HB 344-DRUG PRESCRIPTION DATABASE  4:04:12 PM CHAIR SEATON announced that the next order of business would be HOUSE BILL NO. 344, "An Act relating to the controlled substance prescription database; and providing for an effective date." [Before the committee was the proposed committee substitute (CS) for HB 344, Version 29-LS1378\N, Bruce, 3/14/16, as a working document.] 4:04:30 PM The committee took an at-ease from 4:04 p.m. to 4:07 p.m. 4:07:40 PM CHAIR SEATON moved to adopt Amendment 2, labeled 29-LS1378\N.3, which read: Page 16, line 16, following "patient": Insert "more than a three-day supply of" REPRESENTATIVE TARR objected for discussion. CHAIR SEATON explained that this amendment would add an exemption to the mandatory review of the database required in Sec. 19, page 16, lines 14-20. The exemption would mean that a practitioner or pharmacist would not be required to check the database if they are dispensing a controlled substance with a supply of three days or less. Although, they could still check but there would not be a requirement to check. 4:08:59 PM REPRESENTATIVE TARR noted that it reads more than a three day and surmised that it includes the third day. CHAIR SEATON agreed, and said three days or less. 4:09:28 PM REPRESENTATIVE TARR removed her objection. There being no objection, Amendment 2 was adopted. 4:10:00 PM CHAIR SEATON moved to adopt Amendment 3, Version 29-LS1378\N.5, which read: Page 17, line 17, following "state": Insert "for an occupation or activity listed under AS 08.01.010" REPRESENTATIVE STUTES objected for discussion. CHAIR SEATON referred to Sec. 20, subsection (q), page 17, lines 15-17, which read: (q) A pharmacist or practitioner may only delegate access to the database under (b) or (d) of this section to an employee or agent who is licensed or registered in the state. CHAIR SEATON explained that the amendment would clarify that the person must be licensed or registered for an occupation or activity listed in AS 08.01.010. The reason being to make clear that they must be licensed or registered with the Division of Corporations, Business, and Professional Licensing and not some unintended registration, such as the sex offender registry, thereby, designating which licenses or registration would be covered, he advised. 4:11:18 PM REPRESENTATIVE STUTES removed her objection. There being no objection, Amendment 3 was adopted. 4:11:47 PM CHAIR SEATON moved to adopt Amendment 4, Version 29-LS1378\N.6, which read: Page 18, line 15, following "TRANSITION.": Insert "(a)" Page 18, following line 18: Insert a new subsection to read: "(b) On or before October 1, 2019, the Department of Commerce, Community, and Economic Development shall solicit comments on the level of burden on providers created by the review requirement in AS 17.30.200(k)(4), enacted by sec. 19 of this Act. The department shall summarize, in a report to the legislature, the comments received by the department and its findings based on the comments. The department shall deliver the report to the senate secretary and the chief clerk of the house of representatives not later than October 1, 2019, and notify the legislature that the report is available. The legislature may assess whether the review requirement under AS 17.30.200(k)(4), enacted by sec. 19 of this Act, remains necessary or if alternative language should be considered based on the report." REPRESENTATIVE TARR objected for discussion. CHAIR SEATON explained that the amendment would add to the uncodified law, under Sec. 22 of the HB 334. He paraphrased that the amendment directs the Department of Commerce, Community & Economic Development to solicit comments from providers regarding the level of burden on providers created by the review requirement of AS 17.30.200(k)(4) and to deliver to the legislature a report summarizing the comments and the Department of Commerce, Community & Economic Development's findings based on the comments. The report would be due October 1, 2019, and the legislature may assess whether the review requirement is still necessary or whether alternative language would be preferable. Basically, he pointed out, this directs the Department of Commerce, Community & Economic Development to collect comments on the burden on providers created by the requirement to review the database prior to prescribing, dispensing, or administering, and the department would then present comments to the legislature with the findings. The legislature would then have the option to re-examine and review the requirement. It is not a sunset but it is a review and report. The date of October 1, 2019 would give the department two years and three months from the effective date to collect these comments and generate a report. 4:13:45 PM REPRESENTATIVE TARR asked who would prepare the report because the Department of Commerce, Community & Economic Development (DCCED) is the stop gap to move the database over to the department as it does the professional licensing, but is the department well equipped to receive comments. For example, the Department of Health and Social Services (DHSS) is regularly communicating with its Medicaid providers, and suggested that possibly it should be DCCED and DHSS. CHAIR SEATON said he presumed that each one of the professional boards would be handling those, and called on Ms. Janey Hovenden to respond. 4:14:54 PM JANEY HOVENDEN, Director, Division of Corporations, Business, and Professional Licensing, Department of Commerce, Community & Economic Development, explained that as she reads the amendment, the program coordinator would coordinate all information with all of the different boards and members in licensing, which is how a survey would be generated. The survey would go out to all registered people with a database and solicit their input, collect the information and prepare the required report to the legislature, she said. 4:15:42 PM REPRESENTATIVE TARR asked whether she felt equipped to handle this task and the volume of respondents which could be in the hundreds or thousands. She further asked that whether with existing resources the department would be able to pull together a report, or whether the report would be a self-generated report with something such as "Survey Monkey and that would be sufficient. MS. HOVENDEN replied that even though the department is slowly gathering email addresses it isn't quite equipped for that and would notify as it does all regulation projects or anything like that, send snail mail to everyone. The program coordinator being requested in this bill would spearhead that entire project as one of the duties of the position. REPRESENTATIVE TARR related that sounds more realistic in terms of a hefty project and she did not know what to expect and sometimes given the opportunity people have a lot to say. CHAIR SEATON commented that he agrees that without a program coordinator if the legislature was just dumping this on the department, which would not be something that would be easily handled. 4:17:15 PM REPRESENTATIVE STUTES asked whether this project could be performed in a timely fashion. She described concern that people cannot receive a response from the Division of Corporations, Business, and Professional Licensing, currently. CHAIR SEATON reiterated that there is a program coordinator hired for this specific coordination of the database and it is not giving the department another job. The description of a program coordinator is located within the fiscal note and the report period is for two years and three months only. There will be a summary of the problems received prepared for the legislature. REPRESENTATIVE STUTES asked whether the coordinator would work under the Division of Corporations, Business, and Professional Licensing. MS. HOVENDEN replied yes. REPRESENTATIVE STUTES said that was her concern. 4:19:22 PM REPRESENTATIVE VAZQUEZ said she likes the intent of the amendment in receiving feedback from providers regarding the burden that will be placed upon them, but she is concerned there will not be feedback until three and one-half years away because that is too long of a period of time. At most it should be one year from now, or something in January, 2017. Although, she commented, not all of the information will have been received to assess the type of burden but there would be an initial indication and annual reports thereafter. She referred to line 11 of Amendment 4, and pointed out that the amendment states a report shall be submitted on "not later than October 1, 2019," and it is now March 24, 2016. 4:20:32 PM CHAIR SEATON explained that the effective date is July 2017. REPRESENTATIVE VAZQUEZ asked to shorten the time frame in order to know the type of burden it will impose on the providers. 4:21:08 PM CHAIR SEATON responded that he was trying to give at least one year of the program being in effect to coordinate that information in an effective manner, and this is not an annual report. He remarked he has tried to eliminate some of the burden by allowing the chief pharmacist to also authorize someone who is licensed or registered in the health field, and there is accountability against their license. The testimony the committee received was that the department is the busiest at the end of the legislature or the fiscal year and the best time to prepare the report is October or November so it would be ready for the legislature in the following year. He commented that preparing a report in June or July for the legislature may not be reviewed until the next session, and receiving a shorter term report wouldn't cover an entire year's worth of the program and the intention is to calculate feedback. In the event the committee does not wish to have a report, he said he could remove the report. 4:23:40 PM REPRESENTATIVE TARR noted that the effective date is July 1, 2017, and a full year would be 2018, and suggested using January 1, 2019. CHAIR SEATON asked whether the department could change the report date. MS. HOVENDEN responded that the report will be presented whenever it is requested. 4:24:50 PM REPRESENTATIVE TARR moved to adopt Conceptual Amendment 1 to Amendment 4, to change the date on line 6 to January 1, 2019; and on line 11 to change the date to January 1, 2019. CHAIR SEATON objected. He surmised that it would be Conceptual Amendment 1 to Amendment 4 to change October 1, 2019, to January 1, 2019, on line 6 and line 11. REPRESENTATIVE TARR agreed. 4:25:41 PM REPRESENTATIVE WOOL said that based on the pharmacist's comments that expressed possibly foreseeable problems, he opined that it gives them a year to evaluate, and after that year the department has five months to complete a report. He related that it is a good timeline. CHAIR SEATON removed his objection. There being no objection, Conceptual Amendment 1 to Amendment 4 was adopted. 4:26:34 PM REPRESENTATIVE TARR removed her objection to Amendment 4 as amended. There being no objection, Amendment 4, as amended, was adopted. 4:27:36 PM REPRESENTATIVE VAZQUEZ moved to report CSHB 344, Version 29- LS1378\N, as amended, out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, CSHB 344(HSS) was reported from the House Health, Education and Social Services Standing Committee