Report 2016-046 Recommendation 23 Responses

Report 2016-046: Board of Registered Nursing: Significant Delays and Inadequate Oversight of the Complaint Resolution Process Have Allowed Some Nurses Who May Pose a Risk to Patient Safety to Continue Practicing (Release Date: December 2016)

Recommendation #23 To: Registered Nursing, Board of

To ensure that it has prompt access to adequate information that could affect the status of a nurse's license, by June 2017, BRN should establish formal agreements with other agencies and other health boards that have information pertaining to a nurse's misconduct.

Annual Follow-Up Agency Response From October 2018

BRN has finalized an agreement for data sharing between the California Department of Public Health (CDPH) and the BRN. The final agreement was approved in November 2017. The BRN also has a data sharing agreement with the Bureau for Private Postsecondary Education (BPPE). The BRN finalized an agreement with the Los Angeles Superior Court in March 2018 to provide licensee information to the BRN.

California State Auditor's Assessment of Annual Follow-Up Status: Fully Implemented

BRN provided evidence demonstrating that it reached out to several health boards in an attempt to establish MOUs regarding the sharing of enforcement information. It also provided evidence demonstrating that it is in the process of developing an MOU with one health board. Further, BRN provided MOUs that it has entered into with certain agencies regarding the sharing of information, which, according to BRN's executive officer, will allow the sharing of information regarding nurse misconduct.

1-Year Agency Response

BRN has finalized an agreement for data sharing between the California Department of Public Health (CDPH) and the BRN. The final agreement was approved in November 2017. The BRN also has a data sharing agreement with the Bureau for Private Postsecondary Education (BPPE). The BRN finalized an agreement with the Los Angeles Superior Court in March 2018 to provide licensee information to the BRN.

On May 31, 2017, the BRN met with DCA Executives to discuss Memorandums of Understanding (MOU). The DCA is currently exploring the process of sharing enforcement information between all boards and bureaus.

Any agreement entered into by the board/bureau will conform to Business and Professions Code section 11180 etc. to ensure any agreement or MOU drafted either by DCA or as a result of a delegation granted by the Director is compliant with Business and Professions Code section 11183 so as to maintain the confidential nature of the information shared.

California State Auditor's Assessment of 1-Year Status: Pending

Although BRN claims it has fully implemented this recommendation, it did not provide evidence demonstrating that it has. Until it does so, we will continue to assess the status of this recommendation as pending.

6-Month Agency Response

BRN is currently finalizing an agreement for data sharing between the California Department of Public Health (CDPH) and the BRN. The document is currently being reviewed by CDPH legal. A final agreement is anticipated by July/August 2017.

BRN and the California Department of Corrections and Rehabilitation (CDCR) have discussed preliminary procedures for exchange of information for BRN complaints. Discussions are ongoing.

BRN's EO met with various Nursing and Hospital Associations to discuss possible solutions in an effort to obtain timely evidence during BRN investigations. Discussions are ongoing.

On May 31, 2017, BRN's EO, Assistant EO and Chief of Discipline, Probation and Intervention met with DCA's Director and Chief Deputy Director to discuss Memorandums of Understanding (MOU). The Director stated DCA will take the lead on this to assist all boards and bureaus regarding sharing enforcement information.

Any agreement entered into by the board/bureau will conform to Business and Professions Code section 11180 etc. to ensure any agreement or MOU drafted either by DCA or as a result of a delegation granted by the Director is compliant with Business and Professions Code section 11183 so as to maintain the confidential nature of the information shared.

BRN considers this item to be partially implemented pending additional action from community partners.

California State Auditor's Assessment of 6-Month Status: Pending

60-Day Agency Response

To ensure the BRN has prompt access to adequate data, the BRN has met with the California Department of Public Health (CDPH), California Department of Corrections and Rehabilitation (CDCR), and DCA's healing arts boards to discuss establishing formal agreements and/or memorandums of understanding (MOU) to share data that includes a nurse's misconduct and other pertinent information.

The BRN's EO met with several healing arts board's EO's in December 2016 to initiate discussion of establishing routine meetings regarding mutual issues of concern. Meetings will be scheduled on a quarterly basis. A more formal MOU will be presented to DCA's Legal Office for review which will allow all healing arts boards within DCA to share information.

Initial meetings were held with CDCR and CDPH during the month of January 2017. Follow-up meetings are scheduled to formalize the MOU process pending legal approval of the agreements by all involved parties.

California State Auditor's Assessment of 60-Day Status: Pending

All Recommendations in 2016-046

Agency responses received are posted verbatim.