Calif. Officials Propose Changes to Boards That Oversee Health Workers
After Gov. Arnold Schwarzenegger (R) replaced most members of the California Board of Registered Nursing, state officials announced plans to review the practices of all boards that investigate complaints against health care workers, the Ventura County Star reports.
Schwarzenegger took action after the Los Angeles Times and the news organization ProPublica published an investigation finding that the board takes an average of three years and five months to settle misconduct complaints against nurses.
Officials say they plan to examine the need for more investigators and for improved expediency in removing health care workers who endanger patients.
Challenges Facing Health Boards
Some observers say the boards are inefficient because the state Department of Consumer Affairs oversees boards for numerous professions in addition to health care workers.
The department currently employs 30 investigators, who each manage complaints for 19 to 25 different boards.
In addition, investigators often use a fragmented enforcement process in which cases travel between the oversight board, the Consumer Affairs department, the Attorney General's Office and the Office of Administrative Hearings.
The state Medical Board, which investigates complaints about physicians, has its own investigators and a more streamlined process. However, the board still has many vacant investigator positions because it offers relatively low salaries, Julie D'Angelo Fellmeth of the Center for Public Interest Law at UC-San Diego said.
In addition, the Medical Board's fiscal 2007-2008 report found that the board took an average of more than 2.5 years to resolve complaints.
Fred Aguiar, secretary of the State and Consumer Services Agency, said that although it is too early to discuss specific changes, the health care boards will face significant reform.
Other observers have suggested that officials could reform the health care boards by:
- Depoliticizing board appointments;
- Employing an expanded pool of Medical Board investigators to handle all health care complaints;
- Ending state-mandated furloughs for board staff;
- Hiring more investigators;
- Increasing legislative reviews;
- Implementing mandatory fingerprinting for health workers;
- Offering more support for board staff;
- Recruiting enforcement monitors; and
- Streamlining case management.
Sen. Gloria Negrete MacLeod (D-Chino) also has scheduled an August hearing to discuss further reform efforts, including a proposal to hire an outside monitor to recommend changes to the enforcement process (Kisken, Ventura County Star, 7/19).
On Friday, KQED's "Forum" included a discussion of the staff changes at the nursing board.Â The panelists were:
- Bonnie Castillo, legislative director of the California Nurses Association labor union;
- D'Angelo Fellmeth;
- Jane Hirsch, clinical professor and director of Nursing and Health Systems Leadership, Masters Specialty Area at the UCSF School of Nursing; and
- Tracy Weber, senior reporter for ProPublica (Iverson, "Forum," KQED, 7/17).
ÂThis is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.