CSSB 306(FIN) am: "An Act relating to the practice of naturopathic medicine; and providing for an effective date."

00                     CS FOR SENATE BILL NO. 306(FIN) am                                                                  
01 "An Act relating to the practice of naturopathic medicine; and providing for an effective                               
02 date."                                                                                                                  
03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:                                                                
04    * Section 1.  AS 08.01.010(26) is amended to read:                                                                 
05                 (26)  regulation of the practice of naturopathic medicine                                           
06       [NATUROPATHY] under AS 08.45;                                                                                     
07    * Sec. 2.  AS 08.45.010 is amended to read:                                                                        
08            Sec. 08.45.010.  Practice of naturopathic medicine [NATUROPATHY]                                         
09       without license prohibited.  A person who does not hold a license issued under this                         
10       chapter may not                                                                                               
11                 (1)  practice naturopathic medicine [NATUROPATHY] in the state;                             
12       or                                                                                                            
13                 (2)  use any of the following titles:  "doctor of naturopathy,"                                     
14       "naturopath," or "naturopathic physician" [WITHOUT A LICENSE].                                                
01    * Sec. 3.  AS 08.45.020 is amended to read:                                                                        
02            Sec. 08.45.020.  Application for license.  A person desiring to practice                                   
03       naturopathic medicine [NATUROPATHY] shall apply in writing to the division of                                 
04       occupational licensing of the Department of Community and Economic Development.                                   
05    * Sec. 4.  AS 08.45.030 is repealed and reenacted to read:                                                         
06            Sec. 08.45.030.  Issuance of license.  The division shall issue a license to                               
07       practice naturopathic medicine on receipt of                                                                      
08                 (1)  an application on a form acceptable to the division;                                               
09                 (2)  documentation satisfactory to the division that the applicant                                      
10                      (A)  is a graduate of an approved naturopathic medical college                                     
11            or program; and                                                                                              
12                      (B)  has passed the naturopathic physicians licensing                                              
13            examination approved by the division with a score that meets the requirements                                
14            established in regulation; and                                                                               
15                 (3)  all applicable fees.                                                                               
16    * Sec. 5.  AS 08.45.050 is repealed and reenacted to read:                                                         
17            Sec. 08.45.050.  Restrictions on practice of naturopathic medicine.  (a)  A                              
18       person who practices naturopathic medicine may not engage in surgery except that a                                
19       person who practices naturopathic medicine may perform minor surgery under                                        
20       AS 08.45.120(a)(6).                                                                                               
21            (b)  Notwithstanding that a specific act is within the definition of "naturopathic                           
22       medicine" or is described as an activity authorized under AS 08.45.120, a person                                  
23       licensed under this chapter may not perform the act if the person lacks appropriate                               
24       education or training related to the act.                                                                         
25    * Sec. 6.  AS 08.45.060 is amended to read:                                                                        
26            Sec. 08.45.060.  Grounds for suspension, revocation, or refusal to issue a                                 
27       license.  The division may deny a license to an applicant under this chapter or,                            
28       after a hearing, impose a disciplinary sanction authorized under AS 08.45.070 on a                            
29       person licensed under this chapter when the division finds that the applicant or                              
30       licensee                                                                                                          
31                 (1)  secured, or attempted to secure, a license through deceit, fraud, or                           
01       intentional misrepresentation;                                                                                    
02                 (2)  engaged in deceit, fraud, or intentional misrepresentation in the                                  
03       course of providing professional services or engaging in professional activities;                                 
04                 (3)  advertised professional services in a false or misleading manner;                                  
05                 (4)  has been convicted of a felony or other crime that affects the                                     
06       applicant's or licensee's ability [TO CONTINUE] to practice competently and safely;                           
07                 (5)  failed to comply with this chapter, with a regulation adopted under                                
08       this chapter, or with an order of the division;                                                                   
09                 (6)  is [CONTINUED TO PRACTICE AFTER BECOMING] unfit to                                         
10       practice naturopathic medicine due to                                                                         
11                      (A)  professional incompetence;                                                                    
12                      (B)  addiction or severe dependency on alcohol or a drug that                                      
13            impairs the applicant's or licensee's ability to practice safely; or                                 
14                      (C)  physical or mental disability; or                                                         
15                 (7)  engaged in lewd or immoral conduct in connection with the                                          
16       delivery of professional service to patients.                                                                     
17    * Sec. 7.  AS 08.45.070(a) is amended to read:                                                                     
18            (a)  When it finds that a licensee under this chapter has violated AS 08.45.050                          
19       or 08.45.120 [AS 08.45.040 - 08.45.050] or is guilty of an offense under                                      
20       AS 08.45.060, the division may impose the following sanctions singly or in                                        
21       combination:                                                                                                      
22                 (1)  permanently revoke the license to practice;                                                        
23                 (2)  suspend the license for a determinate period of time;                                              
24                 (3)  censure the licensee;                                                                              
25                 (4)  issue a letter of reprimand to the licensee;                                                       
26                 (5)  place the licensee on probationary status and require the licensee to                              
27                      (A)  report regularly to the division upon matters involving the                                   
28            basis of probation;                                                                                          
29                      (B)  limit practice to those areas prescribed;                                                     
30                      (C)  continue professional education until a satisfactory degree                                   
31            of skill has been attained in areas determined by the division to need                                       
01            improvement;                                                                                                 
02                 (6)  impose limitations or conditions on the practice of the licensee.                                  
03    * Sec. 8.  AS 08.45.080 is amended to read:                                                                        
04            Sec. 08.45.080.  Unlicensed practice or use of title a misdemeanor.  A                                   
05       person who violates [PRACTICES NATUROPATHY IN THE STATE WITHOUT A                                             
06       LICENSE IN VIOLATION OF] AS 08.45.010 is guilty of a misdemeanor and upon                                         
07       conviction is punishable by a fine of not more than $1,000, or by imprisonment for not                            
08       more than a year, or by both.                                                                                     
09    * Sec. 9.  AS 08.45.100 is amended by adding new subsections to read:                                              
10            (b)  After consideration of draft regulations, if any, prepared by the division in                           
11       collaboration with a qualified trade association of naturopathic physicians, the                                  
12       department may adopt regulations to                                                                               
13                 (1)  establish the standards the division will use to approve naturopathic                              
14       medical colleges or programs for satisfaction of the requirements of                                              
15       AS 08.45.030(2)(A), 08.45.120(a)(4), 08.45.120(a)(6), and 08.45.120(a)(8); the                                    
16       standards must require, at a minimum, that the college or program include a four-year,                            
17       full-time resident program of academic and clinical study of naturopathic medicine;                               
18                 (2)  implement the peer review process under (c) of this section;                                       
19                 (3)  implement the continuing education requirement of AS 08.45.110;                                    
20       and                                                                                                               
21                 (4)  establish the standards under which the division may issue                                         
22       certificates of specialty practice for a person licensed under this chapter.                                      
23            (c)  The division shall establish a naturopathic peer review committee                                       
24       consisting of three members appointed annually from a list of nominees presented to                               
25       the division by an approved qualified trade association for naturopathic physicians.                              
26       The committee members serve without compensation for their work on the committee.                                 
27       The committee shall meet to review complaints filed with the division under this                                  
28       chapter.  Attendance and participation at meetings of the committee may be by                                     
29       teleconferencing or other two-way communication method.  The committee shall                                      
30       make written recommendations to the division as to whether grounds for disciplinary                               
31       action exist under AS 08.45.060 and as to appropriate disciplinary sanctions under                                
01       AS 08.45.070 in each case under review.  If the division approves the                                             
02       recommendations of the committee, the licensee may either accept the                                              
03       recommendations of the committee or request a hearing before the division.                                        
04    * Sec. 10.  AS 08.45 is amended by adding new sections to read:                                                    
05            Sec. 08.45.110.  Continuing education requirement.  Before a license may                                   
06       be renewed, the licensee shall document to the division's satisfaction that the licensee                          
07       has received at least 45 hours of continuing education in naturopathic medicine in the                            
08       previous two years, at least 15 hours of which was instruction in pharmacology or                                 
09       pharmacotherapeutics presented by a licensed pharmacist or another professional                                   
10       approved by the division.                                                                                         
11            Sec. 08.45.120.  Authorized activities; use of titles.  (a)  A person licensed                             
12       under this chapter may                                                                                            
13                 (1)  prescribe or administer for preventive and therapeutic purposes the                                
14       following: food, extracts of food, vitamins, minerals, enzymes, whole gland                                       
15       substances, botanical medicines, and homeopathic preparations;                                                    
16                 (2)  prescribe or administer intravenous botanicals, substances,                                        
17       vitamins, and minerals;                                                                                           
18                 (3)  administer health care counseling, nutritional counseling and                                      
19       dietary therapy, naturopathic physical applications, therapeutic devices, and                                     
20       nonprescription drugs;                                                                                            
21                 (4)  if authorized under regulations of the department, prescribe                                       
22       schedules IIIA, IVA, and VA controlled substances as described under AS 11.71.160,                                
23       11.71.170, and 11.71.180 if the person has                                                                        
24                      (A)  registered with the federal Drug Enforcement                                                  
25            Administration;                                                                                              
26                      (B)  successfully completed pharmacology training from an                                          
27            approved naturopathic medical college; and                                                                   
28                      (C)  entered into a collaborative agreement as described under                                     
29            AS 08.45.125 with a person or persons licensed to practice medicine under                                    
30            AS 08.64;                                                                                                    
31                 (5)  prescribe and implement barrier devices for contraception;                                         
01                 (6)  perform minor surgery after providing proof satisfactory to the                                    
02       division of successful completion of training in minor surgery from an approved                                   
03       naturopathic medical college;                                                                                     
04                 (7)  perform or order for diagnostic purposes a physical or orificial                                   
05       examination, ultrasound, phlebotomy, clinical laboratory test or examination,                                     
06       physiological function test, and other diagnostic procedures commonly used by a                                   
07       person licensed to practice medicine under AS 08.64.230(a); and                                                   
08                 (8)  if authorized under regulations of the department, prescribe legend                                
09       drugs or prescription drugs if the person has                                                                     
10                      (A)  successfully completed pharmacology training from an                                          
11            approved naturopathic medical college; and                                                                   
12                      (B)  entered into a collaborative agreement as described under                                     
13            AS 08.45.125 with a person or persons licensed to practice medicine under                                    
14            AS 08.64; and                                                                                                
15                 (9)  use the title of "doctor of naturopathy," "naturopath," "naturopathic                              
16       physician," or their abbreviations.                                                                               
17            (b)  In this section, "legend drug" and "prescription drug" have the meanings                                
18       given in AS 08.80.480.                                                                                            
19            Sec. 08.45.125.  Collaborative agreements for drugs.  (a)  A collaborative                                 
20       agreement required under AS 08.45.120(a)(4) and (a)(8) must be in writing in a form                               
21       approved by the department and include                                                                            
22                 (1)  a commitment of at least one collaborating physician who is                                        
23                      (A)  licensed to practice medicine under AS 08.64;                                                 
24                      (B)  able to comply with the terms of the agreement;                                               
25                      (C)  engaged in the active practice of medicine in the state; and                                  
26                      (D)  committed to collaborate with not more than six licensees                                     
27            under this section;                                                                                          
28                 (2)  a formulary of controlled substances and legend drugs or                                           
29       prescription drugs that                                                                                           
30                      (A)  are authorized under AS 08.45.120(a)(4) and (a)(8) and                                        
31            regulations adopted under that section that describes the standard protocols and                             
01            practices that must be used;                                                                                 
02                      (B)  are approved by the collaborating physician to be                                             
03            prescribed or dispensed by the person licensed under this chapter; and                                       
04                      (C)  include standard protocols and practices that describe the                                    
05            circumstances under which each drug on the formulary may be prescribed or                                    
06            dispensed, the extent of supervision required of the collaborating physician, if                             
07            any, and a periodic review of the licensee's competence and standard practices;                              
08                 (3)  a requirement that the licensee consult with and have a patient                                    
09       protocol approved by a collaborating physician before prescribing a schedule IIIA                                 
10       controlled substance for each patient; and                                                                        
11                 (4)  a requirement that the licensee review the formulary, including the                                
12       standard practices under (2) of this subsection, with a collaborating physician before                            
13       executing a collaborative agreement, six months after executing the agreement, and                                
14       every 12 months thereafter.                                                                                       
15            (b)  A collaborating physician licensed under AS 08.64 and a person licensed                                 
16       to practice naturopathic medicine under this chapter are not liable for the actions or                            
17       inactions of the other as a result of a collaborative agreement entered into under this                           
18       section.                                                                                                          
19            (c)  The licensee shall post the name of the collaborating physician under (a) of                            
20       this section in a conspicuous location visible to patients of the licensee.                                       
21            (d)  Upon request, the licensee shall provide a copy of the standard practices                               
22       under (a)(2) of this section to a pharmacist licensed in the state.                                               
23            (e)  The licensee shall include the name of the collaborating physician under                                
24       (a) of this section on each prescription written under AS 08.45.120(a)(4) or (a)(8) by                            
25       the licensee.                                                                                                     
26            Sec. 08.45.130.  Fees.  The division shall set fees under AS 08.01.065 for each                            
27       of the following:                                                                                                 
28                 (1)  a license issued under this chapter;                                                               
29                 (2)  renewal of a license issued under this chapter.                                                    
30    * Sec. 11.  AS 08.45.200(3) is amended to read:                                                                    
31                 (3)  "naturopathic medicine" ["NATUROPATHY"] means the use of                                       
01       hydrotherapy, dietetics, electrotherapy, sanitation, suggestion, mechanical and manual                            
02       manipulation for the stimulation of physiological and psychological action to establish                           
03       a normal condition of mind and body; in this paragraph, "dietetics" includes herbal                               
04       and homeopathic remedies.                                                                                         
05    * Sec. 12.   AS 08.45.200 is amended by adding new paragraphs to read:                                             
06                 (4)  "approved naturopathic medical college or program" means a                                         
07       college or program that grants a degree of doctor of naturopathy or doctor of                                     
08       naturopathic medicine and that                                                                                    
09                      (A)  is accredited by the Council on Naturopathic Medical                                          
10            Education or another accrediting agency recognized by the United States                                      
11            Department of Education;                                                                                     
12                      (B)  has the status of candidate for accreditation by an entity                                    
13            described in (A) of this paragraph; or                                                                       
14                      (C)  has been approved under a regulation adopted by the                                           
15            department under this chapter;                                                                               
16                 (5)  "department" means the Department of Community and Economic                                        
17       Development;                                                                                                      
18                 (6)  "minor surgery"                                                                                    
19                      (A)  means the use of                                                                              
20                           (i)  operative, electrical, or other methods for surgical                                     
21                 repair and care incidental to superficial lacerations and abrasions or                                  
22                 superficial lesions, and the removal of foreign bodies located in                                       
23                 superficial tissues; and                                                                                
24                           (ii)  antiseptics and local anesthetics in connection with                                    
25                 methods authorized under (i) of this subparagraph;                                                      
26                      (B)  does not include use of general or spinal anesthetics, major                                  
27            surgery, surgery of the body cavities, or specialized surgery, such as plastic                               
28            surgery, surgery involving the eyes, or surgery involving tendons, ligaments,                                
29            nerves, or blood vessels.                                                                                    
30    * Sec. 13.  AS 47.08.050 is amended to read:                                                                       
31            Sec. 47.08.050.  Services excluded from coverage.  Annually, the committee                                 
01       shall determine in light of appropriated funds and expected need the medical expenses                             
02       reimbursable under AS 47.08.010 - 47.08.140, except that the following are not                                    
03       reimbursable:                                                                                                     
04                 (1)  dentistry and optometry unless prescribed by a licensed dentist or                                 
05       physician as medically necessary as the result of the injury or illness;                                          
06                 (2)  elective medical or surgical procedures;                                                           
07                 (3)  drugs and medications not prescribed by a licensed physician;                                      
08                 (4)  services received as a result of a pregnancy or birth without                                      
09       unusual complications;                                                                                            
10                 (5)  private psychological or psychiatric treatment or private alcoholism                               
11       treatment, unless not available from public agencies or programs;                                                 
12                 (6)  chiropractic services and services provided by a person who                                        
13       practices naturopathic medicine [NATUROPATHY];                                                                
14                 (7)  services not of a medical nature;                                                                  
15                 (8)  medical services currently provided to persons in the custody of the                               
16       Department of Corrections;                                                                                        
17                 (9)  costs incurred before July 1976.                                                                   
18    * Sec. 14.  AS 08.45.035 and 08.45.040 are repealed.                                                               
19    * Sec. 15.  AS 08.45.120(a)(4)(C), 08.45.120(a)(8)(B), and 08.45.125, as enacted by sec. 10                        
20 of this Act, are repealed July 1, 2009.                                                                                 
21    * Sec. 16.   The uncodified law of the State of Alaska is amended by adding a new section                          
22 to read:                                                                                                                
23       LICENSE TO PRACTICE NATUROPATHY; TRANSITIONAL PROVISIONS.  A                                                      
24 license to practice naturopathy issued under AS 08.45, including a temporary license, that is                           
25 in effect on February 28, 2005, remains in effect for the period for which the license was                              
26 issued and is considered to be a license to practice naturopathic medicine under AS 08.45, as                           
27 amended by this Act.  However, a person who holds a license issued under AS 08.45 that is in                            
28 effect on February 28, 2005, is subject to the authority of the department in regard to acts of                         
29 the licensee that occurred on or before February 28, 2005, to impose a disciplinary sanction                            
30 under AS 08.45.070.                                                                                                     
31    * Sec. 17.  AS 08.45.110, as enacted by sec. 10 of this Act, takes effect January 1, 2007.                         
01    * Sec. 18.  Except as provided in sec. 17 of this Act, this Act takes effect March 1, 2005.