Legislature(2021 - 2022)BARNES 124
04/27/2022 03:15 PM House LABOR & COMMERCE
| Audio | Topic |
|---|---|
| Start | |
| SB186 | |
| SB190 | |
| SB193 | |
| HB405|| HB406 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 382 | TELECONFERENCED | |
| + | SB 45 | TELECONFERENCED | |
| += | HB 405 | TELECONFERENCED | |
| += | HB 406 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| + | SB 186 | TELECONFERENCED | |
| + | SB 190 | TELECONFERENCED | |
| + | SB 193 | TELECONFERENCED | |
SB 186-EXTEND BOARD OF EXAMINERS IN OPTOMETRY
3:19:12 PM
CO-CHAIR FIELDS announced that the first order of business would
be SENATE BILL NO. 186, "An Act extending the termination date
of the Board of Examiners in Optometry; and providing for an
effective date."
3:19:25 PM
SENATOR GARY STEVENS, Alaska State Legislature, as the prime
sponsor, presented SB 186 and urged that the Board of Examiners
in Optometry be extended. He stated that optometrists provide
most of the eye care to patients across Alaska, plus an in-
person examination by a Doctor of Optometry is recognized as the
standard for ensuring healthy vision. He pointed out that over
270 serious health conditions can be detected through eye exams,
including diabetes, high blood pressure, autoimmune diseases,
and cancers. The Board of Examiners in Optometry is essential
to the practice of optometry in Alaska, he continued. It is
self-funded and is the regulatory body that helps protect the
public by implementing standards of care, ongoing education, and
training in the field of optometry. The board, he reported,
received an overall favorable audit indicating its work is an
important public service.
3:21:16 PM
CO-CHAIR FIELDS opened invited testimony on SB 186.
3:21:29 PM
KRIS CURTIS, CPA, CISA, Legislative Auditor, Division of
Legislative Audit, provided invited testimony on SB 186. She
spoke from the written audit report in the committee packet
titled "A Sunset Review of the Department of Commerce,
Community, and Economic Development, Board of Examiners in
Optometry (board)," dated 6/9/21. She stated that, overall, the
audit concluded [pages 5-8 of the report] that this board
conducted it meetings in compliance with state laws, effectively
licensed optometrists, and actively amended regulations to
address statutory changes and improve the licensing function.
However, she specified, the audit also found that the Division
of Corporations, Business and Professional Licensing (DCBPL)
staff did not serve the public's interest by not consistently
recording the existence of a [federal] Drug Enforcement
Administration (DEA) number in the DCBPL database, by not
ensuring continuing education audits were conducted timely, and
by not monitoring licensees' compliance with continuing
education in pain management and opioid use and addictions. Ms.
Curtis said the division is therefore recommending a six-year
extension for this board, two years less than the eight-year
maximum allowed under statute, reflecting the need for more
timely oversight given the audit findings.
MS. CURTIS drew attention to page 9 [Exhibit 2] of the audit
report and noted that as of [1/31/21] there were 218 licensed
optometrists, an 18 percent increase since the board's last
sunset date of 2013. She then drew attention to page 10
[Exhibit 3] depicting the board's schedule of revenues and
expenditures and discussed the board's deficit of approximately
$52,000 as of 1/31/21. She said a fee increase recommended in
April 2020 was not made due to the governor's direction not to
increase the fees of occupational boards to help mitigate the
financial impact of the COVID-19 pandemic.
MS. CURTIS reviewed the audit recommendations on pages 13-15 of
the audit report. The first recommendation, she related, is
that the DCBPL director dedicate resources to ensure that the
existence of a DEA license number is accurately reported in the
DCBPL database. This information, she explained, is important
to allow electronic crossmatch with the controlled substance
prescription database to monitor the requirement to register
with the controlled substance prescription database. Staff were
provided instructions on how to do this, she noted, but did not
follow the instructions. According to DCBPL management, she
continued, regular turnover in the board's licensing examiner
and supervisor positions contributed to this. She said the
second recommendation is that the board chair and DCBPL director
should change the license renewal form to allow the board to
monitor compliance with continuing education requirements. A
change effective July 2018, she explained, required licensees to
obtain two hours of continuing education in pain management and
opioid use and addiction. This change was two years prior to
license renewal, but auditors found that the December 2020
license renewal form was not changed to require licensees to
report compliance with this new requirement. The third
recommendation, Ms. Curtis stated, is that DCBPL's director
should ensure adequate resources are available to perform
continuing education audits. These audits, she explained, are
DCBPL's main internal control to ensure that licensees comply
with continuing education requirements. The audit found that it
took two and a half years to complete the continuing education
audits that were due during the audit period, which was due to
multiple licensing staff vacancies and turnover.
MS. CURTIS concluded with a review of the management's response
to the audit on pages 25-27 of the audit report. She stated
that the DCBPL commissioner concurs with the conclusions and
recommendations. She said the commissioner noted that the
licensing examiner for this board turned over five times during
the three-and-a-half-year audit period and the supervisor
position turned over four times. That turnover, Ms. Curtis
added, contributed to all the findings. She related that the
board chair's response states that the deficiencies in the
application of the renewal form will be corrected before the
next renewal cycle.
3:25:34 PM
CO-CHAIR SPOHNHOLZ inquired about the reason for the staffing
turnover.
MS. CURTIS replied that she doesn't recall a reason.
CO-CHAIR SPOHNHOLZ remarked that it is a significant turnover
occurring on a routine basis and it undermines the board's
ability to function. She stated that for some licensing boards
the salaries are defined in statute, but she doesn't remember if
this is one of those boards.
MS. CURTIS deferred to the DCBPL director to provide an answer.
3:26:11 PM
SARA CHAMBERS, Director, Division of Corporations, Business and
Professional Licensing (DCBPL), Department of Commerce,
Community, and Economic Development (DCCED), answered that DCBPL
regularly has turnover as well as challenges in adequate
resourcing. She explained that this position is especially
difficult because the Board of Examiners in Optometry does not
warrant the workload of a full position control number (PCN), so
it is a part of a PCN and, as part of a PCN, this position
sometimes gets moved around. However, she explained further,
the work this examiner does is deep, so the audit, which is
complex in some of the statutory compliance elements, requires
supervisory oversight. The day-to-day work for this board is
not especially challenging but when routine issues come up, like
renewal and audits every two years, then more hands-on is needed
and those things require more institutional memory and training.
This is endemic to some of the challenges that the committee has
been talking about with the division, Ms. Chambers added. She
further advised that these are classified positions as opposed
to established in statute.
3:28:08 PM
CO-CHAIR SPOHNHOLZ asked what the [division] is planning to do
to ensure that the issue is not experienced again in another six
years if the sunset extension is approved as proposed in SB 186.
MS. CHAMBERS responded that, except for the audit, the first two
findings were related to the new prescription drug monitoring
program (PDMP) legislation. She explained that DEA registration
and opioid education were new statutes being implemented for
this board at this moment for the first time; those will not
come up again because that work has already been done. She
related that the division has now put into place several steps
to have a fail-safe with continuing education audit training and
calendaring. She said oversight by the division's paralegal has
been added to ensure that in addition to the supervisor, there
are eyes on this program's audits as well as all program audits.
So, she advised, all these findings have been resolved.
CO-CHAIR SPOHNHOLZ recalled legislation in 2018 that expanded
the legal scope of optometrists to be consistent with the
training of optometrists. She asked whether adopting the
regulations to implement that legislation was part of the issue.
MS. CHAMBERS replied that the board has not had any issues
implementing the elements of that law. The findings of the
audit, she explained, are administrative oversight or problems
that are the responsibility of the division rather than concerns
over scope of practice or elements that the board is held
responsible for, so they are not at all related.
3:31:11 PM
REPRESENTATIVE MCCARTY inquired whether licensees were asked to
engage a DEA number. He further inquired whether a biennial
license is done online and, if so, whether there is room for the
licensee to provide a DEA number along with other information to
expedite the process for the division.
MS. CHAMBERS answered that the problem relevant to DEA numbers
was that the division had to make changes to its system to
accommodate and implement the new PDMP law. The division had to
change its procedures in the database, she continued, and while
DCBPL had published instructions and supervisors had issued
instructions to examiners, the examiner did not make that change
and the old way was not sufficient to meet the new standards of
the PDMP. The DEA information was being collected but was being
deposited in a different part of the database which made it hard
to reconcile. That has been rectified, she specified.
REPRESENTATIVE MCCARTY restated his question about the ability
to renew a license online and whether the licensee can provide
the information in a manner that expedites going into the state
system and bypasses the examiner having to manually enter that
information.
MS. CHAMBERS replied yes, the division has online renewals for
all 43 of its licensing programs, and this would be included.
REPRESENTATIVE MCCARTY asked whether the DEA number is in the
online request or must still be added to that.
MS. CHAMBERS responded that the DEA number is collected in the
initial application, but she doesn't recall whether the DEA
number must be asked for again at renewal. She said she doesn't
think DEA numbers change, but if it was required to be on the
renewal the online application would mirror the paper
application, so all the questions about opioid education, DEA,
prescribing, and dispensing would be online as well as on paper.
The online would make it more efficient to enter that data
automatically.
REPRESENTATIVE MCCARTY asked whether this could be expedited by
removing the paper process and making it all online so that the
licensee would be doing everything, so less load on staff to re-
enter things.
MS. CHAMBERS responded that the division is currently working on
technology improvements to automate more of what the division is
providing to its consumers and put that more in the hands of the
applicant so it would bypass manual data entry. The division is
looking forward to implementing that type of technology for all
its programs, she said.
3:35:41 PM
CO-CHAIR FIELDS [continued] invited testimony.
3:35:50 PM
DAMIEN DELZER, OD, DipABO, Chair, Board of Examiners in
Optometry, Division of Corporations, Business and Professional
Licensing (DCBPL), Department of Commerce, Community, and
Economic Development (DCCED), provided invited testimony on SB
186. He stated he has practiced optometry in Alaska for nearly
29 years and has served eight years on the Board of Examiners in
Optometry, serving as chair for the last three.
DR. DELZER explained that the board is charged with commission
of public protection through vetting of new applicants, assuring
appropriate continuing competency of licensees, addressing
inquiries from the public, investigating any complaints, and
crafting and enforcing regulations to implement legislative
statutory change. The board implemented nearly 20 regulatory
changes over the past three years, he related, including issues
such as continuing education requirements like opioid education,
scope of practice, military exemptions, specialty designations,
modernizing the law examination, modernizing prescription
requirements, and modifying emergency regulation during the
recent COVID-19 pandemic.
DR. DELZER noted there have been no reported PDMP violations
during his eight years on the board. The board is self-funded
through license fees, he said, and board travel expenses have
been minimized through exclusive use of Zoom meetings over the
past three years. The board chair, he added, participates in
bi-weekly board chair meetings and bi-weekly PDMP meetings.
3:37:41 PM
JESSICA GIESEY, OD, Alaska Eyecare Center, provided invited
testimony in support of SB 186. She stated she has been
practicing optometry in Alaska for eight years. She said the
Board of Examiners in Optometry is vital to the practice of
optometry in Alaska, acting to protect the public by ensuring
that only qualified practitioners are licensed in Alaska and
making sure that all optometrists licensed in Alaska follow
continuing education guidelines. The board, she continued,
regularly updates regulations ? (indisc. audio interruption)
training from accredited schools and colleges of optometry.
3:38:36 PM
REPRESENTATIVE MCCARTY asked whether optometrists are having
difficulty getting their continuing education units (CEUs) post-
COVID-19.
DR. DELZER replied that he has not seen any issues with that.
After the audit findings, he related, a continuing education
audit was done in a very timely manner, and it does not appear
that anyone is having difficulty finding appropriate virtual or
live CEUs.
[SB 186 was held over.]