Rewarding dysfunction
State lawmakers were agitating for tax and spending increases long before reckless practices at Las Vegas medical clinics created a public health scare. But since it was disclosed that the Endoscopy Center of Southern Nevada infected six patients with hepatitis C, some representatives have answered public outrage with even louder calls for bigger regulatory budgets.
Nevada’s 50 ambulatory surgery centers are required to be recertified every six years. When state Bureau of Licensure and Certification regulators witnessed the reuse of syringes and single-use medication vials at the endoscopy center in early January, it was their first inspection of the facility in more than six years. When bureau workers found similar practices at the Gastrointestinal Diagnostic Clinic on South Maryland Parkway last month, it was their first inspection of that business in more than 11 years. Twenty other clinics haven’t been surveyed by the state within the past six years.
To Carson City’s big spenders, the solution is a familiar refrain: Throw piles of cash at the problem.
"We need to vastly improve our ability to inspect these facilities more frequently and more comprehensively," said Assemblywoman Sheila Leslie, D-Reno, chairwoman of the Legislative Committee on Health Care. "We know inspections can save lives, and we need to do whatever it takes to ensure the public’s health is not jeopardized."
Ms. Leslie has directed some of her criticism at Gov. Jim Gibbons for his initial opposition to the hiring of 10 additional surveyors last year. Eventually, he and the Legislature compromised and created six new positions for the Bureau of Licensure and Certification.
But the agency still has 14 vacant inspector positions. So Ms. Leslie is mad that there aren’t 18 vacancies? Or 30 vacancies? How would that help public safety?
No, the problem isn’t a lack of inspectors. It’s the performance of the inspectors and the Bureau of Licensure and Certification.
When surveyors saw health care professionals violating safety protocols taught in introductory medicine, they didn’t intervene. They watched patients be put at risk and filled out their paperwork.
After it was determined the unsafe practices had spread incurable disease, the agency allowed the Endoscopy Center of Southern Nevada to remain in business despite years of cutting corners and assessed a $3,000 fine when it could have brought regulatory hellfire upon the clinic.
Finally, while testifying before Ms. Leslie’s committee, bureau chief Lisa Jones disclosed that unsafe practices had been discovered at other clinics, but she initially refused to identify the facilities. Assembly Speaker Barbara Buckley had to read from the Nevada Revised Statutes to point out to Ms. Jones that she had the power to suspend a clinic’s license.
And Ms. Leslie believes giving this agency a bigger budget and more employees will make the public safer? Please.
The bureau’s inability to make required inspections is a result of poor prioritization, planning and execution, nothing more — surveyors haven’t had much problem catching up over the past two weeks now that the public is paying attention.
Here’s an idea for the Legislature’s big-government boosters: Don’t reward dysfunction. Provide the oversight expected of elected officials and make the state’s multi-layered health care bureaucracy do its job.