Audit: State open to health-care risks

The state's process for licensing health professionals opens the door for unqualified providers to practice in Washington and leaves citizens at risk of harm, an audit ordered by the governor has concluded.

The review of the state Health Professions Quality Assurance office (HPQA), part of the Department of Health, found that having so many different professional boards and commissions overseeing different health-care professions can lead to inconsistency in discipline.

The audit, released Tuesday, also found that the state's weak internal controls over background checks and a lack of national criminal background checks could "expose the public to serious risk."

The audit was requested by Gov. Christine Gregoire after The Seattle Times published an investigation last year called "License to Harm," which revealed that state health regulators were failing to adequately investigate and discipline health-care practitioners accused of sexual misconduct.

State Auditor Brian Sonntag commissioned the audit by the Clifton Gunderson consulting firm.

The HPQA office regulates more than 300,000 health-care professionals in 62 professions, from doctors and dentists to veterinarians and massage therapists. But the review was critical of the fact that the various professions are overseen by 16 boards and commissions that all have their own rules and standards.

In general, the audit criticized HPQA for its performance standards and oversight of disciplinary processes. It noted that even when practitioners are disciplined, the state's process doesn't ensure they actually comply with the sanctions.

The audit also recommended the state should do more to educate the public in how to file complaints about unprofessional conduct.

At the same time, the audit praised HPQA for some "best practices," such as sorting complaints so those involving alleged sexual misconduct or "imminent danger to the public" are expedited.

Department of Health Secretary Mary Selecky noted that the auditor praised the department for taking steps to address some of the most serious shortcomings.

"We take the work of patient safety very seriously," she said. "The findings were not a surprise."

Some of those steps include using case-management teams to expedite cases and making recommendations to the Legislature to change the way registered counselors are licensed. The Seattle Times investigation found that profession to have the most sanctions for sexual misconduct.

Selecky said the department also has developed uniform sanctioning guidelines for its boards and commissions and is in the process of developing specific criteria for "imminent harm."

The audit recommended that the Legislature take several other steps, including:

• Separate "misconduct" violations from those involving the "standard of care." The Secretary of Health would discipline all health professionals for misconduct, while the boards and commissions would discipline for standard-of-care violations.

• Eliminate the registered-counselor credential as it now exists.

• Give the department authority to access State Patrol criminal-background information, as well as the FBI database for national background checks.

• Require the department to conduct national background checks on all credential holders.

Carol M. Ostrom: 206-464-2249 or costrom@seattletimes.com