Legislature(2021 - 2022)BELTZ 105 (TSBldg)

03/07/2022 01:30 PM Senate LABOR & COMMERCE

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
*+ SB 186 EXTEND BOARD OF EXAMINERS IN OPTOMETRY TELECONFERENCED
Moved SB 186 Out of Committee
-- Invited & Public Testimony --
*+ SB 222 EXTEND PT & OCCUPATIONAL THERAPY BOARD TELECONFERENCED
Moved SB 222 Out of Committee
-- Invited & Public Testimony --
+ Bills Previously Heard/Scheduled TELECONFERENCED
**Streamed live on AKL.tv**
         SB 186-EXTEND BOARD OF EXAMINERS IN OPTOMETRY                                                                      
                                                                                                                                
1:33:00 PM                                                                                                                    
ACTING CHAIR MICCICHE announced  the consideration of SENATE BILL                                                               
NO. 186  "An Act extending the  termination date of the  Board of                                                               
Examiners in Optometry; and providing for an effective date."                                                                   
                                                                                                                                
He stated  that this is  the first  hearing. The intention  is to                                                               
hear from  the sponsor, hear  invited and public  testimony, take                                                               
committee  questions, and  either hold  the bill  or look  to the                                                               
will of the committee.                                                                                                          
                                                                                                                                
1:33:27 PM                                                                                                                    
SENATOR STEVENS, speaking  as sponsor, explained that  the SB 186                                                               
extends  the June  30,  2022  termination date  of  the Board  of                                                               
Examiners  in  Optometry for  six  years  to  June 30,  2028,  as                                                               
recommended by  the Division of  Legislative Audit in  its sunset                                                               
review of the board.                                                                                                            
                                                                                                                                
1:33:57 PM                                                                                                                    
TIM   LAMKIN,  Staff,   Senator   Gary   Stevens,  Alaska   State                                                               
Legislature, Juneau,  Alaska, stated that optometrists  provide a                                                               
majority of  eye care to  Alaskans, particularly in  rural areas.                                                               
Examinations  by  an  optometrist are  the  medically  recognized                                                               
standard for  safe eyecare and  they safeguard overall  health by                                                               
detecting  diseases  such  as   high  blood  pressure,  diabetes,                                                               
autoimmune diseases, and cancers.                                                                                               
                                                                                                                                
MR.  LAMKIN  stated  that  the   Alaska  Board  of  Examiners  in                                                               
Optometry is  essential for optometrist  practicing in  the state                                                               
and has done an outstanding  job of regulating the profession and                                                               
is  self-funded. This  board has  received  an overall  favorable                                                               
audit  and the  sponsor encourages  the committee  to extend  the                                                               
board as suggested.                                                                                                             
                                                                                                                                
1:35:42 PM                                                                                                                    
ACTING CHAIR MICCICHE asked Ms. Curtis to provide her testimony.                                                                
                                                                                                                                
1:35:54 PM                                                                                                                    
KRIS CURTIS,  Legislative Auditor, Division of  Legislative Audit                                                               
Alaska  State Legislature,  Juneau, Alaska,  reviewed the  sunset                                                               
audit for  the Board of  Examiners in Optometry  ("board") during                                                               
the hearing on SB 186.                                                                                                          
                                                                                                                                
MS.  CURTIS  paraphrased  the  first   paragraph  of  the  report                                                               
conclusions on page i.                                                                                                          
                                                                                                                                
     REPORT CONCLUSIONS                                                                                                       
                                                                                                                                
     Overall, the audit  concluded, with certain exceptions,                                                                    
     that board  operations were  conducted in  the public's                                                                    
     interest.   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.                                                                           
                                                                                                                                
MS.  CURTIS  stated  that  the   Division  of  Legislative  Audit                                                               
recommends  the legislature  extend the  termination date  of the                                                               
board to  June 30, 2028, which  is two years less  than the eight                                                               
year  maximum   extension  provided  in  statute.   This  reduced                                                               
extension reflects  the need for  more timely oversight  in light                                                               
of the audit findings.                                                                                                          
                                                                                                                                
1:37:08 PM                                                                                                                    
MS.  CURTIS turned  to Exhibit  2 on  page 9  that shows  that on                                                               
January  31, 2021  there were  218 licensed  optometrists in  the                                                               
state,  which is  an 18  percent increase  since the  2013 sunset                                                               
audit. Exhibit  3 on  page 10 provides  the schedule  of revenues                                                               
and expenditures  for the board.  It shows  that the board  had a                                                               
$52  thousand  deficit  on  January 31,  2021.  The  prior  audit                                                               
recommended a  fee increase but  that did not happen  because the                                                               
governor  froze occupational  board fee  levels to  help mitigate                                                               
the financial effect of the pandemic.                                                                                           
                                                                                                                                
MS.  CURTIS reviewed  the three  recommendations the  report made                                                               
starting on page 13.                                                                                                            
                                                                                                                                
Recommendation   No.  1:   The  director   of  the   Division  of                                                             
Corporations, Business and  Professional Licensing (DCBPL) should                                                               
dedicate resources to  ensure licensees holding a  DEA number are                                                               
consistently recorded in the licensing database.                                                                                
                                                                                                                                
She explained  that this  information is  needed to  help monitor                                                               
the  requirement  to  register   with  the  controlled  substance                                                               
prescription  database.  The  audit found  that  DCBPL  licensing                                                               
staff did receive  training on how to enter  this information but                                                               
it was not entered consistently.                                                                                                
                                                                                                                                
MS.   CURTIS  stated   that  DCBPL   management  attributed   the                                                               
deficiency to regular turnover in  the board's licensing examiner                                                               
and licensing supervisor positions.                                                                                             
                                                                                                                                
1:38:36 PM                                                                                                                    
MS. CURTIS reviewed Recommendation 2 on page 14.                                                                                
                                                                                                                                
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.                                                                      
                                                                                                                                
She  explained  that  effective   July  2018,  optometrists  were                                                               
required to obtain two hours  of education in pain management and                                                               
opioid  use and  addiction during  the two  years prior  to their                                                               
license renewal date. However, the  audit found that the December                                                               
2020  form  had   not  been  changed  to   require  licensees  to                                                               
compliance with the new education requirement.                                                                                  
                                                                                                                                
MS. CURTIS described Recommendation 3 on page 15.                                                                               
                                                                                                                                
Recommendation  No. 3:  DCBPL's director  should ensure  adequate                                                             
resources are available to perform continuing education audits.                                                                 
                                                                                                                                
She  explained that  DCBPL's primary  internal control  to ensure                                                               
compliance  with  the  continuing education  requirement  is  the                                                               
continuing education  audit. The division requires  10 percent of                                                               
licensees to be audited, but the  sunset audit found that it took                                                               
2.5 years to  complete the review for the 2018  renewal. This was                                                               
due to turnover and multiple licensing staff vacancies.                                                                         
                                                                                                                                
1:39:55 PM                                                                                                                    
MS. CURTIS  directed attention to the  commissioner's response to                                                               
the audit beginning  on page 25. The  commissioner concurred with                                                               
the  conclusions   and  recommendations.   In  response   to  the                                                               
recommendations,   she  relayed   that  the   licensing  examiner                                                               
position turned  over five times in  the 3.5 year period  and the                                                               
licensing  supervisor  position  turned  over  four  times.  That                                                               
turnover contributed to all the recommendations and findings.                                                                   
                                                                                                                                
The chair's  response to  the recommendations is  on page  27. In                                                               
response  to Recommendation  2 regarding  the form  deficiencies,                                                               
the chair stated  that the form should be corrected  prior to the                                                               
2022 licensing renewal cycle.                                                                                                   
                                                                                                                                
1:40:44 PM                                                                                                                    
SENATOR STEVENS  asked if she believes  the three recommendations                                                               
are achievable.                                                                                                                 
                                                                                                                                
MS. CURTIS  answered yes;  many are  simple fixes.  She suggested                                                               
she  ask Director  Chambers about  the compliance  audits because                                                               
those are probably a resource issue which is not as easy to fix.                                                                
                                                                                                                                
1:41:38 PM                                                                                                                    
DR.  DAMIEN  DELZER,  Chair, Board  of  Examiners  in  Optometry,                                                               
Fairbanks, Alaska, testified by invitation  in support of SB 186.                                                               
He stated that he had practiced  optometry in Alaska for about 29                                                               
years and recently  completed eight years on the  board, three of                                                               
which were  as chair. He  stated that  the board is  charged with                                                               
public protection,  assuring competency of  continuing licensees,                                                               
addressing queries  and complaints from the  public, and crafting                                                               
and enforcing  regulations to  implemented statutory  changes. He                                                               
noted  that the  board implemented  nearly 2o  regulatory changes                                                               
over  last  three  years.  These  included  continuing  education                                                               
requirements  including  opioid  education,  scope  of  practice,                                                               
military    exemptions,   specialty    designations,   and    the                                                               
modernization  of law  exams and  prescription requirements.  The                                                               
board also  implemented emergency  regulations during  the height                                                               
of  the  COVID-19 pandemic.  He  said  the board  is  self-funded                                                               
through  licensing  fees  and board  travel  expenses  have  been                                                               
minimized by holding meetings exclusively  by Zoom the last three                                                               
years. He highlighted  that the board chair  also participates in                                                               
biweekly  board chair  meetings  and  biweekly prescription  drug                                                               
monitoring program meetings.                                                                                                    
                                                                                                                                
DR. DELZER  thanked the  committee for  its consideration  of the                                                               
extension for the Board of Examiners in Optometry.                                                                              
                                                                                                                                
1:43:38 PM                                                                                                                    
SENATOR   STEVENS  asked   if  he   believes   the  three   audit                                                               
recommendations were  achievable and  if he  had any  thoughts on                                                               
the shorter extension.                                                                                                          
                                                                                                                                
DR  DELZER said  he believes  all the  recommendations have  been                                                               
addressed. The application deficiency  was corrected prior to the                                                               
publication of  the sunset audit.  The issue with  the continuing                                                               
education  audits  was  corrected  and the  follow-up  audit  was                                                               
completed timely.  The issue regarding  PDMP compliance  has also                                                               
been  corrected.  A PDMP  representative  during  the last  board                                                               
meeting reported  near 100 percent compliance  with registration.                                                               
The current  examiner, with oversight from  Director Chambers has                                                               
been very attentive.                                                                                                            
                                                                                                                                
SENATOR STEVENS  asked if  he was  comfortable with  the six-year                                                               
extension.                                                                                                                      
                                                                                                                                
DR DELZER  said yes, but he  would point out that  all the issues                                                               
have been addressed.                                                                                                            
                                                                                                                                
1:46:16 PM                                                                                                                    
DR. STEVEN  DOBSON, founder of Diamond  Vision Clinic, Anchorage,                                                               
Alaska, testified  by invitation in  support of SB 186  to extend                                                               
the termination  date of the  Board of Examiners in  Optometry to                                                               
June 30,  2028. He stated that  he is a lifelong  Alaskan who has                                                               
been  practicing optometry  for  39 years.  He  related that  his                                                               
service on the board in the late  '80s and early '90s gave him an                                                               
appreciation of  the importance  of the  board in  protecting the                                                               
visual  welfare of  Alaskans. He  explained that  optometrists in                                                               
Alaska look  to the  board to  ensure that  both new  and current                                                               
licensees  are  qualified  to   maintain  the  high  professional                                                               
standards the  board has established. The  board must continually                                                               
update and  implement regulations  that reflect the  high quality                                                               
education provided by the schools and colleges of optometry.                                                                    
                                                                                                                                
1:48:09 PM                                                                                                                    
At ease                                                                                                                         
                                                                                                                                
1:48:32 PM                                                                                                                    
ACTING CHAIR MICCICHE  reconvened the meeting and  listed who was                                                               
available to answer questions.                                                                                                  
                                                                                                                                
SENATOR  STEVENS  asked Ms.  Chambers  to  comment on  the  three                                                               
recommendations in the sunset audit.                                                                                            
                                                                                                                                
1:49:11 PM                                                                                                                    
SARA CHAMBERS,  Director, Division  of Corporations  Business and                                                               
Professional   Licensing   (DCBPL),   Department   of   Commerce,                                                               
Community  and  Economic  Development  (DCCED),  Juneau,  Alaska,                                                               
stated  that she  agrees with  the board  chair that  the matters                                                               
highlighted  in the  audit  had been  corrected.  She added  that                                                               
DCBPL continues to be vigilant  because the division continues to                                                               
face turnover  and vacancies as its  institutional memory leaves.                                                               
That  being said,  audits are  taken seriously  and the  division                                                               
always  takes  immediate  action  when  it  finds  areas  it  can                                                               
improve.                                                                                                                        
                                                                                                                                
1:50:17 PM                                                                                                                    
ACTING CHAIR MICCICHE opened public  testimony on SB 186, finding                                                               
none, he closed public testimony.                                                                                               
                                                                                                                                
ACTING CHAIR MICCICHE found no  further questions or comments and                                                               
solicited the will of the committee.                                                                                            
                                                                                                                                
1:50:51 PM                                                                                                                    
SENATOR  GRAY-JACKSON moved  to  report SB  186,  work order  32-                                                               
LS1476\A,  from  committee  with individual  recommendations  and                                                               
attached fiscal note(s).                                                                                                        
                                                                                                                                
ACTING CHAIR MICCICHE found no  objection and SB 186 was reported                                                               
from the Senate Labor and Commerce Standing Committee.                                                                          

Document Name Date/Time Subjects
SB 186 Sponsor Statement.pdf HL&C 4/25/2022 3:15:00 PM
SL&C 3/7/2022 1:30:00 PM
SB 186
SB 186 Fiscal Note 2360 - DCCED.pdf SL&C 3/7/2022 1:30:00 PM
SB 186
SB 186 Supporting Document - Optometry Board Audit.pdf SL&C 3/7/2022 1:30:00 PM
SB 186
SB 186 Letters of Support received as of 3.4.2022.pdf HL&C 4/25/2022 3:15:00 PM
SL&C 3/7/2022 1:30:00 PM
SB 186
SB 222 Sponsor Statement.pdf SL&C 3/7/2022 1:30:00 PM
SB 222
SB 222 Sectional Analysis.pdf SL&C 3/7/2022 1:30:00 PM
SB 222
SB 222 Fiscal Note 2360 - DCCED.pdf SL&C 3/7/2022 1:30:00 PM
SB 222
SB 222 Supporting Document - PT-OT Board Audit.pdf SL&C 3/7/2022 1:30:00 PM
SB 222
SB 222 Letters of Support received as of 3.4.22.pdf SL&C 3/7/2022 1:30:00 PM
SB 222