SB 71-VACCINE CERTIFICATION FOR PHARMACISTS    5:15:52 PM CHAIR OLSON announced that the final order of business would be SENATE BILL NO. 71, "An Act relating to the practice of pharmacy; and relating to the administration of vaccines and related emergency medications." 5:16:16 PM JANE CONWAY, Staff, Senator Cathy Giessel, Alaska State Legislature, on behalf of the prime sponsor, Senator Cathy Giessel, stated that SB 71 would allow Alaska pharmacists to administer all vaccines without a collaborative practice agreement. Since 2001, Alaska pharmacists have required oversight by medical doctor or a nurse practitioner to administer vaccines. These oversight practice agreements cost $50-500 annually for pharmacists depending on the agreement with the oversight physician or nurse practitioner. The oversight amounts to the physician or nurse practitioner overseeing the immunization records. 5:17:28 PM MS. CONWAY offered that some pharmacies have difficulty finding a collaborative medical doctor or nurse practitioner and this hurdle reduces access to needed vaccines to the public. This bill, SB 71 will give already educated and certified pharmacists the authority to immunize Alaskan adults and children without having to contract with often hard to find an overseeing physician or nurse practitioner. MS. CONWAY explained that the appropriate clinical procedure for vaccine administration is part of the course work for a pharmacy doctorate degree, which has been the case since 2005. The level of entry into the pharmacist position is a doctorate or PhD of pharmacology. Under the bill, pharmacists educated prior to 2005 are required to immunization education program outlined by the Board of Pharmacy. 5:19:23 PM SENATOR CATHY GIESSEL, Alaska State Legislature, stated that the Board of Pharmacy would provide a vaccine administration program. The pharmacists already understand the vaccines, including the pharmacology and side effects, but they would be polishing their skills on the administration. Their education already includes the drug therapy, dosing, and adverse events. How to respond to adverse events was a question raised in the other committees. When she prescribes she often asks pharmacists for information since they know the drugs and are definitely qualified [to administer vaccines]. In addition, this bill would help rural communities since people often have more interaction with their pharmacists than they do their health care providers. Many states already authorize this and have experienced higher immunization rates, which Alaska could benefit from. 5:20:54 PM SENATOR GIESSEL explained that the statewide database "vacstracks" was used to track vaccines. Pharmacists would be required to enter the vaccine data, which is accessible to all health care providers in the state. In 2013, pharmacists administered over 13,000 flu vaccines. This bill could definitely make more vaccines available through these pharmacists and pharmacies. 5:21:26 PM REPRESENTATIVE LEDOUX asked whether pharmacists currently required to enter data into the statewide database. SENATOR GIESSEL answered yes. 5:21:45 PM REPRESENTATIVE HUGHES related her understanding that they are trained on dosages. She asked whether pharmacists are also trained in administering them. SENATOR GIESSEL answered that pharmacists from 2005 forward have been educated in the administration of vaccines. Those pharmacists educated prior to 2005 will be required to take the vaccine administration course that the Board of Pharmacy approves. 5:22:16 PM REPRESENTATIVE HUGHES asked whether taking patient's medical history was part of process since she did not think of pharmacists as taking medical history. SENATOR GIESSEL answered that currently for flu vaccines citizen fills out a form citing medications they currently take, any allergies to medications, and any chronic conditions they may have. The same requirements would happen with other vaccines administered. 5:23:02 PM REPRESENTATIVE HUGHES wondered if this might lower the cost of administration of vaccines. SENATOR GIESSEL was unsure. Certainly, that would be the goal and it will reduce the cost for the individual professionals who administer the vaccines. Currently, it can take 6-12 months for collaborative agreements to be solidified. 5:23:57 PM REPRESENTATIVE LEDOUX asked for further clarification that administering means actually giving the shots. SENATOR GIESSEL answered yes. 5:24:10 PM REPRESENTATIVE LEDOUX said she really likes this bill. She wondered whether it might be possible in the future to allow pharmacists some limited powers to prescribe drugs. She has experienced picking up prescription drugs such as antibiotics in other countries. SENATOR GIESSEL replied that it would require changes in the pharmacists' educational program to perform diagnosis. She said that the state insurance program has nurse advice lines for patients to receive advice. 5:25:40 PM REPRESENTATIVE JOSEPHSON asked whether the footprint of pharmacies would need to change. SENATOR GIESSEL answered that pharmacists currently administer vaccines so they already have the facilities. 5:26:27 PM REPRESENTATIVE KITO related his understanding rural Alaska experiences problems obtaining oversight agreements. He asked whether other circumstances exist in which doctors or pharmacists are having difficulties in putting together agreements. SENATOR GIESSEL answered that she was not certain and deferred to the pharmacists to respond. 5:27:04 PM BARRY CHRISTENSEN, Co-Chair, Alaska Pharmacists Association, stated the Alaska Pharmacists Association membership consists of pharmacists, pharmacies, and pharmacy technicians. The association fully supports this bill, which he characterized as a "win-win-win" such that it will ensure that pharmacists who are currently immunizing can continue to do so. It would also open up open up immunizations to pharmacists who have had difficulty obtaining a partner for a collaborative practice agreement. Further, it would open up access to patients for immunizations. Finally, it's a "win" for employers since this will keep people healthier. The Center for Disease Control has reported that every dollar spent on immunization will save $10 in overall health care costs. This bill has support from "mom pop" pharmacies to chain pharmacies. 5:28:58 PM LIS HOUCHEN, Counsel, NW Regional Director, National Association of Chain Drugstores (NACD) stated that she represents chain drug stores in the Northwest region, including Costco, Genoa Health Care, Good neighbor Health Mart, Carrs-Safeway, Target, Walgreen, and Walmart. She thanked members for hearing this important bill to allow pharmacists to independently prescribe and administer immunizations in Alaska. She said that Senator Giessel mentioned that the state was not doing as good a job as it could. In 2012, only 1.2 percent of Alaskans were immunized for influenza flu, which ranked as 49th in the nation. MS. HOUCHEN said that the organization was encouraged by SB 71 since many additional needed vaccines will be administered in local villages by pharmacists to patients and families that may otherwise go without being immunized. 5:30:33 PM CHAIR OLSON commented that he gets his flu shots at the pharmacy. 5:31:36 PM RYAN RUGGLES, Pharmacist, Carrs-Safeway, stated that he works as a pharmacist and he currently administers vaccines. He offered strong support for SB 71, which all comes down to patient access. Although Carrs-Safeway stores has a collaborative practice provider that they regularly use, but if the provider is traveling or unavailable, it can take time to find a substitute. Sometimes the pharmacists simply waits for the collaborative practice provider to return. 5:32:56 PM CHAIR OLSON, after first determining no one wished to testify, closed public testimony on SB 71. 5:33:09 PM REPRESENTATIVE COLVER remarked that this was an excellent bill. He stated that this can help combat health care costs. He offered his belief that it was common in other countries to have a streamlined process to administer vaccines. Further, a number of people already obtain their immunizations from their neighborhood pharmacies. 5:33:37 PM REPRESENTATIVE HUGHES acknowledged that pharmacists eager to get in place. She asked whether nurse practitioners and physicians support this concept. SENATOR GIESSEL answered that there has not been any opposition to the bill. 5:34:11 PM REPRESENTATIVE HUGHES moved to report SB 71 out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, SB 71 was reported from the House Labor and Commerce Standing Committee. The committee took a brief at ease.