Legislature(2017 - 2018)SENATE FINANCE 532
04/13/2018 01:30 PM Senate FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| HB323 | |
| HB318 | |
| HB110 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| += | HB 110 | TELECONFERENCED | |
| += | HB 318 | TELECONFERENCED | |
| += | HB 323 | TELECONFERENCED | |
HOUSE BILL NO. 323
"An Act extending the termination date of the Board of
Pharmacy; and providing for an effective date."
4:25:20 PM
REPRESENTATIVE COLLEEN SULLIVAN-LEONARD, SPONSOR, discussed
the bill. She explained that the bill extended the
termination date of the Board of Pharmacy. The bill would
extend the board for four years; from June 30, 2018 through
June 30, 2022. Adoption of the bill would continue existing
activities by the board, and administration by the Division
of Corporations, Business and Professional Licensing
(DCBPL). Failure to adopt the legislation would result in a
one-year wind-down of the board, with the division assuming
all license responsibility in FY 20. The composition of the
board was seven members including five licensed pharmacists
and three members from the public.
Representative Sullivan-Leonard continued to discuss the
bill; informing that the board regulated admission in to
the practice of pharmacy, established and enforced
compliance with professional standards, and adopted
regulations. The board established and maintained a
controlled substance database. The board also oversaw
licensing for pharmacists, pharmacy interns, technicians,
licensing for drug rooms (inside institutional facilities);
and also registered pharmacies located outside the state if
a pharmacy shipped drugs to consumers inside the State of
Alaska.
4:27:47 PM
AT EASE
4:28:15 PM
RECONVENED
KRIS CURTIS, LEGISLATIVE AUDITOR, ALASKA DIVISION OF
LEGISLATIVE AUDIT, reminded that the purpose of a sunset
audit was to determine whether a board or commission was
serving the public interest and should be extended. She
referenced the document "A Sunset Review of Department of
Commerce, Community and Economic Development, Board of
Pharmacy (board)" (copy on file).
Ms. Curtis read from the report conclusions listed on the
first page:
The audit concluded the board operated in the public
interest by effectively licensing pharmacists,
pharmacy interns, pharmacy technicians, in-state
pharmacies, drug rooms, and wholesale distributors.
Board meetings were conducted in accordance with
applicable laws and the board was active in amending
regulations to improve the industry.
Ms. Curtis read from page 9 of the report, which showed
licensing and registration activity. She detailed that
there were 3,747 active licenses as of March 2017; which
was a 33 percent increase compared to the prior 2009 sunset
audit.
Ms. Curtis directed attention to the schedule of revenues
and expenditures on page 10 of the report and noted that
the board had a surplus of approximately $275,000 as of the
end of FY 17. She noted that there was a schedule of
licensing fees at the bottom of page 11 and added that
DCBPL management planned to do a fee analysis at the end of
2017 to examine adjustment of fees.
Ms. Curtis relayed that the Division of Legislative Audit
was recommending a four-year extension for the board in
recognition that recent statutory changes expanded the
board's responsibilities in relation to the controlled
substance prescription database. She read from the
background information on page 3 of the report:
Senate Bill 196, passed in 2008, requires the Board of
Pharmacy (board) to establish and maintain a
controlled substance prescription database as provided
in AS 17.30.200. The law was passed with the intent to
improve patient care and foster the goal of reducing
misuse, abuse, and diversion of controlled substances.
The statute requires each dispenser submit to the
board, by electronic means, information regarding each
prescription dispensed for a controlled substance. The
database electronically collects information from in-
state and out of-state pharmacies as well as other
dispensers of controlled substance prescriptions. The
database allows pharmacists and practitioners to
review prescription history prior to prescribing or
dispensing a controlled substance. The database is
also to be used to:
• monitor prescribing practices and patterns of
prescribing or dispensing;
• identify practitioners who prescribe controlled
substances in an unprofessional or unlawful manner;
• identify individuals who may be abusing controlled
substances; and
• identify individuals who present forgeries or
otherwise false or altered prescriptions to a
pharmacy.
Ms. Curtis relayed that there were quite a few structural
problems when the legislation went into effect in 2008, and
the problems were slow to be addressed. The report grouped
the challenges into two areas, including the completeness
of information, which was listed on page 4. The law did not
provide a way to identify the people that were required to
submit information to the database, so the board could not
verify completeness. Regulations established at the time of
the creation of the database called for monthly reporting;
which was not timely enough to be useful.
Ms. Curtis continued to discuss the requirement for the
board to monitor the prescription drug database. The second
area of challenge was the use of the information gathered.
The law did not require practitioners and pharmacists to
consult the database prior to prescribing or dispensing,
rather it was totally voluntary. The board was advised by
the Department of Law that information in the database
could not be forwarded to practitioners or pharmacists
because it was illegal to send an unsolicited report.
Consequently, the board did not use the information, and it
was not used to identify patterns of abuse or prescribing
practices.
4:31:58 PM
Ms. Curtis continued discussing the new requirements
regarding the drug database. She described that there had
been recent significant changes in the law to address the
problem areas. Changes included that prescribers and
dispensers must register with the database, and the board
of pharmacy could notify other occupational boards that
licensees had registered. The change provided a way to
identify incompleteness and noncompliance. In 2018,
beginning in July, dispensers would be required to submit
information to the database daily. Dispensers and
practitioners would be required to check the database prior
to dispensing or prescribing or administering medication
with controlled substances (with some exclusions). The
board was also able to provide unsolicited reports.
Ms. Curtis noted that on page 12 of the report there was a
conclusion that with the statutory changes the board was
empowered to help combat the abuse of controlled substance.
Given that the changes were very recent, the audit was
unable to evaluate the degree to which the board would use
the new authority to serve the public's interest. The
conclusion furthered that DCBPL management did not believe
the board should proactively analyze data to meet public
health objectives. Further, Department of Commerce,
Community, and Economic Development (DCCED) management
indicated that additional resources were needed if the
legislature intended for the board to analyze data and
become proactive in helping enforce prescription drug laws.
Ms. Curtis continued discussing the recommendations of the
audit. She noted that the report included two
recommendations that began on page 14:
Recommendation 1: DCBPL's chief investigator should
work with the director to improve the timeliness of
investigations.
The audit identified and reviewed 13 of 20 cases
opened for over 180 days between July 2014 and March
2017. Six of the 13 (46 percent) cases were found to
have unjustified periods of inactivity ranging from 51
to 184 days.
Ms. Curtis explained that the periods of inactivity were
largely due to competing priorities, specifically oversight
of the controlled substance prescription database.
Ms. Curtis read recommendation 2 from page 14 of the
report:
DCBPL's director should improve procedures to ensure
required licensure documentation is appropriately
obtained and retained.
Three of 25 facility applications tested as part of
the audit did not include the required regulatory
documentation.
Ms. Curtis reported that in one case, a self-inspection
report was not provided, in one case a background check
report was not obtained, and in one case DCBPL staff did
not follow up when an application disclosed that a citation
was issued on a pharmacist out-of-state license. The board
was not held responsible for the errors, as it did
appropriately approve the license pending receipt of key
documentation. The oversight was due to lack of follow-
through by DCBPL staff in obtaining the documentation.
Further, the division tested 25 individual licenses tested
found that one pharmacy intern's license application file
did not include evidence of the applicant meeting the
educational requirement.
4:35:03 PM
Ms. Curtis informed that responses to the audit began on
page 45. The governor's office agreed that the board served
the public's interest and should be extended and did not
comment regarding the controlled prescription drug
database. The department's response was on page 47. It
agreed with both recommendations of the audit. Regarding
recommendation 1, DCCED stated that it had implemented new
procedures to address the finding. Regarding recommendation
2, the department agreed that additional checks and
balances were needed to make sure that administrative
record was complete. The department stated that additional
resources were needed to ensure that standards were being
met. The board chair's response was on page 49, and the
chair agreed with both recommendations.
4:35:53 PM
Vice-Chair Bishop asked about Exhibit 1 on page 1; and
asked if the board was fully staffed.
Ms. Curtis deferred the question to the board chair. She
stated that the audit was dated August 2016.
Co-Chair MacKinnon planned on bringing up the department
staff to address questions. She addressed the excess
receipt authority in the amount of $275,000. She wondered
why there a request had not been made to hire the necessary
personnel.
Representative Sullivan-Leonard was pleased to see that the
board extension was recommended for four years rather than
six or eight. She thought it was important to follow the
board closely with regard to new statutory requirements; as
well as ensure that the board had the necessary resources
to accomplish its goals.
4:37:30 PM
RICHARD HOLT, CHAIR, AK BOARD OF PHARMACY, ANCHORAGE (via
teleconference), stated that the board worked diligently in
the protection of Alaskan patients and serving communities.
The board had worked hard in adapting to ever-changing
pharmacy practice and licensing, in addition to the
controlled substance prescription database. He supported
the extension of the board, in order for the board to
continue serving the needs of patients and populations that
were reliant upon the board as subject matter experts in
the field of pharmacy.
Co-Chair MacKinnon asked if Mr. Holt had heard the comments
from Ms. Curtis regarding the department's assertion that
the board needed more personnel to complete its duties.
Mr. Holt informed that the board had a new employee that
split duties between board functions and monitoring of the
prescription drug database. He referenced SB 37, which had
proposed to give the board authority to hire an executive
administrator using licensing receipts services fees for
out of state entities.
Co-Chair MacKinnon asked how the board was trying to gain
authority.
Mr. Holt explained that SB 37 was heard in the House
Finance Committee the previous day and would provide the
board with authority to hire an executive administrator.
4:40:18 PM
Senator Stevens asked about the board's $275,000 of surplus
funds.
Mr. Holt did not recall the exact amount of surplus from
year to year. He thought the amount of surplus was
cumulative.
Co-Chair MacKinnon informed that according to the
Legislative Finance Division (LFD) the carry-forward for FY
12 to FY 13 was $29,896; for FY 14 to FY 15 the carry-
forward was $201,479; and in FY 16 to FY 17 the carry-
forward surplus was $275,216.
4:41:25 PM
Vice-Chair Bishop asked Mr. Holt if the board was at full
strength.
Mr. Holt answered in the affirmative.
4:41:56 PM
LEIF HOLM, BOARD OF PHARMACY, NORTH POLE (via
teleconference), agreed with the remarks of the previous
testifier.
Co-Chair MacKinnon OPENED public testimony.
Co-Chair MacKinnon CLOSED public testimony.
4:42:43 PM
Vice-Chair Bishop discussed FN 1 from Department of
Commerce, Community and Economic Development. The fiscal
note had a cost of $27,900 annually if the bill passed.
There would be $26,400 of expenses would be incurred for
travel for members to attend four board meetings.
Advertising the board meetings would cost $400, and $1000
in expenses would be incurred for training and conference
fees. There would be $100 stipends for board members
attending.
Co-Chair MacKinnon noted that the fiscal note did not
reflect the full cost to the state or the board members.
The board's total revenue was $1,014,241 and its total
expenditures was $940,504.
Vice-Chair Bishop stated that the funds were Designated
General Funds (DGF) of receipt supported services.
Co-Chair MacKinnon noted that the members of the profession
were providing the state with resources to continue the
administration of the pharmacy profession.
4:44:34 PM
JANEY MCCULLOUGH, DIRECTOR, DIVISION OF CORPORATIONS,
BUSINESS AND PROFESSIONAL LICENSING, DEPARTMENT OF
COMMERCE, COMMUNITY AND ECONOMIC DEVELOPMENT, stated that
the board had a level of pharmacy expertise that was needed
in the division. She recommended extension of the board.
Senator Micciche asked about a gap of $75,000 between funds
received and the cost to run the program.
Ms. McCullough asked if Senator Micciche was talking about
revenues and expenditures listed in the report. She
informed that the excess funds were carried forward for the
program to be used in years of non-renewal of licenses.
Senator Micciche asked if Co-Chair MacKinnon could repeat
the figures associated with the cost of operating the
board.
Co-Chair MacKinnon specified that in FY 16 and FY 17, the
board's total expenditures were $940,504. The information
came from an LFD review.
4:46:24 PM
Senator Micciche asked who covered the costs.
Co-Chair MacKinnon asked if those who were licensed under
the board paid a fee and supported the DGF.
Ms. McCullough stated that the licensing fees paid by all
licensees supported the program and paid all the expenses.
There was no other revenue received to support the expense
of the board.
Senator Micciche considered the actual cost of the programs
was being discussed. He thought it was helpful for the
public to understand that all the costs were covered by
licensees.
Ms. McCullough answered in the affirmative.
4:47:51 PM
AT EASE
4:49:16 PM
RECONVENED
Co-Chair MacKinnon stated that there were 72 hours
remaining in session. The committee had discussed the bill
and the associated funding. She wanted to make sure that
the bill would pass both bodies before the legislature
adjourned.
Vice-Chair Bishop MOVED to report HB 323 out of Committee
with individual recommendations and the accompanying fiscal
note. There being NO OBJECTION, it was so ordered.
HB 323 was REPORTED out of committee with a "do pass"
recommendation and with one previously published fiscal
impact note: FN 1(CED).
4:51:01 PM
AT EASE
4:52:52 PM
RECONVENED
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 110 Massage Therapy Testimony.docx |
SFIN 4/13/2018 1:30:00 PM |
HB 110 |