Gregoire pledges to reform health-care licensing

Gov. Christine Gregoire is launching sweeping changes this week that are intended to combat health-care practitioners who commit sexual misconduct against patients.

Gregoire's initiatives are in response to a Seattle Times investigation, "License to Harm," which reported last week that state health regulators repeatedly failed to adequately investigate and penalize health-care practitioners accused of sexual misconduct.

In the past decade, the state dismissed one-third of all sexual-misconduct complaints without any investigation, The Times found. When it did act, the state often returned offenders to work under dubious safeguards, such as treating female patients only if they were older than 50.

"This is not just about us enforcing the law and investigating complaints and taking disciplinary actions," Gregoire said Friday. At the center of every state action or, all too often, inaction is a patient who experienced a "terrible incident," she said.

Sexual misconduct is one of the leading disciplinary problems in Washington health care.

Gregoire's plan includes:

• For the first time, the state Health Department will require new applicants for health-care licenses to be screened for disciplinary charges filed by health departments in other states. Most states do such screening already.

• Also for the first time, the state will use the National Practitioner Data Bank and other federal databases to screen Washington applicants seeking to be licensed as physicians, nurses, chiropractors and other professionals.

The data bank is a computerized listing of 260,000 health-care practitioners cited for malpractice or disciplinary actions against their licenses. It was created in 1990 by the U.S. Department of Health and Human Services as a safety program, and most states have used the system for at least a decade.

Health Department Secretary Mary Selecky said this change, which doesn't require legislation, will take place later this year.

• Gregoire also wants the Health Department to run criminal background checks on health-care practitioners each time they renew state licenses, which they must do every few years. Currently, they are screened only when they first apply.

The Times investigation found 55 practitioners with active licenses who had rap sheets for sex crimes. The Health Department has now begun investigating many of them and has suspended the licenses of three.

The Legislature would have to change the law to allow the more frequent screening.

• The governor wants to create stricter qualifications to become a "registered counselor." Currently, registered counselors pay a $40 registration fee and take a four-hour class on AIDS awareness but are not required to have any training or education, not even a high-school diploma.

Washington is the only state to issue credentials to so many registered counselors under such scant qualifications. Higher-level counselors, such as licensed mental-health counselors, must earn master's degrees and garner extensive clinical experience to qualify for a license.

The Times reported last week that 104 registered counselors have been charged with sexual misconduct since 1995, more than any other profession.

Gregoire said she was stunned to learn that the state had 17,000 counselors who were not required to have any education or training.

"When you put yourself out as a registered therapist, in the mind's eye of the average person, that means you have some special credentials," she said. "That should mean something."

A new task force, overseen by the Health Department, will study the registered-counselor program and recommend new educational standards, Gregoire said.

Tougher standards will require a change in Washington law.

Many registered counselors may have college degrees, but the state doesn't ask them to list their education.

"If we're going to continue to register them, then we better make sure people have met some minimum qualifications," Gregoire said.

• By executive order, Gregoire will require the Health Department and the state's 16 medical profession boards to come up with a uniform definition of sexual misconduct. The governor appoints members to these boards.

More than half of the state's 57 health-care professions have failed to legally define sexual misconduct, a shortcoming used by scores of practitioners to sidestep disciplinary action.

Gregoire's call for action bolstered a loose-knit, bipartisan group of state legislators who have pressed for years to reform the state's troubled disciplinary system.

"Washington is behind the curve. In my opinion, there is no excuse for it," said state Sen. Karen Keiser, D-Kent, chairwoman of the Senate Health and Long-Term Care Committee.

Gregoire did not propose conducting national criminal checks before approving health-care licenses, as Oregon and 13 other states do.

Rep. Tom Campbell, R-Roy, vice chairman of the House Health Care Committee, sponsored legislation earlier this year that would have required national background checks, but it failed to pass.

"This is a real slap in the face to the health-care consumer," he said of the Legislature's failure to pass the bill.

Some professions, such as physicians, opposed this expansion of state powers.

Also, representatives for nursing assistants and other lower-paid professions have argued that national background checks would raise registration fees by an estimated $30 to $50, representing an unfair financial burden.

Sen. Jeanne Kohl-Wells, D-Seattle, co-chairwoman of the Joint Task Force on Criminal Background Check Processes, said efforts to screen applicants for convictions in all states are stalled for now.

National screening would cost about $4 million to implement, state estimates show. Task-force members will study the issue this year, Kohl-Wells said.

Michael J. Berens: 206-464-2288 or mberens@seattletimes.com