A California State Senate panel on Monday approved a bill to subject continuing education providers to greater scrutiny after Rewire revealed that national organizations were teaching classes for state nursing credit based on anti-choice ideology.
SB 1039 promises to shore up the lax oversight of continuing nursing education, by directing the state Board of Registered Nursing (BRN) to audit continuing education providers at least once every five years, and to revoke the approval of violators.
The reform measure tightens class standards by requiring courses to be “related to the scientific knowledge or technical skills required for the practice of nursing.” Passed in a 6-2 vote, the legislation now heads to the Senate Appropriations Committee.
State Sen. Jerry Hill (D-San Mateo), who chairs the Senate Business, Professions, and Economic Development Committee, introduced the reforms after a Rewire investigation in January exposed the BRN’s lax oversight and regulatory loopholes that allowed anti-choice groups to teach questionable medicine.
“The changes make the requirements for standards stronger,” Hill said in an email. The committee and BRN representatives crafted the reform language.
Rewire’s investigation described how some of the nation’s more prominent abortion rights opponents gained the BRN’s approval to teach continuing education courses on “abortion pill reversal”—a treatment rejected by the medical establishment—and other scientifically baseless topics.
After reviewing the state-approved applications of three organizations—Heartbeat International, Care Net, and the National Institute of Family and Life Advocates—Rewire found the providers failed to disclose to the board the medically dubious subjects they taught to nurses.
Heartbeat International, for example, taught the class “Abortion Pill Reversal and Your Clinic” for continuing education credit to nurses at a St. Louis conference last year. On its state application, however, the group said it was teaching “Knobology Applications: Or How to Get Better Pictures.”
Care Net is touting its state approval on the brochure for its annual conference, scheduled for September in Orlando, Florida, where it is offering courses for California continuing education nursing credit.
State law requires the BRN to vet the providers, which range from private companies to universities. But the board doesn’t approve the materials that providers teach.
As Christina Sprigg, chief of licensing and administrative services with the state board, previously told Rewire, “We do not approve courses, we only approve the providers.” The board approved 82 percent of the 764 providers vetted between 2012 and 2014.
A legislative analysis prepared for Monday’s hearing on SB 1039 cited Rewire’s reporting on the deficiencies in the BRN’s oversight:
“The Miseducation of California Nurses: Legal Loophole Enables Spread of Anti-Choice Medical Myths,” highlighted a BRN CE Provider, Heartbeat International, offering credits to nurses who take a class about undoing a pill-induced abortion; a procedure unsupported by sufficient evidence. When confronted with the information, the BRN was basically nonresponsive to the reporter and cited code sections that restate that the BRN approves the provider and the provider accepts full responsibility for course content and instructor qualifications. According to the acting EO, the BRN began looking further into the CE provider when the reporter started looking into them for this story. BRN indicated they do not audit CE providers regularly, but do look into them when an issue with one is raised.”
The providers identified in Rewire‘s investigation, Heartbeat International and Care Net, remain in good standing, according to the BRN website.
The BRN between 2001 and 2014 failed to audit a single continuing education provider, according to a 2015 joint oversight report prepared for the state Senate Business, Professions, and Economic Development Committee and the California State Assembly Committee on Business and Professions.
The oversight report laid out more than a dozen reforms, telling the board to tighten the standards applied to continuing education (CE) classes and continuing education providers (CEP):
ISSUE #14: (OVERSIGHT OF CONTINUING EDUCATION FOR LICENSEES) The BRN has not provided appropriate oversight of its continuing education program despite admonition to do so in the previous review.
The BRN should review its criteria for CEPs and require content to be science-based and directly related to professionally appropriate practice. The BRN should continue to pursue additional staffing for CE auditors, but should simultaneously rebalance its existing workload and prioritize ongoing CE and CEP audits.
The BRN has said it’s running out of money and, without a fee hike, may need to cut staff. In the past few years, the BRN has loaned the state General Fund $13.3 million, and has been paid back $3 million.