Legislature(2023 - 2024)BELTZ 105 (TSBldg)
04/10/2023 01:30 PM Senate LABOR & COMMERCE
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| Audio | Topic |
|---|---|
| Start | |
| SB70 | |
| HB56 | |
| HB51 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SB 73 | TELECONFERENCED | |
| += | SB 70 | TELECONFERENCED | |
| *+ | HB 51 | TELECONFERENCED | |
| *+ | HB 56 | TELECONFERENCED | |
HB 56-CONTROLLED SUB. DATA: EXEMPT ANIMAL RX
2:09:14 PM
CHAIR BJORKMAN reconvened the meeting and announced the
consideration of HOUSE BILL NO. 56 "An Act exempting controlled
substances prescribed or dispensed by a veterinarian to treat an
animal from the requirements of the controlled substance
prescription database."
He noted that the companion bill, SB 51, was heard on March 24,
2023 and held in committee.
2:10:28 PM
REPRESENTATIVE JUSTIN RUFFRIDGE, District 7, Alaska State
Legislature, Juneau, Alaska, sponsor of HB 56, stated that he
became aware of this bill while serving as chair of the Board of
Pharmacy. The Veterinary Medical Association approached the
Board of Pharmacy to look into issues underlying the
Prescription Drug Monitoring Program (PDMP) and how that aligned
with veterinary use of that program. He said medical providers,
particularly those with the Alaska State Medical Association,
are at least neutral to HB 56 for a couple reasons:
1. Veterinarians do not use opioids very much as a dispenser.
They use opiates inside their clinics and sometimes during
surgery, but are not high users of opiate medications. Drugs of
abuse are not dispensed out of veterinary practices with any
regularity. In fact, less than .34 percent of all opiates
dispensed nationwide come through a veterinary practice.
2. The main reason for supporting HB 56 is the issue of privacy.
The veterinarian is required to query the Prescription Drug
Monitoring Program and look up the pet owners data if a
controlled substance is to be used in the animal's care to
determine if a veterinary prescription is appropriate.
Veterinarians are not trained in human medication and do not
spend any time learning about human medication. Human data is
not relevant to making a decision about dispensing a
prescription to a pet. Being required to access this database,
gives veterinarians access to human information that they do not
need.
REPRESENTATIVE RUFFRIDGE opined that imposing the PDMP
requirements on veterinarians was an oversight in the state's
haste to solve some of the problems with the current opiate
crisis. He said he and others who signed on as co-sponsors do
not believe that HB 56 would worsen the opiate crisis. He
reminded the committee that they heard the companion bill
earlier in the session, and noted that two local veterinarians
were available to deliver a brief presentation.
2:14:18 PM
SENATOR GRAY-JACKSON asked whether there was any difference
between HB 56 and the similar bill proposed last year.
REPRESENTATIVE RUFFRIDGE answered that they are the same.
2:14:52 PM
SENATOR DUNBAR asked whether this presentation was different
from the one that the committee heard when they considered the
companion bill.
REPRESENTATIVE RUFFRIDGE answered that he didn't know because he
was not part of the earlier presentation.
SENATOR DUNBAR stated that he supported the bill before and
supports it now, and didnt need to hear it again.
2:15:41 PM
SENATOR MERRICK asked why the effective dates differ between the
House and Senate versions of the bill.
REPRESENTATIVE RUFFRIDGE answered there wasn't a reason.
CHAIR BJORKMAN invited Dr. Berngartt and Dr. Ward to begin the
presentation.
2:17:15 PM
TRACY WARD, DMV, Past President, Alaska State Veterinary Medical
Association, Juneau, Alaska, presented the slideshow to exempt
veterinarians from the Prescription Drug Monitoring Program, in
support of HB 56. She stated this is the same slideshow
presented previously and if everyone is comfortable, they could
skip the presentation and go straight to questions.
CHAIR BJORKMAN said it would be helpful to hear the
presentation, why the bill is important to veterinarians
statewide, how this bill simplifies processes and makes
veterinarian businesses run better, and how it protects the
private medical information of people who happen to own pets and
want them to be treated.
DR. WARD began the presentation on slides 2 and 3. She read the
following:
HB 56: AN ACT EXEMPTING VETERINARIANS FROM THE
REQUIREMENTS OF THE CONTROLLED SUBSTANCE PRESCRIPTION
DATABASE.
THE ALASKA STATE VETERINARY MEDICAL ASSOCIATION
(AKVMA) SUPPORTS HB 56.
THE ALASKA BOARD OF VETERINARY EXAMINERS (BOVE)
SUPPORTS HB 56.
THE ALASKA BOARD OF PHARMACY
SUPPORTS
EXEMPTING VETERINARIANS FROM PARTICIPATING IN THE PDMP
3 2.18.2022 Board of Pharmacy Meeting Voted and Passed
Motion to Support
DR. WARD advanced to slide 4 and paraphrased the following:
Background: The PDMP.
2008: Alaska's PDMP established by SB 196.
2017: In reaction to growing opioid epidemic, the PDMP
was amended by via HB 159 to include all DEA permit
holders, including veterinarians.
Neither AKVMA nor BOVE were consulted regarding this
amendment.
PDMP reporting is required for all actively licensed
practitioners who hold a Federal Drug Enforcement
Agency registration number and who prescribe,
administer, or dispense federally scheduled II IV
controlled substances in the state.
DR. WARD reviewed slide 5:
Why it Makes Sense to Exempt:
The PDMP is not an effective database for
veterinarians or our patients.
• The PDMP was established for human medicine.
Querying of PDMP data for animals is not possible
with the PDMP (and reported drugs for an animal
are not visible in the PDMP database).
• A query is made on the individual(s) that bring
the animal to the veterinarian and human data is
obtained, not animal data.
• Human data obtained from the PDMP query is not
usable for the veterinarian. Veterinarians are
not trained in human medicine to understand what
the dosages mean.
2:21:22 PM
DR. WARD advanced to slide 6:
Why it Makes Sense to Exempt:
Querying human PDMP information is invasion into an
individual's medical privacy.
• Clients find it intrusive when the veterinarian
is required to query their private health data in
the PDMP.
• An individual's private medication information
becomes known to the veterinarian for certain
drugs, such as narcotics, sedatives, and
stimulants.
Examples of some common medications seen include, but
are not limited to: Adderall, Ritalin, anabolic
steroids such as testosterone, postpartum depression
medications, sex hormones, Xanax, Klonopin, Valium,
Ativan, Domar, and sleep aids like Ambien and Lunesta.
DR. WARD reviewed slide 7:
Why It Makes Sense to Exempt:
Veterinarians are monitored by the Drug Enforcement
Agency and must adhere to controlled substance
regulations.
• Veterinarians who prescribe or dispense
controlled substances are licensed through the
Drug Enforcement Agency (DEA). There is already a
significant level of accountability, record
keeping, and medication storage requirements that
veterinarians must adhere to.
• Distributors of controlled substances monitor
utilization patterns of veterinarians. The
Suspicious Order Monitoring System is in place
and data is gathered by distribution companies
who are required by the DEA to monitor and report
unusual purchase patterns a veterinarian may
have. Distributors are required to flag purchases
that fall outside of norms for either previous
purchase history or the norms for practices of
similar size/type. DEA oversight is to
control/prevent diversion from licensed
professionals to drug dealers and users.
2:23:37 PM
RACHEL BERNGARTT, DVM, Chair, Board of Veterinary Examiners,
Juneau, Alaska, continued the presentation to exempt
veterinarians from the Prescription Drug Monitoring Program, in
support of HB 56. She mentioned that one big step forward this
year was that the Alaska State Medical Association does not
oppose exempting veterinarians from the PDMP.
DR. BERNGARTT paraphrased slide 8:
33 other states have exempted veterinarians from
participating in the PDMP.
• 10 states formerly mandated veterinary reporting
but repealed their inclusion due to the problems
experienced, lack of identified benefits to
veterinary participation, and demonstration that
exempting veterinarians does not decrease
protection of public health and safety. These
states are Alabama, Arizona, Idaho, Illinois,
Kansas, Kentucky, Louisiana, New Mexico, West
Virginia (2021), and Wyoming.
• Missouri was the last state to implement a PDMP
in 2021 and did not require veterinarians to
participate.
2:24:40 PM
DR. BERNGARTT reviewed slide 9:
Why It Makes Sense to Exempt:
Veterinarians are not a source of the drugs of primary
concern.
Synthetic opioids excluding methadone overdose deaths
increased 97-fold
Psychostimulants with abuse potential (primarily
methamphetamine) overdose deaths increased 59-fold
Cocaine increased 6.4-fold
Rx opioid deaths increased 4.9-fold
Opioid medications prescribed by veterinarians
(728,223) were only 0.34% of the total opioid
prescriptions (214 million) that were dispensed by
U.S. retail pharmacies in 2017.
DR. BERNGARTT advanced to slide 10:
Why It Makes Sense to Exempt:
The unwieldy PDMP leads to costly and burdensome
investigations of veterinarians by the Alaska Board of
Veterinary Examiners.
Costly and onerous requirements for monitoring
veterinarians have been placed on the board of
veterinary examiners (BOVE).
2:26:49 PM
DR. BERNGARTT advanced to slide 11:
Why It Makes Sense to Exempt:
Licensing fees for veterinarians will likely increase
as a result of the cost to conduct needless
investigations of veterinarians with DEA licenses. The
cost of doing business will be passed on to consumers.
Alaska has the highest licensing fees for
veterinarians in the country.
Licensing fees are expected to increase in the State
of Alaska as a result of the cost of PDMP
investigations.
Charging veterinarians for the cost of enforcement of
an unusable PDMP system, and regulations with which
they are unable to comply, is not responsible
stewardship of resources.
2:28:07 PM
DR. BERNGARTT advanced to slide 12:
AKVMA and BOVE ask for Support
of HB 56
An Exemption of Veterinarians from participating in
the PDMP:
Will allow veterinarians to provide the
appropriate, timely, medical management
appropriate for each patient.
Will increase the efficiency of the PDMP system
for its intended purpose, by allowing for
accurate interpretation of data and trends in
human medicine.
Will allow continued judicious use of controlled
substances that is already practiced by
veterinarians.
Will eliminate unnecessary and disproportionate
business burdens for veterinarians.
2:28:58 PM
CHAIR BJORKMAN thanked the presenters and held HB 56 in
committee.