Legislature(2019 - 2020)BARNES 124
02/19/2020 03:15 PM LABOR & COMMERCE
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HB 91-NATUROPATHS: LICENSING; PRACTICE 3:20:02 PM CHAIR SPOHNHOLZ announced that the first order of business would be HOUSE BILL NO. 91, "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." 3:20:19 PM REPRESENTATIVE STUTES moved to adopt the proposed committee substitute (CS) for HB 91, labeled 31-LS0608\K, Fisher, 2/8/20, as the working draft. 3:20:38 PM CHAIR SPOHNHOLZ objected for the purpose of discussion. 3:20:46 PM ERIN SHINE, Staff, Representative Jennifer Johnston, Alaska State Legislature, on behalf of Representative Johnston, prime sponsor, explained the changes to HB 91 proposed under Version K, which replaces Version M. She paraphrased from a document provided in the committee packet, entitled "House Bill 91 ver. K Explanation of Changes," which read as follows [original punctuation provided]: Section 2 Adds a five-person Naturopathy Advisory Board for the purpose of making recommendations on adoption of regulations and other department matters relating to naturopaths Sections 3-7, 10-15, 18 Adds and amends sections to provide the Department of Commerce, Community and Economic Development's Division of Corporations, Business and Professional Licensing appropriate powers and oversight of naturopathic doctors for licensing, investigations, and disciplinary actions Section 8 Adds a provision that requires naturopathic doctors to pass the Naturopathic Physicians Licensing Examination pharmacology portion to be able to prescribe allowed medications Section 10 Amends to increase the public health duties to report for naturopathic doctors to mirror the requirements for other health care providers Section 14 Adds requirement for the department to report actions on naturopathic licensees to the National Practitioner Data Bank Section 15 Adds title protection for naturopath Section 22 Updates the effective date to January 1, 2021 3:23:54 PM The committee took a brief at-ease. 3:23:59 PM REPRESENTATIVE STORY asked if Version K narrows the scope of prescriptive ability for naturopathic doctors (NDs). MS. SHINE offered her belief that it does not. She said they envisioned the same prohibitions in Version K as in the previous CS, which prohibits naturopaths from prescribing controlled substances and chemotherapeutic agents. 3:25:19 PM REPRESENTATIVE STORY, referring to Section 8 of Version K, said the addition of a provision that requires naturopathic doctors to pass an exam seems to narrow their scope of practice further. MS. SHINE noted that their prescriptive abilities remain the same; however, naturopathic doctors would have to pass the pharmacology portion of the Naturopathic Physicians Licensing Examination to be able to prescribe in Alaska. 3:25:54 PM REPRESENTATIVE STUTES directed attention to the fiscal note [identifier: HB091-DCCED-CBPL-01-16-20] and asked how it's $0 when there's an advisory board. MS. SHINE offered her understanding that the previous CS had $4,200 appropriated for adopting regulations. She explained that if Version K were to move from committee, the division director would probably update the fiscal note to reflect the costs. She noted that this wouldn't be spent from general funds because the licensing professions bear their own costs in their licensing fees. 3:26:55 PM CHAIR SPOHNHOLZ removed her objection. There being no further objection, Version K was adopted as the working draft. 3:27:55 PM SUZETTE MAILLOUX, Alaska Association of Naturopathic Physicians, provided a brief personal background. She said Alaska is missing out on many qualified, capable [naturopathic] doctors who don't want to accept the state's limited scope of practice. She pointed out that naturopaths are trained as primary care physicians and offered her belief that the limited scope of practice is a waste of their training. She reflected on her personal experience with the inability to prescribe to her patients, which forces them to see other providers - costing them more time and money. She said the reality of medicine is that prescriptions and minor office procedures are often necessary. She touted the safety record that NDs have in both Alaska and in states that allow for a full scope of practice. She reiterated that they are fully trained as physicians and want to stay in Alaska to provide safe an effective care. To conclude, she addressed opposing testimony consisting of malpractice claims that she said are unsubstantiated and were never reported to the state. 3:31:38 PM REPRESENTATIVE STORY questioned whether Ms. Mailloux took pharmacology classes that would allow her to prescribe. MS. MAILLOUX answered yes, adding that she received her training in Oregon where, had she stayed and pursued licensure, she would have the full scope of practice of a primary care physician. She further noted that the addition of Section 8 in the current CS would ensure that naturopathic doctors stay up to date with current pharmacological knowledge and training. 3:32:53 PM REPRESENTATIVE STUTES asked if there are residencies involved in a naturopath's education. MS. MAILLOUX replied that residencies are not required for naturopathic doctors, they are optional. She noted that there are not enough residency positions for NDs in the U.S., as they do not practice hospital-based medicine. 3:33:47 PM REPRESENTATIVE FIELDS sought to clarify which surgeries naturopaths would be allowed do under HB 91. He directed attention to Section 8, paragraph (3), which read as follows: perform procedures in the office using operative, electrical, or other methods, including the use of antiseptics and local anesthetics, for the surgical repair and care of superficial lacerations, abrasions, and lesions and the removal of foreign bodies located in the superficial tissues of the human body; the procedures may not include general or spinal anesthetics, major surgery, surgery of the body cavities, plastic surgery, surgery involving the eyes, or surgery involving tendons, ligaments, nerves, or blood vessels; and 3:34:27 PM MS. MAILLOUX, in response to Representative Fields, listed small biopsies, mole removals, stitches of minor cuts, and IUD [intrauterine device] placement and removal. 3:35:01 PM REPRESENTATIVE FIELDS asked how naturopaths and medical doctors differ in the dermatological training they receive. MS. MAILLOUX said it's similar; however, they differ in the variety of treatments offered, as well as the philosophy of medicine. Regarding the basic science, pathology, or assessing for illness - both are "on par." 3:35:57 PM CHAIR SPOHNHOLZ announced that HB 91 was held over.