Legislature(2015 - 2016)SENATE FINANCE 532
04/15/2015 01:30 PM Senate FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| HB26 | |
| HB116 | |
| HB178 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 26 | TELECONFERENCED | |
| + | HB 116 | TELECONFERENCED | |
| + | HB 176 | TELECONFERENCED | |
| + | HB 178 | TELECONFERENCED | |
| += | SB 50 | TELECONFERENCED | |
| += | HB 106 | TELECONFERENCED | |
HOUSE BILL NO. 26
"An Act extending the termination date of the Board of
Certified Direct-Entry Midwives; and providing for an
effective date."
1:57:20 PM
LAURA STIDOLPH, STAFF, REPRESENTATIVE KURT OLSON, discussed
HB 26, which would extend the termination date for the
Board of Certified Direct-Entry Midwives to June 30, 2017.
She shared that each year the Division of Legislative Audit
reviewed state boards and commissions to determine whether
they should be reestablished per AS 24.44. The division of
Legislative Audit reviewed the activity of the board in
order to determine whether there was a demonstrated public
need for the board's continued existence and whether it had
been operating in an effective manner. She relayed that it
was the opinion of the division that the board be extended
two years to June 30, 2017. She stated that in the
auditor's opinion the board was serving the public's
interest by effectively licensing certified direct-entry
midwives and apprentices. She furthered that it had been
found that the board continued to improve the profession by
modifying and adopting midwifery regulations to conform to
current standards of care. She spoke to the four findings
and recommendations from the audit, including; having the
department pursue disciplinary cases, increasing licensing
fees to eliminate the boards operating deficit, having the
board communicate certificate requirements to continuing
education providers and approving apprentice applications
in accordance with statutes. She concluded that the Board
of Certified Direct-Entry Midwives served an important role
in protecting the wellbeing of Alaskans by identifying
individuals who were willing to pursue technical training
and meet specified technical qualifications necessary for
licenses as midwives; the continuation of the board was
important to the health and safety of Alaska's women and
children.
2:00:00 PM
Senator Olson asked why the board was only being extended
for two years.
Ms. Stidolph related that a number of issues brought up in
the audit had led to the recommendation of the shortened
extension.
2:00:33 PM
Senator Dunleavy understood that the board was doing a good
job in spite of the issues raised in the audit.
Ms. Stidolph replied that the responsibility for the issues
highlighted by the audit was found to lie with the
Department of Commerce, community and Economic Development.
She assured the committee that the department had taken
action on the issues.
2:01:08 PM
Co-Chair MacKinnon directed the committee's attention to a
report from Legislative Budget and Audit (copy on file).
KRIS CURTIS, LEGISLATIVE AUDITOR, ALASKA DIVISION OF
LEGISLATIVE AUDIT, testified that the division had
performed and audit of the board and recommended a short
extension. She spoke to the four recommendations:
Recommendation No. 1
The Department of Commerce, Community, and Economic
Development's (DCCED) commissioner should take
immediate action to pursue disciplinary sanctions for
certified direct-entry midwives (CDM) cases when
warranted.
Disciplinary sanctions were not actively pursued for
four CDM-related investigations which were completed
during the audit period. The investigations, involving
two people, supported disciplinary sanctions including
probation with continuing education and license
revocation.
However, Division of Corporations, Business and
Professional Licensing (DCBPL) investigative staff did
not actively pursue disciplinary sanctions to protect
the public's safety.
In all four CDM cases, the respondents refused to sign
a CA. Rather than file an accusation and pursue an
administrative hearing, DCBPL staff followed alternate
procedures. Two of the four cases were forwarded to
the Department of Law's Office of Special Prosecutions
and Appeals (OSPA) without a sufficiency of evidence
review by an AAG. A year after the cases were
forwarded to OSPA, no action had been taken. According
to OSPA, the cases represent their lowest priority as
the related offenses were categorized as Class B
misdemeanors. The other two cases were held by DCBPL
investigators with the understanding that the cases
would be forwarded to OSPA once the other cases were
addressed. Due to staff turnover, it is unclear why
DCBPL staff did not pursue a civil licensing action as
required by standard operating procedures. At a
minimum, licensing action should be pursued
concurrently to ensure the public is protected from
incompetent, negligent, or unlicensed practitioners.
By not pursuing licensing action, the respondents were
allowed to continue practicing, and the public's
safety was placed at risk.
2:04:08 PM
Ms. Curtis discussed the three remaining recommendations:
Recommendation No. 2
DCBPL, in consultation with the board, should increase
licensing fees to eliminate the board's operating
deficit.
As of March 31, 2014, the board had an operating
deficit of $115,261.
Recommendation No. 3
The board should communicate certificate requirements
to continuing education providers to facilitate
compliance with centralized licensing regulations.
Recommendation No. 4
The board should approve apprentice permit
applications in accordance with statutes.
For two of two apprentice applications tested, permits
were inappropriately issued by DCBPL's licensing
examiner rather than by the board.
Senator Bishop asked whether the word "apprentice" was a
term of art, and was the occupation of midwife federally
recognized by the United States Department of Labor.
Ms. Curtis deferred the question to the department.
2:04:48 PM
Co-Chair MacKinnon welcomed Co-Chair Kelly to the table.
2:05:14 PM
SARA CHAMBERS, ADMINISTRATIVE OPERATIONS MANAGER, DIVISION
OF CORPORATIONS, BUSINESS AND PROFESSIONAL LICENSING,
DEPARTMENT OF COMMERCE, COMMUNITY AND ECONOMIC DEVELOPMENT,
related that she was unsure whether "apprentice" was a
federally recognized term; however, the term was created
through the board statutes and regulations to recognize
someone who had yet to fully meet the technical standards
to become a midwife, but was in training to meet the
standards.
2:05:49 PM
Senator Bishop requested further clarification.
2:06:04 PM
Co-Chair MacKinnon asked for the name of the board
president.
Ms. Chambers related that the board president's name was
Cheryl Corrick; Deborah Schneider was the board's
representative for the hearing.
Co-Chair MacKinnon asked how long Ms. Corrick had been
serving as board president.
Ms. Chambers replied two to three years.
2:06:41 PM
Co-Chair MacKinnon wondered why the board should be
extended given the mismanagement highlighted in the audit.
Ms. Chambers stated that the concerns that were raised in
the audit were being addressed. She shared that the primary
concern, the investigative procedures, had been addressed
by the department. She explained that different management
strategies had been implemented, as well as quality control
elements that served all licensing programs. She deferred
to the board to speak to the topic of public service.
2:08:23 PM
Co-Chair MacKinnon asked whether the recommendations were
reoccurring.
Ms. Curtis stated that the deficit and the fees were
reoccurring issues. She noted that the 2006 audit had
identified that the board's fee was the highest of any
board, over $2000. She said that it had been a continual
struggle, with the small number of licensees, to bear the
cost of investigations and regulatory projects. She said
that the issue of investigative staff was isolated to one
instance, the department routinely went into the division
and scrutinized their investigative function; a systematic
problem had not been identified, the problem seemed
specific to this particular board.
2:09:23 PM
Co-Chair MacKinnon asked if the deficit the board faced was
due to investigations.
Ms. Curtis replied that the audit had determined that the
deficit was based on investigative and regulatory costs.
She furthered that the board had recently undergone a
regulatory project and thought that some of the incurred
costs were due to the project.
Ms. Chambers reiterated that it was difficult for a
licensing group of less than 50 licensees to sustain the
statutory requirement for all of their expenses to be
covered by revenues. She furthered that the board currently
had the highest licensing fee of any other program, which
would continue to be raised on a regular basis in order to
overcome the deficit. She expressed concern that the
organization was "top heavy" due to the nature of the work
and fees.
2:11:26 PM
Senator Hoffman asked if there were any midwives in Western
Alaska.
Ms. Chambers responded that she would follow up with the
information at a later date.
2:11:44 PM
Senator Dunleavy asked what would occur if the legislation
did not pass.
Ms. Curtis responded that the licensing function of the
board would revert back to the department.
Ms. Chambers reiterated that there was a one year period in
which the board transition responsibilities over to the
department. She shared that the department had 43 licensing
programs, only 21 with boards.
2:13:10 PM
Co-Chair MacKinnon pointed out that over the last two years
work had been done to understand why certain licensee
groups in the state had deficit balances.
2:14:16 PM
Co-Chair MacKinnon asked whether the board was acting on
first recommendation of the audit.
DEBORAH SCHNEIDER, CERTIFIED DIRECT ENTRY BOARD OF
MIDWIVES, WASILLA (via teleconference), replied yes. She
said that the recommendations in the audit had been
addressed by the board. [The quality of the audio is
failing. This testimony is nearly impossible to decipher.]
2:18:03 PM
AT EASE
2:19:45 PM
RECONVENED
Co-Chair MacKinnon repeated her question.
Ms. Schneider stated that the board had worked with
investigators to address the issues in the audit. She
stressed that the board was working within its legal
authority in the investigation issue.
Co-Chair MacKinnon reminded Ms. Schneider that the legal
authority of the board was outlined in state statute.
Co-Chair MacKinnon asked how the board was communicating to
its providers the certificate requirements for continuing
education.
Ms. Schneider specified that a letter detailing the state
requirements had been drafted and sent to the Midwife
Association of Alaska. She said that license renewal
certificates were being reviewed to assure that state
requirements were being met, and that agencies that were
providing continuing education were notified of those
specific requirements.
2:22:29 PM
Co-Chair MacKinnon asked whether the board understood that
they were responsible for approving apprenticeship permit
applications in accordance with state statutes.
Ms. Schneider explained that the board was aware and had
directed that the apprentice permits come before the board
for approval.
2:23:11 PM
Co-Chair MacKinnon wondered why the board' authorization in
state statute should be extended.
Ms. Schneider explained that the board worked to ensure
that midwives practiced under the most current regulations.
She stated that midwifery was a growing practice and that
well written regulations and experienced oversight were
important. She shared that Alaska was one of the first
states to have licensure of direct-entry midwives, which
had been a blueprint for many other states when developing
their own guidelines.
2:24:55 PM
Senator Bishop asked how many midwives and apprentices were
currently licensed in the state.
Ms. Schneider replied that there were 34 licensed midwives.
She said she was unsure on the number of apprentices.
2:25:38 PM
Co-Chair MacKinnon OPENED public testimony.
2:26:07 PM
Co-Chair MacKinnon CLOSED public testimony.
2:26:13 PM
Senator Olson assumed that the licensing fee was paid
biannually.
Ms. Chambers replied yes.
Senator Olson asked if investigators were shared among
other boards and departments.
Ms. Chambers said that the department adhered to a positive
time keeping practice to assure that investigators were
being used that had the highest skillset in the healthcare
community, while spreading resources across the various
competing, and ever-changing, needs of the division. She
stated that the investigator was not a full-time position
for the board.
Senator Olson expressed concern that the public welfare
could be harmed due to malpractice.
2:28:33 PM
HB 26 was HEARD and HELD in committee for further
consideration.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB26 Sponsor Statement.pdf |
SFIN 4/15/2015 1:30:00 PM |
HB 26 |
| HB26 Supporting Documents-Legislative Audit 6-30-2014.pdf |
SFIN 4/15/2015 1:30:00 PM |
HB 26 |
| HB116 Sponsor Statement.pdf |
SFIN 4/15/2015 1:30:00 PM |
HB 116 |
| HB116 Supporting Document - Legislative Audit 05-30-14.pdf |
SFIN 4/15/2015 1:30:00 PM |
HB 116 |
| HB 176 Legal Opinion re Geo Diff.pdf |
SFIN 4/15/2015 1:30:00 PM |
HB 176 |
| HB 176 Sponsor Statement (2).pdf |
SFIN 4/15/2015 1:30:00 PM |
HB 176 |
| HB178 Sponsor Statement.pdf |
SFIN 4/15/2015 1:30:00 PM |
HB 178 |
| HB178 Supporting Documents-CSHB316(FIN) Sectional Analysis ver R.pdf |
SFIN 4/15/2015 1:30:00 PM |
HB 178 HB 316 |
| HB178 Supporting Documents-HB316 enacted in 2014.PDF |
SFIN 4/15/2015 1:30:00 PM |
HB 178 HB 316 |