ALASKA STATE LEGISLATURE  SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE  April 22, 2025 3:41 p.m. MEMBERS PRESENT Senator Forrest Dunbar, Chair Senator Cathy Giessel, Vice Chair Senator Matt Claman Senator Löki Tobin Senator Shelley Hughes MEMBERS ABSENT  All members present COMMITTEE CALENDAR  SENATE JOINT RESOLUTION NO. 16 Urging the United States Congress to pass the Ensuring Lasting Smiles Act; and urging lawmakers to advocate for policies that guarantee equitable access to vital healthcare. - MOVED SJR 16 OUT OF COMMITTEE SENATE BILL NO. 147 "An Act relating to the prescription and administration of drugs and devices by pharmacists; relating to reciprocity for pharmacists; and providing for an effective date." - HEARD & HELD PREVIOUS COMMITTEE ACTION  BILL: SB 147 SHORT TITLE: PHARMACIST PRESCRIPTION AUTHORITY SPONSOR(s): SENATOR(s) GIESSEL BY REQUEST 03/26/25 (S) READ THE FIRST TIME - REFERRALS 03/26/25 (S) HSS, L&C 04/15/25 (S) HSS AT 3:30 PM BUTROVICH 205 04/15/25 (S) Heard & Held 04/15/25 (S) MINUTE(HSS) 04/22/25 (S) HSS AT 3:30 PM BUTROVICH 205 BILL: SJR 16 SHORT TITLE: FEDERAL ENSURING LASTING SMILES ACT SPONSOR(s): SENATOR(s) GRAY-JACKSON 04/02/25 (S) READ THE FIRST TIME - REFERRALS 04/02/25 (S) HSS 04/10/25 (S) HSS AT 3:30 PM BUTROVICH 205 04/10/25 (S) Heard & Held 04/10/25 (S) MINUTE(HSS) 04/22/25 (S) HSS AT 3:30 PM BUTROVICH 205 WITNESS REGISTER ELVI GRAY JACKSON, District G Alaska State Legislature Juneau, Alaska POSITION STATEMENT: Sponsor of SJR 16. BRIAN BRUBAKER, representing self Anchorage, Alaska POSITION STATEMENT: Testified in support of SJR 16. ERIC HOLLAND, representing self Anchorage, Alaska POSITION STATEMENT: Testified in support of SB 147. AIMEE YOUNG, representing self Anchorage, Alaska POSITION STATEMENT: Testified in support of SB 147. BRITTANY KARNS, representing self Fairbanks, Alaska POSITION STATEMENT: Testified in support of SB 147. ASHLEY SCHABER, Chair Alaska Board of Pharmacy Anchorage, Alaska POSITION STATEMENT: Answered a question on SB 147 concerning insurance. BRANDY SEIGNEMARTIN, Executive Director Alaska Pharmacists Association Eagle River, Alaska POSITION STATEMENT: Answered a question on SB 147 concerning insurance. ACTION NARRATIVE 3:41:17 PM CHAIR DUNBAR called the Senate Health and Social Services Standing Committee meeting to order at 3:41 p.m. Present at the call to order were Senators Giessel, Tobin, Hughes, and Chair Dunbar. Senator Claman arrived thereafter. SJR 16-FEDERAL ENSURING LASTING SMILES ACT  3:41:57 PM CHAIR DUNBAR announced the consideration of SENATE JOINT RESOLUTION NO. 16 Urging the United States Congress to pass the Ensuring Lasting Smiles Act; and urging lawmakers to advocate for policies that guarantee equitable access to vital healthcare. 3:42:14 PM ELVI GRAY JACKSON, District G, Alaska State Legislature, Juneau, Alaska, sponsor of SJR 16 stated that the resolution supports individuals with congenital anomalies and birth defects who face lifelong health challenges. Many require multiple surgeries that can cost families up to $100,000 out of pocket and are often mischaracterized as cosmetic, despite testimony demonstrating otherwise. She said by adopting this resolution, the legislature can promote fairness in health care, protect vulnerable populations, and send a clear message to the congressional delegation that the state prioritizes health outcomes and supports individuals in leading healthy, productive lives. 3:43:19 PM CHAIR DUNBAR opened public testimony on SJR 16. 3:43:45 PM BRIAN BRUBAKER, representing self, Anchorage, Alaska, testified in support of SJR 16. He explained that his only daughter Emily, who testified previously, has Hypohidrotic Ectodermal Dysplasia (HED). He stated that HED requires costly dental care that is not covered by private insurance because it is deemed cosmetic under federal law. He said teeth are essential for speech and nutrition and should not be deemed cosmetic. He said he found out that his daughter's HED is hereditary and genetically dominant, the condition will affect future generations. SJR 16 will have a lasting effect on future generations. 3:43:51 PM SENATOR CLAMAN arrived at the meeting. 3:45:29 PM CHAIR DUNBR closed public testimony on SJR 16. 3:45:38 PM CHAIR DUNBAR solicited the will of the committee. 3:45:39 PM SENATOR GIESSEL moved to report SJR 16, work order 34-LS0788\A, from committee with individual recommendations and attached fiscal note(s). 3:45:56 PM CHAIR DUNBAR found no objection and SJR 16 was reported from the Senate Health and Social Services Standing Committee. 3:46:07 PM At ease. SB 147-PHARMACIST PRESCRIPTION AUTHORITY  3:47:40 PM CHAIR DUNBAR reconvened the meeting and announced the consideration of SENATE BILL NO. 147 "An Act relating to the prescription and administration of drugs and devices by pharmacists; relating to reciprocity for pharmacists; and providing for an effective date." 3:47:58 PM SENATOR GIESSEL speaking as sponsor of SB 147 provided opening comments saying the bill establishes a limited framework for pharmacist-provided patient care services and is a targeted reform focused on improving access to care. SB 147 does not expand pharmacists' scope of practice beyond services they are already educated and trained to provide, nor does it permit pharmacists to prescribe abortion-inducing medications, which remains expressly prohibited under current Alaska law. She said SB 147 allows pharmacists to more fully serve patients within clearly defined standards of competence and professional accountability. She said the bill is intended to increase access to basic care, reduce delays, ease pressure on primary care providers, lower health care costs, and improve overall health outcomes. These benefits are supported by existing research previously reviewed by the committee. 3:49:51 PM CHAIR DUNBAR opened public testimony on SB 147. 3:50:10 PM ERIC HOLLAND, representing self, Anchorage, Alaska, testified in support of SB 147. He stated that with Alaska not having an in- state pharmacy program, students are trained through a joint degree program with Idaho State University. The university has one of the most expansive pharmacy practice statutes and regulations. He said students are educated to diagnose, assess, treat, and manage a range of conditions and expect to practice at that level after graduation. However, Alaska's more restrictive regulations limit this practice. He said he has worked in settings that would be affected by SB 147, including community pharmacy point-of-care testing and chronic care management. He stated that he currently works at the Anchorage Neighborhood Health Center, where pharmacist-managed diabetes care has strong support from other health care providers. 3:52:15 PM AIMEE YOUNG, representing self, Anchorage, Alaska, testified in support of SB 147. She said she nearly has 20 years as a licensed pharmacist and has practiced at the top of her training through the Indian Health Service. She pioneered a walk-in pharmacy immunization clinic in 2006 that expanded vaccine access and increased vaccination rates. More recently, she specialized in pain management, collaborating with multidisciplinary teams to provide high-quality, non-opioid care that reduced opioid use. She said as a trusted medication expert and accessible health care provider, she urged passage of SB 147 to allow pharmacists to better serve Alaskan communities. 3:54:03 PM BRITTANY KARNS, representing self, Fairbanks, Alaska, testified in support of SB 147. She emphasized that pharmacists complete extensive training through PharmD programs and are educated to practice at a high level of clinical knowledge. Working at the Indian Health Service Clinic in Fairbanks, she described being regularly sought out by physicians for prescribing guidance, particularly where integrated clinical pharmacy services are not otherwise available. She said pharmacists practice within a defined scope and are not seeking to exceed it, and rather work fully within the scope, consistent with other states. Granting prescriptive authority within that scope would help address provider shortages, relieve physician workload, and expand access to care in Alaska. 3:56:26 PM CHAIR DUNBAR closed public testimony on SB 147. 3:56:50 PM CHAIR DUNBAR held SB 147 in committee. 3:57:08 PM SENATOR HUGHES stated she would like to have more information from the sponsor on how SB 147 would affect malpractice insurance. She opined that it would be important to know if malpractice insurance could be a problem. 3:58:49 PM ASHLEY SCHABER, Chair, Alaska Board of Pharmacy, Anchorage, Alaska, answered a question on SB 147 concerning insurance. She replied that pharmacists commonly carry malpractice insurance, either individually or through their employers. An employer in Idaho reported to the Board of Pharmacy that expanding pharmacists' scope of practice did not result in changes to malpractice insurance. She said as with other health care professionals, pharmacists are responsible for maintaining appropriate malpractice coverage. 4:00:05 PM BRANDY SEIGNEMARTIN, Executive Director, Alaska Pharmacists Association, Eagle River, Alaska, answered a question on SB 147 concerning insurance. She responded that pharmacists do carry malpractice insurance, and discussions have been held with Pharmacists Mutual, a major insurer, regarding this issue. She offered to provide the committee with a summary of the insurer's considerations and emphasized the importance of pharmacists maintaining their own malpractice coverage. 4:00:41 PM SENATOR GIESSEL commented on a statement that, "if malpractice insurance is expensive the legislature should care." She stated that this isn't something the Alaska legislature regulates and it should be regulated by clinical professionals to determine if they will perform the expanded services. Each professional has the option to choose to carry their own malpractice insurance. The legislature doesn't control malpractice insurance prices. 4:02:13 PM There being no further business to come before the committee, Chair Dunbar adjourned the Senate Health and Social Services Standing Committee meeting at 4:02 p.m.