HD31 - Interim Report: Review of the Health Regulatory Boards


Executive Summary:
HJR 139 and the Appropriation Act, approved by the 1998 General Assembly, direct JLARC to study the effectiveness of Virginia's health regulatory boards and the Department of Health Professions (DHP). DHP, and the 12 health regulatory boards for which the department provides staff support, have responsibility for ensuring the safe and competent delivery of health care services through the regulation of the health professions.

JLARC staff are conducting this review of DDHP and the health regulatory boards in two phases. The first phase review includes a review of the licensure and rule-making functions of the boards. This report also includes a review of the composition and structure of the boards, the financial responsibilities of the boards and DHP, and the role of the Board of Health Professions (BHP). The second phase review will focus on the disciplinary system used by the boards and department to address cases in which health care practitioners have been alleged to have violated standards of conduct or practice. The second phase report will be completed in 1999.

Based on this first phase of the review, it appears that the composition of the health regulatory boards is generally appropriate, and the boards and DHP appear to perform their licensure function effectively. However, there are some problems that need to be addressed, including the management of board finances, the minimal role currently played by the Board of Health Professions, and the use of some part-time (P-14) employees in a manner that appears inappropriate. The primary findings of the report include:

• The composition of the health regulatory boards appears to be appropriate in most instances, but the role of citizen members should be enhanced in some instances, and their eligibility requirements need to be clarified.

• The licensure process used by the health regulatory boards appears to work relatively well, but the boards need the authority of conduct criminal background checks. Also, current law may unreasonably restrict out-of-state dentists from gaining licensure in Virginia.

• The work of the health regulatory boards is slowed by a lengthy rule making process which frustrates board members and DHP staff.

• Most boards are not complying with the statutory requirement that they adjust fees so that their revenues and expenditures match within ten percent.

• The Certified Nurse Aide Program has a growing deficit, and efforts to eliminate the deficit have been unsuccessful.

• Due to the department's difficulty in obtaining approval to hire additional full-time staff, DHP is employing part-time workers (P-14s) in a manner that appears inconsistent with State personnel policy.

• The Board of Health Professions does not appear to be effectively fulfilling its role as defined by the Code of Virginia.