Written: 7/9

By now you've likely heard...

BRN executives knowingly falsified data sent to the California State Auditor. But, often times there is additional context needed to better understand the parties involved and why this continues to be an issue.

As nurses, we have an ethical obligation to protect our patients' safety...

At the end of this newsletter, we call you to take action - to hold all parties accountable to the highest standards, protect our patients' safety, and ensure our future as the most trusted profession!

To remain silent is to be complicit.

Let's dive in...

-Your ANA\California Team

The Board of Registered Nursing (BRN) falsified data according to the California State Auditor's report released on June 30th. The audit alleges that executives within the BRN intentionally manipulated data and delivered a falsified report in 2018 to President pro Tempore of the Senate and Speaker of the Assembly. This is a MUST READ.

According to the audit, Executives "A, B, and C" manipulated Enforcement Program data to satisfy a recommendation the State Auditor had made during a 2016 audit of BRN’s Enforcement Program . The executives are never named in the report...

Learn what the repercussions are defrauding the State Auditor and gross misconduct here . Hint: That's it?!?

The executives manipulated the complaint caseload to show at or below 20 cases per investigator. To do so, the BRN shifted cases from the current team to three additional employees to "spread the load" - one employee was on extended leave from the BRN's office. 10 days after the report was submitted they reverted the caseload back to the original investigators.

This is very important because it can take the California BRN an average of three years to complete an investigation of a nurse under investigation, according to the 2016 audit report. The BRN receives 8,500 complaints annually... Meaning potentially 8,500 non-compliant nurses continuing to practice for extended periods of time after the initial complaint is filed.

Although the BRN is responsible for the licensure of all registered nurses in California, their primary directive is always public safety first.

The BRN must respond to the State Auditor's report by August 12th, 2020.

Oh… and yeah… this isn't the first time this has been a problem... In 2016, the State Auditor released a report titled, "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."

Oh... and in 2008, too... ProPublica conducted an investigation in 2008 and found the BRN's average days from complaint to discipline was 1,254 days. Compared to Texas, who has a similar amount of RNs as California, Texas averaged 173 days form complaint to discipline.

So, the question you and many nursing leaders are likely asking right now is, "Who is at fault?" Pro political tip: The answer is likely more complicated than it seems.

In July 2009, Gov. Arnold Schwarzenegger replaced most members of the California BRN , citing the unacceptable time it takes to discipline nurses accused of egregious misconduct.

The most senior member of the current BRN Board of Directors, Michael D. Jackson, was appointed to the BRN in 2012 by Gov. Jerry Brown. Most other members were appointed in the last 2 years. In 2015, Michael D. Jackson was appointed as Board President. Let’s not forget that BRN President Michael Jackson was recently found guilty (2016) of violations of the Political Reform Act, including "failure to adequately maintain committee records and personal use of campaign funds."

The BRN has faced a Sunset Review in 2002 , 2010 , and 2014 , with a supplemental review in 2016 . What is the Sunset Review? A review of the BRN's ability to adequately operate... if their actions are deemed inadequate, the BRN goes dark... But obviously there is a more technical answer than this - keep reading.

The BRN's next Sunset Review is scheduled for 2021 .

To help ensure that the BRN fulfills its mission and legal obligations, the State of California enacted a statute in 2015 that requires the State Auditor to conduct an audit of the BRN. State law compels the State Auditor to solicit responses from statutorily audited entities within 60 days, six months, and one year of an audit report’s publication and annually thereafter until the audit team determines that each recommendation has been fully implemented.

California licensing boards, by law, must be renewed by legislation periodically. The California BRN, because of the Sunset Review, was set to expire on January 1st, 2012, unless new legislation was enacted. After one month of being absorbed by Department of Consumer Affairs (DCA) via an Interagency Agreement, Gov. Brown reinstated the BRN with the signing of SB 98.

Gov. Brown vetoed SB 538 - which would've extended the authority of the BRN for another four years in 2012 - because there were provisions in the bill to authorize the BRN to have its own sworn peace officers as investigators.

That's right... The new bill stopped the BRN from having authority over it's own investigators, instead moving them under the authority of the DCA.

Why didn't/doesn't the DCA hire more investigators? Glad you asked. In the 2016 supplemental Sunset Review, it was noted that Gov. Brown signed a bill that would allow the BRN to increase licensing fees to increase revenue. See page 9.

However, this was not an immediate fix. Hiring decisions were delayed by then Executive Director Joseph Morris because the increase in fees had yet amount to the costs that would be incurred by hiring new employees.

So let's recap:

  • Negligence in complaint processing has been widely reviewed since at least 2008.
  • Gov. Schwarzenegger and Gov. Brown reprimanded the BRN'S leadership for their inability to handle misconduct complaints.
  • The DCA has had authority over investigations since 2012, yet still the problem persists.
  • The BRN has raised fees, with the support of Gov. Brown, but this, too, has yet to address the issue.
  • This is ultimately a patient safety concern with thousands of lives at risk.

To allow this issue to persist for at least 12+ years is to devalue the lives in which you, as nurses, so deeply care for. Hold the BRN's Executive Director, the DCA's Executive Director, your State Representatives, and Gov. Newsom accountable to their primary duties.

Now is the time for action!

Special thanks to Brooke Newman for helping develop these advocacy statements and messages.

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