05/02/2022 01:30 PM House FINANCE

CS FOR SENATE BILL NO. 193(FIN)                                                                                               
                                                                                                                                
     "An Act extending the termination  date of the Board of                                                                    
     Chiropractic  Examiners; requiring  a  report on  audit                                                                    
     compliance by the Board  of Chiropractic Examiners; and                                                                    
     providing for an effective date."                                                                                          
                                                                                                                                
1:32:46 PM                                                                                                                    
                                                                                                                                
MADISON  GOVIN, STAFF,  SENATOR  PETER MICCICHE,  introduced                                                                    
the  bill  with  prepared  remarks.  She  relayed  that  the                                                                    
legislation  extended the  Board of  Chiropractic Examiners                                                                     
(BCE)  termination date  five years  to June  30, 2027.  The                                                                    
audit concluded that the board  served the public's interest                                                                    
by  conducting  meetings  in  accordance  with  State  laws,                                                                    
amending  certain regulations  to  improve the  chiropractic                                                                    
profession,   and  effectively   licensing  and   regulating                                                                    
chiropractic physicians.  The bill required  the Legislative                                                                    
Audit Division to submit a  report to the Legislative Budget                                                                    
and Audit  Committee (LBA) concerning the  compliance of the                                                                    
board within  one year after  the effective date.  She urged                                                                    
the committees support in extending the board.                                                                                  
                                                                                                                                
Co-Chair  Merrick  asked  to   hear  from  the  Division  of                                                                    
Legislative Audit.                                                                                                              
                                                                                                                                
1:33:46 PM                                                                                                                    
                                                                                                                                
KRIS  CURTIS,   LEGISLATIVE  AUDITOR,  ALASKA   DIVISION  OF                                                                    
LEGISLATIVE AUDIT, reviewed the  legislative audit. She read                                                                    
the conclusions from page 1 of the Audit:                                                                                       
                                                                                                                                
     Overall, the audit concluded that  the board served the                                                                    
     public's interest by  conducting meetings in accordance                                                                    
     with  State  laws,   amending  certain  regulations  to                                                                    
     improve  the chiropractic  profession, and  effectively                                                                    
     licensing   and  regulating   chiropractic  physicians.                                                                    
     Additionally, the audit found  one board member did not                                                                    
     meet   statutory  requirements   for  appointment   and                                                                    
     additional resources  were needed to  investigate cases                                                                    
     in a timely manner.                                                                                                        
                                                                                                                                
     In  accordance with  AS 08.03.010(c)(5),  the board  is                                                                    
     scheduled to  terminate on June 30,  2022. We recommend                                                                    
     that  the legislature  extend  the board's  termination                                                                    
     date five  years to June  30, 2027, which is  less than                                                                    
     the eight-year maximum allowed  in statute. The reduced                                                                    
     extension  is due  to an  issue  identified during  the                                                                    
     audit that  may impact  the board's ability  to protect                                                                    
     the public. The  details of the issue  are not included                                                                    
     in this  report to  preserve the confidentiality  of an                                                                    
     ongoing investigation.  The reduced  extension reflects                                                                    
     the need for continued oversight.                                                                                          
                                                                                                                                
Ms.  Curtis drew  attention  to  Page 5  of  the audit  that                                                                    
included a  chart titled "Exhibit  2" that listed  the BCEs                                                                     
licensing  activity. She  indicated that  as of  January 31,                                                                    
2021, there  were 306 licensed chiropractors.  She turned to                                                                    
the chart  titled "Exhibit  3" on Page  6 that  depicted the                                                                    
board's revenues  and expenditures.  She indicated  that the                                                                    
board alternated between a deficit  and a surplus. According                                                                    
to  the Division  of Corporate,  Business, and  Professional                                                                    
Licensing  (DCBPL)  management,  the deficit  was  within  a                                                                    
reasonable range  and no fee  changes were  recommended. She                                                                    
noted that the license fees  were listed on the chart titled                                                                    
 Exhibit 4   on page  7. She furthered  that the  audit made                                                                    
two recommendations  found on  page 9  of the  audit report.                                                                    
She stated the first recommendation as follows:                                                                                 
                                                                                                                                
     The   governor  should   make  Board   of  Chiropractic                                                                    
     Examiners  (board)  appointments   in  compliance  with                                                                    
     statutory requirements.                                                                                                    
                                                                                                                                
Ms.  Curtis   delineated  that  the  governor   appointed  a                                                                    
licensed Emergency  Medical Technician  (EMT) as  the public                                                                    
member on  the board. Statutes prohibited  the public member                                                                    
to  not  have  a  financial  interest  in  the  health  care                                                                    
industry.  She   moved  to  the  second   recommendation  as                                                                    
follows:                                                                                                                        
                                                                                                                                
     DCBPL's director  should allocate  sufficient resources                                                                    
     to ensure cases are addressed in a timely manner.                                                                          
                                                                                                                                
     All 11 cases open over  180 days from July 2017 through                                                                    
     January  2021  were  evaluated   by  auditors.  It  was                                                                    
     identified that  seven of the  cases involved  the same                                                                    
     chiropractor and were combined  into one case. Auditors                                                                    
     found  the   case  had  four  periods   of  unjustified                                                                    
     inactivity ranging  from 55 to  208 days.  According to                                                                    
     DCBPL  investigative  staff,  the  inactivity  was  the                                                                    
     result   of  competing   priorities  and   insufficient                                                                    
     resources.                                                                                                                 
                                                                                                                                
Ms.  Curtis highlighted  that managements   response to  the                                                                    
audit began on  Page 21. She reported  that the commissioner                                                                    
of  the  Department  of  Commerce,  Community  and  Economic                                                                    
Development (DCCED)  hired two new investigators,  which she                                                                    
believed  would  improve  the   quality  and  timeliness  of                                                                    
investigations. The  governor's response  was on page  23 of                                                                    
the audit.  She related  that the  governor agreed  with the                                                                    
first  recommendation  and  notified the  auditor  that  the                                                                    
board member had been removed.  The boards  chairs  response                                                                    
began on  Page 25. She  communicated that the chair  did not                                                                    
agree with the 5-year extension.  He believed that the board                                                                    
was being  unfairly penalized for  actions on behalf  of the                                                                    
governors  office and DCBPL. He  requested that the board be                                                                    
granted an 8-year extension.                                                                                                    
                                                                                                                                
1:37:13 PM                                                                                                                    
                                                                                                                                
GLENN  HOSKINSON, DIVISION  OF CORPORATIONS,  BUSINESSES AND                                                                    
PROFESSIONAL  LICENSING, DEPARTMENT  OF COMMERCE,  COMMUNITY                                                                    
AND ECONOMIC DEVELOPMENT  (via teleconference), reviewed the                                                                    
department's published fiscal impact  fiscal note (FN3 (CED)                                                                    
for DCCED, DCBPL. She explained  that the fiscal note showed                                                                    
the cost  of operating  the board  and not  the cost  of the                                                                    
program.  The  expenses  incurred were  as  follows:  Travel                                                                    
costs were  $20.3 thousand for  5 board members and  1 staff                                                                    
member  to   attend  four  board   meetings  per   year  and                                                                    
associated  costs and  services  for  advertising of  public                                                                    
notice of board meetings,  training and conference fees, and                                                                    
stipends for  board members attending board  meetings in its                                                                    
community of residence.                                                                                                         
                                                                                                                                
SB  193  was  HEARD  and   HELD  in  committee  for  further                                                                    
consideration.                                                                                                                  
                                                                                                                                
1:38:29 PM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
1:38:57 PM                                                                                                                    
RECONVENED