Legislature(2019 - 2020)BARNES 124

04/03/2019 03:15 PM House LABOR & COMMERCE

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03:21:07 PM Start
03:21:49 PM Confirmation Hearing(s):|| Board of Nursing
03:40:03 PM Confirmation Hearing(s):|| Board of Massage Therapists|| Board of Certified Direct-entry Midwives|| Occupational Safety & Health Review Board|| Board of Examiners in Optometry|| Board of Pharmacy|| Board of Physical & Occupational Therapy|| Board of Psychologists & Psychological Associate Examiners|| Board of Certified Real Estate Appraisers|| Real Estate Commission|| Board of Social Work Examiners|| Board of Veterinary Examiners|| Alaska Workers' Compensation Board|| State Board of Registration for Architects, Engineers, & Land Surveyors
03:43:04 PM HB91
04:12:42 PM HB102
04:29:32 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Consideration of Governor's Appointees: Board of TELECONFERENCED
Massage Therapists, Board of Certified
Direct-Entry Midwives, Occupational Safety &
Health Review Board, Board of Examiners in
Optometry, Board of Pharmacy, Board of Physical
& Occupational Therapy, Board of Psychologists &
Psychological Associate Examiners, Board of
Certified Real Estate Appraisers, Real Estate
Commission, Board of Social Work Examiners,
Board of Veterinary Examiners, Alaska Workers'
Compensation Board, State Board of Registration
for Architects, Engineers, & Land Surveyors,
Board of Nursing
-- Public Testimony <Time Limit May Be Set> --
*+ HB 91 NATUROPATHS: LICENSING; PRACTICE TELECONFERENCED
Heard & Held
*+ HB 102 RENTAL VEHICLE BY PRIVATE OWNER TELECONFERENCED
Heard & Held
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
          HOUSE LABOR AND COMMERCE STANDING COMMITTEE                                                                         
                         April 3, 2019                                                                                          
                           3:21 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Gabrielle LeDoux, Co-Chair                                                                                       
Representative Adam Wool, Co-Chair                                                                                              
Representative Zack Fields                                                                                                      
Representative Sara Hannan                                                                                                      
Representative Louise Stutes                                                                                                    
Representative Josh Revak                                                                                                       
Representative Dave Talerico                                                                                                    
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
All members present                                                                                                             
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
CONFIRMATION HEARING(S):                                                                                                        
                                                                                                                                
Board of Nursing                                                                                                              
                                                                                                                                
     Shannon Connelly - Palmer                                                                                                  
     Emily Henry - Anchorage                                                                                                    
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Board of Massage Therapists                                                                                                   
                                                                                                                                
     Julie Endle - Palmer                                                                                                       
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Board of Certified Direct-Entry Midwives                                                                                      
                                                                                                                                
     Dana Espindola - Eagle River                                                                                               
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Occupational Safety & Health Review Board                                                                                     
                                                                                                                                
     Vincent Perez - Wasilla                                                                                                    
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Board of Examiners in Optometry                                                                                               
                                                                                                                                
     Dr. Bradley Cross - Soldotna                                                                                               
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Board of Pharmacy                                                                                                             
                                                                                                                                
     Leif Holm - North Pole                                                                                                     
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Board of Physical & Occupational Therapy                                                                                      
                                                                                                                                
     Dr. Enlow Walker - North Pole                                                                                              
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Board of Psychologists & Psychological Associate Examiners                                                                    
                                                                                                                                
     Matthew Dammeyer - Soldotna                                                                                                
     Erin Johnson - Anchorage                                                                                                   
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Board of Certified Real Estate Appraisers                                                                                     
                                                                                                                                
     Ashlee Stetson - Wasilla                                                                                                   
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Real Estate Commission                                                                                                        
                                                                                                                                
     Cheryl Markwood - Fairbanks                                                                                                
     Jaime Matthews - Glennallen                                                                                                
     PeggyAnn McConnochie - Juneau                                                                                              
     Margaret Nelson - Anchorage                                                                                                
     Jesse Sumner - Wasilla                                                                                                     
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Board of Social Work Examiners                                                                                                
                                                                                                                                
     Geoffry McCormick - North Pole                                                                                             
     Colleen Vague - Wasilla                                                                                                    
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Board of Veterinary Examiners                                                                                                 
                                                                                                                                
     Dr. Scott Flamme - Fairbanks                                                                                               
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Alaska Workers' Compensation Board                                                                                            
                                                                                                                                
     Bradley Austin - Juneau                                                                                                    
     Randy Beltz - Anchorage                                                                                                    
     Charles "Chuck" Collins Jr. - Juneau                                                                                       
     Bob Doyle - Wasilla                                                                                                        
     Julie Duquette - Fairbanks                                                                                                 
     Sara Faulkner - Homer                                                                                                      
     Diane Thompson - Anchorage                                                                                                 
     Kimberly Ziegler - Palmer                                                                                                  
     Sarah Lefebvre - Fairbanks                                                                                                 
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
State Board of Registration for Architects, Engineers, & Land                                                                 
Surveyors                                                                                                                     
                                                                                                                                
     Phillip Schneider - Palmer                                                                                                 
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
HOUSE BILL NO. 91                                                                                                               
"An Act relating to the  practice of naturopathy; relating to the                                                               
licensure  of   naturopaths;  relating   to  the   Department  of                                                               
Commerce, Community, and Economic  Development; and providing for                                                               
an effective date."                                                                                                             
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
HOUSE BILL NO. 102                                                                                                              
"An Act relating to rental vehicles; relating to vehicle rental                                                                 
networks; relating to liability for vehicle rental taxes; and                                                                   
providing for an effective date."                                                                                               
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: HB  91                                                                                                                  
SHORT TITLE: NATUROPATHS: LICENSING; PRACTICE                                                                                   
SPONSOR(s): REPRESENTATIVE(s) JOHNSTON                                                                                          
                                                                                                                                
03/13/19       (H)       READ THE FIRST TIME - REFERRALS                                                                        
03/13/19       (H)       L&C, FIN                                                                                               
04/03/19       (H)       L&C AT 3:15 PM BARNES 124                                                                              
                                                                                                                                
BILL: HB 102                                                                                                                  
SHORT TITLE: RENTAL VEHICLE BY PRIVATE OWNER                                                                                    
SPONSOR(s): REPRESENTATIVE(s) WOOL                                                                                              
                                                                                                                                
03/20/19       (H)       READ THE FIRST TIME - REFERRALS                                                                        
03/20/19       (H)       L&C, FIN                                                                                               
04/03/19       (H)       L&C AT 3:15 PM BARNES 124                                                                              
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
SHANNON CONNELLY, Appointee                                                                                                     
Board of Nursing                                                                                                                
Palmer, Alaska                                                                                                                  
POSITION STATEMENT:  Testified as appointee to the Board of                                                                   
Nursing.                                                                                                                        
                                                                                                                                
EMILY HENRY, Appointee                                                                                                          
Board of Nursing                                                                                                                
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified as appointee to the Board of                                                                   
Nursing.                                                                                                                        
                                                                                                                                
ERIN SHINE, Staff                                                                                                               
Representative Jennifer Johnston                                                                                                
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented HB 91 on behalf of Representative                                                              
Johnston, prime sponsor.                                                                                                        
                                                                                                                                
SARA CHAMBERS, Director                                                                                                         
Division of Corporations, Businesses, and Professional Licensing                                                                
Department of Commerce, Community & Economic Development                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Answered questions during the hearing on HB
91.                                                                                                                             
                                                                                                                                
ABBY LAING, ND                                                                                                                  
Thrive Integrative Medicine;                                                                                                    
President, Alaska Association of Naturopathic Physicians                                                                        
Anchorage, Alaska                                                                                                               
POSITION  STATEMENT:    Answered   questions  as  a  naturopathic                                                             
physician during the hearing on HB 91.                                                                                          
                                                                                                                                
ASHLEY STRAUCH, Staff                                                                                                           
Representative Adam Wool                                                                                                        
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Answered questions  during the hearing on HB
102, on behalf of Representative Wool, prime sponsor.                                                                           
                                                                                                                                
BRANDON SPANOS, Deputy Director                                                                                                 
Tax Division                                                                                                                    
Department of Revenue                                                                                                           
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Answered questions  during the hearing on HB
102.                                                                                                                            
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
3:21:07 PM                                                                                                                    
                                                                                                                                
CO-CHAIR ADAM WOOL  called the House Labor  and Commerce Standing                                                             
Committee meeting to order at  3:21 p.m.  Representatives Fields,                                                               
Hannan, Revak,  Talerico, LeDoux,  and Wool  were present  at the                                                               
call to order.  Representative  Stutes arrived as the meeting was                                                               
in progress.                                                                                                                    
                                                                                                                                
^CONFIRMATION HEARING(S):                                                                                                       
^Board of Nursing                                                                                                               
                    CONFIRMATION HEARING(S):                                                                                
                        Board of Nursing                                                                                    
                                                                                                                              
                                                                                                                              
3:21:49 PM                                                                                                                    
                                                                                                                                
CO-CHAIR WOOL  announced that the  first order of  business would                                                               
be confirmation hearings for appointees to the Board of Nursing.                                                                
                                                                                                                              
3:22:02 PM                                                                                                                    
                                                                                                                                
SHANNON  CONNELLY,  Appointee, Board  of  Nursing,  gave a  brief                                                               
description  of  her experience  working  as  a teacher  for  the                                                               
Anchorage  School District  for  9  years.   She  noted that  she                                                               
currently serves  on the city  of Palmer's Parks,  Recreation and                                                               
Cultural Resources Board.   Her interest in serving  on the Board                                                               
of Nursing stems  from her concern about the  state's shortage of                                                               
nurses.   She  said  she wants  to help  ensure  that there  will                                                               
continue to be quality nurses in Alaska.                                                                                        
                                                                                                                                
CO-CHAIR  WOOL asked  if Ms.  Connelly is  applying for  a public                                                               
seat on the board.                                                                                                              
                                                                                                                                
MS. CONNELLY answered yes.                                                                                                      
                                                                                                                                
3:24:06 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FIELDS asked  if restricting  reproductive health                                                               
services is an appropriate role for the Board of Nursing.                                                                       
                                                                                                                                
MS. CONNELLY Answered no, it's a role for individual practices.                                                                 
                                                                                                                                
3:25:32 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE STUTES, referencing  Ms. Connelly's resume, sought                                                               
clarification on "the Popcorn Colonel" volunteer position.                                                                      
                                                                                                                                
MS. CONNELLY  explained that  it's a  position that  oversees the                                                               
popcorn fundraiser sales for the Boy Scouts of America.                                                                         
                                                                                                                                
3:27:02 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  HANNAN  questioned  whether  Ms.  Connelly  would                                                               
advocate  for the  extension  and continuation  of  the Board  of                                                               
Nursing  and  asked  if  the  board's  statutory  expiration  was                                                               
discussed at the meeting she attended.                                                                                          
                                                                                                                                
MS. CONNELLY confirmed  that it was brought up  during a previous                                                               
board meeting.   She noted  that there would be  more information                                                               
on  how  to  advocate  for  the board's  extension  at  the  next                                                               
meeting.                                                                                                                        
                                                                                                                                
CO-CHAIR WOOL  asked if  Ms. Connelly  had experience  serving on                                                               
other boards in the past.                                                                                                       
                                                                                                                                
Ms. CONNELLY  revealed that this would  be the second, as  she is                                                               
currently  serving on  Palmer's  Parks,  Recreation and  Cultural                                                               
Resources Board.                                                                                                                
                                                                                                                                
3:29:32 PM                                                                                                                    
                                                                                                                                
CO-CHAIR WOOL opened public testimony.                                                                                          
                                                                                                                                
3:30:00 PM                                                                                                                    
                                                                                                                                
EMILY HENRY, Appointee, Board of  Nursing, informed the committee                                                               
that  she   is  originally  from   Delaware  and  gave   a  brief                                                               
description of her educational  background and experience working                                                               
as a homecare nurse wherein  she mostly worked with special needs                                                               
children.   She stated  that she  moved to  Alaska two  years ago                                                               
after accepting  a job  with Providence  Extended Care  where she                                                               
oversees 12 residents.   She said her interest in  serving on the                                                               
board stems from her desire to  share the insight she gained from                                                               
her homecare experience.                                                                                                        
                                                                                                                                
REPRESENTATIVE  HANNAN asked  how  to ensure  there are  adequate                                                               
licensure programs  for all levels  of nursing in Alaska  and how                                                               
to fulfill the demand for those positions across the state.                                                                     
                                                                                                                                
MS. HENRY  replied that she  works closely with student  CNAs and                                                               
is familiar with  their skills and where they  might lack certain                                                               
knowledge.  She opined that the  board needs to improve their on-                                                               
site visits to training facilities,  which are required every two                                                               
years in order to increase the  quality of CNAs and nurses in the                                                               
state.                                                                                                                          
                                                                                                                                
3:35:33 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FIELDS asked  if restricting  reproductive health                                                               
services is an appropriate role for the Board of Nursing.                                                                       
                                                                                                                                
MS.  HENRY  opined  that  there's  no reason  for  the  board  to                                                               
restrict anything  related to women's  health.  She  expounded on                                                               
the importance of women making  regular doctor's appointments and                                                               
check-ups.                                                                                                                      
                                                                                                                                
CO-CHAIR WOOL  noted that this  board position is  specifically a                                                               
licensed  practical nurse  (LPN)  seat.   He  asked  if that  was                                                               
correct.                                                                                                                        
                                                                                                                                
MS. HENRY  answered yes, adding  that she  has been an  LPN since                                                               
2011 and is currently licensed in the state of Alaska.                                                                          
                                                                                                                                
3:39:18 PM                                                                                                                    
                                                                                                                                
CO-CHAIR WOOL closed public testimony.                                                                                          
                                                                                                                                
3:39:30 PM                                                                                                                    
                                                                                                                                
CO-CHAIR  LEDOUX moved  to advance  the  confirmation of  Shannon                                                               
Connelly and Emily Henry, appointees  to the Board of Nursing, to                                                               
the  joint session  of the  House and  Senate for  consideration.                                                               
She  reminded   members  that   signing  the   reports  regarding                                                               
appointments  to  boards  and  commissions  in  no  way  reflects                                                               
individual members'  approval or  disapproval of  the appointees,                                                               
and the nominations are merely  forwarded to the full legislature                                                               
for confirmation  or rejection.   There  being no  objection, the                                                               
confirmations were advanced.                                                                                                    
                                                                                                                                
3:39:59 PM                                                                                                                    
                                                                                                                                
The committee took a brief at-ease.                                                                                             
^CONFIRMATION HEARING(S):                                                                                                       
^Board of Massage Therapists                                                                                                    
^Board of Certified Direct-Entry Midwives                                                                                       
^Occupational Safety & Health Review Board                                                                                      
^Board of Examiners in Optometry                                                                                                
^Board of Pharmacy                                                                                                              
^Board of Physical & Occupational Therapy                                                                                       
^Board of Psychologists & Psychological Associate Examiners                                                                     
^Board of Certified Real Estate Appraisers                                                                                      
^Real Estate Commission                                                                                                         
^Board of Social Work Examiners                                                                                                 
^Board of Veterinary Examiners                                                                                                  
^Alaska Workers' Compensation Board                                                                                             
^State Board of Registration for Architects, Engineers, & Land                                                                  
Surveyors                                                                                                                       
                    CONFIRMATION HEARING(S):                                                                                
                  Board of Massage Therapists                                                                               
            Board of Certified Direct-Entry Midwives                                                                        
           Occupational Safety & Health Review Board                                                                        
                Board of Examiners in Optometry                                                                             
                       Board of Pharmacy                                                                                    
            Board of Physical & Occupational Therapy                                                                        
   Board of Psychologists & Psychological Associate Examiners                                                               
           Board of Certified Real Estate Appraisers                                                                        
                     Real Estate Commission                                                                                 
                 Board of Social Work Examiners                                                                             
                 Board of Veterinary Examiners                                                                              
               Alaska Workers' Compensation Board                                                                           
 State Board of Registration for Architects, Engineers, & Land                                                              
                           Surveyors                                                                                        
                                                                                                                                
3:40:03 PM                                                                                                                    
                                                                                                                                
CO-CHAIR WOOL turned the committee's attention to the remaining                                                                 
various boards and commissions.                                                                                                 
                                                                                                                                
                                                                                                                                
3:42:26 PM                                                                                                                    
                                                                                                                                
CO-CHAIR   LEDOUX  moved   to  advance   the  confirmations   for                                                               
appointees  referred to  the House  Labor  and Commerce  Standing                                                               
Committee for  consideration to  the joint  session of  the House                                                               
and Senate for consideration.   She reminded members that signing                                                               
the reports  regarding appointments to boards  and commissions in                                                               
no way  reflects individual members'  approval or  disapproval of                                                               
the appointees, and  the nominations are merely  forwarded to the                                                               
full legislature for  confirmation or rejection.   There being no                                                               
objection, the confirmations were advanced.                                                                                     
                                                                                                                                
3:43:00 PM                                                                                                                    
                                                                                                                                
The committee took a brief at-ease.                                                                                             
                                                                                                                                
            HB  91-NATUROPATHS: LICENSING; PRACTICE                                                                         
                                                                                                                                
3:43:04 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  WOOL announced  that the  next order  of business                                                               
would be HOUSE  BILL NO. 91, "An Act relating  to the practice of                                                               
naturopathy; relating  to the licensure of  naturopaths; relating                                                               
to   the  Department   of  Commerce,   Community,  and   Economic                                                               
Development; and providing for an effective date."                                                                              
                                                                                                                                
3:44:47 PM                                                                                                                    
                                                                                                                                
ERIN  SHINE,  Staff,  Representative  Jennifer  Johnston,  Alaska                                                               
State Legislature,  presented HB  91 on behalf  of Representative                                                               
Johnston, prime  sponsor.  She  paraphrased parts of  the sponsor                                                               
statement [included in  the committee packet], which  read in its                                                               
entirety as follows [original punctuation provided]:                                                                            
                                                                                                                                
     House  Bill  91,  by  establishing  a  clear  scope  of                                                                    
     practice for naturopathic doctors,  aims to allow these                                                                    
     primary  health care  providers in  Alaska to  practice                                                                    
     consistent with their education and training.                                                                              
                                                                                                                                
     Alaska's   nearly  60   licensed  naturopaths   provide                                                                    
     valuable  health   care  services   and  can   play  an                                                                    
     important  role  in  helping address  Alaska's  primary                                                                    
     care provider  shortage. However, current  state statue                                                                    
     is   vague   as   to  the   specific   authorities   of                                                                    
     naturopaths, which has  led to the adoption  of some of                                                                    
     the most restrictive  naturopathic medicine regulations                                                                    
     in the nation.                                                                                                             
                                                                                                                                
     For example,  despite being trained to  perform a range                                                                    
     of  minor  office  procedures, such  as  sutures,  wart                                                                    
     removal,  IUD placement  and  removal, naturopaths  are                                                                    
     prohibited  from   performing  any  of   these  routine                                                                    
     procedures in Alaska.  Similarly, many naturopaths have                                                                    
     accredited pharmacological training,  yet under current                                                                    
     regulation  are prohibited  from writing  prescriptions                                                                    
     and  must instead  refer patients  to other  providers                                                                     
     even  though those  providers  may  have less  advanced                                                                    
     training.  These  overly  restrictive  regulations  are                                                                    
     causing  many  naturopaths  to  rethink  practicing  in                                                                    
     Alaska.                                                                                                                    
                                                                                                                                
     HB 91  would correct this by  outlining clear statutory                                                                    
     guidelines,  including,  among other  things,  allowing                                                                    
     licensed  naturopathic practitioners  to perform  minor                                                                    
     office procedures and  to prescribe vitamins, minerals,                                                                    
     and  other non-controlled  substance medications.  This                                                                    
     same scope  is being  practiced safely in  other states                                                                    
     and by other healthcare  providers in Alaska with equal                                                                    
     or lesser training.                                                                                                        
                                                                                                                                
     Naturopathic   medicine   can  provide   valuable   and                                                                    
     complementary care  in the Alaska health  care setting.                                                                    
     Many Alaskans  struggle with basic health  care access.                                                                    
     The ability  for naturopaths to  practice the  scope of                                                                    
     medicine   consistent   with   their   training   would                                                                    
     immediately expand the availability  of primary care in                                                                    
     the state.                                                                                                                 
                                                                                                                                
     Many  Alaskans face  challenges  with chronic  diseases                                                                    
     like  obesity, diabetes,  and  hypertension. These  are                                                                    
     the sorts  of issues  for which naturopaths  have clear                                                                    
     tools to  assist their patients.  Naturopathic training                                                                    
     focuses on disease prevention,  rather than symptom and                                                                    
     medication  management  alone.  In the  long-run,  this                                                                    
     type  of care  can  provide  cost-savings and  improved                                                                    
     health  outcomes  for   consumers,  insurers,  and  the                                                                    
     state. HB 91 aims to  let naturopathic medicine live up                                                                    
     to  this promise  by allowing  naturopathic doctors  to                                                                    
     practice  within  the  scope   of  their  training  and                                                                    
     education,  thereby   increasing  competition   in  the                                                                    
     healthcare sector  and ensuring Alaskan's have  a range                                                                    
        of options when choosing the style of healthcare                                                                        
     that's right for them.                                                                                                     
                                                                                                                                
3:51:14 PM                                                                                                                    
                                                                                                                                
CO-CHAIR WOOL asked for clarification on state regulation.                                                                      
                                                                                                                                
MS. SHINE replied  that in a regulated state,  the governing body                                                               
sets a criterion  of qualifications that must be  met; whereas in                                                               
an unregulated  state, it's  possible for  individuals to  set up                                                               
practices as  naturopathic doctors  (NDs) without  oversight from                                                               
the state.                                                                                                                      
                                                                                                                                
CO-CHAIR WOOL  asked if NDs  in unregulated states  can prescribe                                                               
drugs or do minor office procedures.                                                                                            
                                                                                                                                
MS. SHINE  answered no.   She offered her understanding  that NDs                                                               
must  be registered  or licensed  within a  state to  be able  to                                                               
prescribe medications.  Nonetheless, she  noted that a ND who has                                                               
set  up practice  in  an unregulated  state  could be  performing                                                               
minor procedures without oversight from the state.                                                                              
                                                                                                                                
3:52:31 PM                                                                                                                    
                                                                                                                                
CO-CHAIR  LEDOUX asked  if NDs  in Alaska  are regulated  even if                                                               
they currently can't write prescriptions.                                                                                       
                                                                                                                                
MS.  SHINE answered  yes,  they are  regulated  and cannot  write                                                               
prescriptions.                                                                                                                  
                                                                                                                                
CO-CHAIR LEDOUX questioned whether  the current statute prohibits                                                               
NDs from prescribing.                                                                                                           
                                                                                                                                
MS. SHINE affirmed that.                                                                                                        
                                                                                                                                
3:52:58 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FIELDS indicated  that there  is an  advantage in                                                               
state  regulation in  terms of  transparency for  consumers.   He                                                               
asked  Ms.  Chambers if  there  is  currently adequate  authority                                                               
within   the   Division    of   Corporations,   Businesses,   and                                                               
Professional  Licensing for  someone who  sets up  a naturopathic                                                               
practice without any knowledge or proficiency in the field.                                                                     
                                                                                                                                
3:53:33 PM                                                                                                                    
                                                                                                                                
SARA  CHAMBERS, Director,  Division of  Corporations, Businesses,                                                               
and Professional  Licensing, Department of Commerce,  Community &                                                               
Economic  Development,  explained  that,  currently,  NDs  are  a                                                               
licensed profession in Alaska which  gives the division authority                                                               
to enforce the existing statutory  and regulatory restrictions on                                                               
NDs and to regulate unlicensed practices.                                                                                       
                                                                                                                                
REPRESENTATIVE  FIELDS   established  a  scenario  in   which  an                                                               
individual insists on advertising themselves  as a ND even though                                                               
he or  she doesn't  have the  proper training.   He asked  if the                                                               
division would have the ability to shut down that business.                                                                     
                                                                                                                                
MS. CHAMBERS replied that they  typically have that authority for                                                               
all  their  licensed  programs  and  professions;  however,  it's                                                               
individualized within each  statute.  She stated that  there is a                                                               
process for those  who practice any of  their professions without                                                               
a  license and  if it  extends  beyond their  civil authority  it                                                               
would include law enforcement for criminal authority if needed.                                                                 
                                                                                                                                
3:55:08 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  HANNAN inquired  as to  how long  naturopathy has                                                               
been a licensed profession in the state.                                                                                        
                                                                                                                                
MS. CHAMBERS answered since 1986.                                                                                               
                                                                                                                                
REPRESENTATIVE HANNAN  questioned the  level of  consumer concern                                                               
and frequency of complaints about the practice of NDs.                                                                          
                                                                                                                                
MS. CHAMBERS said  there has been 33 complaints over  the last 20                                                               
years,  adding  that  most  of  those  have  been  low  level  or                                                               
ultimately found to be unsubstantiated.                                                                                         
                                                                                                                                
3:57:14 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  WOOL  sought  clarification on  the  prescriptive                                                               
authority that the current bill is seeking to grant NDs.                                                                        
                                                                                                                                
MS. SHINE  replied that the  prescriptive authority  being sought                                                               
is  noncontrolled  substances  and nonchemotherapeutic  agents  -                                                               
everything  else  that  would require  a  prescription  would  be                                                               
allowed for NDs under their scope.                                                                                              
                                                                                                                                
3:58:10 PM                                                                                                                    
                                                                                                                                
CO-CHAIR  LEDOUX  offered her  understanding  that  the focus  of                                                               
naturopathic  medicine was  nature-based.   She  asked  why a  ND                                                               
would need to write prescriptions  for antibiotics or things that                                                               
aren't "natural."                                                                                                               
                                                                                                                                
MS.  SHINE  acknowledged  that NDs  focus  on  holistic  healing;                                                               
however, they  are still  trained to  be able  to prescribe  as a                                                               
last  resort.   She  noted  that as  the  number of  naturopathic                                                               
primary  care  providers  increases,  this would  allow  them  to                                                               
address their patients  concerns if it gets to the  point that an                                                               
antibiotic or a birth control prescription would be warranted.                                                                  
                                                                                                                                
4:00:12 PM                                                                                                                    
                                                                                                                                
ABBY LAING,  ND, Thrive  Integrative Medicine;  President, Alaska                                                               
Association  of  Naturopathic  Physicians, added  that  sometimes                                                               
antibiotics  are needed.   A  child  with an  ear infection,  for                                                               
example, is situational - sometimes  the infections don't need to                                                               
be  treated with  antibiotics and  others do.   If  someone would                                                               
prefer  to treat  things naturally,  there's also  the "wait  and                                                               
watch approach," in  which case they would get a  supplement or a                                                               
nutraceutical as well  as an antibiotic prescription  in case the                                                               
infection doesn't  get better.   She also  pointed out that  if a                                                               
woman wanted to  get a refill on her  birth control prescription,                                                               
she would have to do that through a different provider.                                                                         
                                                                                                                                
4:02:49 PM                                                                                                                    
                                                                                                                                
CO-CHAIR LEDOUX questioned whether  there is a difference between                                                               
NDs and medical doctors (MDs).                                                                                                  
                                                                                                                                
MS. SHINE  offered her understanding  that both MDs and  NDs have                                                               
four-year degrees;  however, completing  a residency  is required                                                               
of physicians and optional for NDs.   She further noted that they                                                               
take different approaches to medicine.                                                                                          
                                                                                                                                
DR. LAING,  in response to Representative  LeDoux, explained that                                                               
MDs are trained in specialties,  while NDs focus on primary care.                                                               
She also  affirmed that  a residency  is required  of all  MDs in                                                               
order to be licensed, except for  those working at an urgent care                                                               
facility.                                                                                                                       
                                                                                                                                
MS.  SHINE  pointed  out  that   nurse  practitioners  (NPs)  and                                                               
physician's  assistants (PAs)  are  practicing  within a  greater                                                               
scope  than  what's  being  requested by  NDs  because  they  can                                                               
prescribe controlled substances.                                                                                                
                                                                                                                                
4:06:49 PM                                                                                                                    
                                                                                                                                
CO-CHAIR WOOL  offered his  understanding that  PAs and  NPs only                                                               
prescribe under  the direct  supervision of  a MD.   He  asked if                                                               
this was correct.                                                                                                               
                                                                                                                                
MS. SHINE confirmed  that PAs are under the supervision  of a MD,                                                               
while NPs are not.                                                                                                              
                                                                                                                                
CO-CHAIR WOOL asked  if hormone therapy, steroids,  or high blood                                                               
pressure  medicine   would  all   fall  under   the  prescriptive                                                               
authority of a ND if this bill were to pass.                                                                                    
                                                                                                                                
DR.  LAING  explained  that  testosterone   is  classified  as  a                                                               
controlled   substance   and   therefore   excluded   from   NDs'                                                               
prescriptive authority  under HB 91.   She noted  that controlled                                                               
substances  are   contentious  and  not  necessary   to  practice                                                               
effectively.                                                                                                                    
                                                                                                                                
4:09:34 PM                                                                                                                    
                                                                                                                                
CO-CHAIR WOOL announced that HB 91 was held over.                                                                               
                                                                                                                                
4:09:51 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 4:09 p.m. to 4:12 p.m.                                                                       
                                                                                                                                
[Co-Chair Wool passed the gavel to Co-Chair LeDoux.]                                                                            
                                                                                                                                
             HB 102-RENTAL VEHICLE BY PRIVATE OWNER                                                                         
                                                                                                                                
4:12:42 PM                                                                                                                    
                                                                                                                                
CO-CHAIR LEDOUX announced that the  final order of business would                                                               
be  HOUSE BILL  NO. 102,  "An  Act relating  to rental  vehicles;                                                               
relating to  vehicle rental networks;  relating to  liability for                                                               
vehicle rental taxes; and providing for an effective date."                                                                     
                                                                                                                                
4:12:57 PM                                                                                                                    
                                                                                                                                
CO-CHAIR WOOL,  as prime sponsor  of HB 102, introduced  the bill                                                               
and read  the following  sponsor statement  [original punctuation                                                               
provided]:                                                                                                                      
                                                                                                                                
     The ways that  Alaskans procure transportation services                                                                    
     have  changed over  time. In  the past,  getting off  a                                                                    
     commercial  flight and  heading to  the nearest  rental                                                                    
     car  agency was  common  practice.  Now, consumers  are                                                                    
     turning increasingly  to ridesharing, car  pooling, and                                                                    
     rental vehicle  network options to get  around. Vehicle                                                                    
     rental networks are rental  car businesses that arrange                                                                    
     or execute  personal passenger vehicle  rentals through                                                                    
     a  network of  individual private  vehicle owners,  and                                                                    
     are  becoming  a   common  alternative  to  traditional                                                                    
     rental car options.                                                                                                        
                                                                                                                                
     HB  102  adds  a  definition for  the  new  service  of                                                                    
     providing  private vehicle  rental programs,  including                                                                    
     these  services into  existing  statutes that  regulate                                                                    
     car rental  providers to reflect changes  in how people                                                                    
     secure transport  in Alaska.  It also extends  the same                                                                    
     laws  and   regulations  which  apply  to   rental  car                                                                    
     companies   to   private   vehicle   rental   networks,                                                                    
     including  the payment  of the  State's Vehicle  Rental                                                                    
     Tax.  Therefore, HB  102 brings  equity  to the  rental                                                                    
     industry   for  motor   vehicles,  and   will  generate                                                                    
     additional income  for the State's general  fund as the                                                                    
     private  vehicle rental  network industry  continues to                                                                    
     grow and diversify in the Alaskan economy.                                                                                 
                                                                                                                                
     Please join  me in supporting  House Bill 102  to bring                                                                    
     our statutes  up to  date and  to incorporate  this new                                                                    
     industry into  the existing language  governing vehicle                                                                    
     rentals in Alaska.                                                                                                         
                                                                                                                                
4:15:48 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS asked if internet-based car rental                                                                        
companies pay taxes.                                                                                                            
                                                                                                                                
CO-CHAIR WOOL said they do not.                                                                                                 
                                                                                                                                
4:16:08 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE STUTES questioned whether any "peer-to-peer                                                                      
groups" have bricks-and-mortar buildings in Alaska.                                                                             
                                                                                                                                
CO-CHAIR WOOL answered no.                                                                                                      
                                                                                                                                
REPRESENTATIVE STUTES said she presumes their headquarters are                                                                  
out of state.                                                                                                                   
                                                                                                                                
CO-CHAIR WOOL confirmed that.                                                                                                   
                                                                                                                                
REPRESENTATIVE STUTES asked where they are headquartered out of.                                                                
                                                                                                                                
4:16:50 PM                                                                                                                    
                                                                                                                                
ASHLEY  STRAUCH, Staff,  Representative Adam  Wool, Alaska  State                                                               
Legislature, on  behalf of Representative Wool,  prime sponsor of                                                               
HB  102, stated  that the  largest [peer-to-peer]  vehicle rental                                                               
network is  Turo, which  is headquartered  out of  San Francisco,                                                               
California.                                                                                                                     
                                                                                                                                
REPRESENTATIVE STUTES said it sounds  like these companies, which                                                               
operate out of state, do the  bookkeeping for the rental of other                                                               
people's vehicles  within the  state while  paying no  revenue to                                                               
the state  of Alaska;  however, the rental  car companies  do pay                                                               
taxes.  She asked if this was correct.                                                                                          
                                                                                                                                
MS. STRAUCH affirmed that.                                                                                                      
                                                                                                                                
REPRESENTATIVE STUTES surmised that  the current bill "levels the                                                               
playing field so everyone is playing the same game."                                                                            
                                                                                                                                
MS. STRAUCH answered that is correct.                                                                                           
                                                                                                                                
4:17:57 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS  asked if  the Department of  Revenue (DOR)                                                               
has tried  to collect taxes  from these  [peer-to-peer] digitally                                                               
based car rental companies.                                                                                                     
                                                                                                                                
4:18:35 PM                                                                                                                    
                                                                                                                                
BRANDON  SPANOS, Deputy  Director,  Tax  Division, Department  of                                                               
Revenue,  noted  that  it's difficult  to  talk  about  specifics                                                               
because  of confidentiality  statutes.    Nonetheless, he  stated                                                               
that the statute does make it  clear that the rental of a vehicle                                                               
is taxable.  He added that  the current bill would clarify who is                                                               
taxable.   He  divulged  that  the DOR  has  sent  a request  for                                                               
records to  some of the  peer-to-peer companies to  determine who                                                               
is renting  the vehicles, adding  that one of those  requests has                                                               
turned  into  a  subpoena.   He  explained  that  their  subpoena                                                               
language  is lacking  and doesn't  allow the  enforcement of  tax                                                               
subpoenas outside  of Alaska; therefore,  in order to  enforce it                                                               
they  will have  to take  it to  the other  state's court  unless                                                               
there is  a statute change.   He further noted that  other states                                                               
that  have  bed  taxes  have  dealt with  the  same  issues  with                                                               
companies like Airbnb.                                                                                                          
                                                                                                                                
4:20:12 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FIELDS  questioned   whether  the  companies  are                                                               
refusing  to share  information and  pay taxes  even though  they                                                               
continue to operate in Alaska.                                                                                                  
                                                                                                                                
MR.  SPANOS clarified  that they  asked for  records, not  taxes,                                                               
because  its clear  that the  person renting  the vehicle  is the                                                               
taxpayer and  does owe  the tax;  however, they  do not  know who                                                               
that person  is.   He added that  peer-to-peer didn't  exist when                                                               
the  statute was  drafted  so it  doesn't  implicitly state  that                                                               
those companies are the taxpayer, which makes it a grey area.                                                                   
                                                                                                                                
REPRESENTATIVE  FIELDS  commented  that  its  extraordinary  that                                                               
these  companies  are operating  here  and  enabling car  rentals                                                               
without paying taxes.  He opined  that it sounds like tax evasion                                                               
and the only remedy for that would be this bill.                                                                                
                                                                                                                                
4:21:36 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  STUTES  said it  appears  that  HB 102  closes  a                                                               
loophole since this  situation didn't exist when  the statute was                                                               
written.  She asked if this is correct.                                                                                         
                                                                                                                                
4:22:01 PM                                                                                                                    
                                                                                                                                
MS. STRAUCH  acknowledged that this  bill clarifies  the language                                                               
in  statute of  what constitutes  a vehicle  rental by  including                                                               
vehicle rental networks in the definition.                                                                                      
                                                                                                                                
CO-CHAIR LEDOUX  sought clarification on whether  it's the entity                                                               
that does the bookkeeping or the  consumer who rents the car that                                                               
owes taxes.                                                                                                                     
                                                                                                                                
4:22:30 PM                                                                                                                    
                                                                                                                                
MR. SPANOS  replied that the  statute currently reads,  "there is                                                               
imposed an excise  tax on the charge for the  lease of the rental                                                               
vehicle," adding that it's assessed  on the person who is renting                                                               
out their vehicle.                                                                                                              
                                                                                                                                
4:23:31 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE HANNAN asked  Mr. Spanos if he worked  for the DOR                                                               
when Alaska established taxes for Airbnb and similar entities.                                                                  
                                                                                                                                
MR. SPANOS said  the state doesn't have a statewide  bed tax.  He                                                               
explained  that there  are  no  state taxes  on  them unless  the                                                               
company is  a corporation and  the corporate income  tax applies.                                                               
He  added  that other  states  have  dealt  with this  issue  and                                                               
created statutes to implicitly state that they are taxable.                                                                     
                                                                                                                                
4:24:16 PM                                                                                                                    
                                                                                                                                
CO-CHAIR  LEDOUX questioned  whether there  is a  statewide hotel                                                               
bed tax in Alaska.                                                                                                              
                                                                                                                                
MR.  SPANOS  stated  that  there  is not  a  statewide  bed  tax;                                                               
however, municipalities do have them.                                                                                           
                                                                                                                                
CO-CHAIR   LEDOUX    sought   clarification   on    whether   the                                                               
municipalities tax Airbnb the same as hotels.                                                                                   
                                                                                                                                
MR. SPANOS offered that he has  been told they are having trouble                                                               
collecting taxes  on those  types of companies.   Some,  he said,                                                               
have  sought to  change their  ordinances to  create an  economic                                                               
nexus for those companies.                                                                                                      
                                                                                                                                
4:25:42 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TALERICO recounted his  experience with the Denali                                                               
Borough tax structure  and the overnight accommodations  tax.  He                                                               
explained that everyone who provides  nightly rentals is required                                                               
to register  with the  Denali Borough  and provide  the overnight                                                               
accommodations tax on  their rack rate; whether that  be a single                                                               
cabin  or  a  hotel  campus  with 400-500  rooms,  they  are  all                                                               
required to register and fulfill that.                                                                                          
                                                                                                                                
4:26:21 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS offered his belief  that Anchorage has a 12                                                               
percent bed tax that applies to Airbnb.                                                                                         
                                                                                                                                
4:26:33 PM                                                                                                                    
                                                                                                                                
CO-CHAIR WOOL  explained that the  intention is to  implement the                                                               
tax into the  [peer-to-peer] app itself, making it  so the person                                                               
renting the  car will pay the  rental fee plus the  tax that will                                                               
go to  Turo, who in  turn, will keep some  of the rental  fee for                                                               
operating costs  plus the tax,  which they  will then pay  to the                                                               
state.   This would simplify  the process for the  state, because                                                               
instead of taxing each individual  renter they would only have to                                                               
go after several companies.                                                                                                     
                                                                                                                                
4:28:16 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS noted that the existence of a bed tax has                                                                 
not inhibited Airbnb's growth.                                                                                                  
                                                                                                                                
4:28:35 PM                                                                                                                    
                                                                                                                                
CO-CHAIR WOOL  added that this  "centralized" system would  be no                                                               
different than  Uber.  He  said that, instead of  each individual                                                               
driver  paying tax  to  the city  of Juneau,  it  all gets  payed                                                               
through the company itself.                                                                                                     
                                                                                                                                
4:29:17 PM                                                                                                                    
                                                                                                                                
CO-CHAIR LEDOUX announced that HB 102 was held over.                                                                            
                                                                                                                                
4:29:32 PM                                                                                                                    
                                                                                                                                
CO-CHAIR LEDOUX ADJOURNMENT                                                                                                   
                                                                                                                                
There being no further business before the committee, the House                                                                 
Labor and Commerce Standing Committee meeting was adjourned at                                                                  
4:29 p.m.                                                                                                                       

Document Name Date/Time Subjects
Shannon Connelly_Redacted.pdf HL&C 4/3/2019 3:15:00 PM
Emily Henry - Redacted.pdf HL&C 4/3/2019 3:15:00 PM
HB 91.Sponsor.pdf HL&C 4/3/2019 3:15:00 PM
HL&C 4/8/2019 3:15:00 PM
HB 91
HB 91.Bill Version M.PDF HL&C 4/3/2019 3:15:00 PM
HL&C 4/8/2019 3:15:00 PM
HB 91
HB 91.Sectional.pdf HL&C 4/3/2019 3:15:00 PM
HL&C 4/8/2019 3:15:00 PM
HB 91
HB 91.Fiscal.pdf HL&C 4/3/2019 3:15:00 PM
HL&C 4/8/2019 3:15:00 PM
HB 91
HB 91.Backup Naturopathic Regulation.pdf HL&C 4/3/2019 3:15:00 PM
HL&C 4/8/2019 3:15:00 PM
HB 91
HB 91.Backup Naturopathic Perscriptive Authority.pdf HL&C 4/3/2019 3:15:00 PM
HL&C 4/8/2019 3:15:00 PM
HB 91
HB 91.Backup Naturopathic Medicine Background.pdf HL&C 4/3/2019 3:15:00 PM
HL&C 4/8/2019 3:15:00 PM
HB 91
HB 91.Backup Naturopath One-Pager.pdf HL&C 4/3/2019 3:15:00 PM
HL&C 4/8/2019 3:15:00 PM
HB 91
HB 91.Backup Naturopathic Concerns and Answers.pdf HL&C 4/3/2019 3:15:00 PM
HL&C 4/8/2019 3:15:00 PM
HB 91
HB 91. Backup Support Letters Index April 3.pdf HL&C 4/3/2019 3:15:00 PM
HB 91
HB 91.Backup Support Letters.pdf HL&C 4/3/2019 3:15:00 PM
HB 91
HB 91.Backup Education and Scope Comparison.pdf HL&C 4/3/2019 3:15:00 PM
HL&C 4/8/2019 3:15:00 PM
HB 91
2019.HB102.Sponsor Statement.pdf HL&C 4/3/2019 3:15:00 PM
HL&C 4/15/2019 3:15:00 PM
HB 102
HB 102. Bill Version U.PDF HL&C 4/3/2019 3:15:00 PM
HB 102
2019.HB102.Sectional.pdf HL&C 4/3/2019 3:15:00 PM
HB 102
HB 102.Fiscal Note DOL.pdf HL&C 4/3/2019 3:15:00 PM
HL&C 4/8/2019 3:15:00 PM
HL&C 4/15/2019 3:15:00 PM
HL&C 4/22/2019 3:15:00 PM
HB 102
HB 102.Fiscal Note DOR.pdf HL&C 4/3/2019 3:15:00 PM
HL&C 4/8/2019 3:15:00 PM
HL&C 4/15/2019 3:15:00 PM
HL&C 4/22/2019 3:15:00 PM
HB 102
HB 102.Backup Letter of Opposition Drift.pdf HL&C 4/3/2019 3:15:00 PM
HB 102
HB 102.Backup Opposition Alliance of Automobile Manufacturers.pdf HL&C 4/3/2019 3:15:00 PM
HL&C 4/8/2019 3:15:00 PM
HL&C 4/15/2019 3:15:00 PM
HL&C 4/22/2019 3:15:00 PM
HB 102
HB 102.Backup Support Letter Enterprise.pdf HL&C 4/3/2019 3:15:00 PM
HL&C 4/8/2019 3:15:00 PM
HL&C 4/15/2019 3:15:00 PM
HB 102
HB 102 Articles of Opposition.pdf HL&C 4/3/2019 3:15:00 PM
HL&C 4/15/2019 3:15:00 PM
HB 102
HB 102 Additional Letters of Opposition.pdf HL&C 4/3/2019 3:15:00 PM
HL&C 4/15/2019 3:15:00 PM
HB 102