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 Audits 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 these professionals 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 optometrists practicing in the state; it has done an outstanding job of regulating the profession; and it 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 comply 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 asking 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 20 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. During the last board meeting, a PDMP representative 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.