Overhaul of Massachusetts health boards planned

Home Health Columnist / Guide · Jun 4, 2002

massachusetts lawmakers are planning to overhaul the boards that license and discipline nurses, dentists and pharmacists after evidence that these boards have failed to protect the public.

by alice dembner, globe staff, 6/2/2002

http://www.boston.com/dailyglobe2/153/metro/overhaul_of_health_boards_plannedp.shtml

confronted with evidence that the state has failed to protect the public from nurses, dentists, and pharmacists who harm patients, legislative leaders are planning to overhaul the boards that license and discipline these health care professionals.

over the last few years, the boards and their staffs took few meaningful disciplinary steps as some nurses stole drugs from patients and some dentists allowed patients' teeth to rot.

the lawmakers say they will propose giving the boards more authority, more staff, and more money, but in return will require more accountability, including proof that the boards are meting out more sanctions.

''most of our boards rank near the bottom of the nation in discipline against those whose practice is less than adequate,'' said state senator mark montigny, chairman of the senate ways and means committee. ''it's infuriating. the consumer and patient deserve and need more.''

montigny, a new bedford democrat, said the senate budget proposal, scheduled to be unveiled next week, would include more money for the boards, but also would include ''significant changes in the way these boards are overseen.'' montigny declined to disclose details of the proposal until next week.

separately, the house and senate chairmen of the legislature's joint health care committee said they planned to develop legislation to increase the boards' power to investigate wrongdoing, expand their disciplinary options, and strengthen the role of consumers on the boards. typically, there is only one public representative on each board.

the lawmakers' proposals follow articles in the globe that reported low rates of discipline by the boards of nursing, dentistry, and pharmacy. last sunday, the globe reported that bad dentists can escape discipline for years because the state board of registration in dentistry has a backlog of nearly 500 cases. in the last five years, the globe found, the dental board dismissed 94 percent of the 900 complaints it resolved, in part because there were too few staff to pursue discipline. members of the board itself acknowledged that dentists who pose a risk to the public are still practicing.

last month, the globe also reported that hundreds of nurses accused of stealing drugs from the health facilities where they work are still serving at patients' bedsides, despite complaints about them pending before the board of registration in nursing. over the last six years, the board has taken the licenses of only 15 percent of nurses accused of drug offenses in cases referred to it after a preliminary investigation by the department of public health.

and in april, the globe reported that the board of registration in pharmacy meted out discipline in only 10 percent of the 377 investigations completed in the last three years. it dismissed all 11 cases involving alleged medical errors that endangered patients.

the state director of consumer affairs, who oversees the boards, signaled that she would probably not oppose the changes.

''there is a clear consensus that action is needed,'' said jennifer davis carey. ''we plan to work in concert with the legislature on behalf of public protection.''

carey has appointed a panel of five outside lawyers and administrators to review the work of the boards and report back to her this summer on ways to improve their performance.

representative harriett l. stanley, house chairwoman of the health care committee, said she has already gathered information from the nursing board and plans similar meetings with the dental board.

''these agencies really lack the resources to even respond, much less be proactive'' about protecting public safety, said stanley, a west newbury democrat. ''they may need more investigative and prosecutorial powers. i'm told that the legislature has traditionally resisted doing that, but it's a new time. let's look at that again.''

her senate counterpart, uxbridge democrat richard t. moore, said he plans to hold hearings on the nursing and dental boards later this month.

''we're looking at the whole board structure, and the membership of the boards,'' he said. ''the boards should be representing the patients, not the profession.''

nearly all the boards' members come from the profession they are regulating with the exception of one public representative per board. moore said he wants to see more public members and representatives of other health professions on the boards.

montigny agreed. ''whenever you have any profession that is policed by their own, there is a great reluctance to impose speedy and harsh justice,'' he said.

moore said he hopes he can muster support for a bill that would expand disciplinary options for the pharmacy board, empowering it to impose fines and require community service.

this story ran on page b1 of the boston globe on 6/2/2002.