Legislature(2009 - 2010)BARNES 124

03/19/2010 03:15 PM LABOR & COMMERCE

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
Moved CSHB 282(L&C) Out of Committee
Heard & Held
                       HB 282-NATUROPATHS                                                                                   
3:22:12 PM                                                                                                                    
CHAIR OLSON announced  that the first order of  business would be                                                               
HOUSE BILL  NO. 282, "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."                                                                             
3:22:17 PM                                                                                                                    
CHAIR  OLSON,  after first  determining  no  one else  wished  to                                                               
testify, closed public testimony on HB 282.                                                                                     
The committee took an at-ease from 3:22 p.m. to 3:28 pm.                                                                        
3:28:54 PM                                                                                                                    
REPRESENTATIVE  BUCH   made  a  motion  to   adopt  the  proposed                                                               
committee  substitute  (CS), labeled  26-LS1208\C,  Cook/Bullard,                                                               
3/18/10.   There  being no  objection, Version  C was  before the                                                               
3:29:15 PM                                                                                                                    
KENDRA KLOSTER,  Staff, Representative Cathy Munoz,  Alaska State                                                               
Legislature, reviewed the  changes to the bill.   She referred to                                                               
page 2, lines 26-27, which  add a licensed physician and hospital                                                               
administrator to  the proposed Alaska Naturopathic  Medical Board                                                               
(ANMB).   On page 2,  lines 14-16,  language was added  to sunset                                                               
the board June 30, 2015.  On page  3, line 5, the number of board                                                               
members for a quorum changed to  four members due to the addition                                                               
of two board  members.  On page 3, lines  13-20, removed the two-                                                               
tier prescription  provision and added language  that would allow                                                               
naturopaths   to   prescribe   non-controlled   drugs   such   as                                                               
antibiotics,   but   restricted  naturopaths   from   prescribing                                                               
controlled  substances listed  in  federal law  as schedule  I-VI                                                               
drugs.   On  page 3,  lines 25-26,  the pharmacists'  association                                                               
requested  regulations  define a  physician-patient  relationship                                                               
for the purposes of prescribing.                                                                                                
3:31:18 PM                                                                                                                    
REPRESENTATIVE BUCH referred to page 3,  line 19.  He stated that                                                               
he  understood the  exclusion  but he  thought  the language  was                                                               
vague.   He  asked whether  the provision  could be  rewritten to                                                               
more clearly show  that naturopaths are not  allowed to prescribe                                                               
schedule V drugs.                                                                                                               
3:32:56 PM                                                                                                                    
REPRESENTATIVE  HOLMES understood  the  concern that  on page  3,                                                               
line 19, that "or V" appears  to be separate from schedule I, II,                                                               
III, and IV.                                                                                                                    
REPRESENTATIVE BUCH agreed.                                                                                                     
3:33:48 PM                                                                                                                    
REPRESENTATIVE BUCH  maintained that by removing  "or" would help                                                               
to clarify the language since it seems confusing.                                                                               
REPRESENTATIVE HOLMES  suggested removing  "a" from page  3, line                                                               
18 and  19, so  it would  read:   "department; schedule  IA, IIA,                                                               
IIIA, IVA,  VA and VIA  controlled substances under state  law or                                                               
schedule  I,  II,  III,  IV, or  V  controlled  substances  under                                                               
federal law may not be included on the list;"                                                                                   
3:35:17 PM                                                                                                                    
REPRESENTATIVE BUCH offered  his belief that the  only item being                                                               
removed in the bill is schedule V from the federal list.                                                                        
REPRESENTATIVE  HOLMES  related  that  this removes  all  of  the                                                               
previously  mentioned schedules.   She  reiterated that  the bill                                                               
would exclude all of the  controlled substance schedules from the                                                               
list of drugs that Naturopaths can prescribe.                                                                                   
CHAIR OLSON agreed.                                                                                                             
REPRESENTATIVE  BUCH  related  that   schedule  V  was  the  most                                                               
comprehensive list  of controlled  substances under  federal law.                                                               
He removed his concern.                                                                                                         
3:35:55 PM                                                                                                                    
REPRESENTATIVE  T. WILSON  referred to  page 3,  lines 25-26  and                                                               
asked  the  reason  for   the  definition  for  physician-patient                                                               
MS. KLOSTER  explained that the  regulations define  a physician-                                                               
patient relationship  for the purposes of  prescribing and limits                                                               
the  prescribing  to patients  the  Naturopathic  Doctor (ND)  is                                                               
3:36:27 PM                                                                                                                    
MS. KLOSTER, in response to  Chair Olson, agreed that the patient                                                               
must have been seen by the ND.                                                                                                  
3:36:38 PM                                                                                                                    
REPRESENTATIVE T. WILSON said she thought that was clear.                                                                       
MS. KLOSTER commented that the  pharmacists felt more comfortable                                                               
and the  language was similar  to language for optometrists.   In                                                               
response  to  Representative  Holmes,   she  explained  that  the                                                               
specific language for physician-patient  relationship is found on                                                               
page 3, lines 25-26, and on page 5, lines 16-18.                                                                                
MS. KLOSTER  related that concludes  the changes in  the proposed                                                               
CS, except for technical changes.                                                                                               
3:38:05 PM                                                                                                                    
CHAIR OLSON removed his objection.                                                                                              
REPRESENTATIVE  LYNN recalled  that approximately  40 naturopaths                                                               
practice with a 7 member board  administering only 40 people.  He                                                               
inquired as to whether any other boards administer so few.                                                                      
MS.  KLOSTER  was  unsure.    She offered  her  belief  that  the                                                               
standard  is 5  to  7  board members,  but  the  physician and  a                                                               
hospital  administrator  were  added.   In  further  response  to                                                               
Representative Lynn, she agreed  the increase in membership would                                                               
likely increase the  fiscal note, which would be  reviewed by the                                                               
next committee.                                                                                                                 
CHAIR OLSON  pointed out  that this  bill would  likely encourage                                                               
more naturopaths to practice in the state.                                                                                      
3:40:01 PM                                                                                                                    
REPRESENTATIVE  T. WILSON  asked whether  naturopathic physicians                                                               
should be  reflected on  page 3, line  25.  She  did not  wish to                                                               
stop the bill but thought it might mislead some people.                                                                         
REPRESENTATIVE  BUCH recalled  the  pharmacists did  not want  to                                                               
verify the patient  had a valid prescription.  Thus,  the onus is                                                               
on the ND  to provide proof that the patient  was entitled to the                                                               
prescription.  He related that the  ND would call the pharmacy to                                                               
authorize the prescription.                                                                                                     
3:43:56 PM                                                                                                                    
CHAIR OLSON  referred to page  3, line  13, and related  that the                                                               
board will define the physician-patient relationship.                                                                           
REPRESENTATIVE  T. WILSON  explained her  question is  related to                                                               
the terminology.  She had  complaints from hospitals that want to                                                               
distinguish between physicians and NDs.                                                                                         
3:44:42 PM                                                                                                                    
The committee took an at-ease from 3:44 p.m. to 3:45 p.m.                                                                       
3:45:43 PM                                                                                                                    
REPRESENTATIVE T.  WILSON wanted consistency in  the relationship                                                               
between   physicians   and   naturopathic  physicians.      Other                                                               
physicians    wanted   distinction    between   physicians    and                                                               
naturopathic physicians.                                                                                                        
MS. KLOSTER  referred to  page 7, lines  1-5, which  will address                                                               
the concern.                                                                                                                    
3:46:40 PM                                                                                                                    
REPRESENTATIVE LYNN asked  whether a fiscal note  was attached to                                                               
the bill.                                                                                                                       
3:47:00 PM                                                                                                                    
CHAIR OLSON related the bill has two other committee referrals.                                                                 
3:47:48 PM                                                                                                                    
REPRESENTATIVE  HOLMES moved  to  report  the proposed  committee                                                               
substitute  (CS) labeled  26-LS1208\C, Cook/Bullard,  3/18/10 out                                                               
of   committee   with    individual   recommendations   and   the                                                               
accompanying fiscal note.                                                                                                       
REPRESENTATIVE T. WILSON objected.                                                                                              
REPRESENTATIVE T. WILSON  noted she received an  objection from a                                                               
constituent prior to the committee  meeting and she is working to                                                               
address the concern.  She removed her objection.                                                                                
There  being  no  further  objections,   the  CSHB  282(L&C)  was                                                               
reported from the House Labor and Commerce Standing Committee.                                                                  
3:48:40 PM                                                                                                                    
The committee took an at-ease from 3:48 p.m. to 3:51 p.m.                                                                       

Document Name Date/Time Subjects
HB282 POM Marjorie Richards 3-13-10.pdf HL&C 3/19/2010 3:15:00 PM
HB 282
HB282 Letter AAFP 3-15-10.pdf HL&C 3/19/2010 3:15:00 PM
HB 282
HB282 Letter Abby Laing.pdf HL&C 3/19/2010 3:15:00 PM
HB 282
HB282 Letter Tom Laing.pdf HL&C 3/19/2010 3:15:00 PM
HB 282
HB282 Letter Wayne Aderhold 3-1-10.pdf HL&C 3/19/2010 3:15:00 PM
HB 282
HB383 version A.pdf HL&C 3/19/2010 3:15:00 PM
HB 383
HB383-Fiscal Note DNR-AG-03-15-10.pdf HL&C 3/19/2010 3:15:00 PM
HB 383
HB383 Fiscal Note-CED-COM-03-15-10.pdf HL&C 3/19/2010 3:15:00 PM
HB 383
Mar 19 Packet Info.pdf HL&C 3/19/2010 3:15:00 PM
CSHB282 ver C.pdf HL&C 3/19/2010 3:15:00 PM
HB 282
HB282 Letter Tanana Valley Clinic.pdf HL&C 3/19/2010 3:15:00 PM
HB 282
HB282 Letter Tanana Clinic Letter-RX Attachment.pdf HL&C 3/19/2010 3:15:00 PM
HB 282
HB282 Letter (2) Wayne Aderhold.pdf HL&C 3/19/2010 3:15:00 PM
HB 282
HB383 Sponsor Statement ver A.pdf HL&C 3/19/2010 3:15:00 PM
HB 383