Legislature(2017 - 2018)BARNES 124
02/05/2018 03:15 PM House LABOR & COMMERCE
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| Audio | Topic |
|---|---|
| Start | |
| HB323 | |
| SB64 | |
| Presentation: State Residential Building Codes | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | HB 323 | TELECONFERENCED | |
| + | SB 64 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| + | TELECONFERENCED | ||
| += | HB 278 | TELECONFERENCED | |
| += | HB 279 | TELECONFERENCED | |
| += | HB 280 | TELECONFERENCED | |
HB 323-EXTEND: BOARD OF PHARMACY
[Contains discussion of SB 37]
[Contains discussion of HB 9]
3:16:58 PM
CHAIR KITO announced that the first order of business would be
HOUSE BILL NO. 323, "An Act extending the termination date of
the Board of Pharmacy; and providing for an effective date."
3:17:24 PM
REPRESENTATIVE COLLEEN SULLIVAN-LEONARD, Alaska State
Legislature, presented HB 323 as prime sponsor. She paraphrased
the sponsor statement, which reads as follows [original
punctuation provided]:
House Bill 323 extends the termination date for the
Board of Pharmacy to June 30, 2022. Pursuant to
A.S.?08.03.010( c)(16), this Board is scheduled to
sunset on June 30th, 2018 if the legislature does not
pass legislation extending it.
Legislative Audit reviewed the Board's operations and
determined that it is in the best interest of the
state to extend this Board considering recent
statutory changes that expand the Board's
responsibilities in relation to the controlled
substance prescription database. Therefore,
recommendation is made to extend this Board for 4
years or through June 30, 2022.
The Board of Pharmacy is composed of 7 members; 5
licensed pharmacists actively engaged in the practice
of pharmacy in the State for a period of 3 years
immediately preceding their appointments and 2 members
of the public.
The Board also regulates admission into the practice
of pharmacy, establishes and enforces compliance with
professional standards and adopts regulations. It
also establishes and maintains a controlled substance
prescription database and establishes standards for
the independent administration by a pharmacist of
vaccines, related emergency medications and opioid
overdose drugs.
The Board also oversees licensing for pharmacists,
pharmacy interns, pharmacy technicians, pharmacies,
wholesale drug distributors located inside the state,
licenses drug rooms located inside institutional
facilities and also registers pharmacies located
outside of the State if a pharmacy ships, mails or
delivers prescription drugs to consumers of that
state.
These regulations control various aspects of the
field, including but not limited to controlling and
regulating the practice of pharmacy in Alaska.
A.S.?08.80.005 mandates that effective control and
regulation is necessary to promote, preserve and
protect the public's health, safety and
welfare.
3:21:08 PM
KRIS CURTIS, Legislative Auditor, Legislative Audit Division,
Legislative Agencies and Offices, reported August 2017 sunset
audit findings related to HB 323. She stated the board was
licensing effectively and was conducting its meetings in
accordance with the laws. She underlined the board was also
amending regulations to improve the industry. She informed the
board had 3,747 active licenses in March 2017 for a 33 percent
increase in licensees since the previous audit in 2009. The
board had a surplus of just over [$]275 thousand and management
within DCBPL had communicated that it would be performing a fee
analysis at the end of 2017. She explained the division
recommended only a 4-year extension in recognition of recent
statutory changes that expand the board's responsibilities in
relation to the controlled substance prescription database
(CSPD).
MS. CURTIS described the 2008 bill [Senate Bill 196]
establishing the database. She paraphrased the audit document,
entitled "A Sunset Review of the Department of Commerce,
Community, and Economic Development, Board of Pharmacy (board)"
[included in committee packet], which reads as follows [original
punctuation provided]:
The statute requires each dispenser submit to the
board, by electronic means, information regarding each
prescription dispensed for a controlled substance. The
database electronically collects information from in-
state and out-of-state pharmacies as well as other
dispensers of controlled substance prescriptions.
The database allows pharmacists and practitioners to
review prescription history prior to prescribing or
dispensing a controlled substance. The database is
also to be used to:
• monitor prescribing practices and patterns of
prescribing or dispensing;
• identify practitioners who prescribe controlled
substances in an unprofessional or unlawful
manner;
• identify individuals who may be abusing
controlled substances; and
• identify individuals who present forgeries or
otherwise false or altered prescriptions to a
pharmacy.
3:23:40 PM
MS. CURTIS identified that there were many problems with the
2008 statute, including that it did not provide the ability to
identify all dispensers that must submit information so DCBPL
staff could not monitor completeness or identify which specific
dispensers were not submitting the required information. She
added that regulations required monthly reporting of
information; however, monthly reporting was not effective for
monitoring prescription practices.
MS. CURTIS presented that the second issue with the 2008
legislation was that there was no requirement that a dispenser
or practitioner check the database prior to dispensing,
prescribing, or administering medication. She added that
according to DCBPL staff, information in the database was not
analyzed by the board and forwarded to practitioners or
pharmacists because the Department of Law advised that the law
did not allow the agency or board to provide unsolicited
reports.
MS. CURTIS described how the law had been changed so that
currently pharmacists who dispense and practitioners who
prescribe, administer, or dispense controlled substances are
required to register with the database and the board must notify
the applicable occupational boards when practitioners register
with the database, thereby allowing a check for completeness and
the ability to identify noncompliance. She underlined failure
to register is grounds for disciplinary action and dispensers
are required to report weekly and this requirement was
subsequently changed to report daily.
MS. CURTIS stated that access to the database was expanded to
include dispensers, dispenser delegates, and other persons or
entities with a valid business need and the board was authorized
to provide unsolicited notification to a pharmacist or
practitioner if a patient has received one or more prescriptions
for controlled substances inconsistent with generally recognized
standards of safe practice. She added unsolicited reports may
also be issued to a practitioner's licensing board and new
performance measures must be reported to the legislature
annually including measures regarding the impact of the
database. She stated dispensers and practitioners are now
required to check the database prior to dispensing, prescribing,
or administering medication, with specific exclusions.
MS. CURTIS said the audit states that with the changes, the
board was empowered to serve the public interest; however, DCBPL
does not believe this board should be proactively analyzing the
database as it is not traditionally the role of an occupational
board. She added that DCCED had stated additional resources
would be needed if the legislature intends for the board to
analyze the data.
3:26:30 PM
MS. CURTIS presented the two recommendations. She said the
first recommendation was that DCBPL's chief investigator should
work with the director to improve the timeliness of
investigations, and the second was that DCBPL's director should
improve procedures to ensure required licensure documentation is
appropriately obtained and retained.
MS. CURTIS informed the Office of the Governor agreed with the
4-year extension but had not commented on the database concerns;
the department agreed with both recommendations and had
indicated it had implemented new procedures to ensure timeliness
of investigations and did state that additional resources would
be required; and the board chair had agreed with both
recommendations.
3:29:10 PM
REPRESENTATIVE KNOPP asked when the previous audit had been
carried out.
MS. CURTIS answered the previous audit had been carried out in
2009. She pointed to a timeline in the audit document. She
added there are new reporting requirements on the status of the
database.
REPRESENTATIVE KNOPP surmised it would be four years before the
next report on the database.
MS. CURTIS answered it would probably be in 2021.
3:30:44 PM
REPRESENTATIVE BIRCH remarked pharmacies do not have a way to be
compensated for their expertise and said he thought that in
other places pharmacies could be paid for some level of medical
support services. He asked whether it would be appropriate to
solicit the board for recommendations for advancement of the
pharmacy profession.
MS. CURTIS answered the type of audit was unique in that the 11
criteria used were set out in statute. She added unless there
are specific complaints heard at a board meeting or news
article, other issues would not be addressed in the audit.
3:33:53 PM
LEIF HOLM, Chair, Board of Pharmacy, Division of Corporations,
Business and Professional Licensing (DCBPL), Department of
Commerce, Community, and Economic Development (DCCED), testified
in support of HB 323. He testified the board concurred with the
4-year board extension as it was understood that the board's
duties were expanding further.
REPRESENTATIVE BIRCH said he supported the bill proposal but had
concerns regarding pharmacists receiving compensation for their
expertise. He asked where the board chairman would turn to
remedy the situation for pharmacists in the state.
MR. HOLM answered it was a complicated question and underlined
the board tries to stay away from matters of financial interest.
He emphasized he does not speak as a board member when speaking
to PBMs and auditing practices. He said he knows there is an
active push for pharmacies to get provider status at the federal
level to receive payment for their services. He stated the
interest of the board is patient safety.
3:37:08 PM
REPRESENTATIVE KNOPP spoke to the board's database
responsibilities and asked how the board could maintain the
database with no part- or full-time employees.
MR. HOLM answered it had not been working well, and the board
has not had the time or manpower. He added the board had been
actively pursuing a bill to license out-of-state wholesalers in
the state and had attached an executive administrator position
but had not been able to get the bill passed. He added that
with Senate Bill 74, the board was allowed to hire an
administrator for the Prescription Drug Monitoring Program
(PDMP) as well as a board assistant, but he surmised that the
position would be solely focused on the PDMP.
3:39:10 PM
CHAIR KITO spoke to concerns about implementing the PDMP and
asked for Mr. Holm's thoughts regarding how the legislature
could assist the board.
MR. HOLM testified that since the board hired someone to work on
the PDMP progress was being made.
3:41:05 PM
CHAIR KITO opened public testimony on HB 323.
3:41:18 PM
RICHARD HOLT, Vice Chair, Board of Pharmacy, Division of
Corporations, Business and Professional Licensing (DCBPL),
Department of Commerce, Community, and Economic Development
(DCCED), testified in support of HB 323. He said he concurred
with what Mr. Holm had stated in his testimony regarding the
legislative audit. He mentioned other legislation would aid the
board in its duties, such as SB 37 and HB 9.
CHAIR KITO held over HB 323.