Legislature(2021 - 2022)ADAMS 519

05/02/2022 01:30 PM House FINANCE

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ SB 190 REGULATORY COMMISSION AK/REFUSE UTILITIES TELECONFERENCED
Scheduled but Not Heard
<Pending Referral>
+ SB 186 EXTEND BOARD OF EXAMINERS IN OPTOMETRY TELECONFERENCED
Heard & Held
+ SB 193 EXTEND BOARD OF CHIROPRACTIC EXAMINERS TELECONFERENCED
Heard & Held
+ SB 151 EXTEND ALCOHOLIC BEVERAGE CONTROL BOARD TELECONFERENCED
Heard & Held
+ Bills Previously Heard/Scheduled TELECONFERENCED
SENATE BILL NO. 186                                                                                                           
                                                                                                                                
     "An Act extending the termination  date of the Board of                                                                    
     Examiners in Optometry; and  providing for an effective                                                                    
     date."                                                                                                                     
                                                                                                                                
2:01:06 PM                                                                                                                    
                                                                                                                                
TIM  LAMKIN,  STAFF,  SENATOR   GARY  STEVENS,  thanked  the                                                                    
committee for hearing the bill  promptly and deferred to the                                                                    
auditor for comment.                                                                                                            
                                                                                                                                
KRIS  CURTIS,   LEGISLATIVE  AUDITOR,  ALASKA   DIVISION  OF                                                                    
LEGISLATIVE AUDIT, spoke to the  audit findings. She pointed                                                                    
to the Audit Report for  the Board of Examiners of Optometry                                                                    
dated  June  9, 2021  (copy  on  file).  She read  from  the                                                                    
reports conclusions as follows:                                                                                                 
                                                                                                                                
     The  board conducted  its meetings  in compliance  with                                                                    
     state  laws  effectively   licensed  optometrists,  and                                                                    
     actively  amended  regulations   to  address  statutory                                                                    
     changes   and  improve   the  licensing   process.  The                                                                    
     Division  of  Corporations, Business  and  Professional                                                                    
     Licensing  (DCBPL)  staff  failed  to  operate  in  the                                                                    
     public's   interest  by   not  consistently   recording                                                                    
     licensees with federal  Drug Enforcement Administration                                                                    
     (DEA) registration  numbers in the  licensing database,                                                                    
     not   ensuring   continuing   education   audits   were                                                                    
     conducted   timely,  and   not  monitoring   licensees'                                                                    
     compliance with  requirements for  continuing education                                                                    
     in pain management and opioid use and addiction.                                                                           
                                                                                                                                
     In accordance  with AS  08.03.010(c)(15), the  board is                                                                    
     scheduled to  terminate on June 30,  2022. We recommend                                                                    
     the legislature extend the  board's termination date to                                                                    
     June  30,  2028,  which  is two  years  less  than  the                                                                    
     maximum  allowed  in  statute.  The  reduced  extension                                                                    
     reflects  the  need  for   more  routine  oversight  in                                                                    
     recognition of audit findings.                                                                                             
                                                                                                                                
Ms. Curtis pointed  to "Exhibit 2" on Page  9, that included                                                                    
a chart showing the board's  licensing activity from FY 2018                                                                    
through January  31, 2021, that  totaled 218  licensees. The                                                                    
amount  reflected an  18 percent  increase  since its  prior                                                                    
sunset audit.  She turned  to Page  10, "Exhibit  3listing                                                                      
the board's revenues and expenditures  over the same period.                                                                    
She reported that  the board had a deficit  of $52 thousand.                                                                    
A  fee increase  was  proposed by  DCBPL  management to  the                                                                    
board  in April  2020. Fees  were not  increased based  on a                                                                    
directive from  the governor to  help relieve  the financial                                                                    
impact  of  the  COVID-19  pandemic.   She  noted  that  the                                                                    
schedule of  fees was found on  Page 11 in  Exhibit  4.  She                                                                    
indicated  that  the   report  contained  3  recommendations                                                                    
beginning on Page 13, as follows:                                                                                               
                                                                                                                                
     Recommendation No. 1:  DCBPL's director should dedicate                                                                    
     resources to ensure licensees holding  a DEA number are                                                                    
     consistently recorded in the licensing database.                                                                           
                                                                                                                                
     DCBPL  management  provided  written  instructions  and                                                                    
     training  to board  licensing  staff  regarding how  to                                                                    
     record the existence  of a DEA number  in the licensing                                                                    
     database;  however,  DCBPL   licensing  staff  did  not                                                                    
     consistently  follow the  guidance. According  to DCBPL                                                                    
     management, regular  turnover in the  board's licensing                                                                    
     examiner  and  licensing  supervisor positions  led  to                                                                    
     inadequate training and  oversight which contributed to                                                                    
     the finding.                                                                                                               
                                                                                                                                
Ms. Curtis  interjected that it was  important the licensing                                                                    
database had  accurate information  to cross match  with the                                                                    
Controlled  Substances  Prescription  database in  order  to                                                                    
register. She moved to the second recommendation:                                                                               
                                                                                                                                
     Recommendation  No.  2:  The board  chair  and  DCBPL's                                                                    
     director  should change  the  license  renewal form  to                                                                    
     allow the  board to monitor compliance  with continuing                                                                    
     education requirements.                                                                                                    
                                                                                                                                
     Alaska  Statute 08.72.181(d),  effective July  1, 2018,                                                                    
     requires licensees holding a  DEA number to complete at                                                                    
     least  two hours  of education  in pain  management and                                                                    
     opioid  use   and  addiction   during  the   two  years                                                                    
     preceding the  application for renewal.  Auditors found                                                                    
     the board and  DCBPL staff did not  update the December                                                                    
     2020   renewal  form   to   require  licensees   report                                                                    
     compliance with the new continuing                                                                                         
     education requirement.                                                                                                     
                                                                                                                                
     Recommendation  No. 3:  DCBPL's director  should ensure                                                                    
     adequate resources are available to perform continuing                                                                     
     education audits.                                                                                                          
                                                                                                                                
Ms. Curtis  elucidated that the  audits were  the divisions                                                                     
method  of internal  control to  ensure  the licensees  were                                                                    
complying with continuing  education requirements. Licensing                                                                    
staff forwarded noncompliant  licensees to the investigative                                                                    
unit  approximately   two  and   a  half  years   after  the                                                                    
compliance  audit. According  to DCBPL  management, turnover                                                                    
and multiple  licensing staff  vacancies contributed  to the                                                                    
finding. She  highlighted managements  response on  Page 25.                                                                    
She  relayed  that  the   commissioner  concurred  with  the                                                                    
conclusions  and  recommendations. The  commissioner  stated                                                                    
that  the licensing  examiner position  turned over  5 times                                                                    
during  the   3.5  year  audit  period   and  the  licensing                                                                    
supervisor  turned over  4  times, which  led  to all  three                                                                    
findings. She reviewed the chair's  response on Page 27. She                                                                    
pointed to  the second recommendation and  reported that the                                                                    
chair stated the deficiencies would  be addressed before the                                                                    
next licensing renewal cycle.                                                                                                   
                                                                                                                                
2:06:08 PM                                                                                                                    
                                                                                                                                
Representative  Josephson asked  whether it  came under  the                                                                    
auditor's  purview  to  review  the  expansion  of  surgical                                                                    
authority  granted to  optometrists in  HB 103  [Optometry &                                                                    
Optometrists -  Chapter 17 SLA  17, 07/26/2017] in  the 30th                                                                    
legislature.  Ms. Curtis  answered  that the  issue was  not                                                                    
determined to  be a  risk area and  therefore, they  did not                                                                    
 spend   any  resources    on   the  issue.   Representative                                                                    
Josephson  asked if  the auditors  would  have examined  the                                                                    
issue if  it had  been identified as  a subject  of concern.                                                                    
Ms. Curtis  replied that  in the survey  phase of  the audit                                                                    
that looked for complaints  regarding the board it developed                                                                    
fieldwork  procedures to  follow  up on  complaints and  the                                                                    
issue was not identified in the process.                                                                                        
Co-Chair  Merrick  indicated that  Representative  Rasmussen                                                                    
joined the meeting.                                                                                                             
                                                                                                                                
2:07:08 PM                                                                                                                    
                                                                                                                                
DR.  DAMIEN  DELZER,  OD, CHAIRMAN  BOARD  OF  EXAMINERS  IN                                                                    
OPTOMETRY (via teleconference),  provided remarks. He shared                                                                    
that he had served  on the board for 8 years  and the last 3                                                                    
years  served as  chair.  He reiterated  the  duties of  the                                                                    
board. He  relayed that  the board  had implemented  over 20                                                                    
statutory changes  over the last  three years in  areas such                                                                    
as  continuing   education  requirements   including  opioid                                                                    
requirements,  scope   of  practice,   military  exemptions,                                                                    
modernizations    of    prescription    requirements,    and                                                                    
modernization of emergency  regulations during the pandemic.                                                                    
He  reported that  there had  been no  reported Prescription                                                                    
Drug Monitoring  Program (PDMP) violations since  his tenure                                                                    
on the  board. The board  was self-funded and  had minimized                                                                    
travel expenses  through the use  of Zoom meetings  over the                                                                    
last 3 years. He noted  that the board chair participated in                                                                    
bi-weekly board chair meetings and PDMP meetings.                                                                               
                                                                                                                                
2:09:04 PM                                                                                                                    
                                                                                                                                
DR. STEVEN DOBSON, OD, DIMOND  VISION CLINIC, PAST PRESIDENT                                                                    
OF  ALASKA  OPTOMETRIC   ASSOCIATION  (via  teleconference),                                                                    
supported the  bill. He shared  that he  practiced optometry                                                                    
in the  state for 40  years and had  served on the  board in                                                                    
the late 1980s  and served as  chair in the early 1990s.  He                                                                    
appreciated the  importance of the  board in  protecting the                                                                    
visual  welfare of  Alaskans. He  indicated  that the  board                                                                    
ensured  practitioners met  the high  professional standards                                                                    
set   forward  by   the  board.   The  board   ensured  that                                                                    
optometrists in the  state were trained in  the most current                                                                    
advances in the profession.                                                                                                     
                                                                                                                                
2:10:52 PM                                                                                                                    
                                                                                                                                
Co-Chair Merrick  asked the department to  review the fiscal                                                                    
note.                                                                                                                           
                                                                                                                                
GLENN  HOSKINSON, DIVISION  OF CORPORATIONS,  BUSINESSES AND                                                                    
PROFESSIONAL  LICENSING, DEPARTMENT  OF COMMERCE,  COMMUNITY                                                                    
AND ECONOMIC DEVELOPMENT  (via teleconference), reviewed the                                                                    
published fiscal impact  fiscal note for DCCED,  DCBPL (FN 1                                                                    
(CED).  She relayed  that the  fiscal  note represented  the                                                                    
cost of  operating the board  but not the operations  of the                                                                    
program.  She  reported that  the  fiscal  noted showed  the                                                                    
appropriation  of  $15.2 thousand  for  travel  for 7  board                                                                    
members and  1 staff member,  to attend four  board meetings                                                                    
per  year  and  for  additional expenses  for  services  for                                                                    
advertising  of public  notice of  board meetings,  training                                                                    
and  conference   fees,  and  stipends  for   board  members                                                                    
attending board meeting in community of residence.                                                                              
                                                                                                                                
SB  186  was  HEARD  and   HELD  in  committee  for  further                                                                    
consideration.                                                                                                                  
                                                                                                                                
Co-Chair Merrick noted the amendment  deadline of May 5. She                                                                    
reviewed the schedule for the following morning.                                                                                
                                                                                                                                

Document Name Date/Time Subjects
SB 186 Optometry Audit June 2021.pdf HFIN 5/2/2022 1:30:00 PM
SB 186
SB 186 Optometry Letters of Support _bundled as of 3.4.2022.pdf HFIN 5/2/2022 1:30:00 PM
SB 186
SB 186 Optometry Sponsor Statement 2.22.2022.pdf HFIN 5/2/2022 1:30:00 PM
SB 186
SB 193 Audit Summary.pdf HFIN 5/2/2022 1:30:00 PM
SB 193
SB 193 Explanation of Changes, version I to G.pdf HFIN 5/2/2022 1:30:00 PM
SB 193
SB 193 Full Audit.pdf HFIN 5/2/2022 1:30:00 PM
SB 193
SB 193 Sponsor Statement Version G.pdf HFIN 5/2/2022 1:30:00 PM
SB 193
SB 193_Letter of Support.pdf HFIN 5/2/2022 1:30:00 PM
SB 193
SB 151 Explanation of Changes.pdf HFIN 5/2/2022 1:30:00 PM
SB 151
SB 151 Research Audit Summary.pdf HFIN 5/2/2022 1:30:00 PM
SB 151
SB 151 Research Full Audit.pdf HFIN 5/2/2022 1:30:00 PM
SB 151
SB 151 Sponsor Statement.pdf HFIN 5/2/2022 1:30:00 PM
SB 151