Legislature(2023 - 2024)ADAMS 519

03/22/2024 01:30 PM House FINANCE



* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+= HB 115 NATUROPATHS: LICENSING; PRACTICE TELECONFERENCED
Heard & Held
-- Public Testimony --
*+ HB 219 REPEAL ASSISTIVE TECHNOLOGY LOAN PROGRAM TELECONFERENCED
Heard & Held
+ Bills Previously Heard/Scheduled TELECONFERENCED
HOUSE BILL NO. 115                                                                                                            
                                                                                                                                
     "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."                                                                          
                                                                                                                                
Co-Chair Foster                                                                                                                 
                                                                                                                                
2:12:32 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  MIKE PRAX,  SPONSOR, reminded  the committee                                                                    
of the details of the bill //                                                                                                   
                                                                                                                                
2:14:38 PM                                                                                                                    
                                                                                                                                
DR.   CARRIE   BALDWIN-SAYRE,  ASSOCIATE   VICE   PRESIDENT,                                                                    
ADVANCEMENT  AND COMMUNITY  ENGAGEMENT, ALASKA  NATUROPATHIC                                                                    
DOCTORS ASSOCIATION, PORTLAND,  OREGON (via teleconference),                                                                    
was supportive of the bill //                                                                                                   
                                                                                                                                
2:18:24 PM                                                                                                                    
                                                                                                                                
Representative  Josephson  asked  // naturopaths  wanted  to                                                                    
practice medicine  beyond // asked if  naturopaths should be                                                                    
held                                                                                                                            
                                                                                                                                
Dr.  Baldwin-Sayre responded  //  based on  the board  which                                                                    
included a variety of physicians and public members //                                                                          
                                                                                                                                
Representative  Josephson  //  it  seemed  like  naturopaths                                                                    
wanted to  // he asked //                                                                                                       
                                                                                                                                
Dr. Baldwin-Sayre responded // there  was only one way to do                                                                    
certain things //                                                                                                               
                                                                                                                                
2:22:05 PM                                                                                                                    
                                                                                                                                
DR.  SEAN HIGGINS,  EMERGENCY  ROOM  DOCTOR, ANCHORAGE  (via                                                                    
teleconference), allowing doctors to  practice to the extent                                                                    
of their training would increase  // comparable to all other                                                                    
education //                                                                                                                    
                                                                                                                                
Co-Chair Foster  noted that Representative  Justin Ruffridge                                                                    
was in the audience                                                                                                             
                                                                                                                                
Representative Josephson //                                                                                                     
                                                                                                                                
Dr. Sean Higgins responded curcumin//                                                                                           
                                                                                                                                
Representative Josephson //                                                                                                     
                                                                                                                                
Dr. Sean Higgins responded                                                                                                      
                                                                                                                                
Representative Josephson //                                                                                                     
                                                                                                                                
Dr. Sean Higgins responded he was aware of                                                                                      
                                                                                                                                
2:26:55 PM                                                                                                                    
                                                                                                                                
Representative  Galvin paramedic  and now  a physicain  with                                                                    
direct  clinical care  because  his knowledge  base was  not                                                                    
suffienciet // she  asked if there needed to be  a change //                                                                    
the ability to prescribe medications sooner                                                                                     
                                                                                                                                
Dr.  Sean  Higgins responded  that  once  a person  finished                                                                    
frour years  of medical school  // he understood that  // he                                                                    
would challenge the question // he thought                                                                                      
                                                                                                                                
Representative Galvin  understood that  the bill  would give                                                                    
doctors the authority to //                                                                                                     
                                                                                                                                
Dr. Sean Higgins responded//                                                                                                    
                                                                                                                                
Representative Galvin //                                                                                                        
                                                                                                                                
Dr. Sean Higgins responded                                                                                                      
                                                                                                                                
Representative Galvin // if there was enough background //                                                                      
                                                                                                                                
Dr. Sean  Higgins responded it  was part of the  training to                                                                    
// people were typically referred to specialists //                                                                             
                                                                                                                                
2:33:23 PM                                                                                                                    
                                                                                                                                
DR.  CLYDE JENSEN,  PROFESSOR OF  PHARMACOLOGY, NATUROPATHIC                                                                    
ASSOCIATION,  ST.  GEORGE,  UTAH (via  teleconference),  the                                                                    
training was  identical to that  given to doctors  // needed                                                                    
to  understand  the relationship  between  drugs  and //  he                                                                    
opined   that   naturopathic   doctors   were   capable   of                                                                    
confidently   and  conservatively   prescribing  medications                                                                    
commonly used in care practices //                                                                                              
                                                                                                                                
Representative Josephson asked why the bill would //                                                                            
                                                                                                                                
Dr. Jensen responded //                                                                                                         
                                                                                                                                
Representative Josephson  commented that he had  not felt //                                                                    
should be  able to // asked  why it was ok  that naturopathy                                                                    
// decades after a doctor was accredited,                                                                                       
                                                                                                                                
Dr. Jensen  responded // the reason  was because residencies                                                                    
were  not available  to naturopaths  // privately  funded by                                                                    
hospitals//                                                                                                                     
                                                                                                                                
Representative Josephson                                                                                                        
                                                                                                                                
Dr.  Jensen  responded  that  a  collaborative  relationship                                                                    
between a  new and prescribing  // was  not a bad  idea// he                                                                    
received  a call  earlier in  the  day //  the inclusion  of                                                                    
pharmaceuticals //  if a collaborative relationship  were to                                                                    
be  established, there  should be  a finite  time period  //                                                                    
would /                                                                                                                         
                                                                                                                                
2:43:11 PM                                                                                                                    
                                                                                                                                
Representative Coulombe asked /                                                                                                 
                                                                                                                                
Dr.  Jensen  responded  // many  naturopaths  did  not  have                                                                    
access //                                                                                                                       
                                                                                                                                
Representative  Galvin  asked  //   if  there  was  differce                                                                    
between pharmacology  and // she  understood that it  was an                                                                    
ever  evolving science  and  //  continuing education  given                                                                    
that the options available  for medicines chagned constatnly                                                                    
/                                                                                                                               
                                                                                                                                
Dr. Jensen  responded /  naturopaths had  continuing medical                                                                    
education requirements  that were  similar to  // continuing                                                                    
\\\                                                                                                                             
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2:48:41 PM                                                                                                                    
                                                                                                                                
Representative Hannan asked // the pharmacological exam                                                                         
                                                                                                                                
Dr. Jensen //                                                                                                                   
                                                                                                                                
Representative Hannan //                                                                                                        
                                                                                                                                
Representative Ortiz //                                                                                                         
                                                                                                                                
Dr. Jensen //                                                                                                                   
                                                                                                                                
2:54:42 PM                                                                                                                    
                                                                                                                                
DR.   ROBERT  DOWNEY,   FAMILY  PRACTICE   PHYSICIAN,  SOUTH                                                                    
PENINSULA  HOSPITAL, HOMER  (via teleconference),  /// grant                                                                    
doctors   prescribing   privileges  //   naturopaths   would                                                                    
prescribe  the  same  way  //  important  botanical  without                                                                    
downsides or safety concerns //                                                                                                 
                                                                                                                                
3:00:40 PM                                                                                                                    
                                                                                                                                
Representative  Galvin   //  she   found  //  15   hours  of                                                                    
continuing education over a five year period //                                                                                 
                                                                                                                                
Dr. Downey  responded // details  beyond familiarity  // any                                                                    
perso who valued  the power had a respect for  what could go                                                                    
awry  //  there  were  already   prscriptions//  he  was  //                                                                    
separate issues around the pharmacutical industry //                                                                            
                                                                                                                                
3:05:17 PM                                                                                                                    
                                                                                                                                
Co-Chair Foster //                                                                                                              
3:06:26 PM                                                                                                                    
                                                                                                                                
DR.  ROXANNE JONES,  ALASKA  ACADEMY  OF FAMILY  PHYSICIANS,                                                                    
ANCHORAGE (via  teleconference), testified in  opposition to                                                                    
the  bill //  she  pracitced medicine  in  the Norton  sound                                                                    
region //  she had  since transitioned  to anchorage  // she                                                                    
worked  in  a  primary   care  clinic  where  they  accepted                                                                    
Medicare and medicaid// she did  not have intimate knowledge                                                                    
of  the training  / she  did not  support full  prescriptive                                                                    
authority  //  formalize  pathway   to  licensure  //  other                                                                    
qualified individuals  // accreditation was a  good tool for                                                                    
//  not   similar  to  the   standards  for   physicians  //                                                                    
specifically noted that  the goal was to  train primary care                                                                    
or   general  practice   //  same   accrediting  agency   as                                                                    
neurosurgery //  pharmacology was  included //  thousands of                                                                    
hours // the basement was  // medical students had completed                                                                    
300 horus //                                                                                                                    
                                                                                                                                
3:14:08 PM                                                                                                                    
                                                                                                                                
DR.   HILLARY   JOHNSON-JAHNGIR,    AMERICAN   SOCIETY   FOR                                                                    
DERMATOLOGIC SURGERY,  IOWA (via  teleconference), certified                                                                    
in //  worked with  medical professional  organizatrions and                                                                    
weighed in  on policy that  impacted dermatology //  was the                                                                    
lesion benign  or would it lead  to // her parents  moved to                                                                    
iowa // her pre-diabetes went  unnoticed // she reviewed the                                                                    
patient's entire medical history //                                                                                             
                                                                                                                                
Co-Chair Foster //                                                                                                              
                                                                                                                                
3:18:10 PM                                                                                                                    
                                                                                                                                
DR. KRISTIN MITCHELL, PRESIDENT  ELECT, ALASKA STATE MEDICAL                                                                    
ASSOCIATION,  SOLDOTNA  (via teleconference),  certified  by                                                                    
the  board of  internal medicine  // her  concern was  about                                                                    
patience safety  // malpractice implication  and //  keep in                                                                    
mind that any action was reviewed  by the board // she would                                                                    
expect  that naturopaths  be held  to the  same standard  as                                                                    
medical physicians  // she was  concerned that it  was not//                                                                    
circuim was  a supplement //  the bill would not  change the                                                                    
current ability of naturopaths to  infuse circuim //it would                                                                    
be difficutl  for // it was  unlawful for 3 states  // there                                                                    
should not be an equivilance //                                                                                                 
                                                                                                                                
3:26:21 PM                                                                                                                    
                                                                                                                                
DR.  SCOTT FERGUSON,  BOARD  OF  TRUSTEES, AMERICAN  MEDICAL                                                                    
ASSOCIATION,  WEST MEMPHIS,  ARKANSAS (via  teleconference),                                                                    
noted  that he  was  a previous  legislator //  naturopathic                                                                    
education was  different from a  medical education  // there                                                                    
were  crucial gaps  in education  // must  complete clinical                                                                    
training //  credication expenditure // patients  in any age                                                                    
or  condition //  there  was  no //  open  up  the door  for                                                                    
naturopaths to  prescribe any medications //  principals and                                                                    
theraputics that lacked a foundation  in medical evidence //                                                                    
he  urged  that  legislators  take   the  risk  of  patients                                                                    
seriously //  there were fewer than  50 naturopathic doctors                                                                    
in Alaska//                                                                                                                     
                                                                                                                                
3:32:14 PM                                                                                                                    
                                                                                                                                
Co-Chair Foster OPENED public testimony.                                                                                        
                                                                                                                                
3:33:05 PM                                                                                                                    
                                                                                                                                
DR.  NATALIE  WIGGINS,  ALASKA ASSOCIATION  OF  NATUROPATHIC                                                                    
DOCTORS, JUNEAU,  was a naturopathic doctor  in Anchorage //                                                                    
had  a  scope  of  practice  that  reflected  her  level  of                                                                    
traingin //  scheduled and non controlled  medication // she                                                                    
had heard  comments in areas  of concerns // annual  req was                                                                    
30 hours of  cmes (?) which was the standard  of practice //                                                                    
broad  prescriptive  authority  was  not  requested  //  the                                                                    
request  was for  things like  antibiotics  // medicine  was                                                                    
constantly changing // could direct  some of the concerns //                                                                    
there  are many  possible situations  // there  was some  //                                                                    
safety was well illustrated //                                                                                                  
                                                                                                                                
Co-Chair Foster //                                                                                                              
                                                                                                                                
Dr. Wiggins //                                                                                                                  
                                                                                                                                
3:37:28 PM                                                                                                                    
                                                                                                                                
Representative Galvin  thanked Dr.  Wiggins for her  time //                                                                    
referred to a chart amendment a                                                                                                 
                                                                                                                                
Dr. Wiggins //                                                                                                                  
                                                                                                                                
3:40:23 PM                                                                                                                    
                                                                                                                                
Representative Ortiz had heard  arguments that it would help                                                                    
alleviate   the  shortage   of   access   to  primary   care                                                                    
physicians, however  Medicaid and  Medicare would  not cover                                                                    
naturopaths                                                                                                                     
                                                                                                                                
Dr. Wiggins replied  the need was extensive //  she had kept                                                                    
track of  how many  // the  12 patients had  to get  12 more                                                                    
medical care visits to have the needs taken care of//                                                                           
                                                                                                                                
Representative Tomaszewski  noted that there had  been prior                                                                    
testimony that stated // the inference was that //                                                                              
                                                                                                                                
Dr. Wiggins responded in the affirmative //                                                                                     
                                                                                                                                
Representative  Tomaszewski //  fill  the prescriptions  for                                                                    
patients // create more need //                                                                                                 
                                                                                                                                
Dr. Wiggins responded //                                                                                                        
                                                                                                                                
3:44:06 PM                                                                                                                    
                                                                                                                                
Representative Galvin  there was  significant correspondence                                                                    
around the amount of continuing education not having parity                                                                     
                                                                                                                                
Dr. Wiggins responded  // 50 hours every two  years // other                                                                    
states were in excess//                                                                                                         
                                                                                                                                
3:45:36 PM                                                                                                                    
                                                                                                                                
BRUCE  CAMPBELL,   SELF,  FAIRBANKS   (via  teleconference),                                                                    
testified in  support of HB  115 and  he believed it  was an                                                                    
update //  he was on  medicare and his provider  worked with                                                                    
// had received  care from nurse practicioners //  he had to                                                                    
go to  another doctor // there  would be a five  week to six                                                                    
week // it  was an added cost and impediment  to care // the                                                                    
bottom line was that he determined /                                                                                            
                                                                                                                                
3:48:28 PM                                                                                                                    
                                                                                                                                
BART GRABMAN, SELF,  ANCHORAGE (via teleconference), opposed                                                                    
HB 115  // he was   a resident physician //  although it did                                                                    
not address  // school included  4000 hours of  training and                                                                    
hands on clinical  education // by the time  // required for                                                                    
all MDs  // still  not allowed  to //  the bill  would allow                                                                    
naturopaths   prescriptive  authority   //  the   focus  and                                                                    
training was different //                                                                                                       
                                                                                                                                
3:51:45 PM                                                                                                                    
                                                                                                                                
KAREN GONNE-HARRELL,  SELF, ANCHORAGE  (via teleconference),                                                                    
his medical  doctor was a  pediatrician // urged  support of                                                                    
the bill in a safe manner                                                                                                       
3:54:39 PM                                                                                                                    
                                                                                                                                
DR.  TIM   BIRDSALL,  ALASKA  ASSOCIATION   OF  NATUROPATHIC                                                                    
DOCTORS,  ANCHORAGE   (via  teleconference),   relayed  that                                                                    
naturopaths were  not asking  to be  considered the  same as                                                                    
MDs//   increased   both   the   scope   of   practice   and                                                                    
responsibility//  proposed language  that  would require  //                                                                    
license would  allow them to  do brain surgery// one  of the                                                                    
leaders  in   the  nation  in  granting   nurse  practioners                                                                    
independent pracitce authority // the disciplinary                                                                              
                                                                                                                                
3:59:51 PM                                                                                                                    
                                                                                                                                
PAM  VENTGEN,  EXECUTIVE   DIRECTOR,  ALASKA  STATE  MEDICAL                                                                    
ASSOCIATION, ANCHORAGE (via  teleconference), noted that the                                                                    
association  supported  many sections  in  HB  115 //  minor                                                                    
surgery and  prescribing authority // there  were fewer than                                                                    
50  practicing naturopaths  //  did  not cover  naturopathic                                                                    
services  //  no  federally endorsed  training  programs  //                                                                    
faulty argument// the other thing  to consider was that most                                                                    
insurance plans  only covered what  was in state  statute //                                                                    
if  the  scope  of  practice  was  expanded  //increase  the                                                                    
overall  cost of  health care//  urged  not to  pass 115  as                                                                    
written //                                                                                                                      
                                                                                                                                
4:04:00 PM                                                                                                                    
                                                                                                                                
Co-Chair Foster CLOSED public testimony.                                                                                        
                                                                                                                                
Representative Ortiz asked whether the bill had two                                                                             
                                                                                                                                
Representative Prax//                                                                                                           
                                                                                                                                
Representative Ortiz asked if there were //                                                                                     
                                                                                                                                
Representative Prax responded that  there were initially but                                                                    
then the original intent                                                                                                        
                                                                                                                                
Representative Ortiz asked if the amendments were adopted                                                                       
                                                                                                                                
Representative  Prax responded  that  the  bill started  all                                                                    
over again // got away from the intent of the bill //                                                                           
                                                                                                                                
Representative  Ortiz asked  if  the  amendments dealt  with                                                                    
some of the concerns that had been raised //                                                                                    
                                                                                                                                
Representative Prax responded in the affirmative //                                                                             
                                                                                                                                
4:07:38 PM                                                                                                                    
                                                                                                                                
Representative Prax //  it was difficult to  cover a statute                                                                    
that covers every situation //                                                                                                  
                                                                                                                                
4:11:23 PM                                                                                                                    
                                                                                                                                
Co-Chair  Foster  reviewed  the  agenda  for  the  following                                                                    
meeting.                                                                                                                        
                                                                                                                                
HB  115  was  HEARD  and   HELD  in  committee  for  further                                                                    
consideration.                                                                                                                  
                                                                                                                                

Document Name Date/Time Subjects
HB 219 Sponsor Statement 2.6.24.pdf HFIN 3/22/2024 1:30:00 PM
SFIN 5/1/2024 9:00:00 AM
HB 219
HB 219 Sectional Analysis ver B 2.6.24.pdf HFIN 3/22/2024 1:30:00 PM
SFIN 5/1/2024 9:00:00 AM
HB 219
HB219 NEW FN DOLWD-SP-03-15-24.pdf HFIN 3/22/2024 1:30:00 PM
HB 219
HB 219 Public Testimony Rec’d by 3.18.24.pdf HFIN 3/22/2024 1:30:00 PM
HB 219
HB 219 Responses to HFIN Questions 3.22.24.pdf HFIN 3/22/2024 1:30:00 PM
HB 219
HB 115 Additional Authorities and Responsibilities 4.3.24.pdf HFIN 3/22/2024 1:30:00 PM
HB 115
HB 115 Follow Up Answers from 3.22.24 (FIN) Mtg..pdf HFIN 3/22/2024 1:30:00 PM
HB 115