Legislature(2015 - 2016)CAPITOL 106

03/24/2016 03:00 PM House HEALTH & SOCIAL SERVICES

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Audio Topic
03:03:36 PM Start
03:05:35 PM Presentation on Telehealth
04:04:12 PM HB344
04:31:24 PM HB315
05:16:36 PM HB328
07:13:45 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Presentation: TELECONFERENCED
NCSL: Telehealth
+= HB 315 ELECTRONIC VISIT VERIFICATION: MEDICAID TELECONFERENCED
Heard & Held
+= HB 334 CHILD CUSTODY;DOM. VIOLENCE;CHILD ABUSE TELECONFERENCED
<Bill Hearing Rescheduled to 3/29/16>
+= HB 328 REGULATION OF SMOKING TELECONFERENCED
Heard & Held
+ Bills Previously Heard/Scheduled TELECONFERENCED
+= HB 344 DRUG PRESCRIPTION DATABASE TELECONFERENCED
Moved CSHB 344(HSS) Out of Committee
               HB 344-DRUG PRESCRIPTION DATABASE                                                                            
                                                                                                                                
4:04:12 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."                                                                    
                                                                                                                                
[Before the committee was the  proposed committee substitute (CS)                                                               
for HB  344, Version  29-LS1378\N, Bruce,  3/14/16, as  a working                                                               
document.]                                                                                                                      
                                                                                                                                
4:04:30 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 4:04 p.m. to 4:07 p.m.                                                                       
                                                                                                                                
4:07:40 PM                                                                                                                    
                                                                                                                                
CHAIR SEATON  moved to adopt Amendment  2, labeled 29-LS1378\N.3,                                                               
which read:                                                                                                                     
                                                                                                                                
     Page 16, line 16, following "patient":                                                                                 
          Insert "more than a three-day supply of"                                                                          
                                                                                                                                
                                                                                                                                
REPRESENTATIVE TARR objected for discussion.                                                                                    
                                                                                                                                
CHAIR  SEATON   explained  that  this  amendment   would  add  an                                                               
exemption to  the mandatory  review of  the database  required in                                                               
Sec. 19, page  16, lines 14-20.  The exemption  would mean that a                                                               
practitioner or  pharmacist would  not be  required to  check the                                                               
database if  they are  dispensing a  controlled substance  with a                                                               
supply of three  days or less.  Although, they  could still check                                                               
but there would not be a requirement to check.                                                                                  
                                                                                                                                
4:08:59 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR  noted that  it reads more  than a  three day                                                               
and surmised that it includes the third day.                                                                                    
                                                                                                                                
CHAIR SEATON agreed, and said three days or less.                                                                               
                                                                                                                                
4:09:28 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  TARR  removed  her  objection.   There  being  no                                                               
objection, Amendment 2 was adopted.                                                                                             
                                                                                                                                
4:10:00 PM                                                                                                                    
                                                                                                                                
CHAIR SEATON  moved to adopt Amendment  3, Version 29-LS1378\N.5,                                                               
which read:                                                                                                                     
                                                                                                                                
     Page 17, line 17, following "state":                                                                                       
          Insert "for an occupation or activity listed                                                                          
     under AS 08.01.010"                                                                                                        
                                                                                                                                
REPRESENTATIVE STUTES objected for discussion.                                                                                  
                                                                                                                                
CHAIR SEATON referred to Sec.  20, subsection (q), page 17, lines                                                               
15-17, which read:                                                                                                              
                                                                                                                                
          (q) A pharmacist or practitioner may only                                                                             
     delegate access  to the  database under  (b) or  (d) of                                                                    
     this section  to an employee  or agent who  is licensed                                                                    
     or registered in the state.                                                                                                
                                                                                                                                
CHAIR SEATON explained that the  amendment would clarify that the                                                               
person  must  be licensed  or  registered  for an  occupation  or                                                               
activity listed in AS 08.01.010.   The reason being to make clear                                                               
that they  must be  licensed or registered  with the  Division of                                                               
Corporations, Business,  and Professional Licensing and  not some                                                               
unintended  registration,  such  as the  sex  offender  registry,                                                               
thereby,  designating which  licenses  or  registration would  be                                                               
covered, he advised.                                                                                                            
                                                                                                                                
4:11:18 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  STUTES removed  her  objection.   There being  no                                                               
objection, Amendment 3 was adopted.                                                                                             
                                                                                                                                
4:11:47 PM                                                                                                                    
                                                                                                                                
CHAIR SEATON  moved to adopt Amendment  4, Version 29-LS1378\N.6,                                                               
which read:                                                                                                                     
                                                                                                                                
     Page 18, line 15, following "TRANSITION.":                                                                                 
          Insert "(a)"                                                                                                          
                                                                                                                                
     Page 18, following line 18:                                                                                                
     Insert a new subsection to read:                                                                                           
          "(b)  On or before October 1, 2019, the                                                                               
     Department   of  Commerce,   Community,  and   Economic                                                                    
     Development  shall solicit  comments  on  the level  of                                                                    
     burden on  providers created by the  review requirement                                                                    
     in AS 17.30.200(k)(4), enacted by  sec. 19 of this Act.                                                                    
     The  department shall  summarize,  in a  report to  the                                                                    
     legislature,  the comments  received by  the department                                                                    
     and its findings based on  the comments. The department                                                                    
     shall deliver  the report to  the senate  secretary and                                                                    
     the  chief clerk  of the  house of  representatives not                                                                    
     later than October 1, 2019,  and notify the legislature                                                                    
     that  the  report  is available.  The  legislature  may                                                                    
     assess   whether  the   review  requirement   under  AS                                                                    
     17.30.200(k)(4),  enacted  by  sec.  19  of  this  Act,                                                                    
     remains necessary or if  alternative language should be                                                                    
     considered based on the report."                                                                                           
                                                                                                                                
REPRESENTATIVE TARR objected for discussion.                                                                                    
                                                                                                                                
CHAIR  SEATON  explained that  the  amendment  would add  to  the                                                               
uncodified law,  under Sec.  22 of  the HB  334.   He paraphrased                                                               
that the amendment directs the  Department of Commerce, Community                                                               
&  Economic  Development  to   solicit  comments  from  providers                                                               
regarding the level of burden  on providers created by the review                                                               
requirement  of   AS  17.30.200(k)(4)  and  to   deliver  to  the                                                               
legislature a report summarizing  the comments and the Department                                                               
of Commerce,  Community &  Economic Development's  findings based                                                               
on the  comments.  The report  would be due October  1, 2019, and                                                               
the  legislature may  assess whether  the  review requirement  is                                                               
still  necessary   or  whether  alternative  language   would  be                                                               
preferable.  Basically,   he  pointed   out,  this   directs  the                                                               
Department  of  Commerce,  Community &  Economic  Development  to                                                               
collect  comments  on the  burden  on  providers created  by  the                                                               
requirement  to   review  the  database  prior   to  prescribing,                                                               
dispensing,  or  administering,  and the  department  would  then                                                               
present  comments to  the  legislature with  the  findings.   The                                                               
legislature would then  have the option to  re-examine and review                                                               
the requirement.   It  is not  a sunset  but it  is a  review and                                                               
report.   The date of October  1, 2019 would give  the department                                                               
two years  and three  months from the  effective date  to collect                                                               
these comments and generate a report.                                                                                           
                                                                                                                                
4:13:45 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR  asked who would  prepare the  report because                                                               
the  Department of  Commerce,  Community  & Economic  Development                                                               
(DCCED)  is  the stop  gap  to  move  the  database over  to  the                                                               
department  as it  does the  professional licensing,  but is  the                                                               
department well equipped  to receive comments.   For example, the                                                               
Department  of Health  and Social  Services  (DHSS) is  regularly                                                               
communicating  with its  Medicaid providers,  and suggested  that                                                               
possibly it should be DCCED and DHSS.                                                                                           
                                                                                                                                
CHAIR SEATON said  he presumed that each one  of the professional                                                               
boards would be handling those,  and called on Ms. Janey Hovenden                                                               
to respond.                                                                                                                     
                                                                                                                                
4:14:54 PM                                                                                                                    
                                                                                                                                
JANEY  HOVENDEN, Director,  Division  of Corporations,  Business,                                                               
and Professional  Licensing, Department of Commerce,  Community &                                                               
Economic Development, explained that  as she reads the amendment,                                                               
the  program coordinator  would coordinate  all information  with                                                               
all of  the different boards  and members in licensing,  which is                                                               
how a survey would be generated.   The survey would go out to all                                                               
registered  people  with  a database  and  solicit  their  input,                                                               
collect the  information and prepare  the required report  to the                                                               
legislature, she said.                                                                                                          
                                                                                                                                
4:15:42 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  TARR asked  whether she  felt equipped  to handle                                                               
this task  and the volume  of respondents  which could be  in the                                                               
hundreds  or thousands.    She further  asked  that whether  with                                                               
existing resources the department would  be able to pull together                                                               
a report, or whether the  report would be a self-generated report                                                               
with  something  such  as  "Survey   Monkey  and  that  would  be                                                               
sufficient.                                                                                                                     
                                                                                                                                
MS. HOVENDEN  replied that even  though the department  is slowly                                                               
gathering email  addresses it isn't  quite equipped for  that and                                                               
would notify as it does  all regulation projects or anything like                                                               
that,  send snail  mail  to everyone.    The program  coordinator                                                               
being requested in this bill  would spearhead that entire project                                                               
as one of the duties of the position.                                                                                           
                                                                                                                                
REPRESENTATIVE TARR  related that sounds more  realistic in terms                                                               
of  a hefty  project and  she  did not  know what  to expect  and                                                               
sometimes given the opportunity people have a lot to say.                                                                       
                                                                                                                                
CHAIR  SEATON commented  that he  agrees that  without a  program                                                               
coordinator  if the  legislature  was just  dumping  this on  the                                                               
department, which  would not  be something  that would  be easily                                                               
handled.                                                                                                                        
                                                                                                                                
4:17:15 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  STUTES  asked  whether   this  project  could  be                                                               
performed  in  a timely  fashion.    She described  concern  that                                                               
people   cannot  receive   a  response   from  the   Division  of                                                               
Corporations, Business, and Professional Licensing, currently.                                                                  
                                                                                                                                
CHAIR  SEATON  reiterated that  there  is  a program  coordinator                                                               
hired for  this specific coordination  of the database and  it is                                                               
not  giving the  department another  job.   The description  of a                                                               
program coordinator  is located  within the  fiscal note  and the                                                               
report period  is for  two years  and three  months only.   There                                                               
will  be a  summary of  the  problems received  prepared for  the                                                               
legislature.                                                                                                                    
                                                                                                                                
REPRESENTATIVE STUTES  asked whether  the coordinator  would work                                                               
under the  Division of  Corporations, Business,  and Professional                                                               
Licensing.                                                                                                                      
                                                                                                                                
MS. HOVENDEN replied yes.                                                                                                       
                                                                                                                                
REPRESENTATIVE STUTES said that was her concern.                                                                                
                                                                                                                                
4:19:22 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  VAZQUEZ   said  she  likes  the   intent  of  the                                                               
amendment  in receiving  feedback  from  providers regarding  the                                                               
burden that will be placed upon  them, but she is concerned there                                                               
will not be feedback until  three and one-half years away because                                                               
that is too long  of a period of time.  At most  it should be one                                                               
year  from now,  or something  in January,  2017.   Although, she                                                               
commented, not all of the  information will have been received to                                                               
assess  the  type  of  burden  but  there  would  be  an  initial                                                               
indication and annual  reports thereafter.  She  referred to line                                                               
11 of  Amendment 4, and pointed  out that the amendment  states a                                                               
report shall  be submitted on  "not later than October  1, 2019,"                                                               
and it is now March 24, 2016.                                                                                                   
                                                                                                                                
4:20:32 PM                                                                                                                    
                                                                                                                                
CHAIR SEATON explained that the effective date is July 2017.                                                                    
                                                                                                                                
REPRESENTATIVE VAZQUEZ asked  to shorten the time  frame in order                                                               
to know the type of burden it will impose on the providers.                                                                     
                                                                                                                                
4:21:08 PM                                                                                                                    
                                                                                                                                
CHAIR SEATON  responded that he was  trying to give at  least one                                                               
year  of  the   program  being  in  effect   to  coordinate  that                                                               
information in  an effective  manner, and this  is not  an annual                                                               
report.   He  remarked  he has  tried to  eliminate  some of  the                                                               
burden  by  allowing  the  chief  pharmacist  to  also  authorize                                                               
someone who  is licensed or  registered in the health  field, and                                                               
there  is accountability  against their  license.   The testimony                                                               
the committee received was that  the department is the busiest at                                                               
the end of  the legislature or the fiscal year  and the best time                                                               
to  prepare the  report is  October or  November so  it would  be                                                               
ready for  the legislature in  the following year.   He commented                                                               
that preparing a  report in June or July for  the legislature may                                                               
not be reviewed  until the next session, and  receiving a shorter                                                               
term report wouldn't cover an  entire year's worth of the program                                                               
and the  intention is to  calculate feedback.   In the  event the                                                               
committee  does not  wish  to have  a report,  he  said he  could                                                               
remove the report.                                                                                                              
                                                                                                                                
4:23:40 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  TARR noted  that the  effective date  is July  1,                                                               
2017, and a full year would  be 2018, and suggested using January                                                               
1, 2019.                                                                                                                        
                                                                                                                                
CHAIR  SEATON  asked  whether the  department  could  change  the                                                               
report date.                                                                                                                    
                                                                                                                                
MS.  HOVENDEN  responded  that   the  report  will  be  presented                                                               
whenever it is requested.                                                                                                       
                                                                                                                                
4:24:50 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  TARR moved  to adopt  Conceptual  Amendment 1  to                                                               
Amendment 4,  to change the  date on line  6 to January  1, 2019;                                                               
and on line 11 to change the date to January 1, 2019.                                                                           
                                                                                                                                
CHAIR SEATON objected.   He surmised that it  would be Conceptual                                                               
Amendment 1 to Amendment 4 to  change October 1, 2019, to January                                                               
1, 2019, on line 6 and line 11.                                                                                                 
                                                                                                                                
REPRESENTATIVE TARR agreed.                                                                                                     
                                                                                                                                
4:25:41 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE WOOL said that based  on the pharmacist's comments                                                               
that expressed  possibly foreseeable problems, he  opined that it                                                               
gives  them  a  year  to   evaluate,  and  after  that  year  the                                                               
department  has five  months to  complete a  report.   He related                                                               
that it is a good timeline.                                                                                                     
                                                                                                                                
CHAIR SEATON  removed his objection.   There being  no objection,                                                               
Conceptual Amendment 1 to Amendment 4 was adopted.                                                                              
                                                                                                                                
4:26:34 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  TARR  removed her  objection  to  Amendment 4  as                                                               
amended.  There being no  objection, Amendment 4, as amended, was                                                               
adopted.                                                                                                                        
                                                                                                                                
4:27:36 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  VAZQUEZ moved  to  report CSHB  344, Version  29-                                                               
LS1378\N,   as  amended,   out  of   committee  with   individual                                                               
recommendations and  the accompanying fiscal notes.   There being                                                               
no objection, CSHB  344(HSS) was reported from  the House Health,                                                               
Education and Social Services Standing Committee                                                                                

Document Name Date/Time Subjects
HB 344 proposed amendment_Seaton N.6.pdf HHSS 3/24/2016 3:00:00 PM
HB 344
HB 344 Proposed amendment Seaton N 5.pdf HHSS 3/24/2016 3:00:00 PM
HB 344
HB 344 Proposed amendemnt- SEaton N 3.pdf HHSS 3/24/2016 3:00:00 PM
HB 344
HB328 Testimony_Kenai LIO_8 support_032216.pdf HHSS 3/24/2016 3:00:00 PM
HB 328
HB328_Testimony_Kenai LIO_Opposition_032216.pdf HHSS 3/24/2016 3:00:00 PM
HB 328
HB328 support_Mat-Su Health_March 22 2016.pdf HHSS 3/24/2016 3:00:00 PM
HB 328
HB 344 testimony_AMA_ proposed changes letter 3-10-16_UPDATED.pdf HHSS 3/24/2016 3:00:00 PM
HB 344
HB 344 Testimony_Kristi Rice.pdf HHSS 3/24/2016 3:00:00 PM
HB 344
HB 344 testimony Tanana Chiefs.pdf HHSS 3/24/2016 3:00:00 PM
HB 344
HB 344 Testimony Joshua Sonkiss.pdf HHSS 3/24/2016 3:00:00 PM
HB 344
HB315 proposed amendment E.1.pdf HHSS 3/24/2016 3:00:00 PM
HB 315
NCSL Telehealth presentation_March 24 2016.pdf HHSS 3/24/2016 3:00:00 PM
Telehealth
HB344 Letter to Rep Seaton_Holt.pdf HHSS 3/24/2016 3:00:00 PM
HB 344
HB 328 - Supporting Document - Powerpoint Presentation.pdf HHSS 3/24/2016 3:00:00 PM
HB 328
HB 315 Fiscal Note -DHSS-SDSA-3.18.16-UPDATED.pdf HHSS 3/24/2016 3:00:00 PM
HB 315
HB328 Fiscal Note-DOT-NRHA-3.19.16.pdf HHSS 3/24/2016 3:00:00 PM
HB 328
HB328 Fiscal Note DOT-SRHA-3.19.16.pdf HHSS 3/24/2016 3:00:00 PM
HB 328
HB328 Fiscal Note-DOT-IASO-3.19.16.pdf HHSS 3/24/2016 3:00:00 PM
HB 328
HB328 Fiscal Note - DOT-SEF-3.19.16.pdf HHSS 3/24/2016 3:00:00 PM
HB 328
HB328 Fiscal Note -DOT-CRHA-3.19.06.pdf HHSS 3/24/2016 3:00:00 PM
HB 328
HB328 Fiscal Note-DOT-MVO-3.19.16.pdf HHSS 3/24/2016 3:00:00 PM
HB 328
HB 328 amendment Wool.pdf HHSS 3/24/2016 3:00:00 PM
HB 328
HB315 proposed CS_ver W.pdf HHSS 3/24/2016 3:00:00 PM
HB 315
HB 328 Opposition emails March 23.pdf HHSS 3/24/2016 3:00:00 PM
HB 328
HB 328 Opposition- 3.24 testimony_11 letters.pdf HHSS 3/24/2016 3:00:00 PM
HB 328
HB 328 Support_March 24 testimony_14 letters.pdf HHSS 3/24/2016 3:00:00 PM
HB 328
HB 328 Opposition-ALL testimony-39 individuals_3.21-3.26.pdf HHSS 3/24/2016 3:00:00 PM
HB 328
HB 328 Suppport-ALL testimony_74 individuals_3.21-3.26.pdf HHSS 3/24/2016 3:00:00 PM
HB 328
HB 328 Support 8 emails_March 23.pdf HHSS 3/24/2016 3:00:00 PM
HB 328