Legislature(2013 - 2014)CAPITOL 106
03/18/2014 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| Presentation: Pediatric Partnership | |
| Presentation: Alaska Health Workforce Coalition & Vacancy Study | |
| HB324 | |
| HB361 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| += | HB 324 | TELECONFERENCED | |
| *+ | HB 361 | TELECONFERENCED | |
| + | TELECONFERENCED |
HB 324-CONTROLLED SUBST. PRESCRIPTION DATABASE
4:05:08 PM
VICE CHAIR KELLER announced that the next order of business
would be HOUSE BILL NO. 324, "An Act relating to the controlled
substance prescription database."
4:06:34 PM
JIM POUND, Staff, Representative Wes Keller, Alaska State
Legislature, addressed the proposed committee substitute (CS)
for HB 324, labeled 28-LS1427\N, Strasbaugh, 3/7/14 which
proposed to answer some of the concerns from the previous
meeting. He directed attention to page 3, line 9, which added
"directly" so that the hospital would administer the drugs. He
noted that some rural providers did not have access to a
database, so "through an electronic database or another method"
was added on page 3, line 10. He pointed to page 3, line 30,
which added "a secure real-time" and stated that once the
prescription was given to the client the information would be
input to the database. Noting page 4, line 22, "who is
licensed" was added to ensure that access to data was only by a
licensed individual. He stated that the final change was on
page 4, line 29, whereby "provider" was changed to
"practitioner."
4:09:05 PM
REPRESENTATIVE PRUITT moved to adopt the proposed committee
substitute (CS) for HB 324, labeled 28-LS1427\N, Strasbaugh,
3/7/14, as the working draft.
VICE CHAIR KELLER objected for discussion.
REPRESENTATIVE TARR asked if the payment portion would remain
the same as the previous draft.
MR. POUND replied that it would remain the same.
4:09:47 PM
[VICE CHAIR KELLER opened public testimony].
WARD HURLBURT, M.D., Chief Medical Officer/Director, Division Of
Public Health, Central Office, Department of Health and Social
Services, stated that the administration had not taken a
position on the proposed bill. He referred to the passage of a
similar law in Missouri, noting that all 50 states now had a
controlled substance prescription data base program. He said
there was an array for how robust the programs were, and he
pointed to the Oklahoma program with a 10 minute real time
accessibility. He declared that had been a benefit to the
program. He reported that Alaska downloaded the information on
a monthly basis. He declared that all the programs had value
for addressing the national epidemic of controlled substance
prescription drug abuse. He said that annual deaths from the
illicit use of these legal controlled substances had now
surpassed the annual deaths from automobile accidents. He
stated that the more robust the program, the more it would cost.
He noted that the responsible department would have to determine
the program with the greatest value for the cost. He shared an
anecdote of his work prior to working in Alaska. He stressed
that availability of these databases was helpful and important
to medical professionals.
4:12:48 PM
REPRESENTATIVE REINBOLD asked who paid for these programs, and
for his recommendations for funding.
DR. HURLBURT replied that he clearly recognized the challenge
for a reasonable, prudent approach to funding for this important
program.
4:14:01 PM
REPRESENTATIVE TARR asked for clarification that the fees
through the Board of Pharmacy would finance the program.
DR. HURLBURT replied that it was a reasonable cost to impose on
the health care businesses.
REPRESENTATIVE TARR asked if any other programs were charging
the patient for this service.
DR. HURLBURT replied that he did not know, though he offered his
belief that it would be difficult. If a cost was imposed at the
point where the controlled substance was dispensed, then the
patient, or the third party payer, would bear the cost.
4:16:58 PM
MARGARET BRODIE, Director, Director's Office, Division of Health
Care Services, said that it was necessary to study who would
benefit from the database, and look for funding from those who
benefited.
VICE CHAIR KELLER offered his belief that the funding would need
to come from the pharmacists. He suggested that there could be
other funding sources, including private donations, and he asked
for any suggestions from Department of Health and Social
Services (DHSS).
4:18:37 PM
MS. BRODIE stated that DHSS supported the database and would
work with whomever to make it successful.
REPRESENTATIVE REINBOLD declared that the community, as a whole,
benefited from the database. She suggested finding funding
alternatives to avoid conflict with the pharmacies.
4:20:27 PM
DIRK WHITE, Chairman, Board of Pharmacy, reported that the Board
of Pharmacy had taken on the responsibility of overseeing the
program when it was passed in 2008. At that time, there was a
letter of intent that there would not be a financial burden on
the Board of Pharmacy or the pharmacists for running the
program. He declared that it was a public safety issue, and
that everyone in the state benefited by the prevention of
narcotics and other dangerous prescription medication from
reaching the street. He said that, as all the citizenry
benefited, there should not be fees imposed on the providers.
He asked how the fees would be collected and then disseminated.
He said that this would become a non-funded state mandate, and
he listed other non-funded federal mandates for which
pharmacists were responsible. He said that all the providers
had similar fees. He stated that this benefit to all the
citizens of the state needed to be funded by the state.
4:24:15 PM
VICE CHAIR KELLER stated that the fees would get passed on to
the customers.
MR. WHITE explained that these fees would not be passed on, as
the pharmacists cannot change their reimbursement rates, and any
increased costs had to be absorbed by the pharmacist.
4:25:27 PM
PATRICIA SENNER, Family Nurse Practitioner, Alaska Nurses
Association, expressed her support for the change in wording for
entry data users. She relayed that the Legislative Budget and
Audit Committee was holding hearings regarding the accounting
practices of the Division of Corporations, Business, and
Professional Licensing [Department of Commerce, Community &
Economic Development], with some possible "deficiencies or
problems in that area" and she did not want to add any further
responsibilities to that division. She suggested a tax on the
pharmaceutical companies that make the controlled substances.
She pointed to the state tobacco tax and the state liquor tax,
which were collected from the distributors and not the
individual dispensers. She expressed support for the real time
mandate, though she expressed concern for any cost increase over
management of the current system.
4:27:43 PM
VICE CHAIR KELLER said that the proposed bill would be held
over.
4:28:09 PM
LIS HOUCHEN, Director, State Government Affairs, National
Association of Chain Drug Stores, directed attention to the
letter [Included in members' packets] that she had submitted
which listed suggestions for the proposed bill. Referring to
page 2, line 31, and continuing on to page 3, line 1, she
suggested deleting "other than the state." She stated that the
organization was very supportive of this program, noting that
only one state did not have a similar program. She noted the
current lack of ability for online real time, and she asked that
this be removed from the proposed bill. She explained that the
program was trying to discern a history of abuse by a specific
individual, and, as that was revealed by activity over a period
of time, the online real time was not necessary. She asked that
the pharmacist and the prescriber not be taxed, as they were
already paying to provide the information and the materials.
She suggested a search for alternative sources of funding, and
mentioned a user fee for those who access the information. She
stated that the pharmacies could not pass on this cost, as the
rates were already fixed, and she asked that an alternative
source of funding be sought.
4:31:43 PM
VICE CHAIR KELLER replied that there was a conceptual amendment
to be proposed that would address some of those concerns.
4:31:53 PM
BARRY CHRISTENSEN, Pharmacist, Co-Chair, Legislative Committee,
Alaska Pharmacists Association, declared support by the
membership for the prescription substance data base, as it
ensured public safety. He pointed out that the Alaska
Pharmacists Association had submitted a letter [Included in
members' packets]. He expressed appreciation for licensed staff
to have access to the data base, and suggested that it include
licensed staff in other medical practices. He pointed out that
there was not any real time statewide data base for
pseudoephedrine. He asked for a response to why there was not
real time in Alaska.
4:34:47 PM
DAN LYNCH referred to an earlier proposal for a similar bill in
2008 and maintained that his testimony remained unchanged, the
proposed bill was "unconstitutional in the USA, including
Alaska." He referred to the Fourth Amendment [Bill of Rights]
and its statement against unreasonable search and seizure. He
offered his belief that success statistics had determined that
it "won't work now in real time or dream time." He referred to
the letter of intent from the earlier proposed bill, "it is not
the intent of the legislature that the professional users of the
data base absorb the cost of managing this public program
through their license fees or other fee structure," and declared
that this had already been established. He questioned the
change for increased access to the data base, or contracting
with a private data base provider. He declared that the state
was unable to monitor its own employees. He pointed out that
the internet was now the global marketplace for purchases. He
said it was a waste of funds for this "silly, incompetent, feel
good legislation." He suggested using the time, effort and
finances "to address reality, treatment, real issues and real
solutions."
4:38:04 PM
VICE CHAIR KELLER held over HB 324.
4:38:25 PM
The committee took a brief at-ease.
4:38:55 PM
VICE CHAIR KELLER removed his earlier objection to the proposed
work draft. There being no further objection, it was adopted.