00 CS FOR HOUSE BILL NO. 159(FIN) 01 "An Act relating to the prescription of opioids; relating to voluntary nonopioid 02 directives; relating to the controlled substance prescription database; relating to the 03 practice of dentistry; relating to the practice of pharmacy; relating to the practice of 04 medicine; relating to the practice of podiatry; relating to the practice of osteopathy; 05 relating to the practice of nursing; relating to the practice of optometry; relating to the 06 practice of veterinary medicine; relating to the duties of the Board of Pharmacy; 07 relating to pharmacists; providing for an effective date by repealing the effective date of 08 sec. 73, ch. 25, SLA 2016; and providing for an effective date." 09 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 10  * Section 1. The uncodified law of the State of Alaska is amended by adding a new section 11 to read: 12 LEGISLATIVE INTENT. It is the intent of the legislature that the seven-day supply 01 limit for an initial opioid prescription under secs. 5, 16, and 22 of this Act may not be 02 considered as a minimum length of time appropriate for an initial prescription. The United 03 States Centers for Disease Control and Prevention guidelines state that a three-day initial 04 prescription of an opioid is sufficient for most cases of acute pain. The United States Centers 05 for Disease Control and Prevention reported in its March 17, 2017, weekly report that the 06 likelihood of a person's chronic opioid use increases with each additional day of medication 07 supplied after the second day. Practitioners should use their professional judgment in each 08 case and not interpret the seven-day limit as a direction to prescribe the full seven days. 09  * Sec. 2. AS 08.36.070(a), as amended by sec. 5, ch. 25, SLA 2016, is amended to read: 10 (a) The board shall 11 (1) provide for the examination of applicants and the credentialing, 12 registration, and licensure of those applicants it finds qualified; 13 (2) maintain a registry of licensed dentists, licensed dental hygienists, 14 and registered dental assistants who are in good standing; 15 (3) affiliate with the American Association of Dental Boards and pay 16 annual dues to the association; 17 (4) hold hearings and order the disciplinary sanction of a person who 18 violates this chapter, AS 08.32, or a regulation of the board; 19 (5) supply forms for applications, licenses, permits, certificates, 20 registration documents, and other papers and records; 21 (6) enforce the provisions of this chapter and AS 08.32 and adopt or 22 amend the regulations necessary to make the provisions of this chapter and AS 08.32 23 effective; 24 (7) adopt regulations ensuring that renewal of a license, registration, or 25 certificate under this chapter or a license, certificate, or endorsement under AS 08.32 26 is contingent on [UPON] proof of continued professional competence; the  27 regulations must require that a licensee receive not less than two hours of  28 education in pain management and opioid use and addiction in the two years  29 preceding an application for renewal of a license, unless the licensee has  30 demonstrated to the satisfaction of the board that the licensee does not currently  31 hold a valid federal Drug Enforcement Administration registration number; 01 (8) at least annually, cause to be published on the Internet and in a 02 newspaper of general circulation in each major city in the state a summary of 03 disciplinary actions the board has taken during the preceding calendar year; 04 (9) issue permits or certificates to licensed dentists, licensed dental 05 hygienists, and dental assistants who meet standards determined by the board for 06 specific procedures that require specific education and training; 07 (10) require that a licensed dentist who has a federal Drug 08 Enforcement Administration registration number register with the controlled substance 09 prescription database under AS 17.30.200(o). 10  * Sec. 3. AS 08.36.110(a) is amended to read: 11 (a) An applicant for a license to practice dentistry shall 12 (1) provide certification to the board that the applicant 13 (A) is a graduate of a dental school that, at the time of 14 graduation, is approved by the board; 15 (B) has successfully passed a written examination approved by 16 the board; 17 (C) has not had a license to practice dentistry revoked, 18 suspended, or voluntarily surrendered in this state or another state; 19 (D) is not the subject of an adverse decision based on [UPON] 20 a complaint, investigation, review procedure, or other disciplinary proceeding 21 within the five years immediately preceding application, or of an unresolved 22 complaint, investigation, review procedure, or other disciplinary proceeding, 23 undertaken by a state, territorial, local, or federal dental licensing jurisdiction; 24 (E) is not the subject of an unresolved or an adverse decision 25 based on [UPON] a complaint, investigation, review procedure, or other 26 disciplinary proceeding, undertaken by a state, territorial, local, or federal 27 dental licensing jurisdiction or law enforcement agency that relates to criminal 28 or fraudulent activity, dental malpractice, or negligent dental care and that 29 adversely reflects on the applicant's ability or competence to practice dentistry 30 or on the safety or well-being of patients; 31 (F) is not the subject of an adverse report from the National 01 Practitioner Data Bank or the American Association of Dental Boards 02 Clearinghouse for Board Actions that relates to criminal or fraudulent activity, 03 or dental malpractice; 04 (G) is not impaired to an extent that affects the applicant's 05 ability to practice dentistry; 06 (H) has not been convicted of a crime that adversely reflects on 07 the applicant's ability or competency to practice dentistry or that jeopardizes 08 the safety or well-being of a patient; 09 (2) pass, to the satisfaction of the board, written, clinical, and other 10 examinations administered or approved by the board; and 11 (3) meet the other qualifications for a license established by the board 12 by regulation, including education in pain management and opioid use and  13 addiction in the two years preceding the application for a license, unless the  14 applicant has demonstrated to the satisfaction of the board that the applicant  15 does not currently hold a valid federal Drug Enforcement Administration  16 registration number; approved education may include dental school coursework. 17  * Sec. 4. AS 08.36.315 is amended to read: 18 Sec. 08.36.315. Grounds for discipline, suspension, or revocation of license. 19 The board may revoke or suspend the license of a dentist, or may reprimand, censure, 20 or discipline a dentist, or both, if the board finds, after a hearing, that the dentist 21 (1) used or knowingly cooperated in deceit, fraud, or intentional 22 misrepresentation to obtain a license; 23 (2) engaged in deceit, fraud, or intentional misrepresentation in the 24 course of providing or billing for professional dental services or engaging in 25 professional activities; 26 (3) advertised professional dental services in a false or misleading 27 manner; 28 (4) received compensation for referring a person to another dentist or 29 dental practice; 30 (5) has been convicted of a felony or other crime that affects the 31 dentist's ability to continue to practice dentistry competently and safely; 01 (6) engaged in the performance of patient care, or permitted the 02 performance of patient care by persons under the dentist's supervision, regardless of 03 whether actual injury to the patient occurred, 04 (A) that did not conform to minimum professional standards of 05 dentistry; or 06 (B) when the dentist, or a person under the supervision of the 07 dentist, did not have the permit, registration, or certificate required under 08 AS 08.32 or this chapter; 09 (7) failed to comply with this chapter, with a regulation adopted under 10 this chapter, or with an order of the board; 11 (8) continued to practice after becoming unfit due to 12 (A) professional incompetence; 13 (B) addiction or dependence on alcohol or other drugs that 14 impair the dentist's ability to practice safely; 15 (C) physical or mental disability; 16 (9) engaged in lewd or immoral conduct in connection with the 17 delivery of professional service to patients; 18 (10) permitted a dental hygienist or dental assistant who is employed 19 by the dentist or working under the dentist's supervision to perform a dental procedure 20 in violation of AS 08.32.110 or AS 08.36.346; 21 (11) failed to report to the board a death that occurred on the premises 22 used for the practice of dentistry within 48 hours; 23 (12) falsified or destroyed patient or facility records or failed to 24 maintain a patient or facility record for at least seven years after the date the record 25 was created;  26 (13) prescribed or dispensed an opioid in excess of the maximum  27 dosage authorized under AS 08.36.355; or  28 (14) procured, sold, prescribed, or dispensed drugs in violation of  29 a law, regardless of whether there has been a criminal action or harm to the  30 patient. 31  * Sec. 5. AS 08.36 is amended by adding a new section to read: 01 Sec. 08.36.355. Maximum dosage for opioid prescriptions. (a) A licensee 02 may not issue 03 (1) an initial prescription for an opioid that exceeds a seven-day supply 04 to an adult patient for outpatient use; 05 (2) a prescription for an opioid that exceeds a seven-day supply to a 06 minor; at the time a licensee writes a prescription for an opioid for a minor, the 07 licensee shall discuss with the parent or guardian of the minor why the prescription is 08 necessary and the risks associated with opioid use. 09 (b) Notwithstanding (a) of this section, a licensee may issue a prescription for 10 an opioid that exceeds a seven-day supply to an adult or minor patient if, in the 11 professional judgment of the licensee, more than a seven-day supply of an opioid is 12 necessary for 13 (1) the patient's chronic pain management; the licensee may write a 14 prescription for an opioid for the quantity needed to treat the patient's medical 15 condition or chronic pain; the licensee shall document in the patient's medical record 16 the condition triggering the prescription of an opioid in a quantity that exceeds a 17 seven-day supply and indicate that a nonopioid alternative was not appropriate to 18 address the medical condition; or 19 (2) a patient who is unable to access a practitioner within the time 20 necessary for a refill of the seven-day supply because of a logistical or travel barrier; 21 the licensee may write a prescription for an opioid for the quantity needed to treat the 22 patient for the time that the patient is unable to access a practitioner; the licensee shall 23 document in the patient's medical record the reason for the prescription of an opioid in 24 a quantity that exceeds a seven-day supply and indicate that a nonopioid alternative 25 was not appropriate to address the medical condition; in this paragraph, "practitioner" 26 has the meaning given in AS 11.71.900. 27 (c) In this section, 28 (1) "adult" means 29 (A) a individual who has reached 18 years of age; or 30 (B) an emancipated minor; 31 (2) "emancipated minor" means a minor whose disabilities have been 01 removed for general purposes under AS 09.55.590; 02 (3) "minor" means an individual under 18 years of age who is not an 03 emancipated minor. 04  * Sec. 6. AS 08.36.370 is amended by adding a new paragraph to read: 05 (10) "opioid" includes the opium and opiate substances and opium and 06 opiate derivatives listed in AS 11.71.140. 07  * Sec. 7. AS 08.64.107 is amended to read: 08 Sec. 08.64.107. Regulation of physician assistants and intensive care  09 paramedics. The board shall adopt regulations regarding the licensure of physician 10 assistants and registration of mobile intensive care paramedics, and the medical 11 services that they may perform, including the 12 (1) educational and other qualifications, including education in pain  13 management and opioid use and addiction; 14 (2) application and registration procedures; 15 (3) scope of activities authorized; and 16 (4) responsibilities of the supervising or training physician. 17  * Sec. 8. AS 08.64.200(a) is amended to read: 18 (a) Except for foreign medical graduates as specified in AS 08.64.225, each 19 physician applicant shall 20 (1) submit a certificate of graduation from a legally chartered medical 21 school accredited by the Association of American Medical Colleges and the Council 22 on Medical Education of the American Medical Association; 23 (2) submit a certificate from a recognized hospital or hospitals 24 certifying that the applicant has satisfactorily performed the duties of resident 25 physician or intern for a period of 26 (A) one year if the applicant graduated from medical school 27 before January 1, 1995, as evidenced by a certificate of completion of the first 28 year of postgraduate training from the facility where the applicant completed 29 the first year of internship or residency; and 30 (B) two years if the applicant graduated from medical school 31 on or after January 1, 1995, as evidenced by a certificate of completion of the 01 first year of postgraduate training from the facility where the applicant 02 completed the first year of internship or residency and a certificate of 03 successful completion of one additional year of postgraduate training at a 04 recognized hospital; 05 (3) submit a list of negotiated settlements or judgments in claims or 06 civil actions alleging medical malpractice against the applicant, including an 07 explanation of the basis for each claim or action; [AND] 08 (4) not have a license to practice medicine in another state, country, 09 province, or territory that is currently suspended or revoked for disciplinary reasons;  10 and  11 (5) receive education in pain management and opioid use and  12 addiction, unless the applicant has demonstrated to the satisfaction of the board  13 that the applicant does not currently hold a valid federal Drug Enforcement  14 Administration registration number; an applicant may include past professional  15 experience or professional education as proof of professional competence. 16  * Sec. 9. AS 08.64.205 is amended to read: 17 Sec. 08.64.205. Qualifications for osteopath applicants. Each osteopath 18 applicant shall meet the qualifications prescribed in AS 08.64.200(a)(3) - (5) 19 [AS 08.64.200(a)(3) AND (4)] and shall 20 (1) submit a certificate of graduation from the legally chartered school 21 of osteopathy approved by the board; 22 (2) submit a certificate from a hospital approved by the American 23 Medical Association or the American Osteopathic Association that certifies that the 24 osteopath has satisfactorily completed and performed the duties of intern or resident 25 physician for 26 (A) one year if the applicant graduated from a school of 27 osteopathy before January 1, 1995, as evidenced by a certificate of completion 28 of the first year of postgraduate training from the facility where the applicant 29 completed the first year of internship or residency; or 30 (B) two years if the applicant graduated from a school of 31 osteopathy on or after January 1, 1995, as evidenced by a certificate of 01 completion of the first year of postgraduate training from the facility where the 02 applicant completed the first year of internship or residency and a certificate of 03 successful completion of one additional year of postgraduate training at a 04 recognized hospital; 05 (3) take the examination required by AS 08.64.210 or be certified to 06 practice by the National Board of Examiners for Osteopathic Physicians and Surgeons 07 or by the National Board of Osteopathic Medical Examiners;  08 (4) receive education in pain management and opioid use and  09 addiction, unless the applicant has demonstrated to the satisfaction of the board  10 that the applicant does not currently hold a valid federal Drug Enforcement  11 Administration registration number; an applicant may include past professional  12 experience or professional education as proof of professional competence. 13  * Sec. 10. AS 08.64.209(a) is amended to read: 14 (a) Each applicant who desires to practice podiatry shall meet the 15 qualifications prescribed in AS 08.64.200(a)(3) - (5) [AS 08.64.200(a)(3) AND (4)] 16 and shall 17 (1) submit a certificate of graduation from a legally chartered school of 18 podiatry approved by the board; 19 (2) take the examination required by AS 08.64.210; the State Medical 20 Board shall call to its aid a podiatrist of known ability who is licensed to practice 21 podiatry to assist in the examination and licensure of applicants for a license to 22 practice podiatry; 23 (3) receive education in pain management and opioid use and  24 addiction, unless the applicant has demonstrated to the satisfaction of the board  25 that the applicant does not currently hold a valid federal Drug Enforcement  26 Administration registration number; an applicant may include past professional  27 experience or professional education as proof of professional competence;  28 (4) meet other qualifications of experience or education which the 29 board may require. 30  * Sec. 11. AS 08.64.225(a) is amended to read: 31 (a) Applicants who are graduates of medical colleges not accredited by the 01 Association of American Medical Colleges and the Council on Medical Education of 02 the American Medical Association shall 03 (1) meet the requirements of AS 08.64.200(a)(3) - (5) 04 [AS 08.64.200(a)(3) AND (4)] and 08.64.255; 05 (2) have successfully completed 06 (A) three years of postgraduate training as evidenced by a 07 certificate of completion of the first year of postgraduate training from the 08 facility where the applicant completed the first year of internship or residency 09 and a certificate of successful completion of two additional years of 10 postgraduate training at a recognized hospital; or 11 (B) other requirements establishing proof of competency and 12 professional qualifications as the board considers necessary to ensure the 13 continued protection of the public adopted at the discretion of the board by 14 regulation, including education in pain management and opioid use and  15 addiction, unless the applicant has demonstrated to the satisfaction of the  16 board that the applicant does not currently hold a valid federal Drug  17 Enforcement Administration registration number; an applicant may  18 include past professional experience or professional education as proof of  19 professional competence; and 20 (3) have passed examinations as specified by the board in regulations. 21  * Sec. 12. AS 08.64.250 is amended to read: 22 Sec. 08.64.250. License by credentials. The board may waive the examination 23 requirement and license by credentials if the physician, osteopath, or podiatry 24 applicant meets the requirements of AS 08.64.200, 08.64.205, or 08.64.209, submits 25 proof of continued competence as required by regulation, pays the required fee, and 26 has 27 (1) an active license from a board of medical examiners established 28 under the laws of a state or territory of the United States or a province or territory of 29 Canada issued after thorough examination; or 30 (2) passed an examination as specified by the board in regulations. 31  * Sec. 13. AS 08.64.250 is amended by adding a new subsection to read: 01 (b) The board shall adopt regulations under (a) of this section that require an 02 applicant demonstrate professional competence in pain management and addiction 03 disorders. An applicant may include past professional experience or professional 04 education as proof of professional competence. 05  * Sec. 14. AS 08.64.312 is amended to read: 06 Sec. 08.64.312. Continuing education requirements. (a) The board shall 07 promote a high degree of competence in the practice of medicine, osteopathy, and  08 podiatry by requiring every licensee of medicine, osteopathy, and podiatry 09 [PHYSICIAN LICENSED] in the state to fulfill continuing education requirements. 10 (b) Before a license may be renewed, the licensee shall submit evidence to the 11 board or its designee that continuing education requirements prescribed by regulations 12 adopted by the board have been met. Continuing education requirements must  13 include not less than two hours of education in pain management and opioid use  14 and addiction in the two years preceding an application for renewal of a license,  15 unless the licensee demonstrates to the satisfaction of the board that the licensee's  16 practice does not include pain management and opioid treatment or prescribing. 17 (c) The board or its designee may exempt a physician, osteopath, or  18 podiatrist from the requirements of (b) of this section upon an application by the 19 physician, osteopath, or podiatrist giving evidence satisfactory to the board or its 20 designee that the physician, osteopath, or podiatrist is unable to comply with the 21 requirements because of extenuating circumstances. However, a person may not be 22 exempted from more than 15 hours of continuing education in a five-year period; a  23 person may not be exempted from the requirement to receive at least two hours  24 of education in pain management and opioid use and addiction unless the person  25 has demonstrated to the satisfaction of the board that the person does not  26 currently hold a valid federal Drug Enforcement Administration registration  27 number. 28  * Sec. 15. AS 08.64.326(a) is amended to read: 29 (a) The board may impose a sanction if the board finds after a hearing that a 30 licensee 31 (1) secured a license through deceit, fraud, or intentional 01 misrepresentation; 02 (2) engaged in deceit, fraud, or intentional misrepresentation while 03 providing professional services or engaging in professional activities; 04 (3) advertised professional services in a false or misleading manner; 05 (4) has been convicted, including conviction based on a guilty plea or 06 plea of nolo contendere, of 07 (A) a class A or unclassified felony or a crime in another 08 jurisdiction with elements similar to a class A or unclassified felony in this 09 jurisdiction; 10 (B) a class B or class C felony or a crime in another jurisdiction 11 with elements similar to a class B or class C felony in this jurisdiction if the 12 felony or other crime is substantially related to the qualifications, functions, or 13 duties of the licensee; or 14 (C) a crime involving the unlawful procurement, sale, 15 prescription, or dispensing of drugs; 16 (5) has procured, sold, prescribed, or dispensed drugs in violation of a 17 law regardless of whether there has been a criminal action or harm to the patient; 18 (6) intentionally or negligently permitted the performance of patient 19 care by persons under the licensee's supervision that does not conform to minimum 20 professional standards even if the patient was not injured; 21 (7) failed to comply with this chapter, a regulation adopted under this 22 chapter, or an order of the board; 23 (8) has demonstrated 24 (A) professional incompetence, gross negligence, or repeated 25 negligent conduct; the board may not base a finding of professional 26 incompetence solely on the basis that a licensee's practice is unconventional or 27 experimental in the absence of demonstrable physical harm to a patient; 28 (B) addiction to, severe dependency on, or habitual overuse of 29 alcohol or other drugs that impairs the licensee's ability to practice safely; 30 (C) unfitness because of physical or mental disability; 31 (9) engaged in unprofessional conduct, in sexual misconduct, or in 01 lewd or immoral conduct in connection with the delivery of professional services to 02 patients; in this paragraph, "sexual misconduct" includes sexual contact, as defined by 03 the board in regulations adopted under this chapter, or attempted sexual contact with a 04 patient outside the scope of generally accepted methods of examination or treatment of 05 the patient, regardless of the patient's consent or lack of consent, during the term of the 06 physician-patient relationship, as defined by the board in regulations adopted under 07 this chapter, unless the patient was the licensee's spouse at the time of the contact or, 08 immediately preceding the physician-patient relationship, was in a dating, courtship, 09 or engagement relationship with the licensee; 10 (10) has violated AS 18.16.010; 11 (11) has violated any code of ethics adopted by regulation by the 12 board; 13 (12) has denied care or treatment to a patient or person seeking 14 assistance from the physician if the only reason for the denial is the failure or refusal 15 of the patient to agree to arbitrate as provided in AS 09.55.535(a); [OR] 16 (13) has had a license or certificate to practice medicine in another 17 state or territory of the United States, or a province or territory of Canada, denied, 18 suspended, revoked, surrendered while under investigation for an alleged violation, 19 restricted, limited, conditioned, or placed on probation unless the denial, suspension, 20 revocation, or other action was caused by the failure of the licensee to pay fees to that 21 state, territory, or province; or  22 (14) prescribed or dispensed an opioid in excess of the maximum  23 dosage authorized under AS 08.64.363. 24  * Sec. 16. AS 08.64 is amended by adding a new section to article 3 to read: 25 Sec. 08.64.363. Maximum dosage for opioid prescriptions. (a) A licensee 26 may not issue 27 (1) an initial prescription for an opioid that exceeds a seven-day supply 28 to an adult patient for outpatient use; 29 (2) a prescription for an opioid that exceeds a seven-day supply to a 30 minor; at the time a licensee writes a prescription for an opioid for a minor, the 31 licensee shall discuss with the parent or guardian of the minor why the prescription is 01 necessary and the risks associated with opioid use. 02 (b) Notwithstanding (a) of this section, a licensee may issue a prescription for 03 an opioid that exceeds a seven-day supply to an adult or minor patient if, in the 04 professional medical judgment of the licensee, more than a seven-day supply of an 05 opioid is necessary for 06 (1) the patient's acute medical condition, chronic pain management, 07 pain associated with cancer, or pain experienced while the patient is in palliative care; 08 the licensee may write a prescription for an opioid for the quantity needed to treat the 09 patient's medical condition, chronic pain, pain associated with cancer, or pain 10 experienced while the patient is in palliative care; the licensee shall document in the 11 patient's medical record the condition triggering the prescription of an opioid in a 12 quantity that exceeds a seven-day supply and indicate that a nonopioid alternative was 13 not appropriate to address the medical condition; 14 (2) a patient who is unable to access a practitioner within the time 15 necessary for a refill of the seven-day supply because of a logistical or travel barrier; 16 the licensee may write a prescription for an opioid for the quantity needed to treat the 17 patient for the time that the patient is unable to access a practitioner; the licensee shall 18 document in the patient's medical record the reason for the prescription of an opioid in 19 a quantity that exceeds a seven-day supply and indicate that a nonopioid alternative 20 was not appropriate to address the medical condition; in this paragraph, "practitioner" 21 has the meaning given in AS 11.71.900; or 22 (3) the treatment of a patient's substance abuse or opioid dependence; 23 the licensee may write a prescription for an opioid approved for the treatment of 24 substance abuse or opioid dependence for the quantity needed to treat the patient's 25 substance abuse or opioid dependence; the licensee shall document in the patient's 26 medical record the reason for the prescription of an opioid approved for the treatment 27 of substance abuse or opioid dependence in a quantity that exceeds a seven-day supply 28 and indicate that a nonopioid alternative was not appropriate for the treatment of 29 substance abuse or opioid dependence. 30 (c) In this section, 31 (1) "adult" means 01 (A) an individual who has reached 18 years of age; or 02 (B) an emancipated minor; 03 (2) "emancipated minor" means a minor whose disabilities have been 04 removed for general purposes under AS 09.55.590; 05 (3) "minor" means a individual under 18 years of age who is not an 06 emancipated minor. 07  * Sec. 17. AS 08.64.364(c) is amended to read: 08 (c) The board may not impose disciplinary sanctions on a physician for 09 prescribing, dispensing, or administering a prescription drug that is a controlled 10 substance or botulinum toxin if the requirements under (a) of this section and  11 AS 08.64.363 are met and the physician prescribes, dispenses, or administers the 12 controlled substance or botulinum toxin when an appropriate licensed health care 13 provider is present with the patient to assist the physician with examination, diagnosis, 14 and treatment. 15  * Sec. 18. AS 08.64.380 is amended by adding a new paragraph to read: 16 (7) "opioid" includes the opium and opiate substances and opium and 17 opiate derivatives listed in AS 11.71.140. 18  * Sec. 19. AS 08.68.100(a), as amended by sec. 10, ch. 25, SLA 2016, is amended to read: 19 (a) The board shall 20 (1) adopt regulations necessary to implement this chapter, including 21 regulations 22 (A) pertaining to practice as an advanced practice registered 23 nurse, including requirements for an advanced practice registered nurse to 24 practice as a certified registered nurse anesthetist, certified clinical nurse 25 specialist, certified nurse practitioner, or certified nurse midwife; regulations  26 for an advanced practice registered nurse who holds a valid federal Drug  27 Enforcement Administration registration number must address training  28 in pain management and opioid use and addiction; 29 (B) necessary to implement AS 08.68.331 - 08.68.336 relating 30 to certified nurse aides in order to protect the health, safety, and welfare of 31 clients served by nurse aides; 01 (C) pertaining to retired nurse status; and 02 (D) establishing criteria for approval of practical nurse 03 education programs that are not accredited by a national nursing accrediting 04 body; 05 (2) approve curricula and adopt standards for basic education programs 06 that prepare persons for licensing under AS 08.68.190; 07 (3) provide for surveys of the basic nursing education programs in the 08 state at the times it considers necessary; 09 (4) approve education programs that meet the requirements of this 10 chapter and of the board, and deny, revoke, or suspend approval of education 11 programs for failure to meet the requirements; 12 (5) examine, license, and renew the licenses of qualified applicants; 13 (6) prescribe requirements for competence before a former registered, 14 advanced practice registered, or licensed practical nurse may resume the practice of 15 nursing under this chapter; 16 (7) define by regulation the qualifications and duties of the executive 17 administrator and delegate authority to the executive administrator that is necessary to 18 conduct board business; 19 (8) develop reasonable and uniform standards for nursing practice; 20 (9) publish advisory opinions regarding whether nursing practice 21 procedures or policies comply with acceptable standards of nursing practice as defined 22 under this chapter; 23 (10) require applicants under this chapter to submit fingerprints and the 24 fees required by the Department of Public Safety under AS 12.62.160 for criminal 25 justice information and a national criminal history record check; the department shall 26 submit the fingerprints and fees to the Department of Public Safety for a report of 27 criminal justice information under AS 12.62 and a national criminal history record 28 check under AS 12.62.400; 29 (11) require that a licensed advanced practice registered nurse 30 [PRACTITIONER] who has a federal Drug Enforcement Administration registration 31 number register with the controlled substance prescription database under 01 AS 17.30.200(o). 02  * Sec. 20. AS 08.68.270 is amended to read: 03 Sec. 08.68.270. Grounds for denial, suspension, or revocation. The board 04 may deny, suspend, or revoke the license of a person who 05 (1) has obtained or attempted to obtain a license to practice nursing by 06 fraud or deceit; 07 (2) has been convicted of a felony or other crime if the felony or other 08 crime is substantially related to the qualifications, functions, or duties of the licensee; 09 (3) habitually abuses alcoholic beverages, or illegally uses controlled 10 substances; 11 (4) has impersonated a registered, advanced practice registered, or 12 practical nurse; 13 (5) has intentionally or negligently engaged in conduct that has 14 resulted in a significant risk to the health or safety of a client or in injury to a client; 15 (6) practices or attempts to practice nursing while afflicted with 16 physical or mental illness, deterioration, or disability that interferes with the 17 individual's performance of nursing functions; 18 (7) is guilty of unprofessional conduct as defined by regulations 19 adopted by the board; 20 (8) has wilfully or repeatedly violated a provision of this chapter or 21 regulations adopted under this chapter or AS 08.01; 22 (9) is professionally incompetent; 23 (10) denies care or treatment to a patient or person seeking assistance 24 if the sole reason for the denial is the failure or refusal of the patient or person seeking 25 assistance to agree to arbitrate as provided in AS 09.55.535(a);  26 (11) has prescribed or dispensed an opioid in excess of the  27 maximum dosage authorized under AS 08.68.705; or  28 (12) has procured, sold, prescribed, or dispensed drugs in violation  29 of a law, regardless of whether there has been a criminal action or harm to the  30 patient. 31  * Sec. 21. AS 08.68.276 is amended to read: 01 Sec. 08.68.276. Continuing competence required. A license to practice 02 nursing may not be renewed unless the nurse has complied with continuing 03 competence requirements established by the board by regulation. The board shall  04 adopt regulations for renewal of a license of an advanced practice registered  05 nurse. The regulations must require that a licensee receive not less than two  06 hours of education in pain management and opioid use and addiction in the two  07 years preceding an application for renewal of a license unless the licensee has  08 demonstrated to the satisfaction of the board that the licensee does not currently  09 hold a valid federal Drug Enforcement Administration registration number. 10  * Sec. 22. AS 08.68 is amended by adding a new section to article 6 to read: 11 Sec. 08.68.705. Maximum dosage for opioid prescriptions. (a) An advanced 12 practice registered nurse may not issue 13 (1) an initial prescription for an opioid that exceeds a seven-day supply 14 to an adult patient for outpatient use; 15 (2) a prescription for an opioid that exceeds a seven-day supply to a 16 minor; at the time an advanced practice registered nurse writes a prescription for an 17 opioid for a minor, the advanced practice registered nurse shall discuss with the parent 18 or guardian of the minor why the prescription is necessary and the risks associated 19 with opioid use. 20 (b) Notwithstanding (a) of this section, an advanced practice registered nurse 21 may issue a prescription for an opioid that exceeds a seven-day supply to an adult or 22 minor patient if, in the professional judgment of the advanced practice registered 23 nurse, more than a seven-day supply of an opioid is necessary for 24 (1) the patient's acute medical condition, chronic pain management, 25 pain associated with cancer, or pain experienced while the patient is in palliative care; 26 the advanced practice registered nurse may write a prescription for an opioid for the 27 quantity needed to treat the patient's medical condition, chronic pain, pain associated 28 with cancer, or pain experienced while the patient is in palliative care; the advanced 29 practice registered nurse shall document in the patient's medical record the condition 30 triggering the prescription of an opioid in a quantity that exceeds a seven-day supply 31 and indicate that a nonopioid alternative was not appropriate to address the medical 01 condition; or 02 (2) a patient who is unable to access a practitioner within the time 03 necessary for a refill of the seven-day supply because of a logistical or travel barrier; 04 the advanced practice registered nurse may write a prescription for an opioid for the 05 quantity needed to treat the patient for the time that the patient is unable to access a 06 practitioner; the advanced practice registered nurse shall document in the patient's 07 medical record the reason for the prescription of an opioid in a quantity that exceeds a 08 seven-day supply and indicate that a nonopioid alternative was not appropriate to 09 address the medical condition; in this paragraph, "practitioner" has the meaning given 10 in AS 11.71.900. 11 (c) This section does not authorize an advanced practice registered nurse to 12 prescribe a controlled substance if the advanced practice registered nurse is not 13 otherwise authorized to prescribe a controlled substance under policies, procedures, or 14 regulations issued or adopted by the board. 15 (d) In this section, 16 (1) "adult" means 17 (A) an individual who has reached 18 years of age; or 18 (B) an emancipated minor; 19 (2) "emancipated minor" means a minor whose disabilities have been 20 removed for general purposes under AS 09.55.590; 21 (3) "minor" means an individual under 18 years of age who is not an 22 emancipated minor. 23  * Sec. 23. AS 08.68.850 is amended by adding a new paragraph to read: 24 (12) "opioid" includes the opium and opiate substances and opium and 25 opiate derivatives listed in AS 11.71.140. 26  * Sec. 24. AS 08.72.140 is amended to read: 27 Sec. 08.72.140. Qualifications for licensure. An applicant for licensure as an 28 optometrist 29 (1) shall be a graduate of a school or college of optometry recognized 30 by the board; 31 (2) may not have committed an act in any jurisdiction that would have 01 constituted a violation of this chapter or regulations adopted under this chapter at the 02 time the act was committed; 03 (3) may not have been disciplined by an optometry licensing entity in 04 another jurisdiction and may not be the subject of a pending disciplinary proceeding 05 conducted by an optometry licensing entity in another jurisdiction; however, the board 06 may consider the disciplinary action and, in the board's discretion, determine if the 07 person is qualified for licensure; 08 (4) shall have successfully completed 09 (A) the written and practical portions of an examination on 10 ocular pharmacology approved by the board that tests the licensee's or 11 applicant's knowledge of the characteristics, pharmacological effects, 12 indications, contraindications, and emergency care associated with the 13 prescription and use of pharmaceutical agents; 14 (B) a nontopical therapeutic pharmaceutical agent course of at 15 least 23 hours approved by the board or an examination approved by the board 16 on the treatment and management of ocular disease; and 17 (C) an optometry and nontopical therapeutic pharmaceutical 18 agent injection course of at least seven hours approved by the board or 19 equivalent training acceptable to the board; and 20 (5) shall meet other qualifications for licensure as established under 21 this chapter and regulations adopted by the board under AS 08.72.050; the  22 regulations must include qualifications for licensees who hold a valid federal  23 Drug Enforcement Administration registration number that address training in  24 pain management and opioid use and addiction. 25  * Sec. 25. AS 08.72.170 is amended to read: 26 Sec. 08.72.170. Licensure by credentials. The board shall issue a license by 27 credentials to an applicant who 28 (1) is a graduate of a school or college of optometry recognized by the 29 board; 30 (2) has passed a written examination approved by the board that is 31 designed to test the applicant's knowledge of the laws of Alaska governing the practice 01 of optometry and the regulations adopted under those laws; 02 (3) holds a current license to practice optometry in another state or 03 territory of the United States or in a province of Canada that has licensure 04 requirements that the board determines are equivalent to those established under this 05 chapter; 06 (4) at some time in the past, received a license to practice optometry 07 from another state or territory of the United States or from a province of Canada that 08 required the person to have passed the National Board of Examiners in Optometry 09 examination to qualify for licensure; 10 (5) was engaged in the active licensed clinical practice of optometry in 11 a state or territory of the United States or in a province of Canada for at least 3,120 12 hours during the 36 months preceding the date of application under this section; 13 (6) has not committed an act in any jurisdiction that would have 14 constituted a violation of this chapter or regulations adopted under this chapter at the 15 time the act was committed; [AND] 16 (7) has not been disciplined by an optometry licensing entity in another 17 jurisdiction and is not the subject of a pending disciplinary proceeding conducted by 18 an optometry licensing entity in another jurisdiction; however, the board may consider 19 the disciplinary action and, in the board's discretion, determine whether [IF] the 20 person is qualified for licensure; and  21 (8) has received education in pain management and opioid use and  22 addiction adequate for the practice of optometry, unless the applicant has  23 demonstrated to the satisfaction of the board that the applicant does not  24 currently hold a valid federal Drug Enforcement Administration registration  25 number; an applicant may include past professional experience or professional  26 education as proof of professional competence. 27  * Sec. 26. AS 08.72.181(d) is amended to read: 28 (d) Before a license may be renewed, the licensee shall submit to the board 29 evidence that, in the four years preceding the application for renewal, the licensee has 30 (1) completed eight hours of continuing education, approved by the 31 board, concerning the use and prescription of pharmaceutical agents; 01 (2) completed seven hours of continuing education, approved by the 02 board, concerning the injection of nontopical therapeutic pharmaceutical agents; 03 [AND] 04 (3) completed at least two hours of education in pain management  05 and opioid use and addiction, unless the applicant has demonstrated to the  06 satisfaction of the board that the applicant does not currently hold a valid federal  07 Drug Enforcement Administration registration number; and 08 (4) met other continuing education requirements as may be prescribed 09 by regulations of the board to ensure the continued protection of the public. 10  * Sec. 27. AS 08.72.240 is amended to read: 11 Sec. 08.72.240. Grounds for imposition of disciplinary sanctions. The board 12 may impose disciplinary sanctions when the board finds after a hearing that a licensee 13 (1) secured a license through deceit, fraud, or intentional 14 misrepresentation; 15 (2) engaged in deceit, fraud, or intentional misrepresentation in the 16 course of providing professional services or engaging in professional activities; 17 (3) advertised professional services in a false or misleading manner; 18 (4) has been convicted of a felony or other crime that [WHICH] 19 affects the licensee's ability to continue to practice competently and safely; 20 (5) intentionally or negligently engaged in or permitted the 21 performance of patient care by persons under the licensee's supervision that [WHICH] 22 does not conform to minimum professional standards regardless of whether actual 23 injury to the patient occurred; 24 (6) failed to comply with this chapter, with a regulation adopted under 25 this chapter, or with an order of the board; 26 (7) continued to practice after becoming unfit due to 27 (A) professional incompetence; 28 (B) failure to keep informed of or use current professional 29 theories or practices; 30 (C) addiction or severe dependency on alcohol or other drugs 31 that [WHICH] impairs the licensee's ability to practice safely; 01 (D) physical or mental disability; 02 (8) engaged in lewd or immoral conduct in connection with the 03 delivery of professional service to patients; 04 (9) failed to refer a patient to a physician after ascertaining the 05 presence of ocular or systemic conditions requiring management by a physician;  06 (10) procured, sold, prescribed, or dispensed drugs in violation of  07 a law, regardless of whether there has been a criminal action or harm to the  08 patient. 09  * Sec. 28. AS 08.80.030(b), as amended by sec. 12, ch. 25, SLA 2016, is amended to read: 10 (b) In order to fulfill its responsibilities, the board has the powers necessary 11 for implementation and enforcement of this chapter, including the power to 12 (1) elect a president and secretary from its membership and adopt rules 13 for the conduct of its business; 14 (2) license by examination or by license transfer the applicants who are 15 qualified to engage in the practice of pharmacy; 16 (3) assist the department in inspections and investigations for 17 violations of this chapter, or of any other state or federal statute relating to the practice 18 of pharmacy; 19 (4) adopt regulations to carry out the purposes of this chapter; 20 (5) establish and enforce compliance with professional standards and 21 rules of conduct for pharmacists engaged in the practice of pharmacy; 22 (6) determine standards for recognition and approval of degree 23 programs of schools and colleges of pharmacy whose graduates shall be eligible for 24 licensure in this state, including the specification and enforcement of requirements for 25 practical training, including internships; 26 (7) establish for pharmacists and pharmacies minimum specifications 27 for the physical facilities, technical equipment, personnel, and procedures for the 28 storage, compounding, and dispensing of drugs or related devices, and for the 29 monitoring of drug therapy; 30 (8) enforce the provisions of this chapter relating to the conduct or 31 competence of pharmacists practicing in the state, and the suspension, revocation, or 01 restriction of licenses to engage in the practice of pharmacy; 02 (9) license and regulate the training, qualifications, and employment of 03 pharmacy interns and pharmacy technicians; 04 (10) issue licenses to persons engaged in the manufacture and 05 distribution of drugs and related devices; 06 (11) establish and maintain a controlled substance prescription 07 database as provided in AS 17.30.200; 08 (12) establish standards for the independent administration by a 09 pharmacist of vaccines and related emergency medications under AS 08.80.168, 10 including the completion of an immunization training program approved by the board; 11 (13) establish standards for the independent dispensing by a 12 pharmacist of an opioid overdose drug under AS 17.20.085, including the completion 13 of an opioid overdose training program approved by the board; 14 (14) require that a licensed pharmacist [WHO HAS A FEDERAL 15 DRUG ENFORCEMENT ADMINISTRATION REGISTRATION NUMBER] 16 register with the controlled substance prescription database under AS 17.30.200(o). 17  * Sec. 29. AS 08.80 is amended by adding a new section to article 3 to read: 18 Sec. 08.80.345. Prescription for an opioid; voluntary request for lesser  19 quantity. (a) A pharmacist filling a prescription for an opioid that is a schedule II or 20 III controlled substance under federal law may, at the request of the individual for 21 whom the prescription is written, dispense the prescribed opioid in a lesser quantity 22 than prescribed. 23 (b) Nothing in this section shall be construed to prevent substitution of an 24 equivalent drug under AS 08.80.295. 25  * Sec. 30. AS 08.98.050(a) is amended to read: 26 (a) The board shall 27 (1) establish examination requirements for eligible applicants for 28 licensure to practice veterinary medicine; 29 (2) examine, or cause to be examined, eligible applicants for licensure 30 or registration; 31 (3) approve the issuance of licenses and student permits to qualified 01 applicants; 02 (4) establish standards for the practice of veterinary medicine by 03 regulation; 04 (5) conduct disciplinary proceedings in accordance with this chapter; 05 (6) adopt regulations requiring proof of continued competency before a 06 license is renewed; 07 (7) as requested by the department, monitor the standards and 08 availability of veterinary services provided in the state and report its findings to the 09 department; 10 (8) collect, or cause to be collected, data concerning the practice of 11 veterinary technology by veterinary technicians in the state and submit the data to the 12 department for maintenance; 13 (9) establish, by regulation, educational and training requirements for 14 (A) the issuance of student permits; and 15 (B) the delegation of duties by veterinarians licensed under this 16 chapter to veterinary technicians;  17 (10) require that a licensee who has a federal Drug Enforcement  18 Administration registration number register with the controlled substance  19 prescription database under AS 17.30.200(o);  20 (11) identify resources and develop educational materials to assist  21 licensees to identify an animal owner who may be at risk for abusing or misusing  22 an opioid. 23  * Sec. 31. AS 08.98.235 is amended to read: 24 Sec. 08.98.235. Grounds for imposition of disciplinary sanctions. After a 25 hearing, the board may impose a disciplinary sanction on a person licensed under this 26 chapter when the board finds that the person 27 (1) secured a license through deceit, fraud, or intentional 28 misrepresentation; 29 (2) engaged in deceit, fraud, or intentional misrepresentation in the 30 course of providing professional services or engaging in professional activities; 31 (3) advertised professional services in a false or misleading manner; 01 (4) has been convicted of a felony or other crime which affects the 02 person's ability to continue to practice competently and safely; 03 (5) intentionally or negligently engaged in or permitted the 04 performance of animal care by the person's supervisees which does not conform to 05 minimum professional standards regardless of whether actual injury to the animal 06 occurred; 07 (6) failed to comply with this chapter, with a regulation adopted under 08 this chapter, or with an order of the board; 09 (7) continued to practice after becoming unfit due to 10 (A) professional incompetence; 11 (B) addiction or severe dependency on alcohol or other drugs 12 which impairs the person's ability to practice safely; 13 (C) physical or mental disability; 14 (8) engaged in lewd or immoral conduct in connection with the 15 delivery of professional service;  16 (9) procured, sold, prescribed, or dispensed drugs in violation of a  17 law, regardless of whether there has been a criminal action. 18  * Sec. 32. AS 13 is amended by adding a new chapter to read: 19 Chapter 55. Voluntary Nonopioid Directive Act.  20 Sec. 13.55.010. Nonopioid directive; revocation; other requirements. (a) 21 An individual who is 18 years of age or older or an emancipated minor, a parent or 22 legal guardian of a minor, or an individual's guardian or other person appointed by the 23 individual or a court to manage the individual's health care may execute a voluntary 24 nonopioid directive stating that an opioid may not be administered or prescribed to the 25 individual or the minor. The directive must be in a format prescribed by the 26 department and available in an electronic format. 27 (b) The commissioner of health and social services shall adopt regulations to 28 implement this chapter. The regulations must 29 (1) include verification by a health care provider and comply with the 30 written consent requirements under 42 U.S.C. 290dd-2(b); 31 (2) provide standard procedures for an individual, a parent or legal 01 guardian of a minor, or an individual's guardian or other person appointed by the 02 individual or a court to manage the individual's health care to submit a voluntary 03 nonopioid directive to a health care provider or hospital; 04 (3) include appropriate exemptions for emergency medical personnel; 05 (4) ensure the confidentiality of a voluntary nonopioid directive; 06 (5) ensure exemptions for an opioid used for treatment of substance 07 abuse or opioid dependence. 08 (c) An individual who is 18 years of age or older or an emancipated minor, a 09 parent or legal guardian of a minor, or an individual's guardian or other person 10 appointed by the individual or a court to manage the individual's health care may 11 revoke a voluntary nonopioid directive at any time in writing or orally. 12 (d) An individual, a parent or legal guardian of a minor, or an individual's 13 guardian or other person appointed by the individual or a court to manage the 14 individual's health care may submit a voluntary nonopioid directive to a health care 15 provider or a hospital. 16 Sec. 13.55.020. Obligations of health care providers and hospitals. A health 17 care provider, a hospital, or an employee of a health care provider or hospital may not 18 be subject to disciplinary action by the health care provider's or the employee's 19 professional licensing board or held civilly or criminally liable for failure to 20 administer, prescribe, or dispense an opioid, or for inadvertent administration of an 21 opioid, to an individual or a minor who has a voluntary nonopioid directive. 22 Sec. 13.55.030. Prescriptions presumed valid. A prescription presented to a 23 pharmacy is presumed to be valid, and a pharmacist may not be subject to disciplinary 24 action by the pharmacist's professional licensing board or held civilly or criminally 25 liable for dispensing an opioid in contradiction to an individual's or a minor's 26 voluntary nonopioid directive. 27 Sec. 13.55.040. Effect of this chapter. Nothing in this chapter shall be 28 construed to  29 (1) alter an advance health care directive under AS 13.52 (Health Care 30 Decisions Act); 31 (2) limit the prescribing, dispensing, or administering of an opioid 01 overdose drug; 02 (3) limit an authorized health care provider or pharmacist from 03 prescribing, dispensing, or administering an opioid for the treatment of substance 04 abuse or opioid dependence. 05 Sec. 13.55.100. Definitions. In this chapter, unless the context otherwise 06 requires, 07 (1) "department" means the Department of Health and Social Services; 08 (2) "emancipated minor" means a minor whose disabilities have been 09 removed for general purposes under AS 09.55.590; 10 (3) "health care provider" has the meaning given in AS 09.65.340; 11 (4) "hospital" has the meaning given in AS 13.52.268; 12 (5) "minor" means an individual under 18 years of age who is not an 13 emancipated minor; 14 (6) "opioid" includes the opium and opiate substances and opium and 15 opiate derivatives listed in AS 11.71.140; 16 (7) "opioid overdose drug" has the meaning given in AS 09.65.340. 17 Sec. 13.55.110. Short title. This chapter may be known as the Voluntary 18 Nonopioid Directive Act. 19  * Sec. 33. AS 17.30.200(a), as amended by sec. 21, ch. 25, SLA 2016, is amended to read: 20 (a) The controlled substance prescription database is established in the Board 21 of Pharmacy. The purpose of the database is to contain data as described in this 22 section regarding every prescription for a schedule II, III, or IV controlled substance 23 under federal law dispensed in the state to a person other than under the  24 circumstances described in (u) of this section [THOSE ADMINISTERED TO A 25 PATIENT AT A HEALTH CARE FACILITY]. 26  * Sec. 34. AS 17.30.200(b), as amended by sec. 23, ch. 25, SLA 2016, is amended to read: 27 (b) The pharmacist-in-charge of each licensed or registered pharmacy, 28 regarding each schedule II, III, or IV controlled substance under federal law dispensed 29 by a pharmacist under the supervision of the pharmacist-in-charge, and each 30 practitioner who directly dispenses a schedule II, III, or IV controlled substance under 31 federal law other than those dispensed or administered under the circumstances  01 described in (u) of this section [ADMINISTERED TO A PATIENT AT A HEALTH 02 CARE FACILITY], shall submit to the board, by a procedure and in a format 03 established by the board, the following information for inclusion in the database on at 04 least a weekly basis: 05 (1) the name of the prescribing practitioner and the practitioner's 06 federal Drug Enforcement Administration registration number or other appropriate 07 identifier; 08 (2) the date of the prescription; 09 (3) the date the prescription was filled and the method of payment; this 10 paragraph does not authorize the board to include individual credit card or other 11 account numbers in the database; 12 (4) the name, address, and date of birth of the person for whom the 13 prescription was written; 14 (5) the name and national drug code of the controlled substance; 15 (6) the quantity and strength of the controlled substance dispensed; 16 (7) the name of the drug outlet dispensing the controlled substance; 17 and 18 (8) the name of the pharmacist or practitioner dispensing the controlled 19 substance and other appropriate identifying information. 20  * Sec. 35. AS 17.30.200(b), as amended by sec. 34 of this Act, is amended to read: 21 (b) The pharmacist-in-charge of each licensed or registered pharmacy, 22 regarding each schedule II, III, or IV controlled substance under federal law dispensed 23 by a pharmacist under the supervision of the pharmacist-in-charge, and each 24 practitioner who directly dispenses a schedule II, III, or IV controlled substance under 25 federal law other than those dispensed or administered under the circumstances 26 described in (u) of this section, shall submit to the board, by a procedure and in a 27 format established by the board, the following information for inclusion in the 28 database on at least a daily [WEEKLY] basis: 29 (1) the name of the prescribing practitioner and the practitioner's 30 federal Drug Enforcement Administration registration number or other appropriate 31 identifier; 01 (2) the date of the prescription; 02 (3) the date the prescription was filled and the method of payment; this 03 paragraph does not authorize the board to include individual credit card or other 04 account numbers in the database; 05 (4) the name, address, and date of birth of the person for whom the 06 prescription was written; 07 (5) the name and national drug code of the controlled substance; 08 (6) the quantity and strength of the controlled substance dispensed; 09 (7) the name of the drug outlet dispensing the controlled substance; 10 and 11 (8) the name of the pharmacist or practitioner dispensing the controlled 12 substance and other appropriate identifying information. 13  * Sec. 36. AS 17.30.200(d), as amended by sec. 25, ch. 25, SLA 2016, is amended to read: 14 (d) The database and the information contained within the database are 15 confidential, are not public records, and are not subject to public disclosure [, AND 16 MAY NOT BE SHARED WITH THE FEDERAL GOVERNMENT]. The board shall 17 undertake to ensure the security and confidentiality of the database and the 18 information contained within the database. The board may allow access to the 19 database only to the following persons, and in accordance with the limitations 20 provided and regulations of the board: 21 (1) personnel of the board regarding inquiries concerning licensees or 22 registrants of the board or personnel of another board or agency concerning a 23 practitioner under a search warrant, subpoena, or order issued by an administrative law 24 judge or a court; 25 (2) authorized board personnel or contractors as required for 26 operational and review purposes; 27 (3) a licensed practitioner having authority to prescribe controlled 28 substances or an agent or employee of the practitioner whom the practitioner has 29 authorized to access the database on the practitioner's behalf, to the extent the 30 information relates specifically to a current patient of the practitioner to whom the 31 practitioner is prescribing or considering prescribing a controlled substance; the agent 01 or employee must be licensed or registered under AS 08; 02 (4) a licensed or registered pharmacist having authority to dispense 03 controlled substances or an agent or employee of the pharmacist whom the pharmacist 04 has authorized to access the database on the pharmacist's behalf, to the extent the 05 information relates specifically to a current patient to whom the pharmacist is 06 dispensing or considering dispensing a controlled substance; the agent or employee 07 must be licensed or registered under AS 08; 08 (5) federal, state, and local law enforcement authorities may receive 09 printouts of information contained in the database under a search warrant or order 10 issued by a court establishing probable cause for the access and use of the information; 11 (6) an individual who is the recipient of a controlled substance 12 prescription entered into the database may receive information contained in the 13 database concerning the individual on providing evidence satisfactory to the board that 14 the individual requesting the information is in fact the person about whom the data 15 entry was made and on payment of a fee set by the board under AS 37.10.050 that 16 does not exceed $10; 17 (7) a licensed pharmacist employed by the Department of Health and 18 Social Services who is responsible for administering prescription drug coverage for 19 the medical assistance program under AS 47.07, to the extent that the information 20 relates specifically to prescription drug coverage under the program; 21 (8) a licensed pharmacist, licensed practitioner, or authorized 22 employee of the Department of Health and Social Services responsible for utilization 23 review of prescription drugs for the medical assistance program under AS 47.07, to the 24 extent that the information relates specifically to utilization review of prescription 25 drugs provided to recipients of medical assistance; 26 (9) the state medical examiner, to the extent that the information 27 relates specifically to investigating the cause and manner of a person's death; 28 (10) an authorized employee of the Department of Health and Social 29 Services may receive information from the database that does not disclose the identity 30 of a patient, prescriber, dispenser, or dispenser location, for the purpose of identifying 31 and monitoring public health issues in the state; however, the information provided 01 under this paragraph may include the region of the state in which a patient, prescriber, 02 and dispenser are located and the specialty of the prescriber; and 03 (11) a practitioner, pharmacist, or clinical staff employed by an Alaska 04 tribal health organization, including commissioned corps officers of the United States 05 Public Health Service employed under a memorandum of agreement; in this 06 paragraph, "Alaska tribal health organization" has the meaning given to "tribal health 07 program" in 25 U.S.C. 1603. 08  * Sec. 37. AS 17.30.200(e), as amended by sec. 27, ch. 25, SLA 2016, is amended to read: 09 (e) The failure of a pharmacist-in-charge or a [,] pharmacist [, OR 10 PRACTITIONER] to register or submit information to the database as required under 11 this section is grounds for the board to take disciplinary action against the license or 12 registration of the pharmacy or pharmacist. The failure of a practitioner to register  13 or review the database as required under this section is grounds for the  14 practitioner's [OR FOR ANOTHER] licensing board to take disciplinary action 15 against the [A] practitioner. 16  * Sec. 38. AS 17.30.200(p), enacted by sec. 34, ch. 25, SLA 2016, is amended to read: 17 (p) The board shall promptly notify the State Medical Board, the Board of 18 Nursing, the Board of Dental Examiners, [AND] the Board of Examiners in 19 Optometry, and the Board of Veterinary Examiners when a practitioner registers 20 with the database under (o) of this section. 21  * Sec. 39. AS 17.30.200(q), enacted by sec. 34, ch. 25, SLA 2016, is amended to read: 22 (q) The board is authorized to provide unsolicited notification to a pharmacist,  23 practitioner's licensing board, or practitioner if a patient has received one or more 24 prescriptions for controlled substances in quantities or with a frequency inconsistent 25 with generally recognized standards of safe practice. An unsolicited notification to a  26 practitioner's licensing board under this section  27 (1) must be provided to the practitioner;  28 (2) is confidential;  29 (3) may not disclose information that is confidential under this  30 section;  31 (4) may be in a summary form sufficient to provide notice of the  01 basis for the unsolicited notification.  02  * Sec. 40. AS 17.30.200(r), enacted by sec. 34, ch. 25, SLA 2016, is amended to read: 03 (r) The board shall update the database on at least a daily [WEEKLY] basis 04 with the information submitted to the board under (b) of this section. 05  * Sec. 41. AS 17.30.200(n) is amended by adding a new paragraph to read: 06 (5) "opioid" includes the opium and opiate substances and opium and 07 opiate derivatives listed in AS 11.71.140. 08  * Sec. 42. AS 17.30.200 is amended by adding new subsections to read: 09 (t) Notwithstanding (q) of this section, the board may issue to a practitioner 10 periodic unsolicited reports that detail and compare the practitioner's opioid 11 prescribing practice with other practitioners of the same occupation and similar 12 specialty. A report issued under this subsection is confidential and the board shall 13 issue the report only to a practitioner. The board may adopt regulations to implement 14 this subsection. The regulations may address the types of controlled substances to be 15 included in an unsolicited report, the quantities dispensed, the medication strength, 16 and other factors determined by the board. 17 (u) A practitioner or a pharmacist is not required to comply with the 18 requirements of (a) and (b) of this section if a controlled substance is 19 (1) administered to a patient at 20 (A) a health care facility; or 21 (B) a correctional facility; 22 (2) dispensed to a patient for an outpatient supply of 24 hours or less at 23 a hospital 24 (A) inpatient pharmacy; or 25 (B) emergency department. 26  * Sec. 43. AS 18.05.040(a) is amended to read: 27 (a) The commissioner shall adopt regulations consistent with existing law for 28 (1) the time, manner, information to be reported, and persons 29 responsible for reporting for each disease or other condition of public health 30 importance on the list developed under AS 18.15.370; 31 (2) cooperation with local boards of health and health officers; 01 (3) protection and promotion of the public health and prevention of 02 disability and mortality; 03 (4) the transportation of dead bodies, except that the commissioner 04 may not require that a dead body be embalmed unless the body is known to carry a 05 communicable disease or embalmment is otherwise required for the protection of the 06 public health or for compliance with federal law; 07 (5) carrying out the purposes of this chapter; 08 (6) the conduct of its business and for carrying out the provisions of 09 laws of the United States and the state relating to public health; 10 (7) establishing the divisions and local offices and advisory groups 11 necessary or considered expedient to carry out or assist in carrying out a duty or power 12 assigned to it; 13 (8) the voluntary certification of laboratories to perform diagnostic, 14 quality control, or enforcement analyses or examinations based on recognized or 15 tentative standards of performance relating to analysis and examination of food, 16 including seafood, milk, water, and specimens from human beings submitted by 17 licensed physicians and nurses for analysis; 18 (9) the regulation of quality and purity of commercially compressed 19 oxygen sold for human respiration; 20 (10) establishing confidentiality and security standards for information 21 and records received under AS 18.15.355 - 18.15.395;  22 (11) implementation of AS 13.55 (Voluntary Nonopioid Directive  23 Act). 24  * Sec. 44. Sections 22, 24, 26, 28, 30, 32, 52, and 73, ch. 25, SLA 2016, are repealed. 25  * Sec. 45. The uncodified law of the State of Alaska is amended by adding a new section to 26 read: 27 TRANSITION: REGULATIONS. (a) The Department of Health and Social Services 28 may adopt regulations necessary to implement the changes made by secs. 32 and 43 of this 29 Act. The regulations take effect under AS 44.62 (Administrative Procedure Act), but not 30 before the effective date of the relevant provision of this Act implemented by the regulation. 31 (b) The Department of Commerce, Community, and Economic Development and a 01 board that regulates an occupation that includes a practitioner required to register with the 02 controlled substance prescription database under AS 17.30.200 shall adopt regulations to 03 implement the changes made by AS 17.30.200(b), as amended by sec. 35 of this Act, and 04 AS 17.30.200(r), as amended by sec. 40 of this Act. The regulations take effect under 05 AS 44.62 (Administrative Procedure Act), but not before the effective date of the relevant 06 provision of secs. 35 and 40 of this Act implemented by the regulation. In this subsection, 07 (1) "board" has the meaning given in AS 08.01.110; 08 (2) "occupation" has the meaning given in AS 08.01.110; 09 (3) "practitioner" has the meaning given in AS 11.71.900. 10 (c) The Board of Dental Examiners may adopt regulations necessary to implement the 11 changes made by secs. 2 and 3 of this Act. The regulations take effect under AS 44.62 12 (Administrative Procedure Act), but not before the effective date of the relevant provision of 13 secs. 2 and 3 of this Act implemented by the regulation. 14 (d) The State Medical Board may adopt regulations necessary to implement the 15 changes made by secs. 7 - 14 of this Act. The regulations take effect under AS 44.62 16 (Administrative Procedure Act), but not before the effective date of the relevant provision of 17 secs. 7 - 14 of this Act implemented by the regulation. 18 (e) The Board of Nursing may adopt regulations necessary to implement the changes 19 made by secs. 19 and 21 of this Act. The regulations take effect under AS 44.62 20 (Administrative Procedure Act), but not before the effective date of the relevant provision of 21 secs. 19 and 21 of this Act implemented by the regulation. 22 (f) The Board of Examiners in Optometry may adopt regulations necessary to 23 implement the changes made by secs. 24 - 26 of this Act. The regulations take effect under 24 AS 44.62 (Administrative Procedure Act), but not before the effective date of the relevant 25 provision of secs. 24 - 26 of this Act implemented by the regulation. 26  * Sec. 46. Section 28 of this Act takes effect on the effective date of sec. 12, ch. 25, SLA 27 2016. 28  * Sec. 47. Section 33 of this Act takes effect on the effective date of sec. 21, ch. 25, SLA 29 2016. 30  * Sec. 48. Section 34 of this Act takes effect on the effective date of sec. 23, ch. 25, SLA 31 2016. 01  * Sec. 49. Section 36 of this Act takes effect on the effective date of sec. 25, ch. 25, SLA 02 2016. 03  * Sec. 50. Section 37 of this Act takes effect on the effective date of sec. 27, ch. 25, SLA 04 2016. 05  * Sec. 51. Sections 38 and 39 of this Act take effect on the effective date of sec. 34, ch. 25, 06 SLA 2016. 07  * Sec. 52. Section 42 of this Act takes effect on the effective date of secs. 21 and 23, ch. 25, 08 SLA 2016. 09  * Sec. 53. Sections 2, 3, 7 - 14, 19, 21, 24 - 26, 35, and 40 of this Act take effect July 1, 10 2018. 11  * Sec. 54. Sections 32 and 43 of this Act take effect July 1, 2019. 12  * Sec. 55. Except as provided in secs. 46 - 54 of this Act, this Act takes effect immediately 13 under AS 01.10.070(c).