Legislature(2015 - 2016)CAPITOL 106

03/08/2016 03:00 PM House HEALTH & SOCIAL SERVICES

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+= HB 227 MEDICAL ASSISTANCE REFORM TELECONFERENCED
Moved CSHB 227(HSS) Out of Committee
+= HB 344 DRUG PRESCRIPTION DATABASE TELECONFERENCED
Heard & Held
+ Bills Previously Heard/Scheduled TELECONFERENCED
               HB 344-DRUG PRESCRIPTION DATABASE                                                                            
                                                                                                                                
3:53:26 PM                                                                                                                    
                                                                                                                                
CHAIR SEATON announced  that the next order of  business would be                                                               
HOUSE BILL NO. 344, "An  Act relating to the controlled substance                                                               
prescription database; and providing for an effective date."                                                                    
                                                                                                                                
3:53:50 PM                                                                                                                    
                                                                                                                                
CHAIR SEATON opened public testimony.   After ascertaining no one                                                               
wished to testify, closed public testimony.                                                                                     
                                                                                                                                
3:54:19 PM                                                                                                                    
                                                                                                                                
CHAIR SEATON directed  attention to the answers  to the committee                                                               
questions  provided by  the Department  of Commerce,  Community &                                                               
Economic Development [included in members' packets].                                                                            
                                                                                                                                
3:55:09 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 3:55 p.m. to 3:57 p.m.                                                                       
                                                                                                                                
3:57:33 PM                                                                                                                    
                                                                                                                                
CHAIR SEATON brought the committee back to order.                                                                               
                                                                                                                                
3:57:38 PM                                                                                                                    
                                                                                                                                
JANEY  HOVENDEN, Director,  Division  of Corporations,  Business,                                                               
and Professional  Licensing, Department of Commerce,  Community &                                                               
Economic  Development, clarified  that the  original fiscal  note                                                               
did not include  the cost of software upgrades  to update nightly                                                               
or  weekly.   She stated  that  the department  would adjust  the                                                               
fiscal note to match the proposed committee substitute.                                                                         
                                                                                                                                
CHAIR SEATON asked that the  department provide an updated fiscal                                                               
note.                                                                                                                           
                                                                                                                                
3:59:11 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR asked about the  cost to upgrade to weekly or                                                               
daily.                                                                                                                          
                                                                                                                                
MS.  HOVENDEN  explained that  this  had  been corrected  by  the                                                               
vendor to $2,200 annually.                                                                                                      
                                                                                                                                
REPRESENTATIVE WOOL  asked how  often the  software needed  to be                                                               
updated.                                                                                                                        
                                                                                                                                
MS.  HOVENDEN   opined  that   the  updating   reflected  current                                                               
information either nightly  or weekly and was not  an upgrade for                                                               
the system.                                                                                                                     
                                                                                                                                
CHAIR SEATON  noted that the proposed  committee substitute would                                                               
change "from  near real time"  to "at least weekly,"  although it                                                               
was still a requirement for the  pharmacist to submit to the data                                                               
base.                                                                                                                           
                                                                                                                                
MS. HOVENDEN expressed her agreement.                                                                                           
                                                                                                                                
CHAIR  SEATON   referenced  the  question  about   the  methadone                                                               
clinics, considered  to be psychiatric treatment  and; therefore,                                                               
protected under federal law.   He offered an anecdote regarding a                                                               
patient  given something  at an  Emergency Room  which interacted                                                               
badly with  methadone, and resulted  in the patient's death.   He                                                               
suggested  that methadone  be included  in the  database, or,  if                                                               
this was not allowed by federal law, were there any suggestions.                                                                
                                                                                                                                
CHAIR SEATON asked how current  information to the database would                                                               
be  updated by  practitioners  who  did not  have  access to  the                                                               
internet.                                                                                                                       
                                                                                                                                
MS.  HOVENDEN  said that  she  wanted  to clarify,  although  she                                                               
stated that there were ways to  work around for those who did not                                                               
have internet access.   She offered her  understanding that faxes                                                               
could be submitted.                                                                                                             
                                                                                                                                
CHAIR SEATON asked for a statement  of the ways to work around so                                                               
the committee substitute could be aligned.                                                                                      
                                                                                                                                
REPRESENTATIVE WOOL asked about  the requirement for notarization                                                               
to verify identity.                                                                                                             
                                                                                                                                
MS. HOVENDEN relied that this was the current system.                                                                           
                                                                                                                                
REPRESENTATIVE WOOL suggested use of the "MyAlaska" accounts.                                                                   
                                                                                                                                
MS. HOVENDEN  relayed that this  was being explored,  noting that                                                               
this was only an option for Alaska residents already registered.                                                                
                                                                                                                                
CHAIR   SEATON  asked   if  the   requirement   for  license   or                                                               
registration  offered   an  option   other  than   the  notarized                                                               
identification.                                                                                                                 
                                                                                                                                
MS.  HOVENDEN explained  that licensing  offered a  mechanism for                                                               
discipline, otherwise there was not an avenue for discipline.                                                                   
                                                                                                                                
REPRESENTATIVE  VAZQUEZ  asked  for clarification  regarding  the                                                               
data updating.                                                                                                                  
                                                                                                                                
CHAIR  SEATON  replied  that  the  current  committee  substitute                                                               
required it  to be at  least weekly, as it  was now monthly.   He                                                               
pointed  out that  reporting daily  was a  potential problem  for                                                               
rural pharmacies.   He reported  that, as prescription  abuse was                                                               
not  a one-time  issue, requiring  the reporting  to be  at least                                                               
weekly would "catch most things in the system."                                                                                 
                                                                                                                                
4:08:04 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE VAZQUEZ  asked if  the committee  substitute would                                                               
clarify who  had the  responsibility to  check the  database, the                                                               
provider, the dispenser, or both.                                                                                               
                                                                                                                                
CHAIR  SEATON explained  that the  committee substitute  required                                                               
the  physician,  or the  pharmacist-in-chief,  or  a licensed  or                                                               
registered  delegated staff.    He reported  that  fewer than  13                                                               
percent of the  providers in Alaska were  currently registered to                                                               
use the  database, and the  proposed bill would require  them all                                                               
to be registered.   He stated that it was  intended for providers                                                               
to  check the  database  prior  to writing  a  prescription.   He                                                               
reported  that the  proposed  committee  substitute required  the                                                               
initial  prescription to  only be  for seven  days, as  currently                                                               
there  was no  limit, unless  there was  a specific  condition or                                                               
logistical reason for a longer dose for adults.                                                                                 
                                                                                                                                
4:11:12 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE STUTES  asked if there  was a fail-safe  to ensure                                                               
the database was kept current.                                                                                                  
                                                                                                                                
MS.  HOVENDEN  directed  attention   to  the  fiscal  note  which                                                               
requested  a   program  coordinator  to  manage   the  monitoring                                                               
program.                                                                                                                        
                                                                                                                                
REPRESENTATIVE  STUTES asked  if this  person would  maintain the                                                               
system on a current basis.                                                                                                      
                                                                                                                                
MS. HOVENDEN replied  that it would be the  responsibility of the                                                               
program coordinator, with the pharmacy  licensing examiner in the                                                               
back-up role.                                                                                                                   
                                                                                                                                
CHAIR SEATON pointed  out that there was not  a single individual                                                               
with this responsibility in the current program.                                                                                
                                                                                                                                
REPRESENTATIVE STUTES opined that there  could be follow-up if it                                                               
becomes an issue.                                                                                                               
                                                                                                                                
REPRESENTATIVE  WOOL asked  for clarification  that the  proposed                                                               
committee  substitute  only  dealt   with  disbursement  and  not                                                               
prescription.                                                                                                                   
                                                                                                                                
CHAIR  SEATON  replied  that the  proposed  committee  substitute                                                               
required  that   all  the  prescribers,  pharmacists,   or  their                                                               
licensed delegates  check the  data base.   He declared  that the                                                               
purpose of  the proposed  bill was  to ensure  accountability for                                                               
use of  this data base  by the prescription authorities,  as well                                                               
as  the  pharmacists.    He  reiterated that  there  was  also  a                                                               
requirement  for  a  maximum   seven  day  initial  prescription,                                                               
although  the Centers  for Disease  Control and  Prevention (CDC)                                                               
had recommended  a maximum  three day  initial prescription.   He                                                               
pointed  out  that  the  Department   of  Commerce,  Community  &                                                               
Economic Development was only managing the database.                                                                            
                                                                                                                                
REPRESENTATIVE WOOL  opined that  the primary difference  was for                                                               
both the  providers and  the dispensers to  be required  to enter                                                               
the data.                                                                                                                       
                                                                                                                                
[HB 344 was held over.]                                                                                                         

Document Name Date/Time Subjects
HB 227 Summary of Changes_H to N.pdf HHSS 3/8/2016 3:00:00 PM
HB 227
HB 227 Proposed CS ver N_3.7.2016.pdf HHSS 3/8/2016 3:00:00 PM
HB 227
HB 344 Follow Up DCCED_3.8.2016.pdf HHSS 3/8/2016 3:00:00 PM
HHSS 3/10/2016 3:00:00 PM
HB 344
HB 227 Fiscal Note Graphs from Legislative finance_ 3-8-16.pdf HHSS 3/8/2016 3:00:00 PM
HB 227