02/28/2022 03:15 PM House LABOR & COMMERCE

                HB 306-EXTEND BOARD OF PHARMACY                                                                             
                                                                                                                                
3:24:31 PM                                                                                                                    
                                                                                                                                
CO-CHAIR  SPOHNHOLZ announced  that  the next  order of  business                                                               
would be  HOUSE BILL NO.  306, "An Act extending  the termination                                                               
date of  the Board  of Pharmacy; and  providing for  an effective                                                               
date."                                                                                                                          
                                                                                                                                
3:25:19 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 3:25 p.m. to 3:26 p.m.                                                                       
                                                                                                                                
3:26:25 PM                                                                                                                    
                                                                                                                                
CO-CHAIR SPOHNHOLZ invited the bill sponsor to provide comment.                                                                 
                                                                                                                                
3:26:56 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  ANDI  STORY,  Alaska State  Legislature,  as  the                                                               
prime sponsor of  HB 306, provided closing comments  on the bill.                                                               
She  said  the Board  of  Pharmacy  is  important to  Alaska  and                                                               
Alaskans and urged that the board be extended.                                                                                  
                                                                                                                                
3:28:10 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SNYDER inquired  about  the  Board of  Pharmacy's                                                               
position  regarding the  participation  of  veterinarians in  the                                                               
Prescription Drug Monitoring Program (PDMP).                                                                                    
                                                                                                                                
3:28:43 PM                                                                                                                    
                                                                                                                                
JUSTIN RUFFRIDGE, Chair,  Board of Pharmacy, replied  that at its                                                               
last  meeting the  Board of  Pharmacy voted  to support  the bill                                                               
that  was  currently  in  front  of  the  legislature  to  exempt                                                               
veterinarians from the  PDMP [SB 132, HB 91].   He explained that                                                               
some potential updates  are needed in the PDMP for  it to work in                                                               
a  more efficient  and  cohesive  manner.   In  the meantime,  he                                                               
continued, since  the veterinarians are not  participating in the                                                               
current rendition  of the  PDMP until some  changes are  made, it                                                               
seemed  that  the  Board  of  Pharmacy was  in  support  of  that                                                               
exemption until  such time  as those changes  were put  in place.                                                               
He said a letter was recently sent out in that regard.                                                                          
                                                                                                                                
3:29:47 PM                                                                                                                    
                                                                                                                                
CO-CHAIR  SPOHNHOLZ  offered  her understanding  that  the  [July                                                               
2021] sunset  audit report on  the Board of Pharmacy  states that                                                               
veterinarians are  participating at a  higher rate than  are many                                                               
of the other prescribers.   She recalled commenting at the bill's                                                               
previous  hearing  about  the  need  to  potentially  update  the                                                               
statute to make  it easier for veterinarians to use  but said she                                                               
didn't mean  to imply that  veterinarians should  not participate                                                               
in the PDMP.                                                                                                                    
                                                                                                                                
MR. RUFFRIDGE responded that this has  been a long time coming in                                                               
discussion at  the board level.   He confirmed that the  data for                                                               
veterinarians shows  a higher [participation]  rate in  the PDMP,                                                               
but said it is a smaller  number of individuals.  Pharmacists and                                                               
pharmacies, he stated,  currently have the highest  rate of usage                                                               
of the  PDMP, in the high  90 percentages, but it  is because the                                                               
usage  for  pharmacists  and pharmacies  is  relatively  straight                                                               
forward and  clear reporting, with  no review  requirement unless                                                               
it is felt like there is  a necessity to review.  Regarding other                                                               
prescribers, he pointed  out that there are more of  them, and it                                                               
is unclear as  to what the delegate usage can  be, especially for                                                               
physicians, so it would be difficult  to move in the direction of                                                               
needing  to  discipline  licensees for  non-review  requirements.                                                               
The Board of Veterinary Examiners,  he continued, found itself in                                                               
an  equally tough  position of  having to  undergo investigations                                                               
for  individuals who  were in  many cases  just providing  normal                                                               
everyday  care,  but  the  zero-reporting  requirement  was  very                                                               
burdensome  and there  is a  small  number of  individuals.   The                                                               
Board of  Veterinary Examiners made  its case relatively  well at                                                               
the Board of Pharmacy's last meeting  and the board agreed on the                                                               
exemption.   The Board of  Pharmacy has previously  discussed the                                                               
need for some changes to  the PDMP regarding efficiencies and the                                                               
chair  of the  veterinary board  has said  that that  would be  a                                                               
great time to have a seat at the table to discuss those issues.                                                                 
                                                                                                                                
3:32:40 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SNYDER asked  whether the  Board of  Pharmacy has                                                               
reviewed  the  study  published  in   late  2021  or  early  2022                                                               
regarding a significant increase  in the instance of veterinarian                                                               
shopping as  it pertains  to opioids.   She  recommended becoming                                                               
familiar with  the study  prior to future  hearings on  [the bill                                                               
that would exempt veterinarians from the PDMP].                                                                                 
                                                                                                                                
MR. RUFFRIDGE answered that some  things heard at the board level                                                               
echo  those concerns,  including reports  received from  the Drug                                                               
Enforcement Administration  (DEA).  How  veterinary prescriptions                                                               
happen in the PDMP has been  a difficulty, he said.  For example,                                                               
some pharmacies input veterinary  prescriptions under the owner's                                                               
name with  the pet's  name elsewhere in  the record,  while other                                                               
pharmacies  input the  animal's name  and birthdate  and not  the                                                               
owner's name  at all.  The  Board of Pharmacy asked  the question                                                               
of  whether  there  needs  to  be  a  clear  description  of  how                                                               
veterinary data  is input into  the pharmacy software as  well as                                                               
into the PDMP.   The answer was yes, so the  Board of Pharmacy is                                                               
currently  working towards  regulation language  to solidify  how                                                               
reporting of veterinary prescriptions happens in the PDMP.                                                                      
                                                                                                                                
3:35:02 PM                                                                                                                    
                                                                                                                                
CO-CHAIR SPOHNHOLZ  understood Mr. Ruffridge to  have stated that                                                               
work  is being  done  to clarify  what information  veterinarians                                                               
must enter in the  PDMP if they were to continue  to comply.  She                                                               
encouraged  Mr.  Ruffridge to  read  the  "Journal of  Veterinary                                                               
Medicine"  report  that shows  a  three-fold  increase in  opioid                                                               
prescription amongst veterinarians in the  last five years.  Peer                                                               
reviewed data,  she continued, shows an  increase in veterinarian                                                               
shopping  and  the committee  is  interested  in simplifying  the                                                               
statute, providing  statutory updates to  make it easy  for folks                                                               
to  participate,  and   addressing  any  make-work and  ambiguous                                                               
elements.  The opioid epidemic  continues and the cost of turning                                                               
a  blind eye  to a  small  subsection of  the provider  community                                                               
could be  costly for individual  Alaskans over time  and everyone                                                               
bears the cost  of that.  She said she  and Representative Snyder                                                               
are concerned and curious about  potential updates to the statute                                                               
to  meet the  state's public  health need  while making  the PDMP                                                               
more user  friendly and transparent  for veterinarians  and other                                                               
license types who are required to participate in the PDMP.                                                                      
                                                                                                                                
MR.  RUFFRIDGE agreed  with  Co-Chair  Spohnholz's statement  and                                                               
said there  is clear evidence  that tweaks are needed.   Overdose                                                               
deaths in  Alaska have gone up,  he said, and that  has been with                                                               
the PDMP in place.   Additional features could be integrated into                                                               
the PDMP,  he continued, such  as data that is  already collected                                                               
regarding  overdoses, so  physicians  and  other prescribers  are                                                               
aware of issues  with patients that they are seeing.   Work needs                                                               
to be done  on the PDMP and  the Board of Pharmacy  would like to                                                               
participate in that conversation when it is deemed appropriate.                                                                 
                                                                                                                                
CO-CHAIR SPOHNHOLZ stated that the  committee will follow up with                                                               
Mr.  Ruffridge and  Ms. Chambers  to set  up a  time to  identify                                                               
potential solutions.                                                                                                            
                                                                                                                                
3:38:08 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE MCCARTY asked whether  language should be included                                                               
in  the bill  about  the audit  issues that  led  to the  board's                                                               
extension for only six years [rather than eight].                                                                               
                                                                                                                                
CO-CHAIR SPOHNHOLZ explained it is  typical that the sunset audit                                                               
findings   are   presented   alongside   the   sunset   extension                                                               
legislation, but  the legislation  doesn't typically  include any                                                               
reference to that.   She said a shorter  sunset extension implies                                                               
that there were some issues which need to be addressed.                                                                         
                                                                                                                                
3:39:09 PM                                                                                                                    
                                                                                                                                
KRIS  CURTIS,   CPA,  CISA,  Legislative  Auditor,   Division  of                                                               
Legislative Audit, responded that  the reduction in the extension                                                               
isn't  necessarily  a  reflection  of  any  specific  finding  or                                                               
recommendation.  It is to  recognize the board's evolving role in                                                               
combatting  the public  health  crisis,  she said.    It is  also                                                               
recognizing her  recommendation not to  wait eight years  to come                                                               
back to see  how the board is  adapting to the new  laws, as well                                                               
as  because  new  laws  are  continuing to  be  discussed.    The                                                               
legislature  may  want to  consider  reducing  or increasing  the                                                               
extension, she added.                                                                                                           
                                                                                                                                
3:40:04 PM                                                                                                                    
                                                                                                                                
CO-CHAIR SPOHNHOLZ opened public testimony on HB 306.                                                                           
                                                                                                                                
3:40:21 PM                                                                                                                    
                                                                                                                                
DUANE WOOD,  testified in  support of HB  306.  He  said he  is a                                                               
pharmacy  student at  the University  of Alaska  Anchorage (UAA).                                                               
He pointed  out that every state  has such a board  to structure,                                                               
guide,  and  maintain  the  pharmacy  community,  and  the  board                                                               
maintains the professional  licenses of pharmacists, technicians,                                                               
and interns.   The  whole community  benefits from  the knowledge                                                               
that the  professional licenses of  pharmacists and the  Board of                                                               
Pharmacy are on solid ground, he stated.                                                                                        
                                                                                                                                
3:41:42 PM                                                                                                                    
                                                                                                                                
BARRY  CHRISTENSEN, RPh,  Co-Chair Legislative  Committee, Alaska                                                               
Pharmacists  Association, testified  in support  of HB  306.   He                                                               
stated that he  is a practicing pharmacist and that  the Board of                                                               
Pharmacy has always  done a great job.  He  recounted that former                                                               
Senator   Lyda  Green   worked  with   [the  Alaska   Pharmacists                                                               
Association] to  put forward the PDMP,  which has been a  work in                                                               
motion.  He said the Board of  Pharmacy over the years has done a                                                               
great job in nurturing the PDMP and making sure it is continued.                                                                
                                                                                                                                
3:42:45 PM                                                                                                                    
                                                                                                                                
CO-CHAIR  SPOHNHOLZ closed  public  testimony after  ascertaining                                                               
that no one else wished to testify.                                                                                             
                                                                                                                                
3:42:53 PM                                                                                                                    
                                                                                                                                
CO-CHAIR  FIELDS moved  to report  HB 306  out of  committee with                                                               
individual  recommendations and  the  accompanying fiscal  notes.                                                               
There  being no  objection, HB  306 was  moved out  of the  House                                                               
Labor and Commerce Standing Committee.