Legislature(2025 - 2026)BUTROVICH 205

04/15/2025 03:30 PM Senate HEALTH & SOCIAL SERVICES

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
*+ SB 147 PHARMACIST PRESCRIPTION AUTHORITY TELECONFERENCED
Heard & Held
-- Testimony <Invitation Only> --
Bills Previously Heard/Scheduled:
+= SB 134 PHARMACY BENEFITS MANAGER;3RD PARTY ADMIN TELECONFERENCED
Moved SB 134 Out of Committee
                    ALASKA STATE LEGISLATURE                                                                                  
      SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                    
                         April 15, 2025                                                                                         
                           3:30 p.m.                                                                                            
                                                                                                                                
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Senator Forrest Dunbar, Chair                                                                                                   
Senator Cathy Giessel, Vice Chair                                                                                               
Senator Matt Claman                                                                                                             
Senator Löki Tobin                                                                                                              
Senator Shelley Hughes                                                                                                          
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
All members present                                                                                                             
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
SENATE BILL NO. 147                                                                                                             
"An Act relating to the prescription and administration of drugs                                                                
and devices by pharmacists; relating to reciprocity for                                                                         
pharmacists; and providing for an effective date."                                                                              
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
SENATE BILL NO. 134                                                                                                             
"An Act relating to pharmacy benefits managers; relating to                                                                     
third-party administrators; and providing for an effective                                                                      
date."                                                                                                                          
                                                                                                                                
     - MOVED SB 134 OUT OF COMMITTEE                                                                                            
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: SB 147                                                                                                                  
SHORT TITLE: PHARMACIST PRESCRIPTION AUTHORITY                                                                                  
SPONSOR(s): SENATOR(s) GIESSEL BY REQUEST                                                                                       
                                                                                                                                
03/26/25       (S)       READ THE FIRST TIME - REFERRALS                                                                        
03/26/25       (S)       HSS, L&C                                                                                               
04/15/25       (S)       HSS AT 3:30 PM BUTROVICH 205                                                                           
                                                                                                                                
BILL: SB 134                                                                                                                  
SHORT TITLE: PHARMACY BENEFITS MANAGER;3RD PARTY ADMIN                                                                          
SPONSOR(s): SENATOR(s) GIESSEL                                                                                                  
                                                                                                                                
03/18/25       (S)       READ THE FIRST TIME - REFERRALS                                                                        
03/18/25       (S)       HSS, L&C                                                                                               
04/01/25       (S)       HSS AT 3:30 PM BUTROVICH 205                                                                           
04/01/25       (S)       Heard & Held                                                                                           
04/01/25       (S)       MINUTE(HSS)                                                                                            
04/03/25       (S)       HSS AT 3:30 PM BUTROVICH 205                                                                           
04/03/25       (S)       Heard & Held                                                                                           
04/03/25       (S)       MINUTE(HSS)                                                                                            
04/15/25       (S)       HSS AT 3:30 PM BUTROVICH 205                                                                           
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
JANE CONWAY, Staff                                                                                                              
Senator Cathy Giessel                                                                                                           
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Provided the sectional analysis for SB 147.                                                               
                                                                                                                                
ASHLEY SCHABER, Chair                                                                                                           
Alaska Board of Pharmacy                                                                                                        
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Testified by invitation on SB 147.                                                                        
                                                                                                                                
BRANDY SEIGNNEMARTIN, Executive Director                                                                                        
Alaska Pharmacists Association                                                                                                  
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Testified by invitation on SB 147.                                                                        
                                                                                                                                
JENNIFER ADAMS, Associate Dean                                                                                                  
L.S. Skaggs College of Pharmacy                                                                                                 
Idaho State University/University of Alaska Anchorage                                                                           
Pocatello, Idaho                                                                                                                
POSITION STATEMENT: Testified by invitation on SB 147.                                                                        
                                                                                                                                
SYLVAN ROBB, Director                                                                                                           
Division of Corporations, Business,                                                                                             
and Professional Licensing                                                                                                      
Department of Commerce, Community                                                                                               
and Economic Development (DCCED)                                                                                                
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Answered questions regarding SB 147.                                                                      
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
3:30:34 PM                                                                                                                    
CHAIR  DUNBAR  called  the  Senate  Health  and  Social  Services                                                               
Standing Committee meeting  to order at 3:30 p.m.  Present at the                                                               
call to order  were Senators Giessel, Hughes,  Claman, Tobin, and                                                               
Chair Dunbar.                                                                                                                   
                                                                                                                                
            SB 147-PHARMACIST PRESCRIPTION AUTHORITY                                                                        
                                                                                                                                
3:31:14 PM                                                                                                                    
CHAIR DUNBAR announced  the consideration of SENATE  BILL NO. 147                                                               
"An Act relating to the  prescription and administration of drugs                                                               
and  devices   by  pharmacists;   relating  to   reciprocity  for                                                               
pharmacists; and providing for an effective date."                                                                              
                                                                                                                                
3:31:34 PM                                                                                                                    
SENATOR  GIESSEL speaking  as sponsor  of SB  147 introduced  the                                                               
bill.  SB  147  grants  pharmacists  prescription  authority  and                                                               
clarifies  prior  legislation  to allow  independent  prescribing                                                               
within their  education, training,  and experience.  Developed in                                                               
collaboration with  the Alaska Board  of Pharmacy and  the Alaska                                                               
Pharmacy  Association,   SB  147   aligns  with   existing  state                                                               
standards of care and federal  models, including the PREP and MAT                                                               
Acts.  She said  the bill  addresses Alaska's  limited healthcare                                                               
capacity, particularly  in rural  areas, by  enabling pharmacists                                                               
to provide direct  care for minor conditions such  as flu, strep,                                                               
COVID-19,  urinary   tract  infections,  and   similar  ailments.                                                               
Pharmacists are highly trained,  hold Doctor of Pharmacy degrees,                                                               
and  are already  regulated to  ensure patient  safety. She  said                                                               
evidence  from   other  states  shows   pharmacist-provided  care                                                               
improves   access,   maintains   quality,  and   reduces   costs.                                                               
Approximately 90 percent  of Americans live within  five miles of                                                               
a community pharmacy.                                                                                                           
                                                                                                                                
3:37:12 PM                                                                                                                    
SENATOR  GIESSEL stated  that the  study indicates  that not  all                                                               
pharmacist-initiated  treatments require  testing  and that  many                                                               
minor   ailments  may   be  effectively   treated  in   community                                                               
pharmacies  based on  patient-reported symptoms  and examination.                                                               
She  said uncomplicated  urinary  tract infections  are a  common                                                               
example,  with evidence  showing  pharmacists demonstrate  strong                                                               
antimicrobial   stewardship  and   appropriate  antibiotic   use.                                                               
Results from  a three-year study  showed 977 patients  used these                                                               
services,  with  care  outcomes comparable  to  emergency  rooms,                                                               
primary  care,  and  urgent care  settings.  The  analysis  found                                                               
significantly   lower   costs   for   pharmacist-provided   care,                                                               
excellent  follow-up,  and  estimated  savings  of  approximately                                                               
$23.5 million, demonstrating the effectiveness and cost-                                                                        
efficiency of pharmacy-based healthcare services.                                                                               
                                                                                                                                
3:41:24 PM                                                                                                                    
JANE CONWAY, Staff, Senator Cathy Giessel, Alaska State                                                                         
Legislature, Juneau, Alaska, provided the sectional analysis for                                                                
SB 147.                                                                                                                         
                                                                                                                                
[Original punctuation provided.]                                                                                                
                                                                                                                                
     Pharmacist Prescription Authority                                                                                          
     Sectional Analysis                                                                                                         
     "An    Act   relating    to   the    prescription   and                                                                    
     administration  of drugs  and  devices by  pharmacists;                                                                    
     relating to reciprocity  for pharmacists; and providing                                                                    
     for an effective date."                                                                                                    
                                                                                                                                
     Section 1. Amends AS 08.80.030(b)  Powers and duties of                                                              
     the board.                                                                                                               
     to require  that a licensed pharmacist  who prescribes,                                                                    
     administers, or dispenses  a controlled substance under                                                                    
     state  law or  federal law  to  a person  in the  state                                                                    
     register  with  the controlled  substance  prescription                                                                    
     database (PDMP).                                                                                                           
                                                                                                                                
     Section  2.  Amends  AS  08.80.110  Qualifications  for                                                              
     licensure by examination.                                                                                                
     to  require   that  a  pharmacist  who   holds  a  Drug                                                                    
     Enforcement Agency (DEA)  number applying for licensure                                                                    
     (via examination) receive  education in pain management                                                                    
     and opioid  use and addiction, in  alignment with other                                                                    
     practitioners in Alaska who hold DEA numbers.                                                                              
                                                                                                                                
     Section  3. Amends  AS  08.80.145 Reciprocity;  license                                                              
     transfer.                                                                                                                
     to require  that a  pharmacist who  holds a  DEA number                                                                    
     applying  for   licensure  (via   reciprocity)  receive                                                                    
     education  in  pain  management   and  opioid  use  and                                                                    
     addiction,  in alignment  with  other practitioners  in                                                                    
     Alaska  who hold  DEA numbers  and  pay the  associated                                                                    
     fees.                                                                                                                      
                                                                                                                                
     Section  4. Amends  AS  08.80.165 Continuing  education                                                              
     requirements.                                                                                                            
     to  require a  pharmacist who  holds a  DEA number  and                                                                    
     renews  licensure in  Alaska meet  continuing education                                                                    
     requirements including at least  two hours of education                                                                    
     in pain management and opioid  use and addiction in the                                                                    
     two years preceding license  renewal, in alignment with                                                                    
     other practitioners  in Alaska who hold  DEA numbers. A                                                                    
     pharmacist  whose   practice  does  not   include  pain                                                                    
     management and  opioid prescription,  or administration                                                                    
     is exempt from this requirement.                                                                                           
                                                                                                                                
     Section  5.  Amends  AS 08.80.337  Other  patient  care                                                              
     services.                                                                                                                
     (a)to  clarify  that  a   pharmacist  may  not  provide                                                                    
     patient care  services under a  collaborative agreement                                                                    
     with another pharmacist. [email protected]                                                                       
                                                                                                                                
     Section  6.  Amends  AS 08.80.337  Other  patient  care                                                              
     services.                                                                                                                
     (d)  to  clarify  that  "patient  care  services"  mean                                                                    
     medical care services that  include the prescription or                                                                    
     administration of  a drug  or device  to a  patient for                                                                    
     the  purposes  of  curing   or  preventing  a  disease,                                                                    
     reduction  of  patient  symptoms  or  for  slowing  the                                                                    
     disease progression.                                                                                                       
                                                                                                                                
     Section  7. Amends  and  adds a  new  subsection to  AS                                                                
     08.80.337 Other patient care services.                                                                                   
     (e)   requiring  that   a  pharmacist   prescribing  or                                                                    
     administering  a  drug  or device  under  this  section                                                                    
     recognize  the limits  of  the pharmacist's  education,                                                                    
     training, and experience and consult  with and refer to                                                                    
     other  practitioners as  appropriate. This  aligns with                                                                    
     standard of care and pharmacy regulation.                                                                                  
                                                                                                                              
     Section 8. Amends AS 08.80.480 Definitions.                                                                          
     (30)  to  clarify  that   the  "practice  of  pharmacy"                                                                    
     includes providing patient  care services in accordance                                                                    
     with AS 08.80.337. This  includes patient care services                                                                    
     provided    independently   or    under   collaborative                                                                    
     practice.                                                                                                                  
                                                                                                                                
     Section  9.  Amends and  adds  a  new paragraph  to  AS                                                                
     08.80.480 Definitions.                                                                                                   
     (40) adds to the definition  of opioid to include opium                                                                    
     and opiate substances and opium and opiate derivatives                                                                     
                                                                                                                                
     Section  10. Repeals  AS 08.80.337  Other patient  care                                                              
     services (c)                                                                                                             
     to align with clarifications in Section 6.                                                                                 
                                                                                                                                
     Section 11. Provides for an effective date of January                                                                  
     1, 2026.                                                                                                                   
                                                                                                                                
MS. CONWAY noted  that Section 9 was added to  comply with the DA                                                               
requirement and Section 10 has an error.                                                                                        
                                                                                                                                
3:46:08 PM                                                                                                                    
ASHLEY  SCHABER,  Chair,  Alaska Board  of  Pharmacy,  Anchorage,                                                               
Alaska, testified by invitation on SB  147. She moved to slide 2,                                                               
2024 Strategic  Plan, and  stated that the  2024 Alaska  Board of                                                               
Pharmacy Strategic  Plan guides  all board decisions  on statutes                                                               
and  regulations. SB  147  aligns with  the  plan's fourth  goal,                                                               
"grow  the economy  while  promoting  economic growth,  community                                                               
health, and safety."                                                                                                            
                                                                                                                                
3:47:01 PM                                                                                                                    
MS.  SCHABER  moved  to  slide  3,  Background  of  SB  147,  and                                                               
discussed the following:                                                                                                        
                                                                                                                                
[Original punctuation provided.]                                                                                                
                                                                                                                                
     -Result  of multi-year,  multi-chair Board  of Pharmacy                                                                    
     review  of statutes  and  regulations  to align  Alaska                                                                    
     pharmacists'  license authority  with their  education,                                                                    
     training, and experience to increase access to care.                                                                       
         -HB 145 (2021-2022)                                                                                                    
             -New statute added for "other patient care                                                                         
     services"                                                                                                                  
             -Clarifications needed                                                                                             
     -SB 147 addresses changes by:                                                                                              
         -Increasing access to care                                                                                             
         -Incorporating established models of care                                                                              
         -Encouraging interdisciplinary engagement                                                                              
       -Collaborative effort between the Alaska Board of                                                                        
     Pharmacy and the Alaska Pharmacy Association                                                                               
                                                                                                                                
3:48:12 PM                                                                                                                    
MS. SCHABER moved to slide  4, Safe Access with Interdisciplinary                                                               
Engagement, and stated that SB  147 expands access to pharmacist-                                                               
provided  patient care  services  while  aligning state  statutes                                                               
with pharmacists' education and  training. The bill also promotes                                                               
interdisciplinary  collaboration  by   requiring  pharmacists  to                                                               
recognize the limits of their scope  and to consult with or refer                                                               
patients to other healthcare practitioners when appropriate.                                                                    
                                                                                                                                
3:48:53 PM                                                                                                                    
MS. SCHABER moved to slide  5, Incorporates Established Models of                                                               
Care,  and   stated  that  SB  147   grants  Alaska  pharmacists'                                                               
statutory  authority  to  use  proven  models  of  care  under  a                                                               
standard-of-care  regulatory  framework.   This  approach  aligns                                                               
pharmacy  regulation  with  other  health  professions,  supports                                                               
practice within training and scope,  enhances patient safety, and                                                               
is  consistent with  recent federal  legislation and  established                                                               
models such as those used by the Veterans Health Administration.                                                                
                                                                                                                                
3:49:58 PM                                                                                                                    
MS. SCHABER  moved to slide  6, Support, and asked  the committee                                                               
for support of SB 147.                                                                                                          
                                                                                                                                
3:50:20 PM                                                                                                                    
SENATOR CLAMAN asked how a  pharmacist could respond if a patient                                                               
requested an opioid prescription for pain management.                                                                           
                                                                                                                                
3:50:45 PM                                                                                                                    
MS. SCHABER replied that the  definition of opioid is included to                                                               
reflect required  pharmacist training.  She said  the established                                                               
model authorizes  pharmacists to  provide medications  for opioid                                                               
use disorder, not to prescribe opioids for pain treatment.                                                                      
                                                                                                                                
3:51:20 PM                                                                                                                    
SENATOR CLAMAN  asked whether a  pharmacist, visited by  a person                                                               
with  a long  history of  pain complaints,  would be  expected to                                                               
tell that person to go see their regular medical provider .                                                                     
                                                                                                                                
3:51:40 PM                                                                                                                    
MS. SCHABER replied, yes.                                                                                                       
                                                                                                                                
3:51:42 PM                                                                                                                    
SENATOR  CLAMAN  explained that  he  has  a  friend with  a  lung                                                               
infection that  has gone through  a couple types  of medications.                                                               
He asked  whether his friend  could see  a pharmacist to  get the                                                               
drug or would the friend need to go to a doctor.                                                                                
                                                                                                                                
3:52:42 PM                                                                                                                    
MS. SCHABER answered  that it would be considered  a complex case                                                               
requiring  consultation with  an  infectious disease  specialist.                                                               
Such a  case is an  example of when  a pharmacist is  expected to                                                               
engage in interdisciplinary collaboration.                                                                                      
                                                                                                                                
3:53:03 PM                                                                                                                    
SENATOR  TOBIN   asked  for  an  explanation   of  the  different                                                               
scheduled drugs list in SB 147, page 2.                                                                                         
                                                                                                                                
MS.  SCHABER  replied  that the  Drug  Enforcement  Agency  (DEA)                                                               
establishes different  levels of controlled substances,  known as                                                               
schedules,  to regulate  medications based  on the  potential for                                                               
abuse and addiction. The numbers  referenced on page 2 correspond                                                               
to  the DEA-controlled  schedules, indicating  the relative  risk                                                               
and regulatory requirements associated with each medication.                                                                    
                                                                                                                                
3:53:59 PM                                                                                                                    
CHAIR TOBIN asked whether she  could describe the scope and types                                                               
of substances.                                                                                                                  
                                                                                                                                
3:54:22 PM                                                                                                                    
MS. SCHABER  said under the  test-to-treat model allowed  by this                                                               
legislation,  commonly   prescribed  medications   could  include                                                               
antivirals,  while  medications  for opioid  use  disorder  would                                                               
likely fall under Schedule III for medication-assisted therapy.                                                                 
                                                                                                                                
3:55:02 PM                                                                                                                    
CHAIR DUNBAR  said SB 147,  Section 8, expands the  definition of                                                               
pharmacy  practice to  include patient  care  services. He  asked                                                               
what  would  occur if  a  pharmacist  chose  not to  offer  these                                                               
services  and whether  the new  definition  of pharmacy  practice                                                               
would require them to complete additional training.                                                                             
                                                                                                                                
3:55:47 PM                                                                                                                    
MS. SCHABER  replied that  SB 147 does  not require  a pharmacist                                                               
licensee in the state to  provide these services. The decision is                                                               
left to  the pharmacist or  pharmacy, as the bill  authorizes but                                                               
does not mandate participation.                                                                                                 
                                                                                                                                
CHAIR  DUNBAR asked  if additional  educational requirements  are                                                               
also voluntary.                                                                                                                 
                                                                                                                                
3:56:59 PM                                                                                                                    
MS. SCHABER replied  that the continuing education  changes in SB
147 apply  only to pharmacists who  prescribe medication-assisted                                                               
therapy for opioid use disorder  and hold a DEA registration. All                                                               
other pharmacists  would continue  being subject to  the existing                                                               
requirement of 30 hours of  continuing education every two years.                                                               
She  added that  unless the  Board determines  through regulation                                                               
that continuing education requirements should change.                                                                           
                                                                                                                                
3:57:45 PM                                                                                                                    
SENATOR  HUGHES expressed  concern that  diagnosis and  treatment                                                               
typically rely on physical examinations,  and that SB 147 appears                                                               
broader than originally  intended. She asked why the  bill is not                                                               
more  narrowly  defined  and whether  similarly  broad  authority                                                               
exists in other states.                                                                                                         
                                                                                                                                
3:58:56 PM                                                                                                                    
MS.  SCHABER replied  that there  are other  states that  do have                                                               
this broad  prescriptive authority. She said  there are protocols                                                               
in place to help guide the pharmacist.                                                                                          
                                                                                                                                
3:59:55 PM                                                                                                                    
SENATOR   HUGHES  asked   whether  the   board  would   establish                                                               
regulations  specifying which  services  pharmacists may  provide                                                               
and when referrals to other providers are required.                                                                             
                                                                                                                                
4:00:33 PM                                                                                                                    
MS.  SCHABER  replied  that the  Board  anticipates  promulgating                                                               
regulations under SB  147 and would continue to  rely on existing                                                               
standards  of  care  and practice.  Rather  than  adopting  rigid                                                               
lists, the Board expects to  maintain a flexible standard-of-care                                                               
regulatory  approach that  can evolve  with  changes in  pharmacy                                                               
practice and clinical guidelines.                                                                                               
                                                                                                                                
4:01:36 PM                                                                                                                    
BRANDY  SEIGNNEMARTIN,  Executive  Director,  Alaska  Pharmacists                                                               
Association,  Anchorage, Alaska,  testified by  invitation on  SB
147. She  stated that the Alaska  Pharmacy Association represents                                                               
pharmacists,  student   pharmacists,  and   pharmacy  technicians                                                               
statewide  and  supports  high-quality  pharmacy  care  in  local                                                               
communities.  Pharmacists  in  Alaska practice  across  community                                                               
pharmacies, tribal health  systems, hospitals, clinics, long-term                                                               
care,  and  public   health  settings,  providing  immunizations,                                                               
health  screenings,  medication management,  patient  counseling,                                                               
and prevention  of medication-related complications. She  said SB
147 builds on this foundation  by allowing pharmacists to provide                                                               
limited  patient  care  services, including  prescribing,  within                                                               
their education,  training, and  experience. These roles  are not                                                               
new  and have  been  safely implemented  for  decades in  federal                                                               
systems  such  as the  Indian  Health  Service and  the  Veterans                                                               
Health Administration.  She said  SB 147 uses  a standard-of-care                                                               
regulatory  model, requires  interdisciplinary collaboration  and                                                               
referrals  for  complex  cases,   and  relies  on  evidence-based                                                               
guidelines. By  aligning statute  with pharmacists'  training, SB
147 improves access  to safe, timely care,  particularly in rural                                                               
and  underserved communities,  reduces strain  on the  healthcare                                                               
system,  and helps  address workforce  burnout while  maintaining                                                               
strong patient safety safeguards.                                                                                               
                                                                                                                                
4:06:59 PM                                                                                                                    
MS. SEIGNNEMARTIN stated  that SB 147 would  allow pharmacists to                                                               
provide test-and-treat  services for minor  illnesses, preventive                                                               
services such as smoking cessation  and HIV prevention, treatment                                                               
for minor  ailments, support for medication-assisted  therapy for                                                               
opioid  use disorder,  and  collaborative  management of  chronic                                                               
conditions. These  evidence-based models,  already used  in other                                                               
states  and  federal  systems, improve  efficiency  by  utilizing                                                               
healthcare team  members at  the appropriate  level of  care. She                                                               
noted  that  studies   show  pharmacist-provided  care  increases                                                               
access while reducing  costs, with an estimated  $4.81 return for                                                               
every  $1 invested  and $277  lower  cost per  episode for  minor                                                               
illness care without compromising  outcomes. SB 147 adds capacity                                                               
to   Alaska's  strained   healthcare  system,   improves  access,                                                               
especially for working patients  and rural communities, maintains                                                               
patient   safety   through   standard-of-care   safeguards,   and                                                               
represents   a   practical,   cost-effective  solution   to   key                                                               
healthcare challenges.                                                                                                          
                                                                                                                                
4:10:04 PM                                                                                                                    
SENATOR TOBIN noted she was  going to ask about disaster response                                                               
and the role of Indian  Health Services in protecting communities                                                               
but acknowledged  that it was  already addressed  thoroughly. She                                                               
asked  for an  overview of  pharmacists' licensure  requirements,                                                               
continuing education obligations, and  the education and training                                                               
necessary to earn a pharmacy degree.                                                                                            
                                                                                                                                
4:10:38 PM                                                                                                                    
MS.  SEIGNNEMARTIN answered  that to  earn a  Doctor of  Pharmacy                                                               
(PharmD) degree, students first complete  at least three years of                                                               
undergraduate  coursework to  meet program  prerequisites, though                                                               
many  students  also earn  a  bachelor's  degree before  entering                                                               
pharmacy  school. The  pharmacy  program itself  is an  intensive                                                               
four-year  curriculum. She  said  during the  first three  years,                                                               
students primarily engage  in didactic, classroom-based learning,                                                               
attending lectures and  laboratory sessions five days  a week for                                                               
approximately  32  weeks  each year.  From  the  very  beginning,                                                               
students also  participate in hands-on patient  care experiences,                                                               
volunteering   in  community   settings  and   gaining  practical                                                               
exposure  to  pharmacy practice.  Between  the  first and  second                                                               
years, they complete  introductory pharmacy practice experiences,                                                               
starting their  clinical rotations early.  She said in  the final                                                               
year,   students  dedicate   themselves   entirely  to   clinical                                                               
training,  completing seven  six-week rotations  in a  variety of                                                               
practice settings,  which together provide more  than 1,740 hours                                                               
of supervised patient care. This  extensive training exceeds that                                                               
of  many other  healthcare  professions,  ensuring graduates  are                                                               
well-prepared  to  provide  safe,  competent care.  She  said  in                                                               
addition to completing the degree,  graduates must pass the North                                                               
American  Pharmacy Licensure  Examination (NAPLEX),  which serves                                                               
as the  minimum competency standard required  to obtain licensure                                                               
and  practice  as  a  pharmacist  in  any  state.  This  rigorous                                                               
combination  of education,  practical  experience, and  licensure                                                               
ensures  that   pharmacists  are   highly  trained   and  capable                                                               
healthcare professionals.                                                                                                       
                                                                                                                                
4:12:50 PM                                                                                                                    
CHAIR TOBIN  asked for  more oversight of  the Board  of Pharmacy                                                               
and if  there is a bad  actor what is the  consequences for their                                                               
actions.                                                                                                                        
                                                                                                                                
4:12:58 PM                                                                                                                    
MS. SEIGNNEMARTIN replied that  pharmacists are closely monitored                                                               
by  the  Board  of  Pharmacy. She  said  the  Board  investigates                                                               
complaints,  ensures regulatory  compliance, and  holds licensees                                                               
accountable for any patient harm or misconduct.                                                                                 
                                                                                                                                
4:13:35 PM                                                                                                                    
SENATOR HUGHES  expressed concern that  while pharmacist-provided                                                               
care can  improve access and  convenience, patients  with chronic                                                               
conditions  like  diabetes  or hypertension  might  bypass  their                                                               
regular     physicians,    potentially     weakening    in-person                                                               
relationships  and  the  opportunity   for  physical  exams.  She                                                               
emphasized the  importance of  pharmacists referring  patients to                                                               
appropriate practitioners  when needed. She asked  if the patient                                                               
would be referred back to their doctor to get the prescription.                                                                 
                                                                                                                                
4:15:03 PM                                                                                                                    
MS. SEIGNNEMARTIN replied that maintaining  a relationship with a                                                               
primary care provider is crucial.  SB 147 supports a standard-of-                                                               
care,  team-based  model.  Pharmacists   can  provide  urgent  or                                                               
routine  care,  such  as  insulin   refills  or  chronic  disease                                                               
management, while  coordinating with  the patient's  primary care                                                               
provider,  often working  alongside  them in  clinics to  monitor                                                               
conditions   like  diabetes   or  asthma   and  ensure   ongoing,                                                               
appropriate care.                                                                                                               
                                                                                                                                
4:16:50 PM                                                                                                                    
SENATOR  HUGHES noted  that integrated  medical  homes, like  the                                                               
Veterans  Health Administration,  allow coordinated  care between                                                               
pharmacists  and  other  providers. She  expressed  concern  that                                                               
standalone  pharmacies  could  lead   patients  to  bypass  their                                                               
physicians.  She asked  about potential  delays  and longer  wait                                                               
times if pharmacists provide most direct care.                                                                                  
                                                                                                                                
4:17:47 PM                                                                                                                    
MS.  SEIGNNEMARTIN answered  that not  all pharmacies  will offer                                                               
these services, as  many lack the capacity.  She said independent                                                               
or well-equipped  pharmacies could provide this  care, especially                                                               
where waiting times are manageable.                                                                                             
                                                                                                                                
4:18:17 PM                                                                                                                    
SENATOR  GIESSEL asked  if she  is aware  of how  many complaints                                                               
have been filed with the Board related to pharmacist practice.                                                                  
                                                                                                                                
4:18:38 PM                                                                                                                    
MS. SEIGNNEMARTIN replied  no. She stated that  the Idaho board's                                                               
experience with  this practice model showed  that implementing it                                                               
did not lead to an increase in complaints or investigations.                                                                    
                                                                                                                                
4:19:08 PM                                                                                                                    
CHAIR DUNBAR  asked if Senator  Giessel would like to  direct the                                                               
question to Ms. Schaber.                                                                                                        
                                                                                                                                
SENATOR GIESSEL replied yes.                                                                                                    
                                                                                                                                
4:19:20 PM                                                                                                                    
MS. SCHABER  responded that  during her time  on the  board there                                                               
were no known investigations  or complaints regarding pharmacists                                                               
practicing  under  collaborative   agreements  or  their  current                                                               
limited prescriptive authority.                                                                                                 
                                                                                                                                
4:19:47 PM                                                                                                                    
SENATOR  CLAMAN referring  to federal  providers and  non-federal                                                               
providers, in  Alaska, he asked  whether a veteran can  receive a                                                               
prescription  from   a  VA  facility  pharmacist,   when  in  the                                                               
pharmacist's  scope of  practice, and  whether non-veterans  must                                                               
see a doctor or other provider for the same prescription.                                                                       
                                                                                                                                
4:20:22 PM                                                                                                                    
MS. SEIGNNEMARTIN answered yes.                                                                                                 
                                                                                                                                
4:21:20 PM                                                                                                                    
JENNIFER ADAMS, Associate Dean,  L.S. Skaggs College of Pharmacy,                                                               
Idaho   State   University/University    of   Alaska   Anchorage,                                                               
Pocatello, Idaho,  testified by  invitation on  SB 147.  She said                                                               
she  is  also  a  professor  of  pharmacy  practice  and  teaches                                                               
pharmacy law in both Idaho  and Alaska. She is therefore familiar                                                               
with statutes on pharmacy law in Alaska.                                                                                        
                                                                                                                                
4:23:13 PM                                                                                                                    
MS.  ADAMS  stated  that  pharmacists  across  the  U.S.  receive                                                               
standardized   education   and   training   accredited   by   the                                                               
Accreditation Council for  Pharmacy Education, including physical                                                               
assessment, diagnosis,  and independent prescribing  within their                                                               
scope of  practice. She  said states  like Idaho  have full-scope                                                               
authority  for  pharmacists,  and  experience  there  shows  that                                                               
pharmacists  provide  safe,  effective, and  cost-efficient  care                                                               
without incidents  of practicing beyond their  training. Services                                                               
have  been  introduced  gradually   to  ensure  safety,  increase                                                               
access,  and allow  patients  to receive  timely  care for  minor                                                               
illnesses directly in pharmacies.                                                                                               
                                                                                                                                
4:26:13 PM                                                                                                                    
MS.  ADAMS  said  that   pharmacies  are  increasingly  providing                                                               
treatment  for  minor  ailments such  as  pinkeye,  uncomplicated                                                               
UTIs, and cold  sores, allowing patients to  receive timely care.                                                               
Some community  pharmacies, especially in rural  areas, have also                                                               
begun offering these services, though  it remains limited outside                                                               
federal systems.                                                                                                                
                                                                                                                                
4:27:23 PM                                                                                                                    
MS. ADAMS shared  a story of a patient that  came to a pharmacist                                                               
for  help. She  said in  a  rural community,  a pharmacist  began                                                               
offering  buprenorphine therapy  after a  patient approached  the                                                               
pharmacy, explaining  that he had been  purchasing the medication                                                               
off  the street  because there  were no  local clinics  providing                                                               
this  service.  Out of  concern  for  the patient's  safety,  the                                                               
pharmacist  undertook  additional  training and  began  providing                                                               
supervised  treatment. She  said  as a  result,  the patient  now                                                               
receives therapy every two weeks,  is successfully staying clean,                                                               
has  regained stability  in his  personal and  professional life,                                                               
and is able to support his  family. This pharmacy now serves over                                                               
30 patients, providing care they  could not otherwise access. She                                                               
said this story highlights the  importance of SB 147 in expanding                                                               
access to essential healthcare  services, particularly for opioid                                                               
use disorder, while  allowing pharmacists to practice  at the top                                                               
of their education  and training. Implementing SB  147 would help                                                               
modernize pharmacy  practice in  Alaska, enable  ISU-UA graduates                                                               
to  fully utilize  their skills,  and  provide meaningful,  life-                                                               
changing care within their communities.                                                                                         
                                                                                                                                
4:31:02 PM                                                                                                                    
SENATOR HUGHES asked how SB  147 is more restrictive than Idaho's                                                               
statute.                                                                                                                        
                                                                                                                                
MS. ADAMS replied  that SB 147 places  additional restrictions on                                                               
the  types  of  services  pharmacists can  provide,  focusing  on                                                               
preventative care, minor, and  self-limiting conditions. She said                                                               
Idaho  allows  pharmacists  to   have  full-scope  authority  for                                                               
diagnosing and prescribing without such limits.                                                                                 
                                                                                                                                
4:32:25 PM                                                                                                                    
SENATOR  HUGHES stated  that, "outcomes  related to  the cure  or                                                               
prevention of a disease, elimination  or reduction of a patient's                                                               
symptoms  or  resting or  slowing  of  a disease  process"  seems                                                               
broad. She  asked for  examples of  something that's  outside the                                                               
scope.                                                                                                                          
                                                                                                                                
4:32:45 PM                                                                                                                    
MS. ADAMS  replied that  pharmacists are limited  by law  and the                                                               
standard of  care to conditions within  their training, excluding                                                               
highly   complex  diagnoses.   Pharmacists   may  manage   common                                                               
conditions  like  diabetes  or   hypertension  but  not  rare  or                                                               
advanced diseases.                                                                                                              
                                                                                                                                
4:34:10 PM                                                                                                                    
SENATOR GIESSEL  stated that  she had a  question related  to the                                                               
fiscal note.                                                                                                                    
                                                                                                                                
4:34:29 PM                                                                                                                    
SYLVAN ROBB,  Director, Division  of Corporations,  Business, and                                                               
Professional  Licensing, Department  of  Commerce, Community  and                                                               
Economic Development (DCCED),  Juneau, Alaska, answered questions                                                               
regarding SB 147.                                                                                                               
                                                                                                                                
4:34:38 PM                                                                                                                    
SENATOR  GIESSEL noted  that  SB  147, page  2,  has the  unusual                                                               
inclusion  of $30,000  in legal  investigation costs  starting in                                                               
FY26 and  continuing annually. She  asked why  investigations and                                                               
complaints are  assumed to occur immediately  upon implementation                                                               
of SB 147.                                                                                                                      
                                                                                                                                
4:35:35 PM                                                                                                                    
MS.  ROBB replied  that that  the fiscal  note reflects  receipt-                                                               
supported authority, not a new  $30,000 appropriation, and allows                                                               
spending if needed. With  a significant scope-of-practice change,                                                               
the division anticipates increased  legal questions and potential                                                               
complaints requiring  Department of  Law support. She  said these                                                               
costs are expected  to taper off overtime as  issues are resolved                                                               
and the scope becomes settled.                                                                                                  
                                                                                                                                
4:36:58 PM                                                                                                                    
SENATOR GIESSEL asked  why the $30,000 is listed  under change of                                                               
revenues if it  is expected to be covered by  licensing fees. She                                                               
noted that under  the current budget constraints  the fiscal note                                                               
will not be supported by the legislature.                                                                                       
                                                                                                                                
4:37:25 PM                                                                                                                    
MS. ROBB responded  that all costs would be  covered by licensing                                                               
fees. The  fiscal note  reflects a change  in revenue  because it                                                               
grants  receipt   authority  to  collect  and   spend  additional                                                               
licensing  receipts, not  new  general  fund appropriations.  She                                                               
said  division  fiscal  notes  always   show  revenues  equal  to                                                               
projected costs.                                                                                                                
                                                                                                                                
4:38:09 PM                                                                                                                    
CHAIR DUNBAR held SB 147 in committee.                                                                                          
                                                                                                                                
        SB 134-PHARMACY BENEFITS MANAGER;3RD PARTY ADMIN                                                                    
                                                                                                                                
4:38:24 PM                                                                                                                    
CHAIR DUNBAR announced  the consideration of SENATE  BILL NO. 134                                                               
"An  Act  relating to  pharmacy  benefits  managers; relating  to                                                               
third-party  administrators;  and   providing  for  an  effective                                                               
date."                                                                                                                          
                                                                                                                                
4:39:12 PM                                                                                                                    
CHAIR DUNBAR solicited the will of the committee.                                                                               
                                                                                                                                
4:39:14 PM                                                                                                                    
SENATOR GIESSEL moved  to report SB 134,  work order 34-LS0461\A,                                                               
from  committee  with  individual  recommendations  and  attached                                                               
fiscal note(s).                                                                                                                 
                                                                                                                                
4:39:29 PM                                                                                                                    
CHAIR DUNBAR found no objection and  SB 134 was reported from the                                                               
Senate Health and Social Services Standing Committee.                                                                           
                                                                                                                                
4:39:54 PM                                                                                                                    
There being  no further  business to  come before  the committee,                                                               
Chair  Dunbar adjourned  the Senate  Health  and Social  Services                                                               
Standing Committee meeting at 4:39 p.m.                                                                                         
                                                                                                                                
                                                                                                                                

Document Name Date/Time Subjects
SB 147 Pharmacist Prescription Authority vsn I 03.26.25.pdf SHSS 4/15/2025 3:30:00 PM
SB 147
SB 147 Sponsor Statement 04.07.25.pdf SHSS 4/15/2025 3:30:00 PM
SB 147
SB147 Sectional Analysis 04.06.25.pdf SHSS 4/15/2025 3:30:00 PM
SB 147
SB 147 Support AK Board of Pharmacy 04.03.25.pdf SHSS 4/15/2025 3:30:00 PM
SB 147
SB147 Changing role of the community pharmacy technician 04.06.25.pdf SHSS 4/15/2025 3:30:00 PM
SB 147
SB147 AK Pharmacies Fact Sheet 04.06.25.pdf SHSS 4/15/2025 3:30:00 PM
SB 147
SB 147 One Pager 04.08.25.pdf SHSS 4/15/2025 3:30:00 PM
SB 147
SB 147 Support APhA 04.15.25.pdf SHSS 4/15/2025 3:30:00 PM
SB 147
SB 147 Support National Community Pharmacists Assn 04.15.25.pdf SHSS 4/15/2025 3:30:00 PM
SB 147
SB 147 Fiscal Note DCCED 04.11.25.pdf SHSS 4/15/2025 3:30:00 PM
SB 147
SB147 Presentation AK Bd of Pharmacy 04.11.25 final.pdf SHSS 4/15/2025 3:30:00 PM
SB 147
SB147 Test and Treat by state map 04.06.25.pdf SHSS 4/15/2025 3:30:00 PM
SB 147
SB147 PREP Act coverage extended 04.06.25.pdf SHSS 4/15/2025 3:30:00 PM
SB 147
SB147 Alaska - Test and treat common illnesses 04.06.25.pdf SHSS 4/15/2025 3:30:00 PM
SB 147
SB 147 Support AK Pharmacy Assn. 04.08.25.pdf SHSS 4/15/2025 3:30:00 PM
SB 147
SB 147 Highlighted - WA State Cost Study 2024.pdf SHSS 4/15/2025 3:30:00 PM
SB 147