State regulators for years did little as national anti-choice groups taught ideology instead of science to California nurses, as Rewire first reported in January.
Now legislation headed to the California governor’s desk tightens continuing nursing education standards, requiring coursework to be related to “scientific knowledge or technical skills required for the practice of nursing.”
State Sen. Jerry Hill (D-San Mateo) introduced SB 1039 after Rewire revealed how Heartbeat International, Care Net, and the National Institute of Family and Life Advocates capitalized on lax oversight and loopholes in state continuing education to teach dubious medicine.
The legislation requires the state’s chief nursing oversight agency, the Board of Registered Nursing, to audit continuing-ed providers at least every five years—something the agency has not done—and to revoke the approval of violators.
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Hill in a phone interview with Rewire called the bill a consumer protection measure aimed at fixing the board’s “past inability to oversee continuing-education programs.”
National abortion rights opponents had been teaching a variety of classes that weren’t rooted in science, including one suggesting that medication abortion can be reversed with a large dose of hormones. The notion of “abortion pill reversal,” as it’s called, is popular in the anti-choice movement, but rejected by mainstream medicine. But, as Rewire reported, nurses earned California continuing-education credit for taking “Abortion Pill Reversal and Your Clinic” and other classes, which were offered inside and outside the state.
The problem wasn’t isolated to opponents of abortion rights. Another state-approved provider was teaching “The Vaccination Dilemma,” a class that flies in the face of national public health policy stressing the importance of vaccinations.
Hill said the board was “supposed to be auditing the courses to make sure they were appropriate and scientifically based, but what they were doing was auditing the nurses to make sure they were taking the courses. They were never looking at whether the course content was valid or scientifically based.”
The Board of Registered Nursing hasn’t audited a continuing-ed provider for 15 years, even though the board acknowledged in a state senate committee report in April that upholding continuing-ed standards was “essential to ensure public safety and protection.”
Continuing education credits are required of nurses and doctors to maintain licensure in California. The state board regulates more than 400,000 California licensees, such as nurses and nurse practitioners, and continuing-ed providers, which range from private companies to nonprofits.
When Rewire reviewed the state-approved applications of three prominent anti-choice organizations, we found the groups failed to tell the Board of Registered Nursing that they were teaching classes like “Abortion Pill Reversal and Your Clinic” and “Fetal Pain: What’s the Evidence?”
Heartbeat International, for example, said on its application it would teach, “Knobology Applications: Or How to Get Better Pictures.”
The unsubstantiated notion of early fetal pain has become a rallying point for anti-choice activists, who managed to enact a fetal anesthesia law this year in Utah. The American Congress of Obstetricians and Gynecologists has said that fetal pain is unlikely before the third trimester and “no studies since 2005 demonstrate fetal recognition of pain.”
A legislative analysis prepared for a state senate committee hearing on SB 1039 cited the deficiencies Rewire had uncovered:
“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.
Asked about Heartbeat International, Care Net, and the National Institute of Family and Life Advocates, a board spokesperson declined to answer whether the groups are being audited, citing state law. The trio remain in good standing on the board’s licensing verification website.
Some industry experts are critical of the bill, saying it brings a piecemeal solution when what’s needed are systematic regulatory reforms to post-graduate education encompassing all the boards, not just nursing—along with more staff and money.
The board projected a $6 million shortfall for fiscal year 2016-2017 at a March 2015 state senate oversight hearing.
Diana Taylor, professor emerita at the University of California San Francisco School of Nursing and a former member of the Oregon Board of Nursing, said that Hill, in drafting SB 1039, didn’t heed the recommendations of board staff.
“How is it going to be paid for? How is it going to be addressed?” Taylor said in a phone interview with Rewire. “This particular piece of legislation doesn’t really address the real problems.”
Gov. Jerry Brown (D) has until September 30 to sign or veto the legislation.