Legislature(2023 - 2024)BUTROVICH 205

03/07/2023 03:30 PM Senate HEALTH & SOCIAL SERVICES

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Audio Topic
03:32:25 PM Start
03:33:16 PM Confirmation Hearing(s) Commissioner Department of Health
04:02:20 PM SB8
04:13:09 PM SB44
04:31:39 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
Consideration of Governor’s Appointees: Heidi
Hedberg, Commissioner-Designee, Department of
Health
-- Invited & Public Testimony --
+ Bills Previously Heard/Scheduled: TELECONFERENCED
+= SB 8 REPEAL CERTIFICATE OF NEED PROGRAM TELECONFERENCED
Moved CSSB 8(HSS) Out of Committee
+= SB 44 NATUROPATHS: LICENSING; PRACTICE TELECONFERENCED
Moved CSSB 44(HSS) Out of Committee
             SB  44-NATUROPATHS: LICENSING; PRACTICE                                                                        
                                                                                                                                
4:13:09 PM                                                                                                                    
                                                                                                                                
CHAIR   WILSON  reconvened   the   meeting   and  announced   the                                                               
consideration  of SENATE  BILL NO.  44  "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."                                                                                               
                                                                                                                                
4:13:26 PM                                                                                                                    
CHAIR WILSON  noted that  there was  a committee  substitute (CS)                                                               
for the committee to consider. He solicited a motion.                                                                           
                                                                                                                                
4:13:29 PM                                                                                                                    
SENATOR KAUFMAN moved to adopt  the committee substitute (CS) for                                                               
SB 44, work order 33-LS0297\S, as the working document.                                                                         
                                                                                                                                
4:13:40 PM                                                                                                                    
CHAIR WILSON objected for purposes of discussion.                                                                               
                                                                                                                                
4:13:53 PM                                                                                                                    
JANE  CONWAY,   Staff,  Senator   Cathy  Giessel,   Alaska  State                                                               
Legislature, Juneau,  Alaska, provided  the following  summary of                                                               
changes for SB 44 from version B to version S:                                                                                  
                                                                                                                                
     Page 2, lines 23-24: re: Advisory Board composition                                                                      
           The Advisory Board  composition was changed to be                                                                    
           comprised of 2 NDs,  1 pharmacist, 1 MD or OD and                                                                    
           1  public member. (Reduced public  members from 2                                                                    
           to  1,  reduced NDs  from  3 to  2,  and added  1                                                                    
           pharmacist and 1 MD or OD.)                                                                                          
                                                                                                                                
     Page 4, line 4: re: externship                                                                                           
           Removes  the externship  program requirement  for                                                                    
           Naturopath  licensure. The term is  confusing and                                                                    
           unnecessary.  Other  medical  providers with  the                                                                    
           level  of authority  the NDs  are requesting  are                                                                    
           not  required to match or  emulate the MD  and OD                                                                    
           internship process. The  training for NPs is most                                                                    
           commensurate  with  that  of NDs  having  similar                                                                    
           clinical  hours,  and  neither  have  a  required                                                                    
           residency.                                                                                                           
                                                                                                                                
     Page 6, line 13: re: vaccines                                                                                            
           Added  vaccines to  the list  of services  that a                                                                    
           licensed naturopath may provide.                                                                                     
                                                                                                                                
     Page 6, line 19:                                                                                                         
            Deletion of the word  "surgical" to clarify this                                                                    
            sentence  which  only  means   that  a  licensed                                                                    
            naturopath  may treat  superficial  lacerations,                                                                    
            abrasions and  lesions. The word  "surgical" can                                                                    
            be mistaken  to infer  procedures that  they are                                                                    
            not seeking to perform.                                                                                             
                                                                                                                                
     Page 6, line 26:                                                                                                         
             Replaces the  word "ultrasound"  with the  word                                                                    
             "imaging." There are  several types  of imaging                                                                    
             that  a  naturopath   may  wish  to   order  if                                                                    
             necessary. Other types  of imaging could  be an                                                                    
             X-ray, MRI, CT scan, ultrasound, EKG, and other                                                                    
             tests to assist with correct patient diagnosis.                                                                    
                                                                                                                                
     Page 6, line 30:                                                                                                         
             Replaces the  word "ultrasound"  with the  word                                                                    
             "imaging." There are  several types  of imaging                                                                    
             that  a  naturopath   may  wish  to   order  if                                                                    
             necessary  to   assist  with   correct  patient                                                                    
             diagnosis.                                                                                                         
                                                                                                                                
CHAIR WILSON discerned there were no questions or comments.                                                                     
                                                                                                                                
4:16:55 PM                                                                                                                    
CHAIR WILSON removed his objection; he found no further                                                                         
objection and version S was adopted. He noted that Senator                                                                      
Dunbar had an amendment.                                                                                                        
                                                                                                                                
4:17:21 PM                                                                                                                    
At ease                                                                                                                         
                                                                                                                                
4:18:19 PM                                                                                                                    
CHAIR WILSON reconvened the meeting.                                                                                            
                                                                                                                                
4:18:25 PM                                                                                                                    
SENATOR DUNBAR moved to adopt Amendment 1 for SB 44. He noted                                                                   
that the amendment was drafted based on the original bill, but                                                                  
the following reflects the proposed changes to version S.                                                                       
                                                                                                                                
                          AMENDMENT 1                                                                                       
                                                                                                                                
                                                                                                                                
     OFFERED IN THE SENATE                    BY SENATOR DUNBAR                                                                 
          TO: SB 44, version S                                                                                                  
                                                                                                                                
                                                                                                                                
     Page 4, lines 5 - 6:                                                                                                       
          Delete all material.                                                                                                  
                                                                                                                                
     Renumber the following paragraphs accordingly.                                                                             
                                                                                                                                
     Page 6, line 24:                                                                                                           
          Delete "and"                                                                                                          
                                                                                                                                
     Page 6, line 27, following "test":                                                                                         
          Insert "; and                                                                                                         
               (5)  write prescriptions if the person 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"                                                                                                              
                                                                                                                                
4:18:28 PM                                                                                                                    
CHAIR WILSON objected for purposes of an explanation.                                                                           
                                                                                                                                
SENATOR  DUNBAR  explained that  naturopaths  in  Alaska are  not                                                               
required to  have prescriptive authority  to practice, but  SB 44                                                               
would  require  an  individual  who  applies  for  a  license  to                                                               
practice   naturopathy   in   the   state  to   have   passed   a                                                               
pharmaceutical examination  before they apply. The  intent of the                                                               
amendment is to delete the  requirement for naturopaths to pass a                                                               
pharmaceutical  examination.  Then  on  page 6,  line  27  a  new                                                               
paragraph  (5)   adds  the  ability  for   naturopaths  to  write                                                               
prescriptions  if they  have  passed  an approved  pharmaceutical                                                               
examination.  Naturopaths may  obtain prescriptive  authority but                                                               
they aren't required to do so.                                                                                                  
                                                                                                                                
4:20:15 PM                                                                                                                    
SENATOR  GIESSEL  advised  that  Dr.   Clyde  Jensen,  who  is  a                                                               
professor of pharmacology, may wish to comment on Amendment 1.                                                                  
                                                                                                                                
4:20:41 PM                                                                                                                    
CLYDE JENSEN,  Ph.D., MS, Professor of  Pharmacology, Rocky Vista                                                               
University,  Saint   George,  Utah  stated  his   belief  that  a                                                               
naturopath who does not wish  to prescribe should not be required                                                               
to do  so. He then cautioned  the committee to be  mindful of any                                                               
amendment that creates unnecessary obstacles.                                                                                   
                                                                                                                                
4:22:08 PM                                                                                                                    
CHAIR  WILSON  asked Senator  Dunbar  for  confirmation that  the                                                               
amendment would remove  the requirement for a  naturopath to pass                                                               
a pharmaceutical examination.                                                                                                   
                                                                                                                                
4:22:26 PM                                                                                                                    
SENATOR   DUNBAR  clarified   that   Amendment   1  removes   the                                                               
requirement   for  a   naturopath   to   pass  a   pharmaceutical                                                               
examination  to   practice  naturopathy.  It  also   adds  a  new                                                               
paragraph  (5)  on   page  6  that  clarifies   that  a  licensed                                                               
naturopath who wants  to write prescriptions may do  so once they                                                               
have passed an approved pharmaceutical examination.                                                                             
                                                                                                                                
4:22:47 PM                                                                                                                    
CHAIR WILSON asked  Dr. Jensen if there would be  a benefit for a                                                               
naturopath to  take the pharmaceutical  examination even  if they                                                               
do not intend to prescribe.                                                                                                     
                                                                                                                                
4:23:04 PM                                                                                                                    
DR.  JENSEN said  he was  not aware  of a  benefit to  taking the                                                               
examination if a naturopath chooses not to prescribe.                                                                           
                                                                                                                                
4:23:23 PM                                                                                                                    
SENATOR  GIESSEL   stated  that   the  purpose  of   the  state's                                                               
regulatory  boards is  to protect  the public.  She posited  that                                                               
when a  naturopath is  providing health  care services,  they are                                                               
not  confining   their  services  to  individuals   who  are  not                                                               
consuming   pharmaceuticals.  She   opined  that   the  vitamins,                                                               
minerals,  and  herbal  preparations that  naturopaths  recommend                                                               
have  the potential  to create  side effects  when they  interact                                                               
with  pharmaceuticals an  individual has  taken. She  said that's                                                               
the reason  to require naturopaths to  demonstrate pharmaceutical                                                               
knowledge even if they don't  prescribe them. The requirement for                                                               
naturopaths  to   pass  a  pharmaceutical   examination  provides                                                               
documentation  that  the state  has  examined  an individual  and                                                               
asserts  that they  have equivalent  pharmaceutical knowledge  to                                                               
others who  are licensed under  medical statutes. She  noted that                                                               
Dr.  Jenson  testified  in  the  past  that  the  pharmacological                                                               
education  that  naturopaths  receive is  equivalent  to  medical                                                               
physicians.                                                                                                                     
                                                                                                                                
4:26:18 PM                                                                                                                    
SENATOR TOBIN  asked if the  amendment would create two  types of                                                               
licenses  for  naturopaths,  one  with  an  endorsement  and  one                                                               
without.  She  asked who  would  be  checking  to ensure  that  a                                                               
naturopath was practicing within their scope of licensure.                                                                      
                                                                                                                                
4:26:50 PM                                                                                                                    
SENATOR  DUNBAR stated  his  belief  that it  would  be the  same                                                               
regulatory  agency   that  currently  oversees   naturopaths.  He                                                               
continued  to  say   that  if  a  naturopath   were  to  exercise                                                               
prescriptive   authority   without  taking   the   pharmaceutical                                                               
examination,  that same  regulatory  body would  take action.  He                                                               
noted  that Senator  Giessel has  evidence that  most naturopaths                                                               
would take  the examination and seek  prescriptive authority, but                                                               
some  members of  the  public  expressed a  desire  to not  force                                                               
prescriptive authority on naturopaths.                                                                                          
                                                                                                                                
4:28:05 PM                                                                                                                    
SENATOR  DUNBAR said  he appreciates  the changes  in the  CS and                                                               
Senator  Giessel's  reasoned  argument   for  public  safety.  He                                                               
withdrew Amendment 1 and said  he appreciated that the discussion                                                               
was on the record.                                                                                                              
                                                                                                                                
4:28:22 PM                                                                                                                    
CHAIR WILSON found no further  amendments, questions, or comments                                                               
and he solicited a motion.                                                                                                      
                                                                                                                                
4:28:39 PM                                                                                                                    
SENATOR KAUFMAN moved to report the  CS for SB 44, work order 33-                                                               
LS0297\S,  from  committee  with individual  recommendations  and                                                               
attached fiscal note(s).                                                                                                        
                                                                                                                                
4:28:48 PM                                                                                                                    
CHAIR WILSON  found no  objection and  CSSB 44(HSS)  was reported                                                               
from the Senate Health and Social Services Standing Committee.                                                                  

Document Name Date/Time Subjects
Heidi Hedberg Resume 2023.pdf SHSS 3/7/2023 3:30:00 PM
Confirmation Hearing DOH Heidi Hedberg
CS SB 8 v B draft.pdf SHSS 3/7/2023 3:30:00 PM
SB 8
SB 8 CON Testimony 2023 Recind Shier.pdf SHSS 3/7/2023 3:30:00 PM
SB 8
SB 8 PHC Letter in Opposition to SB 8 CON Repeal 22423.pdf SHSS 3/7/2023 3:30:00 PM
SB 8
SB 8 Fuller Repeal of Certificate of need program_Redacted.pdf SHSS 3/7/2023 3:30:00 PM
SB 8
SB8 CON testimony Goldwater Institute.pdf SHSS 3/7/2023 3:30:00 PM
SB 8
SB8 Letter Heffern 2.22.23.pdf SHSS 3/7/2023 3:30:00 PM
SB 8
SB8 letter Jazzo.pdf SHSS 3/7/2023 3:30:00 PM
SB 8
CS SB 44 v S draft.pdf SHSS 3/7/2023 3:30:00 PM
SB 44
SB44 Letter Werle.pdf SHSS 3/7/2023 3:30:00 PM
SB 44
SB 44 Letters 3.6.23.pdf SHSS 3/7/2023 3:30:00 PM
SB 44
SB Supporting Document Prescriptive Authority.pdf SHSS 3/7/2023 3:30:00 PM
SB 44 Supporting Document Prescriptive Authority.pdf SHSS 3/7/2023 3:30:00 PM
SB 44
SB 44 FN DCCED CBPL (updated 3.3.23).pdf SHSS 3/7/2023 3:30:00 PM
SB 44
SB 44 FN DPS (updated 3.2.23).pdf SHSS 3/7/2023 3:30:00 PM
SB 44
SB 44 Letter Shawn Vanio 3.7.23_Redacted.pdf SHSS 3/7/2023 3:30:00 PM
SB 44
SB44 Explanation of Changes vsn B to S 03-06-23.pdf SHSS 3/7/2023 3:30:00 PM
SB 44
SB44 Explanation of Changes vsn B to S 03-06-23.pdf SHSS 3/7/2023 3:30:00 PM
SB 44