03/10/2008 05:00 PM Senate HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SB149 | |
| SCR19 | |
| SB107 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| + | SB 149 | TELECONFERENCED | |
| *+ | SCR 19 | TELECONFERENCED | |
| += | SB 107 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
March 10, 2008
5:13 p.m.
MEMBERS PRESENT
Senator Bettye Davis, Chair
Senator Joe Thomas, Vice Chair
Senator Kim Elton
Senator Fred Dyson
MEMBERS ABSENT
Senator John Cowdery
COMMITTEE CALENDAR
SENATE BILL NO. 149
"An Act relating to redistribution of used eyeglasses."
MOVED CSSB 149(L&C) OUT OF COMMITTEE
SENATE CONCURRENT RESOLUTION NO. 19
Relating to implementation of the recommendations of the
Governor's Summit on Early Learning.
MOVED SSSCR 19 OUT OF COMMITTEE
SENATE BILL NO. 107
"An Act relating to naturopaths and to naturopathic practice;
establishing a Naturopathic Advisory Committee and an Alaska
Naturopathic Formulary Council; amending the duties of the State
Medical Board and the Board of Pharmacy relating to naturopathic
practice; and providing for an effective date."
HEARD AND HELD
PREVIOUS COMMITTEE ACTION
BILL: SB 149
SHORT TITLE: REDISTRIBUTION OF USED EYEGLASSES
SPONSOR(s): SENATOR(s) THERRIAULT
03/30/07 (S) READ THE FIRST TIME - REFERRALS
03/30/07 (S) L&C, HES
02/19/08 (S) L&C AT 1:30 PM BELTZ 211
02/19/08 (S) Heard & Held
02/19/08 (S) MINUTE(L&C)
02/26/08 (S) L&C AT 1:30 PM BELTZ 211
02/26/08 (S) Moved CSSB 149(L&C) Out of Committee
02/26/08 (S) MINUTE(L&C)
02/27/08 (S) L&C RPT CS 5DP NEW TITLE
02/27/08 (S) DP: ELLIS, BUNDE, DAVIS, STEVENS,
HOFFMAN
03/10/08 (S) HES AT 5:00 PM BUTROVICH 205
03/10/08 (S) GOVERNOR'S SUMMIT ON EARLY LEARNING
BILL: SCR 19
SHORT TITLE: GOVERNOR'S SUMMIT ON EARLY LEARNING
SPONSOR(s): SENATOR(s) WIELECHOWSKI
02/19/08 (S) READ THE FIRST TIME - REFERRALS
02/19/08 (S) HES, FIN
03/10/08 (S) SPONSOR SUBSTITUTE INTRODUCED-REFERRALS
03/10/08 (S) HES
03/10/08 (S) HES AT 5:00 PM BUTROVICH 205
03/10/08 (S) Bills Previously Heard/Scheduled
BILL: SB 107
SHORT TITLE: NATUROPATHS
SPONSOR(s): SENATOR(s) DAVIS BY REQUEST
03/07/07 (S) READ THE FIRST TIME - REFERRALS
03/07/07 (S) L&C, HES, FIN
04/19/07 (S) L&C AT 1:30 PM BELTZ 211
04/19/07 (S) Heard & Held
04/19/07 (S) MINUTE(L&C)
01/15/08 (S) L&C AT 1:30 PM BELTZ 211
01/15/08 (S) -- MEETING CANCELED --
01/17/08 (S) L&C AT 1:30 PM BELTZ 211
01/17/08 (S) -- MEETING CANCELED --
01/22/08 (S) L&C AT 1:30 PM BELTZ 211
01/22/08 (S) Heard & Held
01/22/08 (S) MINUTE(L&C)
01/25/08 (S) L&C AT 3:00 PM BELTZ 211
01/25/08 (S) -- Rescheduled from 01/24/08 --
01/28/08 (S) L&C RPT CS 3DP 1NR NEW TITLE
01/28/08 (S) DP: ELLIS, DAVIS, HOFFMAN
01/28/08 (S) NR: BUNDE
02/13/08 (S) HES AT 1:30 PM BUTROVICH 205
02/13/08 (S) Heard & Held
02/13/08 (S) MINUTE(HES)
03/10/08 (S) HES AT 5:00 PM BUTROVICH 205
WITNESS REGISTER
DAVID STANCLIFF, Staff
to Senator Therriault
Alaska State Capitol
Juneau, AK
POSITION STATEMENT: Presented an overview of CSSB 149.
HOWARD SCOTT RIXIE, SR.
Lions Club
Aurora Borealis Chapter
Fairbanks, AK,
POSITION STATEMENT: Supported SSSCR 19.
NANCY SCHOEPOEFER, representing herself
No address provided
POSITION STATEMENT: Supported SSSCR 19.
ABBE HENSLEY, Executive Director
Best Beginnings
Anchorage, AK
POSITION STATEMENT: Supported SSSCR 19.
MICHELLE BROWN, President and CEO
United Way of Anchorage
Anchorage, AK
POSITION STATEMENT: Supported SSSCR 19.
ALPHAEUS BULLARD, Attorney at Law
Legislative Legal and Research Services Division
Legislative Affairs Agency
Juneau, AK
POSITION STATEMENT: Answered questions about CSSB 107.
DR. JOHN RASTER
Alaska State Medical Association
Juneau, AK
POSITION STATEMENT: Opposed CSSB 107.
IRMA NORLAND, representing herself
Juneau, AK
POSITION STATEMENT: Supported CSSB 107.
DR. SCOTT LUPER, President
Alaska Association Of Naturopathic Physicians (AKANP)
Fairbanks, AK
POSITION STATEMENT: Supported CSSB 107.
EMILY KANE, Naturopathic Physician
Juneau, AK,
POSITION STATEMENT: Supported CSSB 107.
ACTION NARRATIVE
CHAIR BETTYE DAVIS called the Senate Health, Education and
Social Services Standing Committee meeting to order at 5:13:52
PM. Present at the call to order were Senators Joe Thomas, Kim
Elton, Fred Dyson, and Bettye Davis.
SB 149-REDISTRIBUTION OF USED EYEGLASSES
CHAIR DAVIS announced consideration of SB 149.
DAVID STANCLIFF, Staff to Senator Therriault, said the Lion's
Club of Alaska asked the sponsor to introduce SB 149. The Lion's
Club had been providing eye glasses to needy persons in third
world countries for many years. The bill as originally written
referenced a board that no longer existed, so a CS was adopted
in the previous committee. The references to "board" were
replaced by "department." Language was also added on page 2,
lines 24-25, stipulating that the prescription conforms "to the
extent possible" with the individual's prescription from a
licensed physician or optometrist. The bill did not require that
the department work with the Lions Club; it merely opened the
door and enabled any qualified non-profit to begin an
association with the State of Alaska to provide used eye
glasses.
CHAIR DAVIS noted that this bill was heard first in Labor and
Commerce, which heard some compelling testimony. She asked if
anyone had signed up to testify in this committee.
5:17:15 PM
HOWARD SCOTT RIXIE, SR., Lions Club, Aurora Borealis Chapter,
Fairbanks, AK, thanked the committee for hearing this bill and
said they looked forward to the time when all Alaskans could
enjoy the gift of sight. He said he had sent each of the
committee members an electronic letter with attachments, which
he asked to be entered into the record on his behalf, and urged
the committee to pass SB 149 on to the full Senate.
SENATOR ELTON noted that in other types of medicine, there was a
credo that all persons would be treated regardless of their
ability to pay and asked Mr. Rixie whether that was true in
optometry and ophthalmology as well.
MR. STANCLIFF replied that he had checked with Jill Geering at
the Alaska Vision Center and was told they did a fair amount of
charitable work; but people in many parts of Alaska did not have
access to a center offering that type of care.
SENATOR ELTON asked if it was true that the eye glasses would
not have to be dispensed by a licensed optometrist or
ophthalmologist.
MR. STANCLIFF answered that was correct. If the state deemed
that the Lions Club had the experience necessary to fill and fit
a prescription provided by a doctor, they would do that in
Alaska with used eye glasses. He clarified that this would not
prevent an optometrist or ophthalmologist from doing it, but
would allow this benevolent group to expand access to this
service in Alaska as they had done in third world countries.
SENATOR THOMAS asked if page 2, lines 22-25 was the area Mr.
Stancliff was discussing.
MR. STANCLIFF answered that the change he referred to was on
lines 24 and 25 and that the exact words added were "to extent
possible," because they may not always have used glasses that
fit another person's prescription perfectly. He stressed that
the department would have to build guidelines into regulation
and policy to define the parameters within which the Lions would
be allowed to operated with regard to decisions about whether a
prescription was close enough.
CHAIR DAVIS specified that the committee was working off CSSB
149, Version \K.
CHAIR DAVIS asked for further questions or comments. When there
were none, she stated that it was her intention not to hear this
bill again, but to move it to the next committee of referral.
5:23:11 PM
SENATOR THOMAS moved to report CSSB 149, Version \K from
committee with individual recommendations and attached zero
fiscal note.
There being no objections, CSSB 149(L&C) moved from committee.
SCR 19-GOVERNOR'S SUMMIT ON EARLY LEARNING
5:23:44 PM
CHAIR DAVIS announced consideration of SCR 19.
SENATOR BILL WIELECHOWSKI, Sponsor, presented an overview of SCR
19, a concurrent resolution asking the legislature to examine
implementing the recommendations of the governor's summit on
early learning. He referenced a previous presentation by Best
Beginnings, which disclosed that Alaska was one of only 10
states awarded a grant in 2007 by the National Governors'
Association to hold a summit on early learning. Approximately
150 policy makers participated in that summit, and one of the
goals was to insure that Alaska's future economy would be
supported by an educated, productive work force. To that end,
the participants drafted a number of recommendations to insure
that all children, especially those most in need, had access to
quality early education opportunities.
SENATOR WIELECHOWSKI went on to say research demonstrated that
certain work force skills were taught most effectively to
children under 6 years of age. Research also showed that
critical brain development occurred most rapidly in those early
years. Based on that research, Alaska seemed to be short-
changing its' youngest learners and as a result, Alaskan
children were falling behind in key areas such as early language
and literacy, thinking and cognitive development, and basic
social skills. Recent studies showed that nearly half of Alaskan
children entered school unprepared to be successful learners.
Experts attributed this largely to a lack of available pre-
school education; Alaska was one of only 10 states without a
state-funded early childhood system.
SENATOR WIELECHOWSKI directed the committee's attention to
research results that were included in their packets. Study
after study documented the value of quality preschool education
in higher achievement test scores; significantly less grade
repetition; major reductions in special education placements;
substantially higher rates of high school graduation; dramatic
increases in college attendance; substantially fewer arrests and
much less reliance on public assistance. One of the most
extensive studies done in this area compared the performance of
low income children at ages 14, 15, 19, 27 and 40 who attended
preschool with those who did not. Even at age 40 the differences
in performance were staggering. Former preschoolers had a
greater rate of employment and higher earnings. According to
economists these factors combine to make returns from
investments in preschool far greater than those from most public
economic development projects. For example, the Federal Reserve
Bank of Minneapolis reported that for every dollar spent on
early education, society reaped $16 of benefit. He drew
particular attention to a page in that report entitled "Large
Return on Investment" that showed the return to society on
investment in preschool not only in terms of reduced spending on
public assistance, education and criminal justice, but in
increased collection of taxes.
SENATOR WIELECHOWSKI commented that support for early education
was strong, with 87 percent of Alaskans supporting state funding
for early education and child care according to a poll conducted
by the McDowell Group. Interestingly, more than three quarters
of Alaskans believed that early learning and child care were
more important to fund than support for local governments or
construction of new roads and highways; and almost two thirds
felt that funding for early education was more important than
funding for university education. Nationally, support for early
learning programs was growing rapidly; last year the Governor of
Illinois took steps to make his state the first in the nation to
provide high quality preschool for every 3 and 4 year old by
2011.
In summary, he said the sponsor substitute for SCR 19 called on
Governor Palin to thoroughly consider the recommendations of the
Summit on Early Education and to work closely with the
legislature to implement those recommendations as appropriate.
It was his intention to further the discussion about the
benefits of preschool and hopefully, come back to the committee
with a more concrete proposal next year.
SENATOR THOMAS asked Senator Wielechowski for a complete copy of
the report titled "High/Scope Perry Preschool Study to Age 40"
[by Larry Schweinhart of the High/Scope Educational Research
Foundation].
SENATOR WIELECHOWSKI said he would provide that to him.
5:29:29 PM
NANCY SCHOEPOEFER supported SCR 19 as a private citizen advocate
for the Best Beginnings Initiative. She said she had been
involved with Best Beginnings since February 2007. At that time
she was employed by Conoco Phillips Alaska Inc. (CPAI) as their
designated representative to Best Beginnings and, since retiring
from CPAI at the end of January, continued to be actively
involved in the program.
MS. SCHOEPOEFER said the Best Beginnings Initiative brought
numerous public and private providers to the table to, among
other things, look at implementing a quality rating and
improvement system, and to conduct a comprehensive public
engagement campaign to inform parents, extended families,
community members and businesses about the economic and social
return on investment of education during a child's early years.
She encouraged passage of SCR 19 and urged Governor Palin to
consider the recommendations of the Governor's Summit on Early
Learning and work closely with the legislature to implement
those recommendations.
ABBE HENSLEY, Executive Director, Best Beginnings, thanked
Senator Wielechowski for sponsoring this resolution. She said
that more than 150 Alaskans came together at request of Governor
Palin to come up with recommendations to address 3 goals:
1) All children, especially those most in need, would have
access to early literacy and learning opportunities in
their homes or in out-of-home settings.
2) Early learning services would be coordinated.
3) Parents, grandparents and extended families would have
needed support resources for their engagement in young
children's learning.
SENATOR THOMAS asked if Ms. Hensley and Best Beginnings
participated in the early learning summit.
MS. HENSLEY responded that Best Beginnings provided the staff
for that summit and was the glue that held it together.
SENATOR THOMAS asked whether she had any dissenting opinion; did
any group feel that the recommendations were not appropriate.
MS. HENSLEY explained that the way recommendations were arrived
at was through people meeting on specific topics in small
groups. Those groups then came together and provided
recommendations to the whole group and they voted on the top
recommendations. Although they didn't make it necessary for
everyone to agree on every recommendation, she believed that
there was consensus on the ones that made the final list.
SENATOR THOMAS asked if it was a fair statement that there was
not really any dissent.
MS. HENSLEY confirmed that it was and said that, although
participants might have disagreed on which recommendations were
more important, they did not disagree with the recommendations
themselves.
5:36:16 PM
MICHELLE BROWN, President and CEO, United Way of Anchorage,
thanked the committee for hearing this resolution and Senator
Wielechowski for bringing it forward. She said the United Way
Board of Directors comprised 25 community and business leaders,
all of whom very strongly endorsed this resolution and the
findings of the Governor's Summit on Early Learning.
The United Way had been studying the issue with community
partners for several years and concurred with the findings of
major business organizations that early learning was necessary,
not just for our youths' academic success, but for Alaska's
economic success in a global economy. As a consequence, the
United Way Board had made this one of their priorities and
invested considerable resources in the hope of developing a
strong public/private partnership for a comprehensive array of
proven quality early learning opportunities. They wanted to
develop a system that would allow families to choose the type of
opportunity that would work best for them, and believed that a
coordinated plan would allow them to accurately measure their
progress.
SENATOR THOMAS asked whether Ms. Brown found that her business
partners believed early learning was helpful to them in
recruiting and retaining employees.
MS. BROWN responded that they conducted workplace campaigns in
many different work environments; and in their discussions they
found that as people became more aware of the research into
early learning and the window to make a difference, they came to
see it as the key to the next generation work force. They also
expressed strong interest in having this array of services
because it provided better productivity in the current work
force if parents were not distracted by having to struggle to
find opportunities for their children.
5:40:35 PM
SENATOR THOMAS moved to adopt the proposed SSSCR 19 as the
working document of the committee. There being no objection, the
motion carried.
CHAIR DAVIS thanked Senator Wielechowski for bringing this
forward and commented that it was important for them to keep
this on their agenda because Alaska was no longer one of 10, but
one of 3 states without early childhood education legislation in
place.
5:41:53 PM
SENATOR THOMAS moved to report SSSCR 19, Version \E, from
committee with individual recommendations. Hearing no
objections, the motion carried.
SB 107-NATUROPATHS
CHAIR DAVIS announced consideration of SB 107.
5:42:58 PM
TOM OBERMEYER, Staff to Senator Davis, presented an overview of
CSSB 107, Version \K, labeled 25-LS0702\K. This act related to
naturopaths and naturopathic practice, establishing an Alaska
Naturopathic Council, amending the duties of the Board of
Pharmacy relating to naturopathic practice, and providing for an
effective date. He explained that the CS before the committee
was drafted after the committee hearing of February 13, because
the committee chair concluded that changes were required in
oversight, training and experience in order to expand
naturopathic practice into areas that had formerly been reserved
to MD's [Medical Doctors] and DO's [Doctors of Osteopathy].
Those areas included minor surgery, prescribing prescription
drugs and ordering medical laboratory tests and imaging.
Changes in the CS were as follows:
1) The Alaska Naturopathic Council was increased from 5 to 7
members including 3 naturopaths, 1 medical doctor, 1
pharmacist and 2 members of the public who have no direct
financial interest in naturopathic practice or the health
care industry.
2) Members of the Naturopathic Council would be appointed by
the Governor.
3) Naturopaths would have to be in practice for 5 years before
being allowed the expanded scope of practice in minor
surgery, prescribing drugs and ordering medical laboratory
tests.
4) Naturopaths who were licensed to prescribe drugs would have
to take 15 hours of pharmacy education each year; those who
would perform minor surgery must have received a minimum of
1200 clinical hours of training under the supervision of
medical doctors, physician's assistants and [or] nurse
practitioners.
MR. OBERMEYER continued that the advisory council had no power
to adopt regulations as a board under the Boards and
Commissions; but it could advise the Department of Commerce,
Community & Economic Development regarding regulation.
He also noted that there was no attempt to recognize what other
states had done, because he had spent a great deal of time
looking at other states and found that each had a different way
of dealing with this particular set of practices.
CHAIR DAVIS asked Mr. Obermeyer to go back over the CS and point
out each change from the original bill.
MR. OBERMEYER recapped the changes. First, the council was
increased from 5 to 7 members, to include 3 naturopaths, 1
medical doctor and 1 pharmacist appointed by their respective
boards and recommended to the Governor for final appointment.
Second, naturopaths would be required to practice for 5 years
before being allowed the expanded scope of practice described.
Third, prescribing naturopaths would have to take 15 contact
hours of pharmacy education training each year after being pre-
qualified as explained in the bill, with 60 hours of training
and satisfaction of other specific requirements. Finally, they
would have to complete clinical training under the supervision
of medical doctors, physician's assistants or nurse
practitioners in minor surgery and anesthetics.
The effective date of the bill, as indicated in section 13,
would be July 1, 2009.
SENATOR THOMAS moved to adopt the proposed committee substitute
CSSB 107, Version \k, as the working document of the committee.
There being no objection, the motion carried.
5:51:05 PM
SENATOR ELTON asked for clarification regarding the makeup of
the council. He said the bill provided that "When appointing
pharmacists and physicians … the governor may appoint a
pharmacist from the list of names submitted by the Board of
Pharmacy … and a physician from the list of names submitted by
the State Medical Board," but there was no provision for the
governor to request a list from the naturopaths. He wondered why
the appointment of a doctor or pharmacist was different from the
appointment of a naturopath.
MR. OBERMEYER answered that the naturopaths did not have their
own board at that time.
SENATOR ELTON said that a quorum of the council was at least 4
members for the transaction of business; one of the most
important chores of the naturopathic council was establishing
and maintaining a list of prescription drugs and medical
devices, but that could be done without a pharmacist present. He
asked if that was correct.
MR. OBERMEYER replied that he was probably correct, but doubted
they would take action without the advice of the pharmacy board
or the pharmacist who was responsible for it. He noted that even
in Kansas they had 2 medical doctors on a formulary council and
one on an advisory council under the medical board; so they were
trying to keep those professionals totally involved in the
naturopathic practice. He assumed they would involve the
appropriate people to deal with any changes to the list of
authorized drugs.
CHAIR DAVIS added that the effective date on the bill gave them
one year to work out those details and differences. That was why
the effective date was moved from July 2008 to July 2009.
5:55:47 PM
SENATOR ELTON directed Mr. Obermeyer to page 5, line 5. He said
that what they had structurally was a council appointed by the
governor. The council would have specific responsibilities that
were delineated earlier in the bill; but the department
[Department of Commerce, Community & Economic Development,
Division of Corporations, Business and Professional Licensing]
would set the fees. He questioned why the department, rather
than the council, would set the fees.
MR. OBERMEYER responded that was what made this an advisory
board; it would not be like the State Medical Board or the Board
of Pharmacy, which had regulatory powers. This board would still
fall under the Department of Commerce, Community & Economic
Development.
CHAIR DAVIS advised that Alphaeus Bullard was on the line and
could answer that question.
5:59:14 PM
SENATOR ELTON asked if he would do so. He re-stated his question
and added that, given Mr. Obermeyer's response that the council
would be advisory in nature, he questioned the language on page
4 under "Duties of the Council," which stated that the council
"shall (1) establish a list of prescription drugs and medical
devices." He asked if that list would be only advisory and could
be amended or modified by the department.
ALPHEUS BULLARD, Attorney at Law, Legislative Legal and Research
Services Division, Legislative Affairs Agency, replied that the
council was completely advisory as indicated by the "may" in
that paragraph. The department would enjoy the end authority to
add, subtract or delineate what drugs would be on that list.
SENATOR ELTON wondered why, if the department would have the
final say on everything, they were establishing a council.
CHAIR DAVIS said she thought, because members were appointed by
the Governor's office, it would no longer be under the
Department of Commerce; she asked what they would have to do to
remove it from Department of Commerce purview.
MR. BULLARD answered that they would be creating a state board
or commission. It remained under the department because it was
purely advisory.
CHAIR DAVIS asked why the governor was appointing the members of
an advisory board.
MR. BULLARD advised that it was a drafting request; it did not
have to work that way.
CHAIR DAVIS asked if there was any reason that all appointments
should not be made by one entity.
MR. BULLARD replied that it was not unusual for the commissioner
to appoint the members of an advisory board or council, or for
the board or council to have no regulatory authority.
6:03:13 PM
SENATOR ELTON was struggling with the notion of adding a council
that would have no authorities or whose authorities could be
"trumped" by the department. Instead of adding advisory groups
he opined, they might want to subtract some if they had no real
powers.
6:04:04 PM
DR. JOHN RASTER, Alaska State Medical Association, testified
that, although they appreciated the changes in the CS, the
Alaska State Medical Association still felt it was somewhat
unregulated and had misgivings about it. The Naturopathic
Council could potentially allow all drugs to be in formulary;
that could include narcotics, OxyContin, Schedule 2 drugs or
chemotherapy. Although the Department of Commerce was given
oversight of the list, he did not believe they had a physician
or pharmacist on staff who could sign off on those drugs; so the
council would essentially decide the formulary. In addition, the
bill allowed in-office minor surgeries [Sec. 6 AS 08.45.200
(4)(A) and (B)] but did not allow surgeries "... involving
tendons, ligaments, nerves or blood vessels;" even one
millimeter beneath the skin there were nerves.
With the medications that could potentially be prescribed along
with the surgery, this would give naturopaths the most broad
prescription and surgical authorities in the country. He noted
also that it was not clear who would handle patient complaints.
CHAIR DAVIS said she did not agree with some of Mr. Raster's
comments; other states were already allowing naturopaths to do
what this bill was proposing. She reproved him for opposing the
bill without offering any practical suggestions, and reminded
him that she had asked repeatedly for the Medical Association's
assistance in this process.
DR. RASTER responded that he would definitely discuss it with
their board of trustees the following day and would come up with
some suggestions.
SENATOR ELTON offered his understanding that the council could
not do the formulary; that power was reserved for the
Department, which "may approve," not "shall approve" the list.
Also, at the bottom of page 4, line 30-31, it stated that "(c)
An endorsement issued under (a) of this section is valid for two
years unless revoked or suspended by the department." That would
seem to give the department the ability to suspend the
privilege.
6:10:56 PM
IRMA NORLAND, representing herself, supported CSSB 107. She said
that her primary medical provider was Emily Kane, a naturopath,
and it would be helpful to her if naturopathic doctors were
empowered to use all the skills they were trained for, including
prescribing medication and performing minor surgery. She
currently had to contact an MD for those services; because
General Practitioners were not readily available, she often had
to go to the Emergency Room, which was more time-consuming and
costly to both her and the medical insurance industry.
MS. NORLAND related an incident that occurred in 2006, when Dr.
Kane diagnosed her as having a life threatening deep vein
thrombosis (DVT) or blood clot, and recommended the proper
treatment. The problem had not been correctly diagnosed by the
MD at the emergency room, which nearly caused her to travel
without the necessary medication to thin her blood. What is
more, Dr. Kane was the only doctor who had worked with her to
reduce the clot.
MS. NORLAND was a nurse for 30 years and it was her opinion that
naturopathic medicine was not only legitimate, but preferable in
many cases to conventional treatments. She was currently being
treated for hypertension, which might require medication, and it
would be less expensive and more convenient if Dr. Kane could
prescribe those medications for her.
6:13:48 PM
DR. SCOTT LUPER, President, Alaska Association Of Naturopathic
Physicians (AKANP), supported CSSB 107. He appreciated the
testimony and wanted to speak to the essence of the bill, which
was that it allowed naturopathic physicians to practice as they
were educated. Naturopaths came into the practice after 4 years
of college, an additional 4 years of medical education, and
testing by a national board in a wide variety of competencies
including minor surgeries and the use of pharmaceuticals. Most
states that licensed Naturopathic Doctors did allow some degree
of prescription authority; Alaska was one of the places that did
not.
DR. LUPER stressed that he wanted to provide the care to his
patients that he was trained to provide. He said he had seen a
patient that week, a 43 year old woman with 3 children, who
complained of fatigue, menstrual problems and headache. He
gathered history, performed a number of tests and examinations,
and came back with a diagnosis of hypothyroidism. Because he
could not prescribe the necessary medication, she had to endure
the added time and expense and the delay in treatment required
to see an MD. He said he would be happy to answer any questions
the committee might have.
SENATOR THOMAS noted that they had heard previous testimony that
the difference in education [between MD's and naturopaths] was
the residency served by MD's that required them to work under
licensed physicians in a hospital environment for a period of
time. He asked if Dr. Luper could explain why he thought that
was not valid, or if in fact the residency was also required of
naturopaths.
DR. LUPER said he was in charge of the residency program at
Southwest School of Naturopathic Medicine and he did think
residency was a good idea; residency was the place that doctors
got to hone their skills. He felt it was unfortunate that the
residency positions available to naturopathic physicians were
fewer than the physicians themselves. The reason was that
naturopathy was not subsidized by the federal government as was
medical or osteopathic practice. The AKANP was trying to correct
that, but it would take some time.
He said that the bottom line however, was that Naturopathic
Doctors were trained well enough after 4 years of medical school
and the thousands of hours of patient contact they had while in
school, to diagnose, treat, prescribe and perform minor surgical
procedures. He pointed out that naturopaths were all trained
under licensed physicians.
6:20:06 PM
EMILY KANE, Naturopathic Physician, Juneau, AK, wanted to make a
point that might alleviate Dr. Raster's concerns and those of
his board. She said her understanding was that one version of
this bill specifically excluded narcotics and chemotherapy from
the potential list of legend drugs; she was not personally
interested in either narcotics or chemotherapeutics and would
guess that she spoke for most naturopaths in that regard. She
asked if her understanding was correct.
CHAIR DAVIS agreed that it was still written that way as far as
she knew and asked Mr. Bullard to speak to that.
DR. KANE asked why then, Dr. Raster was concerned about those
categories.
CHAIR DAVIS said that although Dr. Raster spoke to them, they
were never in the bill.
6:22:03 PM
DR. RASTER said he could not find those exclusions in the
current version of the bill.
SENATOR THOMAS questioned whether on page 2, [line 28], the
verbiage "except as authorized under AS 08.45.056" would cover
that.
MR. BULLARD advised that the exclusions were not in the current
bill.
CHAIR DAVIS wondered why they had been removed. She said they
were running out of time, but the bill was clearly not in the
shape they thought it was; those exclusions should not have come
out.
MR. BULLARD referred Chair Davis to Version \A where the
exclusions did appear on page 2, lines 30-31.
MR. OBERMEYER said he believed that Section 08.45.050 had not
changed except under AS 08.45.056 and that the current
restrictions on controlled substances would cover narcotics.
Chemotherapy was not addressed. If they determined that this
profession should be regulated by the Alaska State Medical
Board, then the law would have to be changed.
SENATOR ELTON asked Mr. Bullard about a possible anomaly on page
4, line 3 and lines 27-29. Line 3 provided that the council
would create a list that the department "may" approve for use by
naturopaths; beginning on line 27 it said that "(b) An
endorsement issued under (a) of this section authorizes the
licensee to prescribe and administer prescription drugs and
medical devices that are on the formulary approved by the Alaska
Naturopathic Council under AS 08.45.054." He asked if line 29
should say approved by the Department rather than by the
Naturopathic Council.
MR. BULLARD agreed with Senator Elton that the verbiage as
written was incorrect.
CHAIR DAVIS announced her intention to close public comment on
the bill until corrections could be made. She held SB 107 in
committee.
There being no further business to come before the committee,
Chair Davis adjourned the meeting at 6:27:04 PM.
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