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CSHB 282(L&C): "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 CS FOR HOUSE BILL NO. 282(L&C) 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01 (2) Board of Dental Examiners; 02 (3) [REPEALED 03 (4)] State Medical Board; 04 (4) [(5)] Board of Nursing; 05 (5) [(6)] Board of Examiners in Optometry; 06 (6) [(7)] Board of Pharmacy; 07 (7) [(8)] State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 08.03.010(c) is amended by adding a new paragraph to read: 15 (23) Alaska Naturopathic Medical Board (AS 08.45.003) - June 30, 16 2015. 17 * Sec. 4. AS 08.45 is amended by adding new sections to read: 18 Sec. 08.45.003. Board created; organization. (a) There is created the Alaska 19 Naturopathic Medical Board. The board consists of seven members appointed by the 20 governor as follows: 21 (1) three members shall be naturopaths licensed under this chapter who 22 have been engaged in the practice of naturopathic medicine in the state for at least five 23 years immediately preceding appointment, at least one of whom lives outside the third 24 judicial district; 25 (2) one member shall be a licensed pharmacist; 26 (3) one member shall be a licensed physician; 27 (4) one member shall be a hospital administrator; and 28 (5) one member shall be a public member who may be a licensed 29 physician. 30 (b) The board shall select from among its members a chair and a secretary. 31 The board shall meet at least twice a year, and additional meetings shall be held on

01 request of the chair or on request of the department. 02 (c) Notwithstanding AS 08.01.035, members of the board serve staggered 03 terms of three years unless removed by the governor for neglect of duty or other just 04 cause. 05 (d) Four members of the board constitute a quorum for the transaction of all 06 business properly before the board. 07 (e) When appointing naturopaths under (a) of this section, the governor may 08 consider licensed naturopaths who have been nominated by the Alaska Association of 09 Naturopathic Physicians. 10 (f) In the event of the death, resignation, or removal of a member, the vacancy 11 shall be filled for the unexpired portion of the term in the same manner as the original 12 appointment. 13 Sec. 08.45.005. Duties of the board. The board shall 14 (1) establish a list of prescription drugs, vaccines, hormones, and 15 medical devices that are consistent with naturopathic education and practice that may 16 be prescribed and administered by a naturopath, and review the list of prescription 17 drugs, vaccines, hormones, and medical devices annually and on request by the 18 department; a schedule IA, IIA, IIIA, IVA, VA or VIA controlled substance under 19 state law or a schedule I, II, III, IV, or V controlled substance under federal law may 20 not be included on the list; 21 (2) approve naturopathic medical programs; 22 (3) implement the continuing education requirements of AS 08.45.058; 23 and 24 (4) adopt regulations necessary to implement this chapter in a manner 25 that protects public health, including regulations that define a physician-patient 26 relationship for purposes of AS 08.45.045(6). 27 * Sec. 5. AS 08.45.030 is amended to read: 28 Sec. 08.45.030. Issuance of license. The board shall request that the 29 department [SHALL] issue, and the department may issue, a license to practice 30 naturopathy to an applicant who provides proof satisfactory to the board 31 [DEPARTMENT] that the applicant has received a degree from an accredited four-

01 year college or university, has paid the applicable fees, and 02 (1) on or before December 31, 1987, has graduated from a school of 03 naturopathy that required four years of attendance at the school and after graduation 04 has received a license in another state after passing an examination for licensure in 05 that state and is licensed by a state at the time of application; or 06 (2) after December 31, 1987, has 07 (A) graduated from a school of naturopathy that required four 08 years of attendance at the school and at the time of graduation the school was 09 accredited or a candidate for accreditation by the Council on Naturopathic 10 Medical Education or a successor organization recognized by the United States 11 Department of Education; and 12 (B) passed the Naturopathic Physicians Licensing Examination. 13 * Sec. 6. AS 08.45.035(a) is amended to read: 14 (a) The board shall request that the department [SHALL] issue, and the 15 department may issue, a temporary license to practice naturopathy to an applicant 16 who has applied for and is qualified to take the next Naturopathic Physicians 17 Licensing Examination offered after the date of application and provides proof 18 satisfactory to the board [DEPARTMENT] that the applicant 19 (1) has paid the applicable fees; 20 (2) meets the requirements of AS 08.45.030(2)(A); and 21 (3) [(2)] has not previously failed the Naturopathic Physicians 22 Licensing Examination. 23 * Sec. 7. AS 08.45 is amended by adding a new section to read: 24 Sec. 08.45.045. Scope of practice as a naturopath. A naturopath may 25 (1) use physical examinations consistent with naturopathic medical 26 education and training for diagnostic purposes; 27 (2) perform and administer therapies consistent with naturopathic 28 medical education and training, including intravenous delivery of dietetic substances; 29 (3) order or conduct medical imaging and laboratory examinations 30 consistent with naturopathic medical education and training; 31 (4) perform preemployment, school, and workplace health

01 examinations; 02 (5) perform minor surgery; in this paragraph, "minor surgery" 03 (A) means the use of 04 (i) operative, electrical, or other methods for surgical 05 repair and care incidental to superficial lacerations and abrasions or 06 superficial lesions and the removal of foreign bodies located in 07 superficial tissues; and 08 (ii) antiseptics and local anesthetics in connection with 09 methods authorized under (i) of this subparagraph; 10 (B) does not include use of general or spinal anesthetics, 11 surgery of the body cavities, or specialized surgery, such as plastic surgery, 12 surgery involving the eyes, or surgery involving tendons, ligaments, nerves, or 13 blood vessels; and 14 (6) administer and prescribe prescription drugs, vaccines, hormones, 15 and medical devices as approved by the board for use by naturopaths under 16 AS 08.45.005(1) and subject to AS 08.45.050, but only for a person with whom the 17 naturopathy practitioner has a physician-patient relationship as defined by the board in 18 regulations. 19 * Sec. 8. AS 08.45.050 is amended to read: 20 Sec. 08.45.050. Restrictions on practice of naturopathy. A person who 21 practices naturopathy may not 22 (1) give, prescribe, or recommend in the practice 23 (A) a prescription drug, vaccine, or hormone, except as 24 authorized under AS 08.45.045(6); 25 (B) a controlled substance; 26 (C) a poison; 27 (2) engage in surgery, except minor surgery as authorized under 28 AS 08.45.045; 29 (3) use general or spinal anesthetics; or 30 (4) administer ionizing radioactive substances for therapeutic 31 purposes [USE THE WORD "PHYSICIAN" IN THE PERSON'S TITLE].

01 * Sec. 9. AS 08.45 is amended by adding a new section to read: 02 Sec. 08.45.058. Continuing education requirements. (a) For each biennial 03 license period, a person licensed to practice naturopathy under AS 08.45.030 shall 04 complete and submit to the board evidence of at least 35 hours of continuing 05 education, at least 15 of which are in pharmaceutical education. The 35 hours of 06 continuing education must be in training programs approved by the board. 07 (b) The department shall publish, on a regular basis, a listing of training 08 programs that may be used to satisfy the continuing education requirements of this 09 section. 10 * Sec. 10. AS 08.45.100 is amended to read: 11 Sec. 08.45.100. Regulations. The board and the department 12 [DEPARTMENT OF COMMERCE, COMMUNITY, AND ECONOMIC 13 DEVELOPMENT] shall adopt regulations to implement this chapter. 14 * Sec. 11. AS 08.45 is amended by adding a new section to read: 15 Sec. 08.45.110. Fees. The department shall set fees under AS 08.01.065 for 16 each of the following: 17 (1) a license issued under this chapter; 18 (2) a temporary license issued under this chapter; 19 (3) renewal of a license issued under this chapter. 20 * Sec. 12. AS 08.45.200 is amended by adding, a new paragraph to read: 21 (4) "board" means the Alaska Naturopathic Medical Board established 22 under this chapter. 23 * Sec. 13. AS 08.64.380(6) is amended to read: 24 (6) "practice of medicine" or "practice of osteopathy" means: 25 (A) for a fee, donation or other consideration, to diagnose, 26 treat, operate on, prescribe for, or administer to, any human ailment, blemish, 27 deformity, disease, disfigurement, disorder, injury, or other mental or physical 28 condition; or to attempt to perform or represent that a person is authorized to 29 perform any of the acts set out in this subparagraph; 30 (B) to use or publicly display a title in connection with a 31 person's name, including "doctor of medicine," "physician," "M.D.," or "doctor

01 of osteopathic medicine" or "D.O.," unless the designation additionally 02 contains the word "naturopathy" or "naturopathic" in the title, or to use 03 or publicly display a specialist designation, such as [INCLUDING] 04 "surgeon," "dermatologist," or a similar title, in such a manner as to show that 05 the person is willing or qualified to diagnose or treat the sick or injured; 06 * Sec. 14. AS 08.80.400 is amended to read: 07 Sec. 08.80.400. Other licensees not affected. This chapter does not affect the 08 practice of medicine by a licensed medical doctor and does not limit a licensed 09 medical doctor, osteopath, podiatrist, physician assistant, advanced nurse practitioner, 10 dentist, veterinarian, dispensing optician, naturopath, or optometrist in supplying a 11 patient with any medicinal preparation or article within the scope of the person's 12 license. 13 * Sec. 15. AS 47.07.030(b) is amended to read: 14 (b) In addition to the mandatory services specified in (a) of this section and the 15 services provided under (d) of this section, the department may offer only the 16 following optional services: case management and nutrition services for pregnant 17 women; personal care services in a recipient's home; emergency hospital services; 18 long-term care noninstitutional services; medical supplies and equipment; advanced 19 nurse practitioner services; naturopathic services; clinic services; rehabilitative 20 services for children eligible for services under AS 47.07.063, substance abusers, and 21 emotionally disturbed or chronically mentally ill adults; targeted case management 22 services; inpatient psychiatric facility services for individuals age 65 or older and 23 individuals under age 21; psychologists' services; clinical social workers' services; 24 midwife services; prescribed drugs; physical therapy; occupational therapy; 25 chiropractic services; low-dose mammography screening, as defined in 26 AS 21.42.375(e); hospice care; treatment of speech, hearing, and language disorders; 27 adult dental services; prosthetic devices and eyeglasses; optometrists' services; 28 intermediate care facility services, including intermediate care facility services for the 29 mentally retarded; skilled nursing facility services for individuals under age 21; and 30 reasonable transportation to and from the point of medical care. 31 * Sec. 16. AS 47.07.900 is amended by adding a new paragraph to read:

01 (20) "naturopathic services" means services that are furnished by a 02 person who is licensed to practice naturopathy under AS 08.45.030 or 08.45.035 and 03 that are within the person's scope of practice under AS 08.45.045. 04 * Sec. 17. The uncodified law of the State of Alaska is amended by adding a new section to 05 read: 06 TRANSITION: REGULATIONS. The Department of Commerce, Community, and 07 Economic Development may proceed to adopt regulations necessary to implement the 08 changes made by this Act. The regulations take effect under AS 44.62 (Administrative 09 Procedure Act), but not before the effective date under sec. 21 of this Act. 10 * Sec. 18. The uncodified law of the State of Alaska is amended by adding a new section to 11 read: 12 TRANSITIONAL PROVISIONS APPLICABLE TO ALASKA NATUROPATHIC 13 MEDICAL BOARD. Notwithstanding AS 08.45.003, as enacted in sec. 4 of this Act, the 14 terms of the first members of the Alaska Naturopathic Medical Board appointed by the 15 governor are as follows: (1) one licensed naturopath member, the licensed pharmacist 16 member, and the physician member shall be appointed for three-year terms; (2) one licensed 17 naturopath member and the public member shall be appointed for two-year terms; and (3) one 18 licensed naturopath member and the hospital administrator member shall be appointed for a 19 one-year term. The governor shall specify the term of office of each licensed naturopath 20 member appointed subject to this section. 21 * Sec. 19. The uncodified law of the State of Alaska is amended by adding a new section to 22 read: 23 TRANSITIONAL PROVISIONS AFFECTING EXISTING LICENSEES. 24 Notwithstanding AS 08.45.030, as amended by sec. 5 of this Act, and AS 08.45.035(a), as 25 amended by sec. 6 of this Act, 26 (1) a license issued under those provisions by the Department of Commerce, 27 Community, and Economic Development before the effective date of this section is valid for 28 the period issued until renewal under the provisions of this Act; and 29 (2) the Department of Commerce, Community, and Economic Development, 30 without prior approval of the Alaska Naturopathic Medical Board, may issue a license or 31 renew a license to practice naturopathy on or after the effective date of this section and until

01 the day before the effective date of the regulations initially adopted by the board setting out 02 procedures under which license applications and renewals are submitted for board review and 03 approval. 04 * Sec. 20. Section 17 of this Act takes effect immediately under AS 01.10.070(c). 05 * Sec. 21. Except as provided in sec. 20 of this Act, this Act takes effect July 1, 2010.