Date: 02/05/2015

Final
BILL SUMMARY for HB15-1075

HOUSE COMMITTEE ON HEALTH, INSURANCE, & ENVIRONMENT

Votes: View--> Action Taken:
Adopt amendment L.001 (Attachment G). The motion p
Adopt amendment L.002 (Attachment J). The motion f
Adopt amendment L.003 (Attachment K). The motion f
Refer House Bill 15-1075, as amended, to the Commi		Pass Without Objection
FAIL
FAIL
PASS



04:08 PM -- HB 15-1075

The committee came back to order. Representative Ginal presented House Bill 15-1075. The bill allows registered naturopathic doctors to treat children under two years of age if certain conditions are met. The conditions outlined in the bill are the same as those under current law for naturopathic doctors who treat children between the ages of two and eight. Specifically, in order to treat a child under the age of two, the bill requires naturopathic doctors to:

• provide the child's parent with the current recommended immunization schedule for children;
• complete 3 hours per year in education or training in pediatrics in any year that he or she treats children under the age of two;
• require the child's parent to sign an informed consent form prior to providing services; and
• refer a child to a licensed physician at his or her first visit if the child does not have a pediatric health care provider.

The informed consent form must inform the parent about the naturopathic doctor's registration under the Naturopathic Doctor Act, state that he or she is not a licensed physician, recommend that the child maintain a relationship with a licensed physician, and request permission to collaborate with the child's pediatric health care provider. An informational packet was distributed to the committee (Attachment F).

150205 AttachF.pdf150205 AttachF.pdf

04:16 PM

Representative Ginal responded to questions about the continuing medical education requirements for naturopathic doctors outlined in the bill. She distributed amendment L.001 (Attachment G). She responded to questions about the medical liability insurance requirements for naturopathic doctors. The committee dialogued with Representative Ginal about the bill.

150205 AttachG.pdf150205 AttachG.pdf

04:23 PM -- Dr. Mark Cooper, Colorado Association of Naturopathic Doctors, spoke in favor of the bill. He discussed the current training requirements for naturopathic doctors. Dr. Cooper answered questions from the committee regarding the scope of practice and regulation of naturopathic doctors. He discussed the importance of referrals and the types of treatments he can provide to patients. Dr. Cooper answered questions from the committee regarding immunization of infants and the training requirements outlined in amendment L.001. He spoke on insurance reimbursements related to naturopathic doctors.

04:35 PM

Representative Ginal spoke on other states that have licensed or registered naturopathic doctors. Dr. Cooper answered questions about naturopathic doctors in Montana. The committee dialogued with Dr. Cooper about vaccination rates in states that license naturopathic doctors. Dr. Cooper answered questions about over-the-counter supplements and herbal treatments. He provided a handout to the committee (Attachment H).

150205 AttachH.pdf150205 AttachH.pdf

04:44 PM -- Ronne Hines, Department of Regulatory Agencies, stated that the department is neutral on the bill. She responded to questions about the complaints the department has received about naturopathic doctors and the continuing education requirements outlined in the bill. Ms. Hines responded to questions about investigations of herbal supplements.

04:48 PM -- Dr. Jody Shevins, Colorado Association of Naturopathic Doctors, testified in support of the bill. She discussed her experience becoming a naturopathic doctor, the recent measles outbreak and vaccinations, and collaborating with medical physicians.

04:55 PM

Representative Ginal relayed statistics on vaccinations rates in other states and Colorado.

04:56 PM -- Larry Sarner, Advocates for Children in Therapy, testified in opposition to the bill. He discussed his organization that was formed after the death of a child receiving attachment therapy. He discussed vaccination rates of children treated by naturopathic doctors. Mr. Sarner answered questions about the treatment he referenced during his testimony.

05:03 PM -- Maureen Maker, Colorado Citizens for Science in Medicine, testified in opposition to the bill. She discussed vaccination rates of children treated by naturopathic doctors and the role of the Department of Regulatory Agencies in regulating naturopathic doctors. Ms. Maker responded to question about vaccination practices of naturopathic doctors and the requirements of the bill related to the immunization schedule. The committee continued to dialogue with Ms. Maker about the treatment of children by naturopathic doctors and childhood immunizations.

05:16 PM -- Linda Rosa, Institute for Science in Medicine, testified in opposition to the bill. She discussed naturopathic doctors' practices concerning immunizations and treating children. Ms. Rosa responded to questions about naturopathic doctors treatments for children.

05:28 PM -- Dr. Christina Suh, Children's Hospital Colorado, testified in opposition to the bill. She provided a handout to the committee (Attachment I). She discussed her concerns about naturopathic doctors treating infants and toddlers. Dr. Suh responded to questions about parents who prefer to have their children treated by naturopathic doctors. She responded to questions about the continuing medical education requirements for pediatricians, potential amendments to the bill, and whether she would refer a parent of a young child to a naturopathic doctor. She responded to questions about residency requirement for various medical professionals and whether those professionals are banned from seeing patients under two years of age. Dr. Suh responded to questions about the position of the Colorado Medical Society on the bill.

150205 AttachI.pdf150205 AttachI.pdf

05:44 PM

Representative Ginal discussed the ability of chiropractors to treat children under two years old. Dr. Suh discussed one of her infant patients who was seen by a chiropractor and had negative results.

05:47 PM -- Alan Lewis, representing himself, testified in support of the bill. He discussed his daughter's personal experience with a pediatrician that resulted in needing to be admitted to the intensive care unit.

05:51 PM -- Janet Opila-Lehman, Colorado Association of Naturopathic Doctors, testified in support of the bill. She discussed vaccinations for children and the training of naturopathic doctors in infant nutritional care. She stated that naturopathic doctors provide safety net care for children whose families refuse to see pediatricians. Ms. Opila-Lehman responded to questions about possibly increasing the continuing medical education requirements in the bill.

05:56 PM -- Donna Walter, Colorado Association of Naturopathic Medicine, testified on the bill. She discussed House Bill 13-1111, concerning the regulation of naturopathic doctors, and Senate Bill 13-215, concerning alternative health care practitioners, that were enacted in 2013. She discussed allowing alternative health practitioners the ability to treat children under two years of age. Ms. Walter answered questions about her educational background and her credentials in naturopathy. She responded to questions about whether the bill provides more or less parental choice.

06:10 PM -- Nate Gorman, Sunshine Health Freedom Foundation, testified on the bill in a neutral capacity. He discussed Senate Bill 13-215 and the prohibition of alternative health practitioners from treating children under two years of age.

06:16 PM -- Zach Zaslow, Children's Hospital Colorado, testified in opposition to the bill. He discussed the ability of certain health care providers to treat children aged zero to two years old. He stated support of a potential amendment to require a referral by a physician prior to a naturopathic doctor treating a child under two years of age. Mr. Zaslow responded to questions about how likely a physician would be to refer a patient to a naturopathic doctor.

06:23 PM -- Dr. Caitlin O'Connor, Colorado Association of Naturopathic Doctors, testified in support of the bill. She discussed consumer choice, consumer safety, and collaboration. She relayed information about other states that license naturopathic doctors. Dr. O'Connor referenced a letter in the informational packet provided to the committee (Attachment F). In response to questions, Dr. O'Connor discussed the types of treatments and herbs that might be prescribed for infants and young children by a naturopathic doctor, if it was permitted. Dr. O'Connor answered questions about the malpractice insurance requirements for naturopathic doctors and the collaborative relationships between physicians and naturopathic doctors. In response to a question, she discussed the scope of practice of naturopathic doctors.


06:42 PM

Representative Ginal answered questions about amendment L.001. The committee discussed the amendment.
BILL:HB15-1075
TIME: 06:43:48 PM
MOVED:Ginal
MOTION:Adopt amendment L.001 (Attachment G). The motion passed without objection.
SECONDED:Ransom
VOTE
Brown
Esgar
Humphrey
Joshi
Klingenschmitt
Landgraf
Lontine
Mitsch Bush
Primavera
Ransom
Ryden
Ginal
McCann
YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


06:45 PM

Representative Ryden explained amendment L.002 (Attachment J) and referenced a letter from the American Academy of Pediatricians that was in the informational packet (Attachment F) that was distributed to the committee. Representative Ginal commented on the amendment. Committee discussion about the amendment ensued. Christy Chase, Office of Legislative Legal Services, responded to questions about the Michael Skolnik Medical Transparency Act and amendment L.002.

150205 AttachJ.pdf150205 AttachJ.pdf
BILL:HB15-1075
TIME: 07:02:56 PM
MOVED:Ryden
MOTION:Adopt amendment L.002 (Attachment J). The motion failed on a vote of 5-8.
SECONDED:Primavera
VOTE
Brown
No
Esgar
No
Humphrey
No
Joshi
Yes
Klingenschmitt
No
Landgraf
No
Lontine
Yes
Mitsch Bush
Yes
Primavera
Yes
Ransom
No
Ryden
Yes
Ginal
No
McCann
No
YES: 5 NO: 8 EXC: 0 ABS: 0 FINAL ACTION: FAIL


07:05 PM

Representative Joshi explained amendment L.003 (Attachment K). Committee discussion about the amendment ensued. Representative Ginal commented on the amendment.

150205 AttachK.pdf150205 AttachK.pdf
BILL:HB15-1075
TIME: 07:12:01 PM
MOVED:Joshi
MOTION:Adopt amendment L.003 (Attachment K). The motion failed on a vote of 6-7.
SECONDED:Landgraf
VOTE
Brown
No
Esgar
Yes
Humphrey
No
Joshi
Yes
Klingenschmitt
No
Landgraf
Yes
Lontine
Yes
Mitsch Bush
Yes
Primavera
No
Ransom
No
Ryden
Yes
Ginal
No
McCann
No
YES: 6 NO: 7 EXC: 0 ABS: 0 FINAL ACTION: FAIL


07:15 PM

Representative Ginal made closing remarks about the bill and answered questions about the bill.
BILL:HB15-1075
TIME: 07:18:56 PM
MOVED:Ginal
MOTION:Refer House Bill 15-1075, as amended, to the Committee of the Whole. The motion passed on a vote of 9-4.
SECONDED:McCann
VOTE
Brown
Yes
Esgar
Yes
Humphrey
Yes
Joshi
No
Klingenschmitt
Yes
Landgraf
Yes
Lontine
No
Mitsch Bush
No
Primavera
Yes
Ransom
Yes
Ryden
No
Ginal
Yes
McCann
Yes
Final YES: 9 NO: 4 EXC: 0 ABS: 0 FINAL ACTION: PASS




07:20 PM

Representative Primavera, on behalf of Representative McCann, announced that the committee would not meet on Tuesday, February 10. The committee adjourned.