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HB 282: "An Act relating to naturopaths and to the practice of naturopathy; establishing an Alaska Naturopathic Medical Board; authorizing medical assistance program coverage of naturopathic services; amending the definition of 'practice of medicine'; and providing for an effective date."

00 HOUSE BILL NO. 282 01 "An Act relating to naturopaths and to the practice of naturopathy; establishing an 02 Alaska Naturopathic Medical Board; authorizing medical assistance program coverage 03 of naturopathic services; amending the definition of 'practice of medicine'; and 04 providing for an effective date." 05 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 06 * Section 1. AS 08.01.010(26) is amended to read: 07 (26) Alaska Naturopathic Medical Board (AS 08.45.003) 08 [REGULATION OF THE PRACTICE OF NATUROPATHY UNDER AS 08.45]; 09 * Sec. 2. AS 08.01.050(d) is amended to read: 10 (d) At the request of one of the following boards, the department may contract 11 with public agencies and private professional organizations to provide assistance and 12 treatment to persons licensed by the board who abuse alcohol, other drugs, or other 13 substances: 14 (1) Board of Social Work Examiners;

01 (2) Board of Dental Examiners; 02 (3) [REPEALED 03 (4)] State Medical Board; 04 (4) [(5)] Board of Nursing; 05 (5) [(6)] Board of Examiners in Optometry; 06 (6) [(7)] Board of Pharmacy; 07 (7) [(8)] State Physical Therapy and Occupational Therapy Board; 08 (8) [(9)] Board of Professional Counselors; 09 (9) [(10)] Board of Psychologist and Psychological Associate 10 Examiners; 11 (10) [(11)] Board of Veterinary Examiners; 12 (11) [AND (12)] Board of Marital and Family Therapy; and 13 (12) Alaska Naturopathic Medical Board. 14 * Sec. 3. AS 08.45 is amended by adding new sections to read: 15 Sec. 08.45.003. Board created; organization. (a) There is created the Alaska 16 Naturopathic Medical Board. The board consists of five members appointed by the 17 governor. Three members shall be naturopaths licensed under this chapter who have 18 been engaged in the practice of naturopathic medicine in the state for at least five 19 years immediately preceding appointment, at least one of whom lives outside the third 20 judicial district. One member shall be a licensed pharmacist. One member shall be a 21 public member who may be a licensed physician. 22 (b) The board shall select from among its members a chair and a secretary. 23 The board shall meet at least twice a year, and additional meetings shall be held on 24 request of the chair or on request of the department. 25 (c) Notwithstanding AS 08.01.035, members of the board serve staggered 26 terms of three years unless removed by the governor for neglect of duty or other just 27 cause. 28 (d) Three members of the board constitute a quorum for the transaction of all 29 business properly before the board. 30 (e) When appointing naturopaths under (a) of this section, the governor may 31 consider licensed naturopaths who have been nominated by the Alaska Association of

01 Naturopathic Physicians. 02 (f) In the event of the death, resignation, or removal of a member, the vacancy 03 shall be filled for the unexpired portion of the term in the same manner as the original 04 appointment. 05 Sec. 08.45.005. Duties of the board. The board shall 06 (1) establish a list of prescription drugs, controlled substances, 07 vaccines, hormones, and medical devices that are consistent with naturopathic 08 education and practice that may be prescribed and administered by a naturopath 09 holding a prescription endorsement, and review the list of prescription drugs, 10 controlled substances, vaccines, hormones, and medical devices annually and on 11 request by the department; 12 (2) approve naturopathic medical programs; 13 (3) implement the continuing education requirements of 14 AS 08.45.056(e) and 08.45.058; and 15 (4) adopt regulations necessary to implement this chapter in a manner 16 that protects public health. 17 * Sec. 4. AS 08.45.030 is amended to read: 18 Sec. 08.45.030. Issuance of license. The board shall request that the 19 department [SHALL] issue, and the department may issue, a license to practice 20 naturopathy to an applicant who provides proof satisfactory to the board 21 [DEPARTMENT] that the applicant has received a degree from an accredited four- 22 year college or university, has paid the applicable fees, and 23 (1) on or before December 31, 1987, has graduated from a school of 24 naturopathy that required four years of attendance at the school and after graduation 25 has received a license in another state after passing an examination for licensure in 26 that state and is licensed by a state at the time of application; or 27 (2) after December 31, 1987, has 28 (A) graduated from a school of naturopathy that required four 29 years of attendance at the school and at the time of graduation the school was 30 accredited or a candidate for accreditation by the Council on Naturopathic 31 Medical Education or a successor organization recognized by the United States

01 Department of Education; and 02 (B) passed the Naturopathic Physicians Licensing Examination. 03 * Sec. 5. AS 08.45.035(a) is amended to read: 04 (a) The board shall request that the department [SHALL] issue, and the 05 department may issue, a temporary license to practice naturopathy to an applicant 06 who has applied for and is qualified to take the next Naturopathic Physicians 07 Licensing Examination offered after the date of application and provides proof 08 satisfactory to the board [DEPARTMENT] that the applicant 09 (1) has paid the applicable fees; 10 (2) meets the requirements of AS 08.45.030(2)(A); and 11 (3) [(2)] has not previously failed the Naturopathic Physicians 12 Licensing Examination. 13 * Sec. 6. AS 08.45 is amended by adding a new section to read: 14 Sec. 08.45.045. Scope of practice as a naturopath. A naturopath may 15 (1) use physical examinations consistent with naturopathic medical 16 education and training for diagnostic purposes; 17 (2) perform and administer therapies consistent with naturopathic 18 medical education and training, including intravenous delivery of dietetic substances; 19 (3) order or conduct medical imaging and laboratory examinations 20 consistent with naturopathic medical education and training; 21 (4) perform preemployment, school, and workplace health 22 examinations; 23 (5) perform minor surgery; in this paragraph, "minor surgery" 24 (A) means the use of 25 (i) operative, electrical, or other methods for surgical 26 repair and care incidental to superficial lacerations and abrasions or 27 superficial lesions and the removal of foreign bodies located in 28 superficial tissues; and 29 (ii) antiseptics and local anesthetics in connection with 30 methods authorized under (i) of this subparagraph; 31 (B) does not include use of general or spinal anesthetics,

01 surgery of the body cavities, or specialized surgery, such as plastic surgery, 02 surgery involving the eyes, or surgery involving tendons, ligaments, nerves, or 03 blood vessels; and 04 (6) under a prescription endorsement issued under AS 08.45.056, 05 administer and prescribe prescription drugs, controlled substances, vaccines, 06 hormones, and medical devices as approved by the board for use by naturopaths. 07 * Sec. 7. AS 08.45.050 is amended to read: 08 Sec. 08.45.050. Restrictions on practice of naturopathy. A person who 09 practices naturopathy may not 10 (1) except as authorized under AS 08.45.056, give, prescribe, or 11 recommend in the practice 12 (A) a prescription drug, vaccine, or hormone; 13 (B) a controlled substance; 14 (C) a poison; 15 (2) engage in surgery, except minor surgery as authorized under 16 AS 08.45.045; 17 (3) use general or spinal anesthetics; or 18 (4) administer ionizing radioactive substances for therapeutic 19 purposes [USE THE WORD "PHYSICIAN" IN THE PERSON'S TITLE]. 20 * Sec. 8. AS 08.45 is amended by adding new sections to read: 21 Sec. 08.45.056. Prescription endorsement. (a) The board shall request that 22 the department issue, and the department may issue, a 23 (1) type I prescription endorsement to a naturopath licensed under this 24 chapter who has 25 (A) practiced naturopathy for five years; and 26 (B) submitted proof satisfactory to the board that the 27 naturopath has 28 (i) successfully completed at least 60 hours of education 29 from a program approved by the board; and 30 (ii) met other requirements relating to the 31 administration and prescription of drugs, vaccines, hormones, and

01 medical devices that the board considers necessary to ensure the 02 protection of the public health; and 03 (2) type II prescription endorsement to a naturopath licensed under this 04 chapter who has 05 (A) met the requirements for a type I endorsement under (1)(A) 06 and (B) of this subsection; and 07 (B) obtained the appropriate registration issued by the Federal 08 Drug Enforcement Administration. 09 (b) A type I endorsement issued under (a)(1) of this section authorizes the 10 licensee to prescribe and administer vaccines, hormones, medical devices, and 11 prescription drugs that are not controlled substances but that are on the formulary 12 approved by the department under AS 08.45.005. 13 (c) A type II endorsement issued under (a)(2) of this section authorizes the 14 licensee to prescribe controlled substances that are on the formulary approved by the 15 department under AS 08.45.005 and to perform all functions of a type I endorsement 16 described in (b) of this section. 17 (d) An endorsement issued under (a) of this section is valid for two years 18 unless revoked or suspended by the department. 19 (e) The department may not renew an endorsement issued under (a) of this 20 section unless the licensee submits proof satisfactory to the board that the licensee has 21 completed at least 15 hours of pharmaceutical education in each of the past two years. 22 Sec. 08.45.058. Continuing education requirements. (a) A person licensed to 23 practice naturopathy under AS 08.45.030 shall complete and submit to the board 24 evidence of at least 35 hours of continuing education for each biennial license period. 25 The 35 hours of continuing education must be in training programs approved by the 26 board. 27 (b) The department shall publish, on a regular basis, a listing of training 28 programs that may be used to satisfy the continuing education requirements of this 29 section. 30 * Sec. 9. AS 08.45.100 is amended to read: 31 Sec. 08.45.100. Regulations. The board and the department

01 [DEPARTMENT OF COMMERCE, COMMUNITY, AND ECONOMIC 02 DEVELOPMENT] shall adopt regulations to implement this chapter. 03 * Sec. 10. AS 08.45 is amended by adding a new section to read: 04 Sec. 08.45.110. Fees. The department shall set fees under AS 08.01.065 for 05 each of the following: 06 (1) a license issued under this chapter; 07 (2) a temporary license issued under this chapter; 08 (3) renewal of a license issued under this chapter; 09 (4) a prescription endorsement issued under this chapter. 10 * Sec. 11. AS 08.45.200 is amended by adding, a new paragraph to read: 11 (4) "board" means the Alaska Naturopathic Medical Board established 12 under this chapter. 13 * Sec. 12. AS 08.64.380(6) is amended to read: 14 (6) "practice of medicine" or "practice of osteopathy" means: 15 (A) for a fee, donation or other consideration, to diagnose, 16 treat, operate on, prescribe for, or administer to, any human ailment, blemish, 17 deformity, disease, disfigurement, disorder, injury, or other mental or physical 18 condition; or to attempt to perform or represent that a person is authorized to 19 perform any of the acts set out in this subparagraph; 20 (B) to use or publicly display a title in connection with a 21 person's name, including "doctor of medicine," "physician," "M.D.," or "doctor 22 of osteopathic medicine" or "D.O.," unless the designation additionally 23 contains the word "naturopathy" or "naturopathic" in the title, or to use 24 or publicly display a specialist designation, such as [INCLUDING] 25 "surgeon," "dermatologist," or a similar title, in such a manner as to show that 26 the person is willing or qualified to diagnose or treat the sick or injured; 27 * Sec. 13. AS 08.80.400 is amended to read: 28 Sec. 08.80.400. Other licensees not affected. This chapter does not affect the 29 practice of medicine by a licensed medical doctor and does not limit a licensed 30 medical doctor, osteopath, podiatrist, physician assistant, advanced nurse practitioner, 31 dentist, veterinarian, dispensing optician, naturopath, or optometrist in supplying a

01 patient with any medicinal preparation or article within the scope of the person's 02 license. 03 * Sec. 14. AS 47.07.030(b) is amended to read: 04 (b) In addition to the mandatory services specified in (a) of this section and the 05 services provided under (d) of this section, the department may offer only the 06 following optional services: case management and nutrition services for pregnant 07 women; personal care services in a recipient's home; emergency hospital services; 08 long-term care noninstitutional services; medical supplies and equipment; advanced 09 nurse practitioner services; naturopathic services; clinic services; rehabilitative 10 services for children eligible for services under AS 47.07.063, substance abusers, and 11 emotionally disturbed or chronically mentally ill adults; targeted case management 12 services; inpatient psychiatric facility services for individuals age 65 or older and 13 individuals under age 21; psychologists' services; clinical social workers' services; 14 midwife services; prescribed drugs; physical therapy; occupational therapy; 15 chiropractic services; low-dose mammography screening, as defined in 16 AS 21.42.375(e); hospice care; treatment of speech, hearing, and language disorders; 17 adult dental services; prosthetic devices and eyeglasses; optometrists' services; 18 intermediate care facility services, including intermediate care facility services for the 19 mentally retarded; skilled nursing facility services for individuals under age 21; and 20 reasonable transportation to and from the point of medical care. 21 * Sec. 15. AS 47.07.900 is amended by adding a new paragraph to read: 22 (20) "naturopathic services" means services that are furnished by a 23 person who is licensed to practice naturopathy under AS 08.45.030 or 08.45.035 and 24 that are within the person's scope of practice under AS 08.45.045. 25 * Sec. 16. The uncodified law of the State of Alaska is amended by adding a new section to 26 read: 27 TRANSITION: REGULATIONS. The Department of Commerce, Community, and 28 Economic Development may proceed to adopt regulations necessary to implement the 29 changes made by this Act. The regulations take effect under AS 44.62 (Administrative 30 Procedure Act), but not before the effective date under sec. 20 of this Act. 31 * Sec. 17. The uncodified law of the State of Alaska is amended by adding a new section to

01 read: 02 TRANSITIONAL PROVISIONS APPLICABLE TO ALASKA NATUROPATHIC 03 MEDICAL BOARD. Notwithstanding AS 08.45.003, as enacted in sec. 3 of this Act, the 04 terms of the first members of the Alaska Naturopathic Medical Board appointed by the 05 governor are as follows: (1) one licensed naturopath member and the public member shall be 06 appointed for two-year terms; (2) the licensed pharmacist member and one licensed 07 naturopath member shall be appointed for three-year terms; and (3) one licensed naturopath 08 member shall be appointed for a one-year term. The governor shall specify the term of office 09 of each licensed naturopath member appointed subject to this section. 10 * Sec. 18. The uncodified law of the State of Alaska is amended by adding a new section to 11 read: 12 TRANSITIONAL PROVISIONS AFFECTING EXISTING LICENSEES. 13 Notwithstanding AS 08.45.030, as amended by sec. 4 of this Act, and AS 08.45.035(a), as 14 amended by sec. 5 of this Act, 15 (1) a license issued under those provisions by the Department of Commerce, 16 Community, and Economic Development before the effective date of this section is valid for 17 the period issued until renewal under the provisions of this Act; and 18 (2) the Department of Commerce, Community, and Economic Development, 19 without prior approval of the Alaska Naturopathic Medical Board, may issue a license or 20 renew a license to practice naturopathy on or after the effective date of this section and until 21 the day before the effective date of the regulations initially adopted by the board setting out 22 procedures under which license applications and renewals are submitted for board review and 23 approval. 24 * Sec. 19. Section 16 of this Act takes effect immediately under AS 01.10.070(c). 25 * Sec. 20. Except as provided in sec. 19 of this Act, this Act takes effect July 1, 2010.