California regulators have announced emergency measures to investigate the criminal backgrounds of all registered nurses in the state, days after The Times reported that dozens of nurses had kept their licenses for years despite multiple convictions.
Effective immediately, the state nursing board will ask all nurses renewing their licenses whether they have been convicted of any crimes in recent years, said Carrie Lopez, director of the California Department of Consumer Affairs, which oversees more than 30 professional licensing agencies.
Many other states already require this information, according to the newspaper's investigation, a collaborative effort with the nonprofit investigative news organization ProPublica. Nurses in California must renew their licenses every two years.
The Board of Registered Nursing must also develop emergency regulations to obtain fingerprints from all nurses licensed before 1990.
Fingerprinting has been required for nurses licensed since that year, allowing law enforcement agencies to flag the nursing board any time a nurse is arrested.
But until now, nurses licensed earlier -- about 40% of the active nurses in California -- had escaped scrutiny.
In written answers Friday to questions from The Times, Lopez said the new regulations would have to be approved by the state's Office of Administrative Law.
She said she anticipated that all nurses who have not been fingerprinted will have to do so when renewing after March 1.
Lopez said she has also directed her staff to develop legislation expanding the requirement to other state licensing boards.
"We are taking swift action to provide additional consumer protections through all of our boards, including the Board of Registered Nursing," she said in a statement earlier this week.
To support the new requirements, the state plans to reallocate staff to more closely scrutinize applicants, Lopez wrote Friday.
If necessary, she said, her agency will seek to hire additional investigators.
Former state Sen. Liz Figueroa, who oversaw professional licensing boards in the Legislature until 2006, called the department's response a "needed step."
"There's no sense in having the boards unless you're going to allow them to do the work," she said.
"They just can't be out there issuing licenses unless you make them accountable and you have the tools to investigate."
Lopez also said a nursing board official erred last week in saying legislative approval might be required to ask nurses renewing their licenses about convictions.
The board, she said, "has and has had the authority to require applicants seeking renewal of their license to identify whether they've been convicted of a crime."
The question will be included on applications beginning this month. Anyone seeking an initial license is already asked about convictions.
Lopez said she will step in if the nursing board fails to protect the public.
The nursing board "is a semi-autonomous board, and I fully expect them to carry out their mission to protect consumers independently," she said.
"Nevertheless, they are under the jurisdiction of my department, and as director I have the authority to issue edicts to our boards when I am alerted to a problem that could leave vulnerable Californians in the hands of criminals."
The Times reported Sunday that it found more than 115 cases since 2002 in which the nursing board failed to act against nurses' licenses until they had racked up three or more convictions.
In 24 cases, nurses had at least five convictions.
The newspaper and ProPublica also found cases in which the board never acted against nurses convicted of sex offenses and Medicare fraud.
At least one nurse is currently in prison; another was able to renew his license from there for years after being convicted of attempted murder.
The California Nurses Assn., the union representing about 65,000 nurses in the state, said this week that it supports criminal checks for all nurses."We have always supported background checks on healthcare workers," said Jill Furillo, the union's Southern California director.
"There should be uniform standards. It sounds to me like there have not been," she said.
California licenses 343,000 active registered nurses, the largest number in the nation.
Hospitals and clinics rely on the website of the Board of Registered Nursing, in part, to check out job applicants. All official accusations and disciplinary actions are posted there for public review.
To gather information about the criminal records of the state's nurses, reporters reviewed stacks of nursing board files and court pleadings, consulted online databases and newspaper clippings and conducted interviews with nurses and experts in several states.
All accusations filed and disciplinary actions taken by the board since 2002 -- more than 2,000 in all -- were analyzed.
Among the offenses were misdemeanors and felonies ranging from petty theft and disorderly conduct to assault, embezzlement and bail jumping. One Redding nurse was convicted 14 times from 1996 to 2006 before the board filed an accusation against her.
In some cases, The Times and ProPublica found out about convicted licensees by comparing government databases -- including a list of sexual predators required by Megan's Law -- with the names and addresses of registered nurses in the state.