Legislature(2019 - 2020)BELTZ 105 (TSBldg)

02/18/2020 01:30 PM LABOR & COMMERCE

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01:31:44 PM Start
01:32:36 PM Confirmation Hearing(s)
01:55:25 PM SB172
02:15:50 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Consideration of Governor's Appointees: TELECONFERENCED
- Board of Examiners in Optometry -
Pamela Steffes
- Workers Compensation Board - Lake Williams
- Board of Professional Counselors -
Eleanor Vinson
- Workers Compensation Appeals Commission -
Deirdre Ford & Amy Steele
-- Public Testimony on all Appointees --
*+ SB 172 EXTENDING THE STATE MEDICAL BOARD TELECONFERENCED
Heard & Held
-- Public Testimony --
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
          SENATE LABOR AND COMMERCE STANDING COMMITTEE                                                                        
                       February 18, 2020                                                                                        
                           1:31 p.m.                                                                                            
                                                                                                                                
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Senator Click Bishop, Chair                                                                                                     
Senator Gary Stevens, Vice Chair                                                                                                
Senator Mia Costello                                                                                                            
Senator Joshua Revak                                                                                                            
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Senator Elvi Gray-Jackson                                                                                                       
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
CONFIRMATION HEARINGS                                                                                                           
                                                                                                                                
Board of Examiners in Optometry                                                                                               
Pamela Steffes - Sitka                                                                                                          
                                                                                                                                
     - CONFIRMATION ADVANCED                                                                                                    
                                                                                                                                
Board of Professional Counselors                                                                                              
Eleanor Vinsor - Juneau                                                                                                         
                                                                                                                                
     - CONFIRMATION ADVANCED                                                                                                    
                                                                                                                                
Workers' Compensation Appeals Commission                                                                                      
Deirdre Ford - Anchorage                                                                                                        
Amy Steel - Anchorage                                                                                                           
                                                                                                                                
     - CONFIRMATIONS ADVANCED                                                                                                   
                                                                                                                                
SENATE BILL NO. 172                                                                                                             
"An Act extending the termination date of the State Medical                                                                     
Board; and providing for an effective date."                                                                                    
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: SB 172                                                                                                                  
SHORT TITLE: EXTENDING THE STATE MEDICAL BOARD                                                                                  
SPONSOR(s): SENATOR(s) OLSON                                                                                                    
                                                                                                                                
02/03/20       (S)       READ THE FIRST TIME - REFERRALS                                                                        
02/03/20       (S)       L&C, FIN                                                                                               
02/18/20       (S)       L&C AT 1:30 PM BELTZ 105 (TSBldg)                                                                      
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
PAMELA STEFFES, Appointee                                                                                                       
Board of Examiners in Optometry                                                                                                 
Sitka, Alaska                                                                                                                   
POSITION STATEMENT: Testified as Appointee to the Board of                                                                    
Examiners in Optometry.                                                                                                         
                                                                                                                                
DEIRDRE FORD, Appointee                                                                                                         
Workers' Compensation Appeals Commission                                                                                        
Department of Labor and Workforce Development (DOLWD)                                                                           
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Testified as Appointee to the Workers'                                                                    
Compensation Appeals Commission.                                                                                                
                                                                                                                                
AMY STEELE, Appointee                                                                                                           
Workers' Compensation Appeals Commission                                                                                        
Department of Labor and Workforce Development (DOLWD)                                                                           
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Testified as Appointee to the Workers'                                                                    
Compensation Appeals Commission.                                                                                                
                                                                                                                                
ELEANOR VINSON, Appointee                                                                                                       
Board of Professional Counselors                                                                                                
Department of Commerce, Community and Economic Development                                                                      
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Testified as appointee to the Board of                                                                    
Professional Counselors.                                                                                                        
                                                                                                                                
SENATOR DONNY OLSON                                                                                                             
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Sponsor of SB 172.                                                                                        
                                                                                                                                
KRIS CURTIS, Legislative Auditor                                                                                                
Legislative Audit Division                                                                                                      
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: During the hearing on SB 172, reviewed the                                                                
sunset audit for the State Medical Board.                                                                                       
                                                                                                                                
SARA CHAMBERS, Director                                                                                                         
Division of Corporations, Business, and Professional Licensing                                                                  
Department of Commerce, Community and Economic Development                                                                      
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Reviewed the fiscal note for SB 172.                                                                      
                                                                                                                                
TIM OLSEN, Physician Assistant and Chair                                                                                        
State Medical Board                                                                                                             
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  During the  hearing on  SB 172,  assured the                                                             
committee  that the  findings and  recommendations in  the sunset                                                               
audit for the State Medical Board would be addressed.                                                                           
                                                                                                                                
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
1:31:44 PM                                                                                                                    
CHAIR CLICK BISHOP called the  Senate Labor and Commerce Standing                                                             
Committee meeting to order at 1:31  p.m. Present at call to order                                                               
were Senators Costello, Stevens,  and Chair Bishop. Senator Revak                                                               
arrived soon thereafter.                                                                                                        
                                                                                                                                
^Confirmation Hearing(s)                                                                                                        
                     CONFIRMATION HEARINGS                                                                                  
                Board of Examiners in Optometry                                                                             
                Board of Professional Counselors                                                                            
            Workers' Compensation Appeals Commission                                                                        
                                                                                                                                
1:32:36 PM                                                                                                                    
SENATOR REVAK joined the committee.                                                                                             
                                                                                                                                
1:33:04 PM                                                                                                                    
CHAIR  BISHOP announced  the  first order  of  business would  be                                                               
consideration of governor appointees.  He asked each appointee to                                                               
place  their name  and affiliation  on the  record, give  a brief                                                               
introduction, and  discuss the reason  they want to serve  on the                                                               
board  or commission.  He noted  that public  testimony would  be                                                               
taken after all appointees have  testified and the names would be                                                               
forwarded to  the full body  for consideration. This  hearing was                                                               
not an indication of any future vote.                                                                                           
                                                                                                                                
1:33:52 PM                                                                                                                    
PAMELA  STEFFES,  Appointee,  Board of  Examiners  in  Optometry,                                                               
Sitka,  Alaska, stated  that she  graduated from  high school  in                                                               
Sitka and  has been working  at SouthEast Alaska  Regional Health                                                               
Consortium (SEARHC)  as a  hospital-based optometrist  for nearly                                                               
21 years, serving  patients from Yakutat to Prince  of Wales. She                                                               
related  that  she  is  a  fellow  of  the  American  Academy  of                                                               
Optometry and  a Diplomate  of the  American Board  of Optometry.                                                               
She has  served on this board  for the last four  years and would                                                               
like  to   continue  as   the  board   works  to   implement  new                                                               
regulations.  She offered  her belief  that  as a  hospital-based                                                               
optometrist she  brings a slightly  different perspective  to the                                                               
board as it works to ensure public safety.                                                                                      
                                                                                                                                
1:35:14 PM                                                                                                                    
SENATOR  STEVENS   asked  her  to  comment   on  her  interesting                                                               
educational background.                                                                                                         
                                                                                                                                
MS.  STEFFES related  that chemistry  stimulated her  interest in                                                               
optometry  school   and  she  was   fortunate  to  work   for  an                                                               
optometrist in Sitka while going  to school. She decided early-on                                                               
that  working in  this  field in  Sitka was  her  goal. She  also                                                               
serves in  this capacity for  the local Native  corporation. That                                                               
work drove her to get her Masters' in Business in 2012.                                                                         
                                                                                                                                
SENATOR   STEVENS   congratulated    her   on   her   educational                                                               
achievements.                                                                                                                   
                                                                                                                                
1:36:19 PM                                                                                                                    
CHAIR BISHOP  suggested she stay  online for public  testimony at                                                               
the end of the hearings.                                                                                                        
                                                                                                                                
1:36:42 PM                                                                                                                    
DEIRDRE   FORD,   Appointee,    Workers'   Compensation   Appeals                                                               
Commission,  Department   of  Labor  and   Workforce  Development                                                               
(DOLWD), Anchorage,  Alaska, stated  that she was  reappointed as                                                               
chair  of the  appeals commission  and  it's been  a pleasure  to                                                               
serve in that capacity for the  last three years. She came out of                                                               
retirement to  serve as  chair of the  commission and  feels that                                                               
this  has been  a wonderful  and challenging  opportunity to  pay                                                               
back her  good fortune  to live  in Alaska  since 1978.  When she                                                               
arrived  in the  state, she  was  a librarian  but couldn't  find                                                               
work. The state  made it possible to return to  school and become                                                               
a lawyer.  She practiced  legal defense work  for about  25 years                                                               
then 3.5 years as a  workers' compensation hearing officer before                                                               
retiring.  When people  on both  sides of  the bar  asked her  to                                                               
apply to the appeals commission she  did so. It's been a pleasure                                                               
to try  to bring some stability  to the commission and  she would                                                               
like to serve for another four years.                                                                                           
                                                                                                                                
SENATOR STEVENS  asked what  the time commitment  is to  serve as                                                               
chair of the Workers' Compensation Appeals Commission.                                                                          
                                                                                                                                
MS.  FORD said  it is  a full-time  position, but  the daily  and                                                               
weekly time commitment depends on  the number of appeals and oral                                                               
arguments and the  complexity of the cases. She  relayed that she                                                               
would like to work on  revising some regulations when she doesn't                                                               
have an  oral argument  pending, a motion,  or decision  to write                                                               
for the commissioners to consider.                                                                                              
                                                                                                                                
1:40:42 PM                                                                                                                    
CHAIR  BISHOP thanked  her for  reapplying and  for helping  give                                                               
injured Alaskans a fair hearing.                                                                                                
                                                                                                                                
MS. FORD said that was her goal.                                                                                                
                                                                                                                                
1:41:09 PM                                                                                                                    
AMY STEELE, Appointee,  Workers' Compensation Appeals Commission,                                                               
Department   of   Labor   and  Workforce   Development   (DOLWD),                                                               
Anchorage, Alaska,  stated that  she was seeking  confirmation as                                                               
an   employer   representative   commissioner  on   the   appeals                                                               
commission. She referenced  her resume that shows that  she was a                                                               
Workers' Compensation  Board member from 2011-2019.  She said she                                                               
wants to serve because she  has specialized knowledge in workers'                                                               
compensation that would  benefit the state. She  relayed that she                                                               
currently  works  as  the  senior  claims  adjuster  for  Chenega                                                               
Corporation overseeing workers' compensation and other claims.                                                                  
                                                                                                                                
1:42:40 PM                                                                                                                    
SENATOR REVAK asked her to  discuss her involvement in the Zurich                                                               
Western Customer Round Table.                                                                                                   
                                                                                                                                
MS. STEELE explained  that Zurich North America  is the insurance                                                               
company  her employer  uses for  workers'  compensation. She  has                                                               
been asked  to participate and  provide feedback  about different                                                               
topics.                                                                                                                         
                                                                                                                                
SENATOR REVAK said it sounds like a great experience.                                                                           
                                                                                                                                
CHAIR  BISHOP  observed that  her  degrees  were in  biology  and                                                               
chemistry but she was working in workers' compensation.                                                                         
                                                                                                                                
1:44:10 PM                                                                                                                    
MS. STEELE explained  that after she graduated she took  a job in                                                               
Georgia to do  water sampling, but the company  decided she would                                                               
be a better fit doing  drug screenings and running OSHA programs.                                                               
After  that  she moved  into  risk  management  and ended  up  in                                                               
insurance.                                                                                                                      
                                                                                                                                
1:44:46 PM                                                                                                                    
ELEANOR  VINSON,  Appointee,  Board of  Professional  Counselors,                                                               
Department  of  Commerce,   Community  and  Economic  Development                                                               
(DCCED),  Juneau,  Alaska,  stated  that she  held  a  degree  in                                                               
sociology. She  moved to Valdez  in 1977 and thereafter  lived in                                                               
different  locations  and  traveled  throughout  the  state.  She                                                               
opined  that her  experience in  different regions  of the  state                                                               
would help  her service  on the  board. She  worked for  DCCED in                                                               
professional licensing  for a number  of years and  was appointed                                                               
to this board as a public member after she retired.                                                                             
                                                                                                                                
1:46:05 PM                                                                                                                    
At ease                                                                                                                         
                                                                                                                                
1:46:24 PM                                                                                                                    
CHAIR BISHOP  reconvened the meeting and  opened public testimony                                                               
on the appointees. Finding none, he closed it.                                                                                  
                                                                                                                                
1:46:39 PM                                                                                                                    
CHAIR BISHOP  stated that  in accordance  with AS  39.05.080, the                                                               
Senate  Labor  and  Commerce   Standing  Committee  reviewed  the                                                               
following  and  recommends the  appointments  be  forwarded to  a                                                               
joint session for consideration:                                                                                                
                                                                                                                                
Board of Examiners in Optometry                                                                                               
Pamela Steffes - Sitka                                                                                                          
                                                                                                                                
Board of Professional Counselors                                                                                              
Eleanor Vinsor - Juneau                                                                                                         
                                                                                                                                
Workers' Compensation Appeals Commission                                                                                      
Deirdre Ford - Anchorage                                                                                                        
Amy Steel - Anchorage                                                                                                           
                                                                                                                                
Signing  the   reports  regarding  appointments  to   boards  and                                                               
commissions in  no way reflects  individual members'  approval or                                                               
disapproval  of  the  appointees;   the  nominations  are  merely                                                               
forwarded to the full legislature for confirmation or rejection.                                                                
                                                                                                                                
1:47:10 PM                                                                                                                    
At ease                                                                                                                         
                                                                                                                                
             SB 172-EXTENDING THE STATE MEDICAL BOARD                                                                       
                                                                                                                                
1:55:25 PM                                                                                                                    
CHAIR   BISHOP  reconvened   the   meeting   and  announced   the                                                               
consideration  of SENATE  BILL  NO. 172,  "An  Act extending  the                                                               
termination date  of the State  Medical Board; and  providing for                                                               
an effective date."                                                                                                             
                                                                                                                                
He noted  that this  was the first  hearing and  public testimony                                                               
would be heard.                                                                                                                 
                                                                                                                                
1:55:54 PM                                                                                                                    
SENATOR DONNY  OLSON, Alaska  State Legislature,  Juneau, Alaska,                                                               
sponsor of SB 172, stated that  this bill extends the life of the                                                               
State Medical Board  for five years. He explained  that the board                                                               
is  composed of  physicians  and lay  people  who review  medical                                                               
license applications. This board  safeguards the people of Alaska                                                               
by ensuring  that these  licensees are operating  in a  legal and                                                               
professional manner.                                                                                                            
                                                                                                                                
CHAIR BISHOP asked Ms. Curtis                                                                                                   
                                                                                                                                
1:57:47 PM                                                                                                                    
KRIS  CURTIS, Legislative  Auditor,  Legislative Audit  Division,                                                               
Alaska  State Legislature,  Juneau, Alaska,  reviewed the  sunset                                                               
audit for the State Medical  Board. She directed attention to the                                                               
April  26,  2019 sunset  audit  of  the Department  of  Commerce,                                                               
Community and  Economic Development (DCCED), State  Medical Board                                                               
that was in  members' packets. She explained that  the purpose of                                                               
a sunset audit  is to determine whether a board  or commission is                                                               
serving  the  public's  interest  and  should  be  extended.  She                                                               
paraphrased the following REPORT CONCLUSIONS:                                                                                   
                                                                                                                                
     The  audit  concluded  the board  served  the  public's                                                                    
     interest    by   effectively    licensing   physicians,                                                                    
     osteopaths,  podiatrists,   physician  assistants,  and                                                                    
     paramedics.  The board  monitored licensees  and worked                                                                    
     to  ensure  only  qualified  individuals  practiced  in                                                                    
     Alaska.  Furthermore, the  board developed  and adopted                                                                    
     certain  regulatory  changes  to  protect  the  public,                                                                    
     improve   the  licensing   process,  and   improve  the                                                                    
     delivery of services.                                                                                                      
                                                                                                                                
     The audit  also concluded the  board did not  serve the                                                                    
     public  interest  by   inconsistently  reporting  board                                                                    
     license  actions to  the  Federation  of State  Medical                                                                    
     Boards  (FSMB). In  addition, the  board did  not adopt                                                                    
     regulations  to  require   licensees  register  in  the                                                                    
     controlled substance prescription  database and did not                                                                    
     adequately  monitor licensees  to ensure  those with  a                                                                    
     DEA  number registered  with  the controlled  substance                                                                    
     prescription database.                                                                                                     
                                                                                                                                
     In accordance  with AS  08.03.010(c)(13), the  board is                                                                    
     scheduled to  terminate on June 30,  2020. We recommend                                                                    
     the legislature extend the  board's termination date to                                                                    
     June  30, 2025,  which  is three  years  less than  the                                                                    
     eight  year maximum  allowed per  statute. The  reduced                                                                    
     extension is mainly due to  the failure of the board to                                                                    
     consistently report license actions  to the FSMB, adopt                                                                    
     regulations  governing registration  in the  controlled                                                                    
     substance    prescription    database,   and    monitor                                                                    
     compliance with the registration requirement.                                                                              
                                                                                                                                
1:59:14 PM                                                                                                                    
MS.  CURTIS  directed  attention to  the  Background  Information                                                               
section of the audit that begins  on page 5. She related that the                                                               
section explains the following:                                                                                                 
                                                                                                                                
     Senate   Bill  74,   effective   July  2017,   required                                                                    
     occupational board licensees  that prescribe controlled                                                                    
     substances  to register  with the  controlled substance                                                                    
     prescription  database  maintained   by  the  Board  of                                                                    
     Pharmacy. The  database is  intended to  reduce misuse,                                                                    
     abuse,   and   diversion  of   controlled   substances.                                                                    
     Practitioners are required to  check the database prior                                                                    
     to    dispensing,    prescribing,   or    administering                                                                    
     medications, with certain exclusions.                                                                                      
                                                                                                                                
MS. CURTIS  turned to Exhibit  2 on page  11 that shows  that the                                                               
board issued about  1,600 new licenses from July  1, 2015 through                                                               
January 31,  2019. At the  end of  January 2019 there  were 5,073                                                               
active  licensees,  which  represents  a  nine  percent  increase                                                               
compared to the previous sunset audit in 2012.                                                                                  
                                                                                                                                
She turned to Exhibit 3,  Schedules of Revenues and Expenditures,                                                               
on page  14. It shows that  at the end  of FY18, the board  had a                                                               
deficit  of  just  over  $800,000. The  board  responded  to  the                                                               
deficit by  raising fees, which are  listed in Exhibit 4  on page                                                               
15.                                                                                                                             
                                                                                                                                
MS. CURTIS  directed attention to  the three  recommendations for                                                               
improvements that begin on page 18.                                                                                             
                                                                                                                                
     Recommendation   No.   1:   The  board   should   adopt                                                                  
     regulations to  guide the process for  registering with                                                                  
     the controlled substance prescription database.                                                                          
                                                                                                                                
     The  board   did  not  adopt  regulations   to  require                                                                    
     licensees with a  Drug Enforcement Administration (DEA)                                                                    
     number   register   with   the   controlled   substance                                                                    
     prescription  database.  Senate  Bill  74,  Section  60                                                                    
     included uncodified  law that directed all  boards that                                                                    
     licensed  occupations  with prescription  authority  to                                                                    
     adopt regulations to implement the law.                                                                                    
                                                                                                                                
     Rather than adopt  regulatory guidance for registering,                                                                    
     the  board   expanded  the  regulatory   definition  of                                                                    
     unprofessional  conduct to  include  licensees that  do                                                                    
     not  register. The  board also  implemented regulations                                                                    
     that  require   review  of  the   controlled  substance                                                                    
     prescription   database   prior   to   prescribing   or                                                                    
     dispensing and  added an  opioid maximum  daily dosage.                                                                    
     Board  members  did  not  consider  the  importance  of                                                                    
     establishing regulations  to guide  in the  process and                                                                    
     believed  the regulatory  changes that  were made  were                                                                    
     sufficient to  satisfy the requirements of  Senate Bill                                                                    
     74.                                                                                                                        
                                                                                                                                
     The database was intended to  reduce misuse, abuse, and                                                                    
     diversion  of   controlled  substances.  The   lack  of                                                                    
     regulations    regarding   registration    requirements                                                                    
     increases  the risk  that licensees  will not  register                                                                    
     which,  in turn,  limits the  database's effectiveness.                                                                    
     As described  in Recommendation No. 2,  the audit found                                                                    
     a high  degree of  noncompliance with  the registration                                                                    
     requirements.                                                                                                              
                                                                                                                                
     We recommend  the board adopt regulations  to guide the                                                                    
     process for  registering with the  controlled substance                                                                    
     prescription database.                                                                                                     
                                                                                                                                
2:01:43 PM                                                                                                                    
     Recommendation   No.  2:   The  board   should  develop                                                                  
     procedures  to  ensure  licensees  with  a  DEA  number                                                                  
     register  in  the   controlled  substance  prescription                                                                  
     database.                                                                                                                
                                                                                                                                
     Per AS 08.64.101(a)(7), effective  July 2017, the board                                                                    
     must  require a  licensee  who has  a DEA  registration                                                                    
     number  to  register   with  the  controlled  substance                                                                    
     prescription  database.  The   audit  reviewed  25  new                                                                    
     licenses (of which 19 had  a DEA number) and 15 renewal                                                                    
     licenses  (of  which 13  had  a  DEA number).  Auditors                                                                    
     noted that  the application  form for new  licenses did                                                                    
     not   require   an   applicant  provide   evidence   of                                                                    
     registration    with     the    controlled    substance                                                                    
     prescription  database.3 Division  staff processed  the                                                                    
     applications  and the  board approved  the applications                                                                    
     without  regard  for  whether   or  not  the  applicant                                                                    
     registered  with  the  database. Auditors  checked  the                                                                    
     database  and found  that five  of the  19 new  license                                                                    
     applicants  with  a DEA  number  (26  percent) had  not                                                                    
     registered    four  applicants were  not listed  in the                                                                    
     database  and one  was listed  in the  database with  a                                                                    
     status of "pending."                                                                                                       
                                                                                                                                
     Auditors  noted   that  the  renewal   application  was                                                                    
     revised  in November  2018  to  request applicants  for                                                                    
     renewal  licenses   list  their   controlled  substance                                                                    
     prescription  database  registration  number.  However,                                                                    
     applicants  were   permitted  to   list  a   status  of                                                                    
     "pending,"  and division  staff did  not verify  that a                                                                    
     licensee  obtained a  registration  number  at a  later                                                                    
     date.  Four of  the 13  renewal applicants  with a  DEA                                                                    
     number (31 percent) had a status of "pending."                                                                             
                                                                                                                                
     The  board   and  DCBPL  failed   to  comply   with  AS                                                                    
     08.64.101(a)(7)  due to  a lack  of procedures  and the                                                                    
     board's  decision to  allow  licensees  a grace  period                                                                    
     before enforcing the new requirements.  The law did not                                                                    
     provide for  a grace period  and had an  effective date                                                                    
     of July 2017.                                                                                                              
                                                                                                                                
     The  controlled  substance  prescription  database  was                                                                    
     intended  to reduce  misuse,  abuse,  and diversion  of                                                                    
     controlled  substances.  Incomplete information  within                                                                    
     the database limits  its effectiveness, which increases                                                                    
     the risk  that controlled  substances may be  abused or                                                                    
     diverted.                                                                                                                  
                                                                                                                                
     We  recommend the  board develop  procedures to  ensure                                                                    
     licensees  with   a  DEA   number  register   with  the                                                                    
     controlled substance prescription database.                                                                                
                                                                                                                                
2:02:15 PM                                                                                                                    
     Recommendation No. 3: The board  chair should work with                                                                  
     DCBPL's director to  establish and implement procedures                                                                  
     to ensure  board disciplinary  actions are  reported in                                                                  
     accordance with state law.                                                                                               
                                                                                                                                
     Of  the 140  board disciplinary  actions issued  by the                                                                    
     State Medical Board between FY  16 and January 2019, 44                                                                    
     (31 percent) were not reported  to the FSMB as required                                                                    
     by AS 08.64.335.                                                                                                           
                                                                                                                                
     Alaska Statute 08.64.335 states:                                                                                           
                                                                                                                                
     The board  shall promptly report  to the  Federation of                                                                    
     State Medical  Boards for  inclusion in  the nationwide                                                                    
     disciplinary  data  bank  license and  permit  refusals                                                                    
     under AS  08.64.240, actions taken  by the  board under                                                                    
     AS  08.64.331, and  license and  permit suspensions  or                                                                    
     surrenders under AS 08.64.332 or 08.64.334.                                                                                
                                                                                                                                
     The 44  disciplinary actions not reported  to FSMB were                                                                    
     actions  taken   by  the  board  under   AS  08.64.331.                                                                    
     According to DCBPL  management, staff misunderstood the                                                                    
     types  of actions  to  be  reported. Additionally,  the                                                                    
     board  and DCBPL  lacked written  procedures to  ensure                                                                    
     the  actions  were  correctly   reported  in  a  timely                                                                    
     manner.                                                                                                                    
                                                                                                                                
     The national  data bank maintained by  FSMB is designed                                                                    
     to restrict  the ability  of incompetent  physicians to                                                                    
     move  from   state  to  state  without   disclosure  or                                                                    
     discovery  of  a  physician's damaging  or  incompetent                                                                    
     performance.  DCBPL's  failure to  report  disciplinary                                                                    
     actions increases the risk to public safety.                                                                               
                                                                                                                                
     We  recommend   the  board  chair  work   with  DCBPL's                                                                    
     director  to  establish  and  implement  procedures  to                                                                    
     ensure  board  disciplinary  actions  are  reported  in                                                                    
     accordance with state law.                                                                                                 
                                                                                                                                
2:03:11 PM                                                                                                                    
MS. CURTIS directed  attention to the responses to  the audit. On                                                               
page  31,  the  commissioner  of   the  Department  of  Commerce,                                                               
Community   and   Economic   Development  (DCCED)   stated   that                                                               
corrective action had been taken in accordance with state law.                                                                  
                                                                                                                                
On page 33 the board chair,  in response to Recommendation No. 1,                                                               
reiterated  her   belief  that   the  statutes   clearly  require                                                               
licensees to  register so regulations  appear to  be unnecessary.                                                               
She  also  stated  that  the   Department  of  Law  reviewed  the                                                               
regulations the  board created and  found them to  be sufficient.                                                               
The chair did  say the board would consult the  Department of Law                                                               
and take action that was deemed necessary.                                                                                      
                                                                                                                                
In  response to  Recommendation No.  2 to  develop procedures  to                                                               
ensure that licensees register, the  chair stated a procedure had                                                               
been created to ensure compliance.  The chair further stated that                                                               
it  was not  the board's  intention to  grant a  grace period  to                                                               
comply with the law, only for enforcing the law.                                                                                
                                                                                                                                
The  chair   agreed  with  Recommendation  No.   3  to  implement                                                               
procedures  that   disciplinary  actions  are  reported   to  the                                                               
national databases.                                                                                                             
                                                                                                                                
2:04:27 PM                                                                                                                    
CHAIR BISHOP asked if there were questions.                                                                                     
                                                                                                                                
2:04:36 PM                                                                                                                    
SENATOR STEVENS  asked if  the normal extension  was 8  years and                                                               
the audit recommendation was a 5-year extension.                                                                                
                                                                                                                                
MS. CURTIS answered yes.                                                                                                        
                                                                                                                                
SENATOR STEVENS asked if she  believes these deficiencies will be                                                               
corrected in 5 years.                                                                                                           
                                                                                                                                
MS. CURTIS  replied she  hoped so but  Legislative Audit  did not                                                               
have a mechanism to check until the next sunset in 5 years.                                                                     
                                                                                                                                
SENATOR STEVENS asked if she  thought a 3-year extension might be                                                               
better.                                                                                                                         
                                                                                                                                
MS. CURTIS  replied Legislative  Audit will take  a hard  look at                                                               
the controlled substance database  across all professions and the                                                               
degree  of compliance  when it  conducts  a sunset  audit on  the                                                               
Board of Pharmacy. She noted  that pharmaceuticals was the reason                                                               
that the board received a 4-year extension on the last audit.                                                                   
                                                                                                                                
2:05:53 PM                                                                                                                    
SENATOR COSTELLO  called the audit  surprising. She asked  if the                                                               
board or  the physician would be  liable if there was  a death or                                                               
egregious outcome as  a result of prescription drug  abuse and it                                                               
turns out  that the  board wasn't doing  due diligence  in asking                                                               
people to report and hasn't written regulations.                                                                                
                                                                                                                                
CHAIR BISHOP said the Department of  Law could answer that at the                                                               
next hearing. He expressed concern  that there was a prescription                                                               
drug abuse  epidemic and  the board still  was not  in compliance                                                               
three years after Senate Bill 74 passed.                                                                                        
                                                                                                                                
He asked Ms. Chambers to discuss the fiscal note.                                                                               
                                                                                                                                
2:08:25 PM                                                                                                                    
SARA CHAMBERS, Director, Division  of Corporations, Business, and                                                               
Professional  Licensing, Department  of  Commerce, Community  and                                                               
Economic Development  (DCCED), Juneau, Alaska, explained  that SB
172 was a sunset audit so  there was no appropriation request for                                                               
FY21 because  the board would go  away if the board  sunsets. The                                                               
costs in subsequent  years reflect the cost of  the medical board                                                               
itself. There was $30 thousand  in travel for eight board members                                                               
and one  staff to attend  four board meetings per  year. Services                                                               
fees  for  public  noticing  of   board  meetings,  training  and                                                               
conference fees, and per diem  stipends for board members amounts                                                               
to $1,500 per year.                                                                                                             
                                                                                                                                
2:10:40 PM                                                                                                                    
CHAIR BISHOP thanked Ms. Chambers and opened public testimony.                                                                  
                                                                                                                                
2:11:05 PM                                                                                                                    
TIM OLSEN,  Physician Assistant and  Chair, State  Medical Board,                                                               
Anchorage, Alaska,  assured the  committee that the  findings and                                                               
recommendations  in  the audit  would  be  addressed in  a  short                                                               
period of time.                                                                                                                 
                                                                                                                                
2:12:15 PM                                                                                                                    
SENATOR STEVENS asked what he meant by a "short period of time."                                                                
                                                                                                                                
MR. OLSEN answered that the  inconsistency resulted from the lack                                                               
of clarity  on the guidelines  set forth  for the board,  but now                                                               
all the required regulations will be passed.                                                                                    
                                                                                                                                
SENATOR STEVENS asked for a time certain.                                                                                       
                                                                                                                                
MR. OLSEN  replied there  was a large  turnover in  state medical                                                               
board members  which made  it difficult to  give a  more specific                                                               
answer, but  it would  require just  one telephonic  meeting that                                                               
could take place in the next month.                                                                                             
                                                                                                                                
CHAIR  BISHOP   listed  the   individuals  available   to  answer                                                               
questions.                                                                                                                      
                                                                                                                                
2:14:23 PM                                                                                                                    
CHAIR BISHOP  said his office would  work with members to  find a                                                               
path forward and public testimony would remain open.                                                                            
                                                                                                                                
SENATOR OLSON said in closing that he anticipated that the board                                                                
would come together to address the problems the audit                                                                           
highlighted.                                                                                                                    
                                                                                                                                
CHAIR BISHOP held SB 172 in committee.                                                                                          
                                                                                                                                
2:15:50 PM                                                                                                                    
There being no further business to come before the committee,                                                                   
Chair Bishop adjourned the Senate Labor and Commerce Standing                                                                   
Committee meeting at 2:15 p.m.                                                                                                  
                                                                                                                                

Document Name Date/Time Subjects
SB 172 Sponsor Statement.pdf SL&C 2/18/2020 1:30:00 PM
SL&C 3/3/2020 1:30:00 PM
SB 172
SB172 DRAFT Fiscal Note DCCED CBPL 02-14-20.pdf SL&C 2/18/2020 1:30:00 PM
SL&C 3/3/2020 1:30:00 PM
SB 172
Audit of DCCED State Medical Board w responses.pdf SL&C 2/18/2020 1:30:00 PM
SL&C 3/3/2020 1:30:00 PM
SB 172
L&C Optometry Examiners Steffes #1.pdf SL&C 2/18/2020 1:30:00 PM
Confirmations
L&C Professional Counselors Vinson #1.pdf SL&C 2/18/2020 1:30:00 PM
Confirmations
L&C Workers Compensation Board Williams #1.pdf SL&C 2/18/2020 1:30:00 PM
Confirmations
L&C Workers Compensation Appeal Ford #1.pdf SL&C 2/18/2020 1:30:00 PM
Confirmations
L&C Workers Compensation Appeal Steele #1.pdf SL&C 2/18/2020 1:30:00 PM
Confirmations