Legislature(2017 - 2018)SENATE FINANCE 532
04/14/2017 01:30 PM Senate FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| SB104 | |
| HB49 | |
| HB141 | |
| SB104 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 49 | TELECONFERENCED | |
| + | HB 141 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | SB 104 | TELECONFERENCED | |
CS FOR HOUSE BILL NO. 49(FIN)
"An Act extending the termination date of the Board of
Certified Direct-Entry Midwives; and providing for an
effective date."
1:58:49 PM
REPRESENTATIVE SAM KITO, SPONSOR, introduced the
legislation. He stated that the bill provided an extension
of Board of Certified Direct-Entry Midwives through 2021,
which was the recommended extension from Legislative Audit.
1:59:53 PM
KRIS CURTIS, LEGISLATIVE AUDITOR, ALASKA DIVISION OF
LEGISLATIVE AUDIT, shared that there was an audit available
dated 2016 (copy on file). The last sunset audit of the
board was conducted in 2014. At that time the Division of
Corporation, Business, and Professional Licensing (DCBPL)
investigative staff had not actively processed
investigations that posed a public safety risk. After that
audit was released, the board was only extended two years.
The most recent audit found that the board was effectively
licensing and regulating certified direct entry midwives
and midwife apprentices, and she recommended a four-year
extension. He stated that there were four recommendations
located in the audit document.
2:04:28 PM
Senator Olson queried the reasons for the deficits. Ms.
Curtis replied that the board had struggled with
investigative fees.
Senator Olson wondered whether there were lawsuits related
to malpractice of midwives. Ms. Curtis replied that there
were four cases involving two individuals that were not
moving forward and resulted in additional costs. She
stressed that the audit did not typically go into detail on
investigative cases.
Senator Olson wondered whether did not pursue a license
because of the high fee. Ms. Curtis deferred to the
department.
Senator Olson asked whether there were any mergers of the
boards for economic reasons in the state or other states.
Ms. Curtis replied that there were no recent board mergers.
Senator Hughes wondered whether the investigations were of
licensed individuals or fraudulent midwives. Ms. Curtis
that, historically, there was a mixture of both.
2:07:48 PM
SARA CHAMBERS, DEPUTY DIRECTOR, DIVISION OF CORPORATIONS,
BUSINESS, AND PROFESSIONAL LICENSING, DEPARTMENT OF
COMMERCE, COMMUNITY AND ECONOMIC DEVELOPMENT, shared that
the department concurred with the first two findings in the
audit regarding administrative errors and fees. She stated
that there was a fee increase to $3800 for fully authorized
midwives, and under $2000 for apprentices. She stated that
there were no documented departures from the industry
because of the fees, but it was a fairly new fee. She
stated that the board only have approximately 50 licensees,
so there was an economy of scale issue with unlicensed
practice and some standard of care investigations.
Co-Chair MacKinnon shared that Senator Olson had valuable
medical expertise.
Senator Olson wondered whether the licensees included the
apprentices. Ms. Chambers responded in the affirmative. She
stated that the latest numbers for the fee analysis
indicated that there were 43 fully licensed midwives and
approximately 20 apprentices.
Senator Olson wondered whether the investigations were for
midwives or apprentices. Ms. Chambers agreed to provide
that information, but midwives had fiduciary responsibility
over apprentices.
Senator Hughes queried the licensure fees for physicians,
nurses, and nurse practitioners. Ms. Chambers replied that
the physician fee was $300, physician assistant's fee was
$200, nurse's fee was approximately $200.
Senator Hughes noted that midwives paid a significantly
larger license fee, and thanked them for their dedication.
2:13:54 PM
Co-Chair MacKinnon wondered whether the department could
advance the concern that was listed from the officer to
either the presiding officers, Labor and Commerce, or the
appropriate chairman. She remarked that there was a
liability for choosing to use a midwife.
Co-Chair Hoffman remarked that the bill only dealt with the
extension. He felt that addressing the third recommendation
in the audit may require work from the Senate Health and
Social Services Committee.
Co-Chair MacKinnon agreed.
Senator Micciche wondered how long it took to build an
operation deficit of $183,083. Ms. Chambers replied that
the board has had a deficit since 2012 of $65,000 and had
grown annually until the most recent renewal cycle. The
deficit began to reduce because of the increased fees. She
remarked that the fees were dropped in 2009, but did not
know the rationale for lowering the fee at that time.
Senator Micciche wondered whether the four-year sunset
renewal was too long, because the board should continue to
be investigated.
Senator Olson supported keeping independent midwives. He
queried the estimated forecast. Ms. Chambers replied that
there was a fee analysis to address the issues with setting
fees. She stated that, assuming that the fees remain the
same, the board's deficit would be eliminated by FY 21.
2:22:31 PM
DEBORAH SCHNIDER, BOARD OF MIDWIVES, ANCHORAGE (via
teleconference), testified in support of the bill.
2:24:21 PM
JOHANNA CROSSETT, MIDWIFE, JUNEAU, spoke in support of the
bill.
Senator Micciche queried whether there was support of the
licensees covering the deficit. Ms. Crossett replied in the
affirmative.
Vice-Chair Bishop wondered whether the midwives might not
want to pay the fee, and stop licensing. Ms. Crossett
replied that the initial proposed licensing fee was $4700.
The reduction to $3800 was a good compromise. She hoped
that there would not be another fee increase.
2:26:25 PM
MADI NOLAN-GRIMES, MIDWIFE, JUNEAU, spoke in support of the
bill.
2:27:21 PM
SUZANNE TREWILLIGER, PRESIDENT, MIDWIVES ASSOCIATION OF
ALASKA, EAGLE RIVER (via teleconference), testified in
support of the bill.
Senator Micciche wondered whether the number of midwives
was changing. Ms. Trewilliger replied that that there was a
reduction of thirteen midwives, and did not know the number
of apprentices.
Co-Chair MacKinnon CLOSED public testimony.
2:31:03 PM
Vice-Chair Bishop addressed the fiscal note: FN 1(CED).
2:32:01 PM
AT EASE
2:32:48 PM
RECONVENED
Vice-Chair Bishop MOVED to REPORT SCS CSHB 49(L&C) out of
committee with individual recommendations and attached
fiscal note.
SCS CSHB 49(L&C) was REPORTED out of committee with a "do
pass" recommendation and with one previously published
fiscal impact note: FIN 1(CED).
2:33:51 PM
AT EASE
2:40:39 PM
RECONVENED
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 49 Supporting Document Medicaid Cost Savings CDMs 2015.pdf |
SFIN 4/14/2017 1:30:00 PM |
HB 49 |
| HB 49 Supporting Document Licensing Fees FY06-17.pdf |
SFIN 4/14/2017 1:30:00 PM |
HB 49 |
| HB049 Support Letters 020217.pdf |
SFIN 4/14/2017 1:30:00 PM |
HB 49 |
| HB049 Supporting Documents-Full Sunset Audit 01.30.17.pdf |
SFIN 4/14/2017 1:30:00 PM |
HB 49 |
| SB 104 Amendment Consolidated 1 MacKinnon.pdf |
SFIN 4/14/2017 1:30:00 PM |
SB 104 |