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Convicts test Department of Health's honor system

"Though the state Department of Health relies on an honor system of self-reporting when one of its health care professionals is convicted of a crime, less-than-honorable convicts continue to practice.Christina L. Oakes, a nurse's assistant registered in Kitsap County, committed a battery of crimes dating from 1993, when she was convicted of four counts of forgery, according to charging documents issued by the Department of Health.Possibly the worst of Oakes' crimes was a September 1998 Kitsap County Superior Court conviction on a charge of maintaining a dwelling for controlled substances. Oakes pleaded guilty.She has also been convicted of third degree theft (twice), driving under the influence, reckless driving and false reporting, according to charging documents.The Department of Health discovered Oakes' record in May 1999, when she re-applied for certification.The agency does not have a record of whether Oakes was working following her initial convictions, though it does show her registration was valid during that time.State law requires health care providers to report themselves if they commit a crime, according to Kendra Pitzler, program manager for the nursing assistant program, the program in which Oakes was registered, but, if some don't, the DOH might not find out about it.The Department of Health currently does not perform background checks. It does not regularly review its licensed, registered or certified health care professionals, nor do law enforcement or the courts share information on arrests or convictions. There are better ways, admitted Diana Ehri, DOH executive director of the health policy office for health professions.The Department of Health has been working with legislators to devise a better method of reporting convictions, Ehri said, but legislation has failed to pass during the past several sessions.Cost is the primary reason bills have consistently failed, Ehri said, but the DOH has examined two approaches to policing the roughly 240,000 licensed healthcare workers in Washington.Conducting initial background checks would be cheap and effective, but would only work when people apply to the DOH. Crimes committed after hiring still would go undetected.DOH officials have also looked into conducting background checks every four years. If a healthcare professional's record remains clean after 12 years, the background checks could end.Pulling records isn't necessarily high-cost, Ehri said, but DOH officials and lawmakers are snarled over who gets to decide which crimes result in license revocation. There's been a lot of resistance and concern with allowing discretion, Ehri said. Furthermore, a healthcare professional threatened with license revocation can request a formal hearing, requiring the DOH to investigate convictions, gather materials and interview witnesses. That's what shoots the cost up, Ehri said.To cover the expense, the DOH would distribute the costs over all its healthcare professionals when they renew their licenses. But that could increase renewal costs by $60 to $80, pricing some out of the industry, Ehri said. For nursing assistants, who currently pay $20 a year to renew their licenses, that works out to a 300 to 400 percent increase. A nursing assistant couldn't afford to renew a license, Ehri said. It would be cheaper for them to find another job.Another point of debate is whether to conduct in-state background checks alone or enlist the use of the Federal Bureau of Investigation's national database.If the DOH goes with the FBI's national system, the department would have to get fingerprints from all 240,000 workers. The FBI charges $50 per fingerprint check.Ultimately, the agency has to find a way to account for who it licenses while keeping costs within a range healthcare professionals can afford. What we have now is not the best system, Ehri said."

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