Thousands of nurses wait for California to clear backlogged licensure applications
Staff used to tell applicants their requests would be process in six to eight weeks, but it reportedly took far less than that—sometimes just days. Now, Heimerich is estimating applications are taking about 90 days to process.
He says 16 to 18 additional employees have been moved to the Board of Registered Nursing to help clear the backlog until the new online application system is in place, but he can’t yet give a date on when that will happen. Out-of-state license requests and licenses by endorsements are also backlogged, but moving faster than new applications, Heimerich says, because those applications are easier for the new employees to learn how to process. It has, however, made it difficult for hospitals in need of newly licensed RNs to get outside help in the interim.
Overall, however, the new system is working and working well, Heimerich says. The state won’t pay for the new system until it’s delivered in its entirety and working perfectly, he says.
“We don’t pay until it delivers what it says it’s going to deliver,” says Heimerich. “That puts a great deal of pressure on the vendor to get it right.”
Heimerich says there weren’t too many options for examples when setting up the new system.
“My understanding is that we’re kind of unique,” Heimerich says. “This will be, once it’s done, the largest such licensing database in the world.”
What the Department of Consumer Affairs is trying to stress now is that employers need to extend the old time frame they use when offering jobs to nursing graduates. Previously, they would offer a job contingent on licensure several weeks later. Now, that is taking longer, and Heimerich says he is trying to make employers see that and work with their job candidates on a more realistic time frame.
“We’ve made some improvements. We’re hoping in the next month or so backlog will at least have a major chunk out of it,” Heimerich says.
One the new online application system is in place, it will alleviate the two major “choke points” in the licensure process, which is data entry for the paper applications and the payments clearing. Applicants will input their own data and pay electronically, so the finished system will be much quicker, Heimerich says.
Still, Olsen has requested a state audit and an oversight hearing, hoping it will reveal some common issues between the problems with the new system implementation and other issues with newer state software programs.
“The larger issue we’re facing in California is that we seem to have persistent problems every time we roll out a new technology system,” Olsen says. “Over and over we have these failures. Maybe we can find common threads where these breakdowns are occurring.”
Olsen says the problem with the new system was first brought to her attention by a hospital in her district that was having trouble maintaining its nurse-to-patient ratios because it couldn’t hire any new graduate nurses. Then, the complaints started coming in from applicants.
The hospitals tried to contract out to traveling nurses in the interim, but couldn’t because their licenses could not be processed to work in California either due to the backlog.
“This has a very clear and direct impact on the health of our economy,” Olsen says, adding that, to make matters worse, the healthcare system is her area is extremely strained right now due to a severe flu outbreak.
Olsen says the staff in the Board of Registerd Nursing have been put in a bad situation trying to clear up the backlog, and it’s not fair to the new graduate nurses to have to put their lives on hold while the software system—which shouldn’t have been launched before it was ready—is up and running in its entirety.
In the future, Olsen wants to be sure new systems will be tested and working completely before they are put into place.
While Heimerich says he is only aware of a comparable database system in Florida, which was launched in 2008, Pamela Crain, deputy press secretary for the Florida Department of Health, the system was designed by the health department and was modeled after systems already in use in other states. The Florida system allows applicants to apply and pay directly online, and she says 80% of all applications are now received through the department’s website. Crain says there were no significant setbacks when Florida launched its online nursing application system.