Legislature(2019 - 2020)ADAMS 519
03/23/2020 01:30 PM House FINANCE
| Audio | Topic |
|---|---|
| Start | |
| SB55 | |
| SB172 | |
| SB115 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| += | SB 115 | TELECONFERENCED | |
| += | SB 55 | TELECONFERENCED | |
| += | SB 172 | TELECONFERENCED | |
CS FOR SENATE BILL NO. 172(L&C)
"An Act extending the termination date of the State
Medical Board; requiring a report on the State Medical
Board's audit compliance; and providing for an
effective date."
1:40:22 PM
Co-Chair Johnston asked the Department of Commerce,
Community and Economic Development (DCCED) to review the
fiscal note.
SARA CHAMBERS, DIRECTOR, DIVISION OF CORPORATIONS, BUSINESS
AND PROFESSIONAL LICENSING, DEPARTMENT OF COMMERCE,
COMMUNITY AND ECONOMIC DEVELOPMENT (via teleconference),
reviewed the fiscal note for the bill. The fiscal note
recognized that the State Medical Board was set to sunset.
The amount included covered board operations only. She
explained that if the board sunset, the amount would not be
continued in the budget. She explained that the amount
would need to be reauthorized, which the bill would do. She
elaborated that the licensing for medical professions was
not included because if the board sunset, the department
would take over the responsibility for licensing, which
would be a different fiscal note.
1:41:58 PM
Representative Sullivan-Leonard requested to hear from the
legislative auditor. First, she addressed a question to the
department. She had concern about the board extension in
light of its noncompliance with a statute from 2017
regarding the prescription database. She asked why the
challenge with noncompliance was taking place.
Ms. Chambers replied that DCCED also had some concerns,
which was part of the reason why the governor had appointed
new board members and why there was a new executive
administrator for the program. She understood that the
board had expressed some misunderstandings and
misconceptions over certain aspects in the audit findings.
The department was committed to moving the board forward
quickly to get into compliance with the PDMP [Prescription
Drug Monitoring Program]. There were related issues the
department had been working on with Representative
Josephson's office that could come up at another time that
could strengthen the PDMP. She elaborated that concerns
included a lack of funding for the PDMP; however, the
issues were outside of the medical board's purview to
ensure providers required to register were registered. The
department had addressed the issues and the new iteration
of the board and DCCED staff were committed to staying on
top of the issue. She believed the new board chair
Dr. Wein was available online and could also address the
topic.
1:44:16 PM
Representative Sullivan-Leonard directed a question to the
legislative auditor. She noted that Ms. Curtis had
[previously] provided a good overview of the audit. She
asked if it would be prudent to extend the board one year
instead of five. She was interested in seeing the board
show its compliance with statute. She wondered if there had
been any discussion on the idea.
KRIS CURTIS, LEGISLATIVE AUDITOR, ALASKA DIVISION OF
LEGISLATIVE AUDIT, answered that the concerns had been
raised in the Senate Labor and Commerce Committee. She
reported that the bill had been amended to include
uncodified law to have the Division of Legislative Audit
provide an updated status of the prior audit findings the
following year in order to check on compliance. The bill
allowed for a full sunset review in three years.
Additionally, the division would review the Board of
Pharmacy that had a sunset audit within the next two years.
The division would be reviewing compliance for the [PDMP]
database over all occupations.
Representative Sullivan-Leonard thought if there was not
enough pressure for the board to be compliant that it may
just continue what it is doing. She asked if Ms. Curtis
felt confident there was enough fortitude within the new
board to get into full compliance.
Ms. Curtis responded that she could not comment on the new
board as it had not been part of the audit. She could not
comment on whether there was fortitude amongst the board
members to take action. She believed the board was paying
attention to the audit findings based on testimony in other
committee hearings. The board had stated on the record that
it planned to take action.
Co-Chair Johnston added that Dr. Wein, a new member on the
board, was available online.
1:46:28 PM
Representative Sullivan-Leonard had concern about the board
moving forward to a five-year extension, especially due to
the restructuring of the board and past noncompliance with
the PDMP database passed in statute in 2017. She understood
there were some changes going forward. She asked for
assurance that the board and physicians in Alaska would be
in full compliance.
RICHARD WEIN, CHAIR, ALASKA MEDICAL BOARD, SITKA (via
teleconference), assured the committee that the members on
the Alaska Medical Board were critically aware of the many
issues it was facing. The board looked forward to
addressing and solving the issues and moving forward. He
believed the board had the fortitude to continue the work.
He assured the committee that, as the current chair, he was
not interested in any misunderstandings and misconceptions
held by the previous board. The board would move forward
with the current team that had been very helpful getting
the completely new board up to speed. He assured the
committee the board would be on top of things, would be
fully compliant, and would be happy to update the
legislature or provide whatever it may need to allay any
concerns.
1:48:32 PM
Representative Carpenter understood there was a changeover
in the board. He asked if the department was providing the
board with everything it needed in order for the board to
"right the ship" and get it headed in the right direction.
Mr. Wein answered in the affirmative. He detailed that he
had received incredible support from the executive
administrator, the division director, and legal in his work
to understand all of the issues. He had been in contact
with the executive administrator on a daily basis and a
working group had been formed with other board chairs
including the Board of Pharmacy and Board of Nursing in
order to collaborate, find common ground, and work
together. He believed it was a new day, coupled with all of
the aspects surrounding the burden of COVID-19, including
the fast tracking of licensure, eliminating any backlog,
and ensuring the state had the capacity to meet any medical
crisis. He reported that the board had just concluded a
meeting 30 minutes earlier. He was gratified at the support
the board was receiving from the department, especially due
to the board's steep learning curve. He highlighted his
vast experience in credentialing and reviewing medical
issues and he felt confident the board could meet the
challenge.
Representative Carpenter asked if the board had been able
to establish some objectives that it felt were necessary to
meet in a given timeline. He recognized that the current
[COVID-19] crisis likely had the board's attention.
1:51:41 PM
Mr. Wein answered in the affirmative. He highlighted the
board's ability to multitask. The full board had a meeting
scheduled for the coming Thursday and it would meet, as
necessary. The formal meeting had been scheduled for May,
but due to everything going on, it was necessary to get
down to business and get it done. The board had a number of
objectives it would have to triage into order of
importance. He assured the committee that compliance was at
the top of the list.
Co-Chair Foster MOVED to REPORT CSSB 172(L&C) out of
committee with individual recommendations and the
accompanying fiscal note.
Representative Sullivan-Leonard OBJECTED.
Representative Sullivan-Leonard MOVED to AMEND the bill to
extend the board to 2021 instead of 2023 in order to see
proof of the board's compliance, especially at a time where
things were happening rapidly with COVID-19. She stressed
the importance of knowing the board could be relied on to
do what was best for the state. She did not currently have
full faith that was the case.
Co-Chair Johnston OBJECTED for discussion.
1:53:36 PM
AT EASE
1:53:58 PM
RECONVENED
Representative Sullivan-Leonard WITHDREW her first motion
and restated the motion. She moved Conceptual Amendment 1,
which would change the date from 2023 to 2021 on page 1,
line 5.
Co-Chair Johnston OBJECTED for discussion. She asked Ms.
Curtis to comment on the proposed amendment.
Ms. Curtis replied that the concern had been raised in the
Senate. She explained that in order to have a 2021 sunset
date, the division would have to start an audit
immediately. She reported that the division did not have
the staff to do that; therefore, the division would not
have the ability to provide the legislature an audit
required by statute to be considered during the sunset
process. The date was not doable from the audit
perspective. She explained that in order to address the
concern, there would be a legislative audit review within
one year to focus on the specific areas the board had not
been compliant. She elaborated that the division had
recommended a five-year extension and the Senate had
reduced it to three years. After one year, the division
would report its review findings to the legislature and the
legislature could take action at that time if desired.
1:55:40 PM
Representative Knopp opposed the amendment. He highlighted
that the board was brand new. He elaborated that all of the
deficiencies had existed with the prior board. He believed
the replacement of the entire board by the administration
was the desired action. He noted that Dr. Wein was aware of
the issues and concerns and sounded sincere in his plan to
address them. He elaborated that Dr. Wein had acknowledged
what the issues were and had relayed it was the number one
priority. He believed the review the Division of
Legislative Audit would conduct in one year was
appropriate.
Representative Josephson asked if the division could do an
audit by 2022.
Ms. Curtis replied it was doable if it was the will of the
legislature. She had pointed out the cost of audits when
discussing the issue with the Senate. She noted there were
limited resources. She elaborated that when the Legislative
Budget and Audit Committee had asked the division to
conduct performance audits, the division did so when
resources were available. She detailed that sunset audits
had a statutory due date; therefore, the division conducted
those first. The financial audit and federal compliance had
timelines and requirements. She explained that with other
available resources and on its down time, the division
would do other audits requested by the legislature to look
at specific things. She clarified that the division would
prioritize the sunset review of the medical board over
other audits if there was a statutory due date.
Representative Carpenter asked when the division's planned
review [of the State Medical Board] would be published.
Ms. Curtis answered that assuming financial and federal
compliance audits were complete on time, staff was
typically freed up in January. She elaborated that the
division could do a sample and inquiry to figure out to
what degree the board was complying. She explained that the
review could be done more quickly than an audit required to
be conducted in accordance with auditing standards. She
relayed that the medical board sunset audit had taken
approximately 500 hours at an hourly rate of about $80. She
reiterated there was a cost associated with increasing
audit activity.
Representative Carpenter asked if the review would start in
January 2021.
Ms. Curtis could not say exactly. She explained that it
depended on COVID-19. She elaborated that the division
could suddenly take much longer to do an audit working
remotely. Typically, audit staff became available in
January. She estimated that she could provide a memo-type
report to the Legislative Budget and Audit Committee by
March for consideration and release to the public.
1:58:49 PM
Representative Carpenter referenced the two previous audits
mentioned in the most recent audit that noticed problems
[with the board]. He asked how long the board had been
extended in each of the two previous audits.
Ms. Curtis answered that in the previous audit the board
had been given an eight-year extension. She did not know
about the one prior to that.
Representative Carpenter stressed the importance of nipping
the situation in the bud if there had been noncompliance
for eight years or more. He thought sounded like a report
would come to the legislature in the first quarter of the
next calendar year to show whether compliance was taking
place. He asked for the accuracy of his statements.
Ms. Curtis confirmed that the division would do a
compliance review in 2021. She detailed that the current
bill would sunset the board in 2023, which meant a full
sunset audit would be conducted in 2022. Currently, the
division was scheduled for a detailed review over the next
two years.
2:00:06 PM
Representative Sullivan-Leonard WITHDREW her conceptual
amendment. She was trying to highlight the urgency and
demand for the state medical board to be in compliance and
working on the incredible medical situations facing the
state. She looked forward to the report in the following
year.
Co-Chair Johnston asked Ms. Curtis to outline the options
that the Legislative Budget and Audit Committee had if it
found the review lacking.
Ms. Curtis believed the committee had the ability to submit
a bill at the committee level.
2:01:26 PM
There being NO further OBJECTION, it was so ordered.
CSSB 172(L&C) was REPORTED out of committee with a "do
pass" recommendation and with one previously published
fiscal impact note: FN2 (CED).
2:01:38 PM
AT EASE
2:22:01 PM
RECONVENED
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 115 Public Testimony Rec'd by 032320.pdf |
HFIN 3/23/2020 1:30:00 PM |
SB 115 |
| SB 134 AMHTA Support 3.23.20.pdf |
HFIN 3/23/2020 1:30:00 PM |
SB 134 |
| SB 115 ver. G 3.23.2020.pdf |
HFIN 3/23/2020 1:30:00 PM |
SB 115 |