Legislature(2023 - 2024)DAVIS 106

03/23/2023 03:00 PM House HEALTH & SOCIAL SERVICES

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03:04:08 PM Start
03:05:26 PM Confirmation Hearing(s): Department of Health, Commissioner|| Confirmation Hearing(s)
04:03:06 PM HB112
04:49:07 PM HB60
05:05:56 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Consideration of Governor’s Appointees: TELECONFERENCED
Department of Health - Commissioner-Designee
Heidi Hedberg
-- Public Testimony --
*+ HB 112 PROFESSION OF PHARMACY TELECONFERENCED
Heard & Held
-- Testimony <Invitation Only> --
+= HB 60 RUNAWAYS; DFCS/DOH: DUTIES/LICENSING/INFO TELECONFERENCED
Moved CSHB 60(HSS) Out of Committee
+ Bills Previously Heard/Scheduled TELECONFERENCED
**Streamed live on AKL.tv**
                 HB 112-PROFESSION OF PHARMACY                                                                              
                                                                                                                                
4:03:06 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX  announced that  the next order  of business  would be                                                               
HOUSE BILL  NO. 112, "An Act  relating to the Board  of Pharmacy;                                                               
relating  to the  practice of  pharmacy; relating  to pharmacies;                                                               
relating   to  prescription   drug  manufacturers;   relating  to                                                               
prescriptions for epinephrine; relating  to the administration of                                                               
epinephrine; and providing for an effective date."                                                                              
                                                                                                                                
4:03:34 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   RUFFRIDGE,  as   prime   sponsor   of  HB   112,                                                               
paraphrased  the   sponsor  statement   [copy  included   in  the                                                               
committee packet],  which read  as follows  [original punctuation                                                               
provided]:                                                                                                                      
                                                                                                                                
     Pharmacists  and pharmacies  are  an  integral part  of                                                                    
     Alaska'  healthcare system.  It is  important that  the                                                                    
     Alaska  statutes  that  guide   them  are  updated  and                                                                    
     reflect   the    services   provided    by   modern-day                                                                    
     pharmacies.                                                                                                                
                                                                                                                                
     House   Bill  112   clarifies  the   Alaska  Board   of                                                                    
     Pharmacy's powers and duties  to align with the federal                                                                    
     Drug Supply  Chain and Security Act  (DSCSA) related to                                                                    
     licensing and oversight  of manufacturers, out-of-state                                                                    
     pharmacies,   outsourcing   facilities,  and   internet                                                                    
     pharmacies  who conduct  business in  Alaska. In  doing                                                                    
     so,  these out-of-state  entities will  be held  to the                                                                    
     same high standard  as those operating in  the state of                                                                    
     Alaska,  helping  to  ensure Alaskans  have  access  to                                                                    
     medications  that  are  safe,   no  matter  where  they                                                                    
     originate.                                                                                                                 
                                                                                                                                
     HB  112 aligns  Alaska's pharmacy  board statutes  with                                                                    
     similar boards  in other  states. It  allows for  it to                                                                    
     meaningfully  recognize retired  pharmacists and  their                                                                    
     contributions.  Stressing  the   importance  of  public                                                                    
     safety, HB  112 would  allow the  board to  institute a                                                                    
     national   criminal   background   check   for   Alaska                                                                    
     pharmacists and pharmacy  technicians. This would align                                                                    
     the  Alaska   Board  of  Pharmacy  with   the  National                                                                    
     Association   of  Boards   and  Pharmacy   Model  State                                                                    
     Pharmacy Act.                                                                                                              
                                                                                                                                
     The Executive  Administrator plays  a critical  role in                                                                    
     the  smooth functioning  of the  board  and requires  a                                                                    
     high  degree of  competency  and  understanding of  the                                                                    
     complexities   of   pharmacy-related  regulations   and                                                                    
     issues.   This   bill   gives  Alaska's   Division   of                                                                    
     Professional Licensing flexibility  to hire a qualified                                                                    
     pharmacist  for  this  administrative role  should  one                                                                    
     apply.                                                                                                                     
                                                                                                                                
     The  changes  proposed  in House  Bill  112  reflect  a                                                                    
     dedicated  collaboration between  the  Alaska Board  of                                                                    
     Pharmacy   and  the   Alaska  Pharmacists   Association                                                                    
     (AKPhA) to modernize pharmacy practice statutes.                                                                           
                                                                                                                                
4:05:33 PM                                                                                                                    
                                                                                                                                
BRAEDAN  GARRET, Staff,  Representative Justin  Ruffridge, Alaska                                                               
State Legislature,  on behalf of Representative  Ruffridge, prime                                                               
sponsor, gave  the sectional analysis  for HB 112  [copy included                                                               
in  the  committee  packet],  which  read  as  follows  [original                                                               
punctuation provided]:                                                                                                          
                                                                                                                                
     Section   1.  Amends   AS  08.08.010(a)   Creation  and                                                                
     membership of board; officers                                                                                          
     Alters  composition   of  the  seven-member   Board  of                                                                    
     Pharmacy  by designating  one member  to be  a licensed                                                                    
     pharmacy technician,  and one being an  individual with                                                                    
     no financial interest in the healthcare industry                                                                           
     Section  2. Amends  AS 08.80.030  Powers and  Duties of                                                                
     Board                                                                                                                  
     (b)(10)   Separates    out   the   licensing/regulating                                                                    
     entities relating to  manufacturing and distributing of                                                                    
     drugs and devices by use of the                                                                                            
     word "or"                                                                                                                  
     (b)(12)  adds  an  epinephrine  auto-injector  training                                                                    
     program                                                                                                                    
     (b)(14)  Clarifies that  only pharmacists  who dispense                                                                    
     federally scheduled  controlled substances  be required                                                                    
     to  register  with  the  Prescription  Drug  Monitoring                                                                    
     Program (PDMP)                                                                                                             
     (b)(16) Adds pharmacies  and manufacturers from out-of-                                                                    
     state  to  the list  of  entities  to be  licensed  and                                                                    
     inspected                                                                                                                  
     (b)(17) Adds  internet-based pharmacies to the  list of                                                                    
     entities to be licensed if they are servicing Alaskans                                                                     
     (b)(18) adds  language adopting  regulations pertaining                                                                    
     to retired pharmacist status                                                                                               
     Section  3.   Amends  08.80.145   Reciprocity;  license                                                                
     transfer                                                                                                               
     (3)  removes character  requirement  -  "of good  moral                                                                    
     character"                                                                                                                 
     (4)  removes internship  details    this is  a national                                                                    
     standard among schools of pharmacy                                                                                         
     Renumbering of statute items                                                                                               
     Section 4. Amends AS 08.80.157 Licensing of facilities                                                                 
     (k)    this    adds   out-of-state    pharmacies    and                                                                    
     manufacturers  to the  list of  entities  that must  be                                                                    
     licensed and inspected                                                                                                     
     Section   5.   Amends   AS  08.80.159   Licensing   and                                                                
     inspection of facilities outside the state                                                                             
     (a)  Adds  "distributor,   pharmacy,  manufacturer"  to                                                                    
     those out-of-state  entities that must be  licensed and                                                                    
     inspected,  under the  Drug Supply  Chain and  Security                                                                    
     Act                                                                                                                        
     Section   6.   Amends   AS  08.80.159   Licensing   and                                                                
     inspection of facilities outside the state                                                                             
     (c) adds  "pharmacy and manufacturer" to  list that may                                                                    
     be inspected if located outside the state                                                                                  
     Section 7. Amends AS 08.80.160 Fees                                                                                    
     (10)  Removes the  word "registration"  since the  bill                                                                    
     mandates licensure of a facility                                                                                           
     Section 8.  Amends 08.80.168 and adds  a new subsection                                                                
       Administration of vaccines and related emergencies                                                                   
     (e) Allows a pharmacist  to administer epinephrine to a                                                                    
     person  or  prescribe   epinephrine  auto-injectors  to                                                                    
     someone  who   has  completed  the   epinephrine  auto-                                                                    
     injector training program                                                                                                  
     Section 9. Amends  AS 08.80.270 Executive administrator                                                                
     of the board                                                                                                           
     (a)  Adds an  additional  salary range  option for  the                                                                    
     executive administrator,  allowing flexibility  for the                                                                    
     Division to select a pharmacist for the role                                                                               
     Section  10. Amends  AS  08.80.420 Certain  advertising                                                                
     prohibited                                                                                                             
     (a) adds  the term "apothecary"  to list of  those that                                                                    
     cannot  be  used in  media  or  advertising unless  the                                                                    
     store employs a licensed pharmacist with regular hours                                                                     
     Section  11.  Amends  AS  12.62.400  National  criminal                                                                
     history record check                                                                                                   
     (a)(23)  adds  pharmacist  and pharmacy  technician  to                                                                    
     list  of  professions  where   a  background  check  is                                                                    
     required.  Aligns   with  State  of   Alaska's  nursing                                                                    
     requirements  and  pharmacy   requirements  typical  in                                                                    
     other  states. This  adds a  national level  background                                                                    
     check                                                                                                                      
     Section   12.   Amends   AS   17.22.010   Prescription,                                                                
     purchase,  administration of  epinephrine by  a trained                                                                
     individual                                                                                                             
     Allows anyone over  18 to purchase or  be prescribed an                                                                    
     epinephrine    auto-injector,    and   to    administer                                                                    
     epinephrine in  an emergency to another  person if they                                                                    
     have  completed an  epinephrine auto-injector  training                                                                    
     program  approved   by  the  board.  It   removes  very                                                                    
     outdated language from this section                                                                                        
     Section   13.  Amends   AS  17.22.020(a)   Approval  of                                                                
     training programs                                                                                                      
     (a) Allows  the board,  rather than the  department, to                                                                    
     adopt  standards  for   the  epinephrine  auto-injector                                                                    
     training program and deletes outdated language                                                                             
     Section   14.  Amends   AS  17.22.020(b)   Approval  of                                                                
     training programs                                                                                                      
     (b) Allows  the board,  rather than the  department, to                                                                    
     approve an  epinephrine auto-injector  training program                                                                    
     that meets the board's standards                                                                                           
     Section 15. Amends AS 17.22.030 Applicability                                                                          
     States  that this  chapter does  not  apply to  someone                                                                    
     currently  authorized under  another law  to administer                                                                    
     epinephrine, such as  a nurse or doctor,  or some other                                                                    
     authorized professional                                                                                                    
     Section 16. Amends AS  17.22.040 Liability of certified                                                                
     individual                                                                                                             
     Outlines that a person may  not be sued who administers                                                                    
     epinephrine  to another  in an  emergency, and  in good                                                                    
     faith,  if  he or  she  has  completed the  epinephrine                                                                    
     auto-injector training program approved by the board                                                                       
     Section 17. Amends AS 17.22.090 Definitions                                                                            
     (3) defines the "board" as the Board of Pharmacy                                                                           
     4                                                                                                                          
     Section 18. Repeals  AS 08.80.110(2) Qualifications for                                                                
     licensure by examination                                                                                               
     •  Repeals (2)  furnish  the board  with  at least  two                                                                    
     affidavits from  reputable citizens that  the applicant                                                                    
     has  known  for at  least  one  year attesting  to  the                                                                    
     applicant's good moral character.  This is not required                                                                    
     in medical board, dental or nursing statutes.                                                                              
     • Repeals 08.80.158  Registration of pharmacies located                                                                    
     outside  the state  since this  bill would  now require                                                                    
     licensure                                                                                                                  
     •  Repeals AS  17.22.020(c) which  is the  Department's                                                                    
     epinephrine auto-injector training program                                                                                 
     • Repeals  AS 17.22.090(1) that defines  the department                                                                    
     as the Dept  of Health, since it will no  longer be the                                                                    
     approving  entity  of   the  epinephrine  auto-injector                                                                    
     training program                                                                                                           
     Section   19.   TRANSITION   LANGUAGE   for   currently                                                                
     registered pharmacies                                                                                                  
     A new  section that  would allow  pharmacies previously                                                                    
     registered  to  continue  to   ship,  mail  or  deliver                                                                    
     prescription  drugs to  its customers  in Alaska  until                                                                    
     their  registration expires.  At that  time, they  will                                                                    
     then have to apply for licensure.                                                                                          
     Section 20. TRANSITION: REGULATIONS                                                                                    
        Allows the Board of Pharmacy and DCCED to adopt                                                                         
     regulations to carry out the changes laid out in this                                                                      
     legislation.                                                                                                               
     Section 21. Section 20 has an immediate effective date                                                                 
     under AS 01.10.070(c)                                                                                                      
     Section 22: Effective date is set to coincide with the                                                                 
      Drug Supply Chain and Security Act that will go into                                                                      
     effect on November 26, 2023.                                                                                               
                                                                                                                                
4:13:37 PM                                                                                                                    
                                                                                                                                
ASHLEY  SCHABER,  Chair, Board  of  Pharmacy,  gave a  PowerPoint                                                               
presentation,  titled "House  bill 112:  Profession of  Pharmacy"                                                               
[hard copy included in the  committee packet].  She explained the                                                               
mission of the Board of Pharmacy  and its guiding principles.  On                                                               
slide 2,  she pointed  out guiding  principal 4,  which addresses                                                               
the issues  that HB 112 would  effect.  She stated  that it would                                                               
help create a routine review  of the effectiveness of regulations                                                               
and reduce barriers to licensure,  while not compromising patient                                                               
health and  safety, as  seen under  4.1.   She pointed  out under                                                               
4.4,  the  proposed  legislation  would help  in  advocating  for                                                               
legislation for  the pharmacy  profession as  it evolves  and new                                                               
opportunities for improvement patient  safety arise.  Pointing to                                                               
4.5,  she  stated  that  the   proposed  legislation  would  help                                                               
anticipate  changes  to  the  Drug  Supply  Chain  Security  Act,                                                               
allowing a proactive response.                                                                                                  
                                                                                                                                
MS. SCHABER moved  to slide 3, which addressed  the background of                                                               
HB 112.   She stated that the proposed legislation  is the result                                                               
of a  multi-year, multi-chair review of  statutes and regulations                                                               
to help ensure the Alaska Board  of Pharmacy can continue to meet                                                               
its  mission.   She  listed  what  HB  112 would  accomplish,  as                                                               
follows: streamline the licensure  process while improving public                                                               
safety;  maintain  compliance  with  DSCSA;  help  alignment  the                                                               
Pharmacy Board with  other boards in Alaska and  in other states;                                                               
clarify  the  role  of pharmacists  in  epinephrine  access;  and                                                               
create  a  collaborative  effort  between  the  Alaska  Board  of                                                               
Pharmacy and the Alaska Pharmacists Association                                                                                 
                                                                                                                                
4:15:53 PM                                                                                                                    
                                                                                                                                
MS.  SCHABER moved  to slide  4  and discussed  how the  proposed                                                               
legislation   would  streamline   the  licensure   process  while                                                               
improving  public safety.   She  stated that  it would  eliminate                                                               
unnecessary  forms currently  required in  statute, clarify  that                                                               
only pharmacists who dispense  controlled substances are required                                                               
to  register  with PDMP,  and  add  national criminal  background                                                               
checks.                                                                                                                         
                                                                                                                                
MS.  SCHABER moved  to slide  5  and discussed  how the  proposed                                                               
legislation  would help  with compliance  with Drug  Supply Chain                                                               
and Security Act.   She explained that DSCSA  further secures the                                                               
U.S. drug supply  through a system to prevent  harmful drugs from                                                               
entering  the  supply chain,  detect  harmful  drugs if  they  do                                                               
enter, and enable  rapid response when such drugs  are found, and                                                               
pharmacy boards play a key  role through appropriate licensing of                                                               
drug distributors and  pharmacies.  She stated that  HB 112 would                                                               
ensure  that  the Alaska  Board  of  Pharmacy powers  and  duties                                                               
support the DSCSA.                                                                                                              
                                                                                                                                
4:18:53 PM                                                                                                                    
                                                                                                                                
MS. SCHABER moved to slide 6  and discussed how HB 112 would help                                                               
align  the Pharmacy  Board with  other  boards in  Alaska and  in                                                               
other  states.   It would  do this  by replacing  one of  the two                                                               
public member  seats with a  pharmacy technician seat,  allow the                                                               
board  to  adopt  language for  retired  pharmacist  status,  and                                                               
clarify  the  executive  administrator's salary,  as  this  would                                                               
allow a pharmacist to serve in this role in the future.                                                                         
                                                                                                                                
MS. SCHABER moved to slide 7  and discussed how HB 112 would help                                                               
the role of  pharmacists in epinephrine access.   She stated that                                                               
an  epinephrine  training program  would  be  implemented, and  a                                                               
clarification  would  be  made  which  states  a  pharmacist  can                                                               
administer epinephrine to a person  or prescribe epinephrine auto                                                               
injectors  to someone  who has  completed  the training  program.                                                               
she  added  that  this would  increases  epinephrine  access  for                                                               
Alaskans with anaphylactic emergencies.                                                                                         
                                                                                                                                
4:22:18 PM                                                                                                                    
                                                                                                                                
MS.  SCHABER   concluded  the  presentation  by   requesting  the                                                               
committee's support  of HB  112, as this  would allow  for better                                                               
public health, safety,  and welfare of Alaskans  by the effective                                                               
control and regulation of the practice of pharmacy.                                                                             
                                                                                                                                
4:22:34 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS  questioned whether  [people on  the board]                                                               
would have a financial interest in the healthcare industry.                                                                     
                                                                                                                                
MS. SCHABER answered  that it is in statute that  a person who is                                                               
a public member  [of the board] would have  no financial interest                                                               
in  the healthcare  industry.   She said  that this  person would                                                               
bring a public consumer interest to the board.                                                                                  
                                                                                                                                
REPRESENTATIVE  FIELDS   questioned  the  current   board  member                                                               
requirements.                                                                                                                   
                                                                                                                                
MS.   SCHABER  deferred   the  question   to  the   [Division  of                                                               
Corporations,  Business,   and  Professional  Licensing].     She                                                               
reiterated that  this is  in statute and  added that  the biggest                                                               
change is a  person having no financial interest.   She said that                                                               
a willingness  to attend quarterly  meetings and a  commitment to                                                               
the work is required.                                                                                                           
                                                                                                                                
4:24:14 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE  added  that there  are  currently  two                                                               
public  member positions  on the  board, with  only one  recently                                                               
filled.   He  stated that  it has  been difficult  to get  public                                                               
members to serve  because of the time commitment, as  well as low                                                               
willingness of  the public to serve  on a board for  a profession                                                               
they might  not know much  about; therefore, HB 112  would change                                                               
one of the public seats to a technician position.                                                                               
                                                                                                                                
4:25:06 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS  expressed appreciation  for the idea.   He                                                               
questioned  the  board's  role  in  supporting  the  training  of                                                               
pharmacy technicians.                                                                                                           
                                                                                                                                
REPRESENTATIVE RUFFRIDGE  responded that during his  time serving                                                               
on  the Board  of Pharmacy,  this was  an item  of interest,  and                                                               
regulations were  passed to add  a certified  pharmacy technician                                                               
as  an  individual  recognized   in  regulatory  practice.    For                                                               
example,  he explained  that  certified  pharmacy technicians  in                                                               
Alaska  currently  have  the  ability   to  do  final  checks  on                                                               
prescriptions, if the prescription  had a drug utilization review                                                               
done by  a pharmacist and  administer vaccinations.   He stressed                                                               
that  there is  an effort  in  the industry  to promote  pharmacy                                                               
technicians as being a "middle step."                                                                                           
                                                                                                                                
4:26:54 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   SADDLER  observed   that  if   there  are   four                                                               
pharmacists on the board right  now, it would seem unnecessary to                                                               
have the  executive director be a  pharmacist.  He asked  why the                                                               
executive director is required to be a pharmacist.                                                                              
                                                                                                                                
REPRESENTATIVE RUFFRIDGE stated  that he is a  previous member of                                                               
the board  and is  a pharmacist  and expressed  the understanding                                                               
that  an  executive  administrator   of  the  Board  of  Pharmacy                                                               
performs many  duties, and  members are expected  to have  an in-                                                               
depth  understanding of  the department's  licensing duties.   He                                                               
pointed out  that many licensing  and professional  questions are                                                               
directed to the  executive administrator.  He added  that in many                                                               
states pharmacists serve in this role.                                                                                          
                                                                                                                                
MS. SCHABER added  that the five pharmacists on  the Alaska Board                                                               
of Pharmacy are  all volunteers and work full time  and would not                                                               
have the time to address questions.                                                                                             
                                                                                                                                
4:30:21 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  MINA asked  how out-of-state  entities are  being                                                               
regulated.                                                                                                                      
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE  answered  that   they  are  not  being                                                               
regulated.   He explained that  they are required to  register in                                                               
the state, but if the  entity is dispensing or providing services                                                               
in the state,  the Board of Pharmacy has no  option to protect or                                                               
promote the safety  and wellbeing of Alaska  patients because the                                                               
entities are not licensed.                                                                                                      
                                                                                                                                
MS. SCHABER  stated that HB  112 would give the  board oversight.                                                               
She  explained that  currently only  a registration  acknowledges                                                               
out-of-state  entities are  providing  services.   She  explained                                                               
that  if there  was a  safety concern  regarding an  out-of-state                                                               
pharmacy, the  board would have no  oversight.  In response  to a                                                               
follow-up  question  concerning  the prevalence  of  out-of-state                                                               
entities,  she  pointed out  that  mail-order  pharmacies are  an                                                               
example,  and some  are  considered  compounding pharmacies  that                                                               
could   provide   either   sterile  or   non-sterile   compounds,                                                               
medications, eye drops, and injections to patients in Alaska.                                                                   
                                                                                                                                
4:33:01 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FIELDS  asked  how  pharmacies  are  adapting  to                                                               
fentanyl being present in adulterated drugs.                                                                                    
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE  answered  that  it  is  a  very  large                                                               
concern.   He explained  that getting a  clearer picture  of what                                                               
the drug supply  chain looks like was one of  the reasons why the                                                               
Drug Supply  Chain Act  is at the  federal level,  as adulterated                                                               
medications are often sent through  Internet pharmacies.  He said                                                               
the proposed legislation would follow federal regulation.                                                                       
                                                                                                                                
MS.  SCHABER added  that the  proposed legislation  would address                                                               
giving the board oversight of Internet pharmacies.                                                                              
                                                                                                                                
4:35:33 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FIELDS expressed  concern  that  gaps in  primary                                                               
care could  lead to  expensive care  for families.   He  asked if                                                               
there are opportunities for the  board to work with other primary                                                               
healthcare providers in an effort to reduce such gaps.                                                                          
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE responded  that there  would be  a more                                                               
detailed   answer  later,   as   there   are  opportunities   for                                                               
pharmacists to fill  gaps in care.  He explained  that during the                                                               
pandemic,  pharmacies across  the  state had  been  able to  fill                                                               
roles that historically  they had not.  He relayed  that there is                                                               
a nationwide  push for pharmacists  to be given  provider status,                                                               
something  HB 112  would not  do;  however, the  state has  taken                                                               
steps  to promote  this  ability.   He alluded  to  a barrier  in                                                               
pharmacy businesses, causing  many to close across  the state and                                                               
country.                                                                                                                        
                                                                                                                                
4:38:53 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SADDLER   asked  for   the  number   of  licensed                                                               
pharmacists in Alaska.                                                                                                          
                                                                                                                                
MS. SCHABER  deferred the question  to the division.   She shared                                                               
that there  has been  a challenge in  ensuring that  licenses are                                                               
processed quickly.                                                                                                              
                                                                                                                                
4:40:42 PM                                                                                                                    
                                                                                                                                
SYLVAN ROBB,  Director, Division  of Corporations,  Business, and                                                               
Professional  Licensing, Department  of Commerce,  Community, and                                                               
Economic  Development,  answered that,  as  of  today, there  are                                                               
1,049   licensed   pharmacists   and  1,206   licensed   pharmacy                                                               
technicians.  In response to  a follow-up question, she expressed                                                               
uncertainty  about  how many  registered  pharmacies  are in  the                                                               
state.  She offered to report back to the committee.                                                                            
                                                                                                                                
4:42:18 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE RUFFRIDGE  thanked members  for hearing  the bill.                                                               
He  said that  the hearing  has been  a good  start in  promoting                                                               
changes that have been worked on for a long time.                                                                               
                                                                                                                                
REPRESENTATIVE  FIELDS  acknowledged  Representative  Ruffridge's                                                               
previous  efforts.   He suggested  that  some regulatory  reforms                                                               
around  staffing could  help address  "pharmacy  deserts" in  the                                                               
state.  He asked if other  reforms would bring more pharmacies to                                                               
unserved places.                                                                                                                
                                                                                                                                
REPRESENTATIVE  RUFFRIDGE responded  that pharmacies  are closing                                                               
because of the  high-barrier entry, namely in payroll  costs.  He                                                               
pointed out  that some corporate  pharmacies are  reducing staff,                                                               
even as  the number  of prescriptions is  rising.   He elaborated                                                               
that many pharmacies operate as  a net loss to large corporations                                                               
because this  margin is small.   He suggested that this  could be                                                               
altered with  the role pharmacy  technicians play, as  they could                                                               
be  more   of  a  manager  while   pharmacists  provide  clinical                                                               
oversight.   He explained that  tele-pharmacies allow  a pharmacy                                                               
to operate in an urban  setting.  For example, downtown Anchorage                                                               
has  three pharmacy  technicians,  as  pharmacists are  centrally                                                               
located in a larger facility,  and technology is used to remotely                                                               
access the prescriptions.  He  explained that this option already                                                               
has a statute  to govern it, and this is  something the board has                                                               
changed to  open the  option now  for pharmacy  deserts; however,                                                               
pharmacies in the state need to adopt this change.                                                                              
                                                                                                                                
4:46:35 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX announced HB 112 was held over.                                                                                      

Document Name Date/Time Subjects
HB 112 Sectional Analysis .pdf HHSS 3/23/2023 3:00:00 PM
HB 112
HB 112 Sponsor Statement Version B.pdf HHSS 3/23/2023 3:00:00 PM
HB 112
HB0112A.PDF HHSS 3/23/2023 3:00:00 PM
HB 112
Heidi Hedberg Resume 2023.pdf HHSS 3/23/2023 3:00:00 PM
HB112 HSS Hearing slides 3.23.23.pdf HHSS 3/23/2023 3:00:00 PM
HB 112
HB 60 CS Version S.pdf HHSS 3/23/2023 3:00:00 PM
HB 60
HB 60 Sectional Analysis (Version S) 3-23-23.pdf HHSS 3/23/2023 3:00:00 PM
HB 60
HB 60 Explanation of Changes Version A to Verson S (3-23-23).pdf HHSS 3/23/2023 3:00:00 PM
HB 60
HB 112 Support as of 3_21 Redacted.pdf HHSS 3/23/2023 3:00:00 PM
HB 112
HB 112 Fiscal Note DCCED.pdf HHSS 3/23/2023 3:00:00 PM
HB 112