HB 145-EXPAND PHARMACIST AUTHORITY  8:12:56 AM CO-CHAIR FIELDS announced that the next order of business would be HOUSE BILL NO. 145, "An Act relating to the Board of Pharmacy; relating to health care services provided by pharmacists and pharmacy technicians; and relating to the practice of pharmacy." 8:13:11 AM REPRESENTATIVE SNYDER reminded the committee that the proposed legislation is intended to clearly define the patient care services that can be provided by pharmacists. She noted that the COVID-19 pandemic particularly highlighted those services, and that HB 145 would help ensure regulation by the Board of Pharmacy as well as contain a component ensuring reimbursement by insurance providers. She noted Representative Kaufman's concern regarding the term "general health and wellness," expressed during the April 12, 2021, meeting of the House Labor and Commerce Standing Committee, which she said would be addressed during this hearing. 8:14:20 AM CO-CHAIR FIELDS opened public testimony on HB 145. 8:14:32 AM ANGELA JAGLOWICZ, PharmD, testified in support of HB 145, noting that she is a practicing primary care pharmacist and certified diabetes education specialist. She described working directly with primary care providers (PCPs) in caring for patients with chronic diseases, ensuring that medications are employed to provide the best possible health outcome for the patient. She pointed out that the care she provides is easily accessed and provides continuity of care while freeing up the schedules of busy PCPs for more urgent situations. She said that as a result of ongoing visits, her patients are able to develop the knowledge needed to manage their own health care more effectively. 8:16:19 AM DAN NELSON, PharmD, Director of Pharmacy, Tanana Chiefs Conference, testified in support of HB 145, noting that the COVID-19 pandemic required an "all hands on deck" situation for healthcare professionals. He characterized pharmacists as some of the most accessible healthcare professionals and that they have rapidly responded to Alaska's healthcare needs. He urged the committee's support for HB 145. 8:17:35 AM JAY FLYNN, MD, testified in support of HB 145, explaining that doctors can't always get to patients with lifesaving vaccines. He said pharmacists' contribution allows the medical community to have a stronger impact in the Norton Sound area. 8:18:56 AM KYLIE GOFF testified in support of HB 145. She said that the medical community relies heavily on the expertise of pharmacists, who have been leaders in organizing child immunizations and well-child checkups. She said that the impact of pharmacists is felt more in communities with a shortage of primary care providers. 8:21:17 AM BARRY CHRISTENSEN, RPh, Legislative Committee Co-Chair, Alaska Pharmacists Association, testified in support of HB 145. He noted the changes within the profession in recent decades and said today's pharmacists are in a better position to help meet their patients' pharmaceutical needs. In order for community pharmacies to survive and serve patients, he said, the statutory language in HB 145 is necessary. 8:23:05 AM NATALIE MCCAY testified in support of HB 145. She said she is a certified pharmacy technician and expressed that the proposed legislation would be especially important to rural and underserved areas such as Petersburg. Pharmacists are often the first stop when patients have questions, she said, and allowing pharmacists and their support staff to provide certain health care services would increase access to health care. 8:24:01 AM DOUGLAS BARTKO testified in support of HB 145. He discussed the problem of claim rejection experienced by pharmacists, saying they need to be paid for the services they provide. 8:25:43 AM JUSTIN RUFFRIDGE, PharmD, testified on behalf of the Board of Pharmacy in support of HB 145. 8:26:21 AM MARK BOHRER, RPh, Pharmacy Practice Coordinator, Fred Meyer, testified in support of HB 145 as the supervisor of all Fred Meyer pharmacy locations in Alaska. He said he has practiced pharmacy in Alaska for 31 years and described how pharmacists have "stepped up" during the COVID-19 pandemic, providing testing and vaccinations. 8:27:55 AM DIRK WHITE, RPh, testified in support of HB 145. He expressed that the practice of pharmacy has changed in the past 35 years and statutes need to evolve into the new century. He said his pharmacy has started offering strep tests and COVID-19 tests but because he and his employees are not classified as medical providers, they're not able to bill insurance companies and are forced to charge patients directly. Passage of HB 145, he said, would improve the profession and allow pharmacists to increase access to healthcare in all parts of Alaska. 8:30:24 AM TALETHIA BOGART testified in support of HB 145. She shared that she is in her 3rd year of pharmacy school and previously was a high school science teacher and pharmacy technician. She said she understands the shortage of health care services in Alaska and that she believes HB 145 would alleviate some of those issues, primarily in primary care settings. She said that she's being prepared to handle many areas of health care including primary care, critical care, emergency medicine, and community pharmacy, and pointed out that she's seen firsthand the impact of her training in remote communities. She said she's participated in COVID-19 vaccine clinics, administering hundreds of vaccines and providing general health care information. 8:33:00 AM JACOB JORDAN testified in support of HB 145. He shared that he is a pharmacy student in his third year, having previously served nine years in the military after graduating from the United States Military Academy at West Point. He described the intense training to become a Doctor of Pharmacy, including four years of education on medication use, safety, and monitoring, with a focus on chronic disease management, health and wellness support, and providing preventative health services in a community setting. He said he's required to have over 2,000 hours of clinical experience, culminating in his clinical training during his fourth year in the program, as well as three years of classroom-based training. Students within the program have taken independent healthcare initiatives, he said, with his class training over 60 volunteers each year to assist in community health care. He said HB 145 would help modernize Alaska's pharmacy practice statutes and resolve longstanding regulatory issues, thereby allowing patients more access to pharmacy healthcare services. 8:35:09 AM MARGARET SODEN, RPh, testified in support of HB 145. She pointed out how pharmacists, pharmacy technicians, and pharmacy students helped during the COVID-19 pandemic. She described some of the changes in the profession since she took her licensing exam in 1965, when the practical exam tested how well one could fold papers for containing powder. She said that all areas of medicine, including pharmacy, have become more sophisticated and it's important to empower the Board of Pharmacy to recognize the changes. 8:37:00 AM KAREN MILLER, RPh, testified in support of HB 145, sharing that she's been a pharmacist at Fairbanks Memorial Hospital for 27 years. She described helping with hospice, long-term care, and patient discharges, noting that oftentimes the pharmacist is in the background ensuring direct and affordable drug therapy. She said pharmacists often struggle to get reimbursement and that she believes HB 145 would be beneficial. 8:38:24 AM AMY TAUL testified in support of HB 145, sharing that she is the clinical faculty pharmacist at Providence Family Medicine Center. She said that the primary resource for treatment is medication, and medical school graduates often receive only one semester of pharmacology. She described supporting physicians and patients through medication and chronic disease management, working alongside physicians to assist in choosing the appropriate medication. She talked about working directly with patients in general health care and disease management, often counseling patients and making the appropriate recommendations. Utilizing clinical pharmacists, she said, would make physicians available to treat more patients. 8:41:36 AM SUSAN WHEELER, PharmD, testified in support of HB 145, sharing that she is a pharmacist at the Yukon-Kuskokwim Health Corporation. She said that pharmacists are fully integrated with other healthcare professionals but are unable to receive compensation for their services due to the absence of their ability to enroll as billing providers. She said pharmacists are often the most readily available healthcare professionals, but are the only providers not currently listed in the provider anti-discrimination statute, meaning they do not receive the same compensation as another professional providing the same service. She said the lack of compensation makes it difficult to sustain and provide the services pharmacists are qualified to provide, which may prevent patients from obtaining needed healthcare. 8:43:32 AM RENEE ROBINSON, PharmD, testified in support of HB 145, sharing that she is an associate professor at the University of Alaska Anchorage/Idaho State University College of Pharmacy. She described her extensive experience working with underserved populations. She said HB 145 would resolve longstanding regulatory issues that impede progress while supporting Board of Pharmacy oversight. 8:45:34 AM CO-CHAIR FIELDS, after ascertaining that no one else wished to testify, closed public testimony on HB 145. 8:45:59 AM CO-CHAIR SPOHNHOLZ moved to report HB 145 out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, HB 145 was reported out of the House Labor and Commerce Standing Committee.