Legislature(2017 - 2018)HOUSE FINANCE 519
02/12/2018 01:30 PM House FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| HB302 | |
| HB318 | |
| HB323 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 302 | TELECONFERENCED | |
| + | HB 318 | TELECONFERENCED | |
| + | HB 299 | TELECONFERENCED | |
| + | HB 323 | TELECONFERENCED | |
| + | TELECONFERENCED |
HOUSE FINANCE COMMITTEE
February 12, 2018
1:33 p.m.
1:33:34 PM
CALL TO ORDER
Co-Chair Foster called the House Finance Committee meeting
to order at 1:33 p.m.
MEMBERS PRESENT
Representative Neal Foster, Co-Chair
Representative Paul Seaton, Co-Chair
Representative Les Gara, Vice-Chair
Representative David Guttenberg
Representative Scott Kawasaki
Representative Dan Ortiz
Representative Lance Pruitt
Representative Steve Thompson
Representative Cathy Tilton
Representative Tammie Wilson
MEMBERS ABSENT
Representative Jason Grenn
ALSO PRESENT
Ashley Strauch, Staff, Representative Adam Wool; Kris
Curtis, Legislative Auditor, Alaska Division of Legislative
Audit; Sara Chambers, Deputy Director, Division do
Corporations, Business, and Professional Licensing,
Department of Commerce, Community and Economic Development;
Representative Ivy Sponholz, Sponsor; Ted Madsen, Staff,
Representative Ivy Sponholz; Representative Colleen
Sullivan-Leonard, Sponsor.
PRESENT VIA TELECONFERENCE
Laura Theisen, Board of Social Work Examiners, Glenallen;
Leif Holm, Chair, Board of Pharmacy, North Pole.
SUMMARY
HB 302 EXTEND: BOARD OF PROFESSIONAL COUNSELORS
HB 302 was REPORTED out of committee with a "do
pass" recommendation and with a previously
published fiscal impact note: FN1(CED).
HB 318 EXTEND: BOARD OF SOCIAL WORK EXAMINERS
CSHB 318(FIN) was REPORTED out of committee
with a "do pass" recommendation and with a
previously published fiscal impact note:
FN1(CED).
HB 323 EXTEND: BOARD OF PHARMACY
HB 323 was REPORTED out of committee with a "do
pass" recommendation and with a previously
published fiscal impact note: FN1(CED).
Co-Chair Foster reviewed the agenda for the day. He
intended to hold public testimony for the three bills being
heard and to move them out of committee if it was the will
of members to do so.
HOUSE BILL NO. 302
"An Act extending the termination date of the Board of
Professional Counselors; and providing for an
effective date."
1:34:56 PM
ASHLEY STRAUCH, STAFF, REPRESENTATIVE ADAM WOOL, relayed
that HB 302 was an extension to the Board of Professional
Counselors. The bill extended the board for 8 years to
2026. The board's primary function was to license
professional counselors and to issue supervisor
certificates. The board was composed of 5 members, all of
which were appointed by the governor. She continued that 4
of the board members were licensed professional counselors
and 1 public member. The board currently oversaw 657
professional counselors and 73 supervisor certificates.
Between FY 14 and FY 16 they issued 190 new licenses, which
represented a 46 percent increase in their licenses. There
were no new recommendations as a part of the audit. The
board was recommended for the full 8-year extension. She
conveyed that Debra Hamilton, a board member, was available
online. A person from Legislative Audit was in the room.
Co-Chair Foster invited Kris Curtis from Legislative Audit
to the table. He asked her to walk the committee through
the sunset audit for the Board of Professional Counselors.
1:36:21 PM
KRIS CURTIS, LEGISLATIVE AUDITOR, ALASKA DIVISION OF
LEGISLATIVE AUDIT, reported that members should have a copy
of the audit in their packets dated April 2017. Report
conclusions began on page 3. Overall, Legislative Audit
concluded that the board was serving the public's interest
by effectively licensing and regulating professional
counselors and certified counselor supervisors. The
division found they monitored licensees and worked to
ensure that qualified individuals practiced. Legislative
audit found that the board actively developed and adopted
regulations to improve their profession and was
recommending the maximum extension of 8 years. She skipped
over the license activity information since Ashley covered
it.
Ms. Curtis continued by noting that page 6 was a schedule
of revenues and expenditures. The board had a surplus of
just over $70,000 as of March 31, 2017. The board and
management expected to decrease fees in FY 18. License fees
were listed on page 7.
Ms. Curtis relayed that the responses to the audit began on
page 19. The Office of the Governor, the department, and
the board all concurred that the board was serving the
public's interest and should be extended. There were no
other recommendations.
1:37:48 PM
Representative Kawasaki asked that when the board had a
surplus, like the $70,000 surplus, at what time would the
fees be ratcheted down.
Ms. Curtis deferred to the department.
1:38:46 PM
SARA CHAMBERS, DEPUTY DIRECTOR, DIVISION OF CORPORATIONS,
BUSINESS, AND PROFESSIONAL LICENSING, DEPARTMENT OF
COMMERCE, COMMUNITY AND ECONOMIC DEVELOPMENT, responded
that the division performed an annual fee analysis in
accordance with statute. The division considered trends,
the board's history, the risk assessment of potential risk,
and fluctuation of expenditures - particularly the risk to
large investigation or appeal of the board's decision,
which could necessitate higher fees to recover costs. There
were several intangibles that accompanied the tangibles.
They were discussed with the board and raised and lowered
fees as necessary.
Co-Chair Foster recognized that the committee was joined
earlier by Representative Guttenberg.
Co-Chair Foster directed Ms. Chambers to walk through the
fiscal note.
Ms. Chambers explained that the fiscal note was for $21,400
which covered the additional expenses that having a board
brought to licensure. If the board were to sunset, the
department would continue to license professional
counselors, but without the addition of the board. It was
an expense of $19,900 for board members to attend 4 board
meetings per year. She elaborated that boards were working
very hard to reduce costs. The division was working to
reduce costs through video conferencing and
teleconferencing. The balance was public noticing of board
meetings, any training and conferences the board might need
to attend, and per diem to help pay for meals while members
were on state business.
1:41:06 PM
Co-Chair Foster OPENED and CLOSED Public Testimony.
Co-Chair Seaton MOVED to report HB 302 out of Committee
with individual recommendations and the accompanying fiscal
note. There being NO OBJECTION, it was so ordered.
HB 302 was REPORTED out of committee with a "do pass"
recommendation and with a previously published fiscal
impact note: FN1(CED).
1:42:05 PM
AT EASE
1:42:35 PM
RECONVENED
HOUSE BILL NO. 318
"An Act extending the termination date of the Board of
Social Work Examiners; and providing for an effective
date."
Co-Chair Foster indicated that there was 1 amendment before
to committee. He invited the bill sponsor, Representative
Sponholz, and her aide to the table.
1:42:42 PM
REPRESENTATIVE IVY SPONHOLZ, SPONSOR, introduced herself
and indicated that her aide would introduce the bill.
TED MADSEN, STAFF, REPRESENTATIVE IVY SPONHOLZ, explained
that the bill was a sunset extension for the Board of
Social Work Examiners. It was currently scheduled to sunset
on June 30, 2018. However, HB 318 would extend the sunset
to June 30, 2026. The Board of Social Work examiners
licenses about 783 social workers throughout the state as
of March 2017. The board issued licenses to qualified
applicants, established continuing education requirements
and a code of professional ethics and standards, and
adopted regulations as necessary. The Division of
Legislative Audit reviewed the operations of the board and
concluded that the board was serving the public's interest
by running effectively. The legislative auditor was
available in the room and Lara Theisen with the Board of
Social Work Examiners to offer testimony.
Co-Chair Foster invited Kris Curtis to the table to walk
the committee through the sunset audit for the Board of
Social Work Examiners.
KRIS CURTIS, LEGISLATIVE AUDITOR, ALASKA DIVISION OF
LEGISLATIVE AUDIT, suggested that members should have a
copy of the audit dated October 2017. She reported that the
division found that board was serving the public's
interesting by effectively licensing and regulating social
work examiners. The division found that board meetings were
conducted in compliance with law, investigations were
generally processed timely, and the board issued or changed
regulations to improve the profession. The division was
recommending the maximum 8-year extension.
Ms. Curtis continued that scheduled licensing activities on
page 6 was 783 licenses as of March 2017, which was a 41
percent increase compared to the prior 2009 sunset audit.
It was a growing profession. A schedule of revenues and
expenditure was on page 7. There was a surplus of about
$95,000 at the end of FY 17. The schedule of license fees
was on page 8.
Ms. Curtis relayed that the division had 2 recommendations
for improvements. The division recommended that the
Division of Corporations, Business, and Professional
Licensing (DCBPL) director improved procedures to ensure
board-required documentation was obtained prior to
licensure. Legislative Audit tested 25 licenses that were
issued the audit period and found one error. The board had
appropriately approved a license pending receipt of key
documentation but found that DCBPL staff failed to obtain
the documentation prior to issuing the license.
Ms. Curtis reviewed Recommendation 2. Legislative Audit
recommended that the Office of the Governor Boards and
Commissions Director work with the board to help identify
interested applicants to fill a vacant board position.
There was a board position that was vacant March 2017 which
was still vacant in October. It was one of the clinical
social work positions. Statute required that 1 of 5 board
member position could not be an employee of the federal
government, the state government, the local government, or
a non-profit agency. The Office of the Governor staff
stated that these were stringent requirements that made it
difficult to identify interested applicants. Responses to
the audit began on page 19. The first response was from the
Office of the Governor. In the response they reiterated the
stringent requirements that made it difficult to find
interested applicants. They agreed to work with the board
to help fill the vacancy.
Ms. Continued that the department's response was on page
21. The department agreed with both recommendations. In
regard to the first recommendation concerning licensure
documentation, they agreed that additional quality checks
were needed to help insure that their administrative record
was complete. They stated that additional supervisory
resources were needed to help ensure that the standards
were met. The board's response was on page 23. The board
agreed with both recommendations.
SARA CHAMBERS, DEPUTY DIRECTOR, DIVISION OF CORPORATIONS,
BUSINESS, AND PROFESSIONAL LICENSING, DEPARTMENT OF
COMMERCE, COMMUNITY AND ECONOMIC DEVELOPMENT, indicated
that the fiscal note was structured similarly to the
previous extension just heard by the committee. She
explained that the $21,400 would provide authority for the
board to do its business including attending 4 board
meetings per year, providing public notices for the board
meetings, and providing stipends pertaining to the board.
If the board were to sunset, the department would take over
licensure.
Representative Wilson asked about the difference between a
private, non-profit organization that was exempt and a non-
exempt non-profit organization. It sounded like some non-
profit organizations would be allowed on the board
currently. By allowing those that were exempt, she wondered
what kind of organizations would be included to be on the
board.
Ms. Chambers thought Representative Wilson's question would
be better addressed by the bill sponsor. She thought that
making a wider pool available would be helpful.
Representative Spohnholz responded that the vast majority
of social workers either work for a government organization
or a non-profit organization. There were very few social
worker that practiced in private practice. Hence, there had
been difficulty recruiting someone for the fifth position
that was required to be licensed in social work but who did
not serve in either a governmental capacity or a non-profit
capacity. The amendment would allow for 1 member of the
board to either be a private practice social worker or work
for a non-profit organization. An example of the kinds of
non-profits that hired social workers would be some of the
tribal health organizations or Denali Family Services, a
non-profit organization in Anchorage that hired social
workers.
1:50:35 PM
Representative Wilson was trying to understand the
difference between exempt versus non-exempt.
Representative Spohnholz replied that all non-profit
organizations were exempt from federal taxes.
1:51:00 PM
Co-Chair Foster OPENED and CLOSED Public Testimony.
Co-Chair Foster MOVED to ADOPT Amendment 1 (copy on file):
Page 1, line 1, following "Examiners;":
Insert "relating to the composition of the Board
of Social Work Examiners;"
Page l, following line 6:
Insert a new bill section to read:
"*Sec. 2. AS 08.95.010(a) is amended to read:
(a)There is created the Board of Social Work
Examiners composed of five members, as follows:
one member licensed under this chapter as a
baccalaureate social worker; one member licensed
under this chapter as a master social worker; two
members licensed under this chapter as clinical
social workers; and one public member who has
never been licensed under this chapter. At least
one of the licensed members must be a person who
is not an employee of a federal, state, or local
government [OR OF A PRIVATE NONPROFIT
ORGANIZATION THAT IS EXEMPT FROM FEDERAL INCOME
TAX]."
Renumber the following bill section accordingly.
Co-Chair Seaton OBJECTED for discussion. He wanted the
auditor to come forward.
Co-Chair Seaton asked if she thought the amendment would
aid in filling the vacancies.
Ms. Curtis replied that Legislative Audit did not conduct
any work to learn what types of employers employed social
workers. She could not comment on whether most of the
social workers worked for non-profits. She could confirm
that the specific stringent requirements and it not being
one of the 4 groups was causing trouble in making sure they
had full representation.
Representative Kawasaki noted that there were 590 clinical
social workers, 117 master social workers, and 47
baccalaureate social workers that looked active. He relayed
that there were 1 out of 47 potential candidates and only
47 potential candidates. Under the master social workers
there were 117 and under the clinical social were close to
600 between the 2. The amendment would delete the private
non-profit organization. He understood it would open up the
administration's ability to find someone to fill the
vacancy. He challenged whether it was really that difficult
to find a person to fill it. He knew it would be made
easier by making the change. He did not know why the
requirement was initially included. Typically, the
legislature had clean board extensions.
Mr. Madsen responded that in discussions with the
Legislative Research they reviewed the law from 1988 which
established the Board of Social Work Examiners. The
discussion at the time was that the board was going to be
regulating social workers who were in governmental
practice, non-profit practice, and private practice. The
idea was to have someone in private practice be able to
regulate those who were also in private practice. However,
over time it was found that the board vacancy had come up
and was very difficult to fill because of the stringent
requirement. He thought Ms. Theisen from the board would be
able to testify as to whether the board was in support of
the amendment.
Representative Kawasaki relayed that the statute state that
at least 1 of the 4 licensed members could not be an
employee of the federal, state, or local government, or a
private non-profit organization. It meant that the other 3
could be. He questions the difficulty in finding 1 person
to qualify for the vacancy. If it was that difficult to
find someone he was fine with it. He would like to hear
from someone on the board.
Mr. Madsen had discussions with the chair of the Board of
Social Worker Examiners. From her discussions it seemed
that Division of Boards and Commissions received a number
of qualified applicants who would be otherwise qualified
for the position. However, they were not able to fill the
position because they worked for non-profits.
1:56:36 PM
LAURA THEISEN, BOARD OF SOCIAL WORK EXAMINERS, GLENALLEN
(via teleconference), reported that the board had looked
for a significant amount of time to find an appropriate
person to fill the position. It had been very difficult.
She believed it would be positive for the board to be able
to broaden the number of possible applicants.
1:57:07 PM
Representative Guttenberg asked that with a change if the
private sector would be properly represented.
Ms. Theirsen asked Representative Guttenberg to repeat his
question.
Representative Guttenberg asked if it would be a problem
not having someone in private practice on the board. He was
concerned with social workers in private practice not being
properly represented. He asked if it was more important to
have a full board or everyone represented.
Ms. Theirsen replied that it would be more important to
have a full board. The goal of the board was public
protection. She believed that the board had representation
from the licensed social workers with 2 of them on the
board. She did not believe there would be an issue.
1:58:44 PM
Representative Wilson asked for the number of private
social workers in the state.
Mr. Madsen was looking for the information. However, on the
website for the Board of Social Work Examiners did not have
the number broken down. It was difficult to find somebody
who was qualified through the private practice position to
serve on the board.
1:59:13 PM
Representative Wilson asked if the amendment would prevent
anyone from applying from the private sector.
Mr. Madsen responded, "That is correct."
Co-Chair Seaton WITHDREW his OBJECTION.
There being NO further OBJECTION, Amendment 1 was ADOPTED.
Co-Chair Seaton MOVED to report CSHB 318(FIN) out of
Committee as amended with individual recommendations and
the accompanying fiscal note.
CSHB 318(FIN) was REPORTED out of committee with a "do
pass" recommendation and with a previously published fiscal
impact note: FN1(CED).
2:00:57 PM
AT EASE
2:01:19 PM
RECONVENED
HOUSE BILL NO. 323
"An Act extending the termination date of the Board of
Pharmacy; and providing for an effective date."
Co-Chair Foster invited Representative Sullivan-Leonard to
proceed with her presentation.
2:01:27 PM
REPRESENTATIVE COLLEEN SULLIVAN-LEONARD, SPONSOR, explained
that HB 323 extended the Pharmacy Board from June 2018 to
June 2022. The adoption of the bill would continue existing
activities by the board and the administration by the
division. She highlighted that Legislative Audit did a
review of the board's operations and determined that it
would be in the best interest to extend the board for 4
years through June 30, 2022. The board was comprised of 7
members. She elaborated that 5 of the members were
pharmacists and the other 2 were public members. In March
2018 the board would have a full composition for the board.
The board met 4 times yearly.
Representative Sullivan-Leonard continued that the board
regulated admission into the practice of pharmacy. They
established and enforced compliance with professional
standards and adopted regulations. The board also
established and maintained a controlled substance
prescription database as well as the administration of
vaccines, emergency medications, and opioid overdose drugs.
It oversaw licensing of pharmacists, pharmacy interns,
pharmacy technicians, and pharmacies. It oversaw wholesale
drug distributors located inside and outside the state if a
pharmacy shipped, mailed, or delivered prescription drugs
within Alaska. She conveyed the available testifiers.
Representative Wilson asked the board chair if he saw any
reason why the legislature should not provide an 8-year
extension to the board.
LEIF HOLM, CHAIR, BOARD OF PHARMACY, NORTH POLE (via
teleconference), offered that he would agree more with an
8-year extension. The board had accepted a 4-year extension
based on some conversations back and forth. Some wanted to
see how the new prescription drug monitoring program (PDMP)
legislation went through. how it was managed, and the
effect it had on opioids and the general running of the
PDMP. It appeared that the auditors would prefer to look at
the issue in 4 years again as opposed to waiting for 8
years. He suggested that all of the changes that had been
made legislatively with the PDMP, there was nothing but a
positive direction it would go in. He did not foresee any
issues going forward. He thought 8 years would be a fair
number of year but would accept 4.
Representative Wilson asked if the board had any issues
implementing new statutes or regulations in the past.
Mr. Holm responded that the pharmacy world was ever
evolving. It was difficult to keep up with the changes. He
hoped to get the help needed to keep up with industry
trends, standards, and legislative changes. Any changes
required of the industry through Alaska's State Legislature
had not been difficult to get through besides the standard
hang-ups of legal and law. In answer to Representative
Wilson's question he would say no. However, as an industry
as a whole, it was consistently struggling to keep up with
industry standards and changes.
2:06:36 PM
Representative Guttenberg asked if, with the state's
prescription drug manager dispensing drugs, the business
bifurcated. In other words, was one side a licensed
pharmacy and the other side a PBM that was not regulated at
all.
Mr. Holm responded affirmatively. It was not necessarily a
board issue, but it was the current situation. Nationwide
PBM were not under any kind of regulation or rules. It was
an issue he was dealing with in pharmacy.
2:07:29 PM
Representative Kawasaki asked about the Legislative Audit
review. Mr. Holm had relayed the pharmacy regulations were
changing rapidly. One of the big changes that came under SB
74 [Legislation passed in 2016, Short Title: Medicaid
Reform; Telemedicine; Drug Database] was that pharmacists
had to register with the prescription drug database.
Failure to do so was against the law and required
disciplinary action. He asked if the board had had to
discipline any pharmacists that were not registered with
the database.
Mr. Holm responded in the negative. The requirement for
everyone to register was still fairly new. They were still
monitoring who had not registered and sending out
notifications about registering. He considered it a grace
period trying to get everyone onboard. The board was having
a good response. However, there were people who were not
aware of the requirement presently.
Representative Kawasaki noted that the division had found
it was difficult to find out which specific dispensers were
not submitting the required information. It was difficult
to determine who needed to be sanctioned and brought to the
board's attention. He asked if it had been Mr. Holm's
observation as a board member.
Mr. Holm responded in the negative. He reported that the
board was making several changes through the vendor with
the PDMP based on the new requirements. He indicated it had
not been that long that the requirement had been in place.
However, everyone had been required to upload for some
time. As a board member, he had not received any reports
showing who was not uploading data. He had not heard a
report from the vendor or the state that anyone was having
trouble determining who was not uploading. He had not seen
such a report.
Co-Chair Foster asked Ms. Curtis to present the audit
findings.
KRIS CURTIS, LEGISLATIVE AUDITOR, ALASKA DIVISION OF
LEGISLATIVE AUDIT, referred to the legislative audit dated
August 2017. She reported that Legislative Audit concluded
that the board was serving the public's interest by
effectively licensing and regulating pharmacists, pharmacy
interns, pharmacy technicians, in-state pharmacies, drug
rooms, and wholesale distributors. Board meetings were
conducted in accordance with state law. The board was also
active in amending regulations to improve the industry. She
noted that page 9 was the schedule of licensing activity.
She reported that by the end of March 2017 there were 3,447
licensees, a 33 percent increase since the 2009 sunset
audit. She indicated that a schedule of revenues and
expenditures was in page 10. There was a surplus of just
over $275,000 at the end of FY 17. The schedule of license
fees was on page 11. According to DCBPL management a fee
analysis was scheduled for the end of 2017.
Ms. Curtis continued that although her division found that
the board was serving the public's interest, it was only
recommending a 4-year extension. It was in recognition of a
very significant statutory changes that had recently
occurred that expanded the board's duties in relation to
the controlled substance prescription database. She
highlighted that page 3 contained the background
information section, which was where Legislative audit went
through the database. She indicated that the Board of
Pharmacy was required to establish a database in 2008.
Statutes required that dispensers of controlled substances
electronically submit information on each prescription that
they dispensed. The database collected the information and
was supposed to allow pharmacists and practitioners to
review prescription history prior to prescribing or
administering medication or controlled substances.
Ms. Curtis relayed that statute also stated that the
database might be used to monitor prescribing practices and
patterns to identify practitioners who prescribed
controlled substances in an unlawful or unprofessional
manner, identify individuals who might be abusing
controlled substances, and identify individuals who might
be presenting forgeries or otherwise false prescriptions to
a pharmacy.
Ms. Curtis reported that there were several structural
problems with the 2008 law and were very slow to be
addressed. Legislative Audit grouped the problems in to 2
different areas beginning on page 4. The first area was the
completeness of information. As Representative Kawasaki had
discussed, there was no way to identify the universe of
individuals that were supposed to be reporting to the
database. As such, the board stated that they were unable
to identify the completeness of the information. They had
to report annually to the legislature. There were some
statistics being reported. It was clear the board was
having some problems getting people to submit information.
Regulations that they put in at that point required monthly
reporting. It was in no way timely enough to be useful.
Ms. Curtis moved to the second area Legislative Audit
grouped was the use of information. The law did not require
practitioners or pharmacists to consult the database prior
to prescribing or dispensing. It was totally voluntary. The
board was advised by the Department of Law that they could
not forward information to a pharmacist or a practitioner
because it would be considered an unsolicited report and
therefore, illegal. Consequently, the board did not analyze
the information and it was not used to identify unlawful
practices or patterns.
Ms. Curtis spoke about there being some recent changes to
address the problems. Currently, prescribers and dispensers
had to register with the database, and the Board of
Pharmacy was required to notify other occupational boards
that they were licensee registered. It allowed for the
identification of non-compliance in a check for
completeness. In 2018, dispensers would be required to
submit information to the database daily. Dispensers and
practitioners were now required to check the database prior
to dispensing and prescribing with some exclusions. The
board could now provide unsolicited reports. She commented
that there were quite a few significant changes.
Ms. Curtis continued to page 12 of the report. Legislative
Audit stated that with the changes the board was now
empowered to help combat the abuse of controlled
substances. Given that the changes were recent, the
division was unable, as part of the audit, to evaluate the
degree to which the board was going to use its new
authority to help serve the public's interest. However, the
division could say that the DCBPL management did not
believe the board should be proactively analyzing data to
serve public health objectives. She relayed that Department
of Commerce, Community and Economic Development management
stated that additional resources would be needed if the
legislature intended for the board to analyze data and to
become proactive in enforcing prescription drug laws.
Ms. Curtis detailed that the report included 2
recommendations for operational improvements beginning on
page 14. The division recommended that DCBPL chief
investigator work with the director to improve the
timeliness of investigations. There were 20 cases that were
open for over 180 days during the audit period. The
division tested 13 of them, 6 of them had unjustified
periods of inactivity. Those periods ranged from 51 to 184
days. She reported that the cause of the delay, at least
partially, was the competing priorities of the main
investigator assigned to the board because that individual
was also assigned to help manage the controlled substance
prescription database.
2:16:49 PM
Ms. Curtis moved to the second recommendation. Legislative
Audit recommended that DCBPL director improve procedures to
ensure required licensure documentation was obtained prior
to licensing. The division tested 20 facility licenses and
found 3 errors. First, in one case, the self-inspection
report was not submitted. In one case, a background check
was not submitted. In another case, an applicant had marked
"Yes" to a professional fitness question indicating that
their out-of-state license had received a citation against
it and the DCBPL staff had not follow-up on the issue. The
board had approved the licenses appropriately pending
receipt of certain documentation. It was the staff that had
not followed through and obtain it. She furthered that the
division tested 25 individual licenses and found one
instance regarding a pharmacy intern where there was no
support that their education had been met.
Ms. Curtis conveyed that responses to the audit began on
page 45. The governor's office agreed that the board was
serving the public's interest and should be extended. They
did not comment on the controlled substance prescription
database. The department's response was on page 47. They
agreed with both recommendations. Regarding recommendation
1, the department reported having implemented new procedure
regarding documentation for investigations and to help
ensure timeliness. Regarding recommendation 2, they agreed
that additional quality checks were needed to help ensure
that administrative records were complete. However, they
stated that additional supervisory resources were needed in
order to ensure that their standards were met. The board
chair's response was on page 49 and the chair agreed with
both recommendations.
2:18:37 PM
Representative Wilson commented that both recommendations
had nothing to do with what the board was supposed to do.
It sounded like it all came back to the law passed in 2008
that was not written correctly. She opined that the board
was being penalized for a law that was made in 2008 that
did not give them all of the needed pieces. She asked if
her assessment was fair.
Ms. Curtis replied that the Legislative Audit Division
viewed itself as a legislative oversight agency. The sunset
process was designed to ensure that the board was serving
the public's interest. She was recommending a 4-year
extension because the powers being given to the board were
very important powers. In the audit process it was not able
to evaluate the degree to which the board had been
effective at serving the public's interest. It was an
oversight mechanism noting that Legislative Audit believed
it would be important to go in earlier than 8 year. In this
particular case, given the importance of the opioid abuse
in the public, the division thought it was prudent to go in
earlier.
2:20:01 PM
Representative Wilson wanted to return to the issue that if
the law had been written correctly in 2008, Legislative
Audit would have had enough time to make and evaluation.
Ms. Curtis was uncertain what to say what Legislative Audit
would have done if things had been done differently. She
pointed to page 6 which had a timeline from 2008. The
board, legislature, and the department were not responsive.
All 3 entities that worked together to ensure that the law
was carried out did not do the best job that they could
have. She continued that given where society was at, the
division felt it was really important to provide as much
information to policy makers as possible as part of the
audit. She referred to appendices A and B. There was a
significant amount of where things were at and to what
degree the original law had been implemented. She indicated
that board was responsible for procuring the database and
encountered long delays. There were problems with the
effectiveness of the database. Legislative Audit believed
that a better job could have been done during those years
but recognized that part of the issue was the law itself.
However, the division focused going forward. There were
currently in place with additional legislation proposed to
further assist the board in carrying out these
responsibilities.
2:22:18 PM
Representative Kawasaki thought that when the board
extension came up in 2009 and has had an 8-year extension,
the legislature probably should not have extended it as
long as it did because of the current issues. He furthered
that it was not just the bill that passed in 2008, it was
all the bills subsequent to that time that had changed the
system significantly, including SB 74 which radically
changed who got access to the database. He added that SB 74
also had the pharmacy registration that required a
pharmacist had to become involved with the database. There
were many changes that had occurred recently. He concurred
that a 4-year board extension made sense. He preferred a
shorter extension due all that had been done subsequent to
the prescription drug database.
2:23:49 PM
Representative Guttenberg asked about Ms. Curtis' comments
about the board not being proactive and did not believe it
should be proactive. He asked Ms. Curtis to further
comment.
Ms. Curtis indicated that essentially the database did not
operate as it was intended. The board was not able to
analyze the data until the legislative fixes happened. What
she had said was that the department did not believe it was
the board's responsibility to be proactive in analyzing
data to help further public health objectives. She reported
that the staff of Legislative Audit had an internal debate
about whether the board was the right for the
responsibility. Many other states had the controlled
substance database under the board. She opined that it was
a policy question. She did not believe the board had been
effective.
2:25:44 PM
Representative Guttenberg asked if it would really make it
effective.
2:25:59 PM
Co-Chair Seaton mentioned the prescription drug database
and the procedures to analyze them. The legislature had not
mandated those things at the time. He asked if there was
anything that had prevented the board from passing
regulations to implement more strict adherences to the
intent of the database.
Ms. Curtis responded that only regulations could be passed
to implement the statutes. The statues, themselves, were
flawed by not providing them certain authority or certain
capabilities.
2:26:49 PM
SARA CHAMBERS, ACTING DIRECTOR, ALCOHOL AND MARIJUANA
CONTROL OFFICE, DEPARTMENT OF COMMERCE, COMMUNITY AND
ECONOMIC DEVELOPMENT, relayed that the fiscal note was
similar to the previous 2 board extensions heard in the
current day's committee. The amount was $27,900, slightly
more than the previous 2 bills, because the board had 7
members rather than 5. The authority, since it was all
funded by license fees, would provide the opportunity for
the board to meet 4 times a year as required in statute.
The money also paid for public notices, board member
training at conferences, and per diem.
2:27:47 PM
Representative Wilson asked why the board did not come back
to the legislature to inform members with an update. She
asked if the department had the ability to do so.
Ms. Chambers replied that until SB 74 and HB 159
[Legislation passed in 2017 - Short Title:
Opioids; Prescriptions; Database; Licenses] came forward,
the administrative support for the board had not dug deeply
into the intent. The department was working with the tools
it had. The legislature's movement to expand the
prescription drug monitoring program, in light of the
public crisis, helped reframe the tools and the abilities
to accomplish those things. The question that had been
posed was whether the Board of Pharmacies to proactively
solve the opioid crisis was the right place. The board was
a licensing board made of pharmacists. The 2 very powerful
bills that were passed brought other boards of
practitioners into the conversation. However, at the end of
the day, it was a question of whether the Board of Pharmacy
proactively trying to solve the opioid crisis. The board
and the department were working in tandem to work with
Department of Health and Social Services to provide them
epidemiological experts and the data they needed to assist
in moving the objective forward. HoweverShe reported that a
handful of pharmacists and a few public members found the
task to be daunting. The department was looking at ways to
collaborate and accomplish the goals within the new,
reframed mandate.
2:30:18 PM
Representative Wilson commented that a shorter sunset
period was not needed to be proactive in make a policy
call. It was a policy call by the legislature and not the
board. She asked if she was correct.
Ms. Chambers responded affirmatively.
Representative Wilson suggested that whether the sunset was
in 4 years or 8 years, the department could always suggest
legislation or suggest to the legislature to look at it if
it was not the right policy. She thought it was separate
from looking at whether it was in the public's interest.
She was certain that in 4 years it would still be in the
public's interest to have the board. She wondered if a
longer sunset would prevent the department or the governor
from coming back and suggesting needed changes.
Ms. Chambers responded that those decisions would
ultimately be made at the level of the governor's office.
Until those decisions and priorities were articulated
through the governor's office, the department would
continue with the mandate before the department.
2:31:46 PM
Co-Chair Seaton noted the policy question Representative
Wilson was discussing was where the board should be
located. He asked how things were normally handled.
Ms. Chambers replied that the department very much
appreciated the work of the legislative auditors. Feedback
was a gift of awareness. She informed the committee that
there were several federal grants through DHSS which set
forward performance measures to test against whether
policies, procedures, data collection, and the analysis
were working well. She noted that with the enhanced
responsibilities, the division had retched up analyzing the
job being done by the depart and board together. There were
internal mechanisms to determine how things were going. It
was an early stage with the new expanded responsibilities
that it would likely take another year or so before having
comprehensive data to see how things were working. If there
was a fundamental breakdown or an inability to meet the
requirements of statute the department would likely bring
forward to address the public health needs of the state.
2:34:23 PM
Co-Chair Foster OPENED and CLOSED Public Testimony.
Representative Wilson MOVED to ADOPT Conceptual
Amendment 1:
Page 1, Line 5:
Delete: 2022
Insert: 2026
Co-Chair Seaton OBJECTED for discussion.
Representative Wilson spoke to her amendment. She thought
the board would do what was necessary.
2:36:51 PM
Representative Kawasaki commented that regarding the
amendment, the legislature was not penalizing the board. He
thought it was a recognition that the legislature passed a
sunset bill in 2009 before the regulation came out that
completely changed the responsibilities of the board. He
did not believe the legislature would not have given an 8-
year sunset had it known there were significant changes
coming through the prescription drug database. The
committee had heard from the chair of the board that there
were several changes going on within the current
administration. The board spanned 3 administrations. He
reemphasized that the committee was not penalizing the
board but looking closely of the details of the present
audit. He anticipated implementing some rules around them.
He though the prescription drug management database were
very important and should be looked at within 2 years. He
thought waiting 8 years would be abrogating the
legislature's responsibilities. Although the legislature
could look at the board at any time, often times the only
time legislators reviewed them was when the saw the
recommendations from the chief auditor. He would stand with
the 4-year sunset as proposed by the legislative auditor.
2:39:08 PM
Representative Wilson thought the board was being penalized
for legislation passed in 2008 that the board did not ask
for. She surmised that had the legislation been written
correctly, the right things would have been in place. She
had faith in the department that it would be monitoring the
board. It was a question whether the legislature believed
that the department would come forward if there was a
problem. She would put her confidence in the board.
2:40:30 PM
Co-Chair Seaton did not believe it was a penalty for the
legislature to get an audit. The legislative auditors went
through what was happening in very fine detail. He thought
if the legislature had had a 4-year sunset, the issues
would not have waited until SB 74 was passed. They would
have been brought to the attention of the legislature much
earlier. Each one of the departments came forward with
recommendations that the legislature had not seen. An audit
was the way in which the legislature determined issues. He
would be opposing the amendment.
Representative Guttenberg would be opposing the amendment
as well. He relayed that the boards and commissions worked
for the legislature. They happened to function under the
executive department. The audits were critical to informing
the legislature about what they were doing. He thought the
legislature, the governor, and the executive office had
created a difficult situation. He spoke of audits showing
difficulties. He thought the audit revealed a convoluted
series of legislation requirements that had been difficult
to deal with. He did not want to wait any longer than
necessary to see the results of their success. He thought
it was important through the audit process to see if
something was working. It was not a penalization. He would
be opposing the amendment.
2:43:42 PM
Representative Wilson thought the discussion was
enlightening. She argued that waiting for an audit to have
a discussion about a serious issue did not work. She
suggested perhaps only a 1-year extension should be
granted. She was concerned that the board had an 8-year
extension. She relayed that the 2 recommendations had
nothing to do with the board. She believed in the board and
the department and that they would do what was needed. If
something could not be done, she thought they would come
back to the legislature, even before the 4-year sunset. The
bill was a sunset bill. She would be voting yes on the 8-
year amendment because of her faith in the board and the
department.
Co-Chair Seaton MAINTAINED his OBJECTION.
A roll call vote was taken on the motion.
IN FAVOR: Thompson, Tilton, Wilson
OPPOSED: Guttenberg, Kawasaki, Ortiz, Pruitt, Gara, Seaton,
Foster
Representative Grenn was absent from the vote.
The MOTION to ADOPT Conceptual Amendment 1 FAILED (3/7).
2:46:39 PM
Co-Chair Seaton MOVED to report HB 323 out of Committee
with individual recommendations and the accompanying fiscal
note.
There being NO OBJECTION, it was so ordered.
HB 323 was REPORTED out of committee with a "do pass"
recommendation and with a previously published fiscal
impact note: FN1(CED).
Co-Chair Foster reviewed the agenda for the following
meeting.
ADJOURNMENT
2:47:51 PM
The meeting was adjourned at 2:47 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 318 Amendment #1 A.1.pdf |
HFIN 2/12/2018 1:30:00 PM |
HB 318 |
| HB318 Sponsor Statement 2.7.2018.pdf |
HFIN 2/12/2018 1:30:00 PM |
HB 318 |
| HB 318 Social-Work-Final-Report-WEB.pdf |
HFIN 2/12/2018 1:30:00 PM |
HB 318 |
| HB302 Sponsor Statement 1.30.18.pdf |
HFIN 2/12/2018 1:30:00 PM |
HB 302 |
| HB 302 Audit BPC-Final-Report-WEB.pdf |
HFIN 2/12/2018 1:30:00 PM |
HB 302 |
| HB 323 Audit Pharmacy-FINAL-Report-WEB.pdf |
HFIN 2/12/2018 1:30:00 PM |
HB 323 |
| HB323 Support Letter 2.5.18.pdf |
HFIN 2/12/2018 1:30:00 PM |
HB 323 |
| HB323 Sectional Analysis 2.2.18.pdf |
HFIN 2/12/2018 1:30:00 PM |
HB 323 |
| HB323.SponsorStatement.verD.2.2.18.pdf |
HFIN 2/12/2018 1:30:00 PM |
HB 323 |