Legislature(2019 - 2020)CAPITOL 106

04/16/2019 03:00 PM HEALTH & SOCIAL SERVICES

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Audio Topic
03:12:19 PM Start
03:12:55 PM HB89
03:21:25 PM HB114
03:26:11 PM Confirmation Hearing(s):|| Mental Health Trust Authority Board of Trustees
04:07:47 PM Commissioner, Department of Health and Social Services
05:22:39 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+= HB 89 OPIOID PRESCRIPTION INFORMATION TELECONFERENCED
Heard & Held
-- Public Testimony --
+= HB 114 MEDICAL PROVIDER INCENTIVES/LOAN REPAYM'T TELECONFERENCED
Moved HB 114 Out of Committee
+ Consideration of Governor's Appointees: TELECONFERENCED
-Alaska Mental Health Trust Authority Board of
Trustees
-Commissioner-Designee Adam Crum, Dept. of Health
& Social Services
+ Bills Previously Heard/Scheduled TELECONFERENCED
             HB 89-OPIOID PRESCRIPTION INFORMATION                                                                          
                                                                                                                                
3:12:55 PM                                                                                                                    
                                                                                                                                
CO-CHAIR  SPOHNHOLZ announced  that the  first order  of business                                                               
would be HOUSE BILL NO. 89,  "An Act relating to the prescription                                                               
of opioids;  relating to the  practice of dentistry;  relating to                                                               
the practice of  medicine; relating to the  practice of podiatry;                                                               
relating to the practice of  osteopathy; relating to the practice                                                               
of nursing; relating  to the practice of  optometry; and relating                                                               
to the practice of pharmacy."                                                                                                   
                                                                                                                                
[Before the committee was the  proposed committee substitute (CS)                                                               
for HB  89, labeled 31-LS0421\U,  Fisher, 4/3/19, adopted  as the                                                               
working document on 4/4/19.]                                                                                                    
                                                                                                                                
3:13:29 PM                                                                                                                    
                                                                                                                                
MIRANDA  DORDAN,  Intern,  Representative Ivy  Spohnholz,  Alaska                                                               
State  Legislature, reviewed  HB 89  on behalf  of Representative                                                               
Spohnholz, sponsor.  She said  the bill would mitigate the opioid                                                               
public  health epidemic  that Alaska  is currently  facing.   The                                                               
bill  would do  this by  increasing patient  awareness of  opioid                                                               
dependence and  addiction before  the patient receives  an opioid                                                               
prescription.    She  paraphrased   from  the  following  written                                                               
sectional analysis  included in the committee  packet, which read                                                               
[original punctuation provided]:                                                                                                
                                                                                                                                
     Section  1.   Bill  Name   is  Opioid   Addiction  Risk                                                                  
     Disclosure.  Legislative Findings  hold that  The State                                                                    
     has a  moral, financial, and public  health interest in                                                                    
     reducing opioid  and heroin addiction in  Alaska. There                                                                    
     has  been  a  copious   amount  of  medically  document                                                                    
     evidence that shows that  opioid prescription drugs are                                                                    
     addictive and can create issues for patients                                                                               
                                                                                                                                
     Section  2.  Amends  AS   08.36.070  Duties  of  Opioid                                                                  
     Prescribing  Dentists: Inform  patients, in  provider's                                                                    
     "own  words",  of   potential  addiction  dangers  from                                                                    
     extended  opioid  use;  and  any  reasonable  treatment                                                                    
     alternatives, if they exist,  to the recommended opioid                                                                    
     prescription;  distribute  Department   of  Health  and                                                                    
     Social  Services   short  handout  on   some  potential                                                                    
     dangers.                                                                                                                   
                                                                                                                                
     Regulations/Enforcement   of  Bill:   Board  power   to                                                                    
     consider  discipline  for   dentists  who  "habitually"                                                                    
     violate bill requirements;  potential board discipline,                                                                    
     but  no  additional  legal  civil  liability  cause  of                                                                    
     action  created by  bill,  to  protect against  hostile                                                                    
     legal relationship between patient and provider.                                                                           
                                                                                                                                
     Section  3. Amends  AS  08.64.101(a)  Duties of  Opioid                                                                  
     Prescribing    Medical,    Osteopathy   and    Podiatry                                                                    
     Providers: Inform patients,  in provider's "own words",                                                                    
     of  potential addiction  dangers  from extended  opioid                                                                    
     use;  and  any  reasonable treatment  alternatives,  if                                                                    
     they  exist, to  the  recommended opioid  prescription;                                                                    
     distribute  Department of  Health  and Social  Services                                                                    
     short handout on some potential dangers.                                                                                   
                                                                                                                                
     Regulations/Enforcement   of  Bill:   Board  power   to                                                                    
     consider   discipline  for   medical,  osteopathy   and                                                                    
     podiatry  providers   who  "habitually"   violate  bill                                                                    
     requirements;  potential   board  discipline,   but  no                                                                    
     additional  legal  civil   liability  cause  of  action                                                                    
     created  by  bill,  to protect  against  hostile  legal                                                                    
     relationship between patient and provider.                                                                                 
                                                                                                                                
     Section  4. Amends  AS  08.68.100(a)  Duties of  Opioid                                                                  
     Prescribing  Registered  Nurses:  Inform  patients,  in                                                                    
     provider's "own words",  of potential addiction dangers                                                                    
     from extended opioid use;  and any reasonable treatment                                                                    
     alternatives, if they exist,  to the recommended opioid                                                                    
     prescription;  distribute  Department   of  Health  and                                                                    
     Social  Services   short  handout  on   some  potential                                                                    
     dangers.                                                                                                                   
                                                                                                                                
     Regulations/Enforcement   of  Bill:   Board  power   to                                                                    
     consider   discipline   for   registered   nurses   who                                                                    
      habitually"   violate  bill   requirements;  potential                                                                    
     board  discipline,   but  no  additional   legal  civil                                                                    
     liability cause  of action created by  bill, to protect                                                                    
     against hostile legal  relationship between patient and                                                                    
     provider.                                                                                                                  
                                                                                                                                
     Section  5.  Amends  AS   08.72.050  Duties  of  Opioid                                                                  
     Prescribing    Optometrists:   Inform    patients,   in                                                                    
     provider's "own words",  of potential addiction dangers                                                                    
     from extended opioid use;  and any reasonable treatment                                                                    
     alternatives, if they exist,  to the recommended opioid                                                                    
     prescription;  distribute  Department   of  Health  and                                                                    
     Social  Services   short  handout  on   some  potential                                                                    
     dangers.                                                                                                                   
                                                                                                                                
     Regulations/Enforcement   of  Bill:   Board  power   to                                                                    
     consider  discipline  for registered  optometrists  who                                                                    
     "habitually"   violate  bill   requirements;  potential                                                                    
     board  discipline,   but  no  additional   legal  civil                                                                    
     liability cause  of action created by  bill, to protect                                                                    
     against hostile legal  relationship between patient and                                                                    
     provider.                                                                                                                  
                                                                                                                                
     Section  6. Amends  AS  08.80.030(b)  Duties of  Opioid                                                                  
     Prescribing    Pharmacists:    Inform   patients,    in                                                                    
     provider's "own words",  of potential addiction dangers                                                                    
     from extended opioid use;  and any reasonable treatment                                                                    
     alternatives, if they exist,  to the recommended opioid                                                                    
     prescription;  distribute  Department   of  Health  and                                                                    
     Social  Services   short  handout  on   some  potential                                                                    
     dangers.                                                                                                                   
                                                                                                                                
     Regulations/Enforcement   of  Bill:   Board  power   to                                                                    
     consider  discipline  for  registered  pharmacists  who                                                                    
     "habitually"   violate  bill   requirements;  potential                                                                    
     board  discipline,   but  no  additional   legal  civil                                                                    
     liability cause  of action created by  bill, to protect                                                                    
     against hostile legal  relationship between patient and                                                                    
     provider.                                                                                                                  
                                                                                                                                
     Section  7. Inserts  a new  paragraph  in AS  47.37.040                                                                  
     under  subheading (24)  that creates  a visual  aid for                                                                    
     providers to hand  out to patients when  they are being                                                                    
     prescribed  opioids. This  handout will  provide easily                                                                    
     understandable  and  concise  information  on  opioids,                                                                    
     including the inherent  addictive and harmful qualities                                                                    
     of  opioids. This  visual aid  also  will also  provide                                                                    
     information on opioid statistics specific to Alaska.                                                                       
                                                                                                                                
3:15:19 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE JACKSON  inquired how HB 89  provides that doctors                                                               
would be held accountable.                                                                                                      
                                                                                                                                
CO-CHAIR  SPOHNHOLZ replied  the  bill would  allow  each of  the                                                               
governing  boards  that  oversee   the  practicing  providers  to                                                               
develop and enforce the regulations as the boards see fit.                                                                      
                                                                                                                                
3:15:55 PM                                                                                                                    
                                                                                                                                
CO-CHAIR SPOHNHOLZ opened public testimony on HB 89.                                                                            
                                                                                                                                
3:16:23 PM                                                                                                                    
                                                                                                                                
ROBIN  MINARD,   Chief  Communications  Officer,   Mat-Su  Health                                                               
Foundation,  testified  in support  of  HB  89.   She  noted  the                                                               
foundation  shares  ownership  in  the  Mat-Su  Regional  Medical                                                               
Center in Wasilla and Palmer,  and that the foundation's share of                                                               
the profits are  invested back into the community  to improve the                                                               
health and wellness of residents.  She continued:                                                                               
                                                                                                                                
     Along with community  partners the foundation conducted                                                                    
     a  community health  needs assessment  and it  included                                                                    
     data analysis,  public polling  in 24  community forums                                                                    
     as  well as  an  online forum.    Our community  ranked                                                                    
     alcohol and  substance abuse as  the number  one health                                                                    
     issue in Mat-Su.                                                                                                           
                                                                                                                                
     In response  to that  we completed a  behavioral health                                                                    
     environmental scan,  and this was a  multi-year project                                                                    
     that   resulted   in   three   reports   and   numerous                                                                    
     recommendations.    One  of those  recommendations  was                                                                    
     adoption   of   strict   guidelines   for   prescribing                                                                    
     narcotics.   The  Prescription Drug  Monitoring Program                                                                    
     is helping a lot in that  arena and HB 89 builds upon a                                                                    
     safer   prescribing   environment  by   ensuring   that                                                                    
     prescribers   educate   patients  about   the   dangers                                                                    
     associated with opioids.                                                                                                   
                                                                                                                                
     There were 10 opioid  related overdose deaths in Mat-Su                                                                    
     in  2018 and  114  deaths statewide.    That means  114                                                                    
     families lost a  child, a father, a  mother, a brother,                                                                    
     or a  sister.  Even  one death is too  many, especially                                                                    
     when  it is  entirely  preventable.   Many  individuals                                                                    
     addicted to heroin  were first exposed to  opioids as a                                                                    
     result  of  legally   written  prescriptions  for  pain                                                                    
     management.   They may have made  different choices had                                                                    
     they  known that  the drug  prescribed by  their doctor                                                                    
     was  highly addictive.    People  occasionally do  need                                                                    
     assistance dealing  with pain,  but when they  do, they                                                                    
     should be  fully informed  about the  potential dangers                                                                    
     of opioids.                                                                                                                
                                                                                                                                
     The impact  of drug  abuse goes  beyond the  tragic and                                                                    
     unnecessary loss  of life and  devastated families.   A                                                                    
     2015  report  from  the   Alaska  Mental  Health  Trust                                                                    
     Authority stated that the estimated  cost of drug abuse                                                                    
     to the Alaska economy  totaled $1.22 billion.  Included                                                                    
     in   that  figure   are   productivity  loss,   traffic                                                                    
     collisions, criminal  justice and  protective services,                                                                    
     health   care,  and   public   assistance  and   social                                                                    
     services.   These costs  are borne  by state  and local                                                                    
     governments, employers,  and residents of Alaska.   The                                                                    
     devastation to  our communities  being done  by opioids                                                                    
     must end.   We believe that HB 89 will  help bring that                                                                    
     end.                                                                                                                       
                                                                                                                                
3:19:12 PM                                                                                                                    
                                                                                                                                
PATTY  OWEN, Member,  Board of  Directors,  Alaska Public  Health                                                               
Association,  testified  in support  of  HB  89.   She  said  the                                                               
association  is a  membership organization  of  about 150  health                                                               
professionals and community members  statewide that are dedicated                                                               
to  improving  "the  health  and  wellbeing  of  Alaska's  public                                                               
health."    The  association  is an  affiliate  of  the  national                                                               
American Public Health Association.   The association supports HB
89 and  subscribes to the  multi-pronged approach of  the Centers                                                               
for Disease Control and Prevention  (CDC) in opioid use and abuse                                                               
prevention,   which   includes  better   prescribing   practices,                                                               
supporting   the  Prescription   Drug  Monitoring   Program,  and                                                               
expanded use of  naloxone.  She is here today  to support patient                                                               
education and education in general  for providers and the public.                                                               
Additionally, the association supports  public education in terms                                                               
of media campaigns and education in schools and communities.                                                                    
                                                                                                                                
3:21:09 PM                                                                                                                    
                                                                                                                                
CO-CHAIR SPOHNHOLZ closed public testimony and held over HB 89.                                                                 
                                                                                                                                

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