CSSB 306(FIN) am: "An Act relating to the practice of naturopathic medicine; and providing for an effective date."

00 CS FOR SENATE BILL NO. 306(FIN) am 01 "An Act relating to the practice of naturopathic medicine; and providing for an effective 02 date." 03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 04 * Section 1. AS 08.01.010(26) is amended to read: 05 (26) regulation of the practice of naturopathic medicine 06 [NATUROPATHY] under AS 08.45; 07 * Sec. 2. AS 08.45.010 is amended to read: 08 Sec. 08.45.010. Practice of naturopathic medicine [NATUROPATHY] 09 without license prohibited. A person who does not hold a license issued under this 10 chapter may not 11 (1) practice naturopathic medicine [NATUROPATHY] in the state; 12 or 13 (2) use any of the following titles: "doctor of naturopathy," 14 "naturopath," or "naturopathic physician" [WITHOUT A LICENSE].

01 * Sec. 3. AS 08.45.020 is amended to read: 02 Sec. 08.45.020. Application for license. A person desiring to practice 03 naturopathic medicine [NATUROPATHY] shall apply in writing to the division of 04 occupational licensing of the Department of Community and Economic Development. 05 * Sec. 4. AS 08.45.030 is repealed and reenacted to read: 06 Sec. 08.45.030. Issuance of license. The division shall issue a license to 07 practice naturopathic medicine on receipt of 08 (1) an application on a form acceptable to the division; 09 (2) documentation satisfactory to the division that the applicant 10 (A) is a graduate of an approved naturopathic medical college 11 or program; and 12 (B) has passed the naturopathic physicians licensing 13 examination approved by the division with a score that meets the requirements 14 established in regulation; and 15 (3) all applicable fees. 16 * Sec. 5. AS 08.45.050 is repealed and reenacted to read: 17 Sec. 08.45.050. Restrictions on practice of naturopathic medicine. (a) A 18 person who practices naturopathic medicine may not engage in surgery except that a 19 person who practices naturopathic medicine may perform minor surgery under 20 AS 08.45.120(a)(6). 21 (b) Notwithstanding that a specific act is within the definition of "naturopathic 22 medicine" or is described as an activity authorized under AS 08.45.120, a person 23 licensed under this chapter may not perform the act if the person lacks appropriate 24 education or training related to the act. 25 * Sec. 6. AS 08.45.060 is amended to read: 26 Sec. 08.45.060. Grounds for suspension, revocation, or refusal to issue a 27 license. The division may deny a license to an applicant under this chapter or, 28 after a hearing, impose a disciplinary sanction authorized under AS 08.45.070 on a 29 person licensed under this chapter when the division finds that the applicant or 30 licensee 31 (1) secured, or attempted to secure, a license through deceit, fraud, or

01 intentional misrepresentation; 02 (2) engaged in deceit, fraud, or intentional misrepresentation in the 03 course of providing professional services or engaging in professional activities; 04 (3) advertised professional services in a false or misleading manner; 05 (4) has been convicted of a felony or other crime that affects the 06 applicant's or licensee's ability [TO CONTINUE] to practice competently and safely; 07 (5) failed to comply with this chapter, with a regulation adopted under 08 this chapter, or with an order of the division; 09 (6) is [CONTINUED TO PRACTICE AFTER BECOMING] unfit to 10 practice naturopathic medicine due to 11 (A) professional incompetence; 12 (B) addiction or severe dependency on alcohol or a drug that 13 impairs the applicant's or licensee's ability to practice safely; or 14 (C) physical or mental disability; or 15 (7) engaged in lewd or immoral conduct in connection with the 16 delivery of professional service to patients. 17 * Sec. 7. AS 08.45.070(a) is amended to read: 18 (a) When it finds that a licensee under this chapter has violated AS 08.45.050 19 or 08.45.120 [AS 08.45.040 - 08.45.050] or is guilty of an offense under 20 AS 08.45.060, the division may impose the following sanctions singly or in 21 combination: 22 (1) permanently revoke the license to practice; 23 (2) suspend the license for a determinate period of time; 24 (3) censure the licensee; 25 (4) issue a letter of reprimand to the licensee; 26 (5) place the licensee on probationary status and require the licensee to 27 (A) report regularly to the division upon matters involving the 28 basis of probation; 29 (B) limit practice to those areas prescribed; 30 (C) continue professional education until a satisfactory degree 31 of skill has been attained in areas determined by the division to need

01 improvement; 02 (6) impose limitations or conditions on the practice of the licensee. 03 * Sec. 8. AS 08.45.080 is amended to read: 04 Sec. 08.45.080. Unlicensed practice or use of title a misdemeanor. A 05 person who violates [PRACTICES NATUROPATHY IN THE STATE WITHOUT A 06 LICENSE IN VIOLATION OF] AS 08.45.010 is guilty of a misdemeanor and upon 07 conviction is punishable by a fine of not more than $1,000, or by imprisonment for not 08 more than a year, or by both. 09 * Sec. 9. AS 08.45.100 is amended by adding new subsections to read: 10 (b) After consideration of draft regulations, if any, prepared by the division in 11 collaboration with a qualified trade association of naturopathic physicians, the 12 department may adopt regulations to 13 (1) establish the standards the division will use to approve naturopathic 14 medical colleges or programs for satisfaction of the requirements of 15 AS 08.45.030(2)(A), 08.45.120(a)(4), 08.45.120(a)(6), and 08.45.120(a)(8); the 16 standards must require, at a minimum, that the college or program include a four-year, 17 full-time resident program of academic and clinical study of naturopathic medicine; 18 (2) implement the peer review process under (c) of this section; 19 (3) implement the continuing education requirement of AS 08.45.110; 20 and 21 (4) establish the standards under which the division may issue 22 certificates of specialty practice for a person licensed under this chapter. 23 (c) The division shall establish a naturopathic peer review committee 24 consisting of three members appointed annually from a list of nominees presented to 25 the division by an approved qualified trade association for naturopathic physicians. 26 The committee members serve without compensation for their work on the committee. 27 The committee shall meet to review complaints filed with the division under this 28 chapter. Attendance and participation at meetings of the committee may be by 29 teleconferencing or other two-way communication method. The committee shall 30 make written recommendations to the division as to whether grounds for disciplinary 31 action exist under AS 08.45.060 and as to appropriate disciplinary sanctions under

01 AS 08.45.070 in each case under review. If the division approves the 02 recommendations of the committee, the licensee may either accept the 03 recommendations of the committee or request a hearing before the division. 04 * Sec. 10. AS 08.45 is amended by adding new sections to read: 05 Sec. 08.45.110. Continuing education requirement. Before a license may 06 be renewed, the licensee shall document to the division's satisfaction that the licensee 07 has received at least 45 hours of continuing education in naturopathic medicine in the 08 previous two years, at least 15 hours of which was instruction in pharmacology or 09 pharmacotherapeutics presented by a licensed pharmacist or another professional 10 approved by the division. 11 Sec. 08.45.120. Authorized activities; use of titles. (a) A person licensed 12 under this chapter may 13 (1) prescribe or administer for preventive and therapeutic purposes the 14 following: food, extracts of food, vitamins, minerals, enzymes, whole gland 15 substances, botanical medicines, and homeopathic preparations; 16 (2) prescribe or administer intravenous botanicals, substances, 17 vitamins, and minerals; 18 (3) administer health care counseling, nutritional counseling and 19 dietary therapy, naturopathic physical applications, therapeutic devices, and 20 nonprescription drugs; 21 (4) if authorized under regulations of the department, prescribe 22 schedules IIIA, IVA, and VA controlled substances as described under AS 11.71.160, 23 11.71.170, and 11.71.180 if the person has 24 (A) registered with the federal Drug Enforcement 25 Administration; 26 (B) successfully completed pharmacology training from an 27 approved naturopathic medical college; and 28 (C) entered into a collaborative agreement as described under 29 AS 08.45.125 with a person or persons licensed to practice medicine under 30 AS 08.64; 31 (5) prescribe and implement barrier devices for contraception;

01 (6) perform minor surgery after providing proof satisfactory to the 02 division of successful completion of training in minor surgery from an approved 03 naturopathic medical college; 04 (7) perform or order for diagnostic purposes a physical or orificial 05 examination, ultrasound, phlebotomy, clinical laboratory test or examination, 06 physiological function test, and other diagnostic procedures commonly used by a 07 person licensed to practice medicine under AS 08.64.230(a); and 08 (8) if authorized under regulations of the department, prescribe legend 09 drugs or prescription drugs if the person has 10 (A) successfully completed pharmacology training from an 11 approved naturopathic medical college; and 12 (B) entered into a collaborative agreement as described under 13 AS 08.45.125 with a person or persons licensed to practice medicine under 14 AS 08.64; and 15 (9) use the title of "doctor of naturopathy," "naturopath," "naturopathic 16 physician," or their abbreviations. 17 (b) In this section, "legend drug" and "prescription drug" have the meanings 18 given in AS 08.80.480. 19 Sec. 08.45.125. Collaborative agreements for drugs. (a) A collaborative 20 agreement required under AS 08.45.120(a)(4) and (a)(8) must be in writing in a form 21 approved by the department and include 22 (1) a commitment of at least one collaborating physician who is 23 (A) licensed to practice medicine under AS 08.64; 24 (B) able to comply with the terms of the agreement; 25 (C) engaged in the active practice of medicine in the state; and 26 (D) committed to collaborate with not more than six licensees 27 under this section; 28 (2) a formulary of controlled substances and legend drugs or 29 prescription drugs that 30 (A) are authorized under AS 08.45.120(a)(4) and (a)(8) and 31 regulations adopted under that section that describes the standard protocols and

01 practices that must be used; 02 (B) are approved by the collaborating physician to be 03 prescribed or dispensed by the person licensed under this chapter; and 04 (C) include standard protocols and practices that describe the 05 circumstances under which each drug on the formulary may be prescribed or 06 dispensed, the extent of supervision required of the collaborating physician, if 07 any, and a periodic review of the licensee's competence and standard practices; 08 (3) a requirement that the licensee consult with and have a patient 09 protocol approved by a collaborating physician before prescribing a schedule IIIA 10 controlled substance for each patient; and 11 (4) a requirement that the licensee review the formulary, including the 12 standard practices under (2) of this subsection, with a collaborating physician before 13 executing a collaborative agreement, six months after executing the agreement, and 14 every 12 months thereafter. 15 (b) A collaborating physician licensed under AS 08.64 and a person licensed 16 to practice naturopathic medicine under this chapter are not liable for the actions or 17 inactions of the other as a result of a collaborative agreement entered into under this 18 section. 19 (c) The licensee shall post the name of the collaborating physician under (a) of 20 this section in a conspicuous location visible to patients of the licensee. 21 (d) Upon request, the licensee shall provide a copy of the standard practices 22 under (a)(2) of this section to a pharmacist licensed in the state. 23 (e) The licensee shall include the name of the collaborating physician under 24 (a) of this section on each prescription written under AS 08.45.120(a)(4) or (a)(8) by 25 the licensee. 26 Sec. 08.45.130. Fees. The division shall set fees under AS 08.01.065 for each 27 of the following: 28 (1) a license issued under this chapter; 29 (2) renewal of a license issued under this chapter. 30 * Sec. 11. AS 08.45.200(3) is amended to read: 31 (3) "naturopathic medicine" ["NATUROPATHY"] means the use of

01 hydrotherapy, dietetics, electrotherapy, sanitation, suggestion, mechanical and manual 02 manipulation for the stimulation of physiological and psychological action to establish 03 a normal condition of mind and body; in this paragraph, "dietetics" includes herbal 04 and homeopathic remedies. 05 * Sec. 12. AS 08.45.200 is amended by adding new paragraphs to read: 06 (4) "approved naturopathic medical college or program" means a 07 college or program that grants a degree of doctor of naturopathy or doctor of 08 naturopathic medicine and that 09 (A) is accredited by the Council on Naturopathic Medical 10 Education or another accrediting agency recognized by the United States 11 Department of Education; 12 (B) has the status of candidate for accreditation by an entity 13 described in (A) of this paragraph; or 14 (C) has been approved under a regulation adopted by the 15 department under this chapter; 16 (5) "department" means the Department of Community and Economic 17 Development; 18 (6) "minor surgery" 19 (A) means the use of 20 (i) operative, electrical, or other methods for surgical 21 repair and care incidental to superficial lacerations and abrasions or 22 superficial lesions, and the removal of foreign bodies located in 23 superficial tissues; and 24 (ii) antiseptics and local anesthetics in connection with 25 methods authorized under (i) of this subparagraph; 26 (B) does not include use of general or spinal anesthetics, major 27 surgery, surgery of the body cavities, or specialized surgery, such as plastic 28 surgery, surgery involving the eyes, or surgery involving tendons, ligaments, 29 nerves, or blood vessels. 30 * Sec. 13. AS 47.08.050 is amended to read: 31 Sec. 47.08.050. Services excluded from coverage. Annually, the committee

01 shall determine in light of appropriated funds and expected need the medical expenses 02 reimbursable under AS 47.08.010 - 47.08.140, except that the following are not 03 reimbursable: 04 (1) dentistry and optometry unless prescribed by a licensed dentist or 05 physician as medically necessary as the result of the injury or illness; 06 (2) elective medical or surgical procedures; 07 (3) drugs and medications not prescribed by a licensed physician; 08 (4) services received as a result of a pregnancy or birth without 09 unusual complications; 10 (5) private psychological or psychiatric treatment or private alcoholism 11 treatment, unless not available from public agencies or programs; 12 (6) chiropractic services and services provided by a person who 13 practices naturopathic medicine [NATUROPATHY]; 14 (7) services not of a medical nature; 15 (8) medical services currently provided to persons in the custody of the 16 Department of Corrections; 17 (9) costs incurred before July 1976. 18 * Sec. 14. AS 08.45.035 and 08.45.040 are repealed. 19 * Sec. 15. AS 08.45.120(a)(4)(C), 08.45.120(a)(8)(B), and 08.45.125, as enacted by sec. 10 20 of this Act, are repealed July 1, 2009. 21 * Sec. 16. The uncodified law of the State of Alaska is amended by adding a new section 22 to read: 23 LICENSE TO PRACTICE NATUROPATHY; TRANSITIONAL PROVISIONS. A 24 license to practice naturopathy issued under AS 08.45, including a temporary license, that is 25 in effect on February 28, 2005, remains in effect for the period for which the license was 26 issued and is considered to be a license to practice naturopathic medicine under AS 08.45, as 27 amended by this Act. However, a person who holds a license issued under AS 08.45 that is in 28 effect on February 28, 2005, is subject to the authority of the department in regard to acts of 29 the licensee that occurred on or before February 28, 2005, to impose a disciplinary sanction 30 under AS 08.45.070. 31 * Sec. 17. AS 08.45.110, as enacted by sec. 10 of this Act, takes effect January 1, 2007.

01 * Sec. 18. Except as provided in sec. 17 of this Act, this Act takes effect March 1, 2005.