Boards that license nurses, doctors and chiropractors in California are working to pass separate slates of get-tough regulations less than a year after a similar proposal died in the Legislature.
Russ Heimerich, a spokesman for the Department of Consumer Affairs, said a number of medical professional licensing boards are drafting the regulations in hopes of accomplishing what the failed bill would have done in one fell swoop.
“There were provisions like not allowing sex offenders to practice," he said of the bill, SB 1111. "Some boards have that, some don’t. The idea was to give that to them all at once. Now the idea is to do that through regulations.”
In addition to automatically revoking licenses from nurses [PDF] who are convicted of a sex offense, the proposed regulations would prohibit chiropractors from entering into "gag clauses" [PDF] in court – orders banning them from discussing their cases, even with regulatory officials. And the board that licenses doctors would gain additional authority [PDF] over doctors who abuse drugs or alcohol, or shirk requirements to work under another physician's watchful eye.
Last year's bill, proposed by state Sen. Gloria Negrete McLeod, D-Chino, was meant to close a variety of loopholes exposed by ProPublica and the Los Angeles Times. Those articles focused on failures by the state nursing board to crack down as nurses harmed patients repeatedly.
But the legislation met stiff opposition from a number of health worker associations and died in a Senate committee. One of the most controversial provisions was a change in state law that would allow the director of the Department of Consumer Affairs to instantly strip workers of their licenses.
Heimerich said the agency cannot and will not pursue that change in regulations.
New provisions aimed at nurses [PDF] include allowing the board to accuse them of “unprofessional conduct” if they refuse to cooperate with an investigation. Also, nurses would be required in some cases to submit to a physical or mental fitness test when applying for a license.
Kelly Green, regulatory advocate for the California Nurses Association, said the union has asked the board to ensure nurses are not unduly penalized or that qualified applicants are not turned away because of limited disabilities.
The Department of Consumer Affairs provided California Watch with regulatory comment letters sent to the board.
Nurses who sent messages railed against a proposal that the board be notified when a nurse is arrested. The nurses said the board should only get notification of convictions, noting that a nurse arrested for protesting or picketing should not be targeted with a board investigation.
Details aside, Green said the regulations fail to address the largest problem facing the board’s mandate to protect the public from unfit nurses: understaffing.
“If you really want to tackle reforming the way the board enacts discipline and investigates cases, you really need to give them the resources to do it,” Green said. “The bottom line is that the board can not tackle the backlog of complaints.”
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