Persistence pays off in bill

For four years, the Legislature has struggled to pass a bill to create a unified system for disciplining health care professionals.

There are 62 categories of health care professionals in this state — nurses, doctors, chiropractors and dozens of others — and discipline for unprofessional conduct is spread among the state Department of Health and 14 professional licensing boards and commissions.

The discipline system has been chaotic, disjointed and unpredictable. Professionals accused of abusing their patients retained their license to practice.

In the past two years, lawmakers have struggled mightily to revamp the discipline system. They could not come to a consensus, rewriting one proposed bill seven times.

Last fall, state Auditor Brian Sonntag used a performance audit to look at the state's medical professional discipline system. Sonntag had a number of recommendations, many of which were incorporated into House Bill 1103 and drew a strong consensus among lawmakers.

"It's 50 pages of remarkable change," said Rep. Tom Campbell, R-Roy, the prime sponsor of the bill.

At the core of his bill, Campbell proposes giving the power to discipline professionals directly to the secretary of the Department of Health, who has a track record of resolving disciplinary complaints in a timely fashion.

Several professions, including doctors represented by the Washington State Medical Association, opposed the bill. They argued that only another physician, for instance, could say whether a doctor had made a clear mistake in a complex medical case.

The final agreement allows various boards to decide whether their profession's standards have been breached in a case, but gives the Health Department control over sexual misconduct investigations.

"People who feel they've been abused by a dentist don't have to sit before a board of dentists to learn the outcome — I think that was a terrible situation," Campbell said.

Dr. Leslie Burger of Vancouver, Wash., a member of the doctors' Medical Quality Assurance Commission, said the independence will allow the commission to communicate more with the public and physicians and also focus on education.

The bill makes a multitude of changes, including allowing the state to do national background checks on people applying for new licenses, strengthening penalties for professionals who don't turn over documents to investigators, and allowing the state to consider arrests and other information that didn't lead to a criminal conviction but could hint at ethical problems.

"Those patient safety tools are significant," said Karen Jensen, policy director for the Health Department's Health Professions Quality Assurance division.

Gov. Chris Gregoire is scheduled to sign the bill into law today. This is one example where persistence, guidance from a strong performance audit and determination to protect patients from harm drove years of negotiations into a realistic and workable legislative solution.