Legislature(2015 - 2016)BELTZ 105 (TSBldg)
04/14/2015 01:30 PM Senate LABOR & COMMERCE
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| Audio | Topic |
|---|---|
| Start | |
| HB26 | |
| HB116 | |
| HB178 | |
| HB46 | |
| HB41 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 107 | TELECONFERENCED | |
| + | HB 26 | TELECONFERENCED | |
| + | HB 41 | TELECONFERENCED | |
| + | HB 46 | TELECONFERENCED | |
| + | HB 116 | TELECONFERENCED | |
| + | HB 178 | TELECONFERENCED | |
| + | TELECONFERENCED |
HB 26-EXTEND CERT. DIRECT-ENTRY MIDWIVES BOARD
CHAIR COSTELLO announced the consideration of HB 26. "An Act
extending the termination date of the Board of Certified Direct-
Entry Midwives; and providing for an effective date."
1:31:53 PM
LAURA STIDOLPH, Staff, Representative Kurt Olson, on behalf of
the prime sponsor, stated that HB 26 would extend the sunset
date for the Board of Certified Direct-Entry Midwives to June
30, 2017. She explained that the Division of Legislative Audit
conducts audits each year to determine if state boards and
commissions should be reestablished. The division reviewed the
activities of the Board of Certified Direct-Entry Midwives to
determine if there is a demonstrated public need for the board's
continued existence and whether it has been operating in an
effective manner. The auditors recommended that the board be
extended two years until June 30, 2017.
1:32:27 PM
SENATOR MEYER joined the committee.
MS. STIDOLPH related that auditors found the Board of Certified
Direct-Entry Midwives has been serving the public's interest by
effectively licensing certified direct-entry midwives (CDM) and
apprentices. In addition, it was found that the board continues
to improve the profession by modifying and adopting midwifery
regulations to conform to current standards of care.
MS. STIDOLPH highlighted that the auditors had four findings and
recommendations: 1) the Department of Commerce, Community and
Economic Development (DCCED) should immediately pursue
disciplinary sanctions for CDM cases when warranted; 2) increase
licensing fees to eliminate the board's operating deficit; 3)
the board should communicate certificate requirements to
continuing education providers to facilitate compliance with
centralized licensing regulations; and 4) the board should
approve apprentice permit applications in accordance with
statute.
1:34:02 PM
KRIS CURTIS, Legislative Auditor, Legislative Audit Division,
Legislative Agencies and Offices, stated that the Audit Division
conducted an audit of the Board of Certified Direct-Entry
Midwives to determine whether it was serving the public purpose
and concluded overall that the board is serving the public's
interest by effectively licensing certified direct-entry
midwives.
However, the audit found that the Division of Corporations,
Business, and Professional Licensing (DCBPL) staff failed to
operate in the public's interest by not pursuing timely
disciplinary sanctions related to midwife investigations.
Because of this serious deficiency, the audit recommends the
board's termination date be extended only two years to June 30,
2017. The audit made four recommendations. The first and most
serious was to the commissioner of DCCED to take immediate
action to pursue disciplinary sanctions for midwife cases when
warranted. The audit found that disciplinary sanctions were not
actively pursued for four investigations that were completed
during the audit period. The investigations of two people
concluded that disciplinary sanctions were needed. However,
DCBPL investigative staff did not actively pursue sanctions to
protect the public safety. The respondents in all four cases
refused to sign a consent agreement.
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 Office of
Special Prosecution and Appeals (OSPA) without a sufficiency of
evidence reviewed by the assistant attorney general. Those two
cases remained at OSPA for over a year without action. According
to OSPA those class B misdemeanor cases are the lowest priority.
The other two cases were held by DCBPL investigators with the
understanding that they would be forwarded to OSPA once the
other two cases were resolved. Due to staff turnover, the audit
could not determine why DCBPL staff did not pursue civil
licensing action as required by their standard operating
procedures. At a minimum, licensing action should be pursued
concurrently with criminal action to ensure that the public is
protected. By not pursuing licensing action, the respondents
were allowed to continue to practice and the public's safety was
at risk.
MS. CURTIS said the audit makes three additional recommendations
for operational improvements: 1) DCBPL and the board should
consult and increase licensing fees to eliminate the board's
$115,000 operating deficit; 2) the board should communicate
certificate requirements to continuing education providers to
facilitate compliance with centralized licensing
recommendations; and 3) the board should approve apprentice
permits in accordance with statutes. The audit found that
permits were being approved by DCBPL staff but statutes only
allow the board to issue the permits.
1:37:31 PM
SENATOR STEVENS asked what the usual extension would be.
MS. CURTIS replied the maximum allowed in statute is an eight-
year extension.
SENATOR STEVENS asked what has to be done in the next two years
for the board to receive another extension.
MS. CURTIS explained that the next audit would focus on what has
been done with the investigative aspects of the board.
1:38:50 PM
SENATOR GIESSEL expressed concern that 4 of 48 licensees had
deficiencies.
MS. CURTIS clarified that some of the investigations could be
related to unlicensed activity.
SENATOR GIESSEL questioned how 48 licensees could make up the
deficit. She asked if the auditors have a plan, or if it will be
left to the division.
MS. CURTIS replied the plan will be left to the division, but it
is an ongoing problem. The 2006 audit of the board identified
that that midwives had the highest fees of any occupation.
1:40:11 PM
SENATOR STEVENS asked what the fees are.
MS. CURTIS reviewed the fees identified on page 15 of the audit.
For FY 14, the Midwife Initial Certification and Renewal Fee was
$1,450. The fee was over $2,000 when the 2006 audit was done.
SENATOR STEVENS asked what happens when someone practices
midwifery without a license.
MS. CURTIS replied that falls under the purview of the division
of to pursue.
1:41:48 PM
JANEY HOVENDEN, Director, Division of Corporations, Business and
Professional Licensing, Department of Commerce, Community and
Economic Development (DCCED), introduced herself.
1:42:13 PM
SARA CHAMBERS, Operations Manager, Division of Corporations,
Business and Professional Licensing, Department of Commerce,
Community and Economic Development (DCCED), offered to answer
questions related to HB 26.
SENATOR STEVENS asked what happens when someone practices
midwifery without a license.
MS. CHAMBERS explained that the division goes through a process
of investigation and discovery that involves either a board
member or subject matter expert to review the facts. If there is
sufficient cause for a violation the division would pursue a
consent agreement that acknowledges a violation and how the
person plans to correct it. That may include licensure, license
probation, or fines. In many cases of unlicensed activity the
person is not willing to work toward an amicable agreement. In
those cases the division works with the Department of Law to
file an accusation of violation of law and pursue the sanctions
available to that licensing program.
CHAIR COSTELLO asked what the division's plan is to address
board deficits.
MS. CHAMBERS explained that the fees for midwives and
apprentices have been increased since the audit was initiated.
The board is aware of the historical deficit and is working with
the division to raise all the license fees within the program.
The division has prescribed a stair step program to try to chip
away at the debt without it becoming overly burdensome to
midwives. She said the board recognizes that it is responsible
for the deficit, but it is difficult because investigations of
licensed and unlicensed practice can be a very expensive.
1:46:39 PM
SENATOR GIESSEL offered her understanding is that the deficit
stems from a large legal case that cost the board a significant
amount.
MS. CHAMBERS agreed.
SENATOR GIESSEL pointed out that it would help if boards could
retain the penalties that are levied against their licensees,
but they go into the general fund. She clarified that these
licensees are direct-entry midwives not certified nurse
midwives.
CHAIR COSTELLO recalled the discussion that if the penalties
were retained by the board it might stimulate interest in
pursuing more penalties.
SENATOR STEVENS asked if midwives work fulltime.
MS. CHAMBERS replied there are both fulltime and part time
midwives. Responding to a further question, she confirmed that
the licensing fee is the same regardless of how much the midwife
works.
1:50:07 PM
MS. CHAMBERS reported that since the division met with the
auditors, DCBPL has reviewed its quality control measures and
investigative protocols with the new chief investigator. They
have worked to tighten the standards and timeframes and have
been working with the Department of Law and OSPA to use the
audit as a tool for further quality improvement agency wide. The
cases that the audit identified are now in full compliance with
the stated protocols. She expressed optimism about standing the
test of compliance per auditing standards.
CHAIR COSTELLO asked her to review of the fiscal note.
1:52:20 PM
MS. CHAMBERS explained that the fiscal note speaks to the sunset
of the board and reflects the changes that are anticipated if
the board dissolves. "Since the sunset assumes that the board
sunsets, this would reinitiate what we're currently expending
for travel," she said.
SENATOR GIESSEL asked Ms. Curtis if she considered a shorter
extension, say one year.
MS. CURTIS replied she worked with Ms. Chambers on the
appropriate timeframe and two years seemed sufficient. She noted
that the division appears to have addressed the issues more
quickly than anticipated.
CHAIR COSTELLO asked Senator Giessel if she wanted an update in
a year.
SENATOR GIESSEL said she would like an interim report, if
possible.
MS. CURTIS said the direction has to come from the Legislative
Budget and Audit (LB&A) Committee, but that has been done.
SENATOR GIESSEL asked if that is best done through intent
language in the sunset bill or an informal request to the LB&A.
MS. CURTIS said she is only aware of it being done through an
informal request to the LB&A.
1:55:42 PM
CHAIR COSTELLO found no public testimony and closed it.
1:56:12 PM
At ease
1:57:05 PM
CHAIR COSTELLO reconvened the meeting and recognized Senator
Giessel.
SENATOR GIESSEL offered a conceptual amendment to capture
legislative intent to request an interim one-year status update
from the Legislative Audit Division on the Board of Certified
Direct-Entry Midwives.
1:57:41 PM
CHAIR COSTELLO found no objection and announced that conceptual
Amendment 1 is adopted.
1:57:55 PM
SENATOR GIESSEL moved to report HB 26, 29-LS 0171\A as amended,
from committee with individual recommendations and attached
fiscal note(s).
CHAIR COSTELLO announced that without objection, SCS HB 26(L&C)
is reported from the Senate Labor and Commerce Standing
Committee.