Legislature(2019 - 2020)BARNES 124

02/28/2020 03:15 PM LABOR & COMMERCE

Note: the audio and video recordings are distinct records and are obtained from different sources. As such there may be key differences between the two. The audio recordings are captured by our records offices as the official record of the meeting and will have more accurate timestamps. Use the icons to switch between them.

Download Mp3. <- Right click and save file as
Download Video part 1. <- Right click and save file as

* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+= HB 24 LIMITED TEACHER CERTIFICATES; LANGUAGES TELECONFERENCED
Moved CSHB 24(L&C) Out of Committee
-- Public Testimony --
+= HB 91 NATUROPATHS: LICENSING; PRACTICE TELECONFERENCED
Heard & Held
-- Public Testimony --
+= HB 235 AK WORKFORCE INVESTMENT BOARD:ALLOCATIONS TELECONFERENCED
<Bill Hearing Canceled>
+= HB 84 WORKERS' COMP: POLICE, FIRE, EMT, PARAMED TELECONFERENCED
Heard & Held
-- Public Testimony --
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
          HOUSE LABOR AND COMMERCE STANDING COMMITTEE                                                                         
                       February 28, 2020                                                                                        
                           3:17 p.m.                                                                                            
                                                                                                                                
                             DRAFT                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Ivy Spohnholz, Chair                                                                                             
Representative Louise Stutes                                                                                                    
Representative Zack Fields                                                                                                      
Representative Sara Hannan                                                                                                      
Representative Andi Story                                                                                                       
Representative Mel Gillis                                                                                                       
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Representative Sara Rasmussen                                                                                                   
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
HOUSE BILL NO. 24                                                                                                               
"An Act relating to instruction in a language other than                                                                        
English; and relating to limited teacher certificates."                                                                         
                                                                                                                                
     - MOVED CSHB 24(L&C) OUT OF COMMITTEE                                                                                      
                                                                                                                                
HOUSE BILL NO. 84                                                                                                               
"An Act relating to the presumption of compensability for a                                                                     
disability  resulting  from  certain diseases  for  firefighters,                                                               
emergency medical technicians, paramedics, and peace officers."                                                                 
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
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                                                                                                             
                                                                                                                                
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: HB  24                                                                                                                  
SHORT TITLE: LIMITED TEACHER CERTIFICATES; LANGUAGES                                                                            
SPONSOR(s): REPRESENTATIVE(s) KREISS-TOMKINS                                                                                    
                                                                                                                                
02/20/19       (H)       PREFILE RELEASED 1/7/19                                                                                
02/20/19       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/20/19       (H)       EDC, L&C                                                                                               
03/29/19       (H)       EDC AT 8:00 AM CAPITOL 106                                                                             
03/29/19       (H)       Heard & Held                                                                                           
03/29/19       (H)       MINUTE(EDC)                                                                                            
04/01/19       (H)       EDC AT 8:00 AM CAPITOL 106                                                                             
04/01/19       (H)       Heard & Held                                                                                           
04/01/19       (H)       MINUTE(EDC)                                                                                            
04/03/19       (H)       EDC AT 8:00 AM CAPITOL 106                                                                             
04/03/19       (H)       Heard & Held                                                                                           
04/03/19       (H)       MINUTE(EDC)                                                                                            
04/05/19       (H)       EDC RPT 5DP 2NR                                                                                        
04/05/19       (H)       DP: TUCK, ZULKOSKY, JOHNSON, STORY,                                                                    
                         DRUMMOND                                                                                               
04/05/19       (H)       NR: REVAK, HOPKINS                                                                                     
04/05/19       (H)       EDC AT 8:00 AM CAPITOL 106                                                                             
04/05/19       (H)       Moved HB 24 Out of Committee                                                                           
04/05/19       (H)       MINUTE(EDC)                                                                                            
04/24/19       (H)       L&C AT 3:15 PM BARNES 124                                                                              
04/24/19       (H)       Heard & Held                                                                                           
04/24/19       (H)       MINUTE(L&C)                                                                                            
05/03/19       (H)       L&C AT 3:15 PM BARNES 124                                                                              
05/03/19       (H)       Heard & Held                                                                                           
05/03/19       (H)       MINUTE(L&C)                                                                                            
05/13/19       (H)       L&C AT 3:15 PM BARNES 124                                                                              
05/13/19       (H)       Heard & Held                                                                                           
05/13/19       (H)       MINUTE(L&C)                                                                                            
02/17/20       (H)       L&C AT 3:15 PM BARNES 124                                                                              
02/17/20       (H)       Heard & Held                                                                                           
02/17/20       (H)       MINUTE(L&C)                                                                                            
02/21/20       (H)       L&C AT 3:15 PM BARNES 124                                                                              
02/21/20       (H)       <Bill Hearing Canceled>                                                                                
02/28/20       (H)       L&C AT 3:15 PM BARNES 124                                                                              
                                                                                                                                
BILL: HB  84                                                                                                                  
SHORT TITLE: WORKERS' COMP: POLICE, FIRE, EMT, PARAMED                                                                          
SPONSOR(s): REPRESENTATIVE(s) JOSEPHSON                                                                                         
                                                                                                                                
03/06/19       (H)       READ THE FIRST TIME - REFERRALS                                                                        
03/06/19       (H)       HSS, L&C                                                                                               
04/04/19       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
04/04/19       (H)       Heard & Held                                                                                           
04/04/19       (H)       MINUTE(HSS)                                                                                            
04/25/19       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
04/25/19       (H)       Moved HB 84 Out of Committee                                                                           
04/25/19       (H)       MINUTE(HSS)                                                                                            
04/26/19       (H)       HSS RPT 5DP                                                                                            
04/26/19       (H)       DP: CLAMAN, TARR, DRUMMOND, ZULKOSKY,                                                                  
                         SPOHNHOLZ                                                                                              
02/24/20       (H)       L&C AT 3:15 PM BARNES 124                                                                              
02/24/20       (H)       Heard & Held                                                                                           
02/24/20       (H)       MINUTE(L&C)                                                                                            
02/26/20       (H)       L&C AT 3:15 PM BARNES 124                                                                              
02/26/20       (H)       <Bill Hearing Canceled>                                                                                
02/28/20       (H)       L&C AT 3:15 PM BARNES 124                                                                              
                                                                                                                                
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                                                                              
04/03/19       (H)       Heard & Held                                                                                           
04/03/19       (H)       MINUTE(L&C)                                                                                            
04/08/19       (H)       L&C AT 3:15 PM BARNES 124                                                                              
04/08/19       (H)       Heard & Held                                                                                           
04/08/19       (H)       MINUTE(L&C)                                                                                            
05/03/19       (H)       L&C AT 3:15 PM BARNES 124                                                                              
05/03/19       (H)       Heard & Held                                                                                           
05/03/19       (H)       MINUTE(L&C)                                                                                            
02/12/20       (H)       L&C AT 3:15 PM BARNES 124                                                                              
02/12/20       (H)       Heard & Held                                                                                           
02/12/20       (H)       MINUTE(L&C)                                                                                            
02/19/20       (H)       L&C AT 3:15 PM BARNES 124                                                                              
02/19/20       (H)       Heard & Held                                                                                           
02/19/20       (H)       MINUTE(L&C)                                                                                            
02/28/20       (H)       L&C AT 3:15 PM BARNES 124                                                                              
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
ERIN HARRINGTON, Staff                                                                                                          
Representative Jonathan Kreiss-Tompkins                                                                                         
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Explained the changes in the committee                                                                   
substitute (CS) for HB 24, Version K, on behalf of                                                                              
Representative Kreiss-Tomkins, prime sponsor.                                                                                   
                                                                                                                                
REPRESENTATIVE JONATHAN KREISS-THOMKINS                                                                                         
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  As prime  sponsor, provided closing comments                                                             
on HB 24.                                                                                                                       
                                                                                                                                
REPRESENTATIVE ANDY JOSEPHSON                                                                                                   
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:   Provided the  opening statement for  HB 84,                                                             
as prime sponsor.                                                                                                               
                                                                                                                                
ELISE SORUM-BIRK, Staff                                                                                                         
Representative Andy Josephson                                                                                                   
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Answered questions  during the hearing on HB                                                             
84 on behalf of Representative Josephson, prime sponsor.                                                                        
                                                                                                                                
JESSICA THROWBRIDGE                                                                                                             
Berkeley, California                                                                                                            
POSITION STATEMENT:   Provided  testimony and  answered questions                                                             
during the hearing on HB 84.                                                                                                    
                                                                                                                                
REPRESENTATIVE JENNIFER JOHNSTON                                                                                                
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:   Provided the  opening statement for  HB 91,                                                             
as prime sponsor.                                                                                                               
                                                                                                                                
ERIN SHINE, Staff                                                                                                               
Representative Jennifer Johnston                                                                                                
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Answered questions  during the hearing on HB                                                             
91 on behalf of Representative Johnston, prime sponsor.                                                                         
                                                                                                                                
SARA CHAMBERS, Director                                                                                                         
Division of Corporations, Business, and Professional Licensing                                                                  
Department of Commerce, Community & Economic Development                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Answered questions  during the hearing on HB                                                             
91.                                                                                                                             
                                                                                                                                
ALEX MALTER                                                                                                                     
Alaska State Medical Association                                                                                                
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in opposition to HB 91.                                                                        
                                                                                                                                
KATHERINE BROWN                                                                                                                 
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of HB 91.                                                                           
                                                                                                                                
MARY FOLAND, MD                                                                                                                 
State Medical Association                                                                                                       
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to HB 91.                                                                        
                                                                                                                                
PATRICK NOLAN, MD                                                                                                               
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to HB 91.                                                                        
                                                                                                                                
RHENE MERKOURIS, MD                                                                                                             
Alaska State Medical Association                                                                                                
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to HB 91.                                                                        
                                                                                                                                
JOHN DEKEYSER, MD                                                                                                               
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to HB 91.                                                                        
                                                                                                                                
JEFFERY DEMAIN, MD                                                                                                              
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in opposition to HB 91.                                                                        
                                                                                                                                
AMY SEIBERLICH, ND                                                                                                              
Alaska Association of Naturopathic Physicians                                                                                   
Fairbanks, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 91.                                                                           
                                                                                                                                
ADAM GROVE, ND                                                                                                                  
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 91.                                                                           
                                                                                                                                
DOUG VERMILLION, MD                                                                                                             
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified during the hearing on HB 91.                                                                   
                                                                                                                                
JOSHUA GREEN, ND                                                                                                                
Vermont                                                                                                                         
POSITION STATEMENT:  Testified in support of HB 91.                                                                           
                                                                                                                                
COURTNEY BOWERS, ND                                                                                                             
Vermont                                                                                                                         
POSITION STATEMENT:  Testified in support of HB 91.                                                                           
                                                                                                                                
DANIEL YOUNG, ND                                                                                                                
Eagle River, Alaska                                                                                                             
POSITION STATEMENT:  Testified in support of HB 91.                                                                           
                                                                                                                                
GARY FERGUSON, ND                                                                                                               
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 91.                                                                           
                                                                                                                                
ANNETTE O'CONNELL                                                                                                               
Kenai, Alaska                                                                                                                   
POSITION STATEMENT:  Testified in support of HB 91.                                                                           
                                                                                                                                
DAVID SCHLEICH                                                                                                                  
Canada                                                                                                                          
POSITION STATEMENT:  Testified in support of HB 91.                                                                           
                                                                                                                                
NATALIE WIGGINS, ND                                                                                                             
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 91.                                                                           
                                                                                                                                
CAMERON O'CONNEL                                                                                                                
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 91.                                                                           
                                                                                                                                
VICKI KENNEDY                                                                                                                   
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of HB 91.                                                                           
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
3:17:59 PM                                                                                                                    
                                                                                                                                
CHAIR IVY SPOHNHOLZ called the  House Labor and Commerce Standing                                                             
Committee meeting to order at  3:17 p.m.  Representatives Stutes,                                                               
Fields, Hannan, Story, Gillis, and  Spohnholz were present at the                                                               
call to order.                                                                                                                  
                                                                                                                                
         HB  24-LIMITED TEACHER CERTIFICATES; LANGUAGES                                                                     
                                                                                                                                
3:18:37 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ announced that the  first order of business would                                                               
be  HOUSE BILL  NO.  24, "An  Act relating  to  instruction in  a                                                               
language  other than  English; and  relating  to limited  teacher                                                               
certificates."                                                                                                                  
                                                                                                                                
3:18:54 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  STUTES  moved  to adopt  the  proposed  committee                                                               
substitute  (CS)  for  HB   24,  labeled  31-LS0290\K,  Caouette,                                                               
2/27/20, as the working document.                                                                                               
                                                                                                                                
3:19:16 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ objected for the purpose of discussion.                                                                         
                                                                                                                                
3:19:29 PM                                                                                                                    
                                                                                                                                
ERIN HARRINGTON, Staff,  Representative Jonathan Kreiss-Tompkins,                                                               
Alaska  State Legislature,  on behalf  of Representative  Kreiss-                                                               
Tomkins, prime sponsor,  explained the changes to  HB 24 proposed                                                               
under Version K, which replaces  Version M.  She paraphrased from                                                               
a   document  provided   in   the   committee  packet,   entitled                                                               
"Explanation of Changes,  Version M to Version K,"  which read as                                                               
follows:                                                                                                                        
                                                                                                                                
     Version  K replaces  version  M,  which was  previously                                                                    
     adopted in the House Labor and Commerce Committee.                                                                         
                                                                                                                                
     Version M  incorporated language related to  changes to                                                                    
     the  Alaska Native  Language Preservation  and Advisory                                                                    
     Council (ANLPAC).  These changed  the council's  name                                                                      
     to  the  Council  for Alaska  Native  Languages     and                                                                    
     increased the number of seats  on the council from five                                                                    
     to seven.                                                                                                                  
                                                                                                                                
     Version  K  leaves the  changes  related  to ANLPAC  in                                                                    
     place but reorganizes the remainder  of the bill having                                                                    
     to   do  with   limited   language  immersion   teacher                                                                    
     certificates.  Whereas  earlier  versions of  the  bill                                                                    
     repealed  and replaced  existing statute  AS 14.25.025,                                                                    
     version   K  retitles   the   bill   and  creates   the                                                                    
     authorities related to  immersion language certificates                                                                    
     in  a  new  statute,  AS  14.25.023,  limited  language                                                                    
     immersion teacher certificates.                                                                                            
                                                                                                                                
     Corresponding changes  to the  name of  the certificate                                                                    
     are made throughout Section 1  of version K. Other than                                                                    
     the changes to the certificate name:                                                                                       
                                                                                                                                
     ?  Subsections   (a)  through  (e)  are   identical  in                                                                    
     substance to version M.                                                                                                    
     ? A  new subsection (f)  creates a 5-year limit  on the                                                                    
     limited  language  immersion certificate  for  teachers                                                                    
     certified   to  teach   in  world   language  immersion                                                                    
     programs.                                                                                                                  
                                                                                                                                
      Sections 2 through 4 are unchanged from the previous                                                                      
     version.                                                                                                                   
                                                                                                                                
3:22:19 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ  removed her objection.   There being  no further                                                               
objection, Version K was adopted as the working document.                                                                       
                                                                                                                                
3:22:49 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE HANNAN  opined that  the ultimate  inspiration for                                                               
HB 24  is to seek  an avenue for  the growth and  preservation of                                                               
Alaska Native  language speakers.   She  expressed her  hope that                                                               
the state  will provide funding  to support districts  who choose                                                               
to  offer  full  language  immersion programs  to  encourage  the                                                               
growing diversity  of language opportunities for  young people in                                                               
Alaska.                                                                                                                         
                                                                                                                                
3:24:36 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE    JONATHAN    KREISS-THOMKINS,    Alaska    State                                                               
Legislature, noted that this is  the first concrete step in terms                                                               
of policy  change that the state  will be making as  an offensive                                                               
move against  language endangerment and  extinction.  He  said it                                                               
means a lot to him and to many Alaskans.                                                                                        
                                                                                                                                
3:26:04 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE STUTES moved to report  CSHB 24, Version LS0290\K,                                                               
Caouette,   2/27/20,    out   of   committee    with   individual                                                               
recommendations  and  the  accompanying fiscal  notes.    Without                                                               
objection,  CSHB  24(L&C) was  moved  from  the House  Labor  and                                                               
Commerce Standing Committee.                                                                                                    
                                                                                                                                
3:26:26 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 3:26 to 3:31 p.m.                                                                            
                                                                                                                                
        HB  84-WORKERS' COMP: POLICE, FIRE, EMT, PARAMED                                                                    
                                                                                                                                
3:31:03 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ announced  that the next order  of business would                                                               
be HOUSE  BILL NO.  84, "An  Act relating  to the  presumption of                                                               
compensability for  a disability resulting from  certain diseases                                                               
for firefighters, emergency  medical technicians, paramedics, and                                                               
peace officers."                                                                                                                
                                                                                                                                
3:31:14 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   ANDY   JOSEPHSON,  Alaska   State   Legislature,                                                               
provided a  brief review  of HB  84, as prime  sponsor.   He said                                                               
providing  coverage  in the  event  of  exposure to  carcinogenic                                                               
chemicals  is a  top priority  for state  law enforcement.   That                                                               
exposure, he noted, causes cancer  within the limited window that                                                               
currently exists in  Title 23.  Additionally,  the bill clarifies                                                               
language in the Adamson v. the  state of Alaska.  Furthermore, HB                                                               
24 clarifies that all state firefighters are covered.                                                                           
                                                                                                                                
CHAIR  SPOHNHOLZ asked  Representative  Josephson  to repeat  his                                                               
last sentence.                                                                                                                  
                                                                                                                                
REPRESENTATIVE  JOSEPHSON   provided  a   scenario  in   which  a                                                               
firefighter  at  the  University   of  Alaska  Fairbanks  gets  a                                                               
respiratory problem  from a fire he  put out.  He  explained that                                                               
under  HB  84,   he  would  not  have  a   presumption  that  the                                                               
respiratory problem he suffered was related to that fire.                                                                       
                                                                                                                                
CHAIR SPOHNHOLZ  sought clarification  as to  who is  included in                                                               
the bill.                                                                                                                       
                                                                                                                                
3:34:03 PM                                                                                                                    
                                                                                                                                
ELISE  SORUM-BIRK, Staff,  Representative Andy  Josephson, Alaska                                                               
State Legislature,  on behalf of Representative  Josephson, prime                                                               
sponsor,  explained   that  employees   of  the  state   who  are                                                               
firefighters or peace officers will be covered.                                                                                 
                                                                                                                                
3:34:23 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  HANNAN questioned  whether  the  definition of  a                                                               
peace officer  includes tribal police  and Village  Public Safety                                                               
Officers (VPSOs).                                                                                                               
                                                                                                                                
MS. SORUM-BIRK  noted that  there are  two definitions  of "peace                                                               
officer" in  Alaska statute, adding  that HB 84 uses  the broader                                                               
definition.     She   answered  yes,   it  would   include  those                                                               
categories.                                                                                                                     
                                                                                                                                
3:35:36 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE JOSEPHSON  addressed a question from  the previous                                                               
bill hearing.   He said the  current benefit from 2008  is rarely                                                               
needed  and   that  approximately  one  cancer   claim  and  four                                                               
respiratory  claims are  filed per  year.   He  stated that  this                                                               
should  not  inflate  municipal or  state  workers'  compensation                                                               
insurance premiums.                                                                                                             
                                                                                                                                
3:37:13 PM                                                                                                                    
                                                                                                                                
MS.  SORUM-BIRK  deferred  questions  regarding  the  correlation                                                               
between   female   firefighters   and  breast   cancer   to   Ms.                                                               
Throwbridge.                                                                                                                    
                                                                                                                                
3:39:17 PM                                                                                                                    
                                                                                                                                
JESSICA  THROWBRIDGE informed  that committee  that she  has been                                                               
studying the  health impact  of exposure  to toxic  chemicals for                                                               
the past nine years.   She added that for the  past six years she                                                               
has specifically focused on the cohort of women firefighters.                                                                   
                                                                                                                                
CHAIR SPOHNHOLZ asked for a high-level summary of her findings.                                                                 
                                                                                                                                
MS.  THROWBRIDGE  explained  that  she is  studying  exposure  to                                                               
perfluoroalkyl  substances (PFASs)  that could  be occupationally                                                               
related.   The  study found  that women  firefighters had  higher                                                               
levels of  three different compounds compared  to nonfirefighters                                                               
by a statistically  significant amount.  She  noted that everyone                                                               
in the study was exposed  to multiple different compounds.  Other                                                               
research  has  documented  high exposure  among  firefighters  in                                                               
general  to  chemicals  like  PAHs,  arsenic,  formaldehyde,  and                                                               
benzene.                                                                                                                        
                                                                                                                                
CHAIR SPOHNHOLZ  pointed out that  in Alaska, there is  a problem                                                               
with  PFAS  water  contamination  as  a result  of  using  it  in                                                               
firefighting  foams.    She  asked  for  a  description  of  what                                                               
exposure  for firefighters  or  other  emergency personnel  might                                                               
look like.                                                                                                                      
                                                                                                                                
MS. THROWBRIDGE  agreed that  PFAS water  contamination is  a big                                                               
problem.  She said in California  they don't have the same levels                                                               
of PFAS in drinking water, which  enabled them to exclude that as                                                               
a potential  source in  their study.   She explained  that common                                                               
exposure among firefighters includes  aqueous [film forming] foam                                                               
(AFFF),  which  fire  fighters  frequently use.    PFAS  is  also                                                               
suspected to  be in the water-resistant  and flame-retardant gear                                                               
that  firefighters  wear.   Furthermore,  the  study  found  that                                                               
firefighters'  job  positions  might   be  associated  with  PFAS                                                               
levels, in  that those  fighting the  fires directly  have higher                                                               
levels than those who drive the truck or provide backup.                                                                        
                                                                                                                                
CHAIR SPOHNHOLZ asked what that means  in terms of an increase in                                                               
cancer rate or causality.                                                                                                       
                                                                                                                                
MS. THROWBRIDGE  said that's a  tough question to  answer because                                                               
their  study  is specifically  focused  on  exposure and  doesn't                                                               
follow the  participants over  time to look  at cancer  rates for                                                               
several reasons.  First, most  fire departments don't have enough                                                               
women to  determine a statistically significant  association even                                                               
if  it exists.   Second,  looking at  cancer outcomes  can hinder                                                               
prevention  efforts  because  it requires  waiting  until  cancer                                                               
cases appear.   Nonetheless, she  stated that  there is a  lot of                                                               
evidence both  in animal and human  studies to show that  PFAS is                                                               
associated with breast cancer.                                                                                                  
                                                                                                                                
3:44:50 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  HANNAN asked  for  Ms. Throwbridge's  speculative                                                               
hypothesis on the time of exposure before the onset of cancer.                                                                  
                                                                                                                                
MS.  THROWBRIDGE asked  if  Representative  Hannan's question  is                                                               
referring to PFAS specifically.                                                                                                 
                                                                                                                                
REPRESENTATIVE  HANNAN  said that  although  she  has a  personal                                                               
interest  in the  PFAS  element,  HB 84  considers  all kinds  of                                                               
carcinogenic exposure.                                                                                                          
                                                                                                                                
MS. THROWBRIDGE  explained that the biology  is very complicated,                                                               
and  it would  be challenging  to establish  a timeframe  between                                                               
exposure and  outcome -  primarily because  there isn't  just one                                                               
exposure  and  the  biology  behind  exposure  isn't  necessarily                                                               
straightforward.   Furthermore,  she pointed  out that  there are                                                               
other exposures  beyond occupational, as firefighters  have lives                                                               
outside  of the  firehouse.   Nonetheless, presumption  laws from                                                               
different places  have cited  five years  for breast  cancer, she                                                               
said.                                                                                                                           
                                                                                                                                
3:47:16 PM                                                                                                                    
                                                                                                                                
CHAIR  SPOHNHOLZ opened  public  testimony.   After  ascertaining                                                               
that no one wished to testify,  she closed public testimony.  She                                                               
announced that HB 84 was held over.                                                                                             
                                                                                                                                
            HB  91-NATUROPATHS: LICENSING; PRACTICE                                                                         
                                                                                                                                
3:47:45 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ announced that the  final 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."                                                                              
                                                                                                                                
3:48:11 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JENNIFER  JOHNSTON,   Alaska  State  Legislature,                                                               
recounted  that  years ago,  her  father-in-law  was the  driving                                                               
force in  getting osteopaths hospital  privileges.  She  shared a                                                               
personal anecdote  about her daughter.   She went on to  say that                                                               
this  bill gives  Alaskans an  affordable alternative  to primary                                                               
care  and that  naturopaths have  the education  and training  to                                                               
provide the  practice outline in this  bill.  She noted  that the                                                               
proposed  prescriptive authority  in  HB  91 excludes  controlled                                                               
substances and chemotherapy  drugs.  She expressed  her hope that                                                               
the committee will  listen to the forthcoming  testimony and that                                                               
they will pass the bill out of committee.                                                                                       
                                                                                                                                
3:50:29 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE STUTES  noted that after speaking  with Ms. Shine,                                                               
she  was reassured  about several  issues regarding  prescriptive                                                               
authority.  She asked Ms. Shine to elaborate.                                                                                   
                                                                                                                                
3:51:00 PM                                                                                                                    
                                                                                                                                
ERIN  SHINE,  Staff,  Representative  Jennifer  Johnston,  Alaska                                                               
State  Legislature,  recounted   that  Naturopathic  doctors  are                                                               
educated in pharmacology throughout  various courses during their                                                               
four-year medical  school.  She  said that although  their school                                                               
is  similar to  that of  medical doctors  (MDs), they  diverge in                                                               
some  training.   She  highlighted  that  for naturopaths  (NDs),                                                               
their  education and  training is  the same  or more  than health                                                               
professionals  who  are  practicing   with  a  broader  scope  of                                                               
practice than this bill provides.                                                                                               
                                                                                                                                
CHAIR  SPOHNHOLZ  clarified   that  nurse  practitioners  receive                                                               
either a  master's degree  or a doctorate,  which is  between six                                                               
and eight years of school.                                                                                                      
                                                                                                                                
MS. SHINE acknowledged that.                                                                                                    
                                                                                                                                
3:52:39 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS said that he is  "between a rock and a hard                                                               
place" because trusted  doctors have strongly opposed  it, but he                                                               
would like  to support his  colleague.  He  asked if there  is an                                                               
opportunity for consensus on a  narrow expansion of authority for                                                               
naturopaths.                                                                                                                    
                                                                                                                                
REP JOHNSTON  opined that it  is already narrow.   She reiterated                                                               
that  the bill  excludes controlled  substances and  chemotherapy                                                               
drugs.    She  said  it  allows  naturopaths  to  prescribe  cold                                                               
medication  for their  patients, for  example.   Furthermore, she                                                               
added that because  they are naturopaths, they're  less likely to                                                               
write prescriptions.                                                                                                            
                                                                                                                                
CHAIR  SPOHNHOLZ noted  that  they have  received  31 letters  of                                                               
opposition and 116 in support of HB 91.                                                                                         
                                                                                                                                
3:54:44 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  STUTES asked  if any  of the  "nightmare" stories                                                               
heard during the bill's previous  period of public testimony have                                                               
been substantiated.                                                                                                             
                                                                                                                                
MS.  SHINE  said  no.    She explained  that  after  hearing  the                                                               
testimony last  year, she  followed up  with Sarah  Chambers, the                                                               
Director  of   the  Division   of  Corporations,   Business,  and                                                               
Professional Licensing,  and not  one of  those stories  has been                                                               
reported  or  investigated  in  Alaska.    She  said  it's  quite                                                               
possible that  those are  stories coming  from outside  Alaska in                                                               
states  that are  unregulated where  people  can call  themselves                                                               
naturopaths  and  potentially operate  like  a  naturopath.   She                                                               
reiterated  that  those  claims  have  never  been  substantiated                                                               
throughout  the  years  that  this   bill  has  been  before  the                                                               
legislature.                                                                                                                    
                                                                                                                                
3:55:36 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   STORY   reported  concerns   about   naturopaths                                                               
identifying themselves differently than doctors.                                                                                
                                                                                                                                
MS. SHINE replied that she did  a deep dive into other states and                                                               
how  they've outlined  titles for  naturopaths  and other  health                                                               
care professionals.  Of the  states that regulate, there are many                                                               
that put a prohibition on using  the word "physician."  In HB 91,                                                               
it does  remove the  current prohibition  from the  1986 statutes                                                               
that were  put into place.   In states that do  allow naturopaths                                                               
to call  themselves naturopathic physicians, they  also recommend                                                               
that they must identify that  they are a "naturopathic physician"                                                               
instead of just "physicians" to prevent confusion for patients.                                                                 
                                                                                                                                
CHAIR SPOHNHOLZ  clarified that the  title "doctor" is  short for                                                               
"doctorate,"  which many  people  hold.   She  added  that it  is                                                               
colloquially used because historically,  medical doctors were the                                                               
primary care givers; however, that is no longer true.                                                                           
                                                                                                                                
3:58:16 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE HANNAN inquired  as to the level  of concern about                                                               
naturopaths' licensure.                                                                                                         
                                                                                                                                
3:58:57 PM3`                                                                                                                  
                                                                                                                                
SARA CHAMBERS, Director, Division  of Corporations, Business, and                                                               
Professional  Licensing,  Department  of  Commerce,  Community  &                                                               
Economic Development,  replied that the Division  of Corporation,                                                               
Business, and  Professional Licensing does not  see many problems                                                               
concerning  licensed naturopaths.   She  offered her  belief that                                                               
the department  averages approximately 7 investigations  every 10                                                               
years.  Furthermore, last year  there was only one complaint that                                                               
was not  followed through with.   She stated that  naturopaths do                                                               
not have a problematic profession.                                                                                              
                                                                                                                                
3:59:51 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE HANNAN asked of  the professional licensure boards                                                               
that  the   department  currently  oversees,  how   many  include                                                               
prescriptive authority.                                                                                                         
                                                                                                                                
MS.  CHAMBERS  listed  the  State Medical  Board,  the  Board  of                                                               
Nursing, the Board  of Dental Examiners, the  Board of Veterinary                                                               
Examiners, and the Board of Examiners in Optometry.                                                                             
                                                                                                                                
REPRESENTATIVE HANNAN  asked how  often there  are investigations                                                               
of  a disciplinary  nature into  those  boards with  prescriptive                                                               
authority   and  whether   there   are  associated   prescriptive                                                               
problems.      She   contemplated  whether   giving   naturopaths                                                               
prescriptive authority should be a legitimate concern.                                                                          
                                                                                                                                
MS.   CHAMBERS   acknowledged   the  nationwide   concern   about                                                               
controlled substances.   She reassured  the committee  that there                                                               
is  nothing in  the bill  that  would give  naturopaths even  the                                                               
illusion   of  having   the  ability   to  prescribe   controlled                                                               
substances.  She  reiterated that this would match  the state law                                                               
with their training.                                                                                                            
                                                                                                                                
4:02:57 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  STORY  reported  that medical  professionals  are                                                               
concerned about naturopaths being inexperienced.                                                                                
                                                                                                                                
4:03:26 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ  sought clarification  on the complaint  that was                                                               
filed and not followed through with.  She asked what that means.                                                                
                                                                                                                                
MS. CHAMBERS explained  that there was nothing  to pursue because                                                               
the person lost  interest or didn't take  the complaint seriously                                                               
enough to pursue.                                                                                                               
                                                                                                                                
4:06:09 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ opened public testimony.                                                                                        
                                                                                                                                
4:06:31 PM                                                                                                                    
                                                                                                                                
ALEX MALTER,  Alaska State Medical  Association, stated  that his                                                               
purpose in testifying  is to respectfully urge  the committee not                                                               
to support expanding the scope  of practice for naturopaths under                                                               
HB 91.   He opined that  these changes would not  enhance patient                                                               
care or  improve Alaskans'  access to  care.   He shared  a brief                                                               
history of  his medical background  and a personal anecdote.   He                                                               
reiterated  his  belief  that  expanding  naturopaths'  scope  of                                                               
practice  would not  enhance medical  care in  Alaska or  improve                                                               
patient  access.    He offered  his  understanding  that  medical                                                               
training for  naturopaths is less  rigorous than that  of medical                                                               
doctors.   He said its  emphasis in alternative healing  does not                                                               
allow adequate time for students  to study the accepted pathology                                                               
and  physiology to  safely treat  most medical  conditions.    In                                                               
general,  medical  doctors  don't  believe  that  the  first  two                                                               
didactic  years  of  naturopath school  and  medical  school  are                                                               
comparable, he  said.  Furthermore,  he argued that even  if they                                                               
are  similar, medical  students are  still required  to spend  an                                                               
additional four  years in clinical  training or  residency before                                                               
being licensed  in the state  of Alaska.   Under HB 91,  he said,                                                               
naturopaths could  be licensed to  prescribe with  less training,                                                               
little  of   which  being  focused  on   relative  pharmaceutical                                                               
treatments.   To conclude, he  said it's unlikely  that expanding                                                               
the  scope of  practice for  naturopaths will  improve access  to                                                               
care for the  underserved.  He urged the committee  to vote no on                                                               
HB 91.                                                                                                                          
                                                                                                                                
4:11:34 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  HANNAN declared  a conflict  of interest,  as Mr.                                                               
Malter  has been  her  primary  care physician  for  the last  25                                                               
years.                                                                                                                          
                                                                                                                                
4:12:02 PM                                                                                                                    
                                                                                                                                
KATHERINE  BROWN,  noted that  she  is  the great-niece  of  Dora                                                               
Sweeney  an   elected  delegate   to  the   state  constitutional                                                               
convention,   representing   Juneau   from   1955-1965   in   the                                                               
territorial and state legislatures.   She stated that NDs receive                                                               
the  same training  as  MDs  for the  first  two  years of  their                                                               
education,  focusing on  natural medicine  afterwards.   She said                                                               
they are fully  qualified to function as  primary care physicians                                                               
and to competently perform minor  surgeries and prescribe certain                                                               
medications.   She offered her  belief that not  taking advantage                                                               
of the full  capacities of Alaska's NDs "is madness."   She added                                                               
that if stories of malpractice  by naturopaths are not documented                                                               
and legally  reported as required by  law, they have no  place in                                                               
the  present discussion.    All Alaskans  should  have access  to                                                               
[naturopathic] care if they so  choose, she opined.  To conclude,                                                               
she asked members to pass HB 91 out of committee.                                                                               
                                                                                                                                
4:15:08 PM                                                                                                                    
                                                                                                                                
MARY  FOLAND,  MD, State  Medical  Association,  stated that  she                                                               
opposes the expansion  of practice.  She reported  that the State                                                               
Medical  Board  has opposed  this  legislation,  adding that  the                                                               
board  believes  these changes  are  the  practice of  allopathic                                                               
medicine and  are not appropriate  or safe  for the public.   She                                                               
indicated  that  she  is  privy   to  substantiated  stories  and                                                               
proceeded to share one about malpractice  committed by a ND.  She                                                               
went  on  to  say  that  HB  91  would  allow  NDs  to  prescribe                                                               
potentially    dangerous   pharmaceuticals    including   cardiac                                                               
antiarrhythmics,   antipsychotics,  blood   thinners,  or   amino                                                               
suppressants,  as  well  as   contraceptive  devices,  which  are                                                               
implanted under the skin or inside  the uterus and carry the risk                                                               
of infection  and uterine perforation.   It would also  allow NDs                                                               
to  order  diagnostic procedures,  she  stated.   She  urged  the                                                               
committee  to act  to protect  the health  and safety  of Alaskan                                                               
patients by not passing the bill.                                                                                               
                                                                                                                                
CHAIR SPOHNHOLZ asked if Dr.  Foland reported the naturopath from                                                               
her story.                                                                                                                      
                                                                                                                                
DR. FOLAND  answered no.   She  said she heard  the story  from a                                                               
physician that was  sharing the results of  an endometrial biopsy                                                               
with a patient.   She alleged that she knows  of a different case                                                               
that  was investigated  by the  State Medical  Board because  the                                                               
investigator  called  her about  "a  naturopath  who did  have  a                                                               
complication injecting  phenol for  back pain," resulting  in the                                                               
patient's collapsed lung.  She declined  to share the name of the                                                               
naturopath who was allegedly involved.                                                                                          
                                                                                                                                
4:19:37 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  HANNAN  asked  if  the  endometrial  cancer  case                                                               
involved a naturopath practicing in the state of Alaska.                                                                        
                                                                                                                                
DR. FOLAND said yes.                                                                                                            
                                                                                                                                
REPRESENTATIVE  HANNAN  asked  if the  aforementioned  case  took                                                               
place in Alaska.                                                                                                                
                                                                                                                                
DR. FOLAND answered yes.                                                                                                        
                                                                                                                                
REPRESNTATIVE  HANNAN  asked if  doctors  have  a legal  duty  to                                                               
report medical  incompetence if they encounter  it while treating                                                               
a patient.                                                                                                                      
                                                                                                                                
DR. FOLAND  offered her understanding  that reports to  the State                                                               
Medical Board  and to the  State Medical  Association's grievance                                                               
committee must come from the patient, not the physician.                                                                        
                                                                                                                                
CHAIR SPOHNHOLZ asked  Ms. Chambers to clarify  who should submit                                                               
the report.                                                                                                                     
                                                                                                                                
4:20:49 PM                                                                                                                    
                                                                                                                                
MS. CHAMBERS  said anyone can  file a complaint, adding  that the                                                               
division  would do  the investigation  by  interviewing both  the                                                               
doctor and  patient.   Some health  care professions  require the                                                               
report  of sexual  abuse  or  child abuse,  she  explained.   She                                                               
offered  her belief  that there  is  no requirement  to report  a                                                               
medical procedure that didn't work out.                                                                                         
                                                                                                                                
CHAIR  SPOHNHOLZ repeated  that  if there  are people  practicing                                                               
health care  in an  unsafe manner,  there is  a process  by which                                                               
health care  providers should take  action on to ensure  that the                                                               
public is safe.                                                                                                                 
                                                                                                                                
4:22:21 PM                                                                                                                    
                                                                                                                                
PATRICK NOLAN,  MD, informed  the committee that  he is  a board-                                                               
certified  internist   and  endocrinologist.    He   said  he  is                                                               
testifying  in opposition  to  HB  91 for  several  reasons.   He                                                               
argued that NDs  don't have the same education  as osteopathic or                                                               
allopathic  physicians  and  for  that reason,  should  stick  to                                                               
naturopathy.   He  opined  that  they should  not  be allowed  to                                                               
prescribe  drugs because  they are  not adequately  trained.   He                                                               
stated   that   the   complexity  of   medicine   has   increased                                                               
tremendously  in the  last 40  years, adding  that NDs  need more                                                               
specialized medical training.                                                                                                   
                                                                                                                                
4:26:40 PM                                                                                                                    
                                                                                                                                
RHENE MERKOURIS,  MD, Alaska State Medical  Association, reported                                                               
that  she is  an obstetrician-gynecologist,  adding  that she  is                                                               
speaking  against HB  91.   She argued  that medical  schools are                                                               
accredited through  standardized tests  that guarantee a  base of                                                               
knowledge, whereas naturopaths do not  have these types of tests.                                                               
In comparison,  she said, there's  no question about  the ability                                                               
to diagnose disease, perform  surgery, or [prescribe] medication.                                                               
She  shared a  personal anecdote.    She stated  that she  speaks                                                               
strongly against HB 91 for these reasons.                                                                                       
                                                                                                                                
4:30:07 PM                                                                                                                    
                                                                                                                                
JOHN DEKEYSER,  MD, informed the  committee that he is  a medical                                                               
doctor  and is  board certified  in family  practice, as  well as                                                               
obstetrics  and gynecology.   He  addressed different  aspects of                                                               
the  Naturopathic Physicians  Licensing  Exam  (NPLX) and  shared                                                               
several anecdotes.                                                                                                              
                                                                                                                                
4:33:53 PM                                                                                                                    
                                                                                                                                
JEFFERY DEMAIN,  MD, offered his belief  that naturopaths provide                                                               
a good service, enhance the  wellness of patients, and treat "the                                                               
whole person."   He  said he also  co-manages patients  with NDs.                                                               
Nonetheless,  he opined  that their  therapies and  approaches to                                                               
diagnostic  management   are  inconsistent   with  evidence-based                                                               
principles.    He  further  stated   that  they  are  counter  to                                                               
scientific evidence  of standard care.   As a result, he  said he                                                               
has  seen patients  misdiagnosed and  mismanaged completely.   He                                                               
addressed the  difference in education  between MDs and NDs.   He                                                               
voiced  his  opposition  to  HB  91, adding  that  it  would  put                                                               
Alaskans at risk and would add  to the shortage of health care in                                                               
the state.                                                                                                                      
                                                                                                                                
4:37:04 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  HANNAN questioned  whether  Dr.  Demean has  ever                                                               
seen his patients misdiagnosed from previous medical doctors.                                                                   
                                                                                                                                
DR. DEMAIN  said misdiagnosis is infrequent  and shared anecdotal                                                               
examples.                                                                                                                       
                                                                                                                                
4:39:55 PM                                                                                                                    
                                                                                                                                
AMY   SEIBERLICH,   ND,   Alaska  Association   of   Naturopathic                                                               
Physicians, provided  a history of her  education through college                                                               
and her work experience beginning  in Fairbanks as a naturopathic                                                               
doctor.   She  recounted  helping patients  with food  addictions                                                               
lose a significant amount of  weight through finding and treating                                                               
underlying medical  conditions, implementing a whole  foods diet,                                                               
targeted nutrient  replacement, and a  lot of counseling.   Along                                                               
with the  wight loss, she  reported regularly seeing  their blood                                                               
pressures  drop  by 40  points,  cholesterol  levels decrease  by                                                               
half, and  blood sugars normalize within  weeks; however, because                                                               
of the  current scope of  practice she  is forced to  refer these                                                               
patients elsewhere  to manage  their medication.   She  said that                                                               
like other  MDs, she is  trained to manage these  medications and                                                               
if  she were  to practice  somewhere else,  she could  easily and                                                               
safely do  so.  This  discrepancy costs Alaska  qualified primary                                                               
care providers, which lowers health  care access and competition,                                                               
while driving up  costs.  HB 91 seeks to  correct this, she said,                                                               
and she encouraged the committee to pass it.                                                                                    
                                                                                                                                
4:43:14 PM                                                                                                                    
                                                                                                                                
ADAM  GROVE, ND,  noted that  he  is a  naturopath practicing  in                                                               
Anchorage and is  also certified as a brain  injury specialist by                                                               
the  Brain   Injury  Association  of   America.    He   shared  a                                                               
description  of   his  educational  background  and   early  work                                                               
experience,  as well  as personal  anecdote about  his work  with                                                               
brain  injuries in  Alaska.   He said  he runs  into problems  in                                                               
rural areas because without prescriptive  rights he cannot manage                                                               
medications or provide the guidance to  those who might be on the                                                               
wrong  medications.   He concluded  by offering  his belief  that                                                               
naturopaths are more equipped to  provide care for complex issues                                                               
like brain  injury.  He urged  the passage of HB  91 and stressed                                                               
that naturopaths  are a  valuable asset  to Alaska  and expanding                                                               
their  privileges to  manage medication  through prescription  is                                                               
essential.                                                                                                                      
                                                                                                                                
4:47:53 PM                                                                                                                    
                                                                                                                                
DOUG  VERMILLION, MD,  stated  that  he is  a  medical doctor  in                                                               
Anchorage  and is  having trouble  getting  patients cleared  for                                                               
surgery and making  sure their optimized.  He said  there are not                                                               
enough primary care doctors and  that more access to primary care                                                               
would  benefit  the  residents  of  Alaska.    As  far  as  being                                                               
credentialed, he  said, it  can be  worked out.   He  offered his                                                               
belief that  Alaskan citizens need  additional access  to primary                                                               
care and many [naturopaths] are very good.                                                                                      
                                                                                                                                
4:49:04 PM                                                                                                                    
                                                                                                                                
JOSHUA  GREEN,   ND,  informed  the   committee  that  he   is  a                                                               
naturopathic physician in the state  of Vermont and the president                                                               
of the Vermont  Association of Naturopathic Physicians.   He said                                                               
he is calling in  support of HB 91.  He  provided a brief history                                                               
about  the licensure  of naturopaths  in Vermont.   He  addressed                                                               
several  claims in  the  testimony put  forth  by physicians  and                                                               
their  opposition to  the bill.   He  pointed out  that NDs  have                                                               
additional training in mechanical  medicine, homeopathy, diet and                                                               
lifestyle counseling,  which is  different than  most physicians.                                                               
To  conclude he  said NDs  refer to  other specialists  often, as                                                               
appropriate, and are  referred by other specialists.   He said he                                                               
is thankful  to have  opening prescribing  rights in  Vermont and                                                               
expressed his hope that Alaska is open to that as well.                                                                         
                                                                                                                                
CHAIR SPOHNHOLZ  noted that HB  91, as proposed, would  not allow                                                               
for open prescribing rights in the state of Alaska.                                                                             
                                                                                                                                
4:53:51 PM                                                                                                                    
                                                                                                                                
COURTNEY BOWERS, ND, provided a  history of her education through                                                               
college and  her work experience  in Vermont  as a ND  in primary                                                               
care.   She  acknowledged the  lack of  residencies available  in                                                               
[naturopathic] education, which lead her  to create her own.  She                                                               
addressed   several  concerns   voiced  by   earlier  testifiers,                                                               
stressing that as  a ND in primary care, she  would never implant                                                               
an intrauterine  device (IUD) or  prescribe anti-cancer  drugs or                                                               
heart failure drugs,  because all require specialists.   She said                                                               
she doesn't  get the  sense that's  what Alaskan  naturopaths are                                                               
asking for - they are asking  for a formulary that is appropriate                                                               
to the scope in which they are trained.   That is what they do in                                                               
Vermont and it's been working very well, she added.                                                                             
                                                                                                                                
4:57:16 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  HANNAN  asked  if  Dr.  Bowers  prescribes  birth                                                               
control.                                                                                                                        
                                                                                                                                
DR. BOWERS  said yes,  adding that  she is  very well  trained in                                                               
oral contraceptive.   She  reiterated that  she does  not implant                                                               
IUDs, instead opting to refer  those patients to gynecologists or                                                               
Planned Parenthood  for the consultation and  application.  Other                                                               
than  oral  contraceptive,  she  noted  that  she  can  prescribe                                                               
diaphragms and spermicide.                                                                                                      
                                                                                                                                
REPRESENTATIVE  HANNAN   asked  if   Dr.  Bowers   does  Norplant                                                               
implants.                                                                                                                       
                                                                                                                                
DR. BOWERS answered no.                                                                                                         
                                                                                                                                
4:58:39 PM                                                                                                                    
                                                                                                                                
DANIEL  YOUNG,  ND,  said he  has  been  practicing  naturopathic                                                               
medicine for  28 years, four of  which have been in  Eagle River.                                                               
He voiced his support for HB 91.   He shared his belief that it's                                                               
a  good   bill  and  that   it's  reasonable  to   allow  trained                                                               
naturopathic  doctors  for  what   they're  asking  for  in  this                                                               
legislation.   He  summarized the  licensure process  for NDs  in                                                               
Alaska.    It  requires  accreditation   and  passing  the  NPLEX                                                               
professional board exams, which are  rigorous and contain a minor                                                               
surgeries  module,  as  well  as a  pharmaceutical  module.    He                                                               
explained  that the  U.S. Department  of  Education oversees  the                                                               
accreditation of  naturopathic medicine just  as well as  they do                                                               
allopathic and  osteopathic medicine.   He  said that  for years,                                                               
naturopaths have been  trying to educate the  legislature on what                                                               
they  can  provide to  Alaskans.    He  added  that NDs  have  an                                                               
excellent safety record.  He urged  the members to pass HB 91 out                                                               
of committee.                                                                                                                   
                                                                                                                                
5:02:10 PM                                                                                                                    
                                                                                                                                
GARY  FERGUSON,   ND,  informed   the  members   that  he   is  a                                                               
naturopathic doctor in  the state of Alaska.  He  said he went to                                                               
naturopathic  medical school  because  he  believes in  wholistic                                                               
based  approaches and  indigenous  based  approaches to  healing,                                                               
which includes botanical  and physical medicine.   He stated that                                                               
he supports HB  91.  He stated that naturopaths  pass a stringent                                                               
licensing exam.   He went on  to say that without  the ability to                                                               
prescribe  they can't  help patients  appropriately manage  their                                                               
medications.  He said HB 91  would allow NDs to practice how they                                                               
were trained.   He shared a  personal anecdote and said,  being a                                                               
Native  Alaskan person,  he sees  the need  for culturally  based                                                               
approaches that NDs can bring to Alaskans.                                                                                      
                                                                                                                                
5:05:53 PM                                                                                                                    
                                                                                                                                
ANNETTE O'CONNELL  shared an anecdote  about her  personal battle                                                               
with  celiac  disease and  how  a  ND  was  the first  doctor  to                                                               
accurately diagnose and treat her.   She revealed that because of                                                               
Alaska's current  laws, she must  travel outside of the  state to                                                               
receive the  care she has come  to trust and the  medications for                                                               
her thyroid  condition.   She asked the  committee to  "stop this                                                               
vendetta  the   medical  establishment  has  against   any  other                                                               
profession that impedes  on their territory."   They believe they                                                               
are  the  only  branch  of the  medical  professionals  that  are                                                               
qualified to  offer services  and that others  are not  safe, she                                                               
said.    She made  several  observations  on statements  made  by                                                               
previous testifiers.   She concluded  by urging the  committee to                                                               
pass HB 91.                                                                                                                     
                                                                                                                                
5:08:54 PM                                                                                                                    
                                                                                                                                
DAVID SCHLEICH noted his credentials.   He pointed out that there                                                               
is  an  uneven  and   inadequate  understanding  of  naturopathic                                                               
training and credentialing.   He said the growth  in the activity                                                               
of naturopathic professionals has been  remarkable in the last 20                                                               
years and that  it's a very good idea to  support and enhance the                                                               
managing   of  medications   within   the   scope  for   Alaska's                                                               
naturopathic professionals,  as outlined  in HB 91.   He  went to                                                               
explain that  naturopaths go through  programmatic accreditation,                                                               
as  well as  state  and regional  accreditation.   He  encouraged                                                               
allopathic  and  biomedicine  professional colleagues  to  become                                                               
more familiar with  the rigor, depth, and  extent of naturopathic                                                               
practice  and  training  -  particularly   to  the  training  and                                                               
education.                                                                                                                      
                                                                                                                                
5:13:52 PM                                                                                                                    
                                                                                                                                
NATALIE  WIGGINS,  ND,  informed  the committee  that  she  is  a                                                               
naturopathic  physician  practicing  in Anchorage  Alaska.    She                                                               
voiced her  support for HB 91.   She shared an  anecdotal example                                                               
illustrating  how the  lack of  prescriptive  rights impacts  her                                                               
ability to treat  her patients.  She stated  that naturopaths are                                                               
highly trained to maintain medication and she urged the                                                                         
committee to support this bill.                                                                                                 
                                                                                                                                
5:16:20 PM                                                                                                                    
                                                                                                                                
CAMERON O'CONNEL, read the following statement:                                                                                 
                                                                                                                                
     I'm writing  in support  of House  Bill 91  and I  am a                                                                    
     naturopathic  doctor.   Born and  raised  in Alaska,  I                                                                    
     hoped to come back to the  state once I had finished my                                                                    
     medical  training and  residency to  set up  a practice                                                                    
     and give back to the  greater Anchorage community.  The                                                                    
     decision was not easy.   My residency was in California                                                                    
     and  as such,  I had  prescription rights.   Having  to                                                                    
     give up  the ability to  do something as simple  as put                                                                    
     my  patients on  (indisc.) for  hypothyroidism made  my                                                                    
     move  back to  Alaska  a much  more difficult  decision                                                                    
     than it should  have been.  A few examples  of how this                                                                    
     limited scope  of practice has  impacted my  ability to                                                                    
     provide care.  A woman came  into my office and she had                                                                    
     fears  about  vaccination   and  subsequently  had  not                                                                    
     vaccinated her children.  I  alleviated those fears and                                                                    
     she agreed to get her  children vaccinated.  However, I                                                                    
     was  unable  to write  a  prescription  or provide  any                                                                    
     vaccines in  my office.   An opportunity was  missed to                                                                    
     give  treatment   and  this,   from  a   public  health                                                                    
     perspective, is a poor outcome.   I have a patient with                                                                    
     a lower respiratory infection come  into my office, and                                                                    
     I provided the naturopathic  standard of care including                                                                    
     informing the  patient when she would  need to progress                                                                    
     from  conservative treatment  to pharmaceuticals.   The                                                                    
     patient was discouraged  to find she would  have to pay                                                                    
     another large  fee to go  to an Urgent Care  or another                                                                    
     provider  to receive  basic antibiotic  therapy if  the                                                                    
     need arose.   In closing, please  consider updating our                                                                    
     bill to  a more modern  scope that lets us  utilize all                                                                    
     of  our   training.    The  statute   that  governs  my                                                                    
     profession was  passed in  1987.  I  was born  in 1982.                                                                    
     I've  grown  a  lot  in  32 years  and  so  should  our                                                                    
     legislation.                                                                                                               
                                                                                                                                
MS. O'CONNEL said the last time she testified residency has was                                                                 
a hot topic.  She explained that she was overseen by three                                                                      
medical doctors and one naturopathic doctor.                                                                                    
                                                                                                                                
5:18:49 PM                                                                                                                    
                                                                                                                                
VICKI KENNEDY  said she  is overwhelmingly in  support of  HB 91.                                                               
She declared that  nearly 400 medical doctors were  put in prison                                                               
for  overwriting opioid  prescriptions in  the last  eight years.                                                               
Nonetheless, she  went on  to say that  most medical  doctors are                                                               
phenomenal;  however,  they  are  in  the  pockets  of  "the  big                                                               
pharma."  She reiterated her support for HB 91.                                                                                 
                                                                                                                                
5:20:23 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ closed public testimony and announced that HB 91                                                                
was held over.                                                                                                                  
                                                                                                                                
5:21:50 PM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no further business before the committee, the House                                                                 
Labor and Commerce Standing Committee meeting was adjourned at                                                                  
5:21 p.m.                                                                                                                       

Document Name Date/Time Subjects
HB24 Sectional Analysis v. K 2.27.2020.pdf HL&C 2/28/2020 3:15:00 PM
HB 24
HB24 Explanation of Changes Ver M to Ver K 02.27.2020.pdf HL&C 2/28/2020 3:15:00 PM
HB 24
HB 24 Work Draft v. K 2.27.2020.pdf HL&C 2/28/2020 3:15:00 PM
HB 24
HB 84 Supporting Document- Women Firefighters Biomonitoring Collaborative Research Update.pdf HL&C 2/28/2020 3:15:00 PM
HL&C 3/20/2020 3:15:00 PM
HB 84
HB 84 Letter of Support ACOA 2.26.20.pdf HL&C 2/28/2020 3:15:00 PM
HL&C 3/20/2020 3:15:00 PM
HB 84
HB 84 APEI Letter of Opposition 02.25.2020.pdf HL&C 2/28/2020 3:15:00 PM
HL&C 3/20/2020 3:15:00 PM
HB 84
HB 91 Responses to L&C Committee Questions 02.14.2020.pdf HL&C 2/28/2020 3:15:00 PM
HB 91
HB 84 Labor and Commerece Committee Question Responses 2.26.20.pdf HL&C 2/28/2020 3:15:00 PM
HL&C 3/20/2020 3:15:00 PM
HB 84
HB 91 Testimony in Opposition Redacted 2.28.2020.pdf HL&C 2/28/2020 3:15:00 PM
HB 91
HB 91 Testimony in Support Redacted 2.28.2020.pdf HL&C 2/28/2020 3:15:00 PM
HB 91
HB 24 Anchorage School District Comment on TRS and Tenure 02.28.2020.pdf HL&C 2/28/2020 3:15:00 PM
HB 24