Legislature(2025 - 2026)DAVIS 106
04/22/2025 03:15 PM House HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| HB147 | |
| HB52 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | HB 147 | TELECONFERENCED | |
| *+ | HB 141 | TELECONFERENCED | |
| += | HB 52 | TELECONFERENCED | |
| + | TELECONFERENCED |
HB 147-PRACTICE OF NATUROPATHY
3:50:05 PM
CHAIR MINA announced that the first order of business would be
HOUSE BILL NO. 147, "An Act relating to the practice of
naturopathy."
3:50:28 PM
REPRESENTATIVE MIKE PRAX, Alaska State Legislature, as prime
sponsor, read the sponsor statement [hard copy included in the
committee file] for HB 147, which read as follows [original
punctuation provided]:
House Bill 147 allows licensed Alaska naturopathic
doctors to apply for a temporary endorsement to
practice closer to their level of education and
training. This will enable Alaskans to choose their
preferred healthcare style and help alleviate the
shortage of primary care providers in the state.
Approximately 50 licensed naturopaths provide
effective care for thousands of Alaskans with chronic
diseases like obesity, diabetes, and hypertension in
an overburdened healthcare system. However, current
limitations on naturopathic care require patients to
schedule duplicate appointments for prescriptions
increasing healthcare congestion and costs.
HB 147 allows licensed naturopaths to obtain a
temporary license endorsement through a written
agreement with a supervising physician. This
endorsement prohibits the prescription of controlled
substances, chemotherapy drugs, antipsychotic drugs,
radioactive substances, and performing invasive
surgeries. After one year under this agreement,
licensed Alaska naturopaths may get an ongoing
endorsement linked to the regular licensing renewal
process.
The legislation requires all licensed Alaska
naturopaths to complete sixty hours of continuing
education every two years, including twenty hours in
pharmacotherapy.
HB 147 authorizes state licensing personnel to suspend
or revoke an endorsement after investigating a
complaint against a licensed naturopath. The
legislation also makes prescribing medicine without an
endorsement illegal and addresses fraudulent actions
to obtain an endorsement.
Naturopathic education emphasizes holistic disease
prevention rather than simply treating symptoms. In
the long term, naturopathic care offers affordable and
enhanced health outcomes for patients, insurers, and
the state, while providing Alaskans the opportunity to
select the type of healthcare that best suits their
needs.
Please join me in supporting House Bill 147.
3:55:23 PM
RILEY NYE, Staff, Representative Mike Prax, on behalf of
Representative Prax, prime sponsor, gave the sectional analysis
[included in the committee file] for HB 147, which read as
follows [original punctuation provided]:
Section 1 adds new sections AS 08.45.033(Issuance of
Temporary Endorsement) and AS 08.45.034 (Issuance of
Endorsement)
Creates a new section of Alaska law to allow
licensed Alaska naturopaths to apply for a temporary
endorsement to prescribe a limited range of
prescription medications upon showing they have:
• passed the pharmacology portion of the
Naturopathic Physicians Licensing Exam or equivalent
test, and
• meet other applicable requirements established
by the Division of Corporations, Business and
Professional Licensing (DCBPL or Division).
Naturopaths holding a valid temporary endorsement may
prescribe a limited range of prescription medications
under a written collaborative agreement with a
licensed Alaska physician who has been prescribing and
administering prescription drugs for at least five
years. The collaborative physician will evaluate the
naturopath's prescriptive practice and provide
feedback. The temporary endorsement must be in place
for a minimum of twelve months and the collaborative
oversight must be reported on a form approved by
DCBPL. At the conclusion of the twelve-month period,
the collaborative physician is required to recommend
to DCBPL whether the naturopath should receive further
supervision, be issued an endorsement, or be denied an
endorsement. The temporary endorsement terminates on
the date a naturopath is issued, or denied, an
endorsement to prescribe. After considering the
recommendation of a collaborative physician, DCBPL
will determine whether to issue, or deny, an
endorsement to a naturopath or require further
prescriptive supervision. A naturopath who receives an
endorsement to prescribe and administer may do so
under the limitation of AS 08.45.050.
Section 2 adds new sections AS 08.45.037 (Continuing
Education Requirements) and AS 08.45.038 (Standards
for License Renewal) Creates a new requirement for all
licensed naturopaths in Alaska to provide proof of
completing sixty hours of division-approved continuing
education as part of their biannual license renewal
process. The required sixty hours must include a
minimum of twenty hours of continuing education
focused on pharmacotherapy. DCBPL may exempt a
naturopath from a portion of this ongoing training for
extenuating circumstances. However, DCBPL may not
grant an exemption for more than fifteen hours total
in a fouryear period. This partial waiver provision is
similar to statutory provisions for other medical
professionals in Alaska that acknowledge the potential
for serious illness, military service, family
emergencies or natural disasters to limit an ability
to complete some continuing medical education. This
section also establishes standards for license renewal
that require naturopaths to pay an appropriate fee,
show they meet the continuing education requirements,
disclose whether they have been found to have
perpetrated a crime that adversely reflects on their
ability to practice safely and have a current
cardiopulmonary resuscitation certificate.
Section 3 amends AS 08.45.050 (Restrictions on
Practice of Naturopathy) Amends existing law to
clarify that naturopaths prescribing and administering
medications under a temporary, or ongoing,
prescription endorsement may NOT prescribe:
1. a prescription drug except as allowed under their
temporary or ongoing prescriptive endorsement,
2. a poison,
3. a chemotherapy drug
4. an antipsychotic drug, or
5. administer a therapeutic ionizing radiation or
radioactive substance. In addition, existing statutory
prohibitions against a naturopath engaging in surgery
or using the word "physician" in the person's title
are preserved in law.
Section 4 amends AS 08.45.060 (Grounds for Suspension,
Revocation, or Refusal to Issue a License) Expands
existing Alaska law to clarify that DCBPL has full
authority to take disciplinary action against a
temporary, or ongoing, prescriptive endorsement held
by a licensed Alaskan naturopath if the division
determines the endorsement was secured through deceit,
fraud, or intentional misrepresentation.
Section 5 amends AS 08.45.070(a) (Disciplinary
Sanctions) Expands existing Alaska law to clarify that
DCBPL can exercise the same disciplinary authority
over a naturopath's temporary, or ongoing,
prescriptive endorsement as it does over a
naturopath's license to practice. This authority
allows the division to revoke, suspend, censure or
reprimand the licensee as well as place them on
probation that limits their practice or requires
additional professional training and reporting.
Section 6 amends AS 08.45.070(c) (Disciplinary
Sanctions) Expands existing Alaska law to clarify that
DCBPL can summarily suspend a temporary, or ongoing,
prescriptive endorsement during a final hearing or
appeals process if the division determines doing
otherwise would endanger the public health.
Section 7 amends AS 08.45.080 (Unlicensed Practice a
Misdemeanor) Expands existing Alaska law to clarify
that a licensed Alaska naturopath is guilty of a class
A misdemeanor if they are found to have prescribed a
prescription medication without having a valid
temporary, or ongoing, endorsement to do so.
Section 8 amends AS 08.45.090 (Fraudulent License)
Expands existing Alaska law to clarify that a
naturopath who obtains, or attempts to obtain, a
temporary endorsement to prescribe prescription
medications fraudulently is punishable by a fine of
not more than five hundred dollars or by imprisonment
for not more than six months, or both.
4:02:06 PM
REPRESENTATIVE GRAY raised concern about excluding chemotherapy
and antipsychotic drugs from the scope of naturopaths. He said
that it would be beneficial for these physicians to be allowed
to prescribe these drugs as they serve purposes outside of their
original intended use.
4:03:28 PM
REPRESENTATIVE PRAX deferred to an expert on pharmacy to answer
that question.
4:04:13 PM
CHAIR MINA announced invited testimony.
4:04:55 PM
LAURA CULBERSON FARR, Executive Director, American Association
of Naturopathic Physicians, testified in support of HB 147. She
explained that naturopathic doctors (NDs) have prescribing
authority in 15 jurisdictions and in some states NDs have nearly
if not equal prescribing authority as medical doctors (MDs).
She emphasized that HB 147 would not be an "experiment" for NDs
in the country. She said that many NDs have more pharmacology
course hours than others with prescribing authority, stating
that that hour comparison is not enough to determine
prescription authority. She said that while NDs do not have a
residency requirement, residencies do not equate to prescribing
authority, as other states allow certain occupations to
prescribe drugs without residencies, such as physician
assistants. She emphasized the history of safe prescriptions by
NDs in other states.
4:10:19 PM
REPRESENTATIVE SCHWANKE asked about the history of ND's full
prescriptive authority in Vermont.
MS. FARR responded that Vermont passed their prescribing
authority legislation in 2012, a bill which HB 147 is modeled
after. She said that since 2012, ND prescription has gone
smoothly with no restrictions.
4:12:26 PM
REPRESENTATIVE GRAY described his prescribing authority as a
physician's assistant (PA) and said HB 147 does not ask for that
much; it is "a modest bill."
REPRESENTATIVE SCHWANKE asked what would happen if a supervising
MD requested that the ND under their supervision does not
utilize their prescribing authority.
4:14:05 PM
GLENN SAVIERS, Deputy Director, Division of Corporations,
Business, and Professional Licensing, Department of Commerce,
Community & Economic Development, responded that the particular
circumstances would need to be considered. She explained that
there would be an investigation, and each case would be treated
individually.
4:15:11 PM
CLYDE JENSEN, PhD, Professor, National University of Natural
Medicine, testified in support of HB 147. He spoke from his own
experience to compare the pharmacology education NDs and MDs
receive, explaining they are held to the same standards of care
and require the same number of classroom hours. He stated that
NDs are supervised by other NDs, who have experience also
prescribing treatments other than drugs, while MDs are often
expected to prescribe drugs as treatments. He stated that
ongoing education is expected of all physicians across the
country and emphasized that NDs are equally educated and
qualified to prescribe drugs.
4:20:27 PM
MR. JENSEN spoke to Representative Gray's previous question
regarding drugs that could be useful for NDs to be allowed to
prescribe but would be excluded from their prescriptive
authority under HB 147. He said that NDs have always faced
opposition from "conventional medical professions" when seeking
prescriptive authority and he believes the intent of HB 147
would be to reduce the opportunity for opposition or debate.
4:21:20 PM
SHANNON BRADEN, ND, Board Member, Federation of Naturopathic
Medicine Regulatory Authorities (FNMRA), provided an overview of
the federation and its disciplinary authorities regarding NDs.
She stated that the FNMRA supports HB 147. She said that in
Oregon over the past 7 years, NDs received far fewer
disciplinary actions compared to MDs and other physicians. She
said that between 2010-2024, in states where NDS have broad
prescriptive rights, there were zero disciplinary actions taken
against NDs for inappropriate prescribing. She emphasized that
similar results would be expected in Alaska under HB 147.
4:26:54 PM
NATALIE WIGGINS, ND, Board Member, Alaska Association of
Naturopathic Doctors, testified in support of HB 147.. She began
by describing the healthcare crisis in Alaska, attributing such
high costs to the limited access to care in the state. She
stated that NDs are ready and able to fill that gap but are
prohibited by their limited scope of practice. She described
the rigorous education and training required by NDs, including
their education in pharmacology and medication management.
While some argue that this training does not equate to residency
experience, she argued that residency experience does not equate
to safe prescriptions. Dr. Wiggins stated that HB 147 would be
a cautious and reasonable step forward for NDs. She explained
that limiting the prescriptive authority of NDs places a burden
on patients, often requiring additional appointments to receive
necessary prescriptions from other physicians.
4:33:41 PM
REPRESENTATIVE GRAY offered his experience in emergency care and
the demand he faced from patients to prescribe medications. He
stated that he believes people who visit a naturopath are less
likely to ask for prescription medications. He asked if any
testifiers could speak to that point.
4:35:38 PM
DR. WIGGINS responded that there is a very thoughtful process
NDs take when making prescriptions, which includes taking the
time to consider non-medication treatment options.
4:36:41 PM
REPRESENTATIVE SCHWANKE spoke about people self-diagnosing and
getting medication online and asked whether HB 147 would
encourage those people to seek care from NDs instead.
DR. WIGGINS answered that that is absolutely true.
4:38:50 PM
CHAIR MINA announced that HB 147 was held over.