I beg you, Include Flower for Medical Cannabis users. The vape oil hurts my lungs. I just moved here from Florida, and I had Great Success with Flower. Also, Please, Please let us have Adult Use. I believe some need medical assistance, while many do not. This should be considered along the lines of supplemental vitamins and herbs. The THC concerns are not in line with common knowledge of users. Users know some THC is beneficial, and sometimes not. With so many strains to choose from, it should be the choice of the user to find which strains they prefer. I personally became 'accustomed' to the affects of THC, and find it 'enhances' my thinking, it does not distort my thinking, save for some strains, but certainly not all. The distortions to my thinking are such that I simply become more artistic, I do not lose my ability to function, nor do I lose the ability to accomplish difficult tasks. When my second knee was replaced, I abandoned my rx, and chose cannabis. My second knee replacement recovery was superior to rx, which had side effects of which my doctors were concerned. Today 90% of my doctors are glad I use cannabinoids vs rx. Health care providers see first hand the benefits of Cannabinoids in the human body. There is growing evidence humans have become cannabinoid deficient since is was removed from the feeding regime of our livestock. The body has cannabinoid receptors, and more and more people are seeing miraculous type healing with most who use cannabinoids as a health supplement, and/or for medical needs. Adult use should be considered along the lines of 'after dinner cocktails or wine' without the fear of using too much. Using too much cannabis simply makes one sleepy. One cannot overdose on cannabis like one can with alcohol. The cannabinoids in cannabis neutralize carcinogens, so there is no fear of cancer, like there is with tobacco. The time is now to legalize and decriminalize the use of cannabis as a medicine or as a lifestyle choice. Christopher Newport College reports that 80% of Virginians Want Decriminalization. That means only 2 out of 10 oppose. You were elected to do the 'will of the people,' so Please, get to work. If you cannot arrange for or provide cannabis to the people, please, let them import it from one of the other legal states, like Washington State, California, Nevada, and more. I am 66 years old and feel I cannot live a fruitful life without free and easy access to Cannabis. I beg you, End The Suffering. People need this herb, especially ones whom work with their body or those who suffer from Inflammatory diseases. Cannabis lessens inflammation thereby lessening pain, thereby lessening anxiety. Don't take my word for it, look to "The Villages" in Florida where most of the medical cannabis is purchased by senior citizens, most of whom are Republicans. This is a bipartisan issue. Everyone wants it legal, Yesterday. Please, Please, I beg you, Legalize it NOW, End the War on Your Cousins, Brothers and Sisters, and yes, even Parents and Grandparents. No one wants anyone using it before age 18 wherein Psychology Today announces it is the end of Brain Development wherein cannabis can inhibit brain growth. After 18 mounting evidence suggests cannabis help Heal the Brain, Especially as we age. I truly hope Virginia sets the example here, I really don't want to drive to the Carolina's the get 'cheaper Cannabis' like some tobacco users do. Let's keep it in Virginia, and keep the tax low

I am supporting HB1988 as written. I am supporting HB 1988 as written. I am supporting HB 2218 nd HB 2222 as written

We thank the Members for hearing HB2005. I would like to stress that we worked closely with the Virginia Bar to craft the bill aligning the priority of the next of kin to closely align with the current Code set out in the Wills, Trusts and Fiduciaries section. We also worked with DHP to be sure there is no conflict with other sections of the Code of Virginia. The following organizations support HB2005: Virginia Funeral Directors Association Virginia Network of Private Providers Virginia Association of Community Services Boards Virginia Association for Hospice Boards SCI Lacy Whittaker Executive Director, VFDA

The Association of Independent Funeral Homes of Virginia represents over 150 independent funeral homes and their chapels throughout the Commonwealth. Our organization opposes HB 2005 introduced by Delegate Sickles. This legislation will reduce a funeral directors ability to work with the right family member as opposed to the one who's highest on a pre-determined list. The legislation sets a double standard where cemeteries will not be held to the same hierarchy requirement even though they are a part of the disposition process. Moreover the hierarchy concept fails to incorporate all appropriate groups/parties such as grandparents and grandchildren. It also fails to permit unmarried couples to be involved in the process until all higher priority groups have waived their rights. Effectively unmarried couples will be removed from this process with the passage of this legislation in most circumstances. Right now a problem does not exists as a Virginia has a good system for making decision for the disposition of a decedent. This change will make it difficult for funeral directors to navigate the difficult family dynamics that often exists. Please oppose HB 2005.

I am supporting HB1988 as written. I am supporting HB 1988 as written. I am supporting HB 2218 nd HB 2222 as written

I encourage you to support HB2005. This bill aligns the priority of next of kin with the right to make arrangements for their loved ones with the Wills, Trusts and Fiduciary section of Code. You may have heard from opposition that this removes "flexibility" for determining which relative is responsible for final arrangements. What they mean is that the FUNERAL HOME does not have the flexibility to determine which relative is responsible for final arrangements. The funeral home should NOT be choosing which relative is responsible; however current Code is ambiguous and actually does allow that. For Example: If you elderly mother is visiting a relative in the far end of Virginia from you and she dies - THAT relative (cousin, aunt...), who may be trying to safe you the anguish of arranging for her funeral has your mother cremated. THAT can happen now. Setting a concise next of kin priority eliminates such occurrences. Opposition indicates that this would increase the funeral home's liability. In fact, HB2005 does the opposite. By establishing the priority in Code, a funeral professional can the show a list to family members, which will set expectations for the family members and provide protections for the funeral home. Without this prioritization, the funeral professional then becomes a mediator for a family in dispute. Those who oppose indicate that this prioritization will create unnecessary delay of arrangements. There are many reasons for delay. Prioritization won't be one of those reasons. In fact, it may prevent intra-family disagreement and and even prevent court action because it is very clear who has the right to make final arrangements. It has been indicated that prioritization of next of kin will increase the cost of funeral arrangements. Untrue. This proposed change protects the consumer first and when a dispute arises and legal action must be taken, a judge will have a clear and concise law to guide a decision. Finally - Opposition indicates that HB2005 is a solution looking for a problem. HB2005 is in fact a solution to an every-increasing problem. With more blended and fractured families, funeral professionals are having to address and mediate family disputes without the clear guidance established in HB2005. Thank you, Laurence F. "Larry" Spiaggi, CFSP, CPC, CCO Certified Celebrant Funeral Director/Owner

HB2005 is a bill that makes clear the priority of the next of kin who have the right to make funeral arrangements for their loved ones. The VFDA worked with the Virginia Bar to align the priority with the Wills, Trusts and Fiduciary section of Code - an alignment that makes perfect sense. This clarification of priority helps a family in disagreement understand fully who has the priority, rather than the current Code that is ambiguous and would allow anyone to make such decisions. The VFDA worked with DHP as well to ensure no conflicts between Code sections, refine notification requirements, and remove embalming as a decision by the funeral home to preserve bodies in the case of family dispute. You have likely heard from some in opposition who say that HB2005 establishes a "rigid hierarchy" for next of kin authorized to make such decisions. This is true! It creates a MUCH NEEDED "rigid hierarchy" that establishes more concise priorities in the process. Opposition indicates that it removes the "flexibility" in determining which relative is responsible for arrangements. When they talk about flexibility, they are referring to the ability for anyone on any level of kinship to control making the final arrangements for the deceased. HB2005 establishes clearer more concise next of kin priorities and sets the expectations of the next of kin - it creates strong consumer protections. PLEASE SUPPORT HB2005

The VA Cemetery Association has been working with the proponents of this bill for the last three sessions to ensure that cemeteries are extricated from this new section of Code. We are getting closer, but we still aren't quite there, but are committed to continue to working to get the language right. We appreciate the willingness to work with us and hope we can come to a satisfactory conclusion this year.

The VAANP requests that the Committee vote YES on HB 2044: 1. Licensing is the most appropriate form of regulation for Naturopathic Doctors (NDs). Title protection will not convey a scope of practice – without this, we will have gained no ground towards the goal of meaningfully expanding access to additional care for Virginians. Additionally: certain parties have stated that NDs do not meet the risk for harm criteria, but that there is no opposition to title protection for the profession. In order to be eligible for title protection, a group or profession must demonstrate that they meet five of the requisite criteria – including Criterion 1: Risk for Harm 2. This is a distinct profession. It is a blend of conventional, scientific, and empirical methodology with natural therapies. Therefore NDs receive education and training in both traditional sciences and naturopathic medicine through competency-based, in-residence doctoral naturopathic medical programs at CNME-accredited schools. These medical programs include: Biomedical sciences, Environmental Health, Pharmacology and pharmacognosy, Diagnostic subject matter/courses, Therapeutic subject matter/ courses, and Clinical subject matter/courses. Note: Certain naturopathic medical schools also receive National Institute of Health (NIH) Research Grants. 3. 25 states & jurisdictions are using the exact same basic educational and training requirements from HB 2044 to define NDs as a profession and regulate them as providers. The scope of practice includes the suggestions made by the BHP Regulatory Research Committee in their recommendation report, and mirrors the core components included in the practice scopes of almost every state that currently licenses Naturopathic Doctors. HB 2044 provides an exceptionally limited scope, focused on the following: o Perform physical exams; o Order labs; o Order diagnostic imaging (without interpretation; that is handled by another licensed provider) There are no prescriptive rights for Schedule II-VI drugs. There is no minor surgery. There are numerous specifications about how NDs shall operate collaboratively with other licensed providers – including MDs – as well as accountability and transparency measures related to how NDs convey their practice and profession to patients and the public.

This is written response to the House taking up HB2044. I am saddened that this piece of legislation has been rushed through the Virginia House of Delegates so quickly that there has not been a chance for both sides of this important legislation be heard. As I mentioned in a previous letter, there are two separate groups of Naturopathic Doctors. One side is represented by this bill and the other will be completely locked out of practice if this passes. I grant the CNME (Council of Naturopathic MEDICAL Education) the use of Natural MEDICAL Doctor (NMD), but as a Naturopath who has over 4,000 hours of education, I am a Doctor. The paradigm I, as well as many Naturopaths in Virginia, practice under is more than just suggesting herbs, minerals and other supplements. Our paradigm is different than what is outlined in HB2044 and a few Naturopaths who went to one of 6 specific schools desire a monopolistic control over our profession. Please do NOT send this to the floor for vote. I understand that this particular language was killed in the Senate Subcommittee. Please follow your fellow lawmakers lead and NOT pass this bill. Thank you, Sir Rev. Dr. Colby Inzer, ND, DN, Sanctified Healer (SMOKH), NBENQA, NCTMB, LMT, President American Naturopathic Association

The National Board of Naturopathic Examiners (Virginia, District of Columbia) 4410 Massachusetts Ave. NW#360 Washington, District of Columbia 20016 Established 1951 The National Board of Naturopathic Examiners sends its greetings to: Virginia House Committee on Health Professionals, Dear sirs and gentle women of this committee, it has come to our attention that a study was conducted last year by the Virginia Department of Health pertaining to Naturopathic Medicine and Naturopathy. Though we were not aware of this study and did not write in, we are now aware and would like to formally announce our opposition to HB2044 for the following reasons. WE OPPOSE HB 2044 for the following reasons: 1. The study conducted by VDHP was not exhaustive as they did not include the oldest certifying and testing body in the nation for Naturopathic Doctors; The National Board of National Board of Naturopathic Examiners. It is our understanding that the American Naturopathic Medical Certification Board and the North American Board of Naturopathic Examiners were studied, neither of these boards predate the National Board of Naturopathic Examiners . 2. Our national exam the NDLEX was not part of the VDH study. 3. HB2044 does not make a distinction between Doctors of Naturopathy and Doctors of Naturopathic Medicine nor the practice of Naturopathy and that of Naturopathic Medicine. This distinction is seen by law in California, New Mexico, Montana, Idaho and Colorado for instance. 4. This bill would disenfranchise those Naturopathic Doctors who do not practice Naturopathic medicine but practice naturopathy . 5. The titles Naturopath, Natural Medicine, ND, and Doctor of Naturopathy do not belong exclusively to graduates of CNME colleges. Their title is Doctor of Naturopathic Medicine or NMD. Sincerely, Dr. Paula Rochelle N.D. Chair of the Board of Naturopathic Examiners

In 1931, the Dictionary of Occupational Licenses defines a Naturopathic Doctor as ” [one who] Diagnoses, treats, and cares for patients, using a system of practice that bases treatment of physiological functions and abnormal conditions on natural laws governing the human body: Utilizes physiological, psychological, and mechanical methods, such as air, water, light, heat, earth, phytotherapy, food and herb therapy, psychotherapy, electrotherapy, physiotherapy, minor and orificial surgery, mechanotherapy, naturopathic correction and manipulation, and natural methods or modalities, together with natural medicines, natural processed foods and herbs, and nature’s remedies. Excludes major surgery, therapeutic use of x-ray and radium, and use of drugs, except those assimilable substances containing elements or compounds of body tissues and are physiologically compatible to body processes for maintenance of life.” This is the definition the ANA still stands behind today. The ANA was formed by Dr. Lust in 1919 as an institution. This organization split into two distinct groups in 1942 w/ separate identities. One of these groups became the American Association of Naturopathic Physicians (AANP) and formed the Council on Naturopathic Medical Education (CNME). The other group retained the name ANA and went dormant for many years following Dr. Lust’s death in 1945. We believe in the distinct sets of education between those who desire to be called “Naturopathic Medical Doctors” (NMD) and “Naturopathic Doctors” (ND). An ND is a professional who has 4,000 hours of post graduate education—including 2,000 hours of clinical experience. In 1950 Dr. Wendel proposed a Standardization of Naturopathy and he provided the following definition: “NATUROPATHY is defined as a scientific system of Natural Healing by a Naturopathic Physician, to diagnosis, treat, prescribe for any human disease, pain, injury, deformity, for any physical, chemical or mental condition through the use of AIR, WATER, LIGHT, HEAT, EARTH, FOOD and HERB THERAPY, PHYSIOTHERAPY,MINOR and ORIFICIAL SURGERY, MECHANOTHERAPY, NATUROPATHIC CORRECTIONS and ADJUSTMENTS, and all Natural Methods or Modalities; together with Natural Medicines; Natural Processed Foods, Herbs and Nature’s remedies, which contains life and health elements, or compounds which are components of body tissues, which has for its objects the maintaining of the body in, or restoring it, to a state of normal health excluding the use of poisonous DRUGS, SERUMS, INJECTIONS, CONCOCTIONS, MAJOR SURGERY, X-RAY and RADIUM for therapeutic purposes or unnecessary surgery or mutilations.” In short we believe in the curative force of NATURE and the use of anything found in nature to encourage the healing of a body. Naturopathic education should embrace the study of life in all its aspects, physical, psychological, spiritual and social. We recognize the importance of Allopathic Medicine and the need for direct acute or traumatic care that needs to be practiced by MD’s, or DO’s who are currently licensed. The paradigm that NMD’s schools fashioned their programs to more closely resemble Medical Education. ND’s ONLY and naturally occurring substances to treat and “cure” the human body understand that a strong education in health sciences is needed.The ANA is asking the Virginia House of Delegates to recognize the distinct trainings of NMD’s and ND’s.

I represent the Virginia Naturopathic Doctors Association affiliated with the American Naturopathic Association which predates the Naturopathic Medical Doctors presented. Naturopathic Medical Doctors are distinct from Naturopathic Doctors. Therefore, this is invalid. Their diplomas say Naturopathic Medicine not Naturopathic Doctors.

Support HB 2044: I have served in the US Navy for twenty-one and a half years as a Hospital Corpsman, retiring as a Chief Petty Officer. I served as a clinical laboratory technician conducting all aspects of clinical medical laboratory medicine to my final duty serving as Operations Department Head for the Biological Defense Research Directorate, Naval Medical Research Center. In that capacity, I was privileged to lead a team in delivering to this nation a rapidly deployable laboratory capability performing RT-PCR, handheld lateral flow assays, and ELISA capability for the detection of biological warfare agents in support of the Joint Special Operations Command, Intelligence Community, FBI, and the USSS from 1999 to 2002. I highlight this to provide the frame of reference from which I evaluate my current experience as a first-year medical student at Bastyr University. As a first-year student, I have experienced the highest standards of education, demonstrating the highest level of medical knowledge. My education to date entails gross anatomy, the physiology of electrical waveform generation in the heart, the biochemistry of lipid transportation, the histology of epithelial cells, the embryology of the development of the heart, as well as charting patient examinations, and conducting clinical skills assessments in preparation for clinic shifts that will begin in the spring. The experience of caring for my wife as she has battled numerous autoimmune conditions for the last twenty-one years convinced me to pursue my ND as opposed to an MD. The combination of naturopathic modalities and allopathic modalities have provided her the greatest relief. Licensing ND’s will enhance access to healthcare in Virginia through complementary modalities of care that augment and enhance the patient’s opportunities for restoring their health. Licensing will provide additional opportunities for positive health outcomes for the patient in a safe, regulated, and licensed fashion. The citizens of the Commonwealth of Virginia deserve access to degreed and licensed naturopathic physicians with a defined scope of care. In 2024, I will graduate from an accredited naturopathic education institution with the intent to practice as a licensed, regulated ND with a defined scope of care. I, and many of my fellow students want to contribute to the health and welfare of the citizens of Virginia when we graduate. My request of you is to support ND licensure in the Commonwealth of Virginia, enabling my fellow NDs and me to serve patients with compassionate and educated care. Failure to do so will only benefit California, Washington, Oregon, and other states that license NDs. I await your decision so I can make mine.

My name is Dr. Baylor Rice, I have been a pharmacist in Virginia for over 25 years and I am in support of HB 2044 and the licensure of naturopathic doctors. I have been serving the community as the President of South River Compounding Pharmacy since 1998 at our locations in both Richmond and Midlothian, Virginia. I testified in support of SB 858 (a bill to license naturopathic doctors in Virginia) during the 2020 legislative session, and I am today again writing in my full support of regulating medically-trained naturopathic doctors in Virginia through licensure. I have been working in collaboration with naturopathic doctors for over 10 years now in the capacity of health optimization. Our work dovetails nicely, and together we are able to offer solutions in the most complex of clinical cases. It is through this experience of co-management that I am able to attest to the depth of the medical knowledge of NDs as well as the capacity of their clinical training. Naturopathic medicine is a distinct health care profession with an entirely unique scope that serves to meet the needs of constituents where many times their health goals are not otherwise met through conventional medicine alone. Naturopathic doctors are experts in their field related to natural therapies where they understand how the systems of the body work as a whole, as well as the interactions between pharmacotherapy, nutrition, and botanical medicine. Even though they have a variety of tools and therapies at their disposal they are trained to know when to refer and the importance of collaboration. They focus on prevention and restoration. As you are aware, naturopathic doctors are graduates that attend onsite 4-year naturopathic medical programs, and they complete board exams in basic sciences. They also complete licensing exams in pharmacology, nutrition, botanical therapies, and physical medicine known as NPLEX. It is important to note that naturopathic doctors have residency training available as do pharmacists and both of which are competitive and can last anywhere between 1-3 years of additional training. Because Naturopathic doctors are trained as primary care providers, their scope should reflect such training. Licensing is the most appropriate level of regulation for medically-trained health care professionals. Neither certification nor registration adequately distinguish between licensable, medically-trained naturopathic doctors and lay naturopaths. With every medical profession, it is important to have oversight to ensure accountability and public safety. The practice of naturopathic medicine is no different. I urge the legislature to vote in favor of licensure for naturopathic doctors.

I am writing to you in support of HB 2044. I am a board certified physician in Internal Medicine, with over 25 years of practice. I currently work for Inova in Ashburn, Virginia. I urge you to pass this bill. Conventional medicine cannot help all our patients. Naturopathic medicine has a distinct and important approach to health in which conventional medicine is lacking. I have referred many patients to naturopathic doctors, who have been able to provide relief or improvement in their conditions. Naturopathic medicine emphasizes health, rather than sickness. I have had quite a few patients who have been able to decrease or stop medication, returning them to a state of health and wellness. There are those in conventional medicine who are opposed to novel ideas in medicine. I trained at UVa, and one of my professors was Barry Marshall. At the time he was teaching us, he told us he was being vilified in the medical community for proposing that H. pylori (a bacteria) could cause ulcers and some cancers. Years later, he won a Nobel Prize in Medicine for this finding. Naturopathic medicine provides many novel ideas and approaches in the care of patients, and trained naturopathic doctors should not be prohibited from practice and from contributing more fully to the collective healthcare field. I believe it is a disservice to Virginia residents, to deny them better access to the full range of care that naturopathic doctors are qualified to safely provide. Please support licensure for naturopathic doctors.

I’m a resident of Henrico County, VA. I am also a graduate of Shenandoah University School of Pharmacy, and – prior to a career shift – was a licensed pharmacist in the state for several years. I urge the General Assembly to support HB 2044. While I am no longer working in this field, the landscape of healthcare in Virginia continues to be a topic of interest (and concern) for me. As a citizen, and a former licensed healthcare professional, it is my opinion that voting to create licensure for Naturopathic Doctors would be the positive and responsible decision. Prior to educating myself on naturopathic modalities and practitioners, I was unaware there were actual naturopathic DOCTORS – with substantial medical training and education, graduates of in-residence doctoral medical programs, and who are licensed in almost half the states in our nation. These practitioners complete standardized exams, and their medical programs are accredited by a federally-recognized body. Before, my experience with and understanding of “naturopath” consisted of anti-medicine and little or no legitimate study or education in evidence-based healthcare. Distinguishing between the different groups is important, and legislative action should not be dictated by opponents who lack sufficient training – or by opponents in organized medicine who misrepresent the qualifications of naturopathic doctors. The scope of practice proposed by HB 2044 is narrow, defined, and specific. Allowing a healthcare provider to practice as fully to the scope of their training as reasonably possible is a responsible and efficient way to govern or regulate healthcare. At this juncture, naturopathic doctors are unreasonably limited in what they are able to provide here in Virginia. The education and training of NDs is more than sufficient to engage in these defined healthcare services. While I do not endorse allowing naturopathic doctors to engage in certain modalities – such as chiropractic care or surgery – restricting their medical education and training as doctors to those services within the exact same parameters of untrained naturopaths is a needless limitation, without any real benefit. How is the health of our state served by voluntarily restricting access to qualified providers, able to diagnose and treat? Naturopathic doctors are equipped to practice to a broader, defined scope, and there is a significant population to serve; licensure is the regulatory vehicle that allows for this. It is also the mechanism through which the state proactively works to protect patients and the public from the risks present.

SUPPORT for HB 2044. I would like to share a few relevant points regarding my career and experience with Naturopathic Doctors. In 1988, I moved to Northern Virginia and opened a practice in Sterling. I was a newly graduated, Board Certified Internal Medicine Physician. It was not long before I recognized the challenge of managing patients with chronic conditions. In 1995, I underwent a 5 year saga of reproductive endocrinology treatment in an effort to conceive. Complications from these procedures led to me being confined to bed for over a year. During this time, I read many books and took an extension course from Harvard in Complementary Medicine, now called Integrative Medicine. I learned the history of medicine, including the birth and subsequent role of the American Medical Association in directing the delivery of health care away from eastern medical treatments, and the systemic rejection of natural therapies with the discovery of now-conventional treatments. When I returned to practice in 2000, I began working with integrative providers. By this point I had expanded from a solo practice to a patient-centered, multi-disciplinary, primary care medical home with four different locations in Northern Virginia. My clinic was the largest integrative, primary care, medical home in Virginia, until being acquired by Inova in 2016. Over 18 years of working NDs, we helped thousands of patients in a team-like manner, merging the best of Eastern and Western medicine with the patient truly at the “Center of Care.” We were referred patients deemed “unresponsive to mainstream approaches,” and it was a rare patient that we didn’t help. Naturopathic doctors are trained to look at “the whole patient”, rather than the reductionist approach that is crippling healthcare today. Many patients were cured by reducing the poly-pharmacy that we see so frequently today. While I understood the value of having naturopathic doctors as part of the team and was glad to employ them in medical practice, larger systems were and remain unable to credential unlicensed providers. Restricting naturopathic doctors from health care practice is unnecessary and almost harmful, in today’s healthcare landscape and with the shortage of providers across the country. They have demonstrated for years that they have the proper education and medical training for the scope of practice suggested in this bill, and I along with many other licensed medical professionals can attest to this. I urge you to support the licensing of naturopathic doctors and vote for HB 2044.

I am a chiropractor licensed in Virginia and in the District of Columbia. I know several Naturopathic doctors that I work with in Virginia. Please support HB 2044, a bill to license naturopathic doctors in Virginia: It provides public safety and transparency by asking the Board of Medicine to oversee and address the potentials for harm in practice, and by outlining the allowed use of certain designations based on medical training and education (“licensed naturopath,” “naturopathic doctor,” etc.). It promotes additional choices in available healthcare approaches for Virginia citizens, that will provide better service and care for patients who choose naturopathic medicine. This legislation will not prohibit “traditional naturopaths” or other lay practitioners from continuing to run their business in Virginia within existing parameters, and will not put limitations on citizens who choose to work with these other natural health practitioners. Patient protection and choice are key. Sincerely yours, Robert Ciprian, D.C., D.I.B.A.K.

I urge you to support HB 2044 for the licensure of medically trained naturopathic doctors, in order to provide additional and safe health care access in our state. I have been a Nurse Practitioner since 1998. I am Board Certified as a Women’s Health Care Nurse Practitioner, and as a Family Nurse Practitioner. I have had the opportunity to work in collaboration with naturopathic doctors for several years, and have found them to operate at a high-level of patient care and safety. When working collaboratively with naturopathic doctors, I have been impressed with the care taken to work with the patient on prevention and to achieve optimal health. The training naturopathic doctors receive is intense: they complete a 4-year on-site, accredited medical program, as well as national board exams in applicable sciences. The training also requires licensing exams in pharmacology, nutrition, botanical therapies, and physical medicine. Naturopathic doctors receive education and clinical competencies training, that is comparable to the preparations a nurse practitioner undergoes. Through their expansive training and practice, naturopathic doctors are distinct experts in their field related to natural therapies, able to understand the interactions between pharmacotherapy, nutrition, and botanical medicine. Naturopathic doctors are already licensed in 22+ states and in DC. Allowing licensure in the Commonwealth of Virginia will increase access to care, while maintaining safety for patients. I have concerns about naturopathic doctors NOT obtaining licensure within Virginia. There are lay naturopaths who do not receive the extensive education and training of naturopathic doctors in accredited doctoral medical programs and yet, they are able to refer to themselves as naturopathic doctors. I believe the public is more at risk when there is no licensure that assures that standards of education and practice are met. Licensure also allows the public to have a regulated means to express their concerns in the event of an untoward outcome.

I urge you to SUPPORT licensing for qualified Naturopathic Doctors by voting YES on HB 2044. I have been a Nurse for almost 30 years and have worked with both Conventional and Natural medicine and have witnessed the benefits of them working together to achieve amazing healing within the body. The patient deserves the best care and the best options for their needs, many have been so over medicated their system needs to be detoxed with natural medicine. Virginians deserve to have the options to see Naturopathic Doctors. Naturopathic Doctors (NDs) are a distinct profession that blends conventional medicine with natural therapies. This approach provides NDs with specialized skills and training – focusing on whole patient wellness through health promotion and disease prevention. NDs attend four-year, in residence doctoral programs in naturopathic medicine at a CNME-accredited school, and complete 4,000 hours of relevant training (including hands on, supervised clinical training). They also pass national licensing exams. NDs are trained and qualified to provide physical exams and order labs and diagnostic imaging – however, because of the lack of a practice license, Virginians are unable to access some of these basic health care services from a Naturopathic Doctor. HB 2044 would help address the provider shortage in Virginia by creating a very limited scope of practice for qualified Naturopathic Doctors, and includes multiple protections for public safety and professional accountability as a part of licensing. Language in the bills also promotes transparency from providers, and ensures that NDs responsibly and fully collaborate with the wider team of licensed health care professionals to be sure each patient receives the best care possible. Exemption language has also been included to make sure that traditional naturopaths and lay practitioners (individuals without accredited education or training) are not prohibited from being able to continue offering the same services and consulting in Virginia that they do today. Almost half the nation is already regulating Naturopathic Doctors. It is now time for Virginia to recognize and license this rapidly growing profession. Please vote YES on HB 2044 and support better access to safe and effective health care for all Virginians! Sincerely, Shannon O’Connor

Dear Honorable Members of the Committee, I am writing to you in support of HB 2044. I am a licensed Naturopathic doctor and licensed Acupuncturist in the state of Maryland with over a decade of clinical experience. I currently own and operate a medical practice in Rockville, MD. I urge you to pass HB 2044. Over the course of my career, now having practiced in two states, I have consistently documented improvement in not only patient-reported outcomes but biomarkers as well. These patients were previously unable to achieve such changes when receiving conventional medical care alone. Naturopathic medicine offers an important approach to health, that is both safe and effective, that is absent in the education and training of conventionally trained doctors. In the decade that I have been in practice, I have enjoyed collegial and collaborative relationships with conventionally trained physicians whether through referral or during my time serving on the Board for Integrative Medicine for the Underserved (IM4US) an organization comprised of primarily conventionally trained physicians from across the United States. These physicians are not alone in their ability to see the value of what Naturopathic medicine has to offer. I have experienced a warm welcome in the state of Maryland from several conventionally trained doctors with whom I have come into contact. They have expressed their desire to work with me and to refer patients to me for my particular expertise in the use of natural therapeutic modalities. Licensure of Naturopathic doctors is prudent not only for the benefit to individual patients but also because Naturopathic doctors can help alleviate the strain on our healthcare system in light of the shortage of primary care practitioners. Licensed Naturopathic doctors have the appropriate education and training to be able to fill the current gaps in primary care. Your support of HB 2044 is essential and would be a great service to the residents of Virginia. Please support licensure for naturopathic doctors. Sincerely, Safiya McCarter, ND, LAc

I am a psychotherapist (LPC) in Richmond, VA writing in support of HB 2044 licensing Naturopathic doctors as full doctors with the ability to diagnose and treat patients, provide complete physical exams and authorize labs and imaging for patients. In my work with clients I often have the honor and privilege of collaborating with local naturopathic doctors. In my experience their broad and holistic view often allows for solutions to complex and troubling medical conditions that are misdiagnosed or under treated by traditional Western medicine. I have also found naturopathic doctors to be quite adept in assessing for mental health issues, triaging and referring patients out for counseling to augment the medical treatment. This has consistently led to better outcomes for my clients. Given the robust and thorough approach of naturopathic doctors, as well as the holistic and patient centered nature of these providers I can only imagine how much it would enhance patient care and access to provide a licensure process and broaden what a naturopathic doctor can provide for patients.

Disclaimer that I don’t work in healthcare or belong to any advocacy group for or against this bill. But as a citizen skeptical of most all folks who get to charge you even when THEY are late for an appointment and who’s gotten lots of friends contacting me about naturopathic medicine and licensing, I do want to post some pretty obvious thoughts on medical businesses and titles. And why representatives should vote YES for Hb2044. 1) Medical doctors are not the only types of doctors. I respect my PCP and listen to their advice when I actually go. But doing a little research on other bills, and VA has a long bad habit of letting Medical lobbyists dictate what can or can’t, or should or shouldn’t happen about the business of ALL professions. It’s not insulting medical docs and the good they do to state the fact that their lobbying society is going to try and protect a business interest-just like Dominion, big tobacco, gambling and others. And when medical society members also belong to some of the state departments that our representatives say they turn to for advice, makes me wonder how much my elected lawmakers are relying on institutions that probably have some bias against other professions getting to practice. 2) Folks can argue over who is a REAL doctor all day long. But just as real; you can go to an online school, wear a white coat and call yourself a Doctor all you want but it doesn’t actually make you one. Representatives here in VA have been able to figure out what makes you eligible to be a so and so and do such and such, for dozens of other occupations and jobs. Other states that have licenses for naturopath doctors and medical doctors and other doctors have been able to figure it out. Seems like the requirements in this bill are a good start to having it all figured out. 3) The government shouldn’t force you to do anything to your own body you don’t want to have done to you. But our government also should keep in mind that some people opposed to this bill think that all modern medicine and prescriptions are poisonous including any vaccines. If social media is any clue they’re not shy about spreading this false information, to the general public. If folks want to listen that’s their right, but VA should also be sure that it isn’t using input from these people to decide what should happen with MEDICAL policy. Thanks for your time.

Please SUPPORT HB 2044. I am writing this in support of licensing Naturopathic Doctors (NDs) in Virginia. I am a practicing Family Medicine doctor, and have had the fortunate experience of working with NDs over the last six years. I found them to be very knowledgeable and helpful to patients and I was grateful that they could provide alternative solutions to medical problems for which conventional approaches had failed. Additionally, while working with NDs I was particularly impressed at their breadth of knowledge regarding the many uses of natural therapies and potential side effects. They were familiar with the appropriate labs to monitor for adverse reactions, and studied the current scientific literature to ensure proper dosing and frequency of supplement regimens. One of the core tenets to their practice includes the ‘Do No Harm’ policy which guided them to always err on the side of safety in an emerging field where large randomized control trials are sometimes lacking. I was very touched by their commitment to the overall well-being and health of our shared patients and I looked to them as valuable players on our health care team. Moreover, I became comfortable referring patients to NDs after learning about their rigorous four-year degree program. The first two years of their education are dedicated to the medical sciences and include courses in biochemistry, anatomy, pathophysiology, and neuroanatomy that are similar in content and length to the courses required for traditional medical doctors. During their second two years they undergo systems and population studies (gynecology, cardiology, gastroenterology, geriatrics, etc.) Throughout their training they focus on the application of natural therapies such as botanical medicine, clinical nutrition, physical medicine and health counseling. Some go on to complete additional training in acupuncture. Additionally, all NDs complete professional board exams, and they have the opportunity to complete residencies to further master their practice. They are credentialed by a committee (the CNME) recognized by the US Department of Education. The licensing of naturopathic doctors would allow them to practice more fully to the scope of their abilities, and would provide an immense service to patients by opening up access to basic healthcare from an ND. I value the critical role that NDs play in the field of integrative medicine and I recognize that they are an essential part to our multidisciplinary approach to patient care. I urge you to support this bill so that we can better meet the needs of our patients in Virginia.

Support HB 2044! I am an engineer and a math tutor. I have been a resident of the Commonwealth for the past 23 years. I am imploring you today to vote YES on HB 2044 in support of the licensing of medically trained Naturopathic Doctors in Virginia. Both my son and I have traveled the difficult road of understanding and managing autoimmune illness. Our first encounter with a naturopathic doctor (ND) was seven years ago, two years after my teenage son was diagnosed with autoimmune encephalitis by a neurologist. He experienced some relief after undergoing the very few medical interventions that were considered appropriate at the time, but he still suffered from overwhelming fatigue and anxiety. His new primary care provider referred us to the ND within her medical group. The insights and guidance of this ND helped us establish a holistic recovery plan for my son that included powerful lifestyle changes and natural options along with referrals to other health professionals including neurofeedback that enabled him to regain his energy and enthusiasm for life. Due to lack of licensing, NDs are outside of the insurance system and visits are out of pocket, so we didn’t approach care with an ND until it was a last resort. This obstacle to holistic care in Virginia delayed his recovery and put school on hold for almost two years. If this care had been readily accessible, we would have used ND services in tandem with his medical interventions shortly after his diagnosis. After the chronic stress of caring for my son, struggling with a strained marriage, and neglecting self-care, my own autoimmune condition flared and I faced a significant decline in my own physical, emotional, and cognitive health. Inspired by my son’s progress, I recruited his ND as a key member of my own care team. However, since she is not a licensed doctor, she cannot order labs or other screenings for me. I feel her frustration with her limited scope of practice knowing that she is well equipped to help me beyond the nutritional consulting role she is limited to, and realize many Virginians are being deprived of the breadth of care these practitioners are trained and capable of providing. Licensing trained naturopathic doctors will provide additional, safe healthcare access for the patients most in need. I respectfully urge the Committee to support HB 2044.

SUPPORT HB 2044 I am writing to convey to you my experience with medical trained naturopathic doctors. I am licensed professional counselor in Virginia and I feel grateful to have naturopathic doctors that I can refer to that are educated in both the conventional medical model and Naturopathic Medicine. I share numerous patients with naturopathic doctors and have found that they are able to help some of the most challenging cases when other therapies have not been enough. I also have a personal story with naturopathic doctors. In fact, I started seeing a naturopathic doctor because I was getting almost no relief from the anxiety, sleep issues and digestive troubles that I was experiencing for about a decade. I was told by numerous primary care doctors in the 15 minutes that they allotted me, to take an SSRI, not watch screens at night and take more laxatives. Needless to say, these “interventions” did nothing to address the root of my issues. I am happy to say that after much work that I am in a different place in my health and have been able to wean down responsibly off of medication where I am stable and have a high quality of life. As Primary Care Doctors become increasingly overwhelmed, the amount of time that is allotted for each visit and the quality of the attention given to each patient is diminishing in my opinion. Naturopathic medicine takes a different approach it is about prevention and restoration- they work to empower patients to engage in their health differently. Naturopathic Doctors are not a luxury. They are a necessity. They fulfill a need that is expanding by the day in our society. The mind and body are not disconnected, as we all know by now. The dividing line between the two is completely arbitrary, just as the dividing line between “human” and “nature” is completely arbitrary. Naturopathic doctors take this into account and it is often the missing link in addressing lifelong symptoms that some of us experience. And right now during a pandemic, it is even more important. Physical exams, imaging, labs, these all should be at the disposal of Naturopathic doctors for public health that is aligned in prevention. Coverage for those that cannot afford it could change the quality of life for countless people. I ask that you choose to move towards a more meaningful healthcare model that truly believes in prevention.

I am writing in personal SUPPORT of HB 2044 for the licensure of naturopathic doctors. I have been a practicing Physician Assistant for six years. I work with naturopathic doctors frequently. I value their nonpharmacological, and oftentimes more natural, approach to restoring balance and health. As you are aware, naturopathic doctors complete a 4-year onsite medical program and also complete board exams in basic sciences. Additionally they take licensing exams in pharmacology, minor surgery, nutrition, botanical therapies, and physical medicine. They are credentialed by the CNME (Council on Naturopathic Medical Education) which is recognized by the US Department of Education. Naturopathic doctors also have privately funded residency training. In my opinion, this education and training should qualify them for licensing and a basic scope of practice in Virginia. Naturopathic doctors are experts in their field related to natural therapies, where they understand the interactions between pharmacotherapy, nutrition, and botanical medicine. Licensure would provide safety and additional access to care, plus a framework of standards for professionalism in naturopathic medicine. And due to healthcare shortages in the state, naturopathic doctors could serve as an additional provider to help us deal with the crises we are having in serving those with pain, addiction, chronic disease, and mental health illness, since naturopathic doctors know how to effectively work collaboratively to serve as another safety net provider. I urge you to support HB 1040, which will further provide additional safe health care access for the Commonwealth.

Vote NO on HB2044 For more than 15 years ANMA has come to VA fighting this bill. And this bill has never passed. During this time members have been opening businesses and practicing low cost naturopathy without incident. ANMA has 213 members in VA. Many studies have been done declaring naturopathy not a threat to the public. Real naturopathy should be available to all citizens. Preventative medicine is the key to good healthy living. ANMA does not support the licensure of naturopathy that isn't properly defined. Naturopathy has a defined scope of practice and it never includes IV's or prescription meds. These practitioners are a threat to the public. It is confusing to the public. In this time of budget short falls due to covid it seems the money could be better spent somewhere else. Thank You

Support HB 2044: I am a Family Nurse Practitioner and have worked in primary care for over 20 years. I have worked with Naturopathic Doctors for over 15 years directly in an integrative primary care setting. I am very aware of the positive outcomes reached with the treatment of patients for a multitude of health problems, and especially those that require further investigative care and treatment beyond the realms of western medicine. Over the years I realized the challenge of managing patients with chronic conditions. I shared the patient’s disappointment with the results obtained from standard of care treatments for many chronic conditions, particularly fibromyalgia, chronic fatigue syndrome, migraine and obesity, to name a few. I have relied heavily on Naturopathic Doctors during my career to aid me in the diagnosis, treatment, and recovery of patients from varying disease processes and to assist patients in remaining well with preventative medicine. In my years of working with naturopathic doctors I have often seen patients recover from the effects of polypharmacy and the adoption of a more healthy lifestyle as a result of their treatment. The skillset and training naturopathic Doctors bring to the table are distinct, and should not be unnecessarily hampered. The onus of sorting out who is a medically trained Naturopathic Doctor, from someone who took online correspondence training but lacks the qualifications to safely practice, should not fall to the patients. Licensing of Naturopathic Doctors will provide patients with better, safer access to essential healthcare. Licensing will also help draw more Naturopathic Doctors to Virginia, increasing patient access to care. And, licensing ultimately creates a framework for Naturopathic Doctors to be able to participate in the greater health care system, helping effectively meet the need for more providers. I urge you to support the licensing of naturopathic doctors and vote yes on HB 2044.

I am writing to you in support of licensing Naturopathic Doctors. I am an Endocrinologist and Obesity Medicine specialist with over 20 years of practice experience, and my office is in Fairfax, VA. I urge you to pass this bill. My training cannot help all my patients. Naturopathic medicine is a complementary approach to conventional medicine. I have shared patients with naturopathic doctors, who have been able to provide relief or improvement in their conditions. Naturopathic medicine emphasizes health, rather than sickness. I have had quite a few patients who have been able to improve or cure conditions when their conventional physicians had run out of options. As a licensed health care colleague, I firmly believe that Naturopathic Doctors have the requisite training and education to employ a modest scope of practice, as suggested by the legislation . While "physician­ led teams" have an important and prominent role in our healthcare system, the provider shortages we are predicted to face in the future are truly frightening. I worry who will take care of me in my older years. We cannot rely on the traditional physician as the only model for making sure basic and most essential health care services are available. Licensing Naturopathic Doctors will not replace conventional physicians, specialists, or other regulated professionals; it will add another collaborative partner, able to stand with all other medical colleagues in a more holistic role. There is often a lack of distinction between a Naturopathic Doctor and a lay naturopath, or other "natural" health practitioners who sometimes use a similar title. This confuses patients and providers, particularly related to the educational, training, and clinical competencies standards that qualify NDs to have a practice license in 20+ other states, which lay persons lack. ND naturopathic medical programs are accredited doctoral programs, and their accrediting body is the only one that US Department of Education recognizes for naturopathic programs. These doctoral programs provide thousands of hours of training in biomedical and clinical sciences, and diagnostics. As all accredited naturopathic programs are in residence, NDs also receive hands on clinical training and practice. Regulating the profession, and giving the Board of Medicine the authority to oversee Naturopathic Doctors and the risk for harm (just as the Board does for other professions), is the common-sense approach to making sure the public has access to other providers to meet their healthcare needs. Please vote YES on HB 2044.

The American Naturopathic Association (ANA)has been asked to compose a letter of regards to HB2044 and what a Naturopathic Doctor is. Merriam Webster defines a Physician: "A person skilled in the art and science of healing sperate from surgery. "Therefore, a Naturopathic Physician is one who is skilled in the art and science of NATURAL healing separate from surgery. In 1931, the Dictionary of Occupational Licenses defines a Naturopathic Doctor as ” [one who] Diagnoses, treats, and cares for patients, using a system of practice that bases treatment of physiological functions and abnormal conditions on natural laws governing the human body. ..." This is the definition the ANA still stands behind today. The ANA was originally formed by Dr. Benedict Lust in 1919 as an educational institution and society. This organization split into two distinct groups in 1942 with separate identities. One of these groups became the American Association of Naturopathic Physicians (AANP) and formed the Council on Naturopathic Medical Education (CNME). The other group retained the name American Naturopathic Association and went dormant for many years following Dr. Lust’s death in 1945. We are currently reviving our association and stand with the position that Dr. Steele has presented to the good gentlemen and ladies of the Virginia House of Delegates. We believe in the distinct sets of education between those who desire to be called “Naturopathic Medical Doctors” (NMD) and “Naturopathic Doctors” (ND). We believe that an ND (in my state, I can still call myself a Naturopathic Physician and use the ND title) is a professional who has 4,000 hours of post graduate education. In 1950 Dr. Paul Wendel said, “NATUROPATHY is defined as a scientific system of Natural Healing by a Naturopathic Physician, to diagnosis, treat, prescribe for any human disease, pain, injury, deformity, for any physical, chemical or mental condition through the use of AIR, WATER, LIGHT, HEAT, EARTH, FOOD and HERB THERAPY, PHYSIOTHERAPY, MINOR and ORIFICIAL SURGERY, MECHANOTHERAPY, NATUROPATHIC CORRECTIONS and ADJUSTMENTS, and all Natural Methods or Modalities; together with Natural Medicines; Natural Processed Foods, Herbs and Nature’s remedies, which contains life and health elements, or compounds which are components of body tissues, which has for its objects the maintaining of the body in, or restoring it, to a state of normal health excluding the use of poisonous DRUGS, SERUMS, INJECTIONS, CONCOCTIONS, MAJOR SURGERY, X-RAY and RADIUM for therapeutic purposes or unnecessary surgery or mutilations.” In short we believe in the curative force of NATURE and the use of anything found in nature to encourage the healing of a body. As an organization, we also recognize the importance of Allopathic (Western) Medicine and the need for direct acute or traumatic care that needs to be practiced by MD’s, or DO’s who are currently licensed to practice Medicine. The paradigm that NMD’s (graduates from an approved CNME school and a member of the AANP) use is a conglomeration of Western Medicine (use of drugs) and Natural Therapeutics and their schools fashioned their programs to more closely resemble Medical Education. ND’s strive to use ONLY naturally occurring substances to treat the human body and understand that a strong education in health sciences is needed. The American Naturopathic Association is asking the State of Virginia to recognize the distinct trainings of NMD’s and ND’s.

I beg you, Include Flower for Medical Cannabis users. The vape oil hurts my lungs. I just moved here from Florida, and I had Great Success with Flower. Also, Please, Please let us have Adult Use. I believe some need medical assistance, while many do not. This should be considered along the lines of supplemental vitamins and herbs. The THC concerns are not in line with common knowledge of users. Users know some THC is beneficial, and sometimes not. With so many strains to choose from, it should be the choice of the user to find which strains they prefer. I personally became 'accustomed' to the affects of THC, and find it 'enhances' my thinking, it does not distort my thinking, save for some strains, but certainly not all. The distortions to my thinking are such that I simply become more artistic, I do not lose my ability to function, nor do I lose the ability to accomplish difficult tasks. When my second knee was replaced, I abandoned my rx, and chose cannabis. My second knee replacement recovery was superior to rx, which had side effects of which my doctors were concerned. Today 90% of my doctors are glad I use cannabinoids vs rx. Health care providers see first hand the benefits of Cannabinoids in the human body. There is growing evidence humans have become cannabinoid deficient since is was removed from the feeding regime of our livestock. The body has cannabinoid receptors, and more and more people are seeing miraculous type healing with most who use cannabinoids as a health supplement, and/or for medical needs. Adult use should be considered along the lines of 'after dinner cocktails or wine' without the fear of using too much. Using too much cannabis simply makes one sleepy. One cannot overdose on cannabis like one can with alcohol. The cannabinoids in cannabis neutralize carcinogens, so there is no fear of cancer, like there is with tobacco. The time is now to legalize and decriminalize the use of cannabis as a medicine or as a lifestyle choice. Christopher Newport College reports that 80% of Virginians Want Decriminalization. That means only 2 out of 10 oppose. You were elected to do the 'will of the people,' so Please, get to work. If you cannot arrange for or provide cannabis to the people, please, let them import it from one of the other legal states, like Washington State, California, Nevada, and more. I am 66 years old and feel I cannot live a fruitful life without free and easy access to Cannabis. I beg you, End The Suffering. People need this herb, especially ones whom work with their body or those who suffer from Inflammatory diseases. Cannabis lessens inflammation thereby lessening pain, thereby lessening anxiety. Don't take my word for it, look to "The Villages" in Florida where most of the medical cannabis is purchased by senior citizens, most of whom are Republicans. This is a bipartisan issue. Everyone wants it legal, Yesterday. Please, Please, I beg you, Legalize it NOW, End the War on Your Cousins, Brothers and Sisters, and yes, even Parents and Grandparents. No one wants anyone using it before age 18 wherein Psychology Today announces it is the end of Brain Development wherein cannabis can inhibit brain growth. After 18 mounting evidence suggests cannabis help Heal the Brain, Especially as we age. I truly hope Virginia sets the example here, I really don't want to drive to the Carolina's the get 'cheaper Cannabis' like some tobacco users do. Let's keep it in Virginia, and keep the tax low

I am supporting HB1988 as written. I am supporting HB 1988 as written. I am supporting HB 2218 nd HB 2222 as written

I am in favor or legalization. If alcohol is legal it only makes sense to legalize marijuana. Alcohol is much more of a danger to society. The state can always use the taxes collected. I have chronic pain and medical marijuana helps me with that alot. I have a couple of vials of pain killers from the doctors that I do not have to use.

I am a Virginia medical cannabis patient and have a neurological condition called Multiple Sclerosis. I support this bill. Patients like myself need the maximum benefits that botanical cannabis can provide and this GREATLY reduces my medication costs which will be almost $12,000 out of pocket since this cannot be claimed with insurance. There are many Virginians who could be served in this medical cannabis program if botanical cannabis was available because of the cost of medical cannabis.

I am supporting HB1988 as written. I am supporting HB 1988 as written. I am supporting HB 2218 nd HB 2222 as written