HB 114: EXTEND TOURISM MARKETING COUNCIL Number 064 REP. CYNTHIA TOOHEY testified as sponsor of HB 114. She related the story of an Anchorage nurse practitioner who asked the state licensing bureau why she was not allowed to dispense medication, as most nurse practitioners are advanced registered nurses operating in the Bush and they are able to prescribe medicines, but are not allowed to dispense them. She said the bill would allow advanced nurse practitioners (ANPs) to dispense medicines when there is no pharmacy available. She cited 126 letters from advanced nurse practitioners about the bill, and a letter from state pharmacists showing no opposition. She said the Indian Health Service uses many advanced nurse practitioners in villages, and to bar them from dispensing would do damage to the state. Number 108 PATRICIA HONG, PRESIDENT OF THE ALASKA NURSES ASSOCIATION, testified from Anchorage in support of HB 114. She urged support so that advanced nurse practitioners could continue the proven valuable services they provide to rural and indigent patients. DARYL YOUNG, DIRECTOR OF STUDENT HEALTH AT THE UNIVERSITY OF ALASKA-ANCHORAGE, testified from Anchorage in support of HB 114. He said ANPs often need to dispense medications when there is no accessible pharmacy, or when clients cannot pay for medications and dispensation. When ANPs can dispense medications, patients are more likely to obtain and take their medications. The university student health center has 8,000 potential patients, many of them lacking money, health insurance, time and inclination to comply with medical orders. Giving ANPs dispensary privileges, even in urban areas, will dramatically increase prompt and proper compliance with medical orders, he said. He also noted that the drugs dispensed at the student health center are premeasured and prepackaged, and none are compounded on-site. Number 183 CHAIR BUNDE noted that the Matanuska-Susitna Legislative Information Office (LIO) was on-line. He asked witnesses to limit testimony to two minutes to save time. Number 186 DR. DIXIE LIGHT, A FAMILY NURSE-PRACTITIONER, testified from the Mat-Su LIO. She said her patients in the Mat-Su valley and north along the Parks Highway have little access to drugstores and therefore may wait days before going to town to fill the prescription, possibly too late. The ability to prescribe supports her simple, rural practice, serving low- income patients with medical care and information. Number 202 SUE ANN JENKENSON, A MEMBER OF THE ALASKA NURSE PRACTITIONER ASSOCIATION (transmission partially unintelligible) testified from Anchorage in support of HB 114. She said the change was necessary to provide complete care to patients too poor to buy medicines or live in rural areas far from pharmacies. Nurse practitioners in Alaska have been able to practice independently since 1984, and to prescribe since 1985, and dispensing would complement these abilities. Number 222 GAIL McGUILL, EXECUTIVE SECRETARY FOR THE ALASKA BOARD OF NURSING, testified from Anchorage in support of HB 114. She said ANP dispensing does occur around the state. A November 1992 survey of nurse practitioners in Alaska showed that 55 percent of the state's nurse practitioners dispense medicine, with 25 percent of nurse practitioners working in areas without pharmacies, and 22 percent in areas without physicians. Ms. McGuill stated HB 114 would help prevent degradation of such services. She said the Boards of Nursing and Pharmacy have cooperated to set parameters for ANP dispensing, and the parameters of ANP dispensation will be defined by Board of Nursing regulation. Number 248 KAY LAHDENPERA, OF THE MUNICIPALITY OF ANCHORAGE, testified from Anchorage in support of HB 114. She said the municipality has employed and used nurse practitioners since 1984 and would be glad to see them win dispensing authority, the better to serve their clients. Number 264 DR. PETER NAKAMURA, DIRECTOR OF THE DIVISION OF PUBLIC HEALTH, testified in support of HB 114. He said it aids in access and cost containment. Number 272 CHAIR BUNDE closed public testimony and asked the will of the committee. REP. AL VEZEY moved passage of HB 114 from the committee with individual recommendations. Hearing no objections to the motion, CHAIR BUNDE declared HB 114 PASSED WITH INDIVIDUAL RECOMMENDATIONS.