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Union Pressure Exacts a Toll on California Bill to Overhaul Health Care Oversight

A bill to overhaul the disciplinary process for California’s nearly 1 million health professionals has run into strong opposition from labor unions. A Senate committee has postponed a vote on the legislation, and the bill's author has agreed to drop some provisions.

 A California Senate committee postponed a vote Monday on legislation to speed up the investigation and discipline of health professionals accused of misconduct, even as the bill’s author removed some provisions opposed by labor unions.

Separately, the committee advanced two other bills to address problems raised in articles last year by ProPublica and the Los Angeles Times. One bill would require that temporary staffing firms perform certain checks before sending nurses to hospitals; the second would mandate that substance-abusing health workers be barred from practice if they test positive for drugs while participating in a treatment program.

The bill to overhaul the disciplinary process for California’s nearly 1 million health professionals is the most contentious. It would require that employers report workers who are fired or suspended for serious wrongdoing, a mandate in place in 36 states already. Some California licensing boards already require this, but the Board of Registered Nursing, which oversees more than 350,000 nurses, does not.

Another controversial provision could result in closure of state-run recovery programs for substance-abusing health professionals.

The Senate Business, Professions and Economic Development Committee heard testimony—including objections from unions and professional trade associations—during a hearing Monday but postponed a vote until Thursday. Even if the legislation clears the committee, it still must get through several others and the full Assembly and Senate.

In response to critics, the bill’s author, Democratic Sen. Gloria Negrete McLeod, agreed to remove a provision that would have allowed the director of the state Department of Consumer Affairs to quickly suspend the license of a practitioner who is believed to pose an imminent risk to the public.

She also stripped language to allow licensing boards to deny a license based on a mental or physical disability.

Negrete McLeod said the bill is urgently needed to keep dangerous and incompetent nurses from being able to continue practicing, sometimes for years, regardless of misconduct allegations. "There was enough blame to go around that we could all get painted with the same brush," she said.

Critics said the changes made the bill better, but the still oppose major elements. It is unclear whether the measure has the votes to pass.

Democratic Sen. Leland Yee said the bill may have an "overemphasis" on consumers at the expense of the rights of professionals. "Some people may say we can throw away" the due process rights of professionals, Yee said. "But that’s not the way we do things in this country."

Negrete McLeod said she found arguments against the bill "ironic." Each of the representatives of the various professional groups had "averred that only 1 percent" of their members were getting into trouble. If that is true, she asked, why was there such a "hue and cry" over the proposed reforms?

This article is part of an ongoing investigation:
When Caregivers Harm

When Caregivers Harm: America's Unwatched Nurses

California has failed to protect patients from nurses who are incompetent and dangerous.

The Story So Far

In California, nurses accused of serious wrongdoing have often been left free to practice for years while their cases were being investigated—with patients unaware of the danger.

The board that oversees the state’s registered nurses has taken more than three years, on average, to discipline nurses with histories of drug abuse, negligence, incompetence and violence.

More »

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