency use
authorization of vaccines. She hopes the long-term effects are
fine, but no one knows what they are. She is happy to know there
is zero protection for those people involved with vaccines in
this bill.
1:41:05 PM
SENATOR HUGHES asked about a scenario in which someone in a
coffee line asks a provider who has not treated or done an exam
of that person for advice and that person takes that advice, but
the person has an adverse reaction when following that advice.
She asked if this bill could relieve that provider of liability.
SENATOR KIEHL replied SB 65 would not apply to that scenario. SB
65 covers consultations between healthcare providers.
SENATOR HUGHES asked him to point that out in the bill.
SENATOR KIEHL responded that page 1, line 7, provides immunity
to a consulting healthcare provider. Page 2, line 20, defines
the consulting healthcare provider, someone who provides advice
to another healthcare provider and then there is a list of
licensed healthcare providers.
SENATOR HUGHES referred to page 2, line 14, beginning with
number 9, a written report is not created as a result of the
consultation. She asked again about a coffee line conversation
in which one provider speaks to another provider and a report is
written and patient treated accordingly. If the patient sues,
she asked if that would be considered a written report or should
the bill specify the written report must be prepared by the
consulting provider.
SENATOR KIEHL replied that he doesn't know if that clarification
would be in any way harmful. It matches the intent because the
liability shield is provided to the consulting provider. It is
not strictly necessary. If he understands her scenario
correctly, the treating provider writes the report. Their
liability rests with the treatment they provided, irrespective
of the report, but he sees no harm in that clarification.
SENATOR HUGHES said that she did not want to imply that
healthcare providers are nefarious, but she could see that if
someone took some informal advice in the coffee line and then
there was an adverse result and the patient sued, that provider
may try to create a report saying they received that advice from
another physician in order to spread the burden of liability.
She could see the need for clarification that the written report
would be by the consulting provider to prevent that type of
situation, even though it would be rather unlikely. She asked if
Senator Kiehl would entertain that as a friendly amendment.
SENATOR KIEHL responded that he had no objection to that
clarification.
1:45:51 PM
CHAIR WILSON called on invited testimony.
1:46:11 PM
JACOB KELLY, M.D., Alaska Heart and Vascular Institute,
Anchorage, Alaska, said SB 65 allows physicians to provide
unencumbered clinical expertise to help patients across Alaska.
Alaska's value and mission is to take care of all Alaskans
regardless of location and ability to pay. This allows better
local care and leads to decreased inappropriate transfers. It
allows patients to be cared for where they are safer. It would
ultimately reduce cost. He receives from 2 to 10 calls a night
from various cities from nurse practitioners, emergency room
physicians, family physicians, and other specialists. It is nice
to be able to support them in their decision-making without
concern about litigation when he has no access to the patient,
their records or data. As a heart failure specialist, people
have questions for him about how to titrate medications. It can
be difficult to transfer a patient to Anchorage for an expensive
visit when a slight titration of medications would lead to
improved survival and quality of life.
SENATOR HUGHES commented that it is important to share knowledge
among experts in the field. Now that there is a precedence of a
consulting provider being sued in another state, she is
concerned that it might inhibit good conversations and knowledge
sharing between providers. She asked if it could inhibit
knowledge sharing if SB 65 does not pass.
DR. KELLY agreed that it would make providers more reticent in
answering specific questions. He would be more likely have a
patient transported to Anchorage to one of the larger hospitals
to provide care that could have been delivered locally.
SENATOR REINBOLD asked if SB 65 could reduce his malpractice
insurance.
DR. KELLY deferred the question to Robert Craig. He said
physicians see this as allowing better quality of care with
fewer restrictors. It is about feeling comfortable providing
care and allowing people to get the best care they can.
1:50:58 PM
ROBERT CRAIG, CEO, Alaska Heart and Vascular Institute,
Anchorage, Alaska, said he doesn't anticipate any change to
malpractice premiums. That is not part of the motivation for
support of the bill. The institute's cardiologists are on call
and available for the state 24/7. That coverage is not part of a
telehealth obligation; these are not their patients and the
institute is not reimbursed for the call. The institute's
cardiologist in Anchorage can take a call any time day or night
from a treating physician. The cardiologist has no patient
record or relationship, which places a special burden on their
doctors to be open to potential civil liability. They are
primarily interested in giving timely and accurate information
to another treating physician. The option is to advise the
treating physician to send the patient to Anchorage or request a
formal consultation, which delays care and/or increases cost.
The goal of the institute's doctors is to continue to provide a
high level of cardiology service to the state's providers in a
high-quality and low-cost manner.
SENATOR REINBOLD commented on her intentions when the bill is
heard in the next committee of referral, and expressed a desire
to see malpractice premiums to go down.
1:54:39 PM
STEVEN COMPTON, M.D., Secretary/Treasurer Elect, Alaska State
Medical Association, Anchorage, Alaska, said he is another
cardiologist at Alaska Heart and Vascular Institute but he is
there representing the Alaska State Medical Association (ASMA).
The institute estimates it is doing 10-20 curbside consults a
day across the state. Some are urgent and some are not so bad.
Sometimes the referring doctor is overly worried and the
cardiologists can calm them down. Sometimes it is the reverse
and a patient needs to come in right away. Many times the
problem can be managed locally. Alaska has a greater need for
this sort of referral network and informal consultation than any
other state because of its size. Because it is so large, there
are healthcare inequities. Someone who lives in a village in the
Yukon does not have access to the same care as someone who lives
in a big city. Alaska has excellent telecommunications and
expert opinions can be provided to every corner of the state. He
has been practicing in Alaska for 20 years. The consults are
done for free as part of their duty to citizens of the state.
About a year and a half ago their insurer asked to speak at a
partner meeting. The insurer reviewed the Minnesota case that
Senator Kiehl alluded to and a few others pending at the time
and said this will be a problem if it is not nipped in the bud.
The insurer anticipated a potential increase in rates, and said
he needed to talk there needs to be a discussion about curbside
consults.
DR. COMPTON said the insurer said the institute could give very
general ideas about how to manage a case, but if there is
anything specific, the doctors could potentially be liable for
anything that happens with a case. The institute's insurers are
saying they should either not do this or transport everyone to
Anchorage or address this legislatively. That is why they are
here. This is not just a cardiology issue. Every specialty gets
these calls from around the state. All providers do this and
think this is an important service. He had not appreciated that
until the conversation with the insurer. This is the lubrication
for this whole machine and help avoid inappropriate costs and
help provide excellent care in remote places. The ASMA supports
SB 65.
SENATOR REINBOLD thanked Dr. Compton for his work and powerful
testimony.
SENATOR BEGICH agreed that his testimony makes a big difference.
2:00:07 PM
CHAIR WILSON opened public testimony on SB 65; finding none, he
closed public testimony.
He held SB 65 in committee.
2:00:45 PM
At ease
SB 70-OPIOID OVERDOSE DRUGS
2:02:56 PM
CHAIR WILSON reconvened the meeting and announced the
consideration of SENATE BILL NO. 70 "An Act relating to opioid
overdose drugs; and providing for an effective date."
Speaking as sponsor, he explained that the bill started as a
disaster declaration by former Governor Bill Walker in Senate
Bill 91, which passed in 2017. The intent was to allow the
medical officer at that time, Dr. Jay Butler, to permit naloxone
to be administered under a four year federal grant. This
committee amended the bill to extend the declaration for four
years to allow for the federal funding.
CHAIR WILSON said the medical office still has funding to
administer this program. Naloxone is not a controlled substance.
It has no potential for abuse. This legislation benefits
Alaskans by saving lives. It translates to direct savings for
emergency services and law enforcement and gives those who
overdose a greater chance of living and an opportunity to get
into treatment.
2:05:09 PM
JASMINE MARTIN, Staff, Senator David Wilson, Alaska State
Legislature, Juneau, Alaska, presented the sectional analysis
for SB 70 on behalf of the sponsor.
Section 1: Repeals language regarding the sunset of the
original authorization.
MS. MARTIN noted that Section 1 is conforming to Section 3.
Section 2: Repeals reporting requirement associated with
Substance Abuse and Mental Health Services Administration
grants and the opioid epidemic.
MS. MARTIN said this was a reporting requirement for the
Department of Health and Social Services (DHSS) related to the
opioid epidemic and these grants.
Section 3: Repeals the sunset date of the original
authorization.
Section 4: Immediate effective date.
2:06:06 PM
SENATOR BEGICH questioned the reasoning to repeal the reporting
requirement since part of the value of the report process was
for the legislature to know the status of the opioid epidemic.
MS. MARTIN answered that reports take a lot of the department's
time, and the information is still available to the legislature
if requested. The report made sense when this was a pilot
program but as it is continuing into perpetuity the idea is not
to make the department continue to report.
CHAIR WILSON said that he put the reporting requirement in the
initial bill and neglected to put an end date. If the program
were to end in June, the department by law still would have to
report to the legislature. He didn't want to have the department
continue to do a report if the federal funds end. The report was
just on the federal funding of the program.
SENATOR BEGICH commented that the bill also repeals the sunset
clause, which implies the program will be continuous. He asked
the reason for repealing the reporting requirement if the
program is going to continue.
CHAIR WILSON replied the department has many reports for
programs that are no longer relevant and he did not want to add
to that for a program that may eventually sunset. He said he was
willing to amend the bill to reinsert the reporting requirement.
SENATOR BEGICH suggested keeping the reporting requirement until
the state is no longer getting federal resources. Otherwise, it
would be difficult for the legislature to keep track on a
regular basis. He offered his view that Section 2 is not
necessary because of Section 3. If the sunset clause is
eliminated, there should be reports.
MS. MARTIN explained that the bill doesn't create a program. It
allows the chief medical officer to issue a standing order, but
it doesn't require it.
SENATOR BEGICH said the legislature wanted a report so it would
know when that authority was exercised. He said he will support
the bill, but he wants to do the right thing with the structure
of the bill.
2:11:41 PM
SENATOR REINBOLD commented on the Opioid crisis, and said the
question of why the report is no longer necessary, needs to be
answered.
CHAIR WILSON explained that he threw in the report requirement
just to follow the federal funding of the new program. If the
committee wants the reports continued into perpetuity, then he
is open to that. The department can speak about the effort
involved with the report.
2:13:53 PM
SENATOR COSTELLO asked if the report is online or printed.
CHAIR WILSON called on Ms. Welton to answer.
2:14:11 PM
THERESA WELTON, Section Chief, Office of Substance Misuse and
Addiction Prevention (OSMAP), Division Public Health, Department
of Health and Social Services (DHSS), Juneau, Alaska, answered
that the reports are available online on the website of her
office and are provided to the legislature by October 1 every
year.
SENATOR COSTELLO asked if the report to the legislature is
printed or online electronically.
MS. WELTON replied both.
SENATOR COSTELLO said if the committee wants to keep the
reporting requirement, the committee could ask for it to be
online.
SENATOR REINBOLD noted that there is no fiscal impact, so she is
leaning toward keeping the report. She agrees with Senator
Costello that an online report is fine. Hiland Mountain
Correctional Center is in her district, and she knows that this
medication is important and has saved lives.
CHAIR WILSON asked Ms. Welton to give her presentation.
2:16:48 PM
MS. WELTON said she would be testifying on the importance of
removing the June 30, 2021 sunset clause to allow for perpetual
authorization of the standing medical order for distribution and
administration of naloxone, an opiate overdose reversal drug, by
any Alaskan.
MS. WELTON said an overdose only takes minutes. If naloxone is
not randomly available to the individual or individuals around
the person who overdosed, that person might have to wait for 20
minutes for EMS (Emergency Management Services) to arrive with
naloxone, which could be too late.
MS. WELTON displayed a graph on slide 3 showing the national
trends of opioid overdoses. Overdoses are increasing
significantly, especially for synthetic opioids, such as
tramadol and fentanyl.
MS. WELTON said too many Alaskans have lost their lives to
overdoses, even though that is preventable with timely
administration of naloxone. In Alaska overdoses were one of the
top 10 causes of death in 2017. Overdoses can cause a
significant medical impact in a person who does not receive
timely administration of naloxone. It takes just three minutes
for someone who overdoses to experience brain damage, a costly
and life-long diagnosis. It takes three-to-four minutes for
paramedics to arrive at a scene in Anchorage. At times people
die within eight minutes of an overdose. In rural areas, it can
take 10-20 minutes and generally much longer for first
responders to appear on the scene. People who survive overdose
with brain damage may also have resulting kidney failure, heart
complications, neurological consequences, and more.
2:19: PM
MS. WELTON said that in the U.S. and in Alaska synthetic
opiates, primarily illicitly manufactured fentanyl, appear to be
the primary driver of the increases in overdose deaths. They
have increased 38.4 percent from the 12 months leading up to
June 2019 compared to the 12 months leading up to May 2020.
Overdoses from May 2020 to September appear to outnumber 2019,
marking the highest overdose death rate in over a decade in
Alaska, next to 2017.
SENATOR BEGICH asked why there is an asterisk after 2019 on
slide 5.
MS. WELTON answered there is a lack of data for the final
quarter of 2019.
SENATOR BEGICH asked if the numbers could be even higher.
2:20:44 PM
MS. WELTON replied that is correct. Continuing with the
presentation, she said 42 states and the District of Columbia
have enacted naloxone standing orders. The World Health
Organization, the U.S. Surgeon General, and the American Society
of Addiction Medicine have officially recommended that naloxone
be accessible to those who are closest to the person using
opiates.
MS. WELTON said the standing medical order currently allows
naloxone to be dispensed to any individuals who are not
prescribers, a practice that would be prohibited. Naloxone is
not a controlled substance, has no potential for abuse, and is
safe to use. By removing the sunset date, local and regional
overdose response programs, first responders, the Department of
Public Safety, the Department of Corrections, and the general
public will continue to have the ability to directly distribute
and use the life-saving drug naloxone.
MS. WELTON said with the foundation of the standing order in
2017, the department was able to start the program Project HOPE,
Harm-reduction Overdose Prevention and Education. Project HOPE
works with community organizations to distribute or administer
NARCAN, otherwise known as naloxone, in Alaska. Since inception,
127 community partners have distributed over 41,000 federally
funded NARCAN kits. Of the 320 documented NARCAN administrations
originating from Project HOPE, overdoses have been reversed at
least 309 times. Alaskan subject-matter experts believe that
when there was a 28 percent decrease in overdose deaths in 2018
compared to 2017, it was largely the result of a maximum
distribution of naloxone by Project HOPE for lay persons to use
across Alaska.
2:23:04 PM
MS. WELTON said that timely administration of naloxone provides
opportunity for recovery, and saving lives saves costs.
According to the Society of Actuaries, 40 percent of the
economic burden of the opioid crisis is driven by lost lifetime
earnings for those who died prematurely. Nearly 33 percent is
for excess healthcare spending, another 15 percent is from lost
productivity in the workforce, and 6 percent is from costs
associated with criminal justice. An estimated 29 percent of the
economic burden is borne by federal, state, and local
governments.
MS. WELTON said the current standing medical order allows
naloxone to be dispensed by any individuals who are not
prescribers. By removing the sunset date, local and regional
overdose response programs, first responders, the Departments of
Public Safety and Corrections, and the general public will
continue to have the ability to directly distribute the life-
saving drug naloxone. Without passage of SB 70, naloxone would
only be available to those with a prescription or by EMS. This
is why it is imperative to continue to make naloxone widely
available to save many lives that otherwise would be lost from
overdose.
2:24:45 PM
SENATOR REINBOLD commented that the bill sounds like a good
idea. She asked how much each kit cost and who picks up the
cost.
MS. WELTON replied the cost for the naloxone kits are borne
entirely by federally-funded grants. The approximate cost of a
kit, which contains two doses of naloxone, additional education
and harm reduction efforts and information for treatment, cost
less than $4. There is no cost to the user or the distributors.
Project HOPE is fully funded for both the substance naloxone and
the coordinator position. The state has full funding for the
next two years for Project HOPE. There are no state funds used
for the kits. The Office of Substance Misuse and Addiction
Prevention (OSMAP) is applying for another federal grant that
will provide complete funding it for five years.
SENATOR REINBOLD commented that at some point she would like the
program to be user paid and not government paid. She suggested
the program needs to be evaluated and perhaps restructured.
2:27:56 PM
SENATOR COSTELLO expressed appreciation for the program and
those who administer it. She said the report is helpful, but it
does not replace a hearing and public testimony and the learning
that happens for the public when legislation that sunsets is
before the committee.
SENATOR BEGICH asked Ms. Welton to describe the experience of
receiving naloxone, as he was sure that it was not pleasant.
MS. WELTON replied it is not a pleasant experience when someone
is administered naloxone in an overdose state. Its biochemistry
blocks the opiate receptors, the "high," and the subsequent
medical event of the cascade of an overdose is stopped in its
tracks. People have a tendency to wake up angry and confused
with an intense headache and potential other medical conditions,
but they are alive. That gives them an opportunity to get into
recovery.
SENATOR BEGICH said her response underscores what the committee
heard from Dr. Butler on the subject. It is very unpleasant
experience. To Senator Reinbold's point, he said he recognizes
and acknowledges that at some point people have to pay the price
for their actions. He offered his belief that the report does
not need to be so lengthy. He noted that the committee heard an
executive order related to the departmental split. He asked if
that split will have any impact on SB 70.
CHAIR WILSON asked if OSMAP would stay in the Department of
Health or be in the Department of Child Services.
MS. WELTON responded that OSMAP would be in the new Department
of Health. The split would not impact OSMAP or Project HOPE.
SENATOR BEGICH wondered whether the chief medical officer would
be in a supervisory role.
SENATOR REINBOLD commented further on the importance of personal
responsibility related to the opioid crisis. She segued to the
covid crisis and the impact that had on all sectors of the
population She asked if there has been an increase in overdoses
and naloxone use since March 2020.
2:34:25 PM
MS. WELTON answered that the state has seen an uptick in
overdose deaths in the first three quarters of 2020 compared to
2019 and definitely to 2018. Due to COVID circumstances, getting
the kits built this past year has been challenging because OSMAP
relies on volunteer groups to put them together and OSMAP has
had to adjust to social distancing. The distribution of NARCAN
kits by partners has also been affected. It could be that not as
much naloxone has been distributed in 2020 or it could be the
circumstance of increased mental health complications as well as
substance misuse. Those numbers are being reviewed and causation
studied.
SENATOR REINBOLD explained that she is trying to look at the
difference between lockdowns and non-lockdowns on regional,
state, and national levels. She has heard suicide is up but she
did not have numbers. She asked how significant the increased
number of deaths is and what type of numbers she had for various
years.
MS. WELTON replied she was using approximate numbers as
represented by the bar graph. For the first three quarters of
2018, there were about 70 overdose deaths and about 100 for the
first three quarters of 2019, a little over 100 for the first
three quarters of 2020. She declined to comment on causation.
SENATOR REINBOLD said she is looking for actual numbers for
overdoses and how much naloxone saved lives. She wants
information from March 2020 when it is available, not just the
first quarter, because she wants to know the impact of the covid
lockdowns.
2:39:05 PM
CHAIR WILSON opened public testimony on SB 70.
2:39:22 PM
KAREN MALCOM-SMITH, founder, David Dylan Foundation, Anchorage,
Alaska, said she is a self-funded advocate for the vast arena of
issues surrounding stigma, including healthcare, education, and
law enforcement. She is a member of the Alaska Mental Health
Advisory Board. Her testimony is strictly personal and does not
represent the board. In June of 2017, just one month short of
NARCAN accessibility to the public without a prescription, her
25-year-old son, Dylan, passed away from an overdose. His
dependency followed a near-fatal ATV accident when he was
irresponsibly cut off without a taper after three months of
morphine and oxycodone. At 25 he relapsed and had just returned
from treatment when he passed away. The man who was with him
called 911 immediately. The first responders were there right
away but did not carry NARCAN. They could possibly have saved
him. In addition to the statistics the committee heard, she
wants to add that nationally, the overdose rate is up almost 38
percent for the first three quarters of 2020.
MS. MALCOM-SMITH said that in her work, she has come into close
contact with families who are experiencing the same loss. She
represents other mothers who have experienced first responders
not carrying NARCAN. Lisa Sauder who runs Bean's Caf? is one of
them. They strongly support SB 70 and strongly encourage that in
the future, it should be mandatory for first responders to carry
NARCAN. She knows eight people whose children's lives would have
been saved. Her son was a stellar human being and citizen who
had a warrior's heart. Police officers and emergency responders
should carry NARCAN.
2:44:37 PM
KATIE BOTZ, representing self, Juneau, Alaska, recalled sitting
in one of the legislative rooms testifying for NARCAN. She lost
a friend around 2017 due to an opioid overdose. He hid his use
of drugs very well. It is important to her that NARCAN get in
the hands of healthcare providers and the police department to
help in cases of opioid overdoses. It is discouraging to hear
cases of police and responders not having it on hand. She asked
the legislature to make it mandatory for healthcare providers
and police officers to have NARCAN on hand.
2:47:35 PM
CHAIR WILSON closed public testimony on SB 70.
SENATOR REINBOLD thanked Ms. Malcom-Smith for her testimony and
for serving on the board of the Alaska Mental Health Advisory
Board and expressed sorrow for her loss. She asked her to send
any numbers that she has about overdoses and the use of NARCAN
or anything about the impact since March to the chair.
2:49:43 PM
CHAIR WILSON said he heard the committee's concerns and he would
offer a committee substitute (CS) that leaves in the reporting
requirement.
CHAIR WILSON held SB 70 in committee for further consideration
2:50:44 PM
There being no further business to come before the committee,
Chair Wilson adjourned the Senate Health and Social Services
Standing Committee meeting at 2:50 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 65 version B.pdf |
SHSS 2/16/2021 1:30:00 PM |
SB 65 |
| SB 65 Sponsor Statement 2.4.2021.pdf |
HHSS 4/27/2021 3:00:00 PM HHSS 4/29/2021 3:00:00 PM HHSS 5/4/2021 3:00:00 PM HJUD 5/5/2021 1:00:00 PM HJUD 5/17/2021 1:00:00 PM SHSS 2/16/2021 1:30:00 PM |
SB 65 |
| SB 65 Sectional Analysis v. B 2.4.2021.pdf |
HHSS 4/27/2021 3:00:00 PM HHSS 4/29/2021 3:00:00 PM HHSS 5/4/2021 3:00:00 PM SHSS 2/16/2021 1:30:00 PM |
SB 65 |
| SB 65 Letter of Support ASMA 2.11.2021.pdf |
HHSS 4/27/2021 3:00:00 PM HHSS 4/29/2021 3:00:00 PM SHSS 2/16/2021 1:30:00 PM |
SB 65 |
| SB 65 FN Dept of Law.pdf |
HHSS 4/29/2021 3:00:00 PM SHSS 2/16/2021 1:30:00 PM |
SB 65 |
| SB70 v. A.PDF |
SHSS 2/16/2021 1:30:00 PM |
SB 70 |
| SB 70 Sponsor Statement 2.10.21.pdf |
HHSS 3/30/2021 3:00:00 PM SHSS 2/16/2021 1:30:00 PM |
SB 70 |
| SB 70 Sectional Summary v. A 2.10.21.pdf |
SHSS 2/16/2021 1:30:00 PM |
SB 70 |
| SB 70 Naloxone Standing Order Fact Sheet1-21-21.pdf |
HHSS 3/30/2021 3:00:00 PM SHSS 2/16/2021 1:30:00 PM |
SB 70 |
| SB 70 Opioid Leg Report DHSS 9.28.20.pdf |
HHSS 3/30/2021 3:00:00 PM SHSS 2/16/2021 1:30:00 PM |
SB 70 |
| SB 70 FN DHSS.pdf |
HHSS 3/30/2021 3:00:00 PM SHSS 2/16/2021 1:30:00 PM |
SB 70 |
| SB 70 SLA 2017 SB 91.PDF |
HHSS 3/30/2021 3:00:00 PM SHSS 2/16/2021 1:30:00 PM |
SB 70 |
| SB 70 Opioid Leg Report DHSS 2017-18.pdf |
HHSS 3/30/2021 3:00:00 PM SHSS 2/16/2021 1:30:00 PM |
SB 70 |
| SB 70 Opioid Leg Report DHSS 2018-19.pdf |
SHSS 2/16/2021 1:30:00 PM |
SB 70 |
| SB 70 DHSS Invited Testimony - SHSS - 02162021 Clean.pptx |
SHSS 2/16/2021 1:30:00 PM |
SB 70 |
| SB 70 Letters of Support, Redacted, 2.16.21.pdf |
SHSS 2/16/2021 1:30:00 PM |
SB 70 |