Nursing reform is slow going

Despite the governor's pledge to better discipline errant health professionals, there are signs that it will be difficult to enact sweeping changes as quickly or easily as the administration has suggested.

At meetings in Sacramento on Monday and last week, regulators and state attorneys generally spoke of the need for reform but picked apart potential solutions presented to them. They offered no concrete time frames for having a workable system in place.

Even officials within the same agency couldn't agree on solutions. One lawyer within the state attorney general's office on Monday cited the benefits of having investigators who are looking into complaints against health professionals work alongside the lawyers who try such cases. But another lawyer in the office said the change wouldn't be any more efficient.

And last week at a meeting of the Board of Registered Nursing, staffers and lawyers turned away suggestions by new board members that they notify employers when serious complaints have been filed against nurses or even when formal accusations have been filed by the board itself.

The meetings came a month after The Times and the nonprofit news organization ProPublica reported that it takes more than three years, on average, to investigate and discipline registered nurses accused of wrongdoing. After the first article was published, the governor replaced most of the nursing board and demanded reform.

Last week, the governor acknowledged that delays extended beyond the nursing board and called for changes at all health licensing agencies.

Luis Farias, a spokesman for the Department of Consumer Affairs, said Monday that the department's new emphasis is a "culture change." The department's new director, who oversees state licensing boards, has called for fundamental changes but has not provided a detailed plan.

Veteran staffers at the Board of Registered Nursing, however, have seemed less than enthusiastic about changing their ways. At one point during a meeting last week, after board members offered new suggestions on warning potential employers about nurses who have been abusing alcohol and drugs, staffers cited prohibitive legal and practical obstacles.

That led to visible frustration among the new board members.

"For some reason, [the staff] seem to feel their system is just fine, that it just needs a little tweaking around the edges here and there," said Julianne D'Angelo Fellmeth.

"There needs to be a significant blowing up of the system."

On Monday, it was also clear that the nursing board staff couldn't explain some of the delays cited by The Times and ProPublica.

Sen. Gloria Negrete McLeod (D-Chino), the lone senator to attend the informational meeting of the Senate Committee on Business, Professions and Economic Development, asked the nursing board staff how it was possible that one nurse given probation in 2005 missed 38 drug screens before the board revoked his probation three years later.

"How does that happen?" Negrete McLeod asked.

"Yeah -- well -- we can't answer that, to be very honest," said interim Executive Officer Louise Bailey, later adding that the board contracts with the Maximus company to handle substance abuse testing.

"How come nobody is watching the company? You're paying them," Negrete McLeod said.

Finally, nursing board President Ann Boynton, recently appointed by the governor, said: "We do not yet understand what the issues are. . . . We are initiating an investigation."


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