Alaska lawmakers override Dunleavy’s veto of bill that expands pharmacists’ scope of care

A newly passed law will expand the range of healthcare services that pharmacists in Alaska can provide.

Alaska House Bill 195 was officially passed into law on June 19 after state lawmakers successfully overrode a veto by Republican Gov. Mike Dunleavy, with about half of Republicans voting with Democrats in favor of the override. The bill goes into effect on Jan. 1, 2027.

The law will allow pharmacists to test for, treat, and provide ongoing monitoring of conditions such as urinary tract infections, conjunctivitis, asthma, diabetes, influenza, earaches, and strep throat, according to the Anchorage Daily News

Brandy Seignemartin, a licensed pharmacist and the executive director of the Alaska Pharmacists Association, told the Alaska Independent that the law had been in the works for several years. 

“In 2022, we passed a bill, House Bill 145, that actually added a section of statute called ‘Other patient care services’ in the pharmacy statute that acknowledged that pharmacists do more than just dispense medications. And so that section of law is what we added to now,” Seignemartin said. “That section of law said that pharmacists could independently provide patient care services, in certain instances with some guardrails, but it did not allow prescribing of medications. And so really, to fully resolve a person’s care, you really need to be able to prescribe them the medication, because if they come in to the pharmacy and, say you do an influenza test, and that comes back positive, but if you’re not able to prescribe them the medication, then they still have to go do another step.”

Alaskans can earn a doctor of pharmacy degree without having to leave the state, thanks to a partnership between the University of Alaska Anchorage College of Health and the Idaho State University College of Pharmacy. Each year, up to 15 students are accepted into the program, completing livestreamed coursework alongside local clinical rotations in Anchorage.

“So when pharmacists graduate with their doctorate degree, they’re fully trained to be generalists, essentially. So they have that training to be able to assess patients, diagnose, take care of those things with a special eye toward optimizing medication therapy profile,” Seignemartin said. 

“Our pharmacists are doctorally prepared clinicians, and they have limited scope of practice here in Alaska,” said state Sen. Cathy Giessel, president of the Alaska Senate, who sponsored the Senate version of the bill, “unlike other states such as Idaho, where a pharmacist utilizing on-site testing for certain illnesses can prescribe treatment for those illnesses. …  They can do these tests in their pharmacy and then diagnose and treat. That was the goal to expand the scope of practice for pharmacists in Alaska because pharmacies are well distributed around our state, and this would allow another level of clinician, doctorally prepared pharmacist, to provide healthcare services to our very remote communities as well as communities here in urban areas such as Anchorage.”

The bill faced opposition from anti-abortion lawmakers and organizations that said the expanded scope of practice would mean that pharmacists would begin prescribing the abortion medications mifepristone and misoprostol. 

The Alaska Department of Law, in response to questions posed by Giessel, said in March that nothing in the bill would allow pharmacists to prescribe or dispense abortion medication. 

“There was pushback from a limited group of legislators who are ardently pro-life and construed that this would allow pharmacists to do a pregnancy test, and thereafter, if the results were positive, to prescribe and dispense abortifacient. An abortifacient is a drug that causes an abortion to occur. This was never the intent of this bill,” Giessel, an advanced nurse practitioner, told the Alaska Independent. “In addition, Alaska has specific law that limits the diagnosis and abortion treatment to physicians, so it’s extremely limited.”

Giessel said the goal of the bill is “to expand the scope of practice for pharmacists in Alaska because pharmacies are well distributed around our state, and this would allow another level of clinician, doctorally prepared pharmacist, to provide healthcare services to our very remote communities as well as communities here in urban areas such as Anchorage.”

“There’s delays, and folks are on their way to work in the morning,” she continued. “Child has a sore throat. Should I keep the child home? Is this a strep infection? Going to the community pharmacy, having the diagnostic test done, having an answer, and allowing mom or dad then to appropriately take care of the child going forward means a lot. So that was why I sought the expanded scope of practice for our doctorally prepared pharmacists in Alaska,” she said.

Seignemartin said the bill means more healthcare access with fewer delays and less administrative burden for pharmacies and providers. 

“One of the most bare examples that I heard about this was from the district manager for the Fred Meyer pharmacies, where he said an experience that he has frequently is somebody comes in with a prescription for a nebulizer solution for their very sick child, but not a prescription for the nebulizer device that they need,” she said. “Meanwhile, a parent is distraught, and their child is sick and not getting the medication that they need. With this policy in place, he can just resolve that in real time and get the parent on their way to take care of their child.” 

The new bill will also address mental health, which Seignemartin noted is a significant healthcare issue in the state. Alaska has the highest suicide rate in the United States, at four times higher than the national average, with an increase of over 29% over the last 20 years. 

“It’s so hard to access psychiatric care in Alaska,” Seignemartin said. “We have board-certified psychiatric pharmacists who can participate in that care. Ultimately, I would love to see pharmacists embedded into mental health and psychiatric care, where maybe a patient comes in and gets diagnosed by the psychiatrist, but maybe they don’t have to see the psychiatrist every time. They could have a visit with the pharmacist to help have medications administered, have counseling, have their medications titrated, and those kinds of things, so that you’re not having to wait every time for the psychiatrist.”