Final
STAFF SUMMARY OF MEETING

HOUSE COMMITTEE ON HEALTH AND HUMAN SERVICES

Date:02/12/2009
ATTENDANCE
Time:01:31 PM to 07:04 PM
Acree
X
Gerou
X
Place:LSB A
Green
E
Kefalas
X
This Meeting was called to order by
Kerr J.
X
Representative Riesberg
McGihon
*
Nikkel
*
This Report was prepared by
Primavera
X
Kelly Stapleton
Swalm
*
Gagliardi
X
Riesberg
X
X = Present, E = Excused, A = Absent, * = Present after roll call
Bills Addressed: Action Taken:
HB09-1223
HB09-1175
Referred to the Committee of the Whole
Amended, Referred to Appropriations


01:31 PM -- House Bill 09-1223

Representative Marostica presented House Bill 09-1223 which extends the deadline for expending moneys for the Colorado Benefits Management System from the health care supplemental appropriations and overexpenditures account of the tobacco litigation supplement cash fund. Representative Marostica provided a fact sheet on the bill to the committee (Attachment A). Representative Marostica explained the history of the bill and the need to extend the deadline.

09HouseHHS0212AttachA.pdf


















BILL:HB09-1223
TIME: 01:37:20 PM
MOVED:Kerr J.
MOTION:Moved to refer House Bill 09-1223 to the Committee of the Whole. The motion passed on a 8-0 roll call vote.
SECONDED:Gagliardi
VOTE
Acree
Yes
Gerou
Yes
Green
Excused
Kefalas
Yes
Kerr J.
Yes
McGihon
Excused
Nikkel
Excused
Primavera
Yes
Swalm
Yes
Gagliardi
Yes
Riesberg
Yes
Final YES: 7 NO: 0 EXC: 3 ABS: 0 FINAL ACTION: PASS


01:38 PM

The committee took a brief recess.


01:44 PM -- House Bill 09-1175

The committee came back to order. Representative Riesberg provided an overview of the bill. He stated it defines educational requirements to be called a naturopathic doctor, and defines which modalities may be used by a naturopathic doctor. He stated that the bill establishes a task force which is directed to establish appropriate scope of power for naturopathic doctors, how complaints against naturopathic doctors are handled, and other issues discussed in the bill.

















BILL:HB09-1175
TIME: 01:46:49 PM
MOVED:Riesberg
MOTION:Moved to adopt prepared L.005 (Attachment B). Representative Curry explained the amendment stating that it exempts out any health care provider that is not a qualified naturopath as defined in the bill. She stated that this includes alternative health care providers. The motion passed without objection.

09HouseHHS0212AttachB.pdf
SECONDED:Kerr J.
VOTE
Acree
Gerou
Green
Excused
Kefalas
Kerr J.
McGihon
Nikkel
Primavera
Swalm
Gagliardi
Riesberg
Not Final YES: 0 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: Pass Without Objection


01:49 PM

Representative Riesberg stated that with the passage of amendment L.005, that the bill only pertains to those meeting the educational requirements as outlined in the bill and does not affect any individual not defined in the bill, specifically any individual who may refer to themselves as an alternative practitioner, or others that provide homeopathic remedies. He stated that the discussion of the bill will be contained to the amended bill.


01:50 PM

Representative Curry spoke to amended House Bill 09-1175. She provided some historical background regarding the regulation of naturopathic doctors.













01:57 PM --
Dr. Roanne Houck, naturopathic doctor, Colorado Association of Naturopathic Physicians, testified in support of the bill. Dr. Houck spoke to her qualifications. She provided a packet of information to the committee which included: the Department of Regulatory Agencies Sunrise Review of Naturopathic Physicians, a description of light therapy, and a fact sheet by the Colorado Association of Naturopathic Physicians (Attachment C).

09HouseHHS0212AttachC.pdf

02:05 PM --
Steven Rissman, naturopathic doctor, Metro State College Denver, testified in support of the bill. Dr. Rissman stated he has a degree from Bastyr College in Washington state. He stated that there are seven universities in the United States and Canada that have been accredited by the Council on Naturopathic Medical Education (CNME). He stated that CNME is the only accrediting agency for naturopathic educational programs and schools. He spoke to the qualifications required to graduate with a naturopathic degree from an accredited university. The committee asked several questions of Dr. Rissman.

02:13 PM --
Dr. Rena Bloom, naturopathic doctor, Colorado Association of Naturopathic Physicians, testified in support of the bill. Dr. Bloom spoke to the task force. She stated that practicing naturopathic medicine in Colorado is currently illegal under the Medical Practice Act. She stated that society has moved forward with regard to its approval of naturopathic remedies and the law needs to catch up. A handout regarding Brian O'Connell who was prosecuted for falsely practicing naturopathic medicine was provided to the committee (Attachment D).

09HouseHHS0212AttachD.pdf

02:26 PM --
Dr. Lynn Parry, Colorado Medical Society, testified in support of the bill. Dr. Parry stated that conventional physicians acknowledge that health care consumers in Colorado seek a variety of medical care. She stated that it is important to protect consumers. She stated that registering naturopathic physicians provides a level of care which protects consumers at the same time.

02:31 PM --
Dr. Mary Fairbanks, Colorado Academy of Family Physicians, testified in support of the bill. She stated that she supports the establishment of the task force. There was some discussion regarding terminology, specifically the use of the term doctor versus physician.

02:36 PM --
Dr. Karen Leamer, American Academy of Pediatrics, testified in support of the bill. She stated that bill limits treatment by naturopathic physicians, specifically that naturopathic physicians cannot treat children under the age of 2, and for children between the ages 2 and 8, there is a requirement that the parent acknowledges care by a naturopathic doctor. She stated that efforts to get every child a medical home are not compromised by the bill.














02:39 PM --
Health Isley, Executive Vice President, Natural Grocers by Vitamin Cottage, testified in support of the bill. She stated that her customers often ask for recommendations for a naturopathic doctor. She stated that Vitamin Cottage provides a list to consumers with recommendations of naturopathic doctors who have a degree from an accredited four year program. Ms. Isley spoke to the liability that her store takes on when they provide a recommendation to a health care provider that is not licensed. She spoke to the need to regulate the practice for the safety of her customers. She also mentioned that the desire to seek treatment or advice from alternative care givers is growing.

02:42 PM --
Steve Rosen, parent of naturopathic doctor, testified in support of the bill. He spoke to his daughter's educational experience that spanned approximately seven years.

02:46 PM --
Dr. Carl Lepisto, representing himself, testified in support of the bill. Dr. Lepisto spoke to the qualifications necessary to become a naturopathic physician. He stated that naturopaths are concerned with preventative care. He also spoke to the collaborative effort between medical physicians and naturopathic doctors. He stated that naturopathic medicine is here to stay.

02:51 PM --
Audress Johnson, patient of a naturopathic doctor, testified in support of the bill. She stated that she is an aerospace engineer. She stated that she does not want to loose access to her preferred health care professional. She stated that she supports the establishment of a task force. She commented that the need and desire for naturopathic doctors is not going away

02:55 PM --
Dr. Reiner Kremer, naturopathic doctor and medical physician, testified in support of the bill. He stated he is licensed as a naturopathic doctor in Arizona and works in a collaborative environment with both naturopathic and medical doctors. He stated he is concerned that there is no regulation on naturopathic practitioners. He asked the committee to think about whether the state should allow the continued practice of unlicensed medicine.
03:01 PM --
Brian Fuller, patient of a naturopathic physician, testified in support of the bill. He stated that he suffers from a specific metal poisoning disorder. He stated that one of the procedures which his wife gets is precluded under the current bill. He expressed his concern that even if naturopathic doctors were to be licensed that she would not be able to get the life saving procedure.

03:05 PM --
Don Howard, representing herself, testified in support of the bill. She stated that she has cerebral palsy which was caught early because her mother sought early intervention for her. As a result of her illness, she has rings in her esophagus which are required to be stretched by a medical doctor. She stressed that she sees both a naturopathic doctor and a medical doctor. She stated that choices are important.

03:08 PM --
Bernie Roland, representing his daughter, Hilary Roland who is a student at Bastyr University, Washington state. Mr. Roland read a letter from his daughter in support of the bill (Attachment E).

09HouseHHS0212AttachE.pdf












03:15 PM --
Rose McCool, Department of Regulatory Agencies, testified in support of the bill. Ms. McCool stated that the department has done two sunrise reviews of naturopathic physicians. In response to several concerns raised about alternative care providers, Ms. McCool clarified that if alternative care practitioner is reported to the department for alleged unlawful acts, the state medical board would review the complaint. Ms. McCool stated that this is the current practice, and even if the bill were to pass, it would remain the practice of the department. She clarified that alternative care practitioners are not covered under this bill. A fact sheet regarding the bill was provided to the committee (Attachment F).

09HouseHHS0212AttachF.pdf

03:37 PM --
Frances Wolpo, representing herself, testified in support of the bill. She stated that her daughter spent six years studying naturopathic medicine. She stated that her daughter is practicing in Oregon, which licenses naturopathic doctors. She stated that her daughter would like to come back to Colorado to practice but cannot because it is illegal.

03:41 PM --
Diana Jackson, representing self, testified in opposition to the bill. She stated she does not know the difference between licensure and a registry. She stated she is concerned with the scope of practice. She stated that she is opposed to the modalities described in the bill as well as the definition of naturopathy.

03:50 PM --
Larry Sarner, Quackwatch, testified in opposition to the bill. Mr. Sarner stated that he feels the bill addresses only a few handful of people. He was critical of the scope of the bill and the intention of the bill. He was concerned that the task force will be comprised of naturopathic physicians and will not act in a way that is objective.

04:05 PM --
Linda Rosa, National Council Against Health Fraud, testified in opposition to the bill. She stated she is opposition to any type of regulation of naturopathic doctors. Ms. Rosa stated that registering naturopaths will not protect consumers. She pointed out that the death of Sean Flannigan. Mr. Flannigan was a young man whose parents sought medical treatment from a man claiming to be a naturopathic doctor who could cure their sons terminal illness. She stated that the subsequent arrest of Brian O'Connell, the man who treated Mr. Flannigan, was prosecuted under current Colorado laws and was sent to prison. She stated she did not think the bill is consumer driven and that the task force will not be objective.

04:18 PM --
Steve Wills, Sunshine Health Freedom Foundation, spoke in opposition to the bill. He stated that the bill is not necessary for the people of Colorado. Representative Riesberg asked if the witness wanted to review amendment L.005 and then comment. He agreed.

04:21 PM --
Jody Coffey, Colorado Coalition for Natural Health, testified in opposition to the bill. She stated that she is concerned that alternative health care providers are not exempted out and that amendment L.005 is too vague. Representative Riesberg clarified that the bill does not address alternative care health care providers. He pointed to Ms. McCool's testimony which stated that these providers are operating outside of the scope approved by the Medical Practice Act. He reiterated that the bill does not change how alternative care providers are treated under Colorado law. Ms. Coffey stated that she is concerned with the definition and the scope of practice defined in the bill. She stated she has not gone to one of the accredited schools, but practices naturopathy.









04:27 PM --
Cindy Sherma, health care consumer, testified in opposition to the bill. She stated that she believes alternative health care providers will not be permitted to practice if the bill is passed. She stated that she would like to see a Health Care Freedom Act passed so that all health care providers may practice freely.

04:29 PM --
Kimberly Sharples, Colorado Coalition for National Health, testified in opposition to the bill.

04:31 PM --
Lynn Vaughen, consumer and herbalist, asked the committee if she considers herself a traditional naturopathic practitioner if she can still practice. Representative Riesberg stated that the bill addresses naturopathic doctors as defined in the bill.

04:34 PM --
Steve Wills, Sunshine Health Freedom Foundation, stated that he reviewed amendment L.005 and has concerns that it still presents a problem for alternative care providers. He also stated that the inclusion of amendment L.005 presents a conflict with other parts of the bill. He stated he does not agree that a handful of selected naturopaths who have attended a specific school should be able to practice legally. He stated that he thinks the bill is exclusionary. There was some discussion regarding whether the bill will exclude traditional naturopaths.

04:55 PM --
Patricia Danzing, Freedom of Choice, testified in opposition to the bill. She stated she is concerned about the definition of a naturopathic doctor and the description of the modalitities in the bill.

05:00 PM --
Kim Green, Colorado Citizens for Health Freedom, spoke in opposition to the bill. She provided a handout to the committee regarding the bill (Attachment G). She spoke to several schools that provide comparable education that an accredited naturopathic university offers. She stated that she feels that the Department of Regulatory Agencies has defined the scope of practice and it is exclusionary to others that practice naturopathic modalities.

09HouseHHS0212AttachG.pdf

05:16 PM --
Sheryl Stron, representing Colorado Coalition of Natural Health, testified against the bill. She shared her educational experience in naturopathy. She stated that the bill is limiting. She stated that in order to have equity in the field of naturopathy, the various stakeholders need to be called to the table, and the task force needs to be more inclusive of the various groups.

05:38 PM --
Ann Johnson, representing herself, spoke in opposition to the bill. She asked the committee not to take away her God given right to practice naturopathic medicine.

05:44 PM --
Linda Summers, representing herself, spoke in opposition to the bill. She stated that she supports the Health Freedom Act. She pointed out that physicians are in decline and feel overworked. She stated that she does not think there should be more laws saying who can and cannot help the sick.

05:50 PM --
Kim Mateo, Sunshine Health Freedom Foundation, spoke in opposition to the bill. She stated that the bill allows individuals who have gone to a special school to be levitated to a special status. She stated that the bill is exclusionary and allows for a monopoly for those individuals.










05:59 PM --
Boyd Landry, Executive Director, Coalition for Natural Health, spoke in opposition to the bill. He stated there may be a difference of legal opinion with regards to amendment L.005. He stated that a judge could strike that language in the amendment. He asked the committee to think about the how registering 90 people will protect consumers. He pointed out that the bill is too narrow. Mr. Landry made a suggestion that the task force meet before the registry goes into effect. He stated that more discussion needs to happen with regard to definition and scope of practice. Mr. Landry stated that the registration fee is exuberant. He concluded by saying that he does not think the bill is ready.

06:10 PM --
Michelle Hastings, representing herself, testified in opposition to the bill. She stated that she does not think the public gets anything out of the bill.
She stated that as a consumer, she wants choice.

06:14 PM --
Suzanne Weber, representing self, spoke in opposition to the bill.

06:20 PM --
Thomas Morris, Office of Legal Services, spoke to amendment L.005 (Attachment B).

06:22 PM --
Rose McCool, Department of Regulatory Agencies, responded to committee questions.


06:34 PM

Representative Curry provided a wrap-up to the bill. She stated that the Department of Regulatory Agencies would have preferred to go further establishing a licensing program, but there was not consensus on the bill. Representative Curry stated that she believes that the consumer wants to know the qualifications of their health care provider and this bill helps to get there.
BILL:HB09-1175
TIME: 06:44:26 PM
MOVED:McGihon
MOTION:Moved to adopt prepared amendment L.002 (Attachment H). Representative Curry explained the amendment. The motion passed without objection.

09HouseHHS0212AttachH.pdf
SECONDED:Gagliardi
VOTE
Acree
Gerou
Green
Excused
Kefalas
Kerr J.
McGihon
Nikkel
Primavera
Swalm
Gagliardi
Riesberg
Not Final YES: 0 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: Pass Without Objection
BILL:HB09-1175
TIME: 06:47:11 PM
MOVED:McGihon
MOTION:Moved to adopt prepared amendment L.003 (Attachment I). Representative Curry explained the amendment. The motion passed without objection.

09HouseHHS0212AttachI.pdf
SECONDED:Gagliardi
VOTE
Acree
Gerou
Green
Excused
Kefalas
Kerr J.
McGihon
Nikkel
Primavera
Swalm
Gagliardi
Riesberg
Not Final YES: 0 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: TIE


06:51 PM

Members of the committee made comments to the bill.























BILL:HB09-1175
TIME: 06:52:26 PM
MOVED:McGihon
MOTION:Moved to refer amended House Bill 09-1175 to the Committee on Appropriations. The motion passed on a 6-4 roll call vote.
SECONDED:Gagliardi
VOTE
Acree
No
Gerou
Yes
Green
Excused
Kefalas
Yes
Kerr J.
No
McGihon
Yes
Nikkel
No
Primavera
Yes
Swalm
No
Gagliardi
Yes
Riesberg
Yes
Final YES: 6 NO: 4 EXC: 1 ABS: 0 FINAL ACTION: PASS


07:04 PM

The committee adjourned.