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HOUSE BILL NO. 242
IN THE LEGISLATURE OF THE STATE OF ALASKA
THIRTY-FIRST LEGISLATURE - SECOND SESSION
BY REPRESENTATIVE JOSEPHSON
Introduced: 2/7/20
Referred: Health & Social Services, Labor & Commerce
A BILL
FOR AN ACT ENTITLED
1 "An Act relating to the prescription of opioids; relating to the practice of dentistry;
2 relating to the practice of medicine; relating to the practice of podiatry; relating to the
3 practice of osteopathy; relating to the practice of nursing; relating to the practice of
4 optometry; relating to the practice of pharmacy; relating to the practice of veterinary
5 medicine; relating to the state medical examiner; relating to the controlled substance
6 prescription database; relating to the duties of the Board of Pharmacy; and providing
7 for an effective date."
8 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:
9 * Section 1. AS 08.36.070(a) is amended to read:
10 (a) The board shall
11 (1) provide for the examination of applicants and the credentialing,
12 registration, and licensure of those applicants it finds qualified;
13 (2) maintain a registry of licensed dentists, licensed dental hygienists,
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1 and registered dental assistants who are in good standing;
2 (3) affiliate with the American Association of Dental Boards and pay
3 annual dues to the association;
4 (4) hold hearings and order the disciplinary sanction of a person who
5 violates this chapter, AS 08.32, or a regulation of the board;
6 (5) supply forms for applications, licenses, permits, certificates,
7 registration documents, and other papers and records;
8 (6) enforce the provisions of this chapter and AS 08.32 and adopt or
9 amend the regulations necessary to make the provisions of this chapter and AS 08.32
10 effective;
11 (7) adopt regulations ensuring that renewal of a license, registration, or
12 certificate under this chapter or a license, certificate, or endorsement under AS 08.32
13 is contingent on proof of continued professional competence; the regulations must
14 require that a licensee receive not less than two hours of education in pain
15 management and opioid use and addiction in the two years preceding an application
16 for renewal of a license, unless the licensee has demonstrated to the satisfaction of the
17 board that the licensee does not currently hold a valid federal Drug Enforcement
18 Administration registration number;
19 (8) at least annually, cause to be published on the Internet and in a
20 newspaper of general circulation in each major city in the state a summary of
21 disciplinary actions the board has taken during the preceding calendar year;
22 (9) issue permits or certificates to licensed dentists, licensed dental
23 hygienists, and dental assistants who meet standards determined by the board for
24 specific procedures that require specific education and training;
25 (10) require that a licensed dentist who has a federal Drug
26 Enforcement Administration registration number register with the controlled substance
27 prescription database under AS 17.30.200(n);
28 (11) adopt regulations that establish opioid prescription dosage
29 standards based on morphine milligram equivalents; in this paragraph,
30 "morphine milligram equivalent" means the conversion factor used to calculate
31 the strength of an opioid using morphine dosage as the comparative unit of
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1 measure.
2 * Sec. 2. AS 08.64.101(a) is amended to read:
3 (a) The board shall
4 (1) except as provided in regulations adopted by the board under (b) of
5 this section, examine and issue licenses to applicants;
6 (2) develop written guidelines to ensure that licensing requirements are
7 not unreasonably burdensome and the issuance of licenses is not unreasonably
8 withheld or delayed;
9 (3) after a hearing, impose disciplinary sanctions on persons who
10 violate this chapter or the regulations or orders of the board;
11 (4) adopt regulations ensuring that renewal of licenses is contingent on
12 proof of continued competency on the part of the licensee;
13 (5) under regulations adopted by the board, contract with private
14 professional organizations to establish an impaired medical professionals program to
15 identify, confront, evaluate, and treat persons licensed under this chapter who abuse
16 alcohol, other drugs, or other substances or are mentally ill or cognitively impaired;
17 (6) adopt regulations that establish guidelines for a physician or
18 physician assistant who is rendering a diagnosis, providing treatment, or prescribing,
19 dispensing, or administering a prescription drug to a person without conducting a
20 physical examination under AS 08.64.364; the guidelines must include a nationally
21 recognized model policy for standards of care of a patient who is at a different location
22 than the physician or physician assistant;
23 (7) require that a licensee who has a federal Drug Enforcement
24 Administration registration number register with the controlled substance prescription
25 database under AS 17.30.200(n);
26 (8) adopt regulations that establish opioid prescription dosage
27 standards based on morphine milligram equivalents; in this paragraph,
28 "morphine milligram equivalent" means the conversion factor used to calculate
29 the strength of an opioid using morphine dosage as the comparative unit of
30 measure.
31 * Sec. 3. AS 08.68.100(a) is amended to read:
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1 (a) The board shall
2 (1) adopt regulations necessary to implement this chapter, including
3 regulations
4 (A) pertaining to practice as an advanced practice registered
5 nurse, including requirements for an advanced practice registered nurse to
6 practice as a certified registered nurse anesthetist, certified clinical nurse
7 specialist, certified nurse practitioner, or certified nurse midwife; regulations
8 for an advanced practice registered nurse who holds a valid federal Drug
9 Enforcement Administration registration number must address training in pain
10 management and opioid use and addiction;
11 (B) necessary to implement AS 08.68.331 - 08.68.336 relating
12 to certified nurse aides in order to protect the health, safety, and welfare of
13 clients served by nurse aides;
14 (C) pertaining to retired nurse status; [AND]
15 (D) establishing criteria for approval of practical nurse
16 education programs that are not accredited by a national nursing accrediting
17 body; and
18 (E) establishing opioid prescription dosage standards based
19 on morphine milligram equivalents; in this subparagraph, "morphine
20 milligram equivalent" means the conversion factor used to calculate the
21 strength of an opioid using morphine dosage as the comparative unit of
22 measure;
23 (2) approve curricula and adopt standards for basic education programs
24 that prepare persons for licensing under AS 08.68.190;
25 (3) provide for surveys of the basic nursing education programs in the
26 state at the times it considers necessary;
27 (4) approve education programs that meet the requirements of this
28 chapter and of the board, and deny, revoke, or suspend approval of education
29 programs for failure to meet the requirements;
30 (5) examine, license, and renew the licenses of qualified applicants;
31 (6) prescribe requirements for competence before a former registered,
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1 advanced practice registered, or licensed practical nurse may resume the practice of
2 nursing under this chapter;
3 (7) define by regulation the qualifications and duties of the executive
4 administrator and delegate authority to the executive administrator that is necessary to
5 conduct board business;
6 (8) develop reasonable and uniform standards for nursing practice;
7 (9) publish advisory opinions regarding whether nursing practice
8 procedures or policies comply with acceptable standards of nursing practice as defined
9 under this chapter;
10 (10) require applicants under this chapter to submit fingerprints and the
11 fees required by the Department of Public Safety under AS 12.62.160 for criminal
12 justice information and a national criminal history record check; the department shall
13 submit the fingerprints and fees to the Department of Public Safety for a report of
14 criminal justice information under AS 12.62 and a national criminal history record
15 check under AS 12.62.400;
16 (11) require that a licensed advanced practice registered nurse who has
17 a federal Drug Enforcement Administration registration number register with the
18 controlled substance prescription database under AS 17.30.200(n).
19 * Sec. 4. AS 08.72.050 is amended to read:
20 Sec. 08.72.050. Regulations. The board shall adopt regulations
21 (1) necessary for the proper performance of its duties;
22 (2) governing the applicants and applications for licensing;
23 (3) for the licensing of optometrists;
24 (4) necessary to govern the practice of optometry, including the
25 prescription and use of pharmaceutical agents for the treatment of eye disease;
26 (5) prescribing requirements that a person licensed under this chapter
27 must meet to demonstrate continued professional competency;
28 (6) developing uniform standards for the practice of optometry;
29 (7) establishing opioid prescription dosage standards based on
30 morphine milligram equivalents; in this paragraph, "morphine milligram
31 equivalent" means the conversion factor used to calculate the strength of an
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1 opioid using morphine dosage as the comparative unit of measure.
2 * Sec. 5. AS 08.80.335 is amended by adding a new subsection to read:
3 (c) Before filling a prescription for and dispensing an opioid that is a schedule
4 II, III, or IV controlled substance under federal law, a pharmacist shall confirm that
5 the prescribing practitioner reviewed the patient's prescription records in the controlled
6 substance prescription database as provided in AS 17.30.200 before prescribing the
7 opioid.
8 * Sec. 6. AS 08.98.050(a) is amended to read:
9 (a) The board shall
10 (1) establish examination requirements for eligible applicants for
11 licensure to practice veterinary medicine;
12 (2) examine, or cause to be examined, eligible applicants for licensure
13 or registration;
14 (3) approve the issuance of licenses and student permits to qualified
15 applicants;
16 (4) establish standards for the practice of veterinary medicine by
17 regulation;
18 (5) conduct disciplinary proceedings in accordance with this chapter;
19 (6) adopt regulations requiring proof of continued competency before a
20 license is renewed;
21 (7) as requested by the department, monitor the standards and
22 availability of veterinary services provided in the state and report its findings to the
23 department;
24 (8) collect, or cause to be collected, data concerning the practice of
25 veterinary technology by veterinary technicians in the state and submit the data to the
26 department for maintenance;
27 (9) establish, by regulation, educational and training requirements for
28 (A) the issuance of student permits; and
29 (B) the delegation of duties by veterinarians licensed under this
30 chapter to veterinary technicians;
31 (10) require that a licensee who has a federal Drug Enforcement
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1 Administration registration number register with the controlled substance prescription
2 database under AS 17.30.200(n);
3 (11) identify resources and develop educational materials to assist
4 licensees to identify an animal owner who may be at risk for abusing or misusing an
5 opioid;
6 (12) adopt regulations that establish opioid prescription dosage
7 standards based on morphine milligram equivalents; in this paragraph,
8 "morphine milligram equivalent" means the conversion factor used to calculate
9 the strength of an opioid using morphine dosage as the comparative unit of
10 measure.
11 * Sec. 7. AS 12.65.020 is amended by adding a new subsection to read:
12 (h) If the state medical examiner or deputy medical examiner determines a
13 person's death was caused by an overdose of a schedule II, III, or IV controlled
14 substance under federal law, the state medical examiner or deputy medical examiner
15 shall report to the Board of Pharmacy the person's name, address, and date of birth.
16 * Sec. 8. AS 17.30.200(c) is amended to read:
17 (c) The board shall maintain the database in an electronic file or by other
18 means established by the board to facilitate use of the database for identification of
19 (1) prescribing practices and patterns of prescribing and dispensing
20 controlled substances;
21 (2) practitioners who
22 (A) prescribe controlled substances in an unprofessional or
23 unlawful manner; or
24 (B) fail to review the information in the database to check a
25 patient's prescription records before dispensing, prescribing, or
26 administering a schedule II, III, or IV controlled substance under federal
27 law to the patient as required under this section or board regulations;
28 (3) individuals who receive prescriptions for controlled substances
29 from licensed practitioners and who subsequently obtain dispensed controlled
30 substances from a drug outlet in quantities or with a frequency inconsistent with
31 generally recognized standards of dosage for that controlled substance; [AND]
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1 (4) individu