SB 107-NATUROPATHS  CHAIR DAVIS announced the consideration of SB 107. She asked Mr. Obermeyer to explain the changes in the proposed CS. 2:13:10 PM TOM OBERMEYER, Staff to Chair Davis, presented an overview of CSSB 107, labeled 25-LS0702, Version \L, an Act relating to naturopaths and to the practice of naturopathy, establishing an Alaska Naturopathic Board and providing for an effective date.{ He pointed out that the first section of the bill identified an addition to the boards under Title 08. Title 08.45, page 2, line 10 included the Alaska Naturopathic Board. A new section, 08.45.003, Section 3, created the board consisting of: seven members appointed by the Governor. Three members shall be naturopaths licensed under this chapter who have been engaged in the practice of naturopathic medicine in the state for at least five years immediately preceding appointment, at least one of whom lives outside the third judicial district. One member shall be a licensed pharmacist. One member shall be licensed physician. Two members shall be public members who, in addition to limitations imposed under AS 08.01.025, may not have a direct financial interest in the health care industry other than as a consumer of health care services. MR. OBERMEYER noted that this board was designated in that section with a chair and a secretary who would serve staggered terms of 3 years unless removed for cause; 4 members of the board would constitute a quorum for transaction of all business before the board. The Governor "may" consider licensed naturopaths who had been nominated by the Association of Naturopathic Physicians. On page 3, under 08.45.005 Duties of the board, it goes on to say: The board shall (1) establish a list of prescription drugs and medical devices that are consistent with naturopathic education and practice that may be prescribed and administered by a naturopath holding a prescription endorsement, and review the list of prescription drugs and medical devices annually and on request by the department; This board would review allegations of misconduct, approve naturopathic medical programs, adopt regulations necessary to implement this chapter and conduct hearings on charges of alleged violations. Section 4 reads: The board shall request the department issue a license to practice naturopathy to an applicant who provides proof satisfactory to the board that the applicant has received a degree from an accredited four-year college or university, has paid the applicable fees, So, the board replaced the department in Section 5. In Section 6, a new section was added as to the scope for diagnostic purposes. It also described the drug endorsement and, subject to (c) of that section, the endorsement to practice minor surgery. Beginning on page 4, line 27 it stipulated that: (c) Minor surgery may be performed by a naturopath licensed under this chapter only if the naturopath has submitted proof satisfactory to the board that the naturopath has completed at least 1,200 hours of training in minor surgery under the supervision of a licensed physician, physician's assistant, or nurse practitioner. The restrictions were on page 5, in the practice. They would be allowed to prescribe prescription drugs only as authorized under AS 08.45.056; could only engage in minor surgery as authorized under AS 08.45.045(b) and (c); and could not use general or spinal anesthetics. MR. OBERMEYER concluded that the whole point of this particular draft was to transfer responsibility from the naturopathic council they had set up, to a formal naturopathic board that would be responsible for all activities including licensing, discipline, and their current practices. 2:18:35 PM CHAIR DAVIS reiterated that this had gone from an advisory board to a complete board that could be appointed by the Governor. SENATOR ELTON referred to page 4, Section 5 of the new committee substitute and said he did not recall a provision for a temporary license in previous versions of the bill. MR. OBERMEYER agreed that he was correct. He thought this was something Leg Legal decided to do and was not sure as to the purpose. He conjectured that it might be issued if a person had applied for and was qualified to take the naturopathic exam and the board was satisfied that the applicant had paid the fees and met the requirements; but he was not sure. It appeared to give the board some type of leeway to issue temporary licenses. CHAIR DAVIS said she would like Jean Mischel to speak to that. 2:20:28 PM JEAN MISCHEL, Attorney at Law, Legislative Legal and Research Services Division, Legislative Affairs Agency, said she had not had a chance to review this bill and asked Chair Davis to give her a few moments to do so. She said this version was drafted by Alphaeus Bullard. SENATOR COWDERY asked if there was a definition for minor surgery. MR. OBERMEYER answered that minor surgery was defined on page 6, [Section 11, paragraph (5)] and means the use of "(i) operative, electrical, or other methods for surgical repair and care incidental to superficial lacerations and abrasions or superficial lesions and the removal of foreign bodies located in superficial tissues; and (ii) antiseptics and local anesthetics in connection with methods authorized under (i) of this subparagraph; (B) does not include use of general or spinal anesthetics, surgery of the body cavities, or specialized surgery, such as plastic surgery, surgery involving the eyes, or surgery involving tendons, ligaments, nerves, or blood vessels" 2:22:34 PM CHAIR DAVIS asked if anyone wished to provide testimony on the bill. 2:23:41 PM JENNIFER STRICKLER, Division Chief, Division of Corporations, Business and Professional Licensing, Department of Commerce, Community and Economic Development, clarified that establishing a regulatory board for 44 licensees was going to be very expensive for those licensees. All licensing boards under centralized licensing 08.01.065 were required to pay their full costs through licensing fees; so this could increase their licensing fees tremendously. CHAIR DAVIS said that they [the naturopaths] were aware of that and it was up to them to decide whether to have a board. MS. STRICKLER said that she had received word from their investigative unit suggesting that lines 8-9 in section 3 on page 3 be removed. If the board were to review allegations, complaints etc., and the complaint resulted in disciplinary action, the board would not be able to act as the final decision maker in the case because it could be argued that the board was tainted. Current statute 08.01.087 provided the department with authority to conduct investigations. MS. STRICKLER continued to page 3, lines 18-19, which the investigative unit also suggested be removed because the provision was already covered in existing 08.45.060, "Grounds for suspension, revocation, or refusal to issue a license," and under 08.45.070, "Disciplinary sanctions". MS. STRICKLER pointed out that the last sentence in Section 14, page 7, lines 21-22, "the board shall specify the term of office of each licensed naturopath and public member appointed subject to this section" might not be necessary because the terms of office were spelled out in the lines above that, under the transitional provisions. SENATOR ELTON said that on page 4, Section 5, the provision for a temporary license read, "the board shall request the department to issue a temporary license;" but the way he interpreted it was that the board "shall" request but the department need not offer a temporary license. He asked Ms. Strickler if his interpretation was correct. MS. STRICKLER answered yes, that was a possibility. She continued that in licensing, because the board collected and put together the application packets, the department would perform the initial screening. If the department felt the applicant could be licensed and there was no need for a temporary license, they would request approval of the board immediately rather than issue a temporary license. SENATOR ELTON assumed a temporary license might be needed if the board met infrequently perhaps. MS. STRICKLER responded that was correct, however they also asked boards to review credentials through the mail and tried not to hold up licensure if possible. 2:29:51 PM SENATOR THOMAS moved to adopt CS for SB 107, Version \L, as the working document. There being no objection the motion carried. SENATOR THOMAS noticed that the Alaska State Medical Association still objected to portions of the bill; in their letter of March 19, 2008 they said that naturopaths were not recognized by Medicare as providers eligible for payment. He questioned whether that was actually the case. MR. OBERMEYER replied that was true; but if they were granted privileges through this bill, they would probably apply for coverage for the additional procedures. CHAIR DAVIS said there was a procedure they would have to follow to be qualified to receive Medicare payments. She asked whether someone from the department would like to comment on that; but no one from Department of Health and Social Services (DHSS) was available. She agreed with the deletions suggested by Ms. Strickland and said she would like to pass the bill out of her committee. SENATOR DYSON asked whether a motion had been made to perform the deletions suggested by Ms. Strickler. CHAIR DAVIS said they had not done so, but Senator Dyson was welcome to make that motion. MS. STRICKLER restated her suggested changes: page 3, removal of lines 8 and 9; also on page 3, removal of lines 18 and 19; and page 7, removal of lines 21 and 22. 2:35:29 PM SENATOR DYSON moved the following conceptual amendment. On page 3, remove all the material in lines 8 and 9 and renumber appropriately; page 3, remove all the material in lines 18 and 19; page 7, remove everything on line 21 after "terms." And all of line 22. CHAIR DAVIS asked for any discussion or objection to the motion on the floor. There being no objection, the motion carried. SENATOR DYSON asked what next committee of referral would be. CHAIR DAVIS thought it would be Finance. SENATOR DYSON asked if there was a companion bill in House. CHAIR DAVIS said a bill mirroring this one was introduced on the House side a couple of weeks prior. 2:37:15 PM SENATOR THOMAS moved to report CSSB 107, Version \L, as amended by the HES committee, from the committee with individual recommendations and accompanying fiscal note. There being no objection, CSSB 107(HES) moved from committee.