Is Nursing Board Leaving the Public at Risk? Christie Administration, Critics Clash
TRENTON — State officials say they’ve cut into a backlog in processing nursing licenses that went public this past summer and that things in that agency aren’t as bad as people say.
Those remarks, however, came after a few hours of those critics layering on additional details of problems at the agency, with its former director saying it lacks independence and adequate funds, plus an assertion that failing nursing-school programs would be closed except for a lack of staffing.
“Perhaps it’s unfair for me to say this, but it sounds like this organization needs a total overhaul,” said Sen. Robert Gordon, D-Bergen, chairman of the Senate Legislative Oversight Committee.
The backlog in processing applications for licenses had reached around 4,000 by mid-August, when executive director Dorothy Smith Carolina resigned. The agency currently has an acting director, and a search is underway for a replacement.
The backlog has since been eased, in part by transferring over nine temporary employees, said Sharon Joyce, acting director of the Division of Consumer Affairs. By next month, the nursing board will have added some permanent employees, she said.
“I think we have met the challenge. We have sufficient staff, and we will be in a much better place when we hire the three to four additional people” and executive director, Joyce said.
Joyce says the state is auditing the remaining backlog to see if there are ways to simplify instructions and speed reviews of applications. She said the application is complicated.
“I think it’s a question of looking at the process and seeing where we can try to shore it up,” she said.
Carolina said the agency had 27 staffers, though few are professional nurses. (Joyce said it’s approximately 30.) She and former board president Patricia Murphy said people aren’t replaced when they leave, with those duties instead falling to temps or ‘government representatives’ – political appointees who don’t report to the executive director.
“I had no authority or autonomy,” Carolina said. “In fact, my immediate supervisor once told me that I even needed to get his permission to move a staff member from one cubicle to another,” she said.
“It is impossible for an executive to have all of the responsibility and none of the authority and only temporary staff,” said Murphy.
Lawmakers were told the Board of Nursing relies an outside part-time consultant, limited to 20 hours of work a week, to oversee more than 80 nursing education programs. Some failed, year after year, to meet state standards about the numbers of students passing board exams.
“A few of these schools were due to be closed two years ago but remain open simply because staff is not available to monitor them. How many others need to be closed?” Carolina said.
The problem cuts in both directions. One attorney, Kathleen Gialanella, told lawmakers she represents a client who has been trying for three and a half years to get a new nursing education program approved.
Assemblywoman Nancy Munoz, R-Union, who is a nurse, said the state should be open to hiring full-time professionals to oversee the board’s education and discipline programs, not just bulk up licensing efforts.
“It’s both a policy issue and a staffing issue,” Joyce said.
“We’ve got students wasting money, which is what we don’t want to do,” Munoz said.
Munoz said she will introduce legislation that seeks to end the backlog that hits the nursing board each spring by having licenses expire in an applicant’s birth month, rather than all expiring on May 31. That’s the approach being taken with driver’s licenses starting next year.
Gordon is drafting a bill that would put a limit on how long a position could remain vacant before an administration would have to take action. He likened long-term vacancies at the Board of Nursing to those for engineers and maintenance spots at New Jersey Transit.
“What I find particularly frightening about this testimony is that I’m concerned that we’re hearing symptoms of a statewide disease,” Gordon said.
A week ago, Gov. Chris Christie appointed 10 new members to the board, filling six spots that had long been vacant and two additional positions created through a state law enacted in July. He also reappointed three board members.
The appointments replaced two board members – Murphy, who had been president, and Avery Hart, who has served as a holdover since 2010. Both went public in July with a letter raising concerns about the nursing board’s budget and staffing challenges.
Murphy said spots that were vacant for three years were suddenly filled when the Legislature’s hearing was scheduled.
“The Governor’s Office gave me no reason for my removal,” Murphy said. “And so I left with no alternative explanation except that they intended retribution towards me as a warning to other public servants that if you draw attention to the administration’s alleged shortcomings, it’s grounds for banishment.”
Christie spokesman Brian Murray didn’t respond to Murphy directly but said the governor nominated 10 new members from dozens of highly qualified applicants.
Murray said the vacancies never delayed action by the nursing board and that “senators were deliberately misleading and inaccurate with claims of backlogs.”
Hart said some board members stopped attending meetings within a few months of being appointed because the workload for an unpaid position was so substantial. Reading more than 500 disciplinary reports before the board’s September meeting took three days, Murphy said.