House Finance hears divided testimony on pharmacist prescribing bill

The House Finance Committee heard sharply divided public testimony Monday on HB 195, which would expand pharmacist authority to provide patient care services. Supporters said the change would improve healthcare access across Alaska, particularly for routine conditions and chronic disease management. Opponents argued the bill could allow pharmacists to dispense abortion medications or psychiatric drugs.

The bill would clarify and expand pharmacists' ability to provide patient care services, including independent prescriptive authority and direct patient care, according to sponsor Rep. Genevieve Mena. It would enable pharmacists to test and treat common conditions such as flu, strep throat, and urinary tract infections. A key component is ensuring community pharmacists can enter into collaborative practice agreements with physicians. These are protocol-driven partnerships that allow pharmacists to initiate and manage medication therapy under defined protocols.

Pharmacists in Alaska already work under collaborative agreements in some clinical settings, managing chronic conditions and prescribing medications. The bill would formalize and expand those arrangements.

"Pharmacists are on the front lines as the most accessible healthcare providers out there, and we are the medication experts," said Amy Young, an Anchorage pharmacist with 30 years of experience. "We are well equipped to do this."

Barry Christianson, owner of Island Pharmacy in Ketchikan, said his community has seen its primary care physicians drop from 10 full-time doctors in 1988 to just one today. "Pharmacists can help fill the gap where needed," he said.

But several testifiers urged the committee to amend the bill to explicitly prohibit abortion-inducing drugs. Therese Siren, calling in opposition, said the State Medical Board opposes the bill and argued it would allow abortion pill prescriptions.

Representative Bynum said he had spoken with the acting attorney general's office about the issue. He told the committee the acting attorney general indicated someone from that office would be available to comment on their legal opinions at the next hearing. Multiple supporters referenced legal guidance stating pharmacists cannot perform abortions under current law.

Representative Allard questioned whether the bill's language could allow pharmacists to provide services not explicitly prohibited through collaborative practice agreements. She asked whether the committee should add language specifically excluding abortion medications.

Brandy Signe-Martin, executive director of the Alaska Pharmacy Association, said advocates had accepted similar amendments in the Senate companion bill but noted concerns about unintended consequences. "There are a lot of different medications that could potentially cause the loss of a pregnancy," she said. She added that pharmacists do not perform the types of procedures involved in abortion care, which she said is outside their scope of practice.

The committee also heard from opponents concerned about psychiatric medications. Kathleen Wiedemeyer of the Citizens Commission on Human Rights argued pharmacists lack adequate training to diagnose and treat mental health conditions and urged amendments to prevent pharmacists from prescribing mind-altering psychiatric drugs.

Multiple supporters emphasized pharmacists' doctoral-level training and existing roles in tribal health, VA, and Indian Health Service settings. Tom Wadsworth, dean of the UAA-ISU Doctor of Pharmacy program, testified that graduates complete well over 2,000 hours of doctorate-level didactic training in physiology, pathophysiology, pharmacology, therapeutics, and clinical decision-making. They also complete more than 1,700 hours of direct patient care with real patients across many settings, he said.

The bill has been included in Alaska's Rural Health Transformation Program as one of several policies needed to maintain federal funding. Dr. Dan Hartman, testifying on behalf of Southcentral Foundation, said the legislation would help expand the healthcare workforce at a time of critical shortages.

"Pharmacists have the skills needed to appropriately use the authorities they would be given under the policy calls in this bill," Hartman said.

Supporters also described practical benefits including emergency refills for travelers who have forgotten medications, test-and-treat services that could reduce unnecessary emergency room visits, and faster access to care for patients who cannot quickly reach a primary care provider. Joshua Max, a district pharmacy manager with Albertsons Companies, said he frequently had to refer patients in Homer to the emergency room for conditions like influenza that could be safely managed in a community pharmacy setting.

Public testimony was extensive and sharply divided, with many callers focused on abortion medication concerns and others on access to routine care in rural and urban communities. Some testifiers described long waits for primary care appointments and unnecessary emergency room visits for conditions pharmacists could manage.

The committee will take up the bill again Thursday at 1:30 p.m. No vote was taken.