Legislature(2021 - 2022)BUTROVICH 205
04/15/2021 01:30 PM Senate HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| SB38 | |
| SB67 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 38 | TELECONFERENCED | |
| += | SB 67 | TELECONFERENCED | |
| += | SB 78 | TELECONFERENCED | |
| += | SB 80 | TELECONFERENCED | |
| + | TELECONFERENCED |
SB 38-NATUROPATHS: LICENSING; PRACTICE
1:36:07 PM
CHAIR WILSON announced the consideration of SENATE BILL NO. 38
"An Act relating to the practice of naturopathy; establishing
the Naturopathy Advisory Board; relating to the licensure of
naturopaths; relating to disciplinary sanctions for naturopaths;
relating to the Department of Commerce, Community, and Economic
Development; and providing for an effective date."
1:36:46 PM
JOE HAYES, Staff, Senator Scott Kawasaki, Juneau, Alaska, stated
he had no additional comments.
1:37:01 PM
SENATOR HUGHES moved Amendment 1.
AMENDMENT 1
32-LS0318\A.2
Fisher
4/12/21
OFFERED IN THE SENATE BY SENATOR HUGHES
TO: SB 38
Page 4, following line 3:
Insert
"(2) has completed a three-year naturopathic
residency program;"
Renumber the following paragraphs accordingly.
Page 4, line 21:
Delete "AS 08.45.030(1)(A) and (2) - (4)"
Insert "AS 08.45.030(1)(A) and (2) - (5)"
CHAIR WILSON objected for purposes of discussion and restated
the Amendment being offered is Amendment 1 [A.2].
1:37:39 PM
SENATOR HUGHES stated naturopaths are a great asset to the field
of healthcare. The scope of a naturopath practice is expanded
by SB 38. The bill includes prescriptive rights. Amendment 1
adds a three-year residency licensing prerequisite. This
prerequisite mirrors the clinical hours and oversight that
physicians experience and that is embedded in the training of
physician assistants and nurse practitioners. She stated she is
in favor of naturopathic doctors having prescriptive authority
if they have extra supervision.
SENATOR REINBOLD stated that committee members were informed
that naturopaths would not be available to testify. This
amendment undermines the naturopaths' prior testimony. Physician
assistants, nurse practitioners, physical therapists, and
chiropractors do not complete residencies. She suggested
naturopaths could work three years in an externship. A three-
year residency is unconscionable, as naturopaths have thirty-
five years of established safe practice.
1:40:13 PM
SENATOR BEGICH asked why there are not enough residencies
available.
MR. HAYES replied that there are more students than naturopaths
and hospitals pay for the residency of medical doctors. They do
not pay for naturopathic doctors.
1:40:41 PM
SENATOR BEGICH asked for the sponsor's view of this amendment.
MR. HAYES replied that Senator Kawasaki has concerns about
fiscal ramifications and who will fund the residencies. There
are fifty-two naturopaths practicing in Alaska. Senator Kawasaki
has concerns about how the amendment will affect them. Alaska
would be the first state to require residency.
1:41:49 PM
SENATOR HUGHES explained that Amendment 1 does not prescribe how
residency would be crafted. She is open to the idea of
grandfathering. There are a variety of ways to accomplish
supervision. Students coming out of school could be paired with
existing naturopaths or primary care providers. MDs and DOs
sometimes have residencies lasting eight to ten years. A three-
year residency is a minimum requirement. Chiropractors and
physical therapists do not prescribe medications. Physician
assistants have clinical hour requirements and after being
licensed are supervised by a physician. She concluded that a
wider scope of practice should require an equivalent amount of
training.
SENATOR REINBOLD offered Conceptual Amendment 1 to Amendment 1.
On page 1 line 3 of the amendment, replace the language in
paragraph (2) and insert "has completed two-years of
naturopathic externship program At the Chair's request she
restated the conceptual amendment.
SENATOR HUGHES asked the difference between an internship and
externship.
1:44:49 PM
SENATOR REINBOLD replied an externship is working in a clinical
setting under supervision and earning money.
SENATOR HUGHES stated residents are interns that earn money. She
is open to the two-year adjustment but has reservations about
the appropriate terminology to use regarding residency.
SENATOR REINBOLD answered that an externship offers supervised
hands-on clinical training in doctor's offices versus hospitals.
SENATOR HUGHES stated she is agreeable to the conceptual
amendment.
SENATOR BEGICH read the definition of externships as,
Experiential learning opportunities, similar to internships,
provided by partnerships between educational institutions and
employers to give students practical experiences in the field of
study."
1:46:25 PM
CHAIR WILSON asked if there was objection to Conceptual
Amendment 1 to Amendment 1.
SENATOR COSTELLO asked if Amendment 1 is intended to make SB 38
more stringent because it offers prescriptive authority to
naturopaths. She noted that in SB 38 the pharmacological portion
of the exam is elective. This amendment would include those who
are not interested in having prescriptive authority. She asked
if the residency requirement is intended for them.
SENATOR HUGHES replied that the residency requirement pertains
to the prescriptive authority and outpatient procedures that
naturopaths will be allowed to perform. She suggested that the
amendment could be changed to exclude office procedures
depending on how it will be defined.
1:48:20 PM
At ease
1:51:02 PM
CHAIR WILSON reconvened the meeting.
He found no further objection and Conceptual Amendment 1 to
Amendment 1 passed.
1:51:33 PM
CHAIR WILSON withdrew his objection. Finding no further
objection, Amendment 1, as amended, passed.
1:51:57 PM
SENATOR HUGHES moved Amendment 2 [A.5].
AMENDMENT 2
32-LS0318\A.5
Fisher
4/12/21
OFFERED IN THE SENATE BY SENATOR HUGHES
TO: SB 38
Page 4, following line 3:
Insert
"(2) has passed a pharmaceutical
examination approved by the department that is
equivalent to any examination of pharmaceutical
knowledge required under AS 08.64.210 or 08.64.220;"
Renumber the following paragraphs accordingly.
Page 4, line 21:
Delete "AS 08.45.030(1)(A) and (2) - (4)"
Insert "AS 08.45.030(1)(A) and (2) - (5)"
CHAIR WILSON objected for purposes of discussion.
1:52:14 PM
SENATOR HUGHES stated this amendment requires naturopaths to
pass a pharmaceutical exam equivalent to what medical and
osteopathic doctors pass to acquire a license. If naturopaths
are to be called physicians their training, examinations and
continuing education should be on par with other doctors who are
called physicians. The Alaska Association of Naturopathic
Physicians uses the word physicians on their website. It is
important to commensurate the requirements of a naturopath with
the average Alaskan's expectation of a physician.
SENATOR REINBOLD stated there is a need to address naturopaths
using the word physician.
1:54:22 PM
At ease
1:59:15 PM
CHAIR WILSON reconvened the meeting and resumed discussion on
Amendment 2.
1:59:21 PM
SENATOR HUGHES stated that her legislative intern could address
statute references.
RILEY NYE, Intern, Senator Shelley Hughes, Alaska State
Legislature, Juneau, Alaska, explained that Amendment 2 deletes
AS 08.45.030(1) (A) and (2) (4) and inserts the same statute
but with a change that includes (2) (5).
SENATOR COSTELLO stated that the statutes listed in Amendment 2
clarify that "the board" is the medical board.
SENATOR BEGICH asked whether the medical board or the department
would set policy regarding pharmaceutical examinations. He
offered his belief that Senator Hughes intended the department
to set policy and asked for confirmation from Ms. Chambers.
2:01:42 PM
SARA CHAMBERS, Director, Division of Corporations, Business, and
Professional Licensing, Juneau, Alaska, stated that the
department is to review examination requirements under AS 08.64
and then approve an equivalent exam. The medical board would not
be involved unless advice was needed. There are standard
examinations that the medical board approves. The department
would be looking for an equivalent exam that is accessible to
naturopaths.
SENATOR REINBOLD offered a conceptual amendment to Amendment 2.
On page 4, line 3 add, If a naturopath seeks increased
prescriptive authority and.
2:03:26 PM
CHAIR WILSON announced SB 38 will be held for further
consideration.
SENATOR COSTELLO stated that the next committee of referral for
SB 38 is Senate Labor and Commerce. She was committed to working
with Senator Kawasaki's office on a committee substitute. If it
is held in the Health and Social Services committee, parties
should work together to rectify issues that the amendments
address. There is a lot of interest in crafting a successful
bill.
SENATOR HUGHES stated this bill has been fourteen years in the
making. She offered her belief that it is important to get the
bill right. She supports Chair Wilson holding it so parties can
work together.
2:05:10 PM
CHAIR WILSON clarified that the bill is being held so the
sponsor and members of the committee can work through language
in the amendments and produce a better bill.
SENATOR REINBOLD stated the remaining amendments would not
consume as much time and the members should keep working to move
the bill out of committee.
CHAIR WILSON stated it would be better to get a CS from the
sponsor than to keep amending amendments.
SENATOR HUGHES stated she is willing to work with the sponsor on
her amendments.
2:06:38 PM
SENATOR REINBOLD expressed her dislike for committee
substitutes. She prefers to work through an open process in
committee rather than two people working behind closed doors.
Working through the amendments in committee is difficult but it
is what the committee is for.
CHAIR WILSON replied he understands.
SENATOR BEGICH commented that amendments are in committee
member's hands. Members should offer suggestions before Tuesday
so the bill can be moved out of committee.
2:07:45 PM
[CHAIR WILSON held SB 27 in committee.]