02/07/2019 01:30 PM Senate LABOR & COMMERCE
| Audio | Topic |
|---|---|
| Start | |
| SB36 | |
| SB29 | |
| SB25 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SB 36 | TELECONFERENCED | |
| *+ | SB 29 | TELECONFERENCED | |
| *+ | SB 25 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE LABOR AND COMMERCE STANDING COMMITTEE
February 7, 2019
1:31 p.m.
MEMBERS PRESENT
Senator Lora Reinbold, Chair
Senator Mia Costello, Vice Chair
Senator Click Bishop
Senator Chris Birch
Senator Elvi Gray-Jackson
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
SENATE BILL NO. 36
"An Act extending the termination date of the Board of Nursing;
and providing for an effective date."
- MOVED SB 36 OUT OF COMMITTEE
SENATE BILL NO. 29
"An Act extending the termination date of the Board of Marine
Pilots; and providing for an effective date."
- MOVED SB 29 OUT OF COMMITTEE
SENATE BILL NO. 25
"An Act extending the termination date of the Board of Dental
Examiners; and providing for an effective date."
- MOVED SB 25 OUT OF COMMITTEE
PREVIOUS COMMITTEE ACTION
BILL: SB 36
SHORT TITLE: EXTEND BOARD OF NURSING
SPONSOR(s): SENATOR(s) GIESSEL
01/25/19 (S) READ THE FIRST TIME - REFERRALS
01/25/19 (S) L&C, FIN
BILL: SB 29
SHORT TITLE: EXTEND BOARD OF MARINE PILOTS
SPONSOR(s): SENATOR(s) STEDMAN
01/23/19 (S) READ THE FIRST TIME - REFERRALS
01/23/19 (S) L&C, FIN
BILL: SB 25
SHORT TITLE: EXTEND BOARD OF DENTAL EXAMINERS
SPONSOR(s): SENATOR(s) WILSON
01/18/19 (S) READ THE FIRST TIME - REFERRALS
01/18/19 (S) L&C, FIN
WITNESS REGISTER
SENATOR CATHY GIESSEL
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Testified as sponsor of SB 36.
KRIS CURTIS, Legislative Auditor
Legislative Audit Division
Legislative Agencies and Offices
Juneau, Alaska
POSITION STATEMENT: Presented audit findings on the Board of
Nursing during the discussion of SB 36.
DAVID SCOTT, Staff
Senator Bert Stedman
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented SB 29 on behalf of the sponsor.
KRIS CURTIS, Legislative Auditor
Legislative Audit Division
Legislative Agencies and Offices
Juneau, Alaska
POSITION STATEMENT: Presented audit findings on the Board of
Marine Pilots during the discussion of SB 29.
BARRY OLIVER, Captain; Member
Southeast Alaska Pilots' Association
Juneau, Alaska
POSITION STATEMENT: Testified during the discussion of SB 29.
SENATOR DAVID WILSON
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Testified as sponsor of SB 25.
KRIS CURTIS, Legislative Auditor
Legislative Audit Division
Legislative Agencies and Offices
Juneau, Alaska
POSITION STATEMENT: Presented audit findings on the Board of
Dental Examiners during the discussion of SB 25.
DAVID NIELSON, Dentist (DDS); Member
Board of Dental Examiners
Division of Corporations, Business & Professional Licensing
Department of Commerce, Community and Economic Development
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 25.
SARA CHAMBERS, Director
Division of Corporations, Business & Professional Licensing
Department of Commerce, Community and Economic Development
Juneau, Alaska
POSITION STATEMENT: Answered questions during the discussion of
SB 25.
DAVID LOGAN, Dentist (DDS)
Executive Director
Alaska Dental Society
Juneau, Alaska
POSITION STATEMENT: Testified during the discussion of SB 25.
ACTION NARRATIVE
1:31:49 PM
CHAIR LORA REINBOLD called the Senate Labor and Commerce
Standing Committee meeting to order at 1:31 p.m. Present at the
call to order were Senators Gray-Jackson, Costello, Birch,
Bishop, and Chair Reinbold.
SB 36-EXTEND BOARD OF NURSING
1:32:50 PM
CHAIR REINBOLD announced that the first order of business would
be SENATE BILL NO. 36, "An Act extending the termination date of
the Board of Nursing; and providing for an effective date."
CHAIR REINBOLD stated her intention to move SB 36 if it is the
will of the committee. She solicited a motion and Senator
Costello made a clarifying motion to bring the original version
before the committee.
SENATOR BISHOP objected for discussion purposes.
1:33:59 PM
SENATOR CATHY GIESSEL, Alaska State Legislature, said she wanted
to declare that she does not have a conflict of interest as the
sponsor of SB 36. She explained that she has two licenses
regulated by the Board of Nursing, but she will not gain any
benefit or harm in sponsoring this bill. The board's charge is
to protect the public through safe practice of nursing, not to
protect her licenses in any way.
She related her understanding that the Legislative sunset review
audit is in members' packets. She directed attention to page 7
of the audit, related to licensing activity for the board from
FY 15-18. She said she served two terms on this board and
chaired this board for five years. The total number of licenses
at the end of January 2018 is nearly 20,000. She estimated that
when she was chair, the total number of licensees for the Board
of Nursing represented about 25 percent of the total licensees
regulated by the state and she is not certain if that percentage
has changed.
SENATOR GIESSEL pointed out that the board oversees six
categories of licenses. She listed them: Certified Nurse Aide
(CNA), Advanced Nurse Practitioner Preceptorship (ANPP),
Advanced Practice Registered Nurse (APRN), Certified Registered
Nurse Anesthetist (CRNA), Licensed Practical Nurse (LPN), and
Registered Nurse (RN).
She said the Board of Nursing regulates the most diverse
population of licensees. Each category on this list has
different education and training requirements for licensure,
ranging from high school to a doctoral degree. She said that
this is a huge task. For example, the CNA is an entry level
position and for certification, a CNA must have a high school
diploma, undergo training for several months, and pass an exam.
SENATOR GIESSEL said the audit report highlights some gaps the
board needs to address. One gap the auditor identified was the
need to better monitor the CNA programs, another gap related to
nursing services being provided via distance delivery or
telemedicine. The nursing profession also refers to telemedicine
as telehealth. During the time she chaired the Board of Nursing,
the board felt that this authority had already been given to the
Advanced Practice Registered Nurses (APRNs). In fact, APRNs have
been providing telehealth services since the late 1990s, she
said. In 1998, an APRN conducted a model or test program in
Girdwood using telemedicine. Avalanches often cause road
closures and limit travel between Anchorage and Girdwood, she
said. If a skier had an injury, using telemedicine the APRN
could transmit the skier's X-ray to an orthopedic surgeon in
Anchorage, who would suggest treatment. This same APRN also
began a clinic in Hope, a small community across Turnagain Arm
that did not have health care services. Using telemedicine, the
clinic communicated telephonically and via computer imaging to
provide medical services to Hope. Until recently, the board
thought it had the authority to authorize telemedicine services.
She suggested that members may wish to ask the board's executive
administrator how the board is progressing on telemedicine.
1:40:17 PM
SENATOR BIRCH asked for further clarification on the difference
in training and qualifications for nurses and paramedics.
SENATOR GIESSEL responded that RNs are educated to care for the
"entire" person, and either are diploma graduates with a two-
year college degree or have earned a bachelor's degree. She said
that RNs can practice in hospitals or clinics and their
practices range from orthopedic care to obstetrics. Paramedics
have extensive and intensive training, are regulated by the
State Medical Board, and have focused education on emergency
medical situations. She described the difference that paramedics
provide very urgent care and RNs provide long-term global health
care and public health nursing services.
1:41:42 PM
KRIS CURTIS, Legislative Auditor, Legislative Audit Division,
Legislative Agencies and Offices, related the division conducted
a sunset audit on the Board of Nursing [Audit Control Number 08-
20113-18]. She explained the purpose of a sunset audit is to
determine whether a board or commission is serving the public's
interest and if its termination date should be extended. The
legislative audit determined that the Board of Nursing is
serving the public's interest by conducting meetings in
accordance with state law, by amending certain regulations to
improve the CNA and nursing occupations, and by effectively
licensing CNAs and nurses. The audit also determined that the
board failed to serve the public's interest because it failed to
establish telehealth regulations, did not adequately monitor the
CNA training program, and did not notify appropriate entities
when a licensee's prescription authority was suspended, revoked,
or surrendered. The audit determined that improvements were
needed with the Division of Corporation, Business, &
Professional Licensing's (DCBPL) investigative process. She said
the auditors recommend the legislature extend the Board of
Nursing for six years.
She remarked Senator Giessel already reviewed the licensing
statistics. She directed attention to page 11 of the sunset
audit to the schedule of revenues and expenditures. This board
had a deficit of $337,000 at the end of March 2018, she said.
According to DCBPL's management, a fee analysis was planned for
May 2018. She directed attention to the board's license fees on
page 12 for more detail.
MS. CURTIS said page 14 of the audit included four
recommendations for improvements. Audit Recommendation No. 1
recommended that the board adopt regulations to address the
distance delivery of nursing services through technology, also
referred to as telehealth. In FY 15, a licensee approached the
board requesting guidance to provide telehealth services. This
prompted the board to issue an advisory opinion, which defined
telehealth and provided limited guidance on the scope of
practice. However, this guidance was insufficient to promote,
preserve or protect the public health, safety, and welfare, she
said. Although the board discussed the need for telehealth
regulations, it could not agree on the specific regulatory
language. Providing insufficient guidance to licensees increases
the risk that nurses may not maintain acceptable standards of
practice and may not adequately protect patient confidentiality.
She said Recommendation No. 2 asked the board to take steps to
ensure that the appropriate entities are notified when a
licensee's prescription authority is suspended, revoked or
surrendered. The audit identified eight APRNs who had their
prescription authority revoked or surrendered between the dates
of July 2014 through January 2018. In all cases, the board did
not notify the Board of Pharmacy or the federal DEA [Drug
Enforcement Agency] about the licensing action. These entities
were not notified because the statutes or regulations were not
in place to require the notification. Failure to notify the DEA
or the Board of Pharmacy increases the risk that controlled
substances are abused or diverted, she said.
1:44:54 PM
MS. CURTIS referred to page 15 to Recommendation No. 3. The
audit recommended that the DCBPL's chief investigator ensure
nurse investigations are adequately documented and performed
timely. The audit identified 273 cases that were open for a
period of more than 180 days. The auditors found that 13 of the
28 cases it reviewed had unjustified periods of inactivity that
ranged from 61 days to 3.6 years. The delays were mainly caused
by investigative staff turnover and competing priorities. The
auditors also found two licensees who had been recommended for
investigation by the Long-term Care Ombudsman as potentially
practicing outside their scope of practice. Auditors could not
evaluate these cases due to a lack of documentation in the
files. However, auditors did note that these cases had been
placed in storage for 1.5 years due to an office remodel and did
not progress during that time. One of the two licensees
continued to practice during the 4 years that the cases were
outstanding, potentially posing a risk to public safety.
1:46:08 PM
MS. CURTIS referred to page 16 to Recommendation No. 4, which
recommends the board chair take steps to ensure that the
required Certified Nurse Aide (CNA) onsite training program
reviews and self-evaluations are conducted prior to re-approving
the programs. The regulations require the CNA training programs
be "board approved" every two years with an onsite review. Self-
evaluations are required in the year that the onsite review is
not conducted. The audit found the onsite reviews and the self-
evaluation forms were not being conducted during the audit
period. According to board staff, the onsite reviews were
performed by a contractor who was terminated in FY 14 due to a
conflict of interest. The procurement process to hire a new
contractor was not successful. Eventually the division was able
to re-designate a PCN [Position Control Number] as a nurse
consultant position, hired and trained a person, and the reviews
resumed in the spring of 2016. The board continued to approve
these training programs due to the need for the programs to
continue to be available to train CNAs.
She said that responses to this audit begin on page 27. The
department stated that procedures had been implemented to notify
the Board of Pharmacy and the federal DEA when the prescription
authority has been revoked or surrendered. Additionally, the
department stated it has instituted procedures to help improve
the timeliness of investigations.
MS. CURTIS said the board's response to the audit begins on page
29. The board agreed with all four recommendations and stated it
will take corrective actions. The board also stated it will work
on the telehealth regulations at its November 2018 meeting.
1:48:00 PM
CHAIR REINBOLD asked for further clarification on the $337,000
deficit for license fees.
MS. CURTIS said the audit does not have any recommendation on
fees. She noted that the board has operated in a surplus except
for this year. The way the statute reads, the board must set
license fees to cover its operating costs. This results in
alternating years of deficit with increased fees, followed by a
surplus with decreased fees. Unless auditors see a pattern arise
in which the board fails to increase fees when the board
routinely has deficits, the auditors will not write a
recommendation and will allow the process to carry out.
CHAIR REINBOLD asked for the next audit date to follow up on the
audit recommendations.
MS. CURTIS answered that it depends on how long the legislature
extends the termination date. If SB 36 were to pass in its
current form, it would extend the board for six years, and the
legislative auditors will conduct another sunset audit in six
years.
1:49:22 PM
SENATOR COSTELLO asked if the division takes into consideration
the board's response to the audit when the agency makes a
recommendation for the length of time to extend the board. She
said six years seemed like a long time, but it seemed that the
Division of Legislative Audit received information that the
board agrees with the audit recommendations and is willing to
address the concerns.
MS. CURTIS answered that the division relies on the legislative
oversight process and the committee process in terms of the
legislature holding the board and the division accountable for
implementing any recommendations and determining the status. She
said that a lag time of eight to ten months typically happens
between the audit and the legislative review. During that time,
the board has an opportunity to take corrective action. She said
the Division of Legislative Audit does not have a standard, but
its auditors review prior recommendations during the next sunset
audit to determine how well the board has implemented them. She
said the 2010 sunset audit had four recommendations, three of
which are still outstanding.
CHAIR REINBOLD said she read the board's letter that the board
agreed with all four recommendations and indicated it will take
corrective action. She said she was very impressed with the
board's response.
1:50:56 PM
SENATOR GIESSEL referred to the budget report on page 14 dated
March 2018. In November 2018 most license renewals are due and
"a glut" of revenue will be collected.
1:51:52 PM
CHAIR REINBOLD opened public testimony on SB 36 and after first
determining no one wished to testify, closed public testimony on
SB 36.
1:54:03 PM
SENATOR GIESSEL said she urged the board to act on two items,
including monitoring the CNA program. The federal government
supplies $100,000 per year to fund a position to examine the
program. She acknowledged it does involve travel throughout the
state. She emphasized that the board needs to fill the position.
She will hold the board's "feet to the fire" on telehealth and
the auditor mentioned the division will also monitor it.
1:54:43 PM
SENATOR BISHOP removed his objection.
1:54:54 PM
SENATOR BISHOP reviewed the fiscal note from the Department of
Commerce, Community and Economic Development (DCCED). The
appropriation is to the Division of Corporations, Business, and
Professional Licensing, the allocation is to the Division of
Corporations, Business, and Professional Licensing, and the OMB
component number is 2360. The bill would extend the Board of
Nursing until June 30, 2025. The source of the total operating
costs of $28,400 are designated general fund (DGF) dollars. He
reviewed the breakdown of expenditures: $26,000 is for seven
board members and one examiner to travel to board meetings, $400
is for advertising, $1,000 is for training and conference fees,
and $100 is for stipends.
1:56:31 PM
SENATOR COSTELLO moved to report SB 36, Version 31-LS0314\A,
from committee with individual recommendations and attached
fiscal note. There being no objection, SB 36 was reported from
the Senate Labor and Commerce Standing Committee.
1:56:44 PM
At-ease.
1:58:21 PM
CHAIR REINBOLD reconvened the meeting.
SB 29-EXTEND BOARD OF MARINE PILOTS
1:58:35 PM
CHAIR REINBOLD announced that the next order of business would
be SENATE BILL NO. 29, "An Act extending the termination date of
the Board of Marine Pilots; and providing for an effective
date."
1:58:44 PM
DAVID SCOTT, Staff, Senator Bert Stedman, Alaska State
Legislature, introduced himself.
CHAIR REINBOLD solicited a motion and Senator Costello made a
clarifying motion to bring the original version before the
committee. Senator Bishop objected for discussion purposes.
1:59:21 PM
MR. SCOTT paraphrased the sponsor statement for SB 29, which
read as follows:
The Board of Marine Pilots (Board) protects the safety
of the public and the environment by licensing and
regulating marine pilots for almost all foreign
vessels and vessels over a certain size in Alaskan
waters. Board activities provide a good level of
assurance that marine pilot licensees are competent
and able to safely pilot passenger and cargo ships.
As required under Title 24 and Title 44 of the Alaska
statutes, the Legislative Budget and Audit Division
reviewed the actions of the Board of Marine Pilots.
The audit found a continued need for the Board and
that the Board is following the law, processing
investigations timely, and actively changing
regulations to "improve the industry and better
protect the public." The audit recommended the
Legislature extend the Board's termination date to
June 30, 2027. SB 29 extends the termination date of
the Board of Marine Pilots to June 30, 2027.
He said that the board consists of seven members consisting of
two pilots, two agents of vessels, two public members, and the
commissioner of the Department of Commerce, Community and
Economic Development. He defined an agent of vessels as someone
who works for the company that owns the vessel or directly for
the vessel who hires the marine pilot. The board adopts
regulations to ensure pilots are competent and qualified, makes
final licensing decisions, and takes disciplinary action against
marine pilots who violate laws, he said. He stated the sunset
audit and the board's response to the audit is in members'
packets and Ms. Curtis will address the two recommendations.
2:01:20 PM
KRIS CURTIS, Legislative Auditor, Legislative Audit Division,
Legislative Agencies and Offices, related the division conducted
a sunset audit on the Board of Marine Pilots dated April 2018
[Audit Control Number 08-20112-18]. She said the audit found the
board is serving the public's interest by effectively licensing
marine pilots, deputy marine pilots, and by appropriately
approving trainees and apprentices. She related that board
meetings were conducted in compliance with law, investigations
were processed timely, and the board actively changed
regulations to improve the industry and better protect the
public. The audit recommends an eight-year extension. She
referred to licensing activity on page 12. She related the board
oversees 103 licensees as of January 2018. She referred to the
board's schedule of revenues and expenditures on page 14. She
noted that board fees are located on page 13, that this board
had a surplus of approximately $229,000 as of March 31, 2018.
She referred to the two recommendations for improvements listed
on page 15-16: Recommendation 1: The audit recommends the Board
of Marine Pilots ensure all applicable documents are aboard
foreign pleasure crafts in accordance with regulatory
requirements. She said that regulations require that the
operator of a pleasure craft applying for a pilotage exemption
must ensure that the pleasure craft have aboard certain
documents, such as nautical charts, tide tables, and other
guides. The auditors found that five of the seven applications
that were tested stated that the vessel did not have those
documents aboard. It has been standard procedure for the board
to approve exemptions with the understanding that the applicant
will follow through at a later date and obtain the required
documents. The board did not consider the need for or importance
of ensuring that those documents were actually obtained. In
addition, the exemption itself did not include a stipulation
that the applicant obtain the required documents prior to
entering the applicable area. She said that issuing foreign
pleasure craft exemptions without verifying required documents
are aboard the vessel increases the risk to public safety.
2:03:30 PM
MS. CURTIS referred to page [16] to Recommendation 2: The board
should ensure the Southeast Alaska Pilots' Association (APA)
improves procedures for tracking drug test notification. She
reported that in a sample of nine drug test donors from the
association, the auditor found three donors notified by mail
were not tracked in terms of date and recipient. The APA relied
on a contractor and was not aware the contractor was not
tracking that information, she said. Inadequate procedures for
tracking drug test notifications limit the ability to verify
timeliness and therefore increase the risk to public safety. She
offered her belief that this should be an easy administrative
fix.
She referred to the responses to the audit on page 25. The
response from the department and the board are essentially the
same response because the commissioner is also the board chair.
She said that the department and the board agree with both
recommendations.
2:04:28 PM
SENATOR COSTELLO asked whether it was common practice for a
commissioner to also serve as the board chair.
MS. CURTIS answered that it happens on occasion.
SENATOR COSTELLO asked for further clarification on the
commissioner and the board chair being the same person.
MS. CURTIS responded that it is not uncommon for an entity
within a department to have very similar responses to an audit.
She remarked it makes one wonder if the responses were "penned"
by the same person. However, it does not raise any concerns from
the Division of Legislative Audit's perspective, she said.
2:05:22 PM
CHAIR REINBOLD asked whether these vessels carry fuels.
MS. CURTIS replied that she had no idea what cargo the vessels
being piloted carry.
CHAIR REINBOLD related she raises concern on drug testing due to
the Exxon Valdez oil spill incident. She said that auditors were
not able to confirm the drug tests is a huge issue for her and
the issue should be addressed.
2:06:48 PM
BARRY OLIVER, Captain; Member, Southeast Alaska Pilots'
Association, stated that he previously served as a pilot for the
Alaska Marine Highway System and currently serves as a Southeast
Alaska marine pilot. Most of the vessels he pilots are cruise
ships, he said. He responded to the concern about drug testing,
by saying, "We are all drug tested." He assured her that drug
testing occurred throughout the period in question. Apparently,
the facility had a computer crash and lost the records so
auditors could not locate the records to confirm the marine
pilots' drug testing. However, he personally confirmed that he
was drug tested.
CHAIR REINBOLD said she was glad to know the marine pilots were
drug tested. She related her understanding that the board will
work with the contractor to remedy the record issue.
CAPTAIN OLIVER replied that is correct.
2:08:26 PM
SENATOR BIRCH referred to the documents that needed to be on
board the vessels, such as charts to bring these vessels in
safely. He asked whether the marine pilots use electronic
devices such as using an iPad instead of a binder that contains
charts and other items.
CAPTAIN OLIVER answered that marine pilots carry "a personal
pilot unit," which is plugged into GPS, so they monitor their
own tracking. He said that marine pilots are trained to use all
of the vessel's instruments, but the personal pilot unit acts as
verification that everything is working satisfactorily. He
explained that the act of piloting is visual, so pilots look out
the window. The background electronics on vessels allow pilots
to verify what they see. The captain is there to protect
personal property, marine life, and the marine environment on
behalf of the state, he said.
2:10:31 PM
CHAIR REINBOLD asked him to identify the three regions in Alaska
that marine pilots serve.
CAPTAIN OLIVER related the three regions for marine pilots in
Alaska: Region 1 covers Southeast Alaska from Ketchikan to
Yakutat Bay, Region 2 covers Southwest and Southcentral Alaska
from Icy Bay to Kodiak, including the Kenai Peninsula, and
Alaska Marine Pilots Region 3 covers the Aleutians. He has
worked on the Alaska Marine Highway System and has pilotage all
the way to Kodiak at the federal level. However, licensing in
the state only allows a pilot to operate in one region at a
time. He lives in Juneau and serves Southeast Alaska.
[CHAIR REINBOLD closed public testimony on SB 29.]
2:12:17 PM
SENATOR BISHOP removed his objection.
2:12:18 PM
SENATOR COSTELLO moved to report SB 29, Version 31-LS0167/A,
from committee with individual recommendations and attached
fiscal note. There being no objection, SB 29 was reported from
the Senate Labor and Commerce Standing Committee.
2:12:33 PM
At-ease
2:14:15 PM
CHAIR REINBOLD reconvened the meeting.
SB 25-EXTEND BOARD OF DENTAL EXAMINERS
2:14:23 PM
CHAIR REINBOLD announced that the final order of business would
be SENATE BILL NO. 25, "An Act extending the termination date of
the Board of Dental Examiners; and providing for an effective
date."
2:14:34 PM
SENATOR COSTELLO clarified that the committee would be
considering the original version of the bill.
SENATOR BISHOP objected for the purpose of discussion.
2:15:03 PM
SENATOR DAVID WILSON, Alaska State Legislature, paraphrased from
his sponsor statement, which read as follows:
Senate Bill 25 extends the termination date for the
Board of Dental Examiners until June 30th, 2027. The
Board of Dental Examiners is composed of nine members:
six dentists, two dental hygienists, and one public
member.
Legislative Audit conducted their review of this board
and determined that "The audit concludes that the
board operated in the public's interest by effectively
licensing and regulating dentists, dental hygienists,
and dental assistants. The board monitored licensees
and worked to ensure only qualified individuals
practiced in Alaska. Furthermore, the board was active
in amending regulations to improve the industry. In
accordance with AS 08.03.010(c)(7), the board is
scheduled to terminate on June 30, 2019. We recommend
that the legislature extend the board's termination
date eight years to June 30, 2027."
The Board of Dental Examiners serves an important role
in adopting regulations to carry out the laws
governing the practice of dentistry and dental hygiene
in Alaska. The continuation of this board plays an
important role in ensuring high standards of dental
care are offered throughout the state.
Thank you for your consideration of this legislation.
SENATOR WILSON remarked that Ms. Curtis could speak to the two
recommendations the audit made.
2:16:38 PM
KRIS CURTIS, Legislative Auditor, Legislative Audit Division,
Legislative Agencies and Offices, presented audit findings on
the Board of Dental Examiners, [Audit Control Number 08-20111-
18] dated April 26, 2018 in members' packets. This audit
concluded that the board served the public's interest by
effectively licensing and regulating dentists, dental
hygienists, and dental assistants. The board monitored licensees
and worked to ensure only qualified individuals practiced in
Alaska. Furthermore, the board was active in amending
regulations to improve the industry. The audit recommends the
legislature extend the board for eight years.
She referred to page 6 and related that the auditors reviewed
licensing activity. She reported the number of licensees at the
end of January 2018 was 2,399 active licensees. On page 7, the
schedule of the board's revenues and expenditures shows that the
board had a deficit of approximately $36,000 as of March 31,
2018. She referred members to page 8 for the 2018 fee analysis.
MS. CURTIS referred to the two audit recommendations on pages 9-
10. She turned to audit recommendation 1, which read, "The Board
of Dental Examiners (board) president should take steps to
correct a regulation error." She said the auditors found that a
2016 regulation change referenced a repealed section of
regulations. She characterized this as an easy administrative
fix.
She turned to audit recommendation 2, which read, "DCBPL's chief
investigator, in consultation with the board, should implement
controls to ensure the appropriate entities are notified when a
licensee's prescription authority is suspended or revoked." She
explained that the auditors found that during the audit period
two licensed dentists had their prescription authority revoked
or suspended. In both cases, the board did not notify the Board
of Pharmacy or the federal Drug Enforcement Administration,
mainly because there were no procedures that required
notification. Failure to notify the DEA that a dentist's
prescription authority has been suspended or revoked may result
in improper or unauthorized prescriptions. She referred to the
department's response to the audit on page 19. The department
reported that it has implemented a policy to notify both
entities. She turned to the board's response on page 21. The
board agreed with both recommendations and agreed to take
corrective action, she said.
2:19:22 PM
CHAIR REINBOLD opened public testimony on SB 25.
2:20:04 PM
DAVID NIELSON, Dentist (DDS); Member, Board of Dental Examiners,
Division of Corporations, Business & Professional Licensing,
Department of Commerce, Community and Economic Development,
stated he was just reappointed to the Board of Dental Examiners.
He said that the board serves a vital role in the regulation of
dentistry by always keeping the health and welfare of Alaska's
citizens in mind. He offered his belief that licensing,
permitting, certification and disciplinary action, when
appropriate, is a cornerstone of what the public should expect
from the state government to have confidence in their health
care providers. He said that he enjoys the challenges and
appreciates the opportunity to continue to fulfill the board's
purpose. He stated his support for SB 25.
2:21:05 PM
SENATOR COSTELLO asked him to address the need for more dentists
in Alaska. She further asked if he would discuss the future of
telemedicine in dentistry.
DR. NEILSON related that the board has been working to accept
more national licensing exams and that will increase the pool of
applicants and will improve the pathway to licensure. Further,
the board has been considering allowing some military training
in lieu of certain things done by examination. The board already
reviews applicants' credentials. The distribution of dentists is
an issue, but the overall number of dentists is probably fine.
DR. NEILSON answered that the tribal system uses teledentistry
with its dental health aide therapists and to some extent
dentists in Alaska use teledentistry with their collaborative
agreements with hygienists. While the mechanisms are in place
and some forms of teledentistry can be performed, dentists in
Alaska do not typically use it.
2:23:01 PM
SENATOR GRAY-JACKSON asked what steps the board has taken to
address the audit recommendations and findings.
DR. NEILSON said he thought the board has already addressed the
regulation issue related to the radiologic inspection. He said
the board agreed this needed to be fixed, that he noticed it
quite a while ago. Secondly, he deferred to the licensing
examiner in terms of reporting prescriptions. He stated that
turnover with examiners has caused some issues with continuity,
and the board has had three licensing examiners during his
tenure. He said the board agrees with both audit
recommendations.
2:24:23 PM
SARA CHAMBERS, Director, Division of Corporations, Business &
Professional Licensing, Department of Commerce, Community and
Economic Development, in response to Representative Gray-
Jackson, replied that this finding is a "sister finding" to the
audit recommendation for Board of Nursing mentioned earlier. She
explained that when the reporting issues were brought to the
division's attention the chief investigator had initiated
actions to improve procedures and better coordinate with the
various prescriber boards, the Board of Pharmacy, and the DEA.
She said the investigator wanted to assure that communications
happen "on a two-way basis," and that the board was not just
waiting for the DEA to perform the check.
2:24:59 PM
SENATOR COSTELLO recalled the legislature passed legislation a
few years ago that asked the state to consider reciprocity for
military experience. She asked her to clarify how that is
working or if the legislature needed to do something more.
MS. CHAMBERS agreed the legislature passed several bills to
address some of the employment concerns of military and military
dependents. This board has been given an opportunity to use a
comparison of military experience to more traditional
educational experience. She pointed out that the board does not
get a lot of military applicants. She said the public is
protected since the dentist has experience and capability and
the applicant with the experience can get to work. That law has
been in place, but some boards do not use it due to the small
number of military applicants. However, it is exciting when the
[experience and education] can be pieced together to get to the
same outcome
2:27:29 PM
DAVID LOGAN, Dentist (DDS); Executive Director, Alaska Dental
Society, stated that Dr. Neilson covered the board pretty well.
He said it was fairly self-evident why the state needs a dental
board.
2:27:51 PM
CHAIR REINBOLD, after first determining no one wished to
testify, closed public testimony on SB 25.
2:28:17 PM
SENATOR BISHOP reviewed the fiscal note from the Department of
Commerce, Community and Economic Development. He identified the
appropriation and allocation as the Division of Corporations,
Business, and Professional Licensing (DCBPL) in the amount
$35,000, as follows: travel $3,360 for nine board members and
one examiner to attend four board meetings, $400 for advertising
public notices of board meetings, $1,000 for training and
conference fees, and $100 for board member stipends.
Professional licensing programs within the division are funded
by receipt-supported services. Licensing fees for each
occupation are set per AS 08.01.065 so the total amount of
revenue collected approximately equals the occupation's actual
regulatory costs, he said.
2:29:54 PM
SENATOR BISHOP removed his objection.
2:30:12 PM
SENATOR COSTELLO moved to report SB 25, 31-LS0125\A, from
committee with individual recommendations and attached fiscal
note. There being no objection, SB 25 was reported from the
Senate Labor and Commerce Standing Committee.
2:30:34 PM
At-ease.
2:32:02 PM
CHAIR REINBOLD remarked that the committee reviewed some of the
governor's appointees on 2/5/19, which were forwarded to the
full body for a vote.
Although it is not required by law, she said she thinks it is a
good policy to remind members that 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.
CHAIR REINBOLD reviewed committee announcements.
2:33:37 PM
SENATOR BISHOP asked the record to reflect that Kris Curtis does
an amazing job on the audit reports. She is articulate and
succinct.
2:34:20 PM
There being no further business to come before the committee,
Chair Reinbold adjourned the Senate Labor and Commerce Standing
Committee meeting at 2:34 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB36 Ver. A.PDF |
HL&C 4/24/2019 3:15:00 PM SL&C 2/7/2019 1:30:00 PM |
SB 36 |
| SB36 Sponsor Statement 1-28-19.pdf |
HL&C 4/24/2019 3:15:00 PM SFIN 3/1/2019 9:00:00 AM SL&C 2/7/2019 1:30:00 PM |
SB 36 |
| SB36 Fiscal Note - SB036-DCCED-CBPL-02-01-19.pdf |
HL&C 4/24/2019 3:15:00 PM SL&C 2/7/2019 1:30:00 PM |
SB 36 |
| SB36 Supporting Document Division of Legislative Audit Sunset Review April 2017.pdf |
HL&C 4/24/2019 3:15:00 PM SFIN 3/1/2019 9:00:00 AM SL&C 2/7/2019 1:30:00 PM |
SB 36 |
| SB36 Supporting Document Division of Legislative Audit Sunset Review Summary 08-20113-18.pdf |
SFIN 3/1/2019 9:00:00 AM SL&C 2/7/2019 1:30:00 PM |
SB 36 |
| SB29 Version A.PDF |
SL&C 2/7/2019 1:30:00 PM |
SB 29 |
| SB29 Sponsor Statement Version A.pdf |
SFIN 3/1/2019 9:00:00 AM SL&C 2/7/2019 1:30:00 PM |
SB 29 |
| SB29 Supporting Document Division of Legislative Audit Board of Marine Pilots Sunset Review.pdf |
SFIN 3/1/2019 9:00:00 AM SL&C 2/7/2019 1:30:00 PM |
SB 29 |
| SB 29 - Letter of Support SEAPA.pdf |
HL&C 4/24/2019 3:15:00 PM SL&C 2/7/2019 1:30:00 PM |
SB 29 |
| SB29 Fiscal Note - SB029-DCCED-CBPL-02-01-19.pdf |
SL&C 2/7/2019 1:30:00 PM |
SB 29 |
| SB25 Version A.PDF |
SL&C 2/7/2019 1:30:00 PM |
SB 25 |
| SB25 Sponsor Statement.pdf |
SFIN 3/1/2019 9:00:00 AM SL&C 2/7/2019 1:30:00 PM |
SB 25 |
| SB25 Letter of Support ADS.pdf |
SL&C 2/7/2019 1:30:00 PM |
SB 25 |
| SB25 Board of Dental Examiners Division of Legislative Audit Sunset Review.pdf |
SL&C 2/7/2019 1:30:00 PM |
SB 25 |
| SB25 Fiscal Note - SB025-DCCED-CBPL-02-01-19.pdf |
SL&C 2/7/2019 1:30:00 PM |
SB 25 |