SB 38: "An Act relating to the practice of naturopathy; establishing the Naturopathy Advisory Board; relating to the licensure of naturopaths; relating to disciplinary sanctions for naturopaths; relating to the Department of Commerce, Community, and Economic Development; and providing for an effective date."

00 SENATE BILL NO. 38 01 "An Act relating to the practice of naturopathy; establishing the Naturopathy Advisory 02 Board; relating to the licensure of naturopaths; relating to disciplinary sanctions for 03 naturopaths; relating to the Department of Commerce, Community, and Economic 04 Development; and providing for an effective date." 05 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 06 * Section 1. AS 08.02.010(a) is amended to read: 07 (a) An acupuncturist licensed under AS 08.06, an audiologist or speech- 08 language pathologist licensed under AS 08.11, a behavior analyst licensed under 09 AS 08.15, a person licensed in the state as a chiropractor under AS 08.20, a 10 professional counselor licensed under AS 08.29, a dentist under AS 08.36, a dietitian 11 or nutritionist licensed under AS 08.38, a naturopath licensed under AS 08.45, a 12 massage therapist licensed under AS 08.61, a marital and family therapist licensed 13 under AS 08.63, a medical practitioner or osteopath under AS 08.64, a direct-entry 14 midwife certified under AS 08.65, a registered or advanced practice registered nurse

01 under AS 08.68, an optometrist under AS 08.72, a licensed pharmacist under 02 AS 08.80, a physical therapist or occupational therapist licensed under AS 08.84, a 03 psychologist under AS 08.86, or a clinical social worker licensed under AS 08.95, 04 shall use as professional identification appropriate letters or a title after that person's 05 name that represents the person's specific field of practice. The letters or title shall 06 appear on all signs, stationery, or other advertising in which the person offers or 07 displays personal professional services to the public. In addition, a person engaged in 08 the practice of medicine or osteopathy as defined in AS 08.64.380, or a person 09 engaged in any manner in the healing arts who diagnoses, treats, tests, or counsels 10 other persons in relation to human health or disease and uses the letters "M.D." or the 11 title "doctor" or "physician" or another title that tends to show that the person is 12 willing or qualified to diagnose, treat, test, or counsel another person, shall clarify the 13 letters or title by adding the appropriate specialist designation, if any, such as 14 "dermatologist," "radiologist," "audiologist," "naturopath," or the like. 15 * Sec. 2. AS 08.45 is amended by adding a new section to read: 16 Sec. 08.45.015. Naturopathy Advisory Board. (a) The Naturopathy Advisory 17 Board is established in the department. 18 (b) The board shall meet at least once each year as requested by the 19 commissioner and provide recommendations to the commissioner on public policy, the 20 adoption of regulations, and other matters related to the exercise of the functions of the 21 department under this chapter. 22 (c) The board consists of five members, who are appointed by and serve at the 23 pleasure of the commissioner, and shall include two public members and three 24 naturopaths licensed under this chapter. The board shall elect a chair from among its 25 membership. 26 (d) Members of the board are appointed for three-year terms and serve until a 27 successor is appointed. A member of the board serves without compensation or 28 reimbursement of expenses. 29 (e) In this section, "commissioner" means the commissioner of commerce, 30 community, and economic development. 31 * Sec. 3. AS 08.45.020 is amended to read:

01 Sec. 08.45.020. Application for license. A person desiring to practice 02 naturopathy shall 03 (1) apply in writing to the department on a form provided by the 04 department; 05 (2) submit to the department the person's fingerprints and the fees 06 required by the Department of Public Safety under AS 12.62.160 for the 07 department to forward to the Department of Public Safety to obtain a report of 08 criminal justice information under AS 12.62.160 and a national criminal history 09 record check under AS 12.62.400; and 10 (3) pay the application fee established by the department. 11 * Sec. 4. AS 08.45.030 is amended to read: 12 Sec. 08.45.030. Issuance of license. The department shall issue a license to 13 practice naturopathy to an applicant who 14 (1) provides proof satisfactory to the department that the applicant 15 (A) has received a doctoral degree from an accredited 16 naturopathic medical school; 17 (B) has [ACCREDITED FOUR-YEAR COLLEGE OR 18 UNIVERSITY, AND 19 (1) ON OR BEFORE DECEMBER 31, 1987, HAS GRADUATED 20 FROM A SCHOOL OF NATUROPATHY THAT REQUIRED FOUR YEARS OF 21 ATTENDANCE AT THE SCHOOL AND AFTER GRADUATION HAS 22 RECEIVED A LICENSE IN ANOTHER STATE AFTER PASSING AN 23 EXAMINATION FOR LICENSURE IN THAT STATE AND IS LICENSED BY A 24 STATE AT THE TIME OF APPLICATION; OR 25 (2) AFTER DECEMBER 31, 1987, HAS 26 (A) GRADUATED FROM A SCHOOL OF NATUROPATHY 27 THAT REQUIRED FOUR YEARS OF ATTENDANCE AT THE SCHOOL 28 AND AT THE TIME OF GRADUATION THE SCHOOL WAS 29 ACCREDITED OR A CANDIDATE FOR ACCREDITATION BY THE 30 COUNCIL ON NATUROPATHIC MEDICAL EDUCATION OR A 31 SUCCESSOR ORGANIZATION RECOGNIZED BY THE UNITED

01 STATES DEPARTMENT OF EDUCATION; AND 02 (B)] passed the Naturopathic Physicians Licensing 03 Examination; 04 (2) is not subject to an unresolved disciplinary action against a 05 license to practice naturopathy in this or another jurisdiction; 06 (3) complies with the requirements of AS 08.45.020; and 07 (4) has not been convicted of, or pled guilty or no contest to, a 08 crime that adversely reflects on the applicant's ability or competency to practice 09 as a naturopath or that jeopardizes the safety or well-being of a patient. 10 * Sec. 5. AS 08.45 is amended by adding a new section to read: 11 Sec. 08.45.032. Documentation of license refusals and revocations. If the 12 department refuses to issue or revokes a license, the department shall issue a concise 13 written statement describing the reasons for the department's decision. 14 * Sec. 6. AS 08.45.035(a) is amended to read: 15 (a) The department shall issue a temporary license to practice naturopathy to 16 an applicant who 17 (1) has applied for and is qualified to take the next Naturopathic 18 Physicians Licensing Examination offered after the date of application; and 19 (2) [AND PROVIDES PROOF SATISFACTORY TO THE 20 DEPARTMENT THAT THE APPLICANT (1)] meets the requirements of 21 AS 08.45.030(1)(A) and (2) - (4) [AS 08.45.030(2)(A); AND 22 (2) HAS NOT PREVIOUSLY FAILED THE NATUROPATHIC 23 PHYSICIANS LICENSING EXAMINATION]. 24 * Sec. 7. AS 08.45 is amended by adding a new section to read: 25 Sec. 08.45.038. Standards for license renewal. The department shall renew a 26 license issued under this chapter to a licensee who 27 (1) applies on a form provided by the department and pays the required 28 fee; 29 (2) meets the continuing education requirements established by the 30 department; 31 (3) has not been convicted of, or pled guilty or no contest to, a crime

01 that adversely reflects on the applicant's ability or competency to practice as a 02 naturopath or that jeopardizes the safety or well-being of a patient; 03 (4) has a current cardiopulmonary resuscitation certification; and 04 (5) has, at least once in the six years immediately preceding the 05 application, submitted to the department fingerprints and the fees required by the 06 Department of Public Safety under AS 12.62.160 for the department to forward to the 07 Department of Public Safety to obtain a report of criminal justice information under 08 AS 12.62.160 and a national criminal history record check under AS 12.62.400. 09 * Sec. 8. AS 08.45 is amended by adding a new section to read: 10 Sec. 08.45.045. Practice of naturopathy. (a) A naturopath licensed under this 11 chapter may 12 (1) only provide naturopathic services that are consistent with the 13 standards and scope of naturopathic education, naturopathic training, and the 14 naturopath's experience, as established by regulations adopted by the department; 15 (2) prescribe and administer for preventive and therapeutic purposes 16 (A) natural therapeutic substances, including food, extracts of 17 food, vitamins, minerals, enzymes, whole gland substances, botanical 18 medicines, and homeopathic preparations; 19 (B) natural therapies, including health care counseling, 20 nutritional counseling and dietary therapy, naturopathic manipulation, 21 naturopathic physical applications, and therapeutic devices; 22 (C) devices for contraception; and 23 (D) drugs, except as provided in AS 08.45.050, if the 24 naturopath has passed the elective pharmacology examination portion of the 25 Naturopathic Physicians Licensing Examination; 26 (3) perform procedures in the office using operative, electrical, or other 27 methods, including the use of antiseptics and local anesthetics, for the surgical repair 28 and care of superficial lacerations, abrasions, and lesions and the removal of foreign 29 bodies located in the superficial tissues of the human body; the procedures may not 30 include general or spinal anesthetics, major surgery, surgery of the body cavities, 31 plastic surgery, surgery involving the eyes, or surgery involving tendons, ligaments,

01 nerves, or blood vessels; and 02 (4) perform or order for diagnostic purposes a physical or orificial 03 examination, an ultrasound, phlebotomy, a clinical laboratory test or examination, or a 04 physiological function test. 05 (b) In this section, "naturopathic physical application" means the therapeutic 06 use by a naturopath of the actions or devices of electrical muscle stimulation, galvanic 07 treatment, diathermy, ultrasound, ultraviolet light, constitutional hydrotherapy, and 08 naturopathic manipulative therapy. 09 * Sec. 9. AS 08.45.050 is amended to read: 10 Sec. 08.45.050. Restrictions on practice of naturopathy. A person who 11 practices naturopathy may not [(1)] give, prescribe, or recommend in the practice 12 (1) [(A) A PRESCRIPTION DRUG; (B)] a controlled substance; or 13 (2) a cancer chemotherapeutic agent [(C) A POISON; 14 (2) ENGAGE IN SURGERY; 15 (3) USE THE WORD "PHYSICIAN" IN THE PERSON'S TITLE]. 16 * Sec. 10. AS 08.45 is amended by adding new sections to read: 17 Sec. 08.45.053. Public health duties. A naturopath, consistent with the scope 18 of practice provided under this chapter, has the same duty as a physician licensed 19 under AS 08.64 regarding public health laws, reportable diseases and conditions, 20 communicable disease control and prevention, recording of vital statistics, health and 21 physical examinations, and municipal boards of health. 22 Sec. 08.45.055. Duty of naturopaths to report. (a) A naturopath who 23 professionally treats a person licensed to practice naturopathy in this state for 24 alcoholism or drug addiction, or for mental, emotional, or personality disorders, shall 25 report the treatment to the department if the treating naturopath reasonably believes 26 that the person may constitute a danger to the health and welfare of the patients of the 27 person or the public if that person continues in practice. The report must state the 28 name and address of the person and the condition found. 29 (b) Upon receiving a report under (a) of this section, the department shall 30 investigate the matter and, upon a finding that there is reasonable cause to believe that 31 the naturopath who is the subject of the report is a danger to the health or welfare of

01 the public or to the naturopath's patients, the department may appoint a committee of 02 health care professionals to examine the naturopath and report its findings to the 03 department. Notwithstanding the provisions of this subsection, the department may 04 summarily suspend a license under AS 08.45.070(c) before appointing an examining 05 committee or before the committee makes or reports its findings. 06 (c) If the department finds that a naturopath is unable to continue in practice 07 with reasonable safety to the naturopath's patients or to the public, the department 08 shall initiate action to suspend, revoke, limit, or condition the naturopath's license to 09 the extent necessary for the protection of the naturopath's patients and the public. 10 (d) A naturopath may not refuse to submit a report under this section or 11 withhold from the department or its investigators evidence related to an investigation 12 under this section on the grounds that the report or evidence 13 (1) concerns a matter that was disclosed in the course of a confidential 14 naturopath-patient or psychotherapist-patient relationship or during a meeting of a 15 hospital medical staff, governing body, or committee that was exempt from the public 16 meeting requirements of AS 44.62.310; or 17 (2) is required to be kept confidential under AS 18.23.030. 18 (e) An action may not be brought against a person for damages resulting from 19 a report made in good faith to a public agency by the person or participation by the 20 person in an investigation by a public agency or an administrative or judicial 21 proceeding relating to the report if the report relates to a naturopath licensed under this 22 chapter. 23 Sec. 08.45.058. Naturopaths to report certain injuries. (a) A naturopath who 24 initially treats or attends to a person with an injury described in (b) of this section shall 25 promptly make an oral report of the injury to the Department of Public Safety, a local 26 law enforcement agency, or a village public safety officer. The naturopath shall submit 27 a written report of an injury described in (b)(1) of this section to the Department of 28 Public Safety within three business days after the naturopath provides treatment. A 29 report filed under this subsection must be on a form provided by the Department of 30 Public Safety. 31 (b) The following injuries shall be reported under (a) of this section:

01 (1) second or third degree burns to five percent or more of a patient's 02 body; 03 (2) a bullet wound, powder burn, or other injury apparently caused by 04 the discharge of a firearm; 05 (3) an injury apparently caused by a knife, axe, or other sharp or 06 pointed instrument, unless the injury was clearly accidental; and 07 (4) an injury that is likely to cause the death of the patient, unless the 08 injury was clearly accidental. 09 (c) A person who, in good faith, makes a report under this section, or who 10 participates in a judicial proceeding related to a report under this section, is immune 11 from any civil or criminal liability that might otherwise be incurred as a result of 12 making the report or participating in the judicial proceeding. 13 * Sec. 11. AS 08.45.060 is amended to read: 14 Sec. 08.45.060. Grounds for suspension, revocation, or refusal to issue a 15 license. The department may, after a hearing, impose a disciplinary sanction on a 16 person licensed under this chapter when the department finds that the licensee 17 (1) secured a license through deceit, fraud, or intentional 18 misrepresentation; 19 (2) engaged in deceit, fraud, or intentional misrepresentation in the 20 course of providing professional services or engaging in professional activities; 21 (3) advertised professional services in a false or misleading manner; 22 (4) has been convicted, including conviction based on a guilty plea 23 or a plea of nolo contendere, of a 24 (A) class A or unclassified felony or a [OTHER] crime in 25 another jurisdiction with elements similar to a class A or unclassified 26 felony in this jurisdiction; 27 (B) class B or class C felony or a crime in another 28 jurisdiction with elements similar to a class B or class C felony in this 29 jurisdiction if the felony or other crime is substantially related to the 30 qualifications, functions, or duties of the licensee; or 31 (C) crime involving the unlawful procurement, sale,

01 prescription, or dispensing of drugs [THAT AFFECTS THE LICENSEE'S 02 ABILITY TO CONTINUE TO PRACTICE COMPETENTLY AND 03 SAFELY]; 04 (5) failed to comply with this chapter, with a regulation adopted under 05 this chapter, or with an order of the department; 06 (6) continued to practice after becoming unfit due to 07 (A) professional incompetence; 08 (B) addiction or severe dependency on alcohol or a drug that 09 impairs the licensee's ability to practice safely; 10 (C) physical or mental disability; 11 (7) engaged in unprofessional conduct, in sexual misconduct, or in 12 lewd or immoral conduct in connection with the delivery of professional service to 13 patients; in this paragraph, "sexual misconduct" includes sexual contact, as 14 defined by the department in regulations adopted under this chapter, or 15 attempted sexual contact with a patient outside the scope of generally accepted 16 methods of examination or treatment of the patient, regardless of the patient's 17 consent or lack of consent, during the term of the naturopath-patient 18 relationship, as defined by the department in regulations adopted under this 19 chapter, unless the patient was the licensee's spouse at the time of the contact or, 20 immediately preceding the naturopath-patient relationship, was in a dating, 21 courtship, or engagement relationship with the licensee; 22 (8) has procured, sold, prescribed, or dispensed drugs in violation 23 of a law, regardless of whether there has been a criminal action or harm to a 24 patient; 25 (9) intentionally or negligently permitted the performance of 26 patient care by a person under the licensee's supervision that does not conform to 27 minimum professional standards, even if the patient was not injured; 28 (10) has demonstrated professional incompetence, gross 29 negligence, or repeated negligent conduct; the department may not make a 30 finding of professional incompetence solely on the basis that a licensee's practice 31 is unconventional or experimental in the absence of demonstrable physical harm

01 to a patient; 02 (11) has violated AS 18.16.010; 03 (12) has violated a code of ethics adopted by regulation by the 04 department; 05 (13) has denied care or treatment to a patient or person seeking 06 assistance from the licensee if the only reason for the denial is the failure or 07 refusal of the patient to agree to arbitrate as provided in AS 09.55.535(a); 08 (14) has had a license or certificate to practice naturopathy in 09 another state or a province or territory of Canada denied, suspended, revoked, 10 surrendered while under investigation for an alleged violation, restricted, limited, 11 conditioned, or placed on probation unless the denial, suspension, revocation, or 12 other action was caused by the failure of the licensee to pay fees to that state, 13 territory, or province; 14 (15) has violated any federal law pertaining to medical practice 15 and drugs. 16 * Sec. 12. AS 08.45.060 is amended by adding a new subsection to read: 17 (b) In a case involving (a)(14) of this section, the final findings of fact, 18 conclusions of law, and order of the authority that suspended or revoked a license or 19 certificate constitutes a prima facie case that the license or certificate was suspended 20 or revoked and the grounds under which the suspension or revocation was granted. 21 * Sec. 13. AS 08.45.070(a) is amended to read: 22 (a) When the department [IT] finds that a licensee under this chapter has 23 violated a provision of this chapter [AS 08.45.040 - 08.45.050] or is guilty of an 24 offense under AS 08.45.060, the department may impose the following sanctions 25 singly or in combination: 26 (1) permanently revoke the license to practice; 27 (2) suspend the license for a determinate period of time; 28 (3) censure the licensee; 29 (4) issue a letter of reprimand to the licensee; 30 (5) place the licensee on probationary status and require the licensee to 31 (A) report regularly to the department on [UPON] matters

01 involving the basis of probation; 02 (B) limit practice to those areas prescribed; 03 (C) continue professional education until a satisfactory degree 04 of skill has been attained in areas determined by the department to need 05 improvement; 06 (6) impose limitations or conditions on the practice of the licensee; 07 (7) impose a civil penalty of not more than $25,000. 08 * Sec. 14. AS 08.45.070 is amended by adding new subsections to read: 09 (d) The department may reinstate a license that has been suspended or revoked 10 if, after a hearing, the department finds that the applicant is able to practice 11 naturopathy with reasonable skill and safety. 12 (e) The department may suspend a license upon receiving a certified copy of 13 evidence that a license to practice naturopathy in another state or a province or 14 territory of Canada has been suspended or revoked. The suspension remains in effect 15 until a hearing is held by the department. 16 (f) The department shall promptly report to the National Practitioner Data 17 Bank maintained by the United States Department of Health and Human Services for 18 inclusion in the data bank license refusals under this chapter and actions taken by the 19 department under this section, including the imposition of a fine and the suspension or 20 surrender of a license. 21 * Sec. 15. AS 08.45 is amended by adding new sections to read: 22 Sec. 08.45.105. Automatic suspension for mental incompetency. 23 Notwithstanding AS 44.62, if a person holding a license to practice naturopathy under 24 this chapter is adjudged mentally incompetent or insane by a final order or 25 adjudication of a court of competent jurisdiction or by voluntary commitment to an 26 institution for the treatment of mental illness, the person's license shall be suspended 27 by the department. The suspension shall continue in effect until the court finds or 28 adjudges that the person has been restored to reason or until a licensed psychiatrist 29 approved by the department determines that the person has been restored to reason. 30 Sec. 08.45.110. Voluntary surrender. The department may accept the 31 voluntary surrender of a license. A license may not be reinstated unless the department

01 determines, under regulations adopted by the department, that the person is competent 02 to resume practice. However, a license may not be reinstated if the voluntary surrender 03 resulted in the dropping or suspension of civil or criminal charges against the licensee. 04 Sec. 08.45.115. Medical and psychiatric examinations. For the purposes of 05 an investigation under this chapter, the department may require a person to whom the 06 department has issued a license to submit to drug or alcohol testing or a medical or 07 psychiatric examination by a practitioner appointed by the department. An 08 examination shall be at the department's expense. 09 Sec. 08.45.120. Reports relating to malpractice actions and claims. A 10 naturopath licensed under this chapter shall report in writing to the department 11 concerning the outcome of each medical malpractice claim or civil action in which 12 damages have been or are to be paid by or on behalf of the licensee to the claimant or 13 plaintiff, whether by judgment or under a settlement. This report shall be made within 14 30 days after resolution of the claim or termination of the civil action. 15 Sec. 08.45.125. Penalty for practicing without a license. Except for a person 16 licensed or authorized under another chapter of this title who engages in practices for 17 which that person is licensed or authorized under that chapter, a person practicing 18 naturopathy in the state without a valid license is guilty of a class A misdemeanor. 19 Each day of illegal practice is a separate offense. 20 Sec. 08.45.130. Prohibited use of title. A person may not use in connection 21 with the person's name or otherwise assume or advertise a title or description tending 22 to convey the impression that the person is a naturopath licensed under this chapter 23 unless the person is licensed under this chapter. 24 * Sec. 16. AS 08.45.200(3) is repealed and reenacted to read: 25 (3) "naturopathy" means a system of health care practiced by a 26 naturopath for the prevention, diagnosis, and treatment of human health conditions, 27 injury, and disease for the purpose of promoting or restoring health by the support and 28 stimulation of an individual's inherent self-healing processes through education of the 29 individual and the use of natural therapies, therapeutic devices and substances, and 30 other therapeutic interventions consistent with naturopathic medical training. 31 * Sec. 17. AS 08.45.200 is amended by adding new paragraphs to read:

01 (4) "accredited naturopathic medical school" means a college or 02 university and program granting a degree of doctor of naturopathy or naturopathic 03 medicine that is accredited by or is a candidate for accreditation with the Council on 04 Naturopathic Medical Education or another accrediting agency recognized by the 05 United States Department of Education; 06 (5) "naturopath" means a person licensed and authorized to practice 07 naturopathy in the state who, because of specialized education from an accredited 08 naturopathic medical school, is capable of performing acts of medical diagnosis and 09 prescription of therapeutic substances and procedures that are consistent with 10 naturopathic medical education. 11 * Sec. 18. AS 12.62.400(a) is amended by adding a new paragraph to read: 12 (21) licensure as a naturopath under AS 08.45. 13 * Sec. 19. The uncodified law of the State of Alaska is amended by adding a new section to 14 read: 15 TRANSITION: EFFECT ON CURRENT LICENSEES. On and after the effective 16 date of secs. 1 - 18 of this Act, a person who holds a valid license to practice naturopathy on 17 the effective date of secs. 1 - 18 of this Act may continue to engage in the practice of 18 naturopathy under the license until the license expires normally under AS 08.45, as AS 08.45 19 existed before the effective date of secs. 1 - 18 of this Act, but shall otherwise comply with 20 AS 08.45, as amended by secs. 1 - 18 of this Act. 21 * Sec. 20. The uncodified law of the State of Alaska is amended by adding a new section to 22 read: 23 TRANSITION: REGULATIONS. The Department of Commerce, Community, and 24 Economic Development may adopt regulations necessary to implement the changes made by 25 this Act. The regulations take effect under AS 44.62 (Administrative Procedure Act), but not 26 before the effective date of the law implemented by the regulation. 27 * Sec. 21. Section 20 of this Act takes effect immediately under AS 01.10.070(c). 28 * Sec. 22. Except as provided in sec. 21 of this Act, this Act takes effect January 1, 2022.