Legislature(2023 - 2024)ADAMS 519
05/11/2023 01:30 PM House FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| SB55 CS FOR SENATE BILL NO. 55(FIN) | |
| HB193 | |
| HB89 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | SB 41 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| + | SB 55 | TELECONFERENCED | |
| *+ | HB 193 | TELECONFERENCED | |
| + | HB 89 | TELECONFERENCED | |
CS FOR SENATE BILL NO. 55(FIN)
"An Act extending the termination date of the Board of
Certified Direct-Entry Midwives; extending the
termination date of the State Medical Board; and
providing for an effective date."
2:09:51 PM
MERCEDES COLBERT, STAFF, SENATOR BILL WIELECHOWSKI,
SPONSOR, thanked the committee for hearing the bill. She
explained that the bill would extend the termination date
of the Board of Certified Direct-Entry Midwives and the
termination date of the State Medical Board. She relayed
that the state auditor recommended a four-year extension
date through June 30, 2027 for the Board of Certified
Direct-Entry Midwives and an eight-year extension through
June 30, 2031 for the State Medical Board. She deferred to
Kris Curtis, legislative auditor for details on the audits.
Additionally, the Department of Commerce, Community and
Economic Development (DCCED) was available to address the
fiscal note.
Co-Chair Foster asked for a review of the audit.
KRIS CURTIS, LEGISLATIVE AUDITOR, ALASKA DIVISION OF
LEGISLATIVE AUDIT, began with the audit findings for the
State Medical Board (copy on file). The audit concluded
that the board developed and adopted regulations to protect
the public, improve the licensing process, and expand
access to healthcare during the pandemic. Further, the
board served the public's interest by effectively licensing
physicians, osteopaths, and podiatrists; however, emergency
courtesy licenses for physician assistants were not always
issued in accordance with law. The audit also found that
the board's workload had increased substantially during the
audit period. The board met frequently, sometimes weekly,
to consider pandemic-related regulations and the number of
license applications considered by the board increased 28
percent compared to the pre-pandemic period. She explained
the increase was a result of physicians traveling to the
state to help meet the need for healthcare services during
the pandemic and out of state practitioners providing
services via telehealth.
Ms. Curtis relayed that board turnover and vacancies were
common during the audit period, but even with the
challenges, the audit found the board operated effectively.
The audit recommended an eight-year extension, which was
the maximum allowed in statute. She directed members to
page 8 of the audit report showing licensing information.
As of March 2022, there were 5,878 active licenses and
permits for the board. Page 10 showed the schedule of
revenues and expenses, showing that as of March 2022, the
board had a surplus of approximately $506,000.
Ms. Curtis directed members to page 14 of the audit report
and highlighted two recommendations. First, the audit
recommended that the board's executive director ensure all
board meetings were adequately public noticed. The audit
found that six of 32 meetings were not publicly noticed or
not publicly noticed accurately. Second, the audit
recommended that the board ensure emergency regulations
comply with statute. The audit found that when the board
established the physician assistant emergency courtesy
license regulation, they did not ensure that the applicant
had a collaborative plan with a supervising physician,
which was a statutory requirement. She relayed that
management's response to the audit began on page 25. She
reported that the governor, commissioner, and board chair
concurred with the findings and recommendations. She stated
that overall, it was a fairly clean audit.
2:14:29 PM
Ms. Curtis addressed the audit findings for the Board of
Certified Direct-Entry Midwives (copy on file). The audit
concluded that the board served the public's interest by
conducting its meetings in an effective manner, by
supporting statutory changes when deemed necessary, and by
actively working towards amending its regulations. The
audit also concluded that the board and the Division of
Corporations, Business and Professional Licensing (CBPL)
staff did not consistently certify midwives and apprentice
midwives in accordance with the law. Further, an
investigation that concerned a potential threat to public
safety was not addressed by CBPL investigators in an
efficient manner. The audit recommended the legislature
extend the board four years, which was half of the eight-
year maximum allowed in statute. The reduced extension
recommendation was based on a need for more timely
oversight of the board and on the fact that the board had
some draft regulations that would significantly change how
it licensed midwives in the future.
Ms. Curtis turned to page 5 of the audit report and relayed
that there were 47 certified midwives and apprentice
midwives as of June 2022. Page 7 showed a schedule of
revenues and expenses showing a surplus of approximately
$68,000 as of March 2022. The audit made four
recommendations for improvement beginning on page 9. In
regard to the investigations that were not done timely, the
audit recommended that the commissioner consult with the
governor's office and other policy makers to improve the
recruitment and retention of investigators. She stated that
because recruitment and retention was a statewide problem,
it should be addressed at a statewide policy level. The
second recommendation was similar in regard to improving
the recruitment and retention of licensing staff, which
contributed to the licensing errors discovered in the
audit.
Ms. Curtis turned to page 11 of the audit report and
addressed the audit recommendation for the director to work
with the board to ensure the online renewal licensing
application form was sufficient to monitor compliance with
continuing education. Additionally, the license referenced
incorrect regulations, which should be cleaned up. The
fourth recommendation, located on page 12, recommended that
the Office of the Governor's Boards and Commissions
director work with the board to identify interested
applicants to fill board vacancies in a timely manner. She
detailed that the board was composed of five members and
for 20 months it was down two positions and for two months
it was down three positions. She shared that the
commissioner, board chair, and governor's office concurred
with the findings and recommendations. She highlighted that
on page 26, the chair asked for an eight-year extension as
opposed to a four-year extension. The request was made
because the recommendations were mainly addressed to the
department and governor's office.
2:17:46 PM
Representative Hannan noted that the audit recommendations
did not really pertain to actions by the board. She
considered various extension options including four, six,
and eight years. She reasoned it was incumbent on the
agency to ensure the board was adequately staffed and
[investigations] were done in a timely manner. She
considered herself to be a fairly new legislator, but she
recalled renewing the board once before. She thought it
seemed there would always be a sort of panic to get on step
when they were down on staff and the concerns were
timeliness but not actions of the board. She asked if she
was missing something.
Ms. Curtis replied it was a common question whenever there
were recommendations addressed to the division and not the
board. She stated it was a legislative oversight mechanism.
She recommended taking a look at the board again earlier
rather than later because the board planned to
significantly change how it licensed midwives.
Additionally, she believed it was important to keep an eye
on the investigations for a board that impacted public
safety. She noted it was the second time there had been
issues with the investigations.
Representative Hannan asked Ms. Curtis to elaborate on any
communications the auditors had with the department about
their focus and ability to address the concerns raised in
the audit. She asked if the department had more
investigators. She wondered if the deficits [in the
division] would remain in four years. She did not recall an
increase in the division's budget for an investigator. She
believed the positions were unfilled. She wondered about
filling or addressing the positions and turning licenses
and investigations around in a timelier fashion.
2:20:22 PM
Ms. Curtis answered that the licensing issue was not
necessarily about timing but about not having the
appropriate documentation in the files or not following up
on certain things. She stated it was attributed to turnover
and vacancies. She stated the same was true with the
investigations. She relayed that the particular case was a
threat to public safety and had been identified in the
audit three years earlier. She reported that no progress
had been made on the issue. She detailed that the chief
investigator stated the division had an untenable workload
due to a high number of cases and a high number of vacant
positions and that efforts to hire had been unsuccessful.
She relayed it was a statewide issue. She explained that it
may not be a budgetary situation if the division could not
find someone to apply for a position or remain in a
position. She considered it may indicate a need for more
statewide policy pertaining to recruitment and retention.
Representative Josephson asked if the board and midwives
had to pay the audit fees if they had to come back in four
years.
Ms. Curtis answered that there was no cost to the
department for a sunset; it was just the department's time
and energy dealing with the auditors. She explained that
sunset audits were part of the Division of Legislative
Audit's budget. She explained that if there were seven
sunsets in a given year, more of the division's resources
would go towards the audits as opposed to doing special
audits at the request of the committee.
Representative Josephson asked from the perspective of the
midwives and board chair why it was so important for the
board to receive a seven-year extension versus four. He
asked if it felt insulting to the board and licensees.
Ms. Curtis answered that the individuals were passionate
about their work and the volunteers worked very hard. She
stated that time and time again she saw that the
individuals felt like it was like a grade on their report.
She stated they wanted an "A" and did not feel that a four-
year extension indicated an A. She acknowledged that the
individuals were doing a wonderful job, they worked very
hard, and the recommendation was not a reflection of their
time.
Co-Chair Foster noted that both of the boards would expire
June 30, 2023 if the bill was not passed. He asked Ms.
Colbert if she had anything to add prior to the review of
the fiscal note.
Ms. Colbert thanked the committee for hearing the bill and
thanked the senator's intern for carrying the bill in the
other body.
Co-Chair Foster asked for a review of the fiscal note.
2:23:43 PM
SYLVAN ROBB, DIRECTOR, DIVISION OF CORPORATIONS, BUSINESS
AND PROFESSIONAL LICENSING, DEPARTMENT OF COMMERCE,
COMMUNITY AND ECONOMIC DEVELOPMENT, highlighted that the
total annual cost to extend both boards was $25,200 from FY
25 through FY 29. She noted there were no costs shown for
FY 24 because per statute, if boards were not extended,
there was a one-year wind down period; therefore, the
division would pay for the board in FY 24 regardless of the
status of the bill.
Representative Hannan asked how the department was doing in
hiring the investigative position and filling the vacancies
that had created some demerits on the audit.
Ms. Robb responded that the division had been successful in
staffing its investigations unit. She detailed that the
unit had been fully staffed until the end of March with 23
filled positions. An individual had retired at the of March
and the position had been filled with an internal promotion
meaning there would still be a vacancy. She stated the
division was doing much better in terms of having the
investigation positions filled.
Representative Hannan asked if the department believed it
would be able to support the board to fully comply with
statute for the next four years if the sunset was extended.
Ms. Robb replied affirmatively.
Co-Chair Edgmon MOVED to REPORT CSSB 55(FIN) out of
committee with individual recommendations and the
accompanying fiscal note.
There being NO OBJECTION, it was so ordered.
CSSB 55(FIN) was REPORTED out of committee with a "do pass"
recommendation and with one previously published fiscal
impact note: FN2 (CED).
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 89 Presentation v.3.pdf |
HFIN 5/11/2023 1:30:00 PM |
HB 89 |