Legislature(2021 - 2022)BELTZ 105 (TSBldg)
02/28/2022 01:30 PM Senate LABOR & COMMERCE
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Audio | Topic |
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Start | |
SB174 | |
SB190 | |
SB193 | |
Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
+ | SB 174 | TELECONFERENCED | |
*+ | SB 190 | TELECONFERENCED | |
*+ | SB 193 | TELECONFERENCED | |
*+ | SB 185 | TELECONFERENCED | |
+ | TELECONFERENCED | ||
SB 193-EXTEND BOARD OF CHIROPRACTIC EXAMINERS 2:25:57 PM CHAIR COSTELLO announced the consideration of SENATE BILL NO. 193 "An Act extending the termination date of the Board of Chiropractic Examiners; and providing for an effective date." 2:26:25 PM KONRAD JACKSON, Staff, Senator Peter Micciche, Alaska State Legislature, Juneau, Alaska, stated that SB 193 extends the Board of Chiropractic Examiners for five years, as recommended by the Division of Legislative Audit. He noted that sunset audits were the legislature's opportunity to review how boards are operating in the public interest and their statutory capacity. 2:27:29 PM MADISON GOVIN, Staff, Senator Peter Micciche, Alaska State Legislature, Juneau, Alaska, introduced SB 193 paraphrasing the following sponsor statement: The Division of Legislative Audit reviewed the Board of Chiropractic Examiners (BCE). The purpose of this audit was to determine whether or not there is a demonstrated public need for BCE's continued existence and whether it has been operating in an effective manner. As a result of this audit, our auditors concluded that the board's termination date should be extended until June 30, 2027. Legislative Audit makes two new recommendations: a. The Office of the Governor should appoint board members in accordance with statute. Currently, one public board member does not meet the statutory requirements for appointment b. The Department should continue efforts to improve the investigative case management system's integrity and confidentiality. Additionally, they determined that the recommendations from the prior sunset audit have been addressed. I urge your support on this legislation to allow the Board of Chiropractic Examiners to continue to carry out their duties of effectively licensing and regulating Chiropractors and to protect and promote the public health, welfare, and safety of Alaskans. CHAIR COSTELLO asked if the full extension allowed in statute was five years. MS. GOVIN answered no. 2:28:41 PM CHAIR COSTELLO invited Kris Curtis to present the sunset audit. 2:28:51 PM KRIS CURTIS, Legislative Auditor, Division of Legislative Audit, Alaska State Legislature, Juneau, Alaska, directed attention to the June 22, 2021 sunset audit summary of the Board of Chiropractic Examiners in members' packets. She read the first paragraph of the Report Conclusions found on page i of the summary. It read: 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. MS. CURTIS stated that the audit recommends a five year extension, which is three years less than the eight-year maximum allowed in statute. She related that the shorter extension is due to an issue the audit identified that may affect the board's ability to protect the public. The audit has no details about this issue because the investigation is ongoing. MS. CURTIS directed attention to the standard information about the board on pages 5 and 6. She related that as of January 31, 2021, there were 306 active licenses and permits for this board. The schedule of annual revenues and expenditures on page 6 shows that [from FY18 through January 31, 2021] the board alternated between a deficit and a surplus. She noted that management of the Division of Corporations, Business, and Professional Licensing deemed the deficits within a reasonable range and did not recommend a fee increase. She said the licensing fees are listed on page 7. 2:30:33 PM MS. CURTIS reviewed the two recommendations from the audit that begin on page 9. Recommendation No. 1 is for the governor to make board appointments in compliance with statutory requirements. The audit found that the public board member was a licensed (EMT), which violates the statutory requirement that prohibits the public member from having a direct financial interest in the health care field. Recommendation No. 2, which starts on page 10, calls for the director of the Division of Corporations, Business, and Professional Licensing (DCBPL) to allocate sufficient resources to ensure cases are investigated in a timely manner. The audit reviewed the 11 cases that were open for more than 180 days during the audit period. Seven of those cases were combined into one case because they were related to the same chiropractor. In that combined case, the audit found four periods of inactivity that ranged from 55 days to 208 days. DCBPL investigative staff reported that the inactivity was due to competing priorities and insufficient resources. 2:31:35 PM MS. CURTIS reviewed the response to the audit from DCCED that starts on page 21 of the audit report. The commissioner stated that the department hired two additional investigators and she believes that will increase both the quality and timeliness of investigations. The governor's response appears on page 23. He agreed with Recommendation No. 1 and reported that the board member who was appointed outside the statutes was removed. The response from the board starts on page 25. The board chair did not agree with the five-year extension. He described the shorter than full extension as an unfair penalty because the issues raised in the findings were outside the board's purview. He countered the audit recommendation and requested the board be granted the full eight-year extension. 2:32:29 PM CHAIR COSTELLO asked if she wanted to comment on the chair's view that the less than maximum extension penalized the board. MS. CURTIS said she had seen the perception by auditees the last two years that the legislative oversight sunset audit was a negative process and anything but a full statutory extension was punitive. She said the division tries to explain that sunset audits are an oversight mechanism to review the state of the board. A shorter than full extension could be due to changes in the law or that the board was reorganized and had new duties that might affect the public. She reiterated that audits are simply a legislative oversight mechanism. CHAIR COSTELLO asked if there were statutes relating to department oversight of the timeliness of investigations. MS. CURTIS answered no; DCBPL has policies to encourage timely investigations, but that division has been under a resource crunch the last several years, which has resulted in continual problems in its investigative process. 2:34:29 PM SENATOR GRAY-JACKSON asked how long the individual who did not meet the qualifications served on the board before being removed. MS. CURTIS asked the chair if she could consult the auditor because she did not have that information. 2:34:52 PM At ease 2:35:18 PM CHAIR COSTELLO reconvened the meeting and explained that the auditor would follow up with the information Senator Gray- Jackson requested. She asked Ms. Curtis to review the history of the audits for this board, including whether shorter than full statutory extensions had ever been recommended. MS. CURTIS said the last sunset audit was conducted in 2013 and the board received an eight-year extension that time. She did not have information about earlier audits with her. CHAIR COSTELLO turned to invited testimony on SB 193. 2:36:20 PM DR. BRIAN LARSON, Chair, Board of Chiropractic Examiners, Department of Commerce, Community and Economic Development (DCCED), Palmer, Alaska, explained that the public member that did not meet the statutory requirement for the position appropriately resigned his commission when it came to light that he was employed fulltime in the health care industry. Dr. Larson offered his understanding that this was the second time in two consecutive eight-year sunset audits that this had happened. The investigative delays also occurred in that same consecutive eight-year timeframe. He said it is difficult to see this shortened extension as anything other than punitive because the board does not evaluate board applicants and it has no say in the investigative process. 2:40:00 PM CHAIR COSTELLO said she understands what he is saying, but she views sunset audits as an opportunity for the legislature to review the activities the board conducts on behalf of Alaskans served by the profession. She noted that the audit also included a review of the Division of Corporations, Business, and Professional Licensing and Sara Chambers would be up next to talk about the challenges the division faced with those investigations. She thanked Dr. Larson and his colleagues for the work they do and restated that sunset audits provide an opportunity for the legislature to look at the entire profession on behalf of the public. It is an opportunity to talk about successes and the challenges facing the board. CHAIR COSTELLO asked Sara Chambers to talk about the audit with particular focus on investigations. 2:41:52 PM SARA CHAMBERS, Director, Division of Corporations, Business, and Professional Licensing, Department of Commerce, Community and Economic Development (DCCED), Juneau, Alaska, agreed with Chair Costello that sunset audits are a necessary process. She offered to talk about the audit findings or answer specific questions. SENATOR STEVENS said he did not have any questions related to the Board of Chiropractic Examiners, but he would like to discuss the Regulatory Commission of Alaska (RCA) outside of this meeting. MS. CHAMBERS advised that RCA was outside her professional purview. She deferred questions to Chair Pickett or another commissioner. CHAIR COSTELLO asked her to talk about what the fees have been for this board historically and whether this investigation is expected to result in a fee increase. 2:44:09 PM MS. CHAMBERS explained that licensing fees cover all matters the audit looked at, including professional licensing investigations. These costs have risen for all boards and commissions in the last few years and the division asked for a small general fund increment in FY21, FY22, and FY23 to prevent fee increases. She said the department is looking to the legislature for direction on addressing this ongoing challenge. She explained that Alaska follows the same model and infrastructure for boards and commissions as many other states, but the economy of scale is very different. For all practical purposes it works well, but not when a case involves a complex investigation or a denial of licensure and the licensee or applicant exercises their due process right to appeal. Those cases run upwards of $100,000 and the licensees, in this case the 300 chiropractors, have to pay for that. She noted that the case in question was an example. MS. CHAMBERS said the division tries to keep enough money in a board's budget to pay for the average bump in investigation or appeal costs. However, costs keep rising as a result of dramatic cases, and there have been several in this profession in particular. She noted that the largest cost is to pay attorneys in the Office of Administrative Hearings, which is outside the division's control. CHAIR COSTELLO asked how many investigators were assigned to the [seven] cases that were combined into one, and what accounted for the periods of inactivity of 200 some days. 2:48:15 PM MS. CHAMBERS explained that a pool of about 17 investigators work for the division. They conduct the investigations for the 43 professional licensing programs and they are assigned according to need. Life, health, and safety are prioritized to protect Alaskans and make the best use of resources. Investigators are also assigned based on their knowledge. In this situation, the investigator was not only working on chiropractic cases but also on dental, and nursing cases. Some cases were deemed more pressing than the one in question and the attorney gave advice that appeared to substantiate that it was lower in priority. MS. CHAMBERS said the case is moving forward now, but at the time of the audit it was not deemed high priority. CHAIR COSTELLO asked when and if the legislature will get information about the case in litigation. MS. CHAMBERS answered that the details of the case under litigation will be made public as soon as there is a ruling. CHAIR COSTELLO asked what happens if the division determines a complaint is criminal in nature. MS. CHAMBERS explained that if there is a criminal element, the division turns the information over to the appropriate criminal unit. That entity moves forward with the investigation. The division is notified of the result and it takes the appropriate licensing action based on the criminal finding. The division worked out this process after an earlier legislative audit found the process could be better. She noted that such improvements were tracked in the case management files. 2:54:16 PM SENATOR STEVENS asked when the determination was made that the board member was inappropriately appointed. MS. CHAMBERS offered her understanding that it was a finding in the audit. As soon as it was brought to the attention of the Governor's Office, the matter was handled appropriately and the board member willingly resigned. She assured the committee that the division has nothing to do with board appointments, the criteria, or who is seated. 2:55:19 PM CHAIR COSTELLO opened public testimony on SB 193; finding none, she closed public testimony. SENATOR REVAK said he had no idea about the intricacies of this board. He continued: It sounds like the board is backbreaking work. Board members certainly require a backbone. It sounds like in many ways, some of their backs are against the wall. We certainly don't want to send them backward. We also certainly don't want to turn our backs on them. He thanked the sponsor for bringing the bill forward. CHAIR COSTELLO said she appreciated the levity. CHAIR COSTELLO held SB 193 in committee for further consideration.