Legislature(2017 - 2018)BARNES 124

03/09/2018 03:15 PM LABOR & COMMERCE

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Audio Topic
03:26:57 PM Start
03:28:25 PM Confirmation Hearing(s)
03:31:27 PM HB147
03:38:10 PM HB326
04:55:57 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+= HB 147 PUBLIC ACCOUNTING TELECONFERENCED
Moved SSHB 147 Out of Committee
-- Public Testimony --
+= HB 309 REJECT OFFICERS COMP. COMMISSION REPORT TELECONFERENCED
Scheduled but Not Heard
-- Public Testimony --
*+ HB 329 REAL ESTATE APPRAISAL MNGMT. COMPANIES TELECONFERENCED
<Bill Hearing Canceled>
-- Public Testimony --
+ HB 264 SHOPPING BAG FEES & RECYCLING TELECONFERENCED
Scheduled but Not Heard
-- Public Testimony --
+ Bills Previously Heard/Scheduled TELECONFERENCED
+ Confirmation Hearing - Board of Professional TELECONFERENCED
Counselors
+= HB 326 NATUROPATHS: LICENSING; PRACTICE TELECONFERENCED
Heard & Held
-- Public Testimony --
+= HB 89 LICENSE RADIOLOGIC/NUC. MED TECHNOLOGISTS TELECONFERENCED
Scheduled but Not Heard
-- Public Testimony --
                    ALASKA STATE LEGISLATURE                                                                                  
          HOUSE LABOR AND COMMERCE STANDING COMMITTEE                                                                         
                         March 9, 2018                                                                                          
                           3:26 p.m.                                                                                            
                                                                                                                                
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Sam Kito, Chair                                                                                                  
Representative Adam Wool, Vice Chair                                                                                            
Representative Andy Josephson                                                                                                   
Representative Louise Stutes                                                                                                    
Representative Chris Birch                                                                                                      
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Representative Gary Knopp                                                                                                       
Representative Colleen Sullivan-Leonard                                                                                         
Representative Mike Chenault (alternate)                                                                                        
Representative Bryce Edgmon (alternate)                                                                                         
                                                                                                                                
OTHER LEGISLATORS PRESENT                                                                                                     
                                                                                                                                
Representative Gera Tarr                                                                                                        
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
CONFIRMATION HEARING(S)                                                                                                         
                                                                                                                                
Board of Professional Counselors                                                                                              
                                                                                                                                
     Alice Baum - Anchorage                                                                                                     
                                                                                                                                
     - HEARD                                                                                                                    
                                                                                                                                
SPONSOR SUBSTITUTE FOR HOUSE BILL NO. 147                                                                                       
"An Act relating to the Board of Public Accountancy; relating to                                                                
the licensure of public accountants; and relating to the                                                                        
practice of public accounting."                                                                                                 
                                                                                                                                
     - MOVED SSHB 147 OUT OF COMMITTEE                                                                                          
                                                                                                                                
HOUSE BILL NO. 326                                                                                                              
"An Act relating to the  practice of naturopathy; relating to the                                                               
licensure  of   naturopaths;  relating   to  the   Department  of                                                               
Commerce, Community, and Economic  Development; and providing for                                                               
an effective date."                                                                                                             
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
HOUSE BILL NO. 309                                                                                                              
"An Act  disapproving all recommendations  of the  State Officers                                                               
Compensation Commission  relating to the  compensation, benefits,                                                               
and allowances of state officers;  and providing for an effective                                                               
date."                                                                                                                          
                                                                                                                                
     - SCHEDULED BUT NOT HEARD                                                                                                  
                                                                                                                                
HOUSE BILL NO. 329                                                                                                              
"An  Act relating  to  the registration  and  regulation of  real                                                               
estate   appraisal   management   companies;  relating   to   the                                                               
establishment of  fees by the Department  of Commerce, Community,                                                               
and  Economic Development;  relating  to the  Board of  Certified                                                               
Real Estate  Appraisers; relating to real  estate appraisers; and                                                               
providing for an effective date."                                                                                               
                                                                                                                                
     - BILL HEARING CANCELED                                                                                                    
                                                                                                                                
HOUSE BILL NO. 264                                                                                                              
"An Act relating to a  fee for disposable shopping bags; relating                                                               
to the sale of reusable  shopping bags; relating to the recycling                                                               
of  disposable  shopping bags;  and  providing  for an  effective                                                               
date."                                                                                                                          
                                                                                                                                
     - SCHEDULED BUT NOT HEARD                                                                                                  
                                                                                                                                
HOUSE BILL NO. 89                                                                                                               
"An   Act  requiring   licensure  of   occupations  relating   to                                                               
radiologic  technology, radiation  therapy, and  nuclear medicine                                                               
technology; and providing for an effective date."                                                                               
                                                                                                                                
     - SCHEDULED BUT NOT HEARD                                                                                                  
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: HB 147                                                                                                                  
SHORT TITLE: PUBLIC ACCOUNTING                                                                                                  
SPONSOR(s): REPRESENTATIVE(s) THOMPSON                                                                                          
                                                                                                                                
03/01/17       (H)       READ THE FIRST TIME - REFERRALS                                                                        
03/01/17       (H)       L&C                                                                                                    
02/02/18       (H)       SPONSOR SUBSTITUTE INTRODUCED                                                                          
02/02/18       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/02/18       (H)       L&C                                                                                                    
02/26/18       (H)       L&C AT 3:15 PM BARNES 124                                                                              
02/26/18       (H)       Heard & Held                                                                                           
02/26/18       (H)       MINUTE(L&C)                                                                                            
03/09/18       (H)       L&C AT 3:15 PM BARNES 124                                                                              
                                                                                                                                
BILL: HB 326                                                                                                                  
SHORT TITLE: NATUROPATHS: LICENSING; PRACTICE                                                                                   
SPONSOR(s): REPRESENTATIVE(s) TARR                                                                                              
                                                                                                                                
02/02/18       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/02/18       (H)       L&C, FIN                                                                                               
03/07/18       (H)       L&C AT 3:15 PM BARNES 124                                                                              
03/07/18       (H)       Scheduled but Not Heard                                                                                
03/09/18       (H)       L&C AT 3:15 PM BARNES 124                                                                              
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
ALICE BAUM, Licensed Professional Counselor                                                                                     
Office of the Governor                                                                                                          
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified as an appointee to the Board of                                                                
Professional Counselors.                                                                                                        
                                                                                                                                
LYNETTE BERGH, Staff                                                                                                            
Representative Steve Thompson                                                                                                   
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented HB 147 on behalf of                                                                            
Representative Thompson, prime sponsor.                                                                                         
                                                                                                                                
KAREN TARVER, Member                                                                                                            
Alaska State Board of Public Accountancy                                                                                        
Office of the Governor                                                                                                          
POSITION STATEMENT:  Answered questions in the hearing on HB                                                                  
147.                                                                                                                            
                                                                                                                                
REPRESENTATIVE GERAN TARR                                                                                                       
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented HB 326 as prime sponsor.                                                                       
                                                                                                                                
ABBY LAING, President                                                                                                           
Alaska Association of Naturopathic Physicians                                                                                   
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in the hearing on HB 326.                                                                      
                                                                                                                                
MELINDA RATHKOPF, Medical Doctor                                                                                                
Board of Alaska Medical Association                                                                                             
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to HB 326.                                                                       
                                                                                                                                
SARA CHAMBERS, Division Operations Manager                                                                                      
Division of Corporations, Business, and Professional Licensing                                                                  
Department of Commerce, Community, & Economic Development                                                                       
(DCCED)                                                                                                                         
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Answered questions in the hearing on HB                                                                  
326.                                                                                                                            
                                                                                                                                
KAILA BUERGER                                                                                                                   
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of HB 326.                                                                          
                                                                                                                                
CLYDE JENSEN, PhD                                                                                                               
National University of Natural Medicine                                                                                         
Portland, Oregon                                                                                                                
POSITION STATEMENT:  Testified in the hearing on HB 326.                                                                      
                                                                                                                                
SCOTT LUPER, Director, Medical Director                                                                                         
Alaska Center for Natural Medicine                                                                                              
Fairbanks, Alaska                                                                                                               
POSITION STATEMENT:  Testified in the hearing on HB 326.                                                                      
                                                                                                                                
JODY OAKES                                                                                                                      
Chugiak, Alaska                                                                                                                 
POSITION STATEMENT:  Testified in support of HB 326.                                                                          
                                                                                                                                
BARON GLASSGOW, Executive Director                                                                                              
Arizona Naturopathic Medical Association                                                                                        
Scottsdale, Arizona                                                                                                             
POSITION STATEMENT:  Testified in the hearing on HB 326.                                                                      
                                                                                                                                
ANNETTE O'CONNELL                                                                                                               
Kenai, Alaska                                                                                                                   
POSITION STATEMENT:  Testified in support of HB 326.                                                                          
                                                                                                                                
ROB DOWNEY, MD                                                                                                                  
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in the hearing on HB 326.                                                                      
                                                                                                                                
ALAN GROSS, MD                                                                                                                  
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 326.                                                                          
                                                                                                                                
GARY FERGUSON                                                                                                                   
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 326.                                                                          
                                                                                                                                
STEVE GEDDES                                                                                                                    
Wasilla, Alaska                                                                                                                 
POSITION STATEMENT:  Testified in the hearing on HB 326.                                                                      
                                                                                                                                
DAVID SCHLEICH, PhD, President                                                                                                  
National University                                                                                                             
Portland, Oregon                                                                                                                
POSITION STATEMENT:  Testified in support of HB 326.                                                                          
                                                                                                                                
JENNIFER YOUNG                                                                                                                  
Eagle River, Alaska                                                                                                             
POSITION STATEMENT:  Testified in support of HB 326.                                                                          
                                                                                                                                
DANIEL YOUNG                                                                                                                    
Naturopathic Doctor                                                                                                             
Eagle River, Alaska                                                                                                             
POSITION STATEMENT:  Testified in support of HB 326.                                                                          
                                                                                                                                
MICHAEL DANZ                                                                                                                    
Palmer, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of HB 326.                                                                          
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
3:26:57 PM                                                                                                                    
                                                                                                                                
CHAIR  SAM KITO  called  the House  Labor  and Commerce  Standing                                                             
Committee meeting  to order at 3:26  p.m. Representatives Stutes,                                                               
Birch,  Josephson, Wool,  and Kito  were present  at the  call to                                                               
order.  Representatives Knopp and Sullivan-Leonard were excused.                                                                
                                                                                                                                
^Confirmation Hearing(s)                                                                                                        
                                                                                                                                
                    CONFIRMATION HEARING(S):                                                                                
           Board of Licensed Professional Counselors                                                                        
                                                                                                                              
3:28:25 PM                                                                                                                    
                                                                                                                                
CHAIR KITO announced that the first order of business would be                                                                  
confirmation hearing(s).                                                                                                        
                                                                                                                                
3:28:38 PM                                                                                                                    
                                                                                                                                
ALICE  BAUM, Licensed  Professional  Counselor,  testified as  an                                                               
appointee to the Board of Professional Counselors.                                                                              
                                                                                                                                
CHAIR   KITO  remarked   that  Ms.   Baum   had  many   religious                                                               
affiliations in her  resume and asked whether she  would have any                                                               
difficulty approving any  candidate who held any  past or current                                                               
affiliation with Planned Parenthood.                                                                                            
                                                                                                                                
MS. BAUM answered  she would not. She said she  is a professional                                                               
councilor  who has  worked  with many  people  who hold  opposing                                                               
views.                                                                                                                          
                                                                                                                                
CHAIR KITO  asked for confirmation  that Ms. Baum was  a licensed                                                               
counselor.                                                                                                                      
                                                                                                                                
MS. BAUM  answered in  the affirmative.   She said  she currently                                                               
works at Southcentral Foundation                                                                                                
                                                                                                                                
CHAIR KITO  shared his  understanding that  the public  member of                                                               
the board could not be a professional counselor with the board.                                                                 
                                                                                                                                
MS. BAUM answered she was not aware of that.                                                                                    
                                                                                                                                
CHAIR KITO said he would bring it up with the governor's office.                                                                
                                                                                                                                
[The  following name  was forwarded  to  a joint  session of  the                                                               
joint House  of Representatives and  the Senate on  4/9/18: Board                                                               
of Professional Counselors, Alice Baum.]                                                                                        
                                                                                                                                
                    HB 147-PUBLIC ACCOUNTING                                                                                
                                                                                                                                
3:31:27 PM                                                                                                                    
                                                                                                                                
CHAIR KITO  announced that  the next order  of business  would be                                                               
HOUSE  BILL NO.  147, "An  Act relating  to the  Board of  Public                                                               
Accountancy;  relating to  the licensure  of public  accountants;                                                               
and relating to the practice of public accounting."                                                                             
                                                                                                                                
3:31:40 PM                                                                                                                    
                                                                                                                                
LYNETTE  BERGH,  Staff,  Representative  Steve  Thompson,  Alaska                                                               
State Legislature,  presented HB 147 on  behalf of Representative                                                               
Thompson,  prime  sponsor.   She  gave  a  brief summary  of  the                                                               
proposed bill.   She said  HB 147 would amend board of accounting                                                               
statutes  by  updating  the  statutes  to  reflect  the  national                                                               
standards  of  the  Uniform  Accountancy  Act  and  the  American                                                               
Institute of  Certified Public  Accountancy Code  of professional                                                               
conduct.   She  said that  by incorporating  the changes,  Alaska                                                               
would be more  in line with national standards  which ensure that                                                               
only qualified persons are practicing.                                                                                          
                                                                                                                                
3:32:43 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  BIRCH said  he appreciates  that the  state would                                                               
"not  be killing  as many  trees" by  having the  regulations and                                                               
forms available online.                                                                                                         
                                                                                                                                
3:33:39 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   JOSEPHSON  asked   about   changes  to   license                                                               
reciprocity.                                                                                                                    
                                                                                                                                
MS. BERGH deferred to the board.                                                                                                
                                                                                                                                
3:34:30 PM                                                                                                                    
                                                                                                                                
KAREN TARVER,  Member, Alaska State Board  of Public Accountancy,                                                               
answered questions in  the hearing on HB 147.   She explained the                                                               
change would  reduce the number  of years of  experience required                                                               
from  four  years  to  two  years so  that  the  two  methods  of                                                               
licensure are consistent.                                                                                                       
                                                                                                                                
3:35:20 PM                                                                                                                    
                                                                                                                                
CHAIR KITO  announced that public  testimony on HB 147  was still                                                               
open from a  previous hearing.  Upon ascertaining  that there was                                                               
no one available to testify, he closed public testimony.                                                                        
                                                                                                                                
3:35:52 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE WOOL moved to report  HB 147 out of committee with                                                               
individual  recommendations and  the  accompanying fiscal  notes.                                                               
There being no objection, it was so ordered.                                                                                    
                                                                                                                                
3:36:16 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 3:36 p.m. to 3:37 p.m.                                                                       
                                                                                                                                
3:37:57 PM                                                                                                                    
                                                                                                                                
            HB 326-NATUROPATHS: LICENSING; PRACTICE                                                                         
                                                                                                                                
CHAIR KITO  announced that  the next order  of business  would be                                                               
HOUSE  BILL  NO.  326,  "An  Act  relating  to  the  practice  of                                                               
naturopathy; relating  to the licensure of  naturopaths; relating                                                               
to   the  Department   of  Commerce,   Community,  and   Economic                                                               
Development; and providing for an effective date."                                                                              
                                                                                                                                
3:38:10 PM                                                                                                                    
                                                                                                                                
The committee took a brief at ease from 3:38 p.m. to 3:38 p.m.                                                                  
                                                                                                                                
3:38:56 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  GERAN TARR,  Alaska State  Legislature, presented                                                               
HB 326 as  prime sponsor.  She explained the  proposed bill would                                                               
outline a clear scope of practice for naturopaths across Alaska.                                                                
                                                                                                                                
3:39:43 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 3:39 p.m. to 3:40 p.m.                                                                       
                                                                                                                                
3:40:55 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  TARR  said  the  proposed  bill  addresses  three                                                               
issues: access,  cost, and allowing professionals  to practice at                                                               
the  whole scoped  of  their  training.   She  indicated slide  1                                                               
showed a map of healthcare costs around America.                                                                                
                                                                                                                                
3:41:55 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR  moved to  slide 2,  "Restrictive Regulations                                                               
Create  a  Significant  Gap  Between  Naturopathic  Training  and                                                               
Allowed Scope":                                                                                                                 
                                                                                                                                
        • Shortage of primary care remains in Alaska                                                                            
          despite the presence of NDs trained to provide it                                                                     
        • NDs qualify for Indian Health Service's national                                                                      
          loan   repayment  program   aimed  at   increasing                                                                    
          healthcare  access  in   remote  Alaska,  but  are                                                                    
          unable  to make  use of  this program  due to  the                                                                    
          limited scope of practice.                                                                                            
        • This decreases competition, drives up costs and                                                                       
          limits access for healthcare consumers                                                                                
                                                                                                                                
3:43:29 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR moved to slide 3, "Solution: Allow                                                                          
Naturopaths to Practice What They are Educated to Do":                                                                          
                                                                                                                                
        • Immediately enables dozens of  new primary  care                                                                      
          providers (~57)                                                                                                       
        • This scope is  being practiced  safely  in  many                                                                      
          other states                                                                                                          
                                                                                                                                
3:44:01 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR spoke to slide 4, "What Are Naturopathic                                                                    
Doctors (NDs)?"                                                                                                                 
                                                                                                                                
        • Training to provide evidence-based primary care,                                                                      
          with a patient-centered focus that prioritizes                                                                        
          disease prevention over symptom management and                                                                        
          drug therapies                                                                                                        
        • Emphasis on longer office visits (~60-90 min.)                                                                        
        • This approach tends to reduce need for healthcare                                                                     
          utilization, as well as long-term costs                                                                               
                                                                                                                                
3:45:16 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR spoke to slide 5, "Education":                                                                              
                                                                                                                                
     4-Year Accredited Medical School Program                                                                                   
        • 2 Years of  basic  sciences;  2  years  clinical                                                                      
          sciences and treatment methods                                                                                        
        • Regulated by the Council of Naturopathic Medical                                                                      
          Education, which is overseen by the US Department                                                                     
          of Education - same as other medical schools                                                                          
        • NDs must   pass    the   two-part   Naturopathic                                                                      
          Physicians Licensing Examinations (NPLEX), before                                                                     
          being licensed to practice                                                                                            
                                                                                                                                
                                                                                                                                
3:46:57 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR addressed slide 6, "ND Therapeutic Order                                                                    
Progresses From Minimal to Higher Levels of Intervention as                                                                     
Necessary":                                                                                                                     
                                                                                                                                
        • Clinical Nutrition / Diet                                                                                             
        • Counseling / Behavior Change                                                                                          
        • Hydrotherapy & Others                                                                                                 
        • Herbal Medicine                                                                                                       
        • Physical Manipulation                                                                                                 
        • Pharmaceuticals (Not allowed in AK)                                                                                   
        • Minor Surgery (Not allowed in AK)                                                                                     
                                                                                                                                
                                                                                                                                
3:47:28 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR moved to slide 7, "HB 326: Key Provisions":                                                                 
                                                                                                                                
          HB 326 defines a clear scope of practice for                                                                          
     naturopathic doctors which                                                                                                 
     reflects their education and training                                                                                      
        • Cleans up outdated language                                                                                           
        • Allows NDs to  perform minor  office  procedures                                                                      
          (minor surgeries)                                                                                                     
        • Allows issuance of vitamins, minerals  and other                                                                      
          non-controlled substance prescription medications                                                                     
        • Requires 24 hours of continuing education every 2                                                                     
          years                                                                                                                 
                                                                                                                                
3:48:55 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR spoke to slide 8, "Key Provision: "Minor                                                                    
Office Procedures":                                                                                                             
                                                                                                                                
        • Allows repair of superficial lacerations  & skin                                                                      
          biopsies (e.g. stitches, wart removal, punch                                                                          
          biopsies)                                                                                                             
        • Does NOT include any sort of major,  internal or                                                                      
          plastic surgery, or those involving the eyes,                                                                         
          tendons, ligaments, nerves, or blood vessels                                                                          
        • NDs complete an avg. of 100 hour of  training in                                                                      
          this area                                                                                                             
        • Being practiced safely in many other states                                                                           
                                                                                                                                
3:49:41 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR addressed slide 9, "Key Provision:                                                                          
Prescriptive Authority":                                                                                                        
                                                                                                                                
        • Applies  only   to    Non-Controlled   Substance                                                                      
         medications (excluding Testosterone & Ambien)                                                                          
        • Alaska already allows prescriptive authority for                                                                      
          other healthcare providers with equal or lesser                                                                       
          pharmacological training                                                                                              
        • This is being practiced safely in in many other                                                                       
          states                                                                                                                
                                                                                                                                
3:51:10 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE WOOL  asked for clarification regarding  the color                                                               
code on slide 9.  He asked what the grey represents.                                                                            
                                                                                                                                
REPRESENTATIVE TARR answered that she  did not have an answer and                                                               
would have to get back to him.                                                                                                  
                                                                                                                                
3:51:46 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  TARR moved  on to  slide 10,  "HB 326  offers one                                                               
clear,  safe  and  tangible step  towards  better  healthcare  in                                                               
Alaska":                                                                                                                        
                                                                                                                                
        • Increases competition and drives down healthcare                                                                      
          costs                                                                                                                 
        • Improves healthcare access                                                                                            
        • Provides clear guidance to state regulators                                                                           
        • Allows healthcare professionals to do what they                                                                       
          are educated to do                                                                                                    
                                                                                                                                
3:53:05 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  TARR  pointed  out  the  relative  comparison  to                                                               
letters of support  and one letter of opposition.   She added the                                                               
answer   to   the  map   question   was   that  grey   represents                                                               
"unlicensed."                                                                                                                   
                                                                                                                                
3:54:09 PM                                                                                                                    
                                                                                                                                
ABBY  LAING,   President,  Alaska  Association   of  Naturopathic                                                               
Physicians,  testified  in the  hearing  on  HB  326.   She  said                                                               
naturopathic doctors  (NDs) want  to provide the  best healthcare                                                               
possible.   She said Alaska  has highly  restrictive regulations.                                                               
She said the proposed bill  would drive down healthcare costs and                                                               
would allow greater freedom to  better access to healthcare.  She                                                               
added  the  proposed bill  is  straightforward  and would  remove                                                               
outdated language.                                                                                                              
                                                                                                                                
3:57:43 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOSEPHSON asked  whether the  grey states  on the                                                               
map are unregulated.                                                                                                            
                                                                                                                                
MS. LAING answered in the affirmative.                                                                                          
                                                                                                                                
CHAIR  KITO mentioned  one  of the  provisions  was proposing  to                                                               
change the prescription authority of NDs.   He pointed out one of                                                               
the items being  removed from prohibition is a poison.   He asked                                                               
whether the request was for the ability to prescribe poisons.                                                                   
                                                                                                                                
MS. LAING  answered the  aim is  to clear  up some  language. She                                                               
emphasized there is no intention or desire to prescribe poison.                                                                 
                                                                                                                                
3:59:20 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE WOOL asked  whether the grey states on  the map do                                                               
not have naturopaths.                                                                                                           
                                                                                                                                
MS. LAING  deferred to Dr.  David Schleich.   She said  that some                                                               
states do not  have naturopaths, and in some states  NDs are just                                                               
not regulated.                                                                                                                  
                                                                                                                                
4:01:05 PM                                                                                                                    
                                                                                                                                
MELINDA  RATHKOPF,  Medical  Doctor,   Board  of  Alaska  Medical                                                               
Association,  testified in  opposition  to HB  326.   She  talked                                                               
about  her experience  in medical  school.   She stated  it's not                                                               
uncommon  to do  additional  testing on  patients  who come  from                                                               
naturopathic  care  providers.    She addressed  the  claim  that                                                               
naturopaths  can   help  bring   down  healthcare  costs.     She                                                               
underlined that for some patients  it drives up healthcare costs.                                                               
She further  addressed the question  of access to  the controlled                                                               
substances  database should  prescription privileges  be granted.                                                               
She  shared her  concerns about  preventative health.   She  said                                                               
that traditionally, NDs haven't  embraced vaccination.  She spoke                                                               
to a  2009 study stating  children are significantly  less likely                                                               
to be vaccinated against preventable  diseases if they are in the                                                               
care  of  a naturopath.    Alaska  is  still below  the  national                                                               
average in  childhood immunization,  and she  said she  is afraid                                                               
that  with  more  naturopaths practicing,  there  will  be  fewer                                                               
children  with  vaccinations. She  relayed  her  experience as  a                                                               
general  pediatrician  and  stated  it  would  be  impossible  to                                                               
maintain 90-minute  appointment times.   She shared  her concerns                                                               
about  training.    She  said   family  practice  physicians  get                                                               
anywhere from 9,000 to 10,000  hours of residency training, where                                                               
naturopaths  generally get  under 1,00  hours of  training, which                                                               
she said  is often optional.   She  added she has  concerns about                                                               
oversight.  She queried who  would monitor patient care issues to                                                               
ensure patient safety.                                                                                                          
                                                                                                                                
4:05:46 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE JOSEPHSON stated HB  426 says that the naturopaths                                                               
are not  seeking to  prescribe controlled  substances.   He asked                                                               
whether she  was suggesting there  was a  way around that  in the                                                               
proposed bill.                                                                                                                  
                                                                                                                                
DR.  RATHKOPF  stated  naturopaths  were asking  to  be  able  to                                                               
prescribe  testosterone  and zolpidem.    She  underlined if  she                                                               
wanted  to  prescribe  similar  substances,  she  would  have  to                                                               
consult the controlled substances database before prescribing.                                                                  
                                                                                                                                
4:06:46 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOSEPHSON  asked  whether  zolpidem  is  a  sleep                                                               
sedative.                                                                                                                       
                                                                                                                                
DR. RATHKOPF answered in the affirmative.   She said Ambien was a                                                               
common name for it.                                                                                                             
                                                                                                                                
4:07:00 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE JOSEPHSON  declared he believes that  young people                                                               
need  vaccinations.   He asked  Dr.  Rathkopf whether  it is  the                                                               
culture of naturopathy to "frown on" immunization.                                                                              
                                                                                                                                
DR. RATHKOPF  said she is not  the best person to  answer what is                                                               
taught in  a naturopathic school.   She  said she does  find that                                                               
the patient population that goes  to naturopaths seems to be less                                                               
likely to be immunized.                                                                                                         
                                                                                                                                
4:08:16 PM                                                                                                                    
                                                                                                                                
MS. LAING said it is a  paradox because naturopaths are unable to                                                               
provide vaccines.   She added it  is standard of care  to provide                                                               
US Centers  for Disease Control  and Prevention  (CDC) guidelines                                                               
for vaccines to patients.                                                                                                       
                                                                                                                                
4:09:23 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  WOOL  asked  Dr. Rathkopf  whether  she  supports                                                               
nurse practitioners having prescriptive powers.                                                                                 
                                                                                                                                
DR. RATHKOPF answered  she has been in Alaska for  12 years.  She                                                               
said she  was trained  in states  where nurse  practitioners were                                                               
not  allowed prescriptive  powers.   She added  a rebuttal  to an                                                               
early  statement.   She  spoke  to a  study  in Washington  state                                                               
regarding child immunization by  naturopaths.  She specified that                                                               
in   that  state,   naturopaths   were   allowed  to   administer                                                               
vaccinations  and the  statistics still  showed low  immunization                                                               
rates.                                                                                                                          
                                                                                                                                
4:11:00 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  WOOL asked  whether Dr.  Rathkopf supports  nurse                                                               
practitioners  having prescriptive  powers now  that they  are in                                                               
place.                                                                                                                          
                                                                                                                                
DR.   RATHKOPF  answered   she  works   with  a   lot  of   nurse                                                               
practitioners   and   she  has   not   had   issues  with   nurse                                                               
practitioners.   She added  most are  trained in  similar medical                                                               
backgrounds and philosophies as allopathic doctors.                                                                             
                                                                                                                                
4:12:37 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOSEPHSON  mentioned  his father  represents  the                                                               
naturopaths  on the  issue of  the scope  of their  license.   He                                                               
asked Ms.  Chambers whether there  is anything in the  request in                                                               
the  legislation that  seems outside  the scope  of practice  for                                                               
states that allow more robust forms of naturopathy.                                                                             
                                                                                                                                
4:12:50 PM                                                                                                                    
                                                                                                                                
SARA   CHAMBERS,  Division   Operations   Manager,  Division   of                                                               
Corporations,  Business, and  Professional Licensing,  Department                                                               
of Commerce, Community, &  Economic Development (DCCED), answered                                                               
questions  in the  hearing  on HB  326.   She  answered the  only                                                               
primary   area  the   department   is  concerned   with  is   the                                                               
administration   of  testosterone,   a   schedule  3,   federally                                                               
scheduled  drug  product.    She  indicated  the  department  has                                                               
requested some changes to the proposed bill.                                                                                    
                                                                                                                                
REPRESENTATIVE WOOL asked how long  Alaska has been a state which                                                               
licenses NDs.                                                                                                                   
                                                                                                                                
MS. CHAMBERS said she would confirm that the answer is 1986.                                                                    
                                                                                                                                
4:15:23 PM                                                                                                                    
                                                                                                                                
CHAIR KITO opened public testimony on HB 326.                                                                                   
                                                                                                                                
4:15:45 PM                                                                                                                    
                                                                                                                                
KAILA BUERGER testified  in support of HB 326.   She said that HB                                                               
326  would allow  NDs to  practice their  extensive knowledge  by                                                               
issuing   vitamins,   minerals,  and   non-controlled   substance                                                               
prescription  medication,  as  well as  performing  minor  office                                                               
procedures.  She  spoke to treating the root of  the issue versus                                                               
the symptoms.   She said it was time all  doctors took a holistic                                                               
approach,  rather   than  handing  out  prescription   drugs  and                                                               
antibiotics.  She shared some  personal experience with NDs.  She                                                               
gave some statistics regarding diabetes.                                                                                        
                                                                                                                                
4:25:29 PM                                                                                                                    
                                                                                                                                
CLYDE  JENSEN,  PhD,  National University  of  Natural  Medicine,                                                               
testified in the  hearing on HB 326.  He  gave his qualifications                                                               
and  background  in  teaching   pharmacology.    He  opined  that                                                               
naturopaths  are well  trained at  professional degree  level and                                                               
said he sees no reason they  should be as restricted as they have                                                               
been in Alaska.                                                                                                                 
                                                                                                                                
4:27:07 PM                                                                                                                    
                                                                                                                                
SCOTT  LUPER,   Medical  Director,  Alaska  Center   for  Natural                                                               
Medicine, testified in  the hearing on HB 326.   He described his                                                               
practice and  underlined that he  is the father of  five children                                                               
who are all vaccinated.                                                                                                         
                                                                                                                                
4:28:33 PM                                                                                                                    
                                                                                                                                
JODY  OAKES  testified in  support  of  HB  326.   She  shared  a                                                               
personal story of  migraines and how an ND helped  her manage her                                                               
pain.  She said she feels safe in the care of her ND.                                                                           
                                                                                                                                
4:30:21 PM                                                                                                                    
                                                                                                                                
BARON GLASSGOW, Executive  Director, Arizona Naturopathic Medical                                                               
Association, testified  in the hearing  on HB  326.  He  gave the                                                               
history  of the  Arizona  Naturopathic Medical  Association.   He                                                               
said naturopathic doctors in Arizona  are considered primary care                                                               
providers.  He  added they complete pediatric course  work on how                                                               
and when to  administer vaccinations.  He stated  NDs can perform                                                               
vaccinations in the state of Arizona.                                                                                           
                                                                                                                                
4:32:03 PM                                                                                                                    
                                                                                                                                
ANNETTE O'CONNELL  testified in  support of HB  326.   She shared                                                               
she  was diagnosed  with  celiac  disease as  a  young woman  and                                                               
compared  the  treatment  she  received  from  a  medical  and  a                                                               
naturopathic doctor.   She said she  is forced to go out of state                                                               
to get her care.                                                                                                                
                                                                                                                                
4:34:08 PM                                                                                                                    
                                                                                                                                
ROB DOWNEY,  MD, testified in the  hearing on HB 326.   He shared                                                               
his  qualifications  and  background.   He  said  he  has  shared                                                               
patients with NDs in trauma and  mental health. He said he thinks                                                               
the minor  surgical procedures requested  in the  legislation are                                                               
extremely safe and limited and will help Alaskans.                                                                              
                                                                                                                                
4:36:41 PM                                                                                                                    
                                                                                                                                
ALAN  GROSS, MD,  testified in  support of  HB 326.   He  said he                                                               
believes the  regulatory interpretations  on naturopaths  are too                                                               
restrictive.    He  opined  naturopaths  coming  from  accredited                                                               
facilities  should be  allowed to  perform  minor procedures  and                                                               
prescribed   non-controlled  substances.     He   spoke  to   his                                                               
experience working with  naturopaths.  He said  the proposed bill                                                               
would lower the cost of healthcare in the state.                                                                                
                                                                                                                                
4:38:26 PM                                                                                                                    
                                                                                                                                
GARY FERGUSON testified in support of  HB 326. He shared he works                                                               
primarily in  public health with  Alaska Native communities.   He                                                               
said naturopaths help reduce the medicines that elders are on.                                                                  
                                                                                                                                
4:40:54 PM                                                                                                                    
                                                                                                                                
STEVE GEDDES testified  in the hearing on HB 326.   He shared his                                                               
personal experience  with naturopathic care.   He said  he thinks                                                               
it is reasonable for naturopaths to treat health conditions.                                                                    
                                                                                                                                
4:43:26 PM                                                                                                                    
                                                                                                                                
DAVID  SCHLEICH, PhD,  President, National  University, testified                                                               
in  support of  HB  326.   He  said  National  University is  the                                                               
longest-standing accredited  university of  naturopathic medicine                                                               
in  the   United  States.     He  gave  his   qualifications  and                                                               
background.   He   highlighted    that   the   accreditation   of                                                               
naturopathic  programs is  "exactly  consistent with"  allopathic                                                               
programs and the  accrediting bodies come from  the Department of                                                               
Education. He  spoke to  the concern  about residencies.  He said                                                               
naturopathy  students  are  prevented from  access  to  residency                                                               
match by  federal practice.    He commented on immunization.   He                                                               
said the  program at his organization  has extensive immunization                                                               
training,  meeting  all requirements  in  those  states in  which                                                               
vaccination  is  approved.   He  stated  in  Oregon  naturopathic                                                               
doctors are  considered primary care  providers.  He  stated that                                                               
the comment  regarding 1,000 hours  of naturopathic  residency is                                                               
not accurate.                                                                                                                   
                                                                                                                                
4:48:59 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   JOSEPHSON    referred   to   a    comment   that                                                               
"there is  lots of teaching  about immunology," that did  not say                                                               
what is taught.                                                                                                                 
                                                                                                                                
DR. SCHLEICH  answered what is taught  is the same thing  that is                                                               
taught in  standard allopathic  medical schools.   He  added that                                                               
the  prerequisites   for  entering  his  program   are  virtually                                                               
identical to those for medical schools.                                                                                         
                                                                                                                                
4:50:20 PM                                                                                                                    
                                                                                                                                
JENNIFER YOUNG shared  that she is a cardiac nurse,  married to a                                                               
naturopathic doctor. She said she  comes across many patients who                                                               
want to be  treated naturally.  She referred to  a comment by Dr.                                                               
Rathkopf  regarding  immunization.    She  opined  it  is  not  a                                                               
reflection of  the naturopathic doctors,  but that  people choose                                                               
for themselves not to be immunized.                                                                                             
                                                                                                                                
4:52:37 PM                                                                                                                    
                                                                                                                                
DANIEL  YOUNG, Naturopathic  Doctor, testified  in support  of HB                                                               
326.   He stated  he has practiced  naturopathic medicine  for 26                                                               
years. He  said naturopathic providers are  trained in ambulatory                                                               
care.  He stated  he had  been in  practice with  another medical                                                               
doctor.    He said he  thinks naturopathic doctors should  all be                                                               
able to practice  how they are trained and  communicate with each                                                               
other.  He underlined the patient is the primary importance.                                                                    
                                                                                                                                
4:55:09 PM                                                                                                                    
                                                                                                                                
MICHAEL DANZ testified  in support of HB 326.   He said he thinks                                                               
NDs should  be allowed to  give the type  of care they  have been                                                               
restricted from [administering].                                                                                                
                                                                                                                                
[CHAIR KITO held over HB 326.]                                                                                                  
                                                                                                                                
4:55:57 PM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no further business before the committee, the House                                                                 
Labor and Commerce Standing Committee meeting was adjourned at                                                                  
4:55 p.m.                                                                                                                       

Document Name Date/Time Subjects
HB147 Summary of Changes ver A to ver J 2.13.18.pdf HL&C 3/9/2018 3:15:00 PM
HB 147
HB147 Sponsor Statement ver J 2.5.18.pdf HL&C 3/9/2018 3:15:00 PM
HB 147
HB147 Sectional Analysis ver J 2.13.18.pdf HL&C 3/9/2018 3:15:00 PM
HB 147
HB147 version A.pdf HL&C 3/9/2018 3:15:00 PM
HB 147
HB147 version J.pdf HL&C 3/9/2018 3:15:00 PM
HB 147
HB147 Fiscal Note DCCED-CBPL 2.22.18.pdf HL&C 3/9/2018 3:15:00 PM
HB 147
HB147 Letters of Support 2.13.18.pdf HL&C 3/9/2018 3:15:00 PM
HB 147
HB326 Letters of Support 3.10.18.pdf HL&C 3/9/2018 3:15:00 PM
HB 326
HB326 Letters of Opposition 3.10.18.pdf HL&C 3/9/2018 3:15:00 PM
HB 326