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 committee. 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 relationship. 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 treating. 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.