Nurses Oppose Proposal to Shift Oversight of State Nursing Board
By Cathryn Domrose
January 17, 2005
Gov. Arnold Schwarzenegger has proposed shifting power away from the California Board of Nursing to the Department of Consumer Affairs, thereby effectively ending its autonomy.
Nursing organizations around the state have vowed to fight this plan.
The nine-member independent board interprets and enforces laws related to nursing education, licensure, practice, and discipline. Under Schwarzenegger’s proposal, the state Department of Consumer Affairs would take over decision-making for the board and oversee its staff.
The board is one of 88 independent boards and commissions the governor said in his State of the State speech Jan. 5 that he wants to reorganize. These include licensing organizations that set rules for at least 16 health care fields, as well as for architects, contractors, cosmetologists, and other professions. The BRN and other health care licensing boards were not recommended for elimination by the governor’s expert panel, the California Performance Review.
Nursing organizations, including those representing union members and nurse executives, say they will work together to keep the board independent, which they say protects nurses’ rights and helps keep patients safe. If the governor’s proposal is approved by the Legislature, California will be the only state without a Board of Registered Nursing.
“The board has so much responsibility for ensuring patient safety in the state of California that this is not the way to go,” says Patricia McFarland, RN, MSN, executive director of the Association of California Nurse Leaders.
Jill Furillo, RN, Southern California director for the California Nurses Association and a member of the board calls the proposal a “power grab” by Schwarzenegger, and a dangerous move. “He’s eliminating any public oversight of the regulation process of nursing practice in California,” she says.
Under the governor’s proposal, all the functions of the board of nursing will stay the same, with no plans to eliminate its staff, says Charlene Zettel, director of the Department of Consumer Affairs. The board will continue to license RNs, accredit nursing schools, and revoke licenses of nurses found to be unsafe to practice.
The only difference will be that the staff will report to her instead of the board, Zettel says, and she and her staff will make decisions now made by the board, with the help of voluntary advisory committees.
The change will streamline the decision-making process and improve accountability, she says. For example, she says, disciplinary decisions could be adopted immediately instead of waiting for a board meeting.
Nurses, though, say they do not see any benefits from this change. Board members now vote immediately on disciplinary actions as soon as an administrative law judge submits them, without waiting for a meeting, Furillo says.
No taxpayer money will be saved because the board pays for itself through licensing fees, says Tricia Hunter, RN, MN, executive director of the American Nurses Association\ California. Board members receive no salaries or benefits other than travel expenses and $100 per meeting.
Hunter predicts bureaucracy will be increased instead of reduced because instead of going through an independent board, decisions about nursing practice will be made by a government department, charged with making decisions about dozens of other professions.
Nurses also worry about the politicization of a regulatory body that now consists of three direct patient care nurses, an administrator, a nurse educator, a physician, and three members of the public, appointed by two California governors and the Legislature. Board members cannot be fired by the governor.
Under the new proposal, decisions about nursing practice and education could “become very partisan,” says Deloras Jones, RN, MS, executive director for the California Institute for Nursing and Healthcare.
Schwarzenegger submitted his proposal Jan. 6 to the Little Hoover Commission, an independent oversight agency. From there, it goes to the Legislature, which has 60 days to act on it. If the Legislature takes no action, it will automatically take effect in July.
Nursing organizations are encouraging their members to actively oppose the proposal. The CNA has scheduled a rally Jan. 18 on the steps of the state Capitol to protest both the proposal to eliminate the board and the governor’s decision not to implement nurse staffing ratios approved by the Legislature.
McFarland says her group will encourage nurses to attend public hearings that the Little Hoover Commission will convene beginning at 9 AM Jan. 26 and Jan. 28 in the Capitol. Nurses also can visit the commission’s website at www.lhc.ca.gov/lhcdir/hear.html and register their comments online.
This proposal comes as the board prepares to celebrate the 100th anniversary of the date the Legislature gave the University of California power to certify and give exams to nurses.
The Board of Nurse Examiners was created in 1939 and eventually changed its name to the California Board of Registered Nursing.