HB 195-PHARMACIST PRESCRIPTION AUTHORITY  3:37:42 PM CHAIR MINA announced that the first order of business would be HOUSE BILL NO. 195, "An Act relating to the prescription and administration of drugs and devices by pharmacists; relating to reciprocity for pharmacists; and providing for an effective date." 3:38:08 PM CHAIR MINA, as prime sponsor, presented HB 195. She stated that HB 195 would be a collaborative effort between the Alaska Board of Pharmacy and the Alaska Pharmacy Association, and would clarify pharmacists' right to independent prescribing, allowing them to practice at the top of the training, education, and experience. She emphasizes the limited access to healthcare in Alaska, and the fact that pharmacists are prepared to help fill gaps in access. She described the education and training required by pharmacists, and the rights that other states have provided pharmacists to prescribe independently. 3:40:38 PM KATY GIORGIO, Staff, Representative Genevieve Mina, offered the sectional analysis for HB 195 [hard copy included in the committee file]. Section 1. Amends AS 08.80.030(b) Powers and duties of  the board. to require that a licensed pharmacist who prescribes, administers, or dispenses a controlled substance under state law or federal law to a person in the state register with the controlled substance prescription database (PDMP). Section 2. Amends AS 08.80.110 Qualifications for  licensure by examination. to require that a pharmacist who holds a Drug Enforcement Agency (DEA) number applying for licensure (via examination) receive education in pain management and opioid use and addiction, in alignment with other practitioners in Alaska who hold DEA numbers. Section 3. Amends AS 08.80.145 Reciprocity; license  transfer.  to require that a pharmacist who holds a DEA number applying for licensure (via reciprocity) receive education in pain management and opioid use and addiction, in alignment with other practitioners in Alaska who hold DEA numbers and pay the associated fees. Section 4. Amends AS 08.80.165 Continuing education  requirements.    to require a pharmacist who holds a DEA number and renews licensure in Alaska meet continuing education requirements including at least two hours of education in pain management and opioid use and addiction in the two years preceding license renewal, in alignment with other practitioners in Alaska who hold DEA numbers. A pharmacist whose practice does not include pain management and opioid prescription, or administration is exempt from this requirement. Section 5. Amends AS 08.80.337 Other patient care  services.    (a)to clarify that a pharmacist may not provide patient care services under a collaborative agreement  with another pharmacist.  Section 6. Amends AS 08.80.337 Other patient care  services.    (d) to clarify that "patient care services" mean medical care services that include the prescription or administration of a drug or device to a patient for the purposes of curing or preventing a disease, reduction of patient symptoms or for slowing the disease progression. Section 7. Amends and adds a new subsection to AS 08.80.337 Other patient care services.    (e) requiring that a pharmacist prescribing or administering a drug or device under this section recognize the limits of the pharmacist's education, training, and experience and consult with and refer to other practitioners as appropriate. This aligns with standard of care and pharmacy regulation. Section 8. Amends AS 08.80.480 Definitions.  (30) to clarify that the "practice of pharmacy" includes providing patient care services in accordance with AS 08.80.337. This includes patient care services provided independently or under collaborative practice. Section 9. Amends and adds a new paragraph to AS 08.80.480 Definitions. (40) adds to the definition of opioid to include opium and opiate substances and opium and opiate derivatives Section 10. Repeals AS 08.80.337 Other patient care  services (c) to align with clarifications in Section 6. Section 11. Provides for an effective date of January 1, 2026. 3:43:48 PM CHAIR MINA announced the committee would hear invited testimony. 3:44:04 PM ASHLEY SCHABER, PharmD, Chair, Alaska Board of Pharmacy, stated that HB 195 would align with the Alaska Board of Pharmacy's strategic plan to promote community health and safety. She said that HB 195 would be the result of work over several years, spanning multiple Board of Pharmacy chairs, with its ultimate goal being to increase access to care. She described House Bill 145, which passed during the Thirty-Second Alaska State Legislature and expanded the scope of practice of pharmacists. She added that the board has deemed it necessary to clarify the expansion of statutory authorities given to pharmacists under HB 145. Dr. Schaber stated that HB 195 would encourage engagement between pharmacists and other healthcare professionals and would help maintain patient safety. She asked the committee to support HB 195. 3:48:02 PM BRANDY SEIGNEMARTIN, PharmD, Executive Director, Alaska Pharmacy Association, testified in support of HB 195. She described how pharmacists are deeply embedded in patient care, especially in Alaska. She said that HB 195 would allow pharmacists to provide a limited set of additional patient care services, including prescribing and services within the bounds of their education, training, and experience. She said that HB 195 would not be new to pharmacists but would be following in the footsteps of federal pharmacists' authorities, who have been allowed to provide these same patient care services since 1979. She emphasized that HB 195 would not allow pharmacists to practice any services outside of their competency levels. She added that closing the gap between pharmacists' education and their scope of practice would help fight burnout. Dr. Seignemartin said that HB 195 would prevent more patients from delaying care or ending up in emergency rooms. She then listed the patient care services that pharmacists would be allowed to practice under HB 195. She described the economic value of pharmacist-provided care, explaining how it saves patients money without sacrificing quality of care. She urged the committee to support HB 195. 3:55:58 PM JEN ADAMS, PharmD, Associate Dean of Academic Programs, Idaho State University, described her role within the Doctor of Pharmacy program at Idaho State University. She described the education requirements regarding prescribing practices for Doctors of Pharmacy. She stated that pharmacy students across the country are trained and qualified to provide the services that would be authorized under HB 195. She described the benefits seen by patients in Idaho, where pharmacists' scope of practice has been expanded already. She shared an anecdote from a patient who received care for a substance abuse disorder from a pharmacist in Idaho. She said that authorizing pharmacists to provide timely, evidence-based, patient care services would increase access to healthcare, reduce the burden on emergency departments, and improve health outcomes across Alaska. She urged the committee to support HB 195. 4:03:04 PM REPRESENTATIVE GRAY asked why it has taken 46 years longer for Alaska to expand pharmacists' practicing authorities than the federal government. CHAIR MINA directed the question to Dr. Schaber. 4:03:44 PM DR. SCHABER explained that pharmacists within the federal system are not bound by individual states' statutes. She said that the goal of HB 195 would be to align Alaskan pharmacists' scope of practice more closely with those in the federal system. REPRESENTATIVE GRAY asked about what circumstances a pharmacist would prescribe schedule IA substances. 4:05:07 PM CHAIR MINA read from page 2, lines 28-30, in Section 1 of HB 195, the section to which Representative Gray had referred. REPRESENTATIVE GRAY stated that in his experience, there is no circumstance where a pharmacist would prescribe a schedule IA substance. DR. SEIGNEMARTIN agreed and presumed that this language was taken from some other statute. DR. SCHABER responded that the drugs identified in this section are controlled substances under state law and that she has not seen anything scheduled under these circumstances. REPRESENTATIVE GRAY asked about the collaborative practices that were mentioned in the sectional analysis. DR. SCHABER responded that collaborative practice refers to the practice between a pharmacist and another practitioner to prescribe services. 4:08:42 PM REPRESENTATIVE RUFFRIDGE said that HB 145 was a bill he did a lot of work on prior to being a legislator. He said that collaborative practice could still occur under HB 195, in addition to independent prescribing. He added that if a pharmacist has prescribing authority, then they cannot be a collaborating provider for another pharmacist that provides those services. REPRESENTATIVE GRAY asked why another pharmacist cannot be the collaborating provider for another pharmacist. REPRESENTATIVE RUFFRIDGE explained that the collaborative provider agreement under HB 145 references the pharmacist with some other kind of provider, to expand their collaborative scope of practice. 4:10:53 PM REPRESENTATIVE PRAX asked if pharmacists are trained on schedule IA substances. 4:11:40 PM DR. ADAMS said that medications classified under schedule IA do not have a medicinal purpose. REPRESENTATIVE GRAY added that federal and state schedule classifications are different. REPRESENTATIVE PRAX asked if HB 195 would need to be amended to address this. REPRESENTATIVE GRAY [shook his head no]. 4:13:12 PM REPRESENTATIVE SCHWANKE asked what the scope of required education would be under HB 195. DR. SCHABER responded that the required education would be in alignment with other providers that prescribe opioids so as not to have any discrepancies there. DR. ADAMS added that a Doctor of Pharmacy education would include the training necessary to prescribe independently and would be consistent with federal law standards. REPRESENTATIVE SCHWANKE asked if a Doctor of Pharmacy degree would meet the education requirement under HB 195. DR. ADAMS said that that is correct. 4:16:31 PM CHAIR MINA announced that HB 195 was held over.