Legislature(2013 - 2014)CAPITOL 120
04/14/2014 01:00 PM House JUDICIARY
| Audio | Topic |
|---|---|
| Start | |
| HB370 | |
| HB315 | |
| SB173 | |
| SB128 | |
| SB170 | |
| HB370 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 315 | TELECONFERENCED | |
| + | SB 170 | TELECONFERENCED | |
| + | HB 370 | TELECONFERENCED | |
| += | SB 173 | TELECONFERENCED | |
| + | SB 128 | TELECONFERENCED | |
| + | SCR 2 | TELECONFERENCED | |
| + | HB 254 | TELECONFERENCED | |
| + | TELECONFERENCED |
HB 370-AWCB CONTROLLED SUBSTANCE PRESCRIPTIONS
1:42:57 PM
CHAIR KELLER announced that the first order of business would be
HOUSE BILL NO. 370, "An Act relating to employer drug testing;
requiring the Alaska Workers' Compensation Board to adopt
regulations relating to the prescription of controlled
substances to employees; and limiting the prescription of
controlled substances to employees."
[Before the committee was CSHB 370(L&C).]
1:43:00 PM
KONRAD JACKSON, Staff, Representative Kurt Olson, Alaska State
Legislature, speaking on behalf of Representative Olson, chair
of the House Labor & Commerce Standing Committee, sponsor,
informed the committee HB 370 is an act relating to employer
drug testing and requires the Alaska Workers' Compensation Board
to adopt regulations related to the prescription of controlled
substances. He noted that two sections of the bill are
especially important. One section directs that should an
injured worker require a long-term opiate prescription, after 90
days he/she may be subject to a random urinalysis test to
confirm that they are taking the medication, and to call for an
adjustment in medication, if needed. It has been found that
after 90 days or longer, a patient may not be taking the
prescriptive dose, and adjustments are needed. The intent is
"to really help get those injured workers well sooner." Mr.
Jackson said further studies indicate that the long-term use of
opioids can lead to addiction, and thus there is a need to
ensure that workers receive the medication at the proper
strength. The other important part of the bill deals with the
length of time for which a Schedule 1 drug [defined by the U.S.
Controlled Substances Act] is prescribed, and recommends
reducing the time period to a 30-day prescription. He stressed
that the focus of the proposed legislation is on the return to
good health of the injured worker for the purpose of returning
him/her to productivity.
1:46:53 PM
REPRESENTATIVE LEDOUX asked whether an employer is required to
pay for more than a 90-day prescription of a controlled
substance.
MR. JACKSON explained that after 90 days of taking a Schedule 1
opiate, a drug test may be administered to the worker. If the
worker is not taking the drug, future prescriptions would not be
paid for under the assumption that is the patient's choice and a
change in medication is warranted. Again, the intent is to help
doctors determine the injured worker's level of pain and the
proper prescription.
CHAIR KELLER said he was convinced that there is a problem in
the state related to the use of painkillers, noting that Alaska
has the highest cost for Workers' Compensation.
REPRESENTATIVE LEDOUX asked whether a worker is limited to a
prescription of 30 days or if there can be an additional
prescription after seeing a doctor.
MR. JACKSON said after another visit with the doctor, an
additional prescription can be written. He pointed out that
these steps will "increase some of the oversight and stop the
large quantities of the opiates from being ... in circulation."
1:51:05 PM
REPRESENTATIVE GRUENBERG asked Mr. Jackson whether the drug
Nuvigil is one of the drugs referred to in the bill on page 2,
lines 7-14, subsections (p) and (q).
MR. JACKSON said he did not know.
REPRESENTATIVE GRUENBERG disclosed that he is prescribed the
drug Nuvigil and may have a conflict of interest.
1:52:35 PM
REPRESENTATIVE LEDOUX posed a scenario in which an injured
worker was instructed by a doctor to reduce the amount of
medication whenever possible, and the worker did, but later
there was a need to return to the higher dosage. She said her
understanding of the bill is that if a worker tests negative due
to the lower dosage, the employer may not pay for a return to
the higher dosage.
MR. JACKSON explained that the bill reduces the prescription to
a 30-day supply to ensure closer interaction between patient and
physician. He opined that all doctors wish patients to reduce
the prescribed dosage as soon as possible to help avoid
addiction. However, after 90 days, the worker should again talk
with a doctor as it is expected that the worker would not need
another prescription. The idea [of the bill] is to encourage
patients to restrict their use of "heavy narcotics" as soon as
possible due to possible addiction problems and the high cost of
the drug to the Workers' Compensation system.
CHAIR KELLER asked whether a worker who is selling his/her drugs
could take one pill to pass the random drug test.
MR. JACKSON said that is a possibility and deferred to the
Division of Worker's Compensation, Department of Labor &
Workforce Development, for information on regulations related to
the administration of the test.
1:56:58 PM
REPRESENTATIVE LEDOUX questioned whether the sponsor's concern
is about doctors who are overprescribing medications, and if so,
suggested the committee discuss the problem with the State
Medical Board, Department of Commerce, Community & Economic
Development. She said she did not see the difference between an
injured worker receiving Workers' Compensation and an injured
person who does not.
MR. JACKSON agreed the focus of HB 370 is on workers who are
receiving Workers' Compensation. The societal problem of
addiction and the overuse of opiates should be a serious concern
of everyone; however, this bill seeks to reduce the high cost of
drugs to Workers' Compensation.
CHAIR KELLER mentioned a bill currently in the House Finance
Committee which addresses the problem from a different approach.
REPRESENTATIVE LEDOUX asked whether state medical organizations
have commented on the bill.
MR. JACKSON expressed his belief that the sponsor has not
received any negative comments from the medical community.
Concerns have been received from labor organizations, although
there has been previous testimony in support of the bill in its
current form from representatives of AFL/CIO and Teamsters.
1:59:47 PM
REPRESENTATIVE GRUENBERG asked about the possible self-
incrimination implications of the bill. He suggested that the
committee hear testimony from the Public Defender Agency,
Department of Administration.
MR. JACKSON assured the committee that the bill is not an
attempt to search for criminals but is focused on getting
workers the level of medication needed.
2:01:46 PM
AESHA PALLESEN, Assistant Attorney General, Labor and State
Affairs Section, Civil Division (Anchorage), informed the
committee that the language in the bill states that the negative
drug test could only be used for the purpose of establishing
that the employer may be able to refuse to pay for a future
prescription of the drug.
REPRESENTATIVE GRUENBERG was not satisfied by the foregoing
information because, although other uses are not allowed by the
language in the bill, other uses must be prevented under Alaska
law. He asked if the bill provides that the information is
confidential, and whether the information could "become the
fruit of the poisonous tree."
MS. PALLESEN advised that the state currently has a "pretty
comprehensive scheme addressing drug and alcohol testing by
employers" and the proposed subsection of the bill would be
subject to all of the conditions and restrictions [currently in
law] including a confidentiality provision. To Representative
Gruenberg's second question, she answered that there may be
concerns about the criminal implications of the bill if the test
result information was used for criminal purposes, but the
limitation on the allowed use of the negative drug test is
intended to prevent that.
REPRESENTATIVE GRUENBERG urged for a full exploration of the
possible implications to physician/patient privilege, and to
"the conduit theory."
2:04:19 PM
MIKE MONAGLE, Director, Central Office, Division of Workers'
Compensation, Department of Labor & Workforce Development,
pointed out that Workers' Compensation is generally exempt under
the Health Insurance Portability and Accountability Act of 1996
(HIPPA); therefore, the communication between those conducting
the testing and the employer does not have the same HIPPA
protection that "general health" would have. Typically, in a
Workers' Compensation action, the term "employer" includes the
employer's insurance company or its claims administrator, thus
testing under the proposed provision would be through the case
manager or claims administrator for the employer's insurance
company.
CHAIR KELLER said HB 370 would be set aside for further
testimony.
[The committee returned to HB 370 later in the meeting.]
HB 370-AWCB CONTROLLED SUBSTANCE PRESCRIPTIONS
4:10:10 PM
CHAIR KELLER returned the committee's attention to the further
discussion of HB 370.
[Before the committee was CSHB 370(L&C).]
KONRAD JACKSON, staff, Representative Kurt Olson, Alaska State
Legislature, speaking on behalf of Representative Olson, chair
of the House Labor & Commerce Standing Committee, sponsor, said
at the request of the committee, he contacted the Office of
Public Advocacy, Department of Administration, to answer
questions.
4:11:26 PM
RICHARD ALLEN, Director, Office of Public Advocacy, Department
of Administration, offered to answer questions.
MR. JACKSON recalled that Representative Gruenberg asked about
"fruit of the poison tree" and the possible criminal
implications of the drug testing described in section 1 of HB
370.
REPRESENTATIVE GRUENBERG asked whether there are criminal
implications within the language of HB 370.
MR. ALLEN answered that it is "a real stretch to try to come up
with any sort of scenario where this would play out." There is
the possibility that if a person who had tested negative was
later charged with the distribution of a narcotic, the test
might be used as some sort of circumstantial evidence.
4:14:18 PM
CHAIR KELLER closed public testimony on HB 370.
4:14:24 PM
REPRESENTATIVE LYNN moved to report CSHB 370(L&C) out of
committee with individual recommendations and the accompanying
fiscal notes. There being no objection, CSHB 370(L&C) was
reported from the House Judiciary Standing Committee.