Legislature(2009 - 2010)CAPITOL 106
03/30/2010 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SB307 | |
| HB277 | |
| HB361 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | SB 307 | TELECONFERENCED | |
| *+ | HB 25 | TELECONFERENCED | |
| += | HB 392 | TELECONFERENCED | |
| *+ | HB 277 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| = | HB 361 | ||
HB 277-EMERGENCY USE OF EPINEPHRINE
3:29:15 PM
CO-CHAIR KELLER announced that the next order of business would
be HOUSE BILL NO. 277, "An Act establishing a program in the
Department of Health and Social Services to certify certain
individuals to be issued a prescription to administer
epinephrine and to possess and administer epinephrine in certain
situations."
The committee took an at-ease from 3:29 p.m. to 3:34 p.m.
3:34:10 PM
CO-CHAIR HERRON moved to adopt the proposed committee substitute
(CS) for HB 277, Version 26-LS0951\S, Bullard, 3/26/10, as the
work draft. There being no objection, Version S was before the
committee.
3:34:36 PM
MICHAEL DUNNING, Intern to Representative Peggy Wilson, Alaska
State Legislature, said that epinephrine was also referred to as
adrenaline, and was naturally occurring. He noted the "fight or
flight" response. He pointed out that it was used daily to
combat asthma and severe reactions. He stated that the bill
proposed to establish a training standard for individuals to
administer epinephrine with auto injectors, often referred to as
epi-pens, as well as with ampules. He explained that epi-pens
administered one or two doses, whereas an ampule was a sterile
glass storage container from which a dosage could be drawn, and
was significantly cheaper than the epi-pen. He gave examples of
existing training programs, which included American Heart
Association, Red Cross, and Wilderness Medical Associates.
MR. DUNNING explained that an individual that successfully
completed the training requirements would be authorized to
obtain a prescription to purchase epinephrine and to administer
it only in the very specific emergency situations outlined in HB
277. He opined that HB 277 would protect Alaskans, increase
safety measures, and hopefully save lives.
3:37:35 PM
REPRESENTATIVE SEATON directed attention to page 2, line 24, Sec
17.22.030 and asked why the applicability was not for
individuals authorized under other laws.
3:38:03 PM
MR. DUNNING said that he did not know.
CO-CHAIR HERRON referred to the language on the last paragraph
of the memorandum from Legislative Legal and Research Services.
REPRESENTATIVE T. WILSON offered her interpretation that an
individual rendering aid would be held harmless under the Good
Samaritan Law, and she asked Mr. Dunning if he agreed.
MR. DUNNING replied that the applicability, the liability of the
certified individual, and the referenced Good Samaritan Laws did
not preclude one another, as an individual may be immune under
one aspect, but not under another aspect. He offered that it
would protect individuals who had completed the training
program.
REPRESENTATIVE T. WILSON questioned if the Good Samaritan Law
would pertain if there was not a training program.
MR. DUNNING replied that this would depend on the individual
facts of a particular case. He explained that HB 277 required
the following to avoid personal liability: the individual would
have to successfully complete the training program; to
administer epinephrine in a narrowly defined emergency
situation; and to have acted in Good Faith.
3:41:18 PM
REPRESENTATIVE T. WILSON expressed concern that the bill would
increase the liability.
MR. DUNNING replied that HB 277 offered another layer of
protection above the Good Samaritan Law for those that had
successfully completed the training program.
REPRESENTATIVE T. WILSON asked who would conduct the training.
MR. DUNNING reiterated that the training programs already
existed, and that some had included the epi-pen training along
with CPR. He noted that successful completion of the training
allowed for a prescription to purchase epinephrine.
REPRESENTATIVE T. WILSON asked to clarify that a pharmacist
would supply the epinephrine as requested.
3:43:48 PM
MR. DUNNING offered his understanding that this would be the
case.
CO-CHAIR KELLER inquired about any concern for abuse of
epinephrine because of HB 277.
MR. DUNNING offered his belief that this was not a concern, and
that it was a proven life saving medication.
CO-CHAIR KELLER shared that his research indicated that
epinephrine was not a recreational drug of choice.
3:44:59 PM
REPRESENTATIVE LYNN, speaking as one of the joint prime sponsors
of HB 277, conveyed a personal story about epinephrine.
3:46:57 PM
REPRESENTATIVE HOLMES indicated support for what the bill was
attempting to do. She stated that she wanted to limit
liability, and referred to the definition of "emergency
situation" on page 3, line 4. She suggested to add "or appears
to experience" after "experiences" on page 3, line 5. She
opined that this would protect an individual who was acting in
good faith from their training. She also suggested adding
"reasonably" after "not" on page 3, line 7.
3:49:19 PM
REPRESENTATIVE HOLMES, in response to Co-Chair Herron, noted
that both the Good Samaritan Law and the limited liability
section of HB 277 on page 2, line 27, Sec. 17.22.040. "Liability
of certified individual" would protect an individual who acted
in good faith. She expressed her desire to ensure that an
individual was covered regardless.
3:51:06 PM
REPRESENTATIVE CISSNA reflected on a personal family incident.
3:52:13 PM
REPRESENTATIVE PEGGY WILSON, Alaska State Legislature, offered
her understanding that Alaska State law currently stated that
only the person with the medication could self medicate, or
receive assistance from a properly trained person. The intent
of the bill was to provide protection to those who were not
currently covered by the law.
3:53:52 PM
WARD HURLBURT, Chief Medical Officer; Director, Division of
Public Health, Office of the Commissioner, said that the
administration was neutral on HB 277.
REPRESENTATIVE T. WILSON asked to clarify that a pharmacist
would supply epinephrine solely upon the presentation of the
card certifying successful completion of the training.
DR. HURLBURT offered his understanding that some details were
still to be worked out to ensure it. He reiterated that the
training programs already existed, and that a physician's
prescription could become part of the process.
REPRESENTATIVE HOLMES observed that it was not possible to walk
in and buy epinephrine without a prescription.
DR. HURLBURT concurred that this was consistent with the current
process.
3:56:18 PM
REPRESENTATIVE T. WILSON expressed her confusion of why a doctor
would write a prescription solely based on successful completion
of a course.
REPRESENTATIVE P. WILSON referred to page 1, lines 10-12, of the
bill, and explained that there was situational justification.
REPRESENTATIVE T. WILSON asked if this was acceptable to the
medical profession.
REPRESENTATIVE P. WILSON replied that one doctor even taught 5
year old children how to self administer the epi-pen.
REPRESENTATIVE HOLMES asked Dr. Hurlburt for any concerns.
3:58:21 PM
DR. HURLBURT replied that epinephrine was a natural substance
and that it was safe, although that did not mean that there was
not any risk. He pointed out that sufficient quantities could
present a risk, but that it was safer than many other over the
counter items found in drug stores.
CO-CHAIR KELLER clarified that the training mitigated the risk.
He opined that it was appropriate to keep the strict language in
the bill.
3:59:53 PM
DR. HURLBURT explained that part of the training was for the
administration of epinephrine, as most people were not trained
to give injections.
4:00:44 PM
REPRESENTATIVE HOLMES referred to her earlier suggestion of
amending page 3, line 5 to add "or appears to experience" after
"experiences," and asked Dr. Hurlburt if it was possible to
mistake the signs of anaphylactic shock.
DR. HURLBURT replied that, as a physician, her amendment was
excellent, as it could not be known with 100 percent certainty.
4:02:14 PM
KEN ZAFREN, Medical Director, Alaska Emergency Medical Services
Program, expressed his agreement with the comments and with
Representative Holmes' amendment to change the wording.
CO-CHAIR KELLER asked how the prescription process would work.
DR. ZAFREN offered that, although it was not addressed in HB
277, most doctors would be comfortable with writing a
prescription for someone who had successfully completed the
training.
4:03:55 PM
CO-CHAIR KELLER closed public testimony on HB 277.
4:04:04 PM
REPRESENTATIVE HOLMES moved to adopt Conceptual Amendment 1,
which would read:
Page 3, line 5, following "experiences"
Insert "or appears to experience"
Page 3, line 7, following "not"
Insert "reasonably"
CO-CHAIR KELLER objected for discussion. There being no other
objections, he removed his objection and Conceptual Amendment 1
was adopted.
REPRESENTATIVE P. WILSON suggested a conforming amendment to
delete "and" between "for" and "purchase" on page 1, line 11.
[Before the committee was a motion to adopt Conceptual Amendment
2, which would read:
Page 1, line 11, following "prescription for"
Delete "and" ]
CO-CHAIR KELLER objected for discussion.
REPRESENTATIVE HOLMES clarified that line 11 would now read
"obtain a prescription for purchase."
CO-CHAIR KELLER removed his objection. There being no further
objection, Conceptual Amendment 2 was adopted.
4:06:08 PM
REPRESENTATIVE T. WILSON moved to report the proposed committee
substitute (CS) for HB 277, 26-LS0951\S, Bullard, 3/26/10, as
amended, out of committee with individual recommendations and
the accompanying fiscal notes. There being no objection, CSHB
277(HSS) was reported from the House Health and Social Services
Standing Committee.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB25prt1.PDF |
HHSS 3/30/2010 3:00:00 PM |
HB 25 |
| HB25prt2.PDF |
HHSS 3/30/2010 3:00:00 PM |
HB 25 |
| SB307pckt.PDF |
HHSS 3/30/2010 3:00:00 PM |
SB 307 |
| HB277pkt.PDF |
HHSS 3/30/2010 3:00:00 PM |
HB 277 |