H.B. 277 Traditional Healing Amendments: transcript

Floor is yours. Thank you so much, uh, Mr. Chair esteem. Senator Ipson, want to invite you real quick, take a trip in a time machine with me. Back to your childhood may be a time when you fell off your bike, skinned your knee, uh, maybe you had a tummy ache, maybe you just weren't feeling good. Uh, you wanted to stay home from school. You know, the way our families react to those situations, as long as they're not a a real medical emergency, I'm willing to bet that, um, your caretakers, whether it was your parents or grandparents, probably Uintah some kind of a, maybe a, a family remedy or a tradition. Uh, maybe it was grandma's chicken soup that helped you feel better. Maybe it was a dandelion tea from some leaves, you know, that you picked out in the yard. Maybe it was a, a massage. Maybe it was consecrated oil and a prayer or a visit to a local community elder, or, uh, a religious leader. House Bill 2 77 is about respect. It's about clarity and access to the cultural wellness practices that have served our indigenous communities for generations. This bill simply clarifies that individuals who provide traditional healing services are not required to obtain a state license when they're practicing within that traditional scope of those services. Uh, in my discussions with Dopel, um, it was apparent that while our law currently does actually define traditional healing provider and traditional health services, uh, there was still a gray area around licensure, uh, in this area. And so this bill clarifies that traditional healing providers do not need to be licensed to practice within the scope of those specific traditional health services. It doesn't replace or discourage clinical medicine, nor does it interfere with existing, uh, licensed healthcare professions. The exemption only applies to traditional providers who are conducting traditional services. Uh, within that scope, it does not authorize, uh, any new, uh, diagnoses powers. It doesn't authorize, um, you know, traditional health practitioners to really do anything, uh, that a licensed me, uh, that licensed medical care, uh, would, uh, entail. And that includes prescribing prescription medication controlled substances, or anything like that. Uh, and you might ask, okay, well, if we are then exempting, um, certain healing providers from licensure, how might this bill impact patient safety? Uh, what safeguards exist to prevent any of us from claiming, uh, that we are, you know, a traditional healer? Uh, in fact, the bill doesn't remove any patient protections. All the existing laws related to fraud related to negligence, abuse, coercion, or anything like that remain, uh, fully enforceable. Uh, and the bill also serve safeguards the public, uh, by relying on definitions developed in consultation, uh, with dapo and with indigenous communities to ensure that, uh, to ensure that legitimacy and prevent the misuse of this exemption. Um, I've invited, uh, professor Yvette Romero to be here with me today and to briefly add further insight to this.

You. Good afternoon, members of the committee. Uh, thank you for the opportunity to speak today. My name is Yvette Romero Coronado. I'm the daughter of migrants of from Mexico, and the descendant of grandparents and elders who care deeply about the topic at hand. I'm also a licensed clinical social worker and a professor of social work at the University of Utah. However, today I'm addressing you on my own behalf, not on behalf of my employer. I'm speaking in support of this bill and would like to share some personal and professional experiences that illustrate the need for it. First, I'll speak to it on a personal level. Since I can remember my grandmothers and mother will have practiced various aspects of traditional medicine, some of which I still practice for myself and for my loved ones today. Growing up, I remember arriving home from school, overwhelmed sometimes in a bad mood, maybe often in a bad mood, and often low energy. After a day of learning and playing, my loving elders would see this overwhelm on my face and greet me with something that's called a head hold. I don't know if you're familiar with it, but it involves literally just like holding the head on the temples and then front and back. And my elders would shake off their hands in case they absorbed any of my negative energy. Um, and that practice would immediately calm my nervous system and make me feel better. Other times I would look, it would look like a cleansing with the room temperature, egg that would travel the length of my body while my elders offered prayers for health and healing as the egg drew out negative energies or the evil eye. If you're familiar with that, I lost my grandmother 24 years ago. So as of late, I've had to lean on others' grandparents to share that knowledge in medicine with me. Most recently, I visited a trusted traditional medicine practitioner in the community for a cleansing. While I was waiting for the treatment, my practitioner asked me to wait a little longer as he had become aware of a police officer standing outside of his home. In that moment, none of us knew whether it was safe to reveal to the officer if he were to ask us what was happening. He didn't know if it was legal for him to give me a cleansing. And I didn't know if it was legal for me to seek that treatment. I just knew it was what I needed and what my elder said I should do In a moment like that, a few moments later, um, you know, the officer, the officer left, we're not sure what he was, what he was doing there, but he was able to continue with his treatment, which was very timely because we were both feeling a little anxious about that. Second, I'd like to address the need for this bill on a professional level. When I meet with clients for mental health services, we start with the biocycle social spiritual assessment to understand their lived experience and presenting needs. It's customary to ask questions about prior mental health treatment and physical health, including medical care. It is not however customary to ask about engagement with traditional medicine practitioners, nor is it customary for clients to disclose such information voluntarily. Because of my lived experience and training, I like to ask my clients about interactions with traditional medicine practitioners and the practice, the individual practice of that knowledge in those technologies. I've had clients respond to those questions with hesitation. They worry that about what I'm gonna do with that information, and if I'm going to think that it's bad or woo woo or, uh, which craft, which I don't. Um, when I, when it's shared with me, I reassure them that my intention is to gain a holistic understanding of how they access care and to, and support so that I can provide client responsive, care aligned and care aligned with their values and cultures. Now, I would like to close by speaking to it at the intersection of the personal and professional. My elders and I continue to seek out these traditional medicine practitioners regularly. And like my clients, we at times feel reluctant or scared to tear, to tell our primary care providers when we see them because we don't want our traditional medicine practitioners to get in trouble. This bill would say to my family, to me and my clients, it's legal and okay to seek services. And it would say to our trusted elders and practitioners that it's legal and okay to provide those culturally aligned services. Traditional medicine practitioners are carriers of important knowledge and are cherished members of our community. By passing this bill, we remove a barrier to accessing care. We create an environment where integrative care is possible, and we support the community's self-determination to seek the care that they see fit. Thank you for your consideration and time. Thank you. Committee. Um, with that, uh, we conclude the presentation of House Bill 2 77 and are open to questions.

Good afternoon. Um, my name is Matt Post. I serve as the executive director of the Urban Indian Center of Salt Lake. So we are a federally qualified health center and nonprofit that has been in the Salt Lake area for the last 52 years. And we strictly serve America Indian Alaskan Natives. So this, this bill is important. Uh, we have been offering traditional services at our center for a very long time, including currently. So what we do, it's not one aspect, it's a whole person. It's mind, body, spirit. And so traditional healing is one aspect of the healing process. And through that it's carried down through traditions. It, it's cultural preservation, and we find better results through it. So we do it through traditional plants, whether that be smudging, our traditional ceremonies. We also do that through our, our sweat lodge. So we hold those weekly, and those can be for various tribes and various genders. And really it's focused on recovery and what's best for the person. So I just wanna come out in support of it. We are an extension of Indian Health Services as well. And this is, and there are many states now that are, are, are focusing on traditional healing and its support for the healing process. So thank you.

Um, so I, I guess I'm trying to figure out where this is, uh, exactly coming from. Has Dopel been investigating? Has there been a discipline issue or, or has any tribal or indigenous healers been under investigation?

Not at all. So it's actually the opposite. It's the fact that, um, this is something that is being safely, uh, and traditionally practiced, uh, in many other areas. In fact, other states, neighboring states like New Mexico, uh, Hawaii, Alaska, for example. Uh, so this just, um, establishes and clarifies in our statute, uh, where licensed medical professional, uh, licensure exists and where it does not, and where this, uh, firmly lies within the purview of indigenous communities, including tribal health, Indian health as was mentioned earlier, uh, that that should lie with them and not with the state licensing.

So I guess that's, I guess that's why I'm asking that question. If there's been no issue and there there've been able to function with no pushback from the state, are we, I mean, I'm, I don't wanna plant weeds just to pull them. Sure. And, and so I'm, I'm, I I don't, I don't see the necessity of this. In fact, I think that it might cause more problems than it's, than you're solving. But

Yeah, if there's anyone in the room or online from Dapo, uh, they would have the, um, a better answer. But I can speak on behalf of that. Uh, this has been fully vetted by Dapo and in fact, uh, they have a very favorable, um, recommendation for this because, uh, it just clarifies what's in code now. Um, excuse me, that gray area that's in code now.

I'm an assistant director at Doppel.

So I guess just maybe a little more clarity as to the question I just asked. I'm trying to figure out why, why this is necessary. Is there, has there been issues, has there been complaints at Dole?

We haven't had complaints and issues as the representative said, from the side of the traditional healers. We have had instances where people have tried to administer illicit substances to others, and we've been able to draw a pretty firm line. But we do appreciate that we, there's probably been some chilling of the traditional, legitimate, traditional healing practices and we wanted to allow and honor that. So that we did worry about That was a good metaphor. We don't wanna plant weeds just to pull them. And so we did work with the representative to give us rule writing authority in there so we can dial in in a little bit more if we need to. But we actually, um, you know, Doppel is neutral on the bills, but we are comfortable with the bill.

I was gonna make a motion, but I think Senator Wiley beat me to it if he wants to. Maybe. It doesn't

I am. You can't get rid of me that easy. Good for that. Um, Yeah, I'd like to, yeah. I really, I actually really, really like this bill. I think it's important that we, um, honor our, our Native American heritage and other traditions and faith. And so I, I would like to make the motion to favorably recommend the bill to the body of the Senate.

The policy is a positive step, uh, in the right direction to ensure that all Utahans have the ability to safely access, uh, the wellness care that reflects their traditions and beliefs. Uh, the measure as mentioned, uh, supported by the council, uh, actually the council delegates of the government of the Navajo Nation, as well as the Urban Indian Center, the Utah Pacific Islander Health Coalition, uh, and various other, uh, indigenous communities throughout the state. And I, I appreciate the motion and the support. Thank you.

Uh, I'll waive. Thank you.

HB 2 77, traditional Healing Amendments Representative Fat. Thank you, Madam Chair. Um, if it pleases the committee, I will be speaking to the substitute on this as well. Um, you know, all of our families and communities have unique and effective, traditional, uh, healthcare practices, healing practices, healing beliefs that have sustained us, uh, our health and our wellness, uh, for centuries. And the bill before you, for your consideration, is a prudent approach, uh, to preserving our indivi individual freedoms to seek healing services that are appropriate for ourselves and for our families. So what this pros proposed measure would do, uh, is simply clarify that traditional healing providers, uh, do not need to be licensed by the state to serve people in their communities, whether those be tribal communities or indigenous communities in the state. Um, the scope of traditional healing providers and the parameters of traditional healing services are already defined in our state code. And this bill does not in any way seek to expand the existing scope, uh, of these services or the roles or services that these providers can provide. Um, but the bill places traditional healing services where they belong within tribal governments and within indi indigenous communities, rather than the state government. And with that introduction, uh, I'd like to ask associate Professor Yvette Romero, uh, to expand on the topic for us as well.

Have to push the button. It's already on. You're good. Thank you. Good afternoon, members of the committee and Chairwoman Hall. Uh, thank you for the opportunity to speak today. My name is Yvette Romero Coronado. I'm the daughter of migrants from Mexico, and the descendant of grandparents and elders who care deeply about this topic. I'm also a licensed clinical social worker and a professor of social work at the University of Utah. And today am I'm addressing you on my own behalf and not on behalf of my employer. Um, I'm speaking in support of this bill and would like to share some personal and professional experiences that illustrate the need for it. First, I'll speak to it on a personal level. Since I can remember. My grandmothers and my mother have practiced various aspects of traditional medicine, some of which I still practice today myself, um, and for my loved ones growing up, I remember arriving home from school, overwhelmed sometimes in a bad mood, um, and often low energy. After a day of learning and playing, my loving elders would see this overwhelm and grip me with something that's called the head hold. And I don't know if you're familiar with them, but it's this very simple applying of the pressure on the head, like temples back in front of the head. And after my elders would do that, they would shake off their hands to release whatever energy they had absorbed from my body, to give you an example. And that practice would immediately calm my nervous system and make me feel better. Other times, it would look like a cleansing with the room temperature, egg that would travel the length of my body while my elders offered prayers for health and healing as the egg drew out negative energies or the evil eye. If you're familiar with that phenomenon, I lost my grandmother 24 years ago. So as of late, I've had to lean on others' grandparents to share that knowledge and medicine with me. Most recently, I visited a trusted traditional medicine practitioner in the community for a cleansing. While I was waiting for the treatment, my practitioner asked me to wait a little longer as he had become aware of a police officer outside of his home. In that moment, none of us knew whether it was safe to reveal to the officer what was happening. He didn't know if it was legal for him to give me a cleansing, and I didn't know if it was legal for me to seek out the treatment. I just knew it was what I needed and what my elders said I should do in a time of need. A few moments after we looked at each other, um, with worry, the officer left and the practitioner provided the treatment, which was very helpful in that moment. Second, I'd like to address the need for this bill on a professional level. When I meet with clients for mental health services, we start with the biocycle spiritual assessment to understand their lived experiences and presenting needs. It's customary to ask questions about prior mental health treatment and physical health, including medical care, but it is not customary to ask them about engagement with traditional medicine practitioners, nor is it customary for clients to disclose such information voluntarily. Because of my lived experience and training, I like to ask my clients, um, about interactions with traditional medicine practitioners and the individual practice of that knowledge and those technologies. I've had clients respond to those questions with hesitation because they worry that I'm going to think that it's bad or that it's woo woo, or that it's witchcraft. Um, in addition to anxieties about not knowing what I'm gonna do with that information, when it's shared with me, I reassure them that my intention is to gain a holistic understanding of how they access, care and support. So I can provide client responsive care aligned with their values and their cultures. Now, I'd like to close by speaking to the intersection of the personal and professional here for me. My elders and I continue to seek out these traditional medicine practitioners regularly. And like my clients, we at times feel reluctant to sh to or scared to tell our primary care providers when we see our traditional practitioners, because we don't want to get them in trouble. This bill would say to my family, to me and my clients, it's legal and okay to seek services. And to our trusted elders and practitioners, it's legal and okay to provide those culturally aligned services. Traditional medicine practitioners are carriers of important knowledge and cherished members of our community. By passing this bill, we remove a barrier to accessing care. We create an environment where integrative care is possible, and we support the community's self-determination to seek the care that they see fit. Thank you for your consideration and time. That conclude concludes our presentation. We're open to questions.

Thank you, Madam Chair. I just have a couple of questions. The first one is, do we currently require a license for this kind of healing?

Okay, thank you. And then the next question is, does this bill apply to tra traditional Chinese medicine, shamanism, Ayurveda, and Brazilian root healers as well? Would it extend to those?

Okay. Thank you. Mm-hmm.

Thank you. I just wondered, on lines 1 23 to 1 24, it talks about medication. Are these traditional healing? Are they allowed to prescribe? Is that okay? So I, I just wondered about that aspect. Right? They, they can't prescribe, right?

Okay. And, um, now I do recall, I think, and you never know if it really made it all the way through, but a few years ago we had a bill that would allow traditional healers to be part of Medicaid.

Okay. Thank you.

Thank you, Madam Chair, for the opportunity to speak. My name is Neil Schultz, and, uh, I speak in favor of this bill in strong support of this bill. My own story begins nearly 17 years ago with a very serious diagnosis that traditional medicine had no opportunity to help me out with. So thus, I pursued some schooling education, graduating from two naturopathic schools, graduating as a traditional board, or excuse me, a board certified traditional naturopath. However, the state of Utah went back to my school and made them revoke those diplomas because the state of Utah would not recognize a traditional naturopath. So, um, I'm alive today because of natural medicine and because of traditional medicine. And so I appreciate the good representative bringing this bill forward, and I just urge you strong support of this bill. Thank you.

Thank you. I move, I want to move that we adopt substitute, um, HB 2, 7 7, substitute one.

Sure. Um, I move that we pass out HB 2 7 7 traditional healing amendments. Substitute one with a favorable recommendation.

I appreciate the discussion and hope for your support.

Yes, I, I support this because it reminds me of how I grew up. Um, I grew up, um, I could count the number of times growing up. I've actually been in a doctor's office. Um, most of what my mom used my mom and my dad used was, um, was, um, medicine or non-traditional medicine that has been passed down through generation a lot from the African culture. Um, and so I just have a, a genuine appreciation for it as I am starting to look more into it, especially as I'm growing my gardening with foods, working with herbs work now. And so I just have an appreciation for what you're, what you're doing.

Thank you Mr. Speaker ProAm and colleagues. I know it's, uh, middle of the afternoon, so why don't you, uh, take a, a mental walk with me. Uh, back to your childhood, back to a time when maybe you had a tummy ache or maybe you fell off your bike and skinned your knee. Maybe you just weren't feeling great one day, you wanted to stay home from school unless it was a real emergency situation. I'm willing to bet that your parents or grandparents or whoever your caretakers were probably went first to some kind of a home remedy, maybe a family tradition. Maybe it was grandma's chicken soup to make you feel better. Maybe it was a dandelion tea, uh, from leaves that you picked out in the yard. Uh, maybe it was a a a masseuse or somebody in your community who knew how to do the special massage that you needed. Uh, or maybe it was consecrated oil or a visit to a, a religious or a cultural elder, um, a specialist in that way. You know, this bill house Bill 2 77 is about respect. It's about clarity, and it's about access to these kinds of cultural traditions and our healing traditions that have sustained our wellness and our health, um, in our families and in our communities for generations and generations. Uh, this bill specifically, uh, is addressing an exemption that we'd like to request for, uh, traditional healers who are practicing traditional healing services. Uh, this does not replace or discourage, uh, clinical medicine at any point or any way, nor does it interfere with existing licensed, uh, medical and healthcare professions. Uh, the exemption only applies to traditional health providers who are providing traditional health services as they are currently, um, codified in our statute. And you might ask, well, if we're exempting traditional healing practitioners, uh, from providing these, uh, services without a license, how might that bill impact patient safety or, uh, what would prevent anybody from claiming that they are a traditional healer providing traditional health services? Well, this is very, uh, this narrowly clarifies, uh, that cultural and traditional healing practices, uh, which if you remember historically operated outside of state licensure anyways, um, are not subject to medical licensing when they remain within their traditional settings and practices. So existing laws relating to fraud, to negligence, to any of those other things, um, are still in full force. Um, and you know, this also ensures legitimacy and prevents the misuse of this exemption, um, as it doesn't authorize any new diagnoses, powers any, uh, prescription for, uh, controlled substances or prescription medications, uh, anything that would currently require medical licensure. So this really is a policy that's a positive step towards, um, ensuring that all Utahans are able to freely, um, obtain and access, uh, safely the wellness care that their communities have been providing. This is a bill that, uh, has the full support, uh, of the council delegates of the Navajo Nation. Uh, the Urban Indian Center also supports this, uh, the Utah Pacific Islander Coalition, uh, and many other indigenous groups throughout the state, uh, who are asking for this and who think this is good policy. And with that, uh, I ask you, uh, for your support in standing with our indigenous communities in allowing this exemption. Thank you.

Thank you, Mr. Speaker. Would the sponsor yield The sponsor yield? Yeah,

of course. Go ahead.

Thank you. Um, in reading this bill, I generally don't have a concern, but I'm just wondering, uh, we had a bill last year that sought to, uh, provide coverage for peyote for the use of peyote. And this seems to me to be language that would actually do that. Um, and I'm wondering if the sponsor could speak to that.

Thank you, uh, Mr. Speaker Proton for the question. Uh, this is actually, um, maybe an adjacent topic, but, uh, I have vetted this really thoroughly with, uh, our code folks in that this, uh, does not open up anything new, uh, in terms of the definition of peyote or its use as a controlled substance, uh, as a religious practice. Uh, this is solely for, um, uh, which is referenced here in the bill, uh, what we have in code as traditional healing services. Um, sorry, I'm pulling it up here if you would allow me to read. Uh, traditional healing providers means an individual who provides traditional healing services in a manner that's recognized by an American Indian or Alaskan native tribe being consistent with the tribe's traditional healing practices. Uh, and then a, the definition in our current code of traditional healing service is a system of culturally appropriate healing methods for physical, mental, and emotional healing. So that a Native American church or the religious exemption for that is not covered in what we're talking about here.

Mr. Speaker, a follow up. Go ahead. Would the sponsor continue to Yield? Sponsor continue to yield? Go ahead. Oh yeah. Thank you. Um, so is treatment with peyote considered a traditional healing service?

If in regards to this, uh, with the, uh, rulemaking that's already here with a dapo and consultation with the Native American tribes or the indigenous groups that are here, uh, they would be allowed to make that determination. Um, but this right here does not involve or change, uh, the current, or excuse me, the previous, uh, legislation regarding peyote specifically.

I appreciate the discussion. Uh, we've had a lot of back and forth, uh, on this in a very positive way, uh, in the groups that do promote this, including, um, uh, I might also add that this does not in any way impact the Medicaid waiver that, uh, the state also applied for, uh, for traditional healing services. Uh, Medicaid department has made that very clear. Uh, and the licensing, our doppel, our state licensing agency is, is very much okay, uh, with this change as well. Thank you for your support.