Legislature(2019 - 2020)BARNES 124

02/19/2020 03:15 PM LABOR & COMMERCE

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
Heard & Held
-- Testimony <Invitation Only> --
Moved CSSB 106(L&C) Out of Committee
-- Public Testimony --
Heard & Held
-- Public Testimony --
+ Bills Previously Heard/Scheduled TELECONFERENCED
            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,                                                                    
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.                                                                             

Document Name Date/Time Subjects
SB 106 LRS Report on Laws for non-renewal 2.17.2020.pdf HL&C 2/19/2020 3:15:00 PM
SB 106
HB 91 ver. K Explanation of Changes 2.18.2020.pdf HL&C 2/19/2020 3:15:00 PM
HB 91
HB 91 ver. K 2.8.2020.pdf HL&C 2/19/2020 3:15:00 PM
HB 91
HB 91 ver. K Sectional Analysis 2.18.2020.pdf HL&C 2/19/2020 3:15:00 PM
HB 91
HB 113 Fiscal Note DOA-DOP 02.14.20.pdf HL&C 2/19/2020 3:15:00 PM
HB 113
HB 113 Powerpoint The Blue Star and Gold Star Families Act 1.31.20.pdf HL&C 2/19/2020 3:15:00 PM
HL&C 2/21/2020 3:15:00 PM
HB 113
HB113 - Explanation of Changes v. S 1.31.20.pdf HL&C 2/19/2020 3:15:00 PM
HB 113
HB113 - Sectional Analisys v. S 1.31.20.pdf HL&C 2/19/2020 3:15:00 PM
HB 113
HB 113 Fiscal Note DLWFD-WH 11.19.19.pdf HL&C 2/19/2020 3:15:00 PM
HB 113
HB113 - Sponsor Statement 1.31.20.pdf HL&C 2/19/2020 3:15:00 PM
HB 113
HB113 Backup Document Top Military Spouse Challenges 1.31.20.pdf HL&C 2/19/2020 3:15:00 PM
HB 113
HB113 Supporting Document 2018 Blue Star Family Survey -Executive-Summary 1.31.20.pdf HL&C 2/19/2020 3:15:00 PM
HB 113
HB113 Reference Document Office of the US President Military Spouses 1.31.20.pdf HL&C 2/19/2020 3:15:00 PM
HB 113
HB113 Supporting Document 2018 Military Family Lifestyle Survey 1.31.20.pdf HL&C 2/19/2020 3:15:00 PM
HB 113
HB113 Supporting Document Column The Military Spouse Employment Plight 1.31.20.pdf HL&C 2/19/2020 3:15:00 PM
HB 113
Hb113 Backup Document Military Families Are Struggling to Make Ends Meet - The Atlantic 1.31.20.pdf HL&C 2/19/2020 3:15:00 PM
HB 113
HB113 Backup Document NCSL veterans' state hiring preference 1.31.20.pdf HL&C 2/19/2020 3:15:00 PM
HL&C 2/21/2020 3:15:00 PM
HB 113