Alaska Legislature: House Health & Social Services, 4/28/26, 3:15pm

Health and Social Services Committee will come to order. It is 3:20 PM Tuesday, April 28th, 2026, in Davis 106. Members present are Representatives Schwanke, Ruffridge, Prox, Fields, Gray, and myself, Representative Mena, Chair. Let the record reflect that we have a quorum to conduct business. Please take this time to silence your cell phones for the duration of the meeting.

Staffing the committee today, we have Andrew Gianotti, our Health and Social Services recording Secretary, Secretary Chloe Miller, our LIO moderator, and Katie Giorgio, my committee aide. If you need anything during the meeting, please don't hesitate to get her attention. Our first item on the agenda today is House Bill 270 by Representative Tomaszewski on opioid overdose drug prescriptions. I'd like to invite Representative Tomaszewski and staff Connor Mariner to come to the presenter's table and begin your bill introduction.

Thank you, Chair Mina and the rest of the committee. For the record, my name is Representative Frank Tomaszewski, representative for District 34, which includes Salcha, Two Rivers, Farmers Loop, China Hot Springs, Ilsen, and Fox. Uh, House Bill 270 is a targeted, common-sense public health measure designed to reduce preventable opioid overdose deaths in Alaska while preserving appropriate access to pain management. The bill requires licensed healthcare providers to offer a prescription for an opioid overdose drug such as naloxone when prescribing opioids under Pacific— specific higher risk circumstance. Opioid overdose continues to be a significant growing.

—Public health concern in Alaska affecting individuals, families, and communities statewide. Currently, prescribed opioids comprise 13% of opioid overdose fatalities here in Alaska and nationwide. The proactive solution naloxone is safe, effective, and widely recognized as a critical tool in overdose prevention. By integrating overdose education and access to routine prescribing practices, House Bill 270 strengthens Alaska's response to the opioid crisis and aims to save Alaskan lives. I will now, if it's the will of the committee, hand over to my staff for a quick overview and presentation of the bill.

Please proceed. Thank you. For the record, Connor Mariner. I'm staffed to Representative Tomaszewski. Currently, there is an overdose crisis here in Alaska.

Uh, in 2024, we saw 339 overdose deaths, uh, which is about 45.6 per 100,000 Alaskans. Um, fentanyl plays a massive factor in this, comprising 73% of all state overdose deaths, and it reflects an ongoing issue across the country with 105,000 drug-involved overdose deaths in 2023. The complexity is increasing. Uh, the majority of these deaths involve more than one drug type, uh, severely compounding systemic risks, uh, within our state.

Right now there's some clinical vulnerability. Um, while it's not a driving factor, prescription medication is a factor in these deaths. Um, like Representative said, about 13% of all fatalities here in Alaska are involved with a prescription drug. Whether that drug was taken legally or not is unknown, but 13%. The most common lethal drug combinations involve synthetic narcotics like benzodiazepine, I think represented the Russians.

Benzo, somewhere around there. Patients that receive potent opioid prescriptions, especially along sedatives, they face acute measurable medical risks. And there is a missed opportunity in co-prescribing, um, the antithesis to these, which would be naloxone to reverse any kind of induced overdose.

So the mechanics of House Bill 270 are, are fairly straightforward. It requires specific healthcare providers that issue opioid prescriptions to also offer a prescription for an opioid overdose drug. They only offer that prescription if the prescription meets a certain criteria that deems it a high-risk prescription. It only applies to licensed physicians, advanced practice registered nurses, dentists, and optometrists, which I think in the state there's about 243 of those across all of our communities. Now it also continues with patient autonomy.

You don't have to accept the prescription. It's just mandated that they offer it. So they still maintain the right to accept or refuse.

So here are the 4 triggers. The first trigger is if the prescription of this opioid exceeds a 3-day supply. The second is if the prescription has, has over 50 morphine milligram equivalents in the prescription per day. If they're currently prescribed benzodiazepine prescription, or if the patient has a known history of overdose or substance use disorder. If any of those are met, this bill would kick in and the prescribing medical professional would offer a naloxone prescription.

So mixing opioids and sedatives makes those drugs much more dangerous and fatal. Um, benzodiazepines were involved in dozens of fatal multidrug combinations from 2020 through 2024. In addition, once a prescribed opioid is above that 50, uh, morphine milligram equivalent per day, it's widely recognized, um, not just here in Alaska but across the, across the country as a clinical threshold where risk significantly, um, increases.

And if the patient has a history of substance abuse disorder, they are much more likely to maybe misuse a drug, or they're susceptible to that, which presents a high risk. The last one is a 3-day supply. Studies have shown that roughly 21 to 28% of, of people that are prescribed over a 3-day supply of, of an opioid tend to misuse them. Which increases the, the risk. So that's why these 4 factors are here in this bill.

Um, naloxone is a very effective, if not the most effective way to reverse an accidental or otherwise overdose. Uh, usually it takes between, I believe, 30 and 40 seconds from the administering of, of naloxone before the patient's breathing is steady and they're heading back to a normal state. And time is critical when these things happen. There's a very short window where naloxone reverses the effects of an overdose. And for high-risk patients, having an antagonist on hand like naloxone provides the fastest and one of the most vital defenses against the rising crisis we face here in Alaska.

It's, it's a pretty practical implementation. Right now in current structure, this would fit pretty seamlessly into existing workflows, requiring only a simple clinical conversation and then a supplementary prescription offer. And it creates a structured tech touchpoint to educate patients on the severe risk of multi-drug interactions. I think part of, part of the problem might be that there's just not enough knowledge around this issue. Um, so even if the patient would decline a prescription, at least they're, they're more informed on the prescription they are receiving.

Um, it, it also normalizes the presence of opioid antagonists as a standard, uh, similar to House Bill 202, which passed in, uh, 2024, which requires schools to have an on-hand supply of, of Narcan, which is a drug that utilizes naloxone to prevent overdoses. And it doesn't just equip the patient with a safety net, it equips the entire household with a safety net as well. You never know the time and place when this could be a vital, vital need in the household.

There are some existing state precedents in addition to national precedents that support this type of legislation. Currently, there's 18 other states in the U.S. that have similar legislation starting back, I think, in 2016. Project HOPE, which started up here recently, they successfully distributed 45,000 free naloxone kits in 2024 to community members and first responders. So 270 is just, you know, another step in the positive direction that Alaska legislation is moving in regards to trying to to tame this curve and prevent, prevent more fatalities from happening.

Currently, uh, the state— in state law, we have the Prescription Drug Monitoring Program, uh, which requires, uh, the monitoring and tracking of, of, uh, prescriptions that involve a controlled substance. Opioids obviously falling into that category. 99% Of Alaska providers, um, they allow to prescribe these substances that are already registered with the PDMP. And it does reveal, you know, it does reveal a 21% decline in dispensed opioids and a 19% decline in benzodiazepines from 2020 to 2024. So there is already provider engagement in risk mitigation, but it is still, it is still very prevalent.

And right now, 85% providers access the PDMP directly through software, so it makes these multi-drug risk identifications straightforward and, and, and much more efficient. Then the Loxone, as I understand— I'm not a medical professional like Representative Rutherford— but is not a controlled substance, so it would not need to be registered in the PDMP. So it doesn't impact the workflow.

In summary, here are the key, the key benefits of House Bill 270. Are it's, it's driven by data. These, these statutory triggers, those four pillars that they align with the highest known risk factors of overdose mortality that's recognized across the nation. It respects workflow, as previously stated. The implementation process would not be too involved.

It expands crucial access. Right now, naloxone is not an over-the-counter drug you can buy. You have to go through a medical professional or Project HOPE. So being able to mitigate some of that.

Some of that time frame expands the much-needed access to this. And most importantly, it equips Alaskans and Alaskan families with the ability to, to save a life if, if ever the need be.

And that's it. I'm happy to answer any and all questions. Thank you, Mr. Mariner and Representative Tomaszewski, for your presentation. We do have available on the line Lindsay Cotto, Director of the Division of Public Health, as well as Director Director Sylvan Robb of CBPL. Do we have any initial questions?

Representative Fields. Thank you. I do have questions, and maybe they're for the bill sponsor staff, or maybe they're for Lindsey Cotto, and there's a lot I don't know. So thank you for educating me. Thank you in advance.

Um, how many prescriptions in Alaska are for a 3-day supply of opioids, if anyone knows the answer to that. Yes, through the chair to Representative Fields, great question. Through my research, the kind of the number, the margin is anywhere from 340,000 to 390,000 prescriptions per year. Okay. Could I ask a few follow-ups?

Follow-up. I'm mainly just trying to figure out what the scope of this means in terms of how many, um, naloxone prescriptions, I guess. And then, um, so for number— so for the 3-day supply, 50 milligrams or more, patients currently prescribed benzodiazepine and history of overdose, obviously there's some overlap, but how many, um, prescriptions are for 50 milligrams or more of morphine, and to the extent you know how many of those are in addition to the 340,000 to 390,000 per year of the 3-day-plus opioid prescriptions. Yeah, through the chair to Representative Fields, great question. For the record, Connor Mariner, staff for Representative Tomaszewski.

Um, it's— it is hard to nail down exact metrics of, of you know, when the— with the prescription, what, you know, what— how many per year are issued that meet these thresholds. But, you know, I would say the conservative estimate, if you lump all 4 of these into one number, you'd probably have 1 in 3 of these, uh, prescribed opioids would, would meet the criteria. Okay, um, and then how many total opioid prescriptions are there?

Uh, yeah, through the chair, uh, to Representative Fields. Um, I believe the number gave was 340,000 to 390,000 prescriptions. Oh, that's the number of total opioids? Total opioid prescriptions, correct. Yeah.

So just through the chair, we're looking at, I don't know, 120,000, 140,000 prescriptions of naloxone per year under this bill? Um, yes, through the chair, Representative Fields, that's correct. You know, anywhere from 100 100,000 to 120,000 of offered naloxone prescriptions. Okay, um, how— through the chair, if I might. Okay, um, how much does a naloxone prescription cost?

Um, through the chair to Representative Fields, I'm actually not quite sure. I'll make sure to get back to you. Maybe Miss Cato— Cato knows that. Director Cato, could you answer Representative Fields' question?

Hi everyone. For the record, this is Lindsay Pato, Division Director for the Division of Public Health. Through the Chair, Representative Fields, I don't have the cost of how much naloxone would be through a pharmacy, through prescription picked up through the pharmacy. I think we'd have to get back to you on that question. We at the Division of Public Health, um, bulk purchase naloxone, um, at a separate price through a separate mechanism.

Through the chair, Miss Cotto, but you can't tell us what that is, what the bulk price is.

Director Cotto looks like— Director Cotto might have dropped off, so we can return to her. Oh, through the chair, my colleague who maybe has access to these things. Looks like some of the prices are $27 to $95, so maybe we could just follow up with the department and see, does that seem accurate? Maybe there is a lower bulk purchase price. I'm just trying to get a ballpark of the idea of the cost, is all.

Yeah, through the chair, once again, Connor Mariner, staff to represent Tomaszewski. Um, yeah, those numbers seem within the benchmark. Okay, Representative Gray. Thank you. Just going off Representative Fields' line of questioning, of course, though, the person doesn't have to pay for this.

They don't have to pick it up. It just has to be prescribed.

Through the chair, Representative Tomaszewski. Yes, Representative Gray, good question. So it is totally optional. It, it's just something that the doctor is going to tell the patient about, give them the prescription, and they have the ability to fill that prescription or not. Follow-up.

Follow-up. Um, and I guess my question is, if you have someone who's like getting chronic pain treatment and is getting opioids, you know, every month, do— is it required that you re-prescribe the naloxone every month? Through the chair, Representative Gray, um, it would be required that they offer a prescription of naloxone every month. Okay, so the patient could say, I already have one and I haven't used it, and you would say, okay, I offered it through the chair? Yes, to my understanding, that is the case.

Um, one last one. So on your slide, you said the prescribers that would be— that this law would cover— I would say that I was left off, and so was the son of the sponsor of the bill, just— and we prescribe a lot of opioids there.

We're physicians. Yeah, I actually had a question just related to that. Just to add on to this, I was curious about the different providers, and you mentioned physicians, APRNs, dentists, optometrists. Why those providers, and also why not PAs or other individuals that have to be DEA approved and prescribed into the PDMP? Yeah, through the— to the chair, that's a great— that's a great question.

I'm not quite sure why it limited that scope to just those providers, but as I understand it, those providers are specifically listed in state statute regarding to opioid prescriptions. I'm more than happy to do some research and follow up with your office on that.

Thank you. I might— it looks like Director Kato is back on. Director Kato, do you know the different providers that are— have to be DEA approved and be able to prescribe opioids?

Uh, for the record, this is Lindsay Cotto, Division Director for the Division of Public Health. Um, through the chair, Representative Nina, were you asking how many pers— or how many providers have a DEA license to be able to prescribe opioids? No, it, uh, which provider types are able to prescribe opioids?

I would actually see if— sorry, through the chair, Representative Nina Longicato, for the record, Division of Public Health Director. I don't want to misspeak on the types of providers who are able to get a DEA license for opioid prescribing. So, I guess I would defer to Sylvan Robb over at licensing. Through the PDMP if she has any knowledge of provider types that are eligible for DEA license. I will do that.

Director Robb.

Thank you, Madam Chair. Good afternoon. For the record, Sylvan Robb, Director of the Division of Corporations, Business, and Professional Licensing, which is the home of the Prescription Drug Monitoring Program. And the bill includes all of the provider types who are able to to prescribe controlled substances in the state.

So does, does it include physician assistants as well? Uh, Madam Chair, it does. Okay, so it does include PAs. Uh, through the chair once again, Connor Marin, her staff, to represent Thomas Hussey. I believe they, they fall under the advanced practice nurses I'm not quite certain.

I'll defer to— okay, they don't. Now I know.

Madam Chair, physician assistants are regulated under AS 0864, which is where physician and physician assistants are regulated.

Okay, thank you.

Other questions from the committee? Representative Fields. I was curious, how much do other states do this? Is there a lot— if other states do have this kind of— if other states make an effort to make sure that overdose treatment is available, how much variation is there in how they do it? Is it similar to the structure?

Is there a lot of differences in the way the states approach it? Through the chair, Representative Fields. Great question. Yes, the answer is yes. Currently there are 18 other states that have very similar legislation to this with those same 4 triggers that would require the offer of prescription.

The only major differences that I've seen in similar legislation is there are other benchmarks that states implement that would require a naloxone prescription. Instead of just a simple offering, they would require it to go alongside with an opioid prescription. Okay. Through the Chair, I mean, I think it would probably be hard to isolate this factor in terms of health insurance costs, but I would be interested when those states implemented those laws and whether there's any discernible effect on health insurance. I mean, I understand this will be covered by health insurance.

I support covering lots of things with health insurance, so I haven't let that be a barrier in the past to necessarily supporting something or not. If we could look at the record and maybe be able to show that it doesn't lead to an increase in health insurance costs, I think that would be a good point of argumentation for the bill. And maybe the Division of Insurance Director could help with that.

Uh, Representative Gray. Thank you. I just wanted to say that, um, through the chair, that I support the bill. I think, um, medical providers shouldn't, as a rule, be providing lots of opiates, period. So, um, and they really, from my perspective, you should never prescribe opioids and benzodiazepines together under any circumstances.

So I think having this additional requirement for folks who are doing something that really should be a very rare occurrence shouldn't be that big of a deal. And if a physician or whomever is doing tons of these prescriptions, then yeah, they should be burdened with doing this extra prescription all the time to remind them this is not something they should be doing. So I support the bill. Thank you. I have a question about, um, how this would be enforced.

Through the— to the chair is the question. That is the question. Okay, um, to the chair, enforcement— I'm not quite certain what that would look like, um, because it's not mandating a prescription, it's offering a prescription that isn't a controlled substance. There really aren't too many enforcement mechanisms that I'm aware of.

So if a provider just never offered the prescription, like, there's no way for the state to track it? There's no report mechanism?

Through the chair, that is correct. If we go back to slide— now you're going to— slide 26. Yes, this slide here. Uh, naloxone isn't a controlled substance, so there is no requirement in state statute that we monitor that prescription.

I, I guess, how would we be able to know that providers would be offering naloxone if this bill were be implemented? To the chair, great question. There isn't currently any enforcement as part of this legislation that would require any, any reporting or making sure they're offering that prescription.

Is that a concern?

Madam Chair. I wanted to see if the bill sponsor had a response and then—. Thank you, Chair Mena. Representative Tomczewski for the record. Yes, that actually, that is a great question and a concern for sure.

Looking at this prescription drug monitoring program and thinking in my mind that it would become part of this program and just be another boilerplate entry into it. And I would, I would just assume that it would all go through there together, but that is definitely something we should look at and make sure that that's the case. And just a final question on my end. Do you know how this is enforced in other states? To the chair, I do not know how these other states enforce this.

Yeah, I'd be interested in that. Just so I, I, I think the more education awareness of Narcan, especially for individuals who are prescribed opioids, is is a good thing in normalizing that awareness. But if the intent is we're trying to do that, I want to make sure that there is that incentive, either a carrot or a stick, for providers who would have to offer the prescription. Representative Prox.

Yes, thank you. Through the chair, just comment first. I would think if it's required in statute to offer the prescription and they don't, and somebody suffers injury or death because of it, there's going to be a malpractice attorney that's going to make a lot of money off of it. So that would be how it would be enforced currently. That would be one way.

They would find out that it would become, I would think, grounds for medical malpractice.

Uh, you know, I might direct that question to Director Rob. I guess under this legislation, would it be a reportable offense if somebody didn't offer a prescription for a naloxone? Would that be a grievance that could be reported to their respective licensing board? Uh, again, for the record, Sylvan Rob. Um, to the chair, um, yes, if this becomes statute that this is something that providers must do and they fail to do it and that comes to our attention, then it would move forward to the board and they could decide to take action on it as they saw fit.

Okay, we have enforcement. Thank you. Great. Any other questions from the committee? Okay, Representative Gray.

Thank you. Um, so just an idea through the chair, um, the pharmacist can always ask, were you offered a naloxone prescription with this opioid prescription? And, um, then of course, depending on how things go, the pharmacist could just write the prescription if it was needed. But I will just point out one flaw in, in, uh, Representative Prox's thinking. You know, let's say I take enormous amounts of opioids and I'm offered a Narcan prescription, a naloxone prescription, and I take it home with me, and then I overdose.

I cannot administer this drug to myself once I'm unconscious. So really, the person who needs to be receiving the naloxone prescription and the training and like knowing what it's for is not the patient who's going to be overdosing, but someone else in the home.

And if I could just respond to that. Representative Tom Scheske, for the record. Yes, absolutely, Representative Gray. That is a great point, and it, it really goes to my reasoning and my story why I have brought this legislation forth. I was out in Tennessee visiting family and ended up with a kidney stone, so I ended up in the ER.

And I've never had a kidney stone before, but it was not a pleasant thing, and they wrote me prescriptions and they told me about this, and I went to the local Walgreens and I got myself a, uh, a naloxone. And I just thought, you know, wow, this is, this is pretty neat that I have it, because I've never had that in my household before. But I've had a lot of opioids, I've had dental work, I've had surgeries, and I generally don't use the amount of painkillers that are prescribed to me. Generally, they're sitting in my medicine cabinet, and so it, it wouldn't just be for me overdosing on it. It could be one of my children or one of my family members that might accidentally get into it or get into it on purpose.

And, and just myself having that, or the family having that in their home, I think is a great way to really get a speedy a lot of, you know, quick help to that situation. And so, yeah, that's really a great question, a great comment, and that's really why I brought this.

Representative Brooks. Thank you, Madam Chair. I guess that brings up two possible questions.

A lot of activity now to get naloxone— is that what it's called?— into schools, get it distributed as widely as possible. And then I believe it expires after a year or two. So does this bring up a concern about it getting into the environment and causing some problems? If it's not disposed of correctly? Have we pondered that problem?

Uh, Representative, uh, this is Representative Frank Tomaszewski for the record to Representative Prox. Great question, and that's something I actually have not pondered. I know there are, um, ways to return your prescription drugs to organizations, but I've never thought about the, uh, the number and what this particular, uh, drug would, um, how that would affect the environment. So, and then related question that you mentioned, because this happened to me, I, uh, actually didn't drink enough water was the problem, but went down to the urgent care center, problem was taken care of with a glass of water, but the Doctor prescribed some sort of painkiller. Frankly, I don't know what it was, but I thought, well, I don't goof around with that.

So I just toughed it out for half a day and didn't need it. And I couldn't tell you right now where that particular drug is. So the next question is, should we be concerned about that, of too many opiate pills laying around in medicine cabinets or kitchen drawers or somewhere. Should there be some sort of mention at any rate if you do distribute this, if a doctor prescribes it, that this is how you should return it if you're not using it? [Speaker:DR. TOMASCHESKY] Yeah.

Representative Tomaszewski for the record. So I believe there are programs to do that. I think I hear them advertised every once in a while. Turning your prescriptions. Maybe a pharmacist in the panel here would— in the committee would have better information on that, but I know I've heard of these opportunities to turn in your opioids and clean out your medicine cabinets and kind of education.

And so I don't know who does that, but I know it's out there. Director Cotto might be able to speak to perhaps any public health campaigns that the state has enacted regarding safe opioid disposal and perhaps safe Narcan disposal. Director Cotto.

Thank you, Director. This is Lindsay Cotto, Director of Public Health. Through the chair, Representative Proks, the state does promote safe disposal of Household Medications, along with the DEA, the Drug Enforcement Administration. For example, there are some sites and pharmacies that you can return your pharmaceutical prescriptions to, or your unused medication, or your expired medication, or unwanted medication. Additionally, the DEA provides ongoing— they call them National Takeback Days.

Where they have throughout the year take-back events where people can bring their unused medications for disposal. I'm not an expert on the, you know, the impacts of naloxone as far as like on the environment or disposal, but naloxone could also be returned. The evidence related to naloxone and expiration is that naloxone has a labeled expiration date, but most studies show it can remain effective well beyond that date, though it's best used before that expiration. So, in addition, the Division of Public Health and our team also have in the past handed out drug disposal bags for unused medication that kind of creates and dissolves the opioid into kind of like a, into a usable kind of hard cement that also neutralizes the opioid component, making it non-injectable. And people can dispose of it that way.

So, but of course, I think the best practice is to use one of the national take-back, a take-back location. For pharmaceutical substance use as well have drug disposal kind of boxes or sites, usually outside pharmacies or outside law enforcement organizations. Colorado comes to mind where they have a 24/7 collection that's unable to be tampered with that people can dispose of there. Medications.

Follow-up. Follow-up. I hesitate to make this a requirement, but, well, just using PFAS as an example, it was used for quite a while before somebody decided that it was harmful to the environment. Now we've got a huge problem in So, I guess, do you have any opinion, I guess, on how effective the current voluntary disposal program is working out? Are we getting some idea of how much is coming back versus how much went out?

And do we need to think about that? Or does somebody else on the committee who might know more about this have an opinion?

Representative Gray. Thank you. Through the chair, I would say that prescription drugs are intended for human consumption, which is different than PFAS, so I think the risk is lower. I did look up some things from you, from the American Pharmacists Association, that naloxone samples with expiration dates in 1990 retained their 11 of the 12 naloxone samples retained between 90 to 110% of their potency. So that gives you a good 37 years to use your naloxone.

Also interestingly, there was effects of heat and freeze-thaw cycling on naloxone stability. So they froze and they made it really hot and froze it 28 days in a row, and there was no change. The naloxone was—. Worked.

I guess even if you left your Naloxone in the car in Alaska, it should probably work. I thought that was very interesting. So, um, that's all. Thank you. Wonderful.

And I do want to note that Representative Mears did join us virtually on Teams at 3:26 PM, and she did let me know that the drug take-back day was last Saturday, and the next one is in October on October 25th. So mark your calendars and tell the public. At this point, I would like to transition over to public testimony. I will now open House Bill 270 for public testimony. First off, is there anyone in the room who wishes to testify?

Seeing none, is there anyone online who wishes to testify? First, I have Miss Sandy Snodgrass, CEO of Alaska Fentanyl Response. Please put yourself on the record and begin your testimony. Hi, good evening. I'm Sandy.

I'm the director of the project, and I'm here today in support of House Bill 70.

Ms. Nodgatz, your audio is cutting in and out. If you might want to restart your testimony.

Okay. I, um, Um, unfortunately I'm in Fairbanks, so I'm roaming. Is this any better now? That is a lot better. Thank you.

Thank you. Um, so my 21-year-old son, Robert Bruce Snodgrass, was poisoned by fentanyl in Anchorage on October 26, 2021. He was my only child.

He was out on a mountain bike ride in Anchorage within the city limits and somehow got a hold of 100% fentanyl that day, and he dropped and died within shouting distance of a Wells Fargo and a McDonald's drive-through on DeBar and Boniface in Anchorage.

He was not able to call out for help.

So since his death, I have made it my life's mission to bring awareness to the opioid crisis in Alaska and the country. One of the ways I do this is to try to impact federal and state laws through, um,.

You know, he had his wisdom teeth out when he was 17 years old, and he had a predisposition to a substance use disorder, genetic predisposition. I believe that that prescription for OxyContin that day kicked that genetic predisposition for him. And there was no conversation held with me, his mother, or with my son, who was 17 at the time. House Bill 270 will change that. I would have been notified by the doctor that he was prescribing very dangerous medication to my 17-year-old son and would have allowed me to have naloxone in my home And within that naloxone, there's additional information about the dangers of opioids and how those medications— one of the other congressmen testified how dangerous these medications are deadly.

And, you know, people are not aware and they do not know. So integrating the education about the dangers of these opioid medications and the possibility of someone being poisoned, possibly causing death, is one of the things that is extremely important to me.

The bill also recognizes the impact of providing to naloxone— providing naloxone to patients when prescribing these powerful medications will potentially save lives. It can save lives. It can prevent down the road possible substance use disorders, which is, you know, really where I live in the world is demand reduction. We think of it many, many times as a three-legged stool. One of the legs of the stool is demand reduction.

You can never die from illicit drugs if you never try an illicit drug. The second one is law enforcement, and we know how hard our law enforcement here in the state and around the country are fighting to keep illicit drugs off the streets. And the third one is treatment for those who are lucky enough to live to get into treatment. So this bill falls in the demand reduction leg of the stool. It can cause And young people, anyone, to recognize that taking these dangerous medications could lead to a substance abuse disorder if they do not use them very, very carefully and only for short periods of time.

And it, it was mentioned that this bill will also protect unintended victims of poisonings, whether that be a resident of the household or a visitor to the household. That may get ahold of these medications and unintentionally poison themselves or kick that substance abuse disorder into gear. And many times, most times, what happens once that euphoric feeling is obtained through illegal medication, they're not able to get those anymore and they go to the street. And we know very well what's on the street in Alaska and the country now is not OxyContin. It is not prescription medication.

It is fentanyl. And fentanyl is killing people in record numbers, as was already discussed here today. And I think we are all aware of that now. So, I want to thank the chair for holding this committee meeting today. And I hope that it's able to move through this committee and move on and be passed into law this year.

The faster we can get this law enacted and doctors start providing this education and this medication to their patients and those who live with these patients or visit these patients' homes, the more lives we can save. Thank you for allowing me to provide my testimony today. Thank you, Miss Snodgrass, for testifying and for sharing your story once again. Uh, next, uh, for public testimony, we have Miss Stacy Stacy Isert calling in from Anchorage. Miss Isert, please put yourself on the record and begin your testimony.

Hello, for the record, my name is Stacy Isert. I'm in favor of Alaska House Bill 270 relating to the prescription opioid overdose drugs and requiring healthcare providers who prescribe opioids to offer their patients a prescription for a potentially lifesaving medication such as naloxone, which can reverse the effects of an opioid overdose. My son Jason became addicted to opioid painkillers 15 years ago after a 20-foot fall, which resulted in several broken ribs. Like Sandy's son, my son had a genetic predisposition to addiction. The doctor stated most people do not survive a fall like he did, that they either die or end up paralyzed.

My husband and I monitored the use of the painkillers, but it was evident that if we hadn't, Jason might have taken more than what was prescribed to him to curb the pain. As he healed and didn't need the painkillers as often for the pain, he tried to get refills unsuccessfully because he, he craved the euphoric feeling he received from the painkillers and also to combat the withdrawal from the physical addiction. When I look back, I remember Jason also receiving opioid painkillers in high school when his wisdom teeth were removed, as well as when his appendix was removed 7 years ago. I feel naive and guilty for administering the painkillers to him, especially during his high school years and after the 20th assault. I was unaware or in denial about the addiction that manifested in Jason because he was thriving as an Anchorage High School teacher.

He also held a master's degree in English literature. His addiction to opioids became evident after his marriage and the birth of his two boys.

Consequently, his marriage ended in divorce and his use of non-legal opioids became worse. He started looking for fake pills online, which resulted in his death from fentanyl poisoning in 2021. If we had not monitored the use of his painkillers while he was in high school and after his 25th fall, chances are he might have died from an overdose back then.

Also, my elderly father was prescribed opioid painkillers while suffering from congestive heart failure. But fortunately for him, he had a hospice nurse monitoring his use of the painkillers because he may certainly have died from an overdose just from not remembering if he had took the recommended dose and took more than what he was prescribed. Personally, I understand why opioid painkillers can become addictive and result in overdose death. Last year, I had two separate total knee replacement surgeries on both my knees. I was prescribed opioid painkillers during my recovery.

They do take the pain away, but they also give you the sense of euphoria. I was so scared to take them that I would only take half the prescribed amount when I couldn't stand the pain anymore or just put up with the pain.

I feel if a patient is at high risk for overdose due to chronic pain, if they are elderly or have an addictive personality, they most certainly would benefit from a prescription for a potentially life-saving medication like Naloxone to be given to them at the time of their prescription for opioid painkillers, along with the education and knowledge of what the opioid painkillers can do to you and how addictive they are. Had the life-saving medication been prescribed and made available to my son Jason when he was prescribed the painkillers, perhaps there would be a chance he would still be alive today. Due to the availability of naloxone and had he been made aware and given knowledge of the dangers of opioid use. It's too late for my son Jason, but perhaps we can save future lives if House Bill 270 passes. I thank you for your time and for your consideration.

Thank you, Ms.

Thank you, Mr. for your testimony and for sharing your story.

Seeing no other individuals seeking to testify, I'm going to go ahead and close public testimony. Is there any further discussion on House Bill 270? Seeing none, um, at this time I'm setting aside House Bill 270 for a future hearing. Thank you for bringing this bill forward. Finally, today we have Senate Bill 272 on the Health Information Exchange.

Senate Bill 272 is the companion bill to House Bill 285 that was considered and passed out of this committee earlier this session. Today's hearing on Senate Bill 272 is largely procedural, as we have already considered and passed this legislation in this committee, but it is necessary for the bill to be passed out of one standing committee out of referral in this body before it can be considered on the House floor. I would like to invite Ariel Harbison, staff to Senator Dunbar, to come forward and give us a brief refresher on the Health Information Exchange Thank you, Chair Mena, and members of the House Health and Social Services Committee. As, uh, Rep. Mena said, just a brief recap for you all. I know that you've heard this bill before.

SB 272 seeks to update and improve Alaska's current health information exchange while continuing to hold the strict privacy and security standards required by law. This bill aims to modernize statutory language and provides greater clarity on legislation that was originally passed in the 26th Alaska State Legislature. The Information Exchange currently facilitates comprehensive health sharing data and provides essential tools to improve health and well-being for all Alaskans. It currently works with more than 130 organizations across the state, serving health networks, care organizations, providers, community-based organizations, payers, government agencies, Tribal Health and more. I want to provide the 4 key updates in SB 272 to the Health Information Exchange for members.

Clearly articulating in statute, the Department of Health shall designate the— an entity to operate the Health Information Exchange, and it outlines the roles and responsibilities of both the designee and the department. It clarifies the scope of data sharing and provides specific details regarding allowable uses for limited healthcare operations. Operations. It ensures that individuals may authorize to disclose their health information for purposes they choose, and it adds a representative to the governing body representing behavioral health providers. SB 272 does not change the core allowable uses of the HIE.

Instead, it provides an updated and clear language ensuring that Alaska's HIE effectively functions as core healthcare infrastructure. These updates strike a careful balance between maximizing the benefits of the health information exchange and protecting patient privacy. And I also wanted to kind of draw back to the presentation you all just heard because electronic health records were brought up in that as well. So, I just wanted to reinforce the importance of these systems. In order for that prescription drug monitoring program, it stated that 85% of providers access that program through their electronic health record system, making multi-drug drug risk identification really straightforward.

So we really believe that updating this is a need for Alaska. Thank you, Ms. Harbison, for that refresher. Do we have any committee questions or discussion on the Senate bill? Seeing none, I do want to note that we do have online available for questions Kendra Sticca, Executive Director of Healthy Connect, on Teams, as well as Jason Ball, Chief Data Officer with the Department of Health. I will now open public testimony for Senate Bill 272.

First off, is there anyone in the room who wishes to testify? Seeing none, is there anyone online who wishes to testify? Seeing no more individuals wishing to testify, I'm going to go ahead and close public testimony. And at this time, I'm going to take a brief at ease.

Back on the record. Thank you everyone in the public for your patience. We will now consider amendments to Senate Bill 272. I move Amendment A1. I'll object for purposes of discussion.

Thank you. Amendment A1 is actually an amendment that Representative Fields had offered in House Labor and Commerce, and this amendment will help align the Senate companion bill to the House bill for the health information exchange. What this amendment does is add additional reporting requirements to the existing report related to the health information exchange, and happy to turn it over to Rep Fields to add any more words. All the amendment does is track if we are getting the information, if the HIE is useful. I think it is a great idea.

I hope it works. I think we should figure out if it is actually helpful, and that is the purpose of the amendment. All right. Will you remove your objection? Seeing no further questions, I remove my objection.

Thank you. Is there any further objection to Amendment A-1? Seeing none, Amendment A1 is adopted. I— my office had also received an amendment from Representative Ruffridge, but I believe that will not be offered at that time— at this time. Is that correct?

I will not be offering Amendment A.3. Thank you. Thank you, Representative Ruffridge.

Uh, seeing none, uh, is there any further discussion on Senate Bill 272? I would now Can I— Yes, for sure. Thank you, through the chair. I just want to make just the same comment that I made when we heard the House bill version of this. This particular law allows for the health information exchange, and I understand.

It's already currently in law. I would have liked to been able to amend this, um, this bill or these series of bills to change our system from an opt-in to, um, sorry, an opt-out to an opt-in type of structure. I, I do feel like there's some language in the bill that, you know, helps maybe clarify that the opt-out procedures need to be fleshed out, and I look forward to seeing what those look like when This goes through. Thanks. Thank you, Representative Schwanke.

Any other comments from the committee? Seeing none, I would now entertain a motion to move the bill from committee. Rep. Nina, I move Senate Bill 272, Work Order 34-LS1383/A, as in alpha, as amended from committee with individual recommendations and attached fiscal note. Is there any objection? Seeing none, Senate Bill 272 passes from committee, and I ask that members please stick around after we adjourn to sign the committee report.

The time is, uh, the next meeting of the House Health and Social Services Standing Committee will be Thursday, April 30th at 3:15 PM. The time is 4:23 PM, and this hearing of the House Health and Social Services Committee is now adjourned.