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.