Accountability in California State Health Boards and Legislation That Can Help

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The recent trend in California is the effort by consumer advocates to improve accountability in the State health care boards. Capitol Weekly on June 12 discussed Julia Fellmeth, the director of the Center of Public Interest Law, and her effort to change the way professional boards operate in California. “Fellmeth said her mission is simple: to put power in the hands of the public.” Fellmeth is also quoted in the article as saying “state boards have sought mainly to protect the professionals they are supposed to be monitoring instead of the public.”

Senator Ridley-Thomas, chair of the committee regulating business and professions, has continuously taken a proactive position in Board reform and has recently enacted several pieces of legislation that will provide necessary safeguards for the public. His Senate Bill 1141 would establish new standards for the oversight, testing and discipline of physicians and others in the medical profession who have substance abuse problems.

The medical boards’ diversion program is meant to help impaired physicians receive appropriate treatment while safeguarding the public; however five in-depth audits have verified that the program has allowed impaired physicians to continue treating patients leading to extreme harm. SB 1141 would require medical boards that use diversion programs along with Department of Consumer Affairs to establish strong standards for the rehabilitation of physicians with substance abuse problems. The Senator states “The Medical Board of California’s Diversion Program offers a prime example of the failures associated with an improperly administered program. It appears the Board would rather protect their own than safeguard the public from impaired doctors.” (Senators’ website 5/12/08)

Another of Ridley-Thomas’ bills, SB797, would allow the Board of Behavioral Science to take action to revoke a license of a therapist in certain cases of sexual abuse of a minor, closing a loophole that currently exists. The bill would allow the revocation even in cases when the current statute of limitations has passed and would be viable even if the abuse occurred before the therapist was licensed. “A June 2007, ‘Los Angeles Times’ article cited a case in which a licensed educational psychologist in the Los Angeles school system allegedly molested a boy hundreds of times over a seven-year period. The Board was unable to revoke the psychologist’s license because the alleged acts occurred prior to the time the individual became licensed by the Board.” (Senator’ website 6/9/08) Fortunately these two crucial bills enacted by Senator Ridley-Thomas have had support by both political parties and are likely to be signed into law by the Governor.

In contrast in November 2007 the Governor vetoed an important piece of the Senator’s legislation, SB801. This bill would have put on the ballot a chance for the public to enact needed reform to the California Chiropractic Board. The board’s illegal activities and ineptitude received much legislative and media attention in 2007 however the Governor has been determined to maintain its status quo.

It is interesting to note that many in the chiropractic community suggested that the Senator was picking on the Chiropractic Board for political reasons and/or catering to the mainstream medical community. On the Chiropractic Association website it’s stated that one reason the Association is against the reform bill is “Allowing amendments by the Legislature would just give CMA (Calif. Medical Association) and other organizations that are out to limit consumer access to our services another way to attack the chiropractic profession.”

An even more outrageous statement can be found in “Flashreport” (10/13/07) when Shawn Steel, a lawyer with strong ties to the chiropractic community, discusses the bill. “Ridley-Thomas was trying to score points to humiliate the Governor….Ridley-Thomas would have abolished the (Chiropractic) Act, require any future chiropractic rights be approved by a rapacious Legislature, generally dominated by Big Medicine and Big insurance.” It’s funny but I’ve heard no claims of attack from the Medical Board or the Board of Behavioral Science. The Senator’s legislation to improve these other health care boards should put the lie to these inane kinds of ideas and speculations.

The “Capitol Weekly” article also mentions the trend to appoint more public members to State Boards. Julia FellmEth views this as an important step in providing accountability to the California consumer. Most of the health care boards’ still have professional members as majority and they are the ones showing major flaws in public protection.

Cindy Boling, President of Advocateweb and faculty member of Professional Boundaries, Inc., sees it this way. “Many patients do not understand that our regulatory boards are charged by legislature with a mission to ‘protect the public.’ The potential for boards to operate outside of their charged mission increases through lack of transparency and unilateral regulation, such as the case with the history of the California Chiropractic Board. The appointment of more public members to regulatory boards would serve well to work against the ‘protect their own’ public perception, as well as provide a balance for decisions concerning transparency.”

As I see it, health care professions already have their lobbies; for example the California Medical Association and the California Chiropractic Association. The boards themselves are not there to be another lobby for the profession but to speak for the people. I recently spoke to James Bowles, formerly of Consumer Affairs as Liaison to the Governor’s office. Mr. Bowles stated, “Professions can’t police their own people. If we support that idea we truly don’t serve the publics’ interest. It would help boards to have more public members who aren’t afraid to speak out. Public members aren’t ingrained in the boards’ profession and can speak for how the public feels and what they are going through.”

It is obvious that Senator Ridley-Thomas is someone who cares and takes his job seriously. Hopefully the trend for accountability will continue and health care boards will strive harder to fulfill their mission to protect and serve the people of California. Referring to state board Reforms, James Bowles sums it up by saying, “People often say they don’t want government in their business but what they don’t realize is that the government is there to protect people like them and even with that, it merely provides a minimum standard of protection.” We all deserve at least that.

Deborah Snow was born and raised in California. Deborah received her BA degree from California Baptist University in Riverside, CA. majoring in both English and Behavioral Science. She is currently employed at University of California, Riverside as a Library Assistant. Deborah is married and has one daughter. She also volunteers in her spare time at Riverside City and County Animal Shelter.

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