Legislature(2023 - 2024)BUTROVICH 205
02/28/2023 03:30 PM Senate HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| SB53 | |
| SB51 | |
| SB59 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| += | SB 53 | TELECONFERENCED | |
| *+ | SB 51 | TELECONFERENCED | |
| *+ | SB 59 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
February 28, 2023
3:31 p.m.
MEMBERS PRESENT
Senator David Wilson, Chair
Senator James Kaufman, Vice Chair
Senator Forrest Dunbar
Senator Cathy Giessel
MEMBERS ABSENT
Senator Löki Tobin
COMMITTEE CALENDAR
SENATE BILL NO. 53
"An Act relating to involuntary civil commitments."
- HEARD & HELD
SENATE BILL NO. 51
"An Act exempting veterinarians from the requirements of the
controlled substance prescription database; and providing for an
effective date."
- HEARD & HELD
SENATE BILL NO. 59
"An Act relating to the licensing of runaway shelters; relating
to advisors to the board of trustees of the Alaska Mental Health
Trust Authority; relating to the sharing of confidential health
information between the Department of Health and the Department
of Family and Community Services; relating to the duties of the
Department of Health and the Department of Family and Community
Services; and providing for an effective date."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: SB 53
SHORT TITLE: COMPETENCY; INVOLUNTARY CIVIL COMMITMENTS
SPONSOR(s): SENATOR(s) CLAMAN
02/01/23 (S) READ THE FIRST TIME - REFERRALS
02/01/23 (S) HSS, JUD
02/21/23 (S) HSS AT 3:30 PM BUTROVICH 205
02/21/23 (S) Heard & Held
02/21/23 (S) MINUTE(HSS)
02/28/23 (S) HSS AT 3:30 PM BUTROVICH 205
BILL: SB 51
SHORT TITLE: CONTROLLED SUB. DATA: EXEMPT VETERINARIAN
SPONSOR(s): SENATOR(s) TOBIN
02/01/23 (S) READ THE FIRST TIME - REFERRALS
02/01/23 (S) HSS, L&C
02/28/23 (S) HSS AT 3:30 PM BUTROVICH 205
BILL: SB 59
SHORT TITLE: RUNAWAYS; DFCS/DOH: DUTIES/LICENSING/INFO
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR
02/06/23 (S) READ THE FIRST TIME - REFERRALS
02/06/23 (S) HSS
02/28/23 (S) HSS AT 3:30 PM BUTROVICH 205
BILL: SB 53
SHORT TITLE: COMPETENCY; INVOLUNTARY CIVIL COMMITMENTS
SPONSOR(s): SENATOR(s) CLAMAN
02/01/23 (S) READ THE FIRST TIME - REFERRALS
02/01/23 (S) HSS, JUD
02/21/23 (S) HSS AT 3:30 PM BUTROVICH 205
02/21/23 (S) Heard & Held
02/21/23 (S) MINUTE(HSS)
02/28/23 (S) HSS AT 3:30 PM BUTROVICH 205
BILL: SB 51
SHORT TITLE: CONTROLLED SUB. DATA: EXEMPT VETERINARIAN
SPONSOR(s): SENATOR(s) TOBIN
02/01/23 (S) READ THE FIRST TIME - REFERRALS
02/01/23 (S) HSS, L&C
02/28/23 (S) HSS AT 3:30 PM BUTROVICH 205
BILL: SB 59
SHORT TITLE: RUNAWAYS; DFCS/DOH: DUTIES/LICENSING/INFO
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR
02/06/23 (S) READ THE FIRST TIME - REFERRALS
02/06/23 (S) HSS
02/28/23 (S) HSS AT 3:30 PM BUTROVICH 205
WITNESS REGISTER
SENATOR CLAMAN, District H
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Sponsor of SB 53.
EMMA POTTER, Staff
Senator Claman
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Provided a summary of changes for SB 53.
JOHN SKIDMORE, Deputy Attorney General
Criminal Division
Alaska Department of Law
Anchorage, Alaska
POSITION STATEMENT: Answered questions on SB 51.
TREVOR BAILLY, Staff
Senator Löki Tobin
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Offered the sponsor statement and sectional
analysis for SB 51 on behalf of the sponsor.
RACHEL BERNGARTT, DVM, JD, Chair
Board of Veterinary Examiners
Juneau, Alaska
POSITION STATEMENT: Testified by invitation on SB 51.
TRACY WARD, DVM, Past-President
Board of Veterinary Examiners
Juneau, Alaska
POSITION STATEMENT: Testified by invitation on SB 51.
SUZE NOLAN, Manager
North Pole Veterinary Hospital
North Pole, Alaska
POSITION STATEMENT: Testified in support of SB 51.
MELISSA BECKER, representing self
Fairbanks, Alaska
POSITION STATEMENT: Testified in support of SB 51.
HEATHER CARPENTER, Deputy Director
Office of the Commissioner
Department of Health (DOH)
Juneau, Alaska
POSITION STATEMENT: Provided the sectional analysis for SB 59.
CLINTON LASLEY, Deputy Commissioner
Department of Family & Community Services
Juneau, Alaska
POSITION STATEMENT: Introduced SB 59 on behalf of Governor
Dunleavy.
STEVE WILLIAMS, CEO
Alaska Mental Health Trust
Anchorage, Alaska
POSITION STATEMENT: Answered questions on SB 59.
ACTION NARRATIVE
3:31:08 PM
CHAIR DAVID WILSON called the Senate Health and Social Services
Standing Committee meeting to order at 3:31 p.m. Present at the
call to order were Senators Kaufman, Dunbar, Tobin, Giessel, and
Chair Wilson.
SB 53-COMPETENCY; INVOLUNTARY CIVIL COMMITMENTS
SB 53-COMPETENCY; INVOLUNTARY CIVIL COMMITMENTS
3:31:43 PM
CHAIR WILSON announced the consideration of SENATE BILL NO. 53
"An Act relating to involuntary civil commitments."
3:32:57 PM
SENATOR MATT CLAMAN, District H, Alaska State Legislature,
Juneau, Alaska, sponsor of SB 53 said his office suggested
changes to SB 53 and that Ms. Potter would provide a summary of
changes.
3:33:14 PM
EMMA POTTER, Staff, Senator Claman, Alaska State Legislature,
Juneau, Alaska, provided an explanation of proposed changes from
Senator Claman's office to SB 53 as follows:
We are suggesting adding the crime of arson to the
legislation. This change reflects suggestions our
office received from the Criminal Division of the
Department of Law. It is their belief that including
the felony offense of arson, in addition to a felony
offense against the person, is necessary for public
safety. The suggested change includes conforming
changes in Section 1, Section 2, and Section 4 of the
legislation.
There are two suggested changes to Section 4 of the
legislation. The first change is the removal of the
word "repeated" from Section 4, line 8. It is our
intention that the provisions outlined in the
legislation apply upon a person's first dismissal of a
felony level offense against a person. The second
change modifies Section 4(e). The subsection relates
to the ability of individuals to petition for early
release. The suggested change is to create a one-year
limit on a new petition from the individual both after
the initial order for involuntary commitment up to
five years and a subsequent denial of a petition for
early release.
There are three suggested changes in AS 12.47.100. The
first change is to add a requirement that requests for
competency evaluation in AS 12.47.100 to be written
requests. The second change allows the court to order
defendants evaluated for competency at out-patient
facilities while on bail. The third change states that
when the psychiatrist or psychologist finds that the
defendant is incompetent and the defendant is charged
with a felony offense against the person or arson, the
psychiatrist or psychologist may evaluation the
defendant for involuntary commitment. The fourth
change allows the court to order defendants treated
for competency restoration at out- patient facilities
on bail.
Other changes to Title 12 include increasing the
maximum time a person can be held for restoration
competency from one year to two years, adding language
that if a court dismisses the charges against a
defendant for incompetence for a felony offense
against a person or arson, the defendant may not be
discharged until 72 hours after the court dismisses
the charges. This is meant to allow time for the civil
commitment petition to be filed.
The final change for Title 12 is changing the number
of evaluations by a psychiatrist or psychologist from
two to one for the insanity defense. This will match
the number of evaluations required for the insanity
defense to the number of evaluations required in the
process for both the evaluation for competency and
involuntary commitment.
The final group of changes to the legislation that we
are proposing addresses alleged victim notice in the
specific instance for an individual found incompetent
to stand trial and related felony level offenses
against the person or arson are dismissed.
The current version of the bill creates a duty for the
department of law to file a civil commitment petition
upon the dismissal of felony level offenses against
the person based on an incompetency finding. The first
change is a process change and would require the
Criminal Division to notify the Civil Division of the
Department of Law within 24 hours of charges being
dismissed in the situation that the bill addresses.
The second change is also a process change, and states
that the Civil Division shall file a petition for
involuntary commitment within 72 hours of the
dismissal of charges in the situation that the bill
addresses. The third change is creating a right for
the alleged victim in the dismissed criminal charges
to receive notice of the time and place of any civil
commitment proceeding of the courts finding, any civil
commitment proceeding, including the length of time
for which the respondent is committed, and of when the
respondent is discharged from any civil commitment.
3:36:42 PM
SENATOR GIESSEL said that in SB 53, page 2, line 12, the word
"repeated" appears. She asked if it would also be removed.
SENATOR CLAMAN replied that the intent is to remove all
references to the word "repeated."
3:37:14 PM
SENATOR DUNBAR noted that Senator Claman's office had conversed
with the Criminal Division of the Department of Law regarding
changes to SB 53. He asked Senator Claman if his office had
considered the notional changes in Disability Law Center's
letter.
3:37:53 PM
SENATOR CLAMAN said he is always happy to talk with the
Disability Law Center. The center has yet to schedule a meeting,
but his office has worked successfully with the center in the
past. He said he does not agree with their interpretation of SB
53 in all instances. He stated his belief that the center does
not like the notional five-year commitment. He opined that other
than dismissing SB 53, the only resolution the center would
consider is returning to a six-month commitment process.
3:38:42 PM
SENATOR DUNBAR asked if there would be a committee substitute
for SB 53 rather than amendments.
3:38:54 PM
CHAIR WILSON said that was correct. The committee previously ran
out of time to talk about changes to SB 53. He wanted to allow
the sponsor time to talk about the changes and receive community
feedback before requesting a committee substitute.
3:39:14 PM
SENATOR DUNBAR said he is uncomfortable adding arson to SB 53
because it is a novel bill that changes criminal law in response
to a tragedy. He opined that changes to criminal law should be
narrowly focused on a set of circumstances. He said he
understands the Criminal Division's perspective because arson is
dangerous; but so is drunk driving, which may kill more people
on average than arsonists. He said that once crimes other than
against people are included, a variety of crimes may fall into
the dangerous category. There may be enough votes in favor of
including arson, but he does not favor its inclusion in SB 53.
3:40:36 PM
SENATOR CLAMAN said SB 53 will not suddenly create a massive
number of people that will fall into a very narrow focus of
incompetent, non-restorable people who reach a certain level of
dangerousness. He said he does not think there is a history of
felony DUI offenders being incompetent and non-restorable. He
suggested Mr. Skidmore could explain why arson should be
included in SB 53 along with the other felony crimes against a
person.
3:42:10 PM
JOHN SKIDMORE, Deputy Attorney General, Criminal Division,
Alaska Department of Law, Anchorage, Alaska, said the division
included arson in SB 53 because the elements of the crime,
particularly arson in the first degree, require another person
to be harmed or be at risk of harm. He said the same steps would
not apply to someone with a DUI unless another person were
injured, thereby making it a DUI with felony assault, which
would be in the same conduct group listed in SB 53. He said that
from his 25 years of practice, the most serious cases the
division sees are homicides, sexual assaults, and arson. When
released from care, individuals with mental health issues pose
the greatest danger and risk to the public. Including arson in
SB 53 is ultimately a policy call for the legislature to make.
3:43:52 PM
SENATOR DUNBAR asked if it is correct to say felony arson should
be included in SB 53 because the crime satisfies similar
elements to a crime against a person, but for some reason, arson
is not categorized as a crime against a person.
3:44:19 PM
MR. SKIDMORE replied that the state codified arson in AS 11.46,
property offenses. However, arson involves an element of danger
or risk of danger to others which separates it from the type of
conduct seen in most property crimes. The rationale is that
setting fire to a structure places other human beings at risk of
physical harm. That is why it makes sense from a policy
perspective to include it in SB 53 with other crimes against a
person.
3:45:09 PM
SENATOR DUNBAR asked whether an arsonist would have to know
someone was in the building before the crime could be classified
as being against a person. Senator Dunbar compared the
governor's bill on fentanyl distribution to arson. The governor
is seeking additional penalties for fentanyl distribution.
Distribution is not a crime against a person, but it is being
categorized as one of the most dangerous crimes, and it is
likely to result in the deaths of many people. He asked why
felony arson is worse than fentanyl distribution.
3:45:52 PM
MR. SKIDMORE responded that the nature of arson poses a risk to
others and therefore does not require foreknowledge of someone
in the building. The governor's bill on fentanyl distribution
penalties addresses the crimes of manslaughter or homicide,
which are AS 11.41 crimes. SB 53 would include AS 11.41 crimes
because they are crimes against a person. He opined that simple
distribution of drugs would not suddenly be a crime included in
SB 53. However, when distribution of drugs causes the death of
someone there are provisions in crimes against persons that
apply.
3:47:00 PM
SENATOR KAUFMAN said there is a boundary between operating with
intent versus being incompetent to act with intent. He asked Mr.
Skidmore to speak to intent and the topics mentioned. For
example, he wondered how somebody would be a drug dealer via
mental incompetence. He opined that drug dealing would require a
certain competence that maybe drunk driving and arson would not.
3:48:13 PM
MR. SKIDMORE said SB 53 addresses when an individual has engaged
in conduct that would be considered criminal but for their
inability to assist in their defense; this is the definition of
incompetency. The state attempts to restore the person to
competency. If restoration cannot occur, there are questions
about whether a person meets the standards for civil commitment.
Competency is not about a person's ability to engage in conduct.
There are two elements to any criminal act, the actus reus which
is the physical act, and mens rea which is the mental element.
Competency is the ability to assist counsel in defending against
accusations. The intent is the ability for someone to decide
they will commit a particular action, which is not what
incompetency necessarily addresses.
3:49:45 PM
CHAIR WILSON held SB 53 in committee.
3:50:09 PM
At ease.
SB 51-CONTROLLED SUB. DATA: EXEMPT VETERINARIAN
3:51:04 PM
CHAIR WILSON reconvened the meeting and announced the
consideration of SENATE BILL NO. 51 "An Act exempting
veterinarians from the requirements of the controlled substance
prescription database; and providing for an effective date."
3:51:32 PM
TREVOR BAILLY, Staff, Senator Löki Tobin, Alaska State
Legislature, Juneau, Alaska, presented the following sponsor
statement for SB 51 on behalf of the sponsor:
[Original punctuation provided.]
In 2008, in response to the nationwide opioid
epidemic, the Alaska State Legislature created the
Prescription Drug Monitoring Program (PDMP). This
program created a database of prescriptions for
controlled substances in Alaska, with the stated
intent was to place obstacles in front of individuals
seeking opioids from multiple providers. In 2016, the
Legislature expanded the program to include
veterinarians. Unfortunately, the program failed to
account for the major differences between the practice
of human medicine and veterinary medicine. SB 51
addresses this conflict by exempting veterinarians
from the Prescription Drug Monitoring Program.
Eliminating the requirement for veterinarians in
Alaska to use the PDMP does not cause deregulation.
Veterinarians will continue to be covered by federal
statutes and regulated by the Drug Enforcement Agency
(DEA) and the Alaska Board of Veterinary Examiners.
Additionally, provisions in state statute will
continue to limit the number of opioids a veterinarian
can prescribe to a seven-day prescription, with two
exceptions. Those exceptions are if the prescription
is part of long-term chronic care, or if there is
logistical or travel barrier to returning within seven
days.
Prescription drug monitoring is not unique to Alaska.
All 50 states have some variation of prescription drug
monitoring, with 34 states exempting veterinarians.
Previously, 10 of those states mandated veterinarians
be part of prescription drug monitoring efforts;
however, those states soon realized that including
veterinarians had no clear benefit. Instead, these
states found that including veterinarians in their
prescription drug monitoring programs placed
unnecessary time-consuming barriers on those who
practice veterinary medicine. In Alaska, the PDMP
fails to be effective because animal patients do not
have identifiers such as social security numbers. As a
result, veterinarians must try to get the private
health data of those who seek care for their animals
prior to treating the animal. This is both inefficient
and an invasion of privacy.
Senate Bill 51 seeks to correct an overexpansion of
the Prescription Drug Monitoring Program to ensure
continued access to veterinary care in Alaska.
3:54:13 PM
MR. BAILLY presented the following sectional analysis for SB 51:
[Original punctuation provided.]
Section 1
Deletes the requirement that the Board of Veterinary
Examiners to notify the Board of Pharmacy when a
practitioner registers with the controlled substance
prescription database.
Section 2
Creates a new subsection in the controlled substance
prescription database statutes that exempts
veterinarians from the requirements of the controlled
substance prescription database.
Section 3
Repeals the subsection that requires veterinarians
register with the controlled substance prescription
database.
Section 4
The act takes effect immediately upon passage.
MR. BAILEY commented that SB 51 is an iteration of legislation
from the 32nd legislature. Although SB 51 may look substantially
different from the previous bill, it still has the same
legislative purpose and intent. The legislative legal department
made SB 51 clear and succinct while meeting the goals of the
previous legislation.
3:55:20 PM
CHAIR WILSON announced invited testimony on SB 51.
3:55:55 PM
RACHEL BERNGARTT, DMV, JD, Chair, Board of Veterinary Examiners,
Juneau, Alaska, introduced herself as a doctor of veterinary
medicine and a lawyer.
3:56:16 PM
TRACY WARD, DVM, Past-President, Board of Veterinary Examiners,
Juneau, Alaska, stated she is a veterinarian that practices
animal rescue.
3:56:32 PM
DR. BERNGARTT turned to slides 2 - 3 and said SB 51 exempts
veterinarians from the controlled substance prescription
database requirements. The Alaska State Veterinary Medical
Association (AKVMA) and the Board of Veterinary Examines (BOVE)
support SB 51. Also, the Alaska Board of Pharmacy, which
administers the PDMP, passed a motion on February 18, 2022, that
supports the exemption of veterinarians from participation.
3:57:01 PM
DR. WARD turned to slide 4 and said the PDMP was established
with voluntary participation in 2008. In 2016, House Bill 159
was amended due to the increase in opioid use in the US. The
amendment mandated participation for all actively licensed
practitioners who held a drug enforcement agency (DEA) license
to prescribe, administer, or dispense controlled substances on
the federal II, III, or IV drug schedules. The change went into
effect in 2017. The committee that was formed to discuss the
amendment included all affected boards except AKVMA and BOVE.
3:58:24 PM
DR. WARD turned to slide 5 and spoke to the following points:
[Original punctuation provided.]
2008: Alaska's PDMP established by SB 196.
2017: In reaction to growing opioid epidemic, the PDMP
was amended by via HB 159 to include all DEA permit
holders, including veterinarians.
Neither AKVMA nor BOVE were consulted regarding this
amendment.
PDMP reporting is required for all actively licensed
practitioners who hold a Federal Drug Enforcement
Agency registration number and who prescribe,
administer, or dispense federally scheduled II IV
controlled substances in the state.
4:00:02 PM
DR. WARD moved to slides 5 - 7 and discussed why it makes sense
to exempt veterinarians from the PDMP:
[Original punctuation provided.]
The PDMP is not an effective database for
veterinarians or our patients.
• The PDMP was established for human medicine.
Querying of PDMP data for animals is not possible
with the PDMP (and reported drugs for an animal
are not visible in the PDMP database).
• A query is made on the individual(s) that bring
the animal to the veterinarian and human data is
obtained, not animal data.
• Human data obtained from the PDMP query is not
usable for the veterinarian. Veterinarians are
not trained in human medicine to understand what
the dosages mean.
Querying of human PDMP information is invasion into an
individual's medical privacy.
• Clients find it intrusive when the veterinarian
is required to query their private health data in
the PDMP
• An individual's private medication information
becomes known to the veterinarian for certain
drugs, such as narcotics, sedatives, and
stimulants.
Examples of some common medications seen include, but
are not limited to: Adderall, Ritalin, anabolic
steroids such as testosterone, postpartum depression
medications, sex hormones, Xanax, Klonopin, Valium,
Ativan, Domar, and sleep aids like Ambien and Lunesta.
Veterinarians are monitored by the Drug Enforcement
Agency and must adhere to controlled substance
regulations.
• Veterinarians who prescribe or dispense
controlled substances are licensed through the
Drug Enforcement Agency (DEA). There is already a
significant level of accountability, record
keeping, and medication storage requirements that
veterinarians must adhere to.
• Distributors of controlled substances monitor
utilization patterns of veterinarians. The
Suspicious Order Monitoring System is in place
and data is gathered by distribution companies
who are required by the DEA to monitor and report
unusual purchase patterns a veterinarian may
have. Distributors are required to flag purchases
that fall outside of norms for either previous
purchase history or the norms for practices of
similar size/type. DEA oversight is to
control/prevent diversion from licensed
professionals to drug dealers and users.
4:03:03 PM
DR. BERNGARTT moved to slide 8 and spoke about why it makes
sense from a licensing perspective to exempt veterinarians from
the PDMP:
[Original punctuation provided.]
33 other states have exempted veterinarians from
participating in the PDMP.
• 10 states formerly mandated veterinary reporting
but repealed their inclusion due to the problems
experienced, lack of identified benefits to
veterinary participation, and demonstration that
exempting veterinarians does not decrease
protection of public health and safety. These
states are Alabama, Arizona, Idaho, Illinois,
Kansas, Kentucky, Louisiana, New Mexico, West
Virginia (2021), and Wyoming.
• Missouri was the last state to implement a PDMP
in 2021 and did not require veterinarians to
participate.
4:04:23 PM
DR. BERNGARTT turned to slide 9 and said the drugs most often
implicated in overdose and death are not drugs veterinarians
prescribe. The graph depicts trends in US drug overdose deaths
from 1999 - 2021. She noted a correction to the synthetic
opioids category stating deaths have increased 97-fold,
excluding methadone overdose. Fentanyl and oxycodone are
synthetic opioids that are increasing deaths the most.
Veterinarians do not prescribe these two drugs for dispensing.
Veterinary fentanyl is administered directly to the animal at
the hospital. Oxycodone does not have veterinary usage. It is
important to remember that veterinarians do not dispense the
drugs that cause problems in the US. She said opioid medications
prescribed by veterinarians (728,223) were only 0.34 percent of
the total opioid prescriptions (214 million) dispensed by US
retail pharmacies in 2017.
4:06:11 PM
DR. BERNGARTT said the PDMP is just one tool for monitoring
veterinary drug use. There is a natural barrier that prevents
drug seekers from using veterinarians for doctor shopping.
Veterinarians require upfront payment for services. If a person
cannot pay for veterinary services, a pet will not receive the
diagnostic services necessary for a vet to consider dispensing
an opiate. Also, if a vet dispensed a drug, it may not be a
sought-after drug. Exempting veterinarians from the PDMP is not
expected to make them a source for doctor shopping.
4:08:09 PM
SENATOR KAUFMAN said one of the objections he has heard is that
the .34 percent of opioid medication prescribed by veterinarians
would increase if veterinarians were exempt. He asked if it
would be possible for a person to visit several veterinary
locations with a dog in obvious pain, pay for services, and
receive desirable opioids.
4:08:58 PM
DR. WARD said anything is possible, but it would be improbable.
Given the current veterinary shortage, the wait time to see a
vet is 3 - 14 days. A visit to the vet for an animal in pain
costs approximately $500 - 800. Rarely are opioids a vet's first
choice for an animal in pain. A vet usually admits an animal if
it is in enough pain to receive an opioid. The medication is
dispensed to the animal by the vet. She estimated that animal
owners had gone home with something other than a non-steroidal
anti-inflammatory less than five times since beginning her
practice. She stated that it is virtually impossible to visit
several vets in a short amount of time to receive opioids.
4:10:44 PM
SENATOR KAUFMAN asked whether veterinarians typically act as the
dispensary for the medications they prescribe and, if so, would
the passage of SB 51 create any tracking issues.
4:11:12 PM
DR. BERNGARTT said approximately 60 veterinarians directly
dispense prescription-controlled substances from their clinics.
The clinics may use the substances in their practice but also
directly dispense them.
4:12:04 PM
SENATOR KAUFMAN asked if veterinarians dispense a controlled
substance in a potency of interest to someone. He also asked if
there would be a control mechanism to track dispersion if
veterinarians were not in the PDMP.
4:12:27 PM
DR. WARD said 60 veterinarians in Alaska dispense drugs. The
other 350 licensed veterinarians in Alaska send written
prescriptions to pharmacies. Record keeping takes place at the
pharmacy.
SENATOR KAUFMAN asked whether SB 51 would create a tracking gap
if veterinarians who dispense controlled substances did not have
to report using the PDMP.
4:13:35 PM
DR. WARD replied that there is a small potential gap. Most of
the 60 Alaskan clinics dispense schedule IV drugs, such as
phenobarbital, for seizure control. Only a handful of clinics
dispense opioid class schedule II drugs.
4:14:20 PM
SENATOR DUNBAR asked how a vet would be caught if one of the 60
that distribute controlled substances did so illegally.
4:14:55 PM
CHAIR WILSON interjected that it might be helpful if Ms. Robb
discussed the utilization of the PDMP because the Drug
Enforcement Agency does not review the PDMP for bad actors.
4:15:28 PM
DR. BERNGARTT said a vet who engages in nefarious behavior with
illicit drug consumption or distribution would not be captured
by the PDMP because a vet who diverts drugs would not be
entering those controlled substances into the data base. She
said she is aware that the DEA caught one vet in eight years,
and it was through drug log requirements.
4:16:56 PM
DR. BERNGARTT moved to slides 10 - 11 and spoke about the
following points:
[Original punctuation provided.]
The unwieldy PDMP leads to costly and burdensome
investigations of veterinarians by the Alaska Board of
Veterinary Examiners.
Costly and onerous requirements for monitoring
veterinarians have been placed on the board of
veterinary examiners (BOVE).
Licensing fees for veterinarians will likely increase
as a result of the cost to conduct needless
investigations of veterinarians with DEA licenses. The
cost of doing business will be passed on to consumers.
Alaska has the highest licensing fees for
veterinarians in the country.
Licensing fees are expected to increase in the State
of Alaska as a result of the cost of PDMP
investigations.
Charging veterinarians for the cost of enforcement of
an unusable PDMP system, and regulations with which
they are unable to comply, is not responsible
stewardship of resources.
4:19:34 PM
DR. BERNGARTT moved to slide 12, AKVMA and BOVE Ask For Support
of SB 51, and read the following:
[Original punctuation provided.]
An Exemption of Veterinarians from participating in
the PDMP:
Will allow veterinarians to provide the appropriate,
timely, medical management appropriate for each
patient.
Will increase the efficiency of the PDMP system for
its intended purpose, by allowing for accurate
interpretation of data and trends in human medicine.
Will allow continued judicious use of controlled
substances that is already practiced by veterinarians.
Will eliminate unnecessary and disproportionate
business burdens for veterinarians.
4:20:25 PM
CHAIR WILSON opened public testimony on SB 51.
4:20:40 PM
SUZE NOLAN, Manager, North Pole Veterinary Hospital, North Pole,
Alaska, testified in support of SB 51. She said she is the
practice manager for a veterinary hospital with nine doctors.
She supports all the statements provided by the invited
testifiers. She asked for a yes vote on SB 51.
4:21:46 PM
MELISSA BECKER, representing self, Fairbanks, Alaska, testified
in support of SB 51. She said that as a veterinarian she has no
interest in looking up pet owners' information before treating
their pets. She does not dispense schedule II and III controlled
substances. The PDMP does not work for animals because animals
in shelters do not have owners, and children sometimes bring in
their pets. Also, an animal's name is easily changed, and there
is no way to prove it is the same animal.
4:23:00 PM
CHAIR WILSON closed public testimony on SB 51.
4:23:23 PM
CHAIR WILSON held SB 51 in committee.
4:23:44 PM
At ease
SB 59-RUNAWAYS; DFCS/DOH: DUTIES/LICENSING/INFO
4:24:50 PM
CHAIR WILSON reconvened the meeting and announced the
consideration of SENATE BILL NO. 59 "An Act relating to the
licensing of runaway shelters; relating to advisors to the board
of trustees of the Alaska Mental Health Trust Authority;
relating to the sharing of confidential health information
between the Department of Health and the Department of Family
and Community Services; relating to the duties of the Department
of Health and the Department of Family and Community Services;
and providing for an effective date."
4:25:48 PM
MS. HEATHER CARPENTER, Deputy Director, Office of the
Commissioner, Department of Health (DOH), Juneau, Alaska, gave a
brief history of SB 59, stating that in 2021 Governor Dunleavy
introduced Executive Order 119 that proposed splitting the
Department of Health and Social Services into two departments,
Department of Health and Department of Family and Community
Services. Governor Dunleavy withdrew the order due to drafting
errors and substantive changes that went beyond the powers of an
executive order. Last session Governor Dunleavy reintroduced the
bill as Executive Order 121. The legislature adopted the order
that took effect July 1, 2022.
4:26:41 PM
CLINTON LASLEY, Deputy Commissioner, Department of Family &
Community Services, Juneau, Alaska, said the departments knew
that Executive Order 121 was a large bill and that the need for
small amendments would surface. SB 59 contains those changes. It
ensures that the new Department of Health (DOH) and the
Department of Family and Community Services (DFCS) share
important information, including confidential, protected health
information necessary to administer programs within each
department to serve Alaskans. It provides in statute the clarity
of work that the Department of Health and Social Services
supplied. The two departments interact daily. For example,
eligibility information for an individual can pertain to DOH for
public assistance and to DFCS for children's services. Also, SB
59 would make the commissioner of DFCS an adviser to the
trustees of the Alaska Mental Health Trust. The departments knew
of the substantive change and that a clean-up bill would be
necessary. The Mental Health Trust supports the change.
Clarifying statutes related to licensing duties assigned to the
former Department of Health and Social Services are reassigned
due to a citation error. Licensing related to runaway shelters
is assigned to DOH, and foster homes licensing is assigned to
DFCS. Finally, an amendment defines the "department" to include
DFCS in AS 18.65.340.
4:29:48 PM
MS. CARPENTER presented the following sectional analysis for SB
59:
[Original punctuation provided.]
Section 1 Amends AS 12.62.400(a) to assign
responsibility for criminal history
checks for the licensing of runaway
shelters to the Department of Health
rather than the Department of Family
and Community Services. This is done to
correct a mistake from EO 121 that
assigned the licensing of runaway
shelters to Department of Family and
Community Services even though a
division of Department of Health
performs this work. Sections 4-9 also
implement this correction.
Section 2 Amends AS 44.25.260 to add the Department of
Family and Community Services
Commissioner to the Alaska Mental
Health Trust Authority board of
advisors.
Section 3 Amends AS 47.05 by adding a new section:
(1) requiring the Department of Health
and Department of Family and Community
Services share identifiable health
information between and within
departments as necessary to enable the
efficient and effective administration
and operation of both departments;
(2) establishing that information acquired, used,
disclosed, and stored under this
section be stored in a confidential and
secure environment;
(3) establishes the definition of "identifiable health
information" with the existing
definition in AS 18.15.395.
Sections 4-9 Amends statute to identify that the
Department of Health holds responsibility
for the licensure of programs and
drafting regulations related to runaway
minors.
Sections 10 Amends AS 47.32.032 to provide clarifying
language in licensing statute to identify
that the Department of Family and
Community Services is responsible for
foster home licensing. This corrects a
mistake from EO 121 that assigned the
licensing of foster homes to Department of
Health even though a division of
Department of Family and Community
Services performs this work.
Sections 11-15 Amends AS 47.32 to provide clarifying
language in licensing statute about the
respective departments having
responsibility for actions related to the
entities they license.
Section 16 Establishes an immediate effective date.
4:34:25 PM
CHAIR WILSON said he had a question regarding Section 2. He
asked how often advisors attend Alaska Mental Health Trust board
meetings and what weight their input carries.
4:34:56 PM
STEVE WILLIAMS, CEO, Alaska Mental Health Trust, Anchorage ,
Alaska, answered that advisors attend once or twice a year.
Commissioners and staff generally attend the board meetings.
Various departments and trustees discuss the needs of
beneficiaries, how partnerships can be improved, and the work of
the trust. The dialogue is often very good.
4:35:31 PM
CHAIR WILSON asked if advisors are invited to each meeting or
just as needed.
4:35:40 PM
MR. WILLIAMS replied that advisors typically are not invited to
each meeting. The board meets four times a year and advisors
attend once or twice a year.
CHAIR WILSON said he wanted to ensure more administrative
influence was not added to a public board.
4:36:12 PM
CHAIR WILSON opened public testimony on SB 59.
4:36:24 PM
CHAIR WILSON closed public testimony on SB 59.
4:36:52 PM
CHAIR WILSON held SB 59 in committee.
4:37:42 PM
There being no further business to come before the committee,
Chair Wilson adjourned the Senate Health and Social Services
Standing Committee meeting at 4:37 p.m.