Legislature(2005 - 2006)BUTROVICH 205
04/22/2005 08:30 AM Senate JUDICIARY
| Audio | Topic |
|---|---|
| Start | |
| HB85 | |
| HB88 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 85 | TELECONFERENCED | |
| + | HB 88 | TELECONFERENCED | |
| + | TELECONFERENCED |
HB 85-PRESCRIBED MEDICATION FOR STUDENTS
CHAIR RALPH SEEKINS announced HB 85 to be up for consideration.
8:43:33 AM
REPRESENTATIVE KEVIN MEYER introduced HB 85, which proposes to
allow children to carry their own inhalers (commonly known as
Epipen®). Not having their medication readily available puts
children at risk. Some children have died because their
medication was in the school nurse's office. HB 85 would allow a
parent or guardian to sign a release of liability provided the
healthcare provider submit a written consent treatment plan and
certify that the child is capable of using the medication. HB 85
would qualify Alaska for federal grants under the Asthmatic
Schoolchildren's Treatment Act of 2004. Thirty-seven states have
passed similar legislation. It protects the schools from
liabilities and it would potentially reduce absences.
8:46:17 AM
SENATOR GRETCHEN GUESS asked Representative Meyer to explain why
pharmacist is listed under the definition of healthcare
provider.
REPRESENTATIVE MEYER explained the reason is pharmacists often
train children to use their inhalers.
8:49:03 AM
MR. MIKE PAWLOWSKI, legislative aide, reiterated Representative
Meyer's assertion that pharmacists are the ones who teach
children how to use their medication. The Department of Public
Health (DPH) supports adding pharmacists.
SENATOR GUESS asserted HB 85 allows pharmacists to write a
treatment plan.
CHAIR SEEKINS said he would feel more comfortable if backup
medicine was available in the school nurse's office.
REPRESENTATIVE MEYER advised under HB 85 children could still
leave backup medication with the nurse.
8:52:42 AM
REPRESENTATIVE MEYER continued families couldn't always afford
two inhalers so he would be hesitant to require a backup.
8:54:38 AM
Senator Gene Therriault joined the committee.
SENATOR CHARLIE HUGGINS expressed concern over children passing
their inhalers around.
REPRESENTATIVE MEYER stated the school would not be liable.
SENATOR HUGGINS said he was worried about children causing the
death of other children by sharing inhalers.
REPRESENTATIVE MEYER countered inhalers wouldn't kill a child
although they might make someone hyperactive.
8:56:21 AM
SENATOR HUGGINS asked the definition of advanced nurse
practitioner.
SENATOR HOLLIS FRENCH advised all nurse practitioners are
advanced nurse practitioners.
CHAIR SEEKINS agreed and stated licensed nurse would be
included. The difference is a licensed nurse who is not a nurse
practitioner would not be able to prescribe medications.
SENATOR FRENCH asked Mr. Pawlowski to explain Epipen®.
MR. PAWLOWSKI advised it is short for epinephrine injector,
which is a self-administered injection.
SENATOR FRENCH asked whether the use of epinephrine inhalers
among schoolchildren was common.
8:58:47 AM
CHAIR SEEKINS replied yes. He explained epinephrine is a form of
adrenaline.
8:59:36 AM
SENATOR THERRIAULT asked the recourse if a child lets a friend
take a dose of the medication.
MR. PAWLOWSKI replied discipline according to the school code
would govern that situation.
9:01:36 AM
SENATOR THERRIAULT asked the recourse when children pass
inhalers around to get each other high.
MR. PAWLOWSKI responded the debate occurred in the House and it
was decided disciplinary action by the schools should be
adequate.
CHAIR SEEKINS mentioned a person can buy some types of inhalers
over the counter and there is no present issue of children
buying inhalers. He asserted it is serious when someone has an
asthma attack.
9:03:35 AM
CHAIR SEEKINS said his only concern was if a student were to
forget to bring their medication. He prefers to have a backup in
place. He read a statement from the Alaska Nurses Association
that asked to require a student to have an extra inhaler stored
in the school nurse's office.
MR. PAWLOWSKI commented that was included in Section 5. A
healthcare provider could include that stipulation in the
written treatment plan.
SENATOR FRENCH said it could be included in the list under
"doses of medications needed."
9:05:27 AM
SENATOR GUESS advised it would be beneficial to keep the option
so as not to mandate families to always have two inhalers. Some
families may not be able to afford two inhalers.
9:07:40 AM
CHAIR SEEKINS said it is not his intent to put someone who can't
afford the medication in risk of violating the law. However, a
serious case of asthma needs to be considered.
9:08:55 AM
MS. PATRICIA SENNER, nurse practitioner, testified in support of
HB 85. She maintained school nurses are having trouble with
managing inhalers. Children often forget them or they run out of
medication. She suggested to stipulate under Section 5 the
healthcare provider state what back up is needed.
9:10:29 AM
MS. SENNER advised the committee albuterol inhalers run about
twenty dollars while steroid inhalers run close to one hundred
dollars. She expressed concern with children carrying Epipens®,
however school nurses report they have not had trouble with
abuse, although there are instances of sharing. The side effects
of albuterol are minimal unless the person suffers from a heart
condition. The Anchorage school districts do have Epipen®
backups.
9:12:08 AM
MS. SENNER admitted the Alaska Nurses Association has a problem
with the definition of healthcare provider. The problem with
adding pharmacists is they do not have personal knowledge of the
child. She suggested restricting the description of healthcare
provider to those people who legally have the authority to
diagnose and treat.
9:13:54 AM
MS. SENNER suggested leaving out licensed nurse and pharmacists.
SENATOR FRENCH asked whether all inhalers have the same active
ingredient.
MS. SENNER replied the most common are rescue inhalers, which
contain albuterol. There are a variety of others.
SENATOR FRENCH asked which kind would work in an emergency
situation.
MS. SENNER stated albuterol.
SENATOR FRENCH asked the reason children bring inhalers to
school.
MS. SENNER informed albuterol is often taken four times per day
and most other inhalers are twice a day medications.
9:15:59 AM
SENATOR FRENCH asked what kind of emergency inhaler a school
would select.
MS. SENNER affirmed it would be albuterol.
SENATOR FRENCH asked the danger from using someone else's
inhaler.
MS. SENNER said the main thing would be a contagious disease
through the transfer of germs.
SENATOR FRENCH asked whether any children have died because of
asthma attacks.
MS. SENNER replied she is not aware of any.
9:17:33 AM
MS. STEPHANIE BIRCH, chief of the women and children's health
section, Division of Public Health (DPH), offered support for HB
85 and also offered to answer questions.
MS. MARGE LARSEN, American Lung Association of Alaska testified
in support. She reminded the committee not every school in
Alaska has a school nurse. The intent of HB 85 is for school
children have access to their medication. Most people who die
from asthma are mild asthmatics who do not manage their asthma.
Rescue medication is a necessary and critical part of asthma
management.
9:20:12 AM
SENATOR GUESS asked the procedure when a school has no school
nurse.
MS. LARSON advised the medications are locked up in the
principal's office.
The LIO connection was lost and so Chair Seekins announced a
brief recess at 9:22:08 AM.
Chair Seekins reconvened the meeting at 9:42:27 AM.
CHAIR SEEKINS proposed Amendment 1.
Page 2, line 19 after the word "permitted to" insert
"personally" and following the word "nurse" insert "or
other school official".
Hearing no objections the motion carried.
9:44:15 AM
CHAIR SEEKINS proposed Amendment 2.
Page 2, line 25 state "in this section, healthcare provider
means a person with prescriptive authority in this state."
SENATOR GUESS objected for the purpose of discussion. She asked
whether a village health aide would fall under that definition.
MS. BIRCH said a village health aide has delegated prescriptive
authority. She suggested adding wording on line 26 to state
"within their state regulations." This would allow for them to
practice within their occupational licensing regulations.
CHAIR SEEKINS said a pharmacist might be the person best capable
of showing the child how to use the inhaler device.
9:49:48 AM
MR. PAWLOWSKI suggested a pharmacist might attempt to do
something outside their authority, such as write a prescription.
SENATOR GUESS expressed concern the definition of healthcare
provider is being used as a catchall.
9:51:36 AM
CHAIR SEEKINS withdrew Amendment 2 and proposed Amendment 3,
which defines healthcare provider. Hearing no objection, the
motion carried.
9:52:32 AM
SENATOR HUGGINS moved Amendment 4, which inserts a permissive
requirement that medication must be kept with a designated
school official. Hearing no objections, the motion carried.
9:54:41 AM
SENATOR GUESS inferred the committee should clarify HB 85 in
regards to public versus private school.
MR. PAWLOWSKI referred to a legal memo included in the packet
dated April 6, 2005 from legislative legal. There is a concern
that the word school is not specific enough. It is problematic
for the state to require a private school to do anything. It is
limited under AS 14.45.100. The sponsor suggested inserting the
word "public" to clarify.
CHAIR SEEKINS moved Amendment 5, insert the word "public."
SENATOR THERRIAULT objected for the purpose of discussion.
9:57:47 AM
SENATOR GUESS noted the drafter might have had a reason not to
specify public school.
MR. PAWLOWSKI admitted that was true. The drafter described it
as not expressly necessary.
10:02:30 AM
SENATOR THERRIAULT suggested asking the drafters for a memo
clarifying the intent that HB 85 addresses public schools and
not private schools.
10:05:11 AM
CHAIR SEEKINS announced he wanted to be on record that it was
not his intent to force private schools to adhere to HB 85.
10:06:38 AM
Amendment 5 was adopted.
CHAIR SEEKINS announced the committee would wait for a clean
version of the amended bill before going further.
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