SB 94-PROFESSION OF PHARMACY  1:32:56 PM CHAIR BJORKMAN announced the consideration of SENATE BILL NO. 94 "An Act relating to the Board of Pharmacy; relating to the practice of pharmacy; relating to pharmacies; relating to prescription drug manufacturers; relating to prescriptions for epinephrine; relating to the administration of epinephrine; and providing for an effective date." He asked the sponsor to introduce the bill. 1:33:17 PM SENATOR CATHY GIESSEL, District E, Alaska State Legislature, Juneau, Alaska, sponsor of SB 94, stated that the goal of the bill is to protect the public by ensuring the safe practice of Alaskan pharmacists. This bill updates obsolete statutes. It is a multi-year collaboration between multiple organizations, multiple chairs of the Board of Pharmacy, and the Alaska Pharmacist's Association. Pharmacology students, retirees, and individuals from the Alaska Tribal Health System all support SB 94. She explained that the practice of pharmacology has evolved over the last couple of decades and through the COVID-19 pandemic, at which time pharmacists fulfilled critical public service roles. She described the changes SB 94 would make. SENATOR GIESSEL spoke to the following sponsor statement: [Original punctuation provided.] Pharmacists and pharmacies are an integral part of Alaska' healthcare system. It is important that the Alaska statutes that guide them are updated and reflect the services provided by modern-day pharmacies. Senate Bill 94 clarifies the Alaska Board of Pharmacy's powers and duties to align with the federal Drug Supply Chain and Security Act (DSCSA) related to licensing and oversight of manufacturers, out-of-state pharmacies, outsourcing facilities, and internet pharmacies who conduct business in Alaska. In doing so, these out-of-state entities will be held to the same high standard as those operating in the state of Alaska, helping to ensure Alaskans have access to medications that are safe, no matter where they originate. SB 94 aligns Alaska's pharmacy board statutes with similar boards in other states. It allows for it to meaningfully recognize retired pharmacists and their contributions. Stressing the importance of public safety, SB94 would allow the board to institute a national criminal background check for Alaska pharmacists and pharmacy technicians. This would align the Alaska Board of Pharmacy with the National Association of Boards and Pharmacy Model State Pharmacy Act. The Executive Administrator plays a critical role in the smooth functioning of the board and requires a high degree of competency and understanding of the complexities of pharmacy-related regulations and issues. This bill gives Alaska's Division of Professional Licensing flexibility to hire a qualified pharmacist for this administrative role should one apply. The changes proposed in Senate Bill 94 reflect a dedicated collaboration between the Alaska Board of Pharmacy and the Alaska Pharmacists Association (AKPhA) to modernize pharmacy practice statutes. 1:35:43 PM REPRESENTATIVE JUSTIN RUFFRIDGE, District 7, Alaska State Legislature, Juneau, Alaska, sponsor of the House companion bill to SB 94, testified in support of SB 94. He announced that he could answer questions as a pharmacist and former chairman of the Board of Pharmacy. This bill and its companion in the other body are the result of a collaboration of multiple chairs of the Board of Pharmacy for right-touch regulations. This included modernizing pharmacy regulations, repealing those that were out- of-date, and implementing updates in compliance with federal law. Many changes in the bill are a result of the Drug Supply Chain and Security Act as well as the need to update licensing requirements, especially for licensees of pharmacist and pharmacist technician practices. Additionally, this bill allows for changes to the Board of Pharmacy, such as allowing for pharmacy technicians to be seated in lieu of a public member. Finally, to increase access to the life-saving drug epinephrine, SB 94 includes the prescribing of auto-injectors, or EpiPens, by pharmacists trained in their use. 1:40:24 PM JANE CONWAY, Staff, Senator Cathy Giessel, Alaska State Legislature, Juneau, Alaska, paraphrased the following sectional analysis for SB 94: [Original punctuation provided.] Section 1. Amends AS 08.08.010(a) Creation and membership  of board; officers Alters composition of the seven-member Board of Pharmacy by designating one member to be a licensed pharmacy technician, and one being an individual with no financial interest in the healthcare industry Section 2. Amends AS 08.80.030 Powers and Duties of Board (b)(10) Separates out the licensing/regulating entities relating to manufacturing and distributing of drugs and devices by use of the word "or" (b)(12) adds an epinephrine auto-injector training program (b)(14) Clarifies that only pharmacists who dispense federally scheduled controlled substances be required to register with the Prescription Drug Monitoring Program (PDMP) (b)(16) Adds pharmacies and manufacturers from out-of- state to list of entities to be licensed and inspected (b)(17) Adds internet-based pharmacies to list of entities to be licensed if they are servicing Alaskans (b)(18) adds language allowing the board to adopt regulations pertaining to retired pharmacist status Section 3. Amends 08.80.145 Reciprocity; license transfer (3) removes character requirement - "of good moral character" (4) removes internship details this is a national standard among schools of pharmacy Renumbering of statute items Section 4. Amends AS 08.80.157 Licensing of facilities (k) this adds out-of-state pharmacies and manufacturers to the list of entities that must be licensed Section 5. Amends AS 08.80.159 Licensing and inspection of  facilities outside the state (a) Adds "distributor, pharmacy, manufacturer" to those out-of-state entities that must be licensed and inspected, under the Drug Supply Chain and Security Act Section 6. Amends AS 08.80.159 Licensing and inspection of  facilities outside the state (c) adds "pharmacy and manufacturer" to list that may be inspected if located outside the state 1:42:31 PM Section 7. Amends AS 08.80.160 Fees (10) Removes the word "registration" since the bill mandates licensure of a facility Section 8. Amends 08.80.168 and adds a new subsection  Administration of vaccines and related emergencies (e) Allows a pharmacist to administer epinephrine to a person or prescribe an epinephrine auto-injector to someone who has completed the epinephrine auto-injector training Section 9. Amends AS 08.80.270 Executive administrator of  the board  (a) Adds an additional salary range option for the executive administrator, allowing flexibility for the Division to select a pharmacist for the role Section 10. Amends AS 08.80.420 Certain advertising  prohibited  (a) adds the term "apothecary" to list of those that cannot be used in media or advertising unless the store employs a licensed pharmacist with regular hours Section 11. Amends AS 12.62.400 National criminal history  record check  (a)(23) adds pharmacist and pharmacy tech to list of professions where a background check is required. Aligns with State of Alaska's nursing requirements and pharmacy requirements typical in other states. This adds a national level background check Section 12. Amends AS 17.22.010 Prescription, purchase,  administration of epinephrine by a trained individual Allows anyone over 18 to purchase or be prescribed an epinephrine autoinjector, and to administer epinephrine shot in an emergency to another person if they have completed an epinephrine auto-injector training program approved by the board. It removes very outdated language from this section Section 13. Amends AS 17.22.020(a) Approval of training  programs (a) Allows the board, rather than the department, to adopt standards for the epinephrine auto-injector training program and deletes outdated language Section 14. Amends AS 17.22.020(b) Approval of training  programs (b) Allows the board, rather than the department, to approve an epinephrine auto-injector training program that meets the board's standards Section 15. Amends AS 17.22.030 Applicability States that this chapter does not apply to someone currently authorized under another law to administer epinephrine, such as a nurse or doctor, or some other authorized professional 1:44:37 PM Section 16. Amends AS 17.22.040 Liability of certified  individual Outlines that a person may not be sued who administers epinephrine to another in an emergency, and in good faith, if he or she has completed the epinephrine auto- injector training program approved by the board Section 17. Amends AS 17.22.090 Definitions (3) defines the "board" as the Board of Pharmacy Section 18. Repeals AS 08.80.110(2) Qualifications for  licensure by examination • Repeals (2) furnish the board with at least two affidavits from reputable citizens that the applicant has known for at least one year attesting to the applicant's good moral character. This is not required in medical, dentistry, or nursing statutes. • Repeals 08.80.158 Registration of pharmacies located outside the state since this bill would now require licensure • Repeals AS 17.22.020(c) which is the Department's epinephrine auto-injector training program • Repeals AS 17.22.090(1) that defines the department as the Dept of Health, since it will no longer be the approving entity of the epinephrine auto- injector training program 1:45:37 PM Section 19. TRANSITION LANGUAGE for currently registered  pharmacies A new section that would allow pharmacies previously registered to continue to ship, mail or deliver prescription drugs to its customers in Alaska until their registration expires. At that time, they will then have to apply for licensure. Section 20. TRANSITION: REGULATIONS Allows the Board of Pharmacy and DCCED to adopt regulations to carry out the changes laid out in this legislation. Section 21. Section 20 has an immediate effective date under AS 01.10.070(c) Section 22: Effective date is set to coincide with the Drug Supply Chain and Security Act that will go into effect on November 26, 2023. 1:47:04 PM BRANDY SEIGNEMARTIN, Executive Director, Alaska Pharmacists Association, Eagle River, Alaska, stated support for SB 94 and Senator Giessel and offered to answer questions. 1:48:03 PM ASHLEY SCHABER, Chair, Board of Pharmacy, Anchorage, Alaska, gave a presentation on SB 94. She began on slide 3, and spoke to the following points: Background of SB 94 • Result of multi-year, multi-chair review of statutes and regulations to ensure the Alaska Board of Pharmacy can continue to meet its mission • SB 94 addresses changes by: o Streamlining licensure process while improving public safety o Compliance with the Drug Supply Chain and Security Act o Alignment with other professional boards in Alaska and pharmacy boards in other states o Clarification of pharmacists' roles in epinephrine access • Collaborative effort between the Alaska Board of Pharmacy and the Alaska Pharmacists Association 1:49:47 PM SENATOR BISHOP joined the meeting. 1:50:23 PM MS. SCHABER advanced to slide 4, and spoke to the following points: Goal: Streamline licensure process while improving public safety • Eliminates unnecessary forms currently required in statute • Clarifies that only pharmacists who dispense controlled substances are required to register with the Prescription Drug Monitoring Program (PDMP) • Adds national criminal background check 1:51:23 PM MS. SCHABER advanced to slide 5, and spoke to the following points: Goal: Compliance with Drug Supply Chain and Security Act • The federal Drug Supply Chain and Security Act (DSCSA) further secures the U.S. drug supply through a system to prevent harmful drugs from entering the supply chain, detect harmful drugs if they do enter, and enable rapid response when such drugs are found o Boards of Pharmacy play a key role in this process through appropriate licensing of drug distributors and pharmacies • SB 94 ensures the AK Board of Pharmacy powers and duties support the DSCSA related to manufacturers, out-of-state pharmacies, and internet pharmacies to ensure Alaskans receive safe medications 1:52:15 PM MS. SCHABER advanced to slide 6, and spoke to the following points: Goal: Alignment • Replaces one of the two public member seats with a pharmacy technician seat • Allows the board to adopt language for retired pharmacist status • Clarifies the board executive administrator's salary, allowing flexibility for a pharmacist to serve in this role in the future 1:53:42 PM MS. SCHABER advanced to slide 7, and spoke to the following points: Goal: Epinephrine Access • Moves epinephrine training program under Board of Pharmacy oversight • Clarifies that a pharmacist can administer epinephrine to a person or prescribe epinephrine auto-injectors to someone who has completed the training program • Increases epinephrine access for Alaskans with anaphylactic emergencies 1:54:11 PM MS. SCHABER advanced to slide 8, and spoke to the following points: Support • The Board of Pharmacy respectfully requests your support of SB 94, allowing us to further promote, preserve, and protect the public health, safety, and welfare of Alaskans by and through the effective control and regulation of the practice of pharmacy. • Thank you for your time! 1:54:40 PM CHAIR BJORKMAN thanked the presenter and held SB 94 in committee.