HD5 - Final Report: Review of the Health Regulatory Boards


Executive Summary:
The Department of Health Professions (DHP) and Virginia's 12 health regulatory boards, along with the Board of Health Professions (BHP), have responsibility for ensuring the safe and competent delivery of health care services through the regulation of health professions. DHP provides coordination and staff support for health regulatory boards and BHP.

HJR 139 and the Appropriation Act, approved by the 1998 General Assembly, direct the Joint Legislative Audit and Review Commission to study the effectiveness of Virginia's health regulator boards and DHP. This is the second of two reports that have been prepared to meet the study mandate. This report focuses on issues related to the boards' disciplinary function. An interim report primarily addressed issues related to the boards' composition, licensing, and rule making functions, as well as budgeting and staffing issues and the role of the Board of Health Professions.

Significant findings of this report include:

• Aspects of the disciplinary process work well, but some statutory changes are necessary to improve the process, and the Board of Nursing may not be adequately addressing certified nurse aide cases involving serious misconduct.

• DHP should enforce laws against unlicensed practice of the health professions when Commonwealth's attorneys do not pursue these cases.

• The disciplinary process takes too long to resolve many cases, particularly some serious disciplinary cases, during which time the practitioners continue to practice and potentially threaten public safety.

• DHP's current inspection program is inadequate and needs to be reevaluated - about 25 percent of licensed pharmacy facilities had their last inspection eight or more years ago.

• The gross negligence standard that applies to Board of Medicine standard of care cases under current law does not appear to adequately protect the public from the substandard practice of medicine by physicians.

• The Board of Medicine does not adequately consider cases that derive from medical malpractice payment reports.

Recommendations to address problems cited in the review are included throughout the report.