Legislature(2007 - 2008)BUTROVICH 205

03/19/2008 01:45 PM Senate HEALTH, EDUCATION & SOCIAL SERVICES


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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
-- Time Change --
+= SB 206 CHILDREN'S TRUST GRANT FOR ENDOWMENT TELECONFERENCED
Heard & Held
+= SB 210 APPROP: ALASKA COMMUNITY FOUNDATION TELECONFERENCED
Scheduled But Not Heard
+ Bills Previously Heard/Scheduled TELECONFERENCED
+= SB 107 NATUROPATHS TELECONFERENCED
Moved CSSB 107(HES) Out of Committee
+= SJR 18 CHILD PRODUCT SAFETY TELECONFERENCED
Moved SJR 18 Out of Committee
                       SB 107-NATUROPATHS                                                                                   
                                                                                                                                
CHAIR DAVIS announced the consideration  of SB 107. She asked Mr.                                                               
Obermeyer to explain the changes in the proposed CS.                                                                            
                                                                                                                                
2:13:10 PM                                                                                                                    
TOM OBERMEYER,  Staff to  Chair Davis,  presented an  overview of                                                               
CSSB  107, labeled  25-LS0702,  Version \L,  an  Act relating  to                                                               
naturopaths and  to the practice of  naturopathy, establishing an                                                               
Alaska Naturopathic  Board and providing for  an effective date.{                                                               
He pointed out  that the first section of the  bill identified an                                                               
addition to the boards under Title  08. Title 08.45, page 2, line                                                               
10  included  the  Alaska  Naturopathic  Board.  A  new  section,                                                               
08.45.003, Section 3, created the board consisting of:                                                                          
     seven members appointed by  the Governor. Three members                                                                    
     shall be  naturopaths licensed  under this  chapter who                                                                    
     have  been  engaged  in the  practice  of  naturopathic                                                                    
     medicine  in   the  state  for  at   least  five  years                                                                    
     immediately  preceding  appointment,  at least  one  of                                                                    
     whom  lives outside  the third  judicial district.  One                                                                    
     member  shall  be  a licensed  pharmacist.  One  member                                                                    
     shall  be  licensed  physician. Two  members  shall  be                                                                    
     public members who, in  addition to limitations imposed                                                                    
     under  AS 08.01.025,  may not  have a  direct financial                                                                    
     interest in  the health care  industry other than  as a                                                                    
     consumer of health care services.                                                                                          
                                                                                                                                
MR.  OBERMEYER  noted that  this  board  was designated  in  that                                                               
section with  a chair and  a secretary who would  serve staggered                                                               
terms  of 3  years unless  removed for  cause; 4  members of  the                                                               
board would constitute  a quorum for transaction  of all business                                                               
before   the  board.   The  Governor   "may"  consider   licensed                                                               
naturopaths  who  had  been  nominated   by  the  Association  of                                                               
Naturopathic Physicians.                                                                                                        
                                                                                                                                
On page  3, under 08.45.005  Duties of the  board, it goes  on to                                                               
say:                                                                                                                            
     The board shall                                                                                                            
     (1) establish a list of prescription drugs and                                                                             
          medical devices that are consistent with                                                                              
          naturopathic education and practice that may be                                                                       
          prescribed and administered by a naturopath                                                                           
          holding a prescription endorsement, and review                                                                        
          the list of prescription drugs and medical                                                                            
          devices annually and on request by the                                                                                
          department;                                                                                                           
                                                                                                                                
This  board  would  review  allegations  of  misconduct,  approve                                                               
naturopathic  medical programs,  adopt  regulations necessary  to                                                               
implement  this  chapter  and  conduct  hearings  on  charges  of                                                               
alleged violations.                                                                                                             
                                                                                                                                
Section 4 reads:                                                                                                                
     The board shall request  the department issue a license                                                                    
     to practice  naturopathy to  an applicant  who provides                                                                    
     proof satisfactory to the board  that the applicant has                                                                    
     received a degree from an accredited four-year college                                                                     
     or university, has paid the applicable fees,                                                                               
                                                                                                                                
So, the  board replaced the  department in Section 5.  In Section                                                               
6,  a new  section  was  added as  to  the  scope for  diagnostic                                                               
purposes. It also described the  drug endorsement and, subject to                                                               
(c) of that  section, the endorsement to  practice minor surgery.                                                               
Beginning on page 4, line 27 it stipulated that:                                                                                
                                                                                                                                
       (c) Minor surgery may be performed by a naturopath                                                                       
           licensed   under  this   chapter   only  if   the                                                                    
           naturopath  has submitted  proof satisfactory  to                                                                    
           the board  that the  naturopath has  completed at                                                                    
           least 1,200  hours of  training in  minor surgery                                                                    
           under the  supervision of  a  licensed physician,                                                                    
           physician's assistant, or nurse practitioner.                                                                        
                                                                                                                                
The restrictions were  on page 5, in the practice.  They would be                                                               
allowed to prescribe prescription  drugs only as authorized under                                                               
AS 08.45.056;  could only engage  in minor surgery  as authorized                                                               
under  AS 08.45.045(b)  and (c);  and  could not  use general  or                                                               
spinal anesthetics.                                                                                                             
                                                                                                                                
MR. OBERMEYER concluded  that the whole point  of this particular                                                               
draft  was  to  transfer  responsibility  from  the  naturopathic                                                               
council  they had  set up,  to a  formal naturopathic  board that                                                               
would  be responsible  for  all  activities including  licensing,                                                               
discipline, and their current practices.                                                                                        
                                                                                                                                
2:18:35 PM                                                                                                                    
CHAIR DAVIS reiterated that this  had gone from an advisory board                                                               
to a complete board that could be appointed by the Governor.                                                                    
                                                                                                                                
SENATOR ELTON referred to page 4,  Section 5 of the new committee                                                               
substitute  and  said  he  did  not  recall  a  provision  for  a                                                               
temporary license in previous versions of the bill.                                                                             
                                                                                                                                
MR. OBERMEYER  agreed that  he was correct.  He thought  this was                                                               
something Leg  Legal decided  to do  and was not  sure as  to the                                                               
purpose. He conjectured  that it might be issued if  a person had                                                               
applied for and  was qualified to take the  naturopathic exam and                                                               
the board was satisfied that the  applicant had paid the fees and                                                               
met the  requirements; but he was  not sure. It appeared  to give                                                               
the board some type of leeway to issue temporary licenses.                                                                      
                                                                                                                                
CHAIR DAVIS said she would like Jean Mischel to speak to that.                                                                  
                                                                                                                                
2:20:28 PM                                                                                                                    
JEAN  MISCHEL, Attorney  at Law,  Legislative Legal  and Research                                                               
Services Division,  Legislative Affairs Agency, said  she had not                                                               
had a  chance to review this  bill and asked Chair  Davis to give                                                               
her a few moments to do so.  She said this version was drafted by                                                               
Alphaeus Bullard.                                                                                                               
                                                                                                                                
SENATOR  COWDERY  asked  if  there was  a  definition  for  minor                                                               
surgery.                                                                                                                        
                                                                                                                                
MR. OBERMEYER answered that minor  surgery was defined on page 6,                                                               
[Section 11, paragraph (5)] and  means the use of "(i) operative,                                                               
electrical,  or  other  methods  for  surgical  repair  and  care                                                               
incidental   to   superficial   lacerations  and   abrasions   or                                                               
superficial lesions and the removal  of foreign bodies located in                                                               
superficial tissues;  and (ii) antiseptics and  local anesthetics                                                               
in  connection   with  methods  authorized  under   (i)  of  this                                                               
subparagraph;  (B) does  not  include use  of  general or  spinal                                                               
anesthetics,  surgery  of  the   body  cavities,  or  specialized                                                               
surgery, such as plastic surgery,  surgery involving the eyes, or                                                               
surgery involving tendons, ligaments, nerves, or blood vessels"                                                                 
                                                                                                                                
2:22:34 PM                                                                                                                    
CHAIR DAVIS  asked if anyone  wished to provide testimony  on the                                                               
bill.                                                                                                                           
                                                                                                                                
2:23:41 PM                                                                                                                    
JENNIFER  STRICKLER, Division  Chief,  Division of  Corporations,                                                               
Business  and  Professional  Licensing, Department  of  Commerce,                                                               
Community and  Economic Development, clarified  that establishing                                                               
a  regulatory  board  for  44  licensees was  going  to  be  very                                                               
expensive  for  those  licensees.   All  licensing  boards  under                                                               
centralized licensing  08.01.065 were required to  pay their full                                                               
costs  through  licensing  fees;  so this  could  increase  their                                                               
licensing fees tremendously.                                                                                                    
                                                                                                                                
CHAIR DAVIS said  that they [the naturopaths] were  aware of that                                                               
and it was up to them to decide whether to have a board.                                                                        
                                                                                                                                
MS.  STRICKLER  said  that  she  had  received  word  from  their                                                               
investigative  unit suggesting  that lines  8-9 in  section 3  on                                                               
page  3 be  removed. If  the  board were  to review  allegations,                                                               
complaints  etc.,  and  the complaint  resulted  in  disciplinary                                                               
action, the board would not be  able to act as the final decision                                                               
maker in the  case because it could be argued  that the board was                                                               
tainted. Current  statute 08.01.087 provided the  department with                                                               
authority to conduct investigations.                                                                                            
                                                                                                                                
MS.  STRICKLER  continued  to  page 3,  lines  18-19,  which  the                                                               
investigative  unit   also  suggested  be  removed   because  the                                                               
provision  was already  covered in  existing 08.45.060,  "Grounds                                                               
for suspension, revocation,  or refusal to issue  a license," and                                                               
under 08.45.070, "Disciplinary sanctions".                                                                                      
                                                                                                                                
MS. STRICKLER pointed  out that the last sentence  in Section 14,                                                               
page  7, lines  21-22,  "the   board shall  specify  the term  of                                                               
office of  each licensed naturopath  and public  member appointed                                                               
subject  to this  section"  might not  be  necessary because  the                                                               
terms of office  were spelled out in the lines  above that, under                                                               
the transitional provisions.                                                                                                    
                                                                                                                                
SENATOR ELTON said  that on page 4, Section 5,  the provision for                                                               
a  temporary   license  read,  "the   board  shall   request  the                                                               
department  to  issue  a  temporary  license;"  but  the  way  he                                                               
interpreted  it  was  that  the board  "shall"  request  but  the                                                               
department  need not  offer  a temporary  license.  He asked  Ms.                                                               
Strickler if his interpretation was correct.                                                                                    
                                                                                                                                
MS.  STRICKLER   answered  yes,  that  was   a  possibility.  She                                                               
continued that in licensing, because  the board collected and put                                                               
together the  application packets,  the department  would perform                                                               
the  initial  screening. If  the  department  felt the  applicant                                                               
could be licensed and there was  no need for a temporary license,                                                               
they would request approval of  the board immediately rather than                                                               
issue a temporary license.                                                                                                      
                                                                                                                                
SENATOR ELTON assumed a temporary  license might be needed if the                                                               
board met infrequently perhaps.                                                                                                 
                                                                                                                                
MS.  STRICKLER  responded that  was  correct,  however they  also                                                               
asked boards  to review  credentials through  the mail  and tried                                                               
not to hold up licensure if possible.                                                                                           
                                                                                                                                
2:29:51 PM                                                                                                                    
SENATOR THOMAS moved  to adopt CS for SB 107,  Version \L, as the                                                               
working document. There being no objection the motion carried.                                                                  
                                                                                                                                
SENATOR THOMAS noticed that the  Alaska State Medical Association                                                               
still objected to portions of the  bill; in their letter of March                                                               
19,  2008  they said  that  naturopaths  were not  recognized  by                                                               
Medicare  as  providers  eligible   for  payment.  He  questioned                                                               
whether that was actually the case.                                                                                             
                                                                                                                                
MR. OBERMEYER  replied that  was true; but  if they  were granted                                                               
privileges  through  this bill,  they  would  probably apply  for                                                               
coverage for the additional procedures.                                                                                         
                                                                                                                                
CHAIR DAVIS said there was a  procedure they would have to follow                                                               
to be qualified  to receive Medicare payments.  She asked whether                                                               
someone from  the department would  like to comment on  that; but                                                               
no one from  Department of Health and Social  Services (DHSS) was                                                               
available.  She  agreed  with  the  deletions  suggested  by  Ms.                                                               
Strickland and  said she would like  to pass the bill  out of her                                                               
committee.                                                                                                                      
                                                                                                                                
SENATOR DYSON  asked whether  a motion had  been made  to perform                                                               
the deletions suggested by Ms. Strickler.                                                                                       
                                                                                                                                
CHAIR DAVIS  said they  had not  done so,  but Senator  Dyson was                                                               
welcome to make that motion.                                                                                                    
                                                                                                                                
MS. STRICKLER restated her suggested  changes: page 3, removal of                                                               
lines 8 and  9; also on page  3, removal of lines 18  and 19; and                                                               
page 7, removal of lines 21 and 22.                                                                                             
                                                                                                                                
2:35:29 PM                                                                                                                    
SENATOR DYSON moved the following conceptual amendment.                                                                         
                                                                                                                                
     On page  3, remove all  the material  in lines 8  and 9                                                                    
     and  renumber appropriately;  page  3,  remove all  the                                                                    
     material in lines 18 and  19; page 7, remove everything                                                                    
     on line 21 after "terms." And all of line 22.                                                                              
                                                                                                                                
CHAIR DAVIS asked  for any discussion or objection  to the motion                                                               
on the floor. There being no objection, the motion carried.                                                                     
                                                                                                                                
SENATOR DYSON asked what next committee of referral would be.                                                                   
                                                                                                                                
CHAIR DAVIS thought it would be Finance.                                                                                        
                                                                                                                                
SENATOR DYSON asked if there was a companion bill in House.                                                                     
                                                                                                                                
CHAIR DAVIS said a bill mirroring  this one was introduced on the                                                               
House side a couple of weeks prior.                                                                                             
                                                                                                                                
2:37:15 PM                                                                                                                    
SENATOR THOMAS moved  to report CSSB 107, Version  \L, as amended                                                               
by  the  HES  committee,  from   the  committee  with  individual                                                               
recommendations  and accompanying  fiscal  note.  There being  no                                                               
objection, CSSB 107(HES) moved from committee.                                                                                  
                                                                                                                                

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