02/08/2012 03:15 PM House LABOR & COMMERCE
| Audio | Topic |
|---|---|
| Start | |
| HB235 | |
| HB266 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 235 | TELECONFERENCED | |
| *+ | HB 266 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
HOUSE LABOR AND COMMERCE STANDING COMMITTEE
February 8, 2012
3:26 p.m.
MEMBERS PRESENT
Representative Kurt Olson, Chair
Representative Craig Johnson, Vice Chair
Representative Dan Saddler
Representative Steve Thompson
Representative Lindsey Holmes
Representative Bob Miller
MEMBERS ABSENT
Representative Mike Chenault
COMMITTEE CALENDAR
HOUSE BILL NO. 235
"An Act relating to certain vehicles, including trailers; and
relating to motor vehicle dealer advertising, motor vehicle
dealer sales of used motor vehicles, motor vehicle sales
contracts, motor vehicle service contracts, and motor vehicle
sales financing."
- MOVED HB 235 OUT OF COMMITTEE
HOUSE BILL NO. 266
"An Act relating to the practice of naturopathy; and providing
for an effective date."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: HB 235
SHORT TITLE: MOTOR VEHICLE TRANSACTIONS
SPONSOR(s): REPRESENTATIVE(s) THOMPSON
04/12/11 (H) READ THE FIRST TIME - REFERRALS
04/12/11 (H) TRA, L&C
01/26/12 (H) TRA AT 1:00 PM CAPITOL 17
01/26/12 (H) Moved Out of Committee
01/26/12 (H) MINUTE(TRA)
01/27/12 (H) TRA RPT 5DP
01/27/12 (H) DP: FEIGE, PRUITT, PETERSEN, GRUENBERG,
P.WILSON
02/08/12 (H) L&C AT 3:15 PM BARNES 124
BILL: HB 266
SHORT TITLE: PRACTICE OF NATUROPATHY
SPONSOR(s): REPRESENTATIVE(s) MUNOZ, TUCK, THOMPSON
01/17/12 (H) PREFILE RELEASED 1/13/12
01/17/12 (H) READ THE FIRST TIME - REFERRALS
01/17/12 (H) L&C
02/08/12 (H) L&C AT 3:15 PM BARNES 124
WITNESS REGISTER
REPRESENTATIVE STEVE THOMPSON
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HB 235 as prime sponsor of the
bill.
JANE PIERSON, Staff
Representative Steve Thompson
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Testified during the discussion of HB 235.
CLYDE (ED) SNIFFEN, JR.
Senior Assistant Attorney General
Commercial/Fair Business Section
Civil Division (Anchorage)
Department of Law (DOL)
Anchorage, Alaska
POSITION STATEMENT: Testified and answered questions on HB 235.
MARTEN MARTENSEN, President
Alaska Automobile Dealers Association (AADA)
Anchorage, Alaska
POSITION STATEMENT: Testified and answered questions on HB 235.
REPRESENTATIVE CATHY MUNOZ
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HB 266, as prime sponsor of the
bill.
C.W. JASPER, Naturopath (ND)
Alaska Association of Naturopathic Physicians
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 266.
GRACE DAVIS
Tenakee Hot Springs, Alaska
POSITION STATEMENT: Testified during the discussion of HB 266.
ACTION NARRATIVE
3:26:38 PM
CHAIR KURT OLSON called the House Labor and Commerce Standing
Committee meeting to order at 3:26 p.m. Representatives Saddler,
Thompson, Holmes, Miller, and Olson were present at the call to
order. Representatives Johnson arrived as the meeting was in
progress.
HB 235-MOTOR VEHICLE TRANSACTIONS
3:27:24 PM
CHAIR OLSON announced that the first order of business would be
HOUSE BILL NO. 235, "An Act relating to certain vehicles,
including trailers; and relating to motor vehicle dealer
advertising, motor vehicle dealer sales of used motor vehicles,
motor vehicle sales contracts, motor vehicle service contracts,
and motor vehicle sales financing."
3:28:32 PM
REPRESENTATIVE STEVE THOMPSON, Alaska State Legislature, thanked
members for the opportunity to present HB 235. This bill would
update statutes AS 45.25.400 - AS 45.25.900, commonly known as
the Alaska Auto Dealers Practices Act. The changes would
clarify provisions concerning the advertising of new and used
automobiles. These revisions should assist consumers in
understanding auto comparison pricing and should eliminate
ambiguities contained in the current statutes while assisting
dealers in following state law. This bill was drafted in
conjunction with the Commercial and Fair Business Section of the
Department of Law. He said, "Additionally, this bill should
take care of the contentious issues of the "doc" fees, making
the issue mute."
3:29:48 PM
JANE PIERSON, Staff, Representative Steve Thompson, Alaska State
Legislature, presented the sectional analysis for HB 235, as
follows [original punctuation provided]:
Section 1. Clarifies the "MSRP" shown on the federal
Monroney sticker is the manufacturer's suggested
retail price, and not the dealer's advertised price.
Also clarifies what items are included by the
manufacturer in arriving at MSRP as shown on the
Monroney sticker, and allows dealers to advertise a
savings or discount from the MSRP.
Section 2. Requires that the dealer's advertised
price must include all dealer fees and costs except
fees paid to a governmental agency such as taxes and
licensing fees.
Section 3. Removes disclosure requirement regarding
use of MSRP in advertising, and removes subsection
dealing with price advertising that is covered in
Section 1 to amendment to AS 45.25.400(b).
Section 4. Requires dealers use nationally recognized
valuation publications (such as Kelly Blue Book or
N.A.D.A. Official Used Car Guide) as the retail value
when advertising comparative pricing for used cars. HB
235 requires that this pricing information be provided
to consumers upon request.
3:31:08 PM
MS. PIERSON continued the sectional analysis for HB 235 by
reading the following [original punctuation provided]:
Section 5. Removes section now covered in Section 2
amendment to 45.25.440; allows dealer to make vehicle
identification information available in the
advertisement or at the dealership - this resolves the
problem of impossible to read small print on
television advertising; and renumbers sections of
45.25.460(a). (This renumbering requires the amendment
in Section 8)
Section 6. Changes the word "verified" to "signed" so
the information provided by an individual to a dealer
need not be notarized.
Section 7. Allows a dealer to have a vehicle on the
sales lot and show it to customers prior to having all
required paper work, but prohibits sale of the vehicle
until the dealer has all required paperwork in its
possession.
Section 8. Conforms AS 45.25.520 with renumbering in
Section 5.
Section 9. Clarifies that the sales contract will be
void if the dealer or the financing institution
changes terms of a separate agreement relative to
financing.
3:32:19 PM
MS. PIERSON continued the sectional analysis for HB 235, by
reading the following [original punctuation provided]:
Section 10. Provides for responsibility of a buyer to
return a vehicle if financing is not approved and the
responsibility of dealer to return a trade-in
delivered to the dealer.
Section 11. Establishes responsibility of a buyer to
return a vehicle if the financing is denied as a
result of intentional misrepresentation in the credit
application, including mileage fee if over 100 miles
are put on the vehicle and responsibility for damage
to the vehicle, parking tickets, towing fees, storage
fees, impound fees, and other similar charges incurred
by the buyer while the vehicle was in possession of
buyer.
Section 12. Removes unnecessary and impractical
obligation imposed on dealers relating to service
contracts.
3:33:09 PM
MS. PIERSON continued the sectional analysis, by reading the
following [original punctuation provided]:
Section 13. Provides that changes affect contracts
entered into on or after the effective date of the act
and provides definitions for terms used in several
sections.
For Section 7 - Motor vehicle is defined in
45.25.590(3) "motor vehicle," notwithstanding the
definition of "motor vehicle" in AS 45.25.990, means a
vehicle, including a trailer, that is required to be
registered under AS 28.10, but does not include a
motorcycle.
For Section 12, Service contract is defined in
45.25.990 (18) "service contract" means an optional
agreement that is separate from a contract for the
sale of a motor vehicle and that covers certain repair
or maintenance functions beyond coverage provided by a
warranty.
For Section Sections 9, 10, 11, and 12, Motor vehicle
is defined in 45.25.990 (12) "motor vehicle" means a
motor vehicle that is required to be registered under
AS 28.10, but does not include a motor home, a
recreational vehicle, or a motorcycle; in this
paragraph,
(A) "all-terrain vehicle" has the meaning given
in AS 45.27.390;
(B) "recreational vehicle" includes an all-
terrain vehicle and a snow machine;
(C) "snow machine" has the meaning given in AS
45.27.390.
3:33:44 PM
REPRESENTATIVE SADDLER referred to page 5, line 23 of HB 235,
which relates to entering into a contract. He asked whether the
contract must be a written contract or if it could be a verbal
contract by a dealer to hold a car until the financing could be
arranged. He further asked what constitutes a contract in
section.
MS. PIERSON offered her belief that the changes in proposed
Section 7 refer to a contract to sell a motor vehicle so it
would be the actual sale.
3:34:23 PM
REPRESENTATIVE SADDLER related a scenario in which a prospective
buyer is interested in a car and asks the dealer to hold it
while he consults with his wife. In the event that another
prospective buyer expresses interest in the car, whether the
dealer is bound by contract to hold the car for the first
customer.
MS. PIERSON offered her belief that the dealer did not have an
agreement to sell a vehicle, but rather just to hold it.
3:35:06 PM
CHAIR OLSON asked whether the MSRP is a country wide pricing,
except for transportation costs. He surmised that the MSRP for
California would be differences due to its stringent pollution
requirements.
MS. PIERSON identified that the MSRP is the manufacturer's
sticker on the vehicle, and is defined by the federal Monroney
statute. She explained that the dealer can adjust prices from
the Monroney sticker, so it represents the manufacturer's price.
CHAIR OLSON offered that the MSRP would be the same as it is in
Nevada, except for transportation costs. He asked for an
explanation of how transportation costs are handled given that
Alaska's transportation costs are much higher than anywhere else
except for Hawaii.
MS. PIERSON related her understanding the prices are the same,
but the auto dealers and department are on-line and could
correct her if that is not so.
3:36:18 PM
REPRESENTATIVE HOLMES referred to Section 5, [to page 3, line
18] and wondered whether this means she does not need to listen
to the numbers rattled off in a commercial.
MS. PIERSON answered yes.
3:36:50 PM
REPRESENTATIVE HOLMES asked for clarification on Section 12, as
she was unsure if the purpose is to streamline this process.
MS. PIERSON deferred to one of the experts. She related her
understanding that this means the service contract must be in
writing and include all provisions.
3:37:52 PM
REPRESENTATIVE JOHNSON related his understanding some
settlements that require disclosure of vehicle identification
numbers (VIN) in advertising, if this bill changes that
settlement, or if is it an antiquated settlement.
3:38:42 PM
REPRESENTATIVE SADDLER referred to Section 6, page 5, line 15,
and asked if the disclosure of the vehicle's history and
condition be true and whether the change in language from verify
to signed change imply any change in the representation.
MS. PIERSON answered no. She explained that it just means it
does not have to be notarized, since the notary is merely
verifying the person is truly the person who is signing it.
3:39:25 PM
REPRESENTATIVE SADDLER related his understanding that it would
not need to be notarized, but also does not say the information
is true.
MS. PIERSON agreed with the function of a notary as limited to
verifying the identity of the person signing the document.
3:39:42 PM
REPRESENTATIVE MILLER referred to page 6, line 31, and page 7,
line 10, specifically to the word "intentional," and read, "if a
buyer's final financing is not approved and the buyer has made
an intentional representation ..." He asked who would make the
determination on the length of time it would take and how this
would be verified.
MS. PIERSON suggested it would be apparent. She related a
scenario in which she was to state that she earns $200,000
working for legislature. It would be apparent to everyone that
her statement wasn't true. Additionally, it would be a
misrepresentation on a financial document. She summarized the
gist of this is to assure people are employed and that their
income and credit ratings are reported accurately. She thought
the language was fairly clear in terms of financial agreements.
REPRESENTATIVE MILLER agreed, but offered other examples might
be somewhat subtle.
MS. PIERSON deferred to the Department of Law to better respond.
3:41:28 PM
REPRESENTATIVE JOHNSON referred to page 7, line 5 of proposed
Section 11 to the business use mileage. He asked for the
current business usage rate.
REPRESENTATIVE MILLER answered that he thought the rate was $.54
or $.59 statewide.
MS. PIERSON said she was unsure, but the figure is recognized by
the Internal Revenue Service (IRS) so the rate would be a
standard rate throughout the U.S.
3:42:15 PM
REPRESENTATIVE JOHNSON offered his belief that the business use
mileage rate and the $.45 a mile rates are in the bill as
placeholders.
MS. PIERSON answered yes.
3:42:38 PM
CLYDE (ED) SNIFFEN, JR., Senior Assistant Attorney General,
Commercial/Fair Business Section, Civil Division (Anchorage),
Department of Law (DOL), offered to answer questions raised thus
far. He explained that his duties include enforcement of this
act. He said he has worked with the auto dealers for the past
12 years on many of these issues and much of this bill is aimed
at clarifying and cleaning up some areas and makes it much
easier for consumers and auto dealers. He indicated he has no
problems with the current language in the bill and the DOL
supports the bill.
3:44:08 PM
MR. SNIFFEN referred to an earlier question with respect to
whether a contract to sell and an oral representation
constitutes an enforceable contract. He offered that it could
be; however, in this bill the intent is that the statute must be
complied with before a dealer can actually enter into a written
contract with a consumer to sell a vehicle. He suggested that
oral representations are more in the nature of offers to hold,
which is not the intent of the language in this bill.
3:44:56 PM
MR. SNIFFEN referred to an earlier question on whether the MSRP
is standard across the country. He related his understanding
that the cost is standard in the U.S. He said at one time
transportation costs were included in the MSRP. He was unsure
whether the transportation charge differential has changed with
respect to the costs for vehicles in Anchorage versus in
Detroit. He suggested that some people in the industry could
better answer the question.
MR. SNIFFEN referred to an earlier question, with respect to
settlements and whether any recent settlements required
disclosure of VINS, and if so, whether they were enforceable.
He said the settlements he has been involved with pertained to a
settlement on dock fees, which did not include disclosure of any
VIN. The rule of law still stands and document preparation fees
must be included and he was not aware of any private
settlements.
3:46:33 PM
MR. SNIFFEN brought up an earlier question on whether the
definition of "verified" versus "signed" and if that would mean
the person had signed, but the information was not verified. He
explained that this statute attempts to ensure that owners who
trade in vehicles provide the accident and repair history. He
further explained that the dealer cannot verify this information
so requiring the owner to sign and verify gives the future
purchaser a record. He reported that the DOL has not had any
issues with this. He suggested this change just makes it easier
for dealers so they would not need to provide a notary every
time a person wants to sell a vehicle.
MR. SNIFFEN recalled an earlier question with respect to
intentional misrepresentation, which he said would be a matter
that would be decided by the courts. Thus if a dispute arose in
which a person intentionally provided false information, the
courts would decide. He agreed with Ms. Pierson's description
of obviously false information. He agreed some gray areas could
arise, such as employment projections. He reiterated the courts
could decide any disputes; however, he did not think that the
amount of money involved in these types of case would warrant
this.
3:48:57 PM
REPRESENTATIVE JOHNSON referred to page 7, line 16, to Section
12 of the bill. He related that a service contract could be
buried in a stack of documents the buyer must review and sign.
He questioned whether it is conceivable for a dealer to add in a
service contract with the car purchase agreement and not clearly
mark it as a contract for a service contract.
MR. SNIFFEN agreed considerable paperwork is involved in these
transactions and although the possibility exists the statute
would require all the terms and conditions of the contract be
presented to the consumer. He highlighted that if a consumer
indicated he/she did not recall agreeing to a service contract,
that it would be the responsibility and burden of the dealer to
prove the consumer requested the service.
3:51:05 PM
REPRESENTATIVE JOHNSON read, "A motor vehicle service contract
must be in writing and contain all essential provisions
regarding the administration of the contract." He pointed out
that this subsection previously included the language, "clearly
and conspicuously marked." He asked whether retaining the
language, "clearly and conspicuously marked" would constitute a
service to the public or if it would be a hindrance to the
dealership. He further asked if this provision would provide a
safety net or if it was yet another obstacle to businesses.
MR. SNIFFEN suggested another provision in the Automobile
Dealer's Act, which he did not have before him, requires that
all disclosures must be done so in a clear and conspicuous
manner. He clarified that the way service contracts work is not
currently done through an application. He reiterated that
provisions for disclosure must be done in a clear and
conspicuous manner and to not do so would be in violation of the
law.
REPRESENTATIVE JOHNSON responded that he wanted to raise the
concern, that the response clarifies this for him.
3:53:08 PM
CHAIR OLSON expressed the same concern about the service
contract being buried in the middle of the paperwork. He
inquired as to whether any complaints of that nature have been
filed.
MR. SNIFFEN answered no. He said he did not recall any
complaints of that nature. He explained that normally those
types of complaints would be a pattern or practice by a dealer.
3:53:45 PM
REPRESENTATIVE JOHNSON reported that the committee staff has
located the specific reference to the statute, which read,
"...separate agreement clearly and conspicuously informs the
buyer...." He affirmed that his questions have been answered.
3:54:46 PM
MARTEN MARTENSEN, President, Alaska Automobile Dealers
Association (AADA), stated that he hoped members would recognize
the changes incorporated in HB 235 attempt to clean up the gray
area and the auto dealers are not asking for any advantages. He
pointed out that some of the current statutes are ambiguous and
open to interpretation. The proposed changes would make it
easier for auto dealers to operate and to work with the DOL in
terms of what is allowable. He characterized HB 235 as a bill
that would make things black and white. He said that he and his
colleagues are here to ask members for their support.
3:56:20 PM
CHAIR OLSON offered his belief that most compelling testimony
the committee has heard today is from Ed Sniffen. He emphasized
when Mr. Sniffen says he supports this bill, and he has done so
on two prior occasions, that it carries a tremendous amount of
weight. He invited anyone in opposition to the bill to come
forward.
3:57:11 PM
REPRESENTATIVE HOLMES asked for the purpose of the changes in
Section 12.
MR. MARTENSEN explained that key word in this section is
"application." He characterized dealers as the middle man and
the paperwork is not considered an application, but is a
contract.
3:58:06 PM
CHAIR OLSON, after first determining no one else wished to
testify, closed public testimony on HB 235.
3:58:43 PM
REPRESENTATIVE JOHNSON moved to report [HB 235] out of committee
with individual recommendations and the accompanying fiscal note
3:59:26 PM
REPRESENTATIVE JOHNSON restated his motion. He moved to report
HB 235 out of committee with individual recommendations and the
accompanying fiscal note. There being no objection, HB 235 was
reported from the House Labor and Commerce Standing Committee.
3:59:56 PM
The committee took an at-ease from 3:59 p.m. to 4:05 p.m.
HB 266-PRACTICE OF NATUROPATHY
4:05:11 PM
CHAIR OLSON announced that the final order of business would be
HOUSE BILL NO. 266, "An Act relating to the practice of
naturopathy; and providing for an effective date."
4:05:18 PM
REPRESENTATIVE CATHY MUNOZ, Alaska State Legislature, introduced
herself and thanked the committee for hearing this bill. She
commended the committee staff, Konrad Jackson, for his excellent
work.
The committee took a brief at-ease due to teleconference
technical issue.
REPRESENTATIVE MUNOZ explained that HB 266 is designed to allow
naturopathic doctors to continue to have the ability to provide
natural medicines to those who rely on them for their wellbeing.
She detailed the geographic location of the 43 Naturopaths (NDs)
practicing in Alaska: 16 in Anchorage, 15 in Fairbanks, 2 in
Eagle River, 2 in Palmer, 2 in the Kenai/Homer area, 1 in
Seward, 4 in Juneau, and 1 in Sitka. She related that NDs have
stated that the measure is needed because some pharmacies
recently are refusing to supply natural and herbal medicines to
NDs, as a result of instructions form the Division of
Corporations, Business, and Professional Licensing (DCBPL). She
explained that HB 266 would put in statute regulatory language
that has been in effect for 18 years. She explained this would
allow NDs to provide their patients medicines. She said this is
taken directly taken from regulation. She read, "...medicines
derived from or a concentrate or extract of a plant, tree, root,
moss, fungus, or other natural substance if the medicine is not
a controlled substance." This is based on state regulation 12
AAC 42.990 (3). This measure is not intended to expand the
scope of practice of NDs, but will protect what NDs currently
provide to patients as prescribed by law, thus giving Alaskans
the power to choose what health modalities work best for them.
She indicated that she has worked with the sponsor of the
companion bill, Senator Lesil McGuire, Senator Cathy Giessel,
the DCBPL, the Division of Public Health, the Alaska State
Medical Association (ASMA), and the naturopathic doctors (NDs)
to craft something that fulfills the sole purpose of this bill.
The purpose of HB 266 is to keep the naturopathic scope of
practice the way it has been in Alaska for nearly two decades.
She stated that she continues to work with the previously
mentioned groups and plans to bring forth an amendment
consistent with the Senate version of the bill. She asked
Doctor (Dr.) Jasper to present an overview.
4:09:45 PM
CHAIR OLSON said he would accommodate one person who has
traveled from Tenakee Springs, but the bill would not be opened
up for public testimony today.
REPRESENTATIVE MUNOZ emphasized that this bill does not contain
any expansion in practice. She informed members that a bill the
committee considered last year was a much broader bill.
CHAIR OLSON related his understanding that the intent of HB 266
is not to broaden the scope of practice but to prevent the
erosion of the practice of naturopathic medicine.
4:10:51 PM
C.W. JASPER, Naturopath (ND), Alaska Association of Naturopathic
Physicians (AANP), offered to testify in support of HB 266. He
thanked members for the opportunity to hear this bill. He
stated that he holds ND license number two in Alaska. He said
he has practiced in Alaska for 20 years. He began a PowerPoint
presentation titled, "The History of Naturopathic Prescribing in
Alaska." He reported that 16 states license, the District of
Columbia, and two territories license Naturopathic Doctors
(NDs). He highlighted that varying scopes of ND practice exists
depending on the state. He acknowledged that the professional
scope of practice for NDs is decided by legislatures. He stated
that 11 states give prescriptive authority in the statutes to
NDs as opposed to Alaska, which has given prescriptive authority
in regulation. He pointed out that five states grant authority
in statute for NDs to prescribe controlled substances. He gave
a brief personal history, including that he came home to Alaska
in 1982, but he has roots in Alaska since his great-grandfather
came over the Chilkoot Trail in 1898. His family has lived in
Alaska since then, he said. He recalled questions by
legislators at the time the enabling legislation was under
consideration as to the reason he sought licensure in this state
and why he would simply not practice in some other state.
4:13:10 PM
DR. JASPER responded that he answered that he is an Alaskan. He
recalled former Senator Binkley questioned him during
deliberations over the enabling legislation. Senator Binkley
related that he must have known that naturopaths did not have
the authority to practice naturopathic medicine in Alaska. He
then provided his educational background, noting once he
completed his naturopathic schooling that he applied to the
medical board to take the medical exam and obtain licensure in
Alaska. He highlighted that the medical board denied his since
the board did not recognize naturopathic schools. At the time
his attorney received a letter from one of the assistant
attorney generals - Bruce Botelho - who had indicated he could
practice in Alaska without a license since the state did not
offer him an opportunity to take the exam, plus the state did
not have a licensing procedure in place. He emphasized that he
came to Alaska in 1982 in good faith. He informed members that
the situation in Alaska dramatically changed when litigation
against an ND, Pat Pettijohn, had charged him with practicing
medicine without a license. Mr. Pettijohn lost the case and
subsequently closed his practice. Additionally, several NDs
were informed by the state of the necessity to either pass a
bill allowing naturopathy, or to stop practicing in Alaska.
4:15:02 PM
DR. JASPER stated that naturopaths successfully passed a
licensure bill in 1986. He described the difficulties the NDs
encountered during the process, noting the late Senator Fred
Zharoff had taken the draft language and modified the bill,
which defined naturopathy to include the use of herbal remedies,
along with a number of other therapies. Even so, the NDs agreed
to the bill. He emphasized that herbal remedies are an
important part of the NDs practice. He pointed out AS 08.45.200
defines naturopathy, which includes the use of herbal remedies
[slide 3-4]. He showed pictures of cayenne peppers, commonly
found in grocery stores [slide 5-6]. He related that eating
cayenne peppers has the effect of making one's nose run since it
is an expectorant. He showed a photo of a bottle of medicinal
quality cayenne pepper, which is also an expectorant used to
treat chronic sinus problems or asthma. The liquid form,
capsicum tincture is used since the medicinal qualities
dissipate with ground cayenne pepper [slide 9-10]. He
elaborated on the advantages of the tincture, including that a
longer shelf life, a date of expiration, and using it has
provided predictable results.
4:18:28 PM
DR. JASPER emphasized that capsicum tincture is a natural
medicine that NDs are trained and qualified to use, but it is
labeled as a prescription medicine. He explained that federal
law prohibits dispensing without a prescription.
DR. JASPER related that language under consideration in the
enabling legislation would have narrowed the definition of
naturopathy under AS 08.45.050 to prohibit prescribing
prescription medicine, but it did not pass. He expressed alarm
over the proposed definition since it would not have allowed NDs
to prescribe capsicum tincture or any other similar herbal
medicines. He related that the ultimate compromise was that the
language narrowed the restriction to prescription drugs, but
allowed NDs to prescribe medicine. He identified drug as a
chemical substance used in treating disease or illness [slide
14].
4:20:22 PM
DR. JASPER stated that the NDs agreed to the changes since it
allowed them to dispense natural prescription medicines. He
pointed to a list titled, "Rx Medicines" noting that capsicum
tincture is on the list, along with other natural medicines
[slide 15].
DR. JASPER referred to a slide of what NDs can and cannot
prescribe, labeled "Rx Medicines" and "Rx Drugs." He offered
that the enabling legislation authorized the department to adopt
regulations under AS 08.45.100. He related that the department
adopted 12.AAC 42.990, including a definition of prescription
drug, which he read: "prescription drug" does not include a
device or herbal or homeopathic remedy or dietetic substance in
a form that is not a controlled substance;" [slides 20-21].
DR. JASPER indicated the regulations under 12 AAC 42.990 (3),
also included a definition for herbal remedy, which he read:
"herbal remedy" includes medicines derived from or a concentrate
or extract of a plant, tree, root, moss, fungus, or other
natural substance; "herbal remedy" does not include a controlled
substance;" [slide 22].
4:22:30 PM
DR. JASPER stressed that regulations have the force of law
[slide 24]. He emphasized that NDs have relied on the
regulations for 18 years and NDs and the state must abide by the
law.
DR. JASPER summarized that the NDs have had the ability to
prescribe herbal remedies, but not prescription drugs. He said
that about a year ago the pharmacies have quit supplying the NDs
with prescription medicines and substances, which has resulted
in many patients being cut off from medicines normally provided
by their NDs [slide 27]. He related his understanding that the
pharmacies have indicated they are complying with instructions
from the State of Alaska. He assured members that he personally
visited pharmacies 18 years ago, at the time the regulations
were adopted, and they all agreed that NDs could prescribe
herbal remedies and medicines. These same pharmacies are now
advising NDs they can no longer supply medicines.
4:24:44 PM
DR. JASPER reported some doctors will not write prescriptions
for natural medicines they are not familiar with so some
patients are deprived use of these medicines.
DR. JASPER reported the NDs seek remedies to re-establish the
longstanding ability to prescribe medicines and herbal remedies.
He said the NDs seek to take the existing regulatory language
under 12 AAC 42.990 and place it into statute.
4:25:35 PM
REPRESENTATIVE SADDLER admitted confusion with respect to the
definitions of medicine and drugs. He asked for definition of
drugs.
DR. JASPER answered that each statute has its own definitions so
a uniform definition is lacking. He highlighted that part of
the statutory restriction was to explicitly restrict NDs from
prescribing controlled substances. He pointed out that water is
included in some definitions of drug so the legislature left
drug undefined in the naturopathic statutes, with the
understanding that the state would develop regulations that
pertain to the practice of naturopathy. Drug wasn't actually
defined in the ND's statutes; however, an herbal remedy was not
considered a drug under AS 08.45.050.
4:27:36 PM
REPRESENTATIVE SADDLER asked for clarification on the federal
definition of drug.
DR. JASPER answered that the federal definition includes any
substance used for the diagnosis, treatment, or mitigation of
disease or illness in human and animals, so injectable water is
considered a drug under federal law. He related that
intravenous therapy (IV) bags contain the federal legend. Thus
even water becomes a drug in some instances because it is
intended for diagnosis or treatment of human disease, illness,
or condition. He indicated that federal definition is mirrored
in the statutes. He acknowledged the legislature barred NDs
from prescribing controlled substances; however, the legislature
did not use the definition of drug since doing so would restrict
use of medicines.
4:29:06 PM
REPRESENTATIVE JOHNSON inquired as to the category of penicillin
since it is derived from fungi. He questioned whether an herbal
remedy would include penicillin as defined by 12 AAC 42.990.
DR. JASPER said he has not written a prescription for penicillin
in his 20 years of practice since it is not germane to his
practice. He was unsure whether any NDs have ever written a
prescription for penicillin, but he offered his belief that
under the regulation they technically had the right to do so.
4:30:33 PM
REPRESENTATIVE JOHNSON questioned whether prescribing penicillin
is germane to his practice.
DR. JASPER offered that the NDs should be viewed as a whole and
not be based solely on his practice.
4:31:15 PM
REPRESENTATIVE JOHNSON asked whether NDs track what
prescriptions by list.
DR. JASPER answered no.
4:31:33 PM
REPRESENTATIVE JOHNSON asked whether it would be possible to
obtain a list of drugs prescribed by the 43 naturopathic doctors
in the last year.
DR. JASPER answered that he did not have a list.
REPRESENTATIVE JOHNSON suggested that a list of what NDs
currently prescribe would provide a baseline for the committee.
4:32:17 PM
CHAIR OLSON suggested that the committee work up a list of
questions for the sponsor to answer. He referred to capsicum as
a substance that his grandmother used. He inquired as to
whether the restriction for capsicum is due to the medium since
it is 180-proof alcohol.
DR. JASPER related other medicines can be purchased at health
food stores that contain alcohol. He concluded that the alcohol
is not the issue but it is the medicine being used and the
intended use of the medicine, which ties into federal criteria.
4:33:40 PM
DR. JASPER asked to clarify that the NDs' position on
prescriptions. He explained that the regulations have allowed
certain things to be prescribed, but if any NDs in Alaska are
prescribing drugs outside the list, the NDs as a whole would not
support that activity. He emphasized that the AANP supports NDs
practicing in accordance with law. He had no knowledge of any
prescriptions written outside of the regulations; however, if
there were any written the AANP and NDs would not endorse that
practice.
4:34:36 PM
REPRESENTATIVE THOMPSON asked what drugs would be prohibited
under HB 266.
DR. JASPER answered that he pulled a list of the 50 most
commonly prescribed drugs from the Internet. He and several
colleagues reviewed the list to see if any of the drugs would be
authorized under HB 266. He answered that only one drug would
be authorized, a drug called Niaspan, which is a time-released B
vitamin. He said people can buy time-released Niaspan without a
prescription; however, the form that has been approved by the
Federal Drug Administration (FDA), which is made according to
their standards is a prescription drug labeled for the treatment
of high cholesterol. He pointed out that this form of B vitamin
has the legend. Typically, medical insurance will provide
reimbursements for the prescription Niaspan. Additionally,
capsicum tinctures and other herbal remedies would be included
in the definition.
REPRESENTATIVE JOHNSON offered his willingness to wait for the
written questions and responses.
4:36:47 PM
REPRESENTATIVE HOLMES admitted she was confused. She was unsure
of whether the distinction of placing the current regulatory
language in statutes would remedy the issues for the NDs.
DR. JASPER agreed the issue is frustrating. He said that 18
years ago pharmacists recognized limited prescriptive authority,
but now the same pharmacists insist the regulation does not
apply. These pharmacists have advised that they use the statute
for guidance on allowable prescriptions. He was unsure of how
it could be that 18 years ago the regulations allowed NDs to
write prescriptions for herbal medicines but now they cannot do
so. The NDs are convinced that if the regulation is adopted in
statute it will validate NDs prescriptions for herbal medicines.
REPRESENTATIVE HOLMES said that everyone is puzzled.
DR. JASPER agreed.
4:38:52 PM
REPRESENTATIVE MILLER referred to slide 9, titled "Now it is a
Prescription Medicine." He pointed out the label also reads
poison. He concluded that the ND's regulations clearly do not
authorize prescribing poison.
4:39:41 PM
DR. JASPER answered that the word poison has different meanings
depending on whether the language is state or federal language.
He said that health care is regulated by the state, but
medicines and drugs are regulated by federal law. He explained
that labels are prepared according to the federal standards. A
federal FDA standard of poison exists and it defines certain
medicines as poisons. He offered that what that means is
consuming a large amount of a drug labeled poison would not be
good, but the state views a poison in terms of dosage. He
referred to 12 AAC 42.990, which defines poison to mean a
substance given in a manner that has a likelihood of causing
physical injury or death. He asserted that capsicum tincture is
not a poison when prescribed in appropriate doses; however
anyone drinking a whole bottle would become quite sick, which is
why the federal label lists it as a poison.
4:41:25 PM
REPRESENTATIVE MILLER offered support for the concept of the
bill, but he wanted to be sure safeguards exist. He inquired as
to how to comport the prohibition of poison with dispensing
medicine.
DR. JASPER recalled in 1986, that the sponsors crafted a bill
based on language derived from other jurisdictions, primarily
from Washington, which unfortunately had the most archaic
language. He pointed out at the time only six states licensed
NDs. Very shortly after that, Washington revised its statutes
with modern terminology. He agreed from the outset Alaska's
terminology was dated. He offered his belief that the term
"poison" was used prior to the adoption of FDA guidelines on
poisons. He offered his belief no other states use that
terminology. He further recalled that the Oregon Supreme Court
upheld that a poison is only a poison when it is administered in
a dose that has a likelihood of causing physical injury or
death. He said that NDs administer doses that are safe, based
on their training and education, concluding the definition of
poison is dose-dependent.
4:44:45 PM
REPRESENTATIVE MILLER pointed out that bleach does not have a
safe dosage since it is poison.
DR. JASPER agreed.
4:45:20 PM
REPRESENTATIVE MILLER expressed concern and asked whether the
language needs to be fixed.
DR. JASPER answered no, that the definition is consistent since
any amount of the bleach would be harmful. He explained by
relating that many drugs have limits between safe doses and
toxic doses, which is one reason that labeling drugs as poison
has fallen out of vogue. He offered that a person who ingests
too much water will drown, yet water is not considered a poison
unless the dose is too high. He characterized this as
consistent for all medicines.
CHAIR OLSON offered his belief the questions being asked go
beyond the expertise of anyone currently in the room. He
offered to have the FDA participate in a future meeting to
answer technical questions. He pointed out that none of the
committee members are doctors.
4:48:11 PM
GRACE DAVIS said she was born in 1926 and is 85 years old. In
1913, her parents settled in Tenakee noting it was a community
half-way between Juneau and Sitka. She later went to Fairbanks
to attend college. She highlighted that not many doctors were
in Alaska at the time, and of those, many would not take new
patients. Thus over time she ended up seeing three different
NDs, including one in Montana and two in Juneau. She pointed
out that two doctors have summer homes in Tenakee, which has
been very helpful to residents. She appreciated the work on
this bill. She takes medications but she acknowledged that has
not ever been very sick. She thanked members.
4:53:44 PM
CHAIR OLSON thanked Ms. Davis. He recognized that
Representative Munoz has actively pursued this bill and he
appreciated her efforts. He concluded by stating that a person
could take a gallon of drinking water and if they poured it on a
cruise ship it could cause the discharge to fail to meet federal
drinking water standards. He acknowledged one of the biggest
challenges is to mesh the laws.
4:56:20 PM
REPRESENTATIVE JOHNSON asked what medicines she is taking that
are prescribed by NDs, if not too personal a question.
MS. DAVIS answered that she takes medicine for thyroid
medication and atenolol. She said she goes to the wellness
center for her prescriptions.
REPRESENTATIVE MUNOZ, in response to a question on whether Ms.
Davis's medicine was prescribed by MDs or NDs, answered that
medical and naturopathic personnel work at the facility.
[HB 266 was held over.]
4:58:19 PM
ADJOURNMENT
There being no further business before the committee, the House
Labor and Commerce Standing Committee meeting was adjourned at
4:57 p.m.