Legislature(2003 - 2004)
03/25/2004 10:01 AM Senate FIN
| Audio | Topic |
|---|
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
MINUTES
SENATE FINANCE COMMITTEE
March 25, 2004
10:01 AM
TAPES
SFC-04 # 57, Side A
SFC 04 # 57, Side B
SFC 04 # 58, Side A
CALL TO ORDER
Co-Chair Gary Wilken convened the meeting at approximately 10:01
AM.
PRESENT
Senator Gary Wilken, Co-Chair
Senator Lyda Green, Co-Chair
Senator Con Bunde, Vice Chair
Senator Fred Dyson
Senator Ben Stevens
Senator Donny Olson
Also Attending: SENATOR RALPH SEEKINS; CLYDE JENSEN, PhD, medical
educator and researcher; JASON HARMON, Naturopathic Doctor, and
Vice President, Alaska Association of Naturopathic Physicians,
Inc.;
Attending via Teleconference: From Mat-Su: CATHERINE WRIGHT; From
Homer: TOM GOODE; From Anchorage: LYNN HORNBEIN, family physician;
JEAN BROOKING, patient of Dr. Hornbein; MADELAINE MORRISON-YOUNG,
physician
SUMMARY INFORMATION
SB 366-STATE SALES TAX
The Committee adopted a committee substitute. The bill was held in
Committee.
SB 306-NATUROPATHIC MEDICINE TASK FORCE
The Committee heard from the sponsor, representatives of the
medical field and members of the public. An amendment was adopted
and the bill was held in Committee.
SB 35-APPROPRIATIONS: K-12, UNIVERSITY
A committee substitute was adopted and an amendment was amended and
adopted. The bill was held in Committee
SB 298-OFF-ROAD VEHICLE USE ON DALTON HIGHWAY
This bill was scheduled but not heard.
SENATE BILL NO. 366
"An Act relating to the levy and collection of sales and use
taxes, to the levy and collection of municipal sales and use
taxes, and to municipal sales and use taxes on alcoholic
beverages; and providing for an effective date."
This was the second hearing for this bill in the Senate Finance
Committee.
Senator Dyson moved to adopt CS SB 366, 23-LS1051\V as a working
document.
Co-Chair Wilken objected for an explanation.
Senator B. Stevens explained this committee substitute addresses
some matters discussed at the previous hearing, including an
exemption from quarterly remittance deadlines for businesses with
less than $250 tax liability. He explained this language on page 7,
lines 13 - 17 would provide that the tax liability could be paid
the following tax quarter, or once the liability reaches $250.
Senator B. Stevens next outlined Section 21 on page 14, following
line 17, which would provide a transition period to allow
municipalities currently collecting a sales tax of one to 2.9
percent, a one-year period to change ordinances to increase the
local sales tax to three percent to qualify for the additional one-
percent tax from the State portion.
Senator B. Stevens stated that subsection (d) was added on page 5
line 4 to Sec. 43.44.010. Levy of sales and use tax; tax rate.,
created in Section 17 that places a $60 tax limit on each invoice.
Senator B. Stevens noted that subsection (11) to Sec. 43.44.020.
Exemptions., in Section 17 on page 6, lines 24 - 26 relates to
property and services used for development of natural resources.
Senator B. Stevens also pointed out the addition of diesel fuel
used for home heating, and water and sewer utilities held by a
private entity, as well as those held by a municipality, would be
exempted from the sales tax, as reflected on page 5, line 31, and
page 6, line 1, in Sec. 43.44.020(5) in Section 17.
Senator Dyson referenced Sec. 43.44.020 (11) pertaining to natural
resources and commented the language is not "exhaustive". He
suggested that cultural products and commercial gathering of wild
berries should not be excluded from the sales tax.
Senator B. Stevens indicated he would review the matter.
Senator B. Stevens characterized the language added in subsection
(f) to Sec. 43.44.030. Collection of sales and use tax., in Section
17 on page 7 lines 18 - 21 as a bundling clause, explaining the
maximum tax amount would be based on an invoice total rather than
individual items.
Senator B. Stevens suggested the Committee adopt this committee
substitute, to allow the Department of Revenue to prepare fiscal
notes reflecting the recent version. He informed that he would
continue developing this legislation and that another update would
be presented the following week.
Co-Chair Wilken removed his objection to the adoption of the
committee substitute.
Senator Olson asked the reason that tax liability would be deferred
until a business' liability reached $250.
Senator B. Stevens replied this resulted from discussions held on
this proposal during Senate Finance Committee meetings on the
Conference of Alaskans proposals. He detailed that if a small
vendor does not have significant tax liability, payment would be
deferred until the next tax quarter.
Without objection the committee substitute was ADOPTED.
Co-Chair Wilken ordered the bill HELD in Committee.
SENATE BILL NO. 306
"An Act relating to the practice of naturopathic medicine; and
providing for an effective date."
This was the first hearing for this bill in the Senate Finance
Committee.
Co-Chair Wilken stated this bill, "updates current law pertaining
to the practice of naturopathic medicine. This legislation allows
for the performing of minor surgery and prescribing of drugs and
controlled substances previously prohibited."
SENATOR RALPH SEEKINS, Sponsor, read his testimony into the record
as follows.
The proposed legislation updates current law pertaining to the
practice of naturopathic medicine. In so doing, Alaskans
accessibility to safe, comprehensive, high quality health care
services would be significantly enhanced.
The key elements of this legislation include one: safeguarding
Alaskan's use of naturopathic medicine. By ensuring the
highest quality care possible from licensed well-trained and
professionally examined naturopathic practitioners. Two:
mandating continuing education requirements whereby
practitioners are subject to a State and national examination
process. Three: establishment of a scope of practice to
include the use of natural substances, homeopathic medicine,
dietary, nutritional, health counseling, minor surgery and all
necessary diagnostic and imaging studies. Four: prescribing
prescriptive rights authority to those naturopathic
practitioners earning licensure. And five: establishment of a
qualified trade association of naturopathic physicians to work
with the Division of Occupational Licensing towards the
implementation of regulations requiring specific State and
federal examinations and licensure requirements.
Like allopathic physicians naturopathic physicians undergo
four years of undergraduate, pre-professional training,
followed by an intensive four-year doctoral program
emphasizing both academic and clinical studies within the
scope of primary care. Therefore its important that the laws
in Alaska that govern the practice of naturopathic medicine
reflect the high quality of education that naturopathic
physicians receive.
The practice of naturopathic medicine was licensed in Alaska
17 years ago. It's now time to revisit these statutes and
apply a fresh coat of paint where needed, and the proposed
legislation neatly accomplishes this necessary purpose.
Finally, it may be of interest to note that similar
legislation currently exists in 14 other states.
Senator Seekins proposed an amendment to the bill to limit
prescription rights to those drugs categorized as Schedule III, IV,
and V.
Co-Chair Wilken requested the proposed amendment in written form.
Senator Bunde relayed his past experience with the field of
naturopathic medicine in which practitioners are often critical of
traditional medicine and "artificial treatment". He questioned the
desire of these critics now requesting authority to dispense
traditional medicine. He asked if utilizing traditional medicines
would undermine the naturopathic principle.
Senator Seekins deferred the question to experts in the field. He
commented that he never discouraged enlightenment. He disputed that
naturopathic medicine has no value, given the thousands of Alaskans
who believe in its benefits. However, neither was he willing to
stop seeking medical care from his traditional physicians.
Senator Dyson disagreed with the generalization of naturopaths
disregarding the necessity of traditional medicines, saying that
it, like most generalizations are inaccurate. The naturopaths he
knew are enlightened and not disparaging of any medicine that is
effective, including prescription medicine.
Amendment #1: This amendment changes language in Section 11 on page
5, lines 16 and 17, adding Sec. 08.45.120. Authorized activities;
use of titles. The amended language of subsection (4) reads as
follows.
(4) after becoming registered with the federal Drug
Enforcement Administration, prescribe only those controlled
substances allowed under Schedules III, IV and V;
Senator Dyson moved for adoption.
Co-Chair Wilken objected for an explanation.
Senator Seekins explained the classification of various types of
scheduled medicines. He relayed that most objections to the
granting of authority to naturopaths to prescribe medications has
been related to those medications classified as Schedule I or II.
In talking with naturopaths, he learned they are willing to limit
their authority to Schedule III, IV and V medications.
Senator Olson further explained that Schedule II drugs are
considered addictive, not only for patients but also for
physicians. He stated that Schedule I drugs are not used for their
medical benefits, such as heroin. Schedule II medications, he
stated, includes other narcotics and stimulants, including cocaine
and morphine. He said Schedule III drugs include other narcotics,
Schedule IV includes Valium, and Schedule V medications have the
lowest abuse potential, usually no more addictive than over the
counter drugs might be.
Senator Olson expressed concern about granting prescription
authority to naturopathic doctors. He pointed out that in addition
to addictive qualities of certain drugs, many drugs could cause
severe allergic reactions and must be carefully monitored. He
wanted more information on how the naturopaths would be self-
regulated to avoid drug addictions and abuse. He recalled abuse and
addictions that occurred in the United States during the 1800s and
the subsequent adoption of the Harrison Act in 1914, which
instituted the federal drug enforcement agency.
Senator Bunde asked the schedule classification of the drug
oxycontin, which has been abused.
Senator Olson and Senator Seekins replied it is a Schedule II drug.
Senator Seekins pointed out that a nurse practitioner with less
educational background than a naturopathic practitioner has
authority to issue Schedule II and higher, prescription drugs. He
noted this amendment would grant authority to naturopaths less than
that granted to nurse practitioners.
Senator Olson stated that only medical doctors and doctors of
allopathy are allowed to prescribe Schedule II and higher drugs. He
remarked that only experimental researchers are allowed access to
Schedule I drugs.
Senator Seekins reiterated that Schedule I drugs usually have no
medical uses.
Without objection and the amendment was ADOPTED.
CATHERINE WRIGHT testified via teleconference from Mat-Su that she
and her family utilize naturopathic care. She described the
improvement to her personal health in the seven to eight years
since she began treatment by a naturopathic doctor with fewer
missed workdays, and less need for prescription medicine. She spoke
to her trust in naturopathic caregivers.
Senator Olson asked why, since the witness has "lost faith" in
traditional medical providers, she supports granting authority to
naturopaths to issue prescription medicine.
Ms. Wright clarified that she has not lost faith in traditional
medical care, but rather that her health has improved with the
combination of both types of care. She emphasized that she still
receives traditional medical care when illness requires treatment
with prescription medication.
CLYDE JENSEN, PhD, medical educator and researcher, testified that
he has traveled to Juneau from Portland, Oregon at his own expense
due to the interest he has in the integration of conventional and
complementary medicine. He told of the doctorate of physiology and
pharmacology he holds from the University of North Dakota, his
positions as a faculty member of a conventional medical school, and
a medical school administrator and noted he is the only known
medical educator to have served in both traditional and
naturopathic fields of medicine.
Dr. Jensen indicated he would address four questions related to
this legislation: are all naturopaths the same; how does the
training of naturopathic physicians compare to that of medical
doctors and doctors of allopathy; are naturopaths adequately
trained to prescribe medicines; and, are naturopaths adequately
trained to perform minor surgery.
Dr. Jensen remarked that not all naturopaths are trained the same.
Many states, he said, allow anyone to use the name "naturopath" and
that those who chose to use natural methods to treat illness or
disease in these jurisdictions could adopt the title of naturopath.
However, he noted that Alaska regulates naturopaths and requires
certain training. He surmised that opposition to this legislation
could be based on the assumption that untrained caregivers could
claim to be naturopaths.
Dr. Jensen then compared the training received by traditional
physicians and naturopaths. He noted that Alaska statute prohibits
naturopaths to be called physicians, although this is allowed in
other states that regulate naturopaths and that he is accustomed to
referring to trained naturopaths as doctors. He described four
linear steps of naturopathic and traditional medical training. He
stated that the premedical education of four years college
education and a bachelor degree required for admittance into a
naturopathic education program is virtually identical to that
required for admittance into a medical doctor education program. He
furthered that the first two years of preclinical basic science
education is similar for both fields and includes courses in
anatomy, physiology, histology, microbiology, biochemistry, and
pharmacology. He assured that the basic sciences courses taught for
naturopathic medicine are of the same duration, of the same content
and are delivered in the same "intensity". He qualified that he has
taught pharmacology in each of the three types of medical schools
and that he utilizes the same lecture notes for each course. He
also observed that medical institutions employ more professors in
each department who are engaged primarily in research activities
and therefore, may be more familiar with recent research findings.
However, he attested he has experienced some of the finest
instruction at naturopathic educational institutions from
professors devoted full-time to teaching.
Dr. Jensen continued in detailing the clinical education
requirements that usually occur during the third and fourth year of
medical school, in which students are exposed to patients and to
diagnostic and therapeutic modalities consistent with professional
practices. He commented the differences in training for
naturopathic and traditional medical students are more significant
during this portion of schooling. He explained that traditional
medical clinical training mostly occurs in hospitals, which
provides students with the benefit of treating a high percentage of
sick patients with a broad scope of illnesses and injuries. By
contrast, he stated that naturopathy is practiced primarily in
outpatient facilities, and subsequently naturopathic clinical
education is mostly conducted in outpatient settings. He informed
that naturopathic students are supervised by a naturopathic doctor
and receive more training in areas of nutrition, botanical medicine
and physical medicine, and less training with prescription
medicines than traditional medicine students.
Dr. Jensen concluded with the graduate portion of medical
education. He stated that medical doctors upon earning a medical
degree are required in virtually all jurisdictions to practice at
least one year in an internship program. In naturopathic medicine,
he noted, this is called a rotation, and is only available for a
limited number of graduates. He detailed the federal funding
available through Medicare programs to fund internship programs,
which is unavailable for naturopathic rotations. He assured that
opportunities for rotations are increasing.
Dr. Jensen next addressed the question of whether naturopaths are
adequately trained to prescribe drugs. He reported that of the 200
most commonly prescribed medications, 42 percent are of natural
origin of compounds naturopaths currently prescribe. He stressed
that naturopaths are specifically trained to administer these types
of drugs. He stated that naturopathic physicians are likely to have
more training with some drugs. He qualified that naturopaths are
likely to have less training in administering non-natural drugs,
including controlled substances.
SFC 04 # 57, Side B 10:48 AM
Dr. Jensen continued that most naturopaths have no application
training for controlled substances, although they receive some
basic training in the effects of these drugs.
Dr. Jensen spoke to the ability of naturopaths to perform minor
surgical procedures. He assured that the procedures proposed in
this legislation "easily falls into" the training received by
educated naturopaths. He described the training provided to
instruct students on suturing superficial lesions, removing warts,
and superficial dermatological procedures. He stressed that
naturopaths are more than adequately trained to perform minor
surgery.
Senator Bunde pointed to limited opportunities for receiving
continuing education in the State. He asked whether Alaskan
naturopaths would be required to relocate to attend continuing
education courses or whether these requirements could be met
through long-distance education.
Dr. Jensen clarified between continuing education and graduate
education. Continuing education, he noted is required of all three
types of physicians. He surmised that if the state of Alaska
mandated 45 hours bi-annually of continuing education for
naturopath physicians, such education could be received in the form
of attending lectures, and shadowing other health care
professionals. He was confident that as the naturopath profession
continues to emerge, standards for continuing education would
mirror that required for other medical professions.
Senator Bunde asked how the continuing education would be
monitored, whether by a board of naturopathic practitioners or by
the State.
Senator Seekins replied the Division of Occupational Licensing
would determine this. He noted that at least 15 hours of education
must be in the area of pharmacology instruction.
Senator Olson relayed that continuing education requirements for
medical doctors and doctors of allopathy are established in statute
and approved. He stated that physicians must meet these
requirements every three years, which does not over encumber the
Division. He noted this legislation would require a higher number
of required training hours for naturopath physicians.
Senator Bunde commented this legislation is not "breaking new
ground" but rather following guidelines established for medical
doctors, as the goal is to require naturopaths to meet similar
standards required of medical doctors. He surmised that a medical
doctor could become qualified and practice naturopathic medicine
upon completion of continuing education training.
Senator Seekins clarified that use of the term "naturopathy" would
be somewhat harder to justify without some training in the
naturopathic medicine. He deferred to the Division of Occupational
Licensing to determine how the term would be defined and its use
restricted.
Senator Olson pointed out that licensure of medical doctors and
doctors of allopathy, specifies the practice of medicine and
surgeries and contains no restrictions.
JASON HARMON, Naturopathic Doctor, and Vice President, Alaska
Association of Naturopathic Physicians, Inc., testified to medical
doctors who have undertaken additional schooling at a naturopathic
medical institution to obtain a "duel degree". He informed that the
Division of Occupational Licensing requires graduation from both
programs as well as passage of examinations for both traditional
and naturopathic medicine to be licensed as a medical doctor and
naturopathic practitioner.
Senator B. Stevens referenced Appendix D: Comparison of
Naturopathic Governance in Licensed States, to the report,
"Assuring Safe Naturopathic Medical Practices for Alaskans" by the
Alaska Association of Naturopathic Physicians, Inc. He noted that
the state of Arizona grants naturopaths full prescriptive rights
and that most of the other states that regulate naturopathy grant
"drug formulary". He asked for a comparison of these states to the
authority this legislation would provide.
Senator Seekins reiterated that naturopaths in Alaska would have
full prescription rights for all drugs except those classified as
Schedule I or II.
Senator B. Stevens asked the definition of drug formulary. He noted
that the scope of practice granted to naturopaths in Alaska would
no longer prohibit minor surgery and asked if any other changes
would occur.
Senator Seekins replied that the existing stipulation providing no
right to laboratory tests and diagnostic tests would likely not
change.
This was verified to be correct.
Senator B. Stevens asked for further explanation of drug formulary.
Dr. Jensen explained that drug formulary is a definitive list of
drugs that naturopathic physicians are authorized to prescribe. He
noted that the number of drugs included in this list increases as
new drugs are developed and the need for existing drugs is
justified. He clarified that drug formulas not a contrivance for
naturopathic practice, but are instead commonly utilized for
managed care providers.
Co-Chair Green asked if statutory change is required each time an
additional drug is authorized in the drug formulary.
Dr. Jensen responded that statutory change is not required in the
states he is familiar. Instead, he told of the board and public
hearing processes utilized.
Co-Chair Wilken understood that statutory change would be required
in Alaska.
UNIDENTIFIED SPEAKER clarified that the state of Alaska does not
operate with a drug formulary.
Co-Chair Green suggested a drug formulary could be adopted and
asked the drugs and corresponding schedules are usually included.
Dr. Jensen replied that the drugs and the schedule levels vary
significantly among the different jurisdictions.
Dr. Jensen listed his education and professional credentials at
Senator Olson's request as follows: undergraduate degree in
zoology, Masters degree in physiology, PhD in pharmacology; his
first position was as an assistant professor at the Oklahoma
College of Osteopathic Medicine and Surgery, was one of the
founding faculty and president of the West Virginia School of
Osteopathic Medicine. He noted his position at the West Virginia
facility was at a time when that state could not afford to fund all
three of its medical schools. He stated he was hired to either
identify alternative methods to allow operation of the school to
continue or to preside over its closure. He remarked he was able to
implement continued operations and subsequently "became known as a
turn around person for medical schools." After this position, he
held a number of positions at schools offering osteopathic,
allopathic, naturopathic, and oriental medicine programs with the
charge of reviving troubled programs.
Senator Olson clarified the witness has no medical doctorate
degree.
Dr. Jensen replied that although he was admitted to a medical
school, he opted to obtain a PhD to better achieve his goal of
becoming a medical researcher and educator. He affirmed he holds no
medical doctorate degree.
Senator Olson cited the definition of "naturopathy" and "healing in
the use of physical defects" provided in medical dictionaries. He
asked that because naturopathy care is primarily based on the use
of botanical remedies, why pharmacology courses are included in
naturopath education programs.
Dr. Jensen replied that many patients seeking care from naturopath
physicians are currently taking prescribed drugs. He furthered that
as the pharmaceutical industry has incorporated additional
products, many of those products were those in which naturopaths
were trained to use as botanicals or nutrients.
Senator Olson surmised that naturopathic students receive
pharmacology training was not primarily with the intent of teaching
these students how to prescribe the drugs, but rather for exposure
to potential effects of drugs their patients could already be
taking.
Dr. Jensen agreed this would be the reason in earlier years of the
profession. He added that the ability to distinguish between a drug
and a botanical herb has become more difficult.
Senator Olson noted that allopathic post-graduate residency
programs have an emphasis in prescription medicines. He pointed out
that a traditional medical doctor could not become licensed before
receiving two years in residency training, but understood that this
training is not available for naturopaths.
Dr. Jensen affirmed and explained that because residency training
is unavailable, naturopaths could become licensed upon completion
of their degree.
Senator Olson told of the standardized medical board examination,
of which much of the questioning is related to pharmacology. He
remarked that many medical doctors fail to pass the exam on the
first attempt, and several are never able to pass. He questioned
how a naturopath would perform on the examination, given the
absence of residency experience.
Dr. Jensen expressed that he would prefer that "part one" of the
United States Medical Licensure Examination be required of
naturopaths, however this is not allowed. Instead, he stated,
naturopaths are administered the Naturopathic Physician Licensing
Examination, which is comparable. He noted that part two of the
naturopath board examination differs from the medical board
examination counterpart in that it has a greater focus on
nutritional and nutrition, botanical medicine and other areas
"foreign" to allopathic medicine. He added that this process has
begun and informed that the state of Utah passed a Naturopathic Act
in 1995, which requires one year of residency training.
TOM GOODE testified via teleconference from Homer in favor of the
bill. He cited the 100,000 deaths that occur in hospitals each year
as a result of adverse drug reactions, and attested that drugs
should not be the only options available to patients. He supported
treatment in conjunction with nutrition and other therapy. He spoke
to hostility traditional medical doctors demonstrate toward
alternative health care practices. He noted this legislation would
provide Alaskans with 30 additional primary physicians to choose
from.
Senator Olson asked why the witness supports granting prescription
authority to additional care providers, suspecting that more deaths
would occur.
Mr. Goode disagreed and asserted that sometimes drug therapy is
necessary.
LYNN HORNBEIN, family physician, testified via teleconference from
Anchorage as a conventional doctor in support of this bill. She
told of her experiences working in conjunction with naturopaths
during the past five to six years after receiving referrals from
naturopathic physicians for their patients requiring prescription
medications. She remarked upon the difficulty many patients have in
visiting two doctors, including the time, expense, and need to
confide personal information to another physician. She stated she
has a significant waiting list for new patients and the hardship
caused from accepting new patients with an existing care provider
for the sole purpose of prescribing medication. She talked about
the ability of naturopaths to perform minor surgeries.
JEAN BROOKING, patient of Dr. Hornbein, testified via
teleconference from Anchorage that she received naturopathic care
before the costs were covered by health insurance. She told how her
naturopathic physician earned a nurse practitioner license to
obtain the ability to prescribe drugs when necessary. She described
an illness her daughter suffered, which the specialists at Virginia
Mason hospital were unable to diagnose. Ms. Brookings reported that
a naturopath was able to correctly diagnose and treat the ailment.
MADELAINE MORRISON-YOUNG, physician, testified via teleconference
from Anchorage on behalf of herself and Dr. Mary Miner in favor of
this bill.
Senator Olson noted that anesthesia is required in minor surgery,
and are often delivered through fast acting intravenous medications
and inhalants. He asked what forms would be permitted under this
legislation.
Dr. Jensen informed that naturopath physicians are trained to use
anesthesia for local use, and are also trained to administer
intravenous vitamin therapy. He expected that training in this area
would constantly expand as the "scope of education and
scholarliness of practitioners expands." He anticipated the issue
would be revisited in 15 years as advances continue.
Senator Olson clarified that naturopathic practitioners are
currently allowed to administer naturopathic intravenously.
Mr. Rolfzen affirmed this is permitted in some jurisdictions and
training is provided in each of the schools.
Senator Olson posed the scenario of a patient's adverse reaction to
anesthesia and the lack of access to emergency medical care. He
expressed concern that adequate emergency care may not be available
in this situation.
Dr. Jensen indicated he would "share that discomfort as well" if he
didn't have access to certain drugs used to treat adverse drug
reactions and other prescription drugs. He stated this would be a
question for the practitioner to determine.
Senator Olson questioned the reference to homeopath health care
providers in the sponsor's testimony on the bill.
Senator Seekins clarified if he did include homeopathic providers
in his testimony it was in error and that the intent is this bill
only apply to naturopaths.
Dr. Harmon relayed his education experience at the Bastyr
University in Seattle, Washington and his four and one-half years
of practicing naturopathic medicine in Anchorage. He asserted that
creating teams of health care providers is an important
accomplishment that provides significant benefits to patients. He
declared that he does not oppose medicine, but rather prefers
noninvasive treatment when possible and he informed that he serves
as a resource for other medical doctors on these matters. He
assured that the issue is allowing naturopaths to better serve
their patients, as opposed to expanding practices. He stated
naturopathy is a viable option for health care in rural areas
unless the provider is unable to dispense prescription medication,
such as those needed to treat hypertension. He commented that most
medical doctors are unaware of the level of education naturopaths
receive. He concluded that both naturopaths and medical doctors
have the ability to learn from each other, with Alaskans benefiting
from these collaborations.
Co-Chair Wilken noted the need to discuss self-regulation. He asked
that other concerns with this legislation be relayed to him.
Co-Chair Wilken ordered the bill HELD in committee.
SPONSOR SUBSTITUTE FOR SENATE BILL NO. 35
"An Act making appropriations for the operating and loan
program expenses of state government, for certain programs,
and to capitalize funds; making appropriations under art. IX,
sec. 17(c), Constitution of the State of Alaska, from the
constitutional budget reserve fund; and providing for an
effective date."
This was the second hearing for this bill in the Senate Finance
Committee.
Co-Chair Green moved for adoption of CS SS SB 35, 23-GS1002\X, as a
working document.
The committee substitute was ADOPTED as a working document without
objection.
Amendment #1: This amendment deletes, "described and in the amounts
and order of priority set out in the department's capital
improvement projects (FY 2005) major maintenance grant fund final
agency decision, dated March 16, 2004." from subsection (b) of
Section 4. DEPARTMENT OF EDUCATION AND EARLY DEVELOPMENT AND
UNIVERSITY OF ALASKA. on page 4, lines 28 - 30 and inserts new
language to read as follows.
(b) If, and only if, each of the appropriations made in
sec. 3(a), (b), (c), and (d) of this Act pass upon an
affirmative vote of at least three-fourths of the members of
each house of the legislature and subject to sec. 5 of this
Act, the sum of $7,400,000 is appropriated from the general
fund to the major maintenance grant fund (AS 14.11.007) for
payment as grants by the Department of Education and Early
Development to the school districts listed for the projects
described in the amounts set out:
SCHOOL DISTRICT PROJECT ALLOCATION
(1)Iditarod Area Blackwell School new $ 90,179
well, Anvik
(2)Copper River Glennallen Elementary 2,053,591
School exterior
upgrade
(3)Yukon-Koyukuk Nulato structural roof 812,850
repair
(4)Nenana City Nenana boiler replacement/ 373,737
heating system upgrade
(5)Alaska Gateway Tetlin School site civil 217,794
improvements
(6)Yukon-Koyukuk Allakaket renovate water/ 297,846
sewer facility
(7)Saint Mary's Elicavicuar Elementary 436,769
exterior upgrades
(8)Kake City Kake Elementary 354,626
ventilation system
upgrade
(9)Alaska Gateway Tetlin School building 855,840
improvements
(10)Iditarod Area David Lewis Memorial 176,525
School emergency
repairs and boiler
relocation, Grayling
(11)Iditarod Area Top of the Kuskokwim 170,030
School boiler
replacement, Nikolai
(12)Iditarod Area Innoko River School tank 242,091
farm pipeline and
remediation, Shageluk
(13)Iditarod Area Holy Cross School 174,205
vocational education
shop upgrade
(14)Yukon-Koyukuk Allakaket restroom 305,625
renovation
(15)Saint Mary's Andreafski High School 170,911
code upgrades
(16)Annette Island Annette Island schools 667,381
security/safety and
major maintenance
upgrades
Co-Chair Green moved for adoption.
Co-Chair Wilken objected for an explanation.
Co-Chair Green moved to amend the amendment to correct a spelling
error in subsection (10). The amended language reads, "David Louis
Memorial School"
Without objection the amendment was AMENDED.
There was no objection and the amended amendment was ADOPTED.
Co-Chair Wilken highlighted the changes included in the amendment
and the committee substitute. He noted the title change to include
"grants for costs of school major maintenance" and "appropriations
for facilities in the Bering Strait School District to provide for
bank stabilization at Shishmaref".
Co-Chair Wilken explained that Section 1 of the committee
substitute includes the provisions of the Governor's proposed FY 05
K-12 education budget and reflects a change in the per student
funding to $4,576. Section 2, Co-Chair Wilken informed, provides
funding for the University of Alaska as proposed by the Governor.
Co-Chair Wilken stated that language in Sections 3 and 4 of the
committee substitute allow access to the Constitutional Budget
Reserve Fund for FY 04 and FY 05 budgets. He pointed out that
Section 4 is comprised of four subsections, the first, subsection
(a), providing an increased appropriation of $82,530,000 million
for education, from the Governor's proposal. Subsection (b), he
continued, allocates funds for major maintenance grants. He noted
that Amendment #1 is included in this subsection and consists of 16
projects as prioritized by the Department of Education and Early
Development on March 16, 2004. He continued that subparagraph (c)
is a reappropriation of $450,000 for the school in Shishmaref,
which would be leveraged to garner a total of $1.6 million to
provide seawall protection for the school. He then stated that
subsection (d) appropriates $15.8 million to the University of
Alaska to fund the Public Employees Retirement System/Teachers
Retirement System [PERS/TRS] component, as well as represents "the
$10 million that currently resides in the capital budget.
Co-Chair Wilken then explained that Section 5 of the committee
substitute stipulates that the provisions of Sections 1 through 4
are contingent upon passage of an increased per student allocation
of at least $4,576.
AT EASE 11:35 AM / 11:36 AM
Co-Chair Wilken ordered the bill HELD in committee.
SFC 04 # 58, Side A 11:36 AM
Co-Chair Wilken concluded the meeting.
Senator Dyson provided an update on efforts to compile a proposed
committee substitute to SJR 3, a resolution providing for a
constitutional spending limit.
ADJOURNMENT
Co-Chair Gary Wilken adjourned the meeting at 11:36 AM
| Document Name | Date/Time | Subjects |
|---|