Legislature(2021 - 2022)BELTZ 105 (TSBldg)
05/10/2022 09:00 AM Senate LABOR & COMMERCE
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| Audio | Topic |
|---|---|
| Start | |
| HB133 | |
| HB289 | |
| HB227 | |
| HB145 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 133 | TELECONFERENCED | |
| + | SB 181 | TELECONFERENCED | |
| *+ | HB 289 | TELECONFERENCED | |
| *+ | HB 145 | TELECONFERENCED | |
| += | HB 227 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
HB 145-EXPAND PHARMACIST AUTHORITY
6:02:18 PM
CHAIR COSTELLO reconvened the meeting and announced the
consideration of CS FOR HOUSE BILL NO. 145(HSS) "An Act relating
to the Board of Pharmacy; relating to health care services
provided by pharmacists and pharmacy technicians; and relating
to the practice of pharmacy."
She noted that this was the first hearing and the intention was
to hear the introduction, take public testimony, answer any
questions, and look to the will of the committee.
6:02:51 PM
REPRESENTATIVE LIZ SNYDER, Alaska State Legislature, Juneau,
Alaska, sponsor of HB 145, described HB 145 as a health care
access bill that provides long overdue updates to the statutes
governing the practice of pharmacy in Alaska so the profession
is able to continue providing the services long associated with
pharmacy. HB 145:
• defines patient care services that pharmacists and support
staff are able to provide
• allows pharmacy technicians to administer vaccines and
emergency medications under the direct supervision of a
licensed pharmacist
• empowers the Board of pharmacy to regulate pharmacists,
student pharmacists, and pharmacy support staff
• updates the statutes consistent with current practices and
training
• updates the provider antidiscrimination statute to support
insurance coverage of these patient care services when they
are provided by a pharmacist
REPRESENTATIVE SNYDER clarified that HB 145 does not expand
pharmacists' prescriptive authority. She highlighted the
extensive support for the bill from pharmacists and health care
organizations throughout the state.
6:05:53 PM
CHAIR COSTELLO asked Alliana Salanguit to walk through the
sectional analysis for HB 145.
6:06:01 PM
ALLIANA SALANGUIT, Staff, Representative Liz Snyder, Alaska
State Legislature, Juneau, Alaska, presented the sectional
analysis for HB 145 on behalf of the sponsor. It read as
follows:
Sec. 1: Adds language to AS 08.80.030(b) Powers and
Duties of the Board, statute that outlines the Board
of Pharmacy's powers, that allows the Board of
Pharmacy to adopt rules to regulate the independent
monitoring of drug therapy and independent pharmacist
prescribing of vaccines and naloxone.
Sec. 2: Adds a new subsection to AS 08.80.045
Nonprescription Drugs that aligns statute with the
current practice of pharmacists recommending non-
prescription medications and devices for treating
minor and self-limited conditions.
Sec. 3: Amends AS 08.80.155 Emergency Permit to
increase the Board of Pharmacy's flexibility to grant
emergency licenses for all relevant licenses used in
pharmacies.
Sec. 4: Amends AS 08.80.168(a) Administration of
Vaccines and Related Emergency Medications by adding
"prescribe" to existing vaccine administration
statute.
6:07:10 PM
MS. SALANGUIT continued the sectional analysis for HB 145.
Sec. 5: Amends AS 08.80.168(b) by replacing "dispense"
with "prescribe and administer" in regards to
administering an opioid overdose drug.
Sec. 6: Adds a new subsection to AS 08.80.168 that
allows a pharmacy technician to administer a vaccine
or related emergency medication but only if they have
been authorized by the Board of Pharmacy to do so AND
if they are under the direct supervision of a licensed
pharmacist who meets the requirements in AS 08.80.168
(a).
Sec. 7: Adds language to AS 08.80.297(a) Prescription
Prices Available to Consumer that allows personnel who
are not licensed pharmacists to disclose the cost of
filling a prescription when directed by a pharmacist
working at the same institution.
6:07:57 PM
Sec. 8: Amends AS 08.080 Pharmacists and Pharmacies by
adding a new section, AS 08.80.337 Other Patient Care
Services, that:
• Allows a pharmacist to provide patient care
services for a disease or condition with an
existing diagnosis under an agreement made with
and approved by a practitioner
• Limits patient care services that pharmacists can
provide to those that are minor, self-limiting,
and have a CLIA-waived laboratory test which
guides clinical decision making.
• Provides language that allows pharmacists to be
reimbursed for providing these services
Sec. 9: Amends AS 08.80.480 Definitions by removing
"dosage form" as a definition of "equivalent drug
product". This allows pharmacists to make minor, non-
therapeutic changes to prescriptions using clinical
judgement and expertise without contacting the
prescriber for verbal or written approval. This does
not allow a pharmacist to substitute a dosage form
that would negatively impact patient outcomes, safety,
or cost effectiveness. Examples of appropriate
substitutions under this section include changing from
a tablet form of medication to a capsule form of the
same medication and strength.
6:09:18 PM
MS. SALANGUIT continued the sectional analysis for HB 145.
Sec. 10: Amends AS 08.80.480(30) by adding
"dispensing" and "independent prescribing" to the
definition of the "Practice of Pharmacy" to align with
the changes made in Section 4 & 5 (AS 08.80.168) of
this bill. These additions better represent actual
provision of naloxone and vaccine by pharmacists.
Sec. 11: Amends AS 21.36.090(d) Unfair Discrimination
to include "pharmacists" as protected health care
providers in the provider anti-discrimination statute.
This aligns the state statute with federal statute
(CFR 438.12) and afford pharmacists the same
protection as all other healthcare providers when
engaging health plans for covered services such as
ordering laboratory tests, point-of-care testing,
vaccine prescribing and administration, preventative
health services, managing minor self-limiting
conditions, and participating in collaborative disease
state management.
Sec. 12: Amends AS 21.42 The Insurance Contract by
adding language ensuring health insurance plans
reimburse pharmacists for eligible health care
services they provide.
CHAIR COSTELLO asked if there were questions.
6:09:34 PM
SENATOR MICCICHE asked for an explanation of "unfair
discrimination" because it seems as though it's related to
providers.
MS. SALANGUIT confirmed that the statute addresses unfair
discrimination by providers; it lists all the health care
providers with the exception of pharmacists.
SENATOR MICCICHE asked what that statute covered and how it was
associated with pharmacists.
6:10:24 PM
REPRESENTATIVE SNYDER explained that Alaska statute and federal
statute CFR 438.12 provide protections for other types of
providers who deliver covered services. Pharmacists have federal
protection and Section 11 of the bill extends that protection to
pharmacists practicing in Alaska. She deferred further
explanation to the chair of the Board of Pharmacy.
SENATOR MICCICHE requested Board of Pharmacy Chair Ruffridge
describe the type of discrimination this protects against.
6:11:37 PM
JUSTIN RUFFRIDGE, Chair, State Board of Pharmacy, Soldotna,
Alaska, explained that the change to the anti-discrimination
statute allows pharmacists to bill for health care services
through Medicare, Medicaid, and private insurance. Pharmacists
often are unable to bill for certain testing and other limited
patient care services because they are not recognized as a
provider. The amendment addresses this issue by specifically
mentioning pharmacists in the anti-discrimination statute.
SENATOR MICCICHE expressed appreciation for the answer.
6:13:08 PM
CHAIR COSTELLO opened public testimony on HB 145.
6:13:13 PM
TOM WADSWORTH, representing self, Wasilla, Alaska, stated that
he is a pharmacist licensed in Alaska and the administrator of
UAAs ISU Doctor of Pharmacy program. He clarified that he was
not representing the university. Rather, he was speaking as a
practicing pharmacist and Doctor of Pharmacy educator in support
of HB 145.
He conveyed that HB 145 represents two years of close
collaboration between the Alaska Pharmacists Association, the
Board of Pharmacy, and the School of Pharmacy. The updates are
long overdue and more accurately reflect the contemporary
practices of pharmacy and pharmacists. The public is aware of
pharmacists working in retail settings such as Walmart or
Safeway but 60 percent of pharmacists actually work in health
systems, primary care systems, and tribal systems.
MR. WADSWORTH explained that a pharmacist is behind ever
medication order and they also provide a variety of health care
services unrelated to dispensing medication. This has been the
case for over 30 years in Alaska, primarily in the VA system,
tribal organizations, and private sector. He said this simply
contemporizes the statute so the Board of Pharmacy is able to
promulgate regulations around those practices.
He highlighted that the Doctor of Pharmacy program in Alaska was
growing its own pharmacists. Over 40 pharmacists had graduated
and they were all practicing in Alaska communities. He said they
are competent health care providers who should be able to
practice at the highest level of their education.
6:15:53 PM
LIV SWONGER, Doctor of Pharmacy Student, UAA/ISU Doctor of
Pharmacy Program, Anchorage, Alaska, stated that she was a
fourth year Doctor of Pharmacy student on the University of
Alaska Anchorage campus, speaking in support of HB 145. She
conveyed her belief that HB 145 will allow her to practice to
the full extent of her education and training when she receives
her Doctor of Pharmacy degree next year. Provisions in HB 145
will increase accessibility for pharmacists to provide critical
health care services such as independently monitoring drug
therapies for high blood pressure and diabetes. Additionally, HB
145 will help give pharmacists the ability to prescribe and be
reimbursed for the life-saving overdose reverse medication such
as Naloxone. This will help combat Alaska's high overdose deaths
involving opioids. Passage of HB 145 will also mitigate barriers
to care by allowing people experiencing illness such as strep
throat or influenza to access testing and treatment through
community pharmacists. Finally, adding pharmacists to the
insurance anti-discrimination statute will ensure the
sustainability of and access to services that pharmacists can
provide.
CHAIR COSTELLO asked Renee Robinson if she wanted to provide
testimony on HB 145.
6:18:35 PM
RENEE ROBINSON, President, Alaska Pharmacists Association (APA),
Anchorage, Alaska, stated that she was available for questions
and had not prepared specific testimony, but as president of the
Alaska Pharmacists Association she was supportive of the
legislation. This has been a collaborative effort among
stakeholders over the past two years, she said.
6:19:00 PM
CHAIR COSTELLO closed public testimony on HB 145.
6:19:20 PM
At ease
6:19:43 PM
CHAIR COSTELLO reconvened the meeting and solicited a motion.
6:19:49 PM
SENATOR REVAK moved to report the committee substitute (CS) for
HB 145, work order 32-LS0720\B, from committee with individual
recommendations and attached fiscal note(s).
CHAIR COSTELLO found no objection, and CSHB 145(HSS) was
reported from the Senate Labor and Commerce Standing Committee.
6:20:19 PM
REPRESENTATIVE SNYDER thanked the committee.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 227 Amendment W.2.pdf |
SL&C 5/10/2022 9:00:00 AM |
HB 227 |