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Senate | May 3, 2016 | Committee Room | Healthcare Committee

Full MP3 Audio File

It does appear we have a majority. >> Thank you members of the committee, welcome to the first healthcare committee of the short session as we hopefully begin to get things rolling and others, I got a few additional things to begin to cover but hopefully we're just kinda getting out today and getting that process rolling with some committee recommendations. First I'm gonna begin by recognizing our pages, if you would stand up so everyone could see you, I have Ketin/g Shelton from Hope Meals, in the back there Lacy Peterson from Apex, thank you Judah Peterson from Rocky Mount/g, welcome. Thanks for coming in. Keyla/g Welch from Eddington, thank you. Macaylor/g Medley from Roseville. Joseph Kenny/g, thanks for coming in from From New bern/g, Doman Kevingthon/g from Riley, thank you. Elizabeth White from Deep Gap welcome, thanks for coming in and Michael Glinin/g from Willow springs. Thank you all for serving this week hope you have You have a wonderful week and hopefully you can learn a lot. sergeant-at-arms with us today as we're getting me with Francis Peterson and Hal Roach. Thanks for coming in. Members we actually have two bills on the committee 736 still needs a little work A little that what coming in we're going to take that up today, that what coming in so it's a study bill but we'll get to that. As we're coming but we're gonna begin with house bill 734 state wide standing order for opiod/g antagonist, Senator [UNKNOWN] is gonna present that but he's gonna have some from the department that would join him The presentation as well. [BLANK_AUDIO] Closures [INAUDIBLE] >> Thank you Mr Chairman and good morning everyone it's a pleasure to be here Here today to talk about something that's very important and I'd like to ask Dr. Randall Williams public health director to please come forward and join me up here if he would and I'll hand it over to him in just a few minutes with your permission Mr. Chairman The joint legislative oversight committee on health and human services looked at some information that had come to our attention. We have a statewide, probably a nationwide problem with drugs even Even in this late day we've been concentrating on it for a number of years as a society we're still having problems and this I think is one important step a long the way in which we can do something. So of course it's senate bill 734, the Amends the law on drug related overdose treatment and specifically authorizes the state health director to issue a state wide standing order for an [UNKNOWN] and antagonist which would allow the overdose treatment drug to be more readily accessible and so with the our good doctor here, we;re going, We're going to do that very thing if we can pass this bill and get it through. This Bill by the way will be [UNKNOWN] referred to J1 if we are able to get it out of this committee and I would like to talk to Williams at this time to speak to you just a moment about this, This and he has members from his staff who also wish hearing in case there are any questions that need to be answered, but Mr. Chairman, with your permission, I'll call Dr. Williams to come to the mic. [BLANK_AUDIO] >> Thank you. >> Dr. Williams >> Thank you Senator Pate and Senator Heiss and members of the committee. My name is Dr. Randall Williams and State Health Director and Deputy Secretary of Health Services, and I just can't thank you enough for your engagement on this and your collaboration. We've worked with many of you on this. I think the issue we're looking at today is probably in many ways the public health crisis of our time, and that is the issue of opioid and opioid overdose. As i mentioned in the previous committee from time to time I go up to the medical examiner, I was there this weekend working. And one out of four of our all top seasonal is, is for drug overdose and many times these are very young people.

I saw a statistic this morning that probably nationwide this is now affecting one in four families. They know someone in their immediate circle, and what we're presenting today is bold initiative, the 15 state, health directors since 1877 and this is never been done before, but we think that the condition warrants that is and what we're asking for is is that for the first time, the state health director will have a standing order that for North Carolina citizens who do to, about enenemity or barriers or they don't have the co-pay to go or they are just concerned about their son or daughter or brother sisters. I've look around this room I notice I've talked to some of you individually, but friends sons and daughters of friends goes many times does affect you on people that they could go and get a prescription under Under my name my DEA number is through the state of North Carolina. And so they'd be able to do this we'll be the third state in the country to do this. The CDS already does this, we have standing orders in place by various people. But for the state to do this it is bold but again this will save lives, and to me it's analogous to a life guard at the beach if somebody is out there drowning we don't ask how they got in that situation we just go out there and save them. And then we try to help them from there but if we don't save them then we don't have a chance to help them and so again I just can't thank you enough for your willingness to engage this. I do know it's bold but we try to be very collaborative about this we present it for the North kind of medical board the North kind of medical society, the North kind of pharmacy board and I would be remised I didn't thank them for their encouragement on this and helping us to work with them I come to you with a very collaborative effort that I think is very important and will help so many families here in North Carolina, thank you. >> Thank you Dr. Williams and I might add that I believe Senator Bingham has a bill about the Good Samaritan and I think this bill will fit right in perfectly with your bill Senator Bingham. So they're not at odds with each other, I think it would be the perfect pair. That's really the presentation that we had to make unless there's at this time we would be glad to entertain any questions Mr. Chairman. >> Thank you members of the committee. Before we go into questions I'll let you know how the bill is also scheduled to be referred to J1. J1 will discuss the SS bill around immunity and the legal aspects we will cover the aspects related to health policy. Thanks for coming in. With that being said I had Senator Barefoot first nothing/g. >> Thank you Mr. Chairman. First, Senator Pate, Senator Tucker, Senator Robinson appreciate you bringing this bill forward. Dr. Williams thank you for your help on this. A couple of months ago I was speaking with Wake County Health Director I ask just what is the profile of the notebook [INAUDIBLE AUDIO] person seem like, Wake county has been moved into a designation as been a heroine distribution center, what does it look like? And there's not a profile, it affects everybody people come to the drug, they're different aspects and there a lot of different reasons for that. I think the analogy you gave of being a lifeguard is an appropriate one that we don't have to ask people how they got their whoop, but there's a state interest in saving lives and so I know there will more comments that I would just like to make a motion at the appropriate time favorable to the J1 committee. We'll consider that motion by continue requesting, I have senator Mckissick nd Senator Bingham. >> If doctor Weis/g perhaps you can help me with this, I like this is an excellent bill, the thing I wanna know is how would we go about implementing it in terms of providing public information so the people know that this medication is readily available, and can be used as an effective intervention tool. So that those that are in need of it can easily access it. What are the thoughts in terms of plan for providing that type of wide spread public information About it's availability? >> Senator Mckissick is an excellent question because of this such a noble thing, it's very innovative, so I think it bafoos/g the department DHHS that we need to get the word out. Technically the way it works that any pharmacy that takes my standing order has to notify us and then And we track the result,

again it's anonymous but we at least know if it's been utilized and so I think you make an excellent point, we provide education to those people who pick up the nacan/g, but I'm hoping through our friends in the media and others. Because this is such a public health event that they will disseminate the word, but that means we also need to be very concerted in our public information efforts so I very much appreciate your raising that. >> Sure. Follow up Mr. Chair >> Follow up. I really think it's an excellent program, a great initiative I know a few years back we begun making it more [INAUDIBLE]. I've received calls and letters from people who commended us on that action so I appreciate it moving forward. In other states that have moved in this direction sir, how long have they been doing this, and what sort of experiences have they seen in terms of reduction potentially in deaths or at least ability to intervene with those who have overdosed. >> We're only the third state that would have done this and it started in October, so the idea of a standing order by the state health director giving that widespread of availability we're still in the infancy Is learning that we know, we take great encouragement from the fact that last year, the cause we have made in our can so available to our first responders, that last year for the first time ever we had more people who were saved than actually died. So we feel Like that this is an evolution of that, so there have been estimates that we could potentially say 500 of the 1000 people who died last year if this was available. And I was reading one of the press releases, we had a young deputy down in Lansing/g county just last week, got called to her Her home, couldn't find the person they were concerned with, found him unresponsive in the backyard and gave him [UNKNOWN] and he lived. And so we think, as you can imagine would be an incredibly desperate feeling if your loved one was there and despite doing CPNR you couldn't do anything but if you knew that you might I have that problem and you had that drug and to give it to them in three minutes, you literally bring them back to life from not breathing, it is just such a gift. >> Oh it's a very compelling statistic and thank you for your leadership. >> Senator Bingham/g. And then I have Senator Davids and Senator Wade. >> Thank you Mr. Chairman I just wanted to say that since we passed the, and several of you were here when we passed the Good Samaritan bill and that was very contentious at the time and I think that was 2011, 13 yeah. Anyway since then I've been told that there's over 3000 reversals which could be possibly Saving the 3000 lives so this expands it tremendously and of course we have quite a push from law enforcement initially but you know now everybody's own [INAUDIBLE] in coming around I certainly appreciate you working in this effort cuz this is a sad situation and just in the small Medium which I know the three people who have died from this very issue so is not I mean this affects the whole country this is a terrible terrible thing so thank you very much for your efforts in doing this so we are certainly moving in the right direction thank you Mr Chairman. >> Thank you for your comments Senator Davis. Thank you Mr Chairman I too would like to commend the bill sponsors for this needed legislation opulate problems is a modern day plague that we have to dress and I would like to Mr Chairman if I may to address a question to a Doctor Williams. Doctor Williams do we know of any risks or Of side effects of Noaxon/g and [UNKNOWN] that would be helpful to the committee. >> Senator Davis, it's a great question. As a physician, you always look at the risk versus the benefits and obviously, we are incredibly motivated by the fact that the benefit here is that if we don't use the drug, than the risk Risk of demises 100% many times now but your point is well made which is that really the only real risk to the drug is that occasionally rarely actually people obviously come out of and withdrawal you can have the symptoms over withdrawal and it looks like in a That of people that have underlying heart conditions that they can develop rhythmies and pulmonary edema but again in this situations if we don't use the drug then we pretty much know that the outcome will be mortality so we think that's unlike others Other drugs that this is one in which the benefits will always out

rate a very small risk. >> And just to follow on that from the committees perspective and others this is dealing with the specific individuals who have overdosed we've got a lot of work to do in the opulate field and I know Senator Davis is working on some Working at some separate legislation and we are looking at several in the treatment side as well and hopefully we can do a lot to prevent individuals from getting to this point and provide some services for those who want to avoid getting to this point as well so it's the problem with [INAUDIBLE] is much bigger than this but this does deal with at least access to medication For individuals that have overdosed. Senator White. [BLANK_AUDIO] >> Thank you Mr. Chairman. My question was on the same line as Senator Davis, but having used [UNKNOWN] in animals of course, and how quick it is and it's great, but my question is if you used it in a person that was Having a problem. We're doing a good [INAUDIBLE] Are there any side effects or any possibility of a problem? >> No, ma'am. The drug is again an opial antagonist and so that's how it works. It's the reverse opiods. So if that wasn't the issue, then it wouldn't be a problem. >> Thank you. >> Thank you though Senator Hetzel/g. [BLANK_AUDIO] >> I'd just like to speak to a little different piece if this and that is very simply I am thankful that for once, the state has looked at the public health as public health and actually given authority to state health director to initiate A reaction to an epidemic of state wide proportions. And I just wanna say thanks. [BLANK_AUDIO] >> Senator Pratt. >> I would like to respond to that. Senator Hertzel/g, thank you very much for that. I think our Department of Health and Human services and our public health director or doing great jobs and think this was no small task for him to take on, I can envision it this bill passes, that we will have a lot of public comment and public service announcements letting people know that this is Is a possibility wherever they are in North Carolina, and so we really need to publicize this and let care takers know that their loved one can be covered around the state anywhere they go. [BLANK_AUDIO] >> Okay. Senator Tarte/g and Senator Robbins. >> Yeah. Thank you Mr. Chair. I will just kind of pick up on Senator Pate's comment as terms of public announcement, many of you may be aware or not, but just to share, finally there is a national webinar on this very topic, that NCSL is actually going going to be the host hub/g. So we're gonna be listening to what other states are doing in this area and hopefully can share what we're doing and moving forward on so it is a national topic that's on the forefront of everyone and I appreciate your [UNKNOWN] efforts again. >> Senator Robertson, thank you Mr. Chair and I simply wanted to say to doctor Williams how much I appreciate and we appreciate his Is foresightedness in terms of issued like this that are prevented, and that's what we are about i terms of the public health sector. Really appreciate looking at issues like this that really exasperate the community, but can be prevented. So I agree with Senator [UNKNOWN] let's say that it affects all sections of the community and this is a preventive effort and I really appreciate your work in this. >> Good. >> Senator Robertson, I greatly appreciate that. Again I would just like to give all the credit to our staff in DPH. They are here today and they are really the ones who brought it to me Said Doctor Williams we wanna do something really novel and use your DEA number in your license. And so I thought it was the right thing to do, but when I give them credit for putting this all up. >> One question I want to give for Steph real quick, just Just want to check in the event of a vacancy or transition in the position, does the order continue to stand during that process? >> It's great. Thank you again. Actually, the new state health director under their licence would have to renew it, just because it is under a DEA number, but I would certainly hope that that would that would happen. >> Just one quick question, considering you're giving them your DEA number, is there any chance of having a problem with your DEA number being used for other type drugs. >> No ma'am cuz they wont actually have my DEA number, the pharmacy will and my DEA number Numbers actually through the state of North Carolina now so the state makes provisions that physicians within the system can get

their DEA numbers so it's not my personal DEA numbers the one I have through the State of North Carolina. >> Any other questions or comments? If not, Senator Barefoot has moved for a favorable For a favorable report to the bill with their referral onto J1 that's for coming in. Seeing no other questions or comments on the motion, all those in favor of the motion, please signify by saying aye. >> Aye. >> All those opposed? Motion carries. Thank you members of the committee be on alert as we'll Continue to have a lot of work left to do in this committee as session goes on. Having exhausted the agenda, we'll stand adjourned. [BLANK_AUDIO]