Legislature(2019 - 2020)BARNES 124
02/12/2020 03:15 PM House LABOR & COMMERCE
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| Audio | Topic |
|---|---|
| Start | |
| HB91 | |
| SB106 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 91 | TELECONFERENCED | |
| + | SB 106 | TELECONFERENCED | |
| + | TELECONFERENCED |
HB 91-NATUROPATHS: LICENSING; PRACTICE
3:18:32 PM
CHAIR SPOHNHOLZ announced that the first 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."
3:19:05 PM
ERIN SHINE, Staff, Representative Jennifer Johnston, Alaska
State Legislature, presented HB 91 on behalf of Representative
Johnston, prime sponsor and provided a presentation entitled,
"House Bill 91 Naturopathic Medicine Reform." She directed
attention to slide 2 to highlight the definition of a
naturopathic doctor. Naturopathic medicine, she said, is a
distinct medical practice that emphasizes prevention and self-
healing processes to treat each person holistically and improve
outcomes while lowering costs. Naturopathic doctors are
educated and trained at accredited naturopathic medical
colleges. They diagnose, prevent, and treat acute and chronic
illness, as well as restore and establish optimal health by
supporting the person's inherent self-healing process. Rather
than just suppressing symptoms, naturopathic doctors work to
identify underlying causes of illness and develop personal
treatment plans to address them. Ms. Shine went on to
paraphrase slide 3 entitled, "What Education do Naturopathic
Doctors Receive," which read in its entirety as follows
[original punctuation provided]:
Education
4-Year Medical School Program accredited by the
Council of Naturopathic Medical Education; including:
• 2 years of medical sciences (anatomy, physiology,
microbiology, immunology, etc.)
• 2 years of clinical sciences and treatment
methods
Prerequisites
• 4 year undergraduate degree and additional pre-
medical coursework
Residencies
• 1-3 year residency options throughout the
country; however, there are not enough residency
opportunities for every graduate
Licensing
• Naturopaths must pass the two-part Naturopathic
Physicians Licensing Examination (NPLEX) before
being licensed to practice
MS. SHINE continued with slide 4 entitled, "Who is not a
Naturopathic Doctor?" She said, unfortunately, "naturopath" has
become a catch-all term for many non-naturopathic doctors that
get lumped together with the practicing physicians who are
licensed in this state. In other states, naturopaths have title
protections so that people can't use their name without being
licensed and going through the same educational process. She
turned attention to slide 5 entitled, "Legislative History of
Naturopath Statutes in Alaska," and paraphrased the following
[original punctuation provided]:
ESTABLISHING STATUTES
1986: AS 08.45 (Naturopaths) established
LEGISLATION PASSED
2004: SB 306 - Established a Naturopathic Medicine
Task Force
2005: SB 42 - Extended Task Force one year and updated
membership
2005: SB 52 - Updated statutes to correct "division"
to "department"
LEGISLATION ATTEMPTS
2007: SB 107
2008: HB 363
2010: HB 282 & SB 70
2011: HB 122
2012: HB 266 & SB 175
2013: HB 7
2017: HB 326 & SB 120
2019: HB 91
MS. SHINE directed attention to two maps on slides 6-7 to
discuss licensing and prescriptive authority for naturopaths in
America. Prescriptive authority is one of the contentious
issues in HB 91. She explained that there are varying degrees
of prescriptive authority, as the map on slide 7 illustrates.
She pointed out that Vermont is the only state with full
prescriptive authority. Alaska, in contrast, is one of 10
states where naturopaths are regulated and have no prescriptive
authority. She noted that naturopathic doctors complete a
rigorous education in pharmacology during their 4-year science-
based medical education. Naturopathic doctors believe that
natural medicine and conventional medicine are not mutually
exclusive and recognize that there are times when both
approaches can be utilized together for patients' benefits. She
addressed slide 8 entitled, "House Bill 91," and read the
following [original punctuation provided]:
Modernizes statutes for Naturopaths by cleaning up
outdated language, requiring continuing education
every 2 years, and imposing the same public health
duties on Naturopaths as other medical providers
Updates scope of practice for Naturopaths to include
limited prescriptive authority and allowing minor
office procedures
Removes the need for duplicative office visits and
improves access to care for patients in Alaska
MS. SHINE concluded by preemptively addressing forthcoming
testimony that will "undoubtedly" be given on HB 91. She said
the testimony will come from several providers who share
personal anecdotes about frightening stories and substandard
medical care provided by naturopaths; however, the stories have
never been substantiated or linked to any licensed naturopath in
Alaska. More importantly, she said, the Division of
Corporations, Business and Professional Licensing has received
no reports alleging the kinds of ethical and medical breaches
purported in these accounts. She added that in the 20 years
that naturopaths have been licensed there have been a total of
33 complaints that have been investigated, albeit not
necessarily sanctioned.
3:29:01 PM
REPRESENTATIVE STORY sought clarification on limited
prescriptive authority.
MS. SHINE explained that each state allows different approaches
to prescriptive authority for naturopathic doctors. HB 91, for
example, would be exclusionary [prescriptive authority] because
it excludes controlled substance and chemotherapeutic agents.
3:29:57 PM
MS. SHINE provided a sectional analysis of HB 91 [included in
the committee packet], which she read in its entirety as follows
[original punctuation provided]:
Section 1 AS 08.02.010(a) Professional designation
requirements. (Amended)
Requires naturopathic practitioners to use appropriate
letters, title and specialist designations
Section 2 AS 08.45.030 Issuance of license.
(Amended)
• Establishes that, to be issued a license, an
applicant must be of good moral character, have
graduated from an accredited naturopathic college
and have passed a licensing examination.
• Removes outdated language requiring that to be
issued a license to practice naturopathy in
Alaska, if an individual graduated before 1988,
they must also have been issued a license to
practice in another state previously.
Section 3 AS 08.45.035(a) Temporary licenses.
(Amended)
Allows the department to issue a temporary license to
a naturopath if they are signed up to
take licensing exams at the next available date after
the date of the application and have not
previously failed the licensing exam.
Section 4 AS 08.45.045 Practice of naturopathy. (New
section)
• Allows naturopaths to practice within the scope
of their education and training
• Allows naturopaths to prescribe natural and
therapeutic substances, natural therapies, drugs
and contraceptive devices
• Allows naturopaths to perform minor surgeries and
perform or order diagnostic procedures
• Defines "naturopathic physical application"
Section 5 AS 08.45.050 Restrictions on practice of
naturopathy. (Amended)
• Removes prohibition for prescribing drugs,
performing minor surgeries, and using the word
"physician" in titles
• Prohibits naturopaths from giving, recommending
or prescribing cancer drugs and controlled
substances
Section 6 AS 08.45.053 & 08.45.057 Public health
duties and renewal of license. (New sections)
• Imposes same public health duties on naturopaths
as other physicians
• Requires naturopaths to complete 24 hours of
continuing education every two years for license
to be renewed
Section 7 AS 08.45.200(3) Definitions. (Repealed and
reenacted)
Repeals and replaces definition for "naturopathy"
Section 8 AS 08.45.200(4) & (5) Definitions. (New
paragraphs)
Defines "approved naturopathic medical school" and
"naturopath"
Section 9 Transitional Language (Uncodified law)
Transitional language allowing currently licensed
naturopaths to practice under the new law
Section 10 Transitional Regulations (Uncodified law)
Allows the Department to adopt transitional
regulations immediately following passage and prior to
the bill's effective date.
Section 11 Effective date. (Uncodified law)
Establishes immediate effective date for section 10
Section 12 Effective date. (Uncodified law)
Establishes effective date for sections 1 - 9 as
January 1, 2020
3:32:44 PM
REPRESENTATIVE STUTES, referencing Section 5, asked if "minor
surgeries" is defined in the bill.
MS. SHINE explained that sutures, punch biopsies, and the
removal or insertion of an IUD [intrauterine device] are all
examples of what would constitute a minor surgery.
REPRESENTATIVE STUTES asked if the word "minor" is defined in HB
91.
3:35:48 PM
MS. SHINE directed attention to page 4, lines 1-7, which read as
follows:
perform procedures in the office using operative,
electrical, or other methods, including the use of
antiseptics and local anesthetics, for the surgical
repair and care of superficial lacerations and
abrasions, superficial lesions, and the removal of
foreign bodies located in the superficial tissues of
the human body; the procedures may not include general
or spinal anesthetics, major surgery, surgery of the
body cavities, plastic surgery, surgery involving the
eyes, or surgery involving tendons, ligaments, nerves,
or blood vessels; and
REPRESENTATIVE RASMUSSEN questioned whether the pharmacology
classes that naturopathic doctors take during their 4-year
college education align with the material that a physician
learns in school.
MS. SHINE offered her understanding that over the first two
years, [naturopaths] follow the same track as a medical doctor
with pharmacology learned throughout most of their courses. She
offered to follow up with a cross-comparison.
CHAIR SPOHNHOLZ, in response to Representative Rasmussen, added
that naturopaths are "naturopathic doctors (NDs"), just like
medical doctors. She explained that the term "doctor" is
generally used in short for medical doctor (MD), but also
applies to anyone that has received a doctorate degree.
3:36:30 PM
CHAIR SPOHNHOLZ announced that HB 91 was held over.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 91 Fiscal Note DCCED-CBPL 1.16.2020.pdf |
HL&C 2/12/2020 3:15:00 PM |
HB 91 |
| HB 91 Supporting Document - Naturopathic Concerns and Answers 4.2.19.pdf |
HL&C 2/12/2020 3:15:00 PM |
HB 91 |
| HB 91 Supporting Document - Naturopathic One-Pager 3.26.19.pdf |
HL&C 2/12/2020 3:15:00 PM |
HB 91 |
| HB 91 Presentation 2.12.2020.pdf |
HL&C 2/12/2020 3:15:00 PM |
HB 91 |
| HB 91 Sectional Analysis v. M 3.26.19.pdf |
HL&C 2/12/2020 3:15:00 PM |
HB 91 |
| HB 91 Sponsor Statement 3.26.19.pdf |
HL&C 2/12/2020 3:15:00 PM |
HB 91 |
| HB 91 Supporting Document - Educational & Scope Comparison 3.26.19.pdf |
HL&C 2/12/2020 3:15:00 PM |
HB 91 |
| SB 106 Sectional Analysis 1.29.2020.pdf |
HL&C 2/12/2020 3:15:00 PM |
SB 106 |
| SB 106 Fiscal Note DCCED-IO 1.17.2020.pdf |
HL&C 2/12/2020 3:15:00 PM |
SB 106 |
| SB 106 Support Testimony Packet 1.29.2020.pdf |
HL&C 2/12/2020 3:15:00 PM |
SB 106 |
| SB 106 Sponsor Statement 1.29.2020.pdf |
HL&C 2/12/2020 3:15:00 PM |
SB 106 |