Legislature(2023 - 2024)DAVIS 106
04/06/2023 03:00 PM House HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| HB115 | |
| HB96 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 115 | TELECONFERENCED | |
| += | HB 96 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
April 6, 2023
3:06 p.m.
MEMBERS PRESENT
Representative Mike Prax, Chair
Representative Justin Ruffridge, Vice Chair
Representative CJ McCormick
Representative Dan Saddler
Representative Zack Fields
Representative Genevieve Mina
MEMBERS ABSENT
Representative Jesse Sumner
COMMITTEE CALENDAR
HOUSE BILL NO. 115
"An Act relating to the practice of naturopathy; establishing
the Naturopathy Advisory Board; relating to the licensure of
naturopaths; relating to disciplinary sanctions for naturopaths;
relating to the Department of Commerce, Community, and Economic
Development; and providing for an effective date."
- HEARD & HELD
HOUSE BILL NO. 96
"An Act relating to licensing and registration requirements for
certain wholesale drug distributors; and providing for an
effective date."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: HB 115
SHORT TITLE: NATUROPATHS: LICENSING; PRACTICE
SPONSOR(s): REPRESENTATIVE(s) PRAX
03/17/23 (H) READ THE FIRST TIME - REFERRALS
03/17/23 (H) HSS, JUD, L&C
03/25/23 (H) HSS AT 3:00 PM DAVIS 106
03/25/23 (H) Heard & Held
03/25/23 (H) MINUTE(HSS)
04/06/23 (H) HSS AT 3:00 PM DAVIS 106
BILL: HB 96
SHORT TITLE: LICENSING:DRUGS/DEVICES FOR HOME DIALYSIS
SPONSOR(s): REPRESENTATIVE(s) PRAX
03/06/23 (H) READ THE FIRST TIME - REFERRALS
03/06/23 (H) HSS, L&C
03/30/23 (H) HSS AT 3:00 PM DAVIS 106
03/30/23 (H) Heard & Held
03/30/23 (H) MINUTE(HSS)
04/06/23 (H) HSS AT 3:00 PM DAVIS 106
WITNESS REGISTER
RILEY NYE, Staff
Representative Mike Prax
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Gave a recap of HB 115, on behalf of
Representative Prax, prime sponsor.
WAYNE ADERHOLD, representing self
Homer, Alaska
POSITION STATEMENT: Gave public testimony in support of HB 115.
JEAN TSIGONIS, MD, representing self
Fairbanks, Alaska
POSITION STATEMENT: Gave public testimony in opposition to HB
115.
JESSICA PANKO, MD, representing self
Fairbanks, Alaska
POSITION STATEMENT: Gave public testimony in opposition to HB
115.
BRUCE CAMPBELL, representing self
Fairbanks, Alaska
POSITION STATEMENT: Gave public testimony in support of HB 115.
ROBERT O'CONNELL, OD, representing self
Kenai, Alaska
POSITION STATEMENT: Gave public testimony in support of HB 115.
ERICK MARTELL, MD, representing self
Fairbanks, Alaska
POSITION STATEMENT: Gave public testimony in opposition to HB
115.
MARGARET CARLSON-COSENTINO, MD, Board Member
Alaska Academy of Family Physicians
Anchorage, Alaska
POSITION STATEMENT: Gave public testimony in opposition to HB
115, on behalf of the Alaska Academy of Family Physicians.
KAREN GONNE-HARRELL, representing self
Anchorage, Alaska
POSITION STATEMENT: Gave public testimony in support of HB 115.
NATALIE WIGGINS, ND, representing self
Anchorage, Alaska
POSITION STATEMENT: Gave public testimony in support of HB 115.
NICHOLAS COSENTINO, MD, representing self
Anchorage, Alaska
POSITION STATEMENT: Gave public testimony in opposition to HB
115.
ALISON SALE, representing self
Anchor Point, Alaska
POSITION STATEMENT: Gave public testimony in support of HB 115.
BIRGIT LENGER, ND, representing self
Anchorage, Alaska
POSITION STATEMENT: Gave public testimony in support of HB 115.
DAVID MONGOLD, representing self
Fairbanks, Alaska
POSITION STATEMENT: Gave public testimony in support of HB 115.
LAURA BONNER, representing self
Anchorage, Alaska
POSITION STATEMENT: Gave public testimony in support of HB 115.
CARLA HOLLINGSWORTH, representing self
Anchorage, Alaska
POSITION STATEMENT: Gave public testimony in support of HB 115.
ROBERT MONBERG, MD, representing self
North Pole, Alaska
POSITION STATEMENT: Gave public testimony in opposition to HB
115.
SCOTT LUPER, ND
Fairbanks, Alaska
POSITION STATEMENT: Answered questions during the hearing on HB
115.
CHADWICK VANCE, Staff
Representative Mike Prax
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Gave a brief recap on HB 96, on behalf of
Representative Prax, prime sponsor.
ACTION NARRATIVE
3:06:14 PM
VICE CHAIR JUSTIN RUFFRIDGE called the House Health and Social
Services Standing Committee meeting to order at 3:06 p.m.
Representatives Saddler, McCormick, Mina, Prax, and Ruffridge
were present at the call to order. Representative Fields
arrived as the meeting was in progress.
HB 115-NATUROPATHS: LICENSING; PRACTICE
3:07:30 PM
VICE CHAIR RUFFRIDGE announced that the first order of business
would be HB 115, "An Act relating to the practice of
naturopathy; establishing the Naturopathy Advisory Board;
relating to the licensure of naturopaths; relating to
disciplinary sanctions for naturopaths; relating to the
Department of Commerce, Community, and Economic Development; and
providing for an effective date."
3:08:29 PM
RILEY NYE, Staff, Representative Mike Prax, Alaska State
Legislature, on behalf of Representative Prax, gave a brief
recap of HB 115. He stated that HB 115 would allow naturopathic
doctors (NDs) to prescribe drugs and perform other functions
that medical doctors (MDs) do, with certain exceptions, such as
the administration of chemotherapy. He added that HB 115 would
create the Board of Naturopathy, similar in structure to other
state boards relating to medicinal practice.
3:10:17 PM
VICE CHAIR RUFFRIDGE opened public testimony on HB 115.
3:10:50 PM
WAYNE ADERHOLD, representing self, expressed support for the
creation of the naturopath board because it would allow NDs to
practice to the full extent of their training. He expressed the
opinion that having medical practitioners who can use the full
extent of their training would result in better outcomes for
patients. He expressed concern for having a pharmacist on the
proposed board because this would represent "competing
professions." He suggested having an ND on other medical
boards, as the professions could learn from each other.
3:14:03 PM
JEAN TSIGONIS, MD, representing self, stated that she has had a
medical license since 1981 and, as a retired doctor, provides
care as needed. Because of the differences in training, she
argued against allowing NDs the ability to prescribe medications
and perform in-office procedures.
3:15:40 PM
JESSICA PANKO, MD, representing self, shared that she is a
radiologist. She said that NDs have a place in medicine;
however, she echoed the concerns of the previous testifier over
giving NDs the ability to prescribe medicine. She argued that
NDs would receive training for alternative types of medicine,
not for prescription drugs. She expressed the belief that this
would be dangerous. She expressed opposition to the proposed
bill.
3:18:37 PM
BRUCE CAMPBELL, representing self, stated that he supports NDs
to have the ability to prescribe medicine. He shared that he
has had positive experiences with treatment from NDs in the
past.
3:19:40 PM
ROBERT O'CONNELL, OD, representing self, shared that he is a
retired optometrist. He stated that Alaska was the 49th state
to allow optometrists to prescribe medicine, and he compared
this to the opposition NDs face in prescribing medicine. He
suggested that healthcare in Alaska improved when optometrists
gained the ability to prescribe medicine, and he expressed the
belief that allowing NDs to do so would have the same result.
3:21:56 PM
ERICK MARTELL, MD, representing self, stated that he has
extensive training as a doctor in surgery and questioned whether
NDs have the proper training and experience necessary to
prescribe medication. He expressed the belief that the proposed
legislation would not be in the best public interest, as NDs'
training is unclear. He said that he has seen good results from
NDs, but he emphasized that they are meant to be "alternative."
3:26:10 PM
MARGARET CARLSON-COSENTINO, MD, Board Member, Alaska Academy of
Family Physicians, stated that the Alaska Academy of Family
Physicians opposes HB 115 because it would give certain
procedural power and the ability to prescribe drugs to NDs. She
expressed support for NDs receiving their own board. Concerning
the ability to prescribe drugs, she expressed the understanding
that NDs would not receive the same level of training and
supervision as MDs. She argued that an ND would not receive the
level of training commensurate to what is necessary for becoming
an MD.
3:28:44 PM
KAREN GONNE-HARRELL, representing self, stated that she supports
HB 115, as NDs can write prescriptions in other states. She
pointed out that NDs can diagnose certain issues, know the
medication necessary, but cannot prescribe it. She referenced a
naturopath who had been able to pass the same tests given to
nurse practitioners (NPs), and she shared her experience with a
naturopath who had treated an underlying condition rather than
using antibiotics. She expressed the opinion that people should
not have to visit a naturopath, and then an NP, to be prescribed
medication.
3:32:08 PM
NATALIE WIGGINS, ND, representing self, shared that she is a ND.
She stated that she previously lived in Arizona, where she had
the ability to prescribe medication. She described the concerns
about NDs prescribing medication as "fear mongering." She
pointed out that to be an ND, there would be 5,000 hours of
training, including 1,200 hours of clinical training and 140
hours of pharmacology training. She stated that the first two
years of school for NDs is comparable to the first two years of
training for an NP. She advised that Alaska is underserved
medically, and NDs should be able to practice to the full extent
of their training.
3:35:24 PM
REPRESENTATIVE SADDLER asked how the training hours are
distributed.
DR. WIGGINS answered that there are pharmacology courses that
are taken within the first few years of an ND's schooling. In
response to a follow-up question, she said that pharmacology
training occurred over the first two years of schooling,
although she does not remember the exact number of courses or
hours per week.
3:39:24 PM
NICHOLAS COSENTINO, MD, expressed concern that NDs would be
allowed to prescribe antimicrobials. He expressed concern that
the over prescription of antimicrobials could lead to drug
resistance, resulting in harsher forms of treatment. He
expressed concern whether NDs would have the adequate training
to prescribe such drugs and warned that it could lead to higher
rates of drug resistance in Alaska. He stated that despite
taking pharmacology courses during his time in medical school,
he did not feel ready to prescribe antimicrobials until he
received more training during residency. He expressed concern
that allowing NDs to prescribe antimicrobials could lead to
public health concerns.
3:44:18 PM
REPRESENTATIVE FIELDS asked what Alaska could do to reduce the
threat of drug resistant microbials.
DR. COSENTINO answered that Alaska currently does not have many
cases where patients would need harsher forms of treatment
because of drug resistance. In response to a follow-up
question, he said that drug resistant microbials usually spread
throughout facilities, such as nursing homes.
3:48:22 PM
ALISON SALE, representing self, shared that she sees an ND for
thyroid issues, and the treatment she receives has been more
effective than the treatment she received from a family
physician. She pointed out that other states treat NDs as
medical professionals, and she expressed the opinion that
denying NDs the ability to prescribe medication would hurt
people who are faced with thyroid problems.
3:51:06 PM
BIRGIT LENGER, ND, representing self, stated that she has been
an ND for 21 years, and she supports HB 115. She shared that
she received a Bachelor of Science degree before completing four
more years of school to become a naturopath. She stated that
NDs receive extensive training regarding pharmacology, anatomy,
and biochemistry, which also includes clinical training. She
argued that NDs are often taught by MDs, who have experience in
areas such as surgery and have the ability to pass certain
medical exams. She concluded that NDs should be able to
diagnose medications, when required, in order to save time and
energy for the patient.
3:55:33 PM
REPRESENTATIVE MINA asked for an example of a minor office
procedures.
DR. LENGER answered that two examples would be removing sutures
and punching a mole for a biopsy. In response to a follow-up
question, she said that NDs have the ability to receive training
on IUD placement.
REPRESENTATIVE MINA asked whether all NDs receive some form of
gynecological training.
DR. LENGER answered in the affirmative. She added that IUD
specific training would be separate.
3:58:52 PM
REPRESENTATIVE FIELDS asked what it means for an ND to "practice
to the scope of their training."
DR. LENGER answered that NDs would receive training in minor
office procedures and the prescription of medication. In
response to a follow-up question, she said that NDs receive
pharmacological training, which includes time spent with an MD.
REPRESENTATIVE FIELDS questioned the difference between an MD
and an ND's training in pharmacology.
DR. LENGER answered that NDs would focus on many of the same
issues as MDs, and she added that pharmacists receive much more
pharmacological training, as this is their area of expertise.
She said that NDs receive more pharmacological training than
physician's assistants.
REPRESENTATIVE FIELDS asked whether normal office procedures
could include minor surgeries. He questioned the line between a
minor and a major surgery.
MS. LENGER answered that minor office procedures would address
superficial issues, such as warts or moles. She said that NDs
would not perform surgeries. In response to a follow-up
question, she said that HB 115 does include language defining
what minor office procedures would be.
4:03:47 PM
DAVID MONGOLD, representing self, shared that he uses a
naturopath for his health care, but his naturopath is unable to
prescribe a glucose monitor. He said that he fully supports HB
115 because it does not make sense that his naturopath is unable
to give him this prescription.
4:05:24 PM
LAURA BONNER, representing self, expressed the belief that HB
115 would be a good start in expanding the scope of practice for
NDs. She said that she brought her daughter to an ND who was
able to treat her entire body, not just the underlying symptoms.
However, her daughter had to visit a pediatrician to receive
antibiotics for an illness diagnosed by the ND. She expressed
the opinion that traditional and naturopathic medicine should be
complementary. She expressed uncertainty concerning whether
NDs should be able to prescribe all types of drugs; however, she
suggested that there is room for NDs to prescribe certain types
of medication.
4:08:50 PM
CARLA HOLLINGSWORTH, representing self, expressed the opinion
that giving NDs the ability to prescribe medication would reduce
health care costs in the state by decreasing the number of
appointments needed to receive prescription medication. She
observed that NDs in other states are able to prescribe
medication and practice to the full scope of their abilities and
training. She continued that NDs place an emphasis on
prevention, and their level of knowledge surpasses that of NPs.
she suggested that NDs would be less likely to overprescribe
unnecessary medication. She said that her naturopath had
diagnosed her post-birth anxiety; however, she had to see
another medical professional in order to receive the necessary
medication for treatment. She suggested that allowing NDs to
practice to the full extent of their training would reduce the
health care provider shortage in Alaska.
4:13:41 PM
ROBERT MONBERG, MD, representing self, commented that people
receive treatment in a variety of ways, and both NDs and MDs
have a place in the healthcare system. He acknowledged that NDs
are able to provide quality care; however, he expressed concern
that NDs do not receive the level of training necessary to
properly prescribe medication.
4:16:52 PM
VICE CHAIR RUFFRIDGE, after ascertaining that there was no one
else who wished to testify, closed public testimony.
4:17:14 PM
REPRESENTATIVE FIELDS questioned the definition of "minor office
procedures" in the proposed legislation.
4:18:15 PM
SCOTT LUPER, ND, answered that minor office procedures would
deal with superficial issues. He stated that this would not
include cutting through the skin into body cavities, ligaments,
tendons, or the eyes. He added that primary care physicians do
not perform surgical procedures. He noted some misconceptions
about naturopathic practice during public testimony, and he
expressed the opinion that NDs have a strong track record of
safe treatment when acting as primary care doctors. He stated
that alternative treatments are often successful, but in certain
cases there are no substitutes for prescription medications. He
stated that NDs must send their patients to a second doctor when
such cases occur. He pointed out that evidence brought forward
shows that NDs would have the training and knowledge required to
prescribe medication.
4:24:00 PM
VICE CHAIR RUFFRIDGE announced that HB 115 was held over.
4:24:07 PM
The committee took two consecutive at-eases from 4:24 p.m. to
4:26 p.m.
HB 96-LICENSING:DRUGS/DEVICES FOR HOME DIALYSIS
4:26:04 PM
VICE CHAIR RUFFRIDGE announced that the final order of business
would be HOUSE BILL NO. 96, "An Act relating to licensing and
registration requirements for certain wholesale drug
distributors; and providing for an effective date."
4:26:40 PM
CHADWICK VANCE, Staff, Representative Mike Prax, Alaska State
Legislature, stated that HB 96 would allow distributors to send
dialysis medications directly to the patients who need them.
4:27:35 PM
VICE CHAIR RUFFRIDGE opened public testimony on HB 96. After
ascertaining that there was no one who wished to testify, he
closed public testimony.
4:28:17 PM
Chair PRAX stated that, despite the language in the bill
sounding complicated, the drugs referenced by HB 96 are not
"exotic drugs."
4:29:53 PM
VICE CHAIR RUFFRIDGE announced that HB 96 was held over.
4:30:02 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 4:30 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 115 Dr. Clyde Jensen testimony 3.25.23.pdf |
HHSS 4/6/2023 3:00:00 PM |
HB 115 |
| HB 115 Dr. Rob Downey MD testimony 3.25.23.pdf |
HHSS 4/6/2023 3:00:00 PM |
HB 115 |
| House Bill 115 Explanation of Changes Version A to S.pdf |
HHSS 4/6/2023 3:00:00 PM |
HB 115 |