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Information on sanctioned nurses and EMTs can be hard to access

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Information on sanctioned nurses and EMTs can be hard to access

Mar 23, 2023 | 5:10 pm ET
By Clark Kauffman
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Information on sanctioned nurses and EMTs can be hard to access
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Some of Iowa’s state licensing boards have not been publicly reporting all of the charges they’ve levied against the state's medical professionals. (Photo via Canva; logos courtesy of the State of Iowa)

Public information on Iowa nurses and emergency medical technicians accused of wrongdoing isn’t always easy to access — and, in some cases, it has been impossible to obtain.

The Iowa Department of Health and Human Services acknowledged this week that it had not disclosed on its website any of the disciplinary actions taken against emergency medical personnel and ambulance services over the past eight months.

The state maintains a public, online database of more than 1,000 disciplinary cases involving emergency medical technicians (EMTs) and emergency medical services (EMS) providers — including all of the recent cases. But that database can’t be sorted by date, so it’s virtually impossible to determine from that source what recent actions have been taken by DHHS’ Bureau of Emergency and Trauma Services, which oversees the profession.

To address that issue, DHHS has maintained a separate webpage with a chronological list of cases dating back to September 2021. But as of this week, that list falsely indicates the bureau has taken no public action of any kind since December 2021.

The Iowa Capital Dispatch first asked DHHS officials about the apparent lack of bureau action last August and was told that while the bureau hadn’t levied any charges or imposed any sanctions in 2022, the online list of cases would be updated once the bureau took action in a case.

The Capital Dispatch asked about the list again this week because it now indicates it has been 15 months since any Iowa-licensed EMT or EMS agency has been sanctioned.

In response, DHHS officials acknowledged they had not updated the list after the Capital Dispatch asked about it last August. The agency then provided the Capital Dispatch with a list of 12 disciplinary cases the bureau acted upon after August 2022.

DHHS spokesman Alex Carfrae said that when the bureau takes action in a disciplinary case, it emails a notice to subscribers — including the Iowa Capital Dispatch — who have signed up to receive those emails. But members of the public seeking information on the bureau’s website are not informed of this option.

Board of Nursing changes practice

Separately, the Iowa Board of Nursing recently acknowledged it had not been updating its disciplinary website to include charges levied against Iowa nurses.

In some instances, disciplinary cases simply weren’t included on the board’s published, periodically updated list of cases.

In other instances, the names of licensees who were disciplined were included in the list, but the corresponding documents that detailed the nature of the charges were never uploaded to the board’s public database of disciplinary cases.

In still other cases, the documents were uploaded to the database and the charges were disclosed – but those steps were taken several months after the charges were initially imposed, once the cases had been resolved.

The Capital Dispatch first began asking the board about the missing cases last year, when it became apparent the published list of disciplinary cases wasn’t being kept up to date.

At that time, the board noted that the names of disciplined nurses – but not the charges against them — could be gleaned from the minutes of board meetings once those minutes were approved at subsequent meetings.

The Capital Dispatch pointed out that one licensee was charged by the board in July 2022, but nothing about the case was posted to the board’s discipline webpage until this year, after the case was settled.

In February, the board staff said they had yet to develop a “process” for making public all of the charges against licensees. Kathleen Weinberg, the board’s executive director, noted that the board “has never refused or withheld the production of any public records when requested.” The Capital Dispatch argued the media and public had no way of knowing what specific records to request if the existence of a particular case wasn’t disclosed.

Weinberg has said the board can make public the charges against a nurse only after receiving proof the nurse has been served with the documents, which she said can be a lengthy process. However, that wouldn’t explain why some charges aren’t made public until months after board hearings are held, settlement negotiations have taken place, and final orders are issued.

Earlier this month, the Capital Dispatch informed the board it would be filing a formal complaint about the Board of Nursing with the Iowa Public Information Board. At that point, the board published an up-to-date lists of all disciplinary actions, and also published the written statements of charges in those cases.

In doing so, the board acknowledged that previously the names of nurses charged with offenses were added to the board’s public list of disciplinary cases only after the matters were resolved.

Randy Evans, executive director of the Iowa Freedom of Information Council, said the timely disclosure of licensing-board sanctions is important to Iowans.

“The people of Iowa deserve to know when nurses or other emergency medical providers who care for our friends, family and neighbors are disciplined by the state licensing boards for improper behavior,” he said. “That’s why it is so troubling when these two licensing boards act as if it is a big inconvenience to post information about the disciplinary actions they take. The state of Iowa licenses these professions to protect the health and safety of the public.”

Iowa discloses less than other states

Because of a 2021 Iowa Supreme Court ruling, Iowa’s licensing boards can only disclose the regulations that licensees are accused of violating – and not the underlying circumstances or alleged facts – until a case is resolved and a final order is issued.

As a result, the public may learn that a particular licensee is charged with an offense such as violating professional ethical standards or failing to meet the acceptable standards of patient care. However, the public won’t be told how, when or where the alleged violations occurred until the case is resolved – a process that sometimes takes a year or more.

Even then, the information that’s publicly shared by Iowa’s licensing boards isn’t as detailed as what boards in other states disclose. The Iowa Board of Nursing, for example, typically doesn’t name the hospitals or care facilities where violations have occurred – information that many other states include in their public statement of charges.

Last year, the Iowa Board of Physician Assistants charged Jon Eason Perry with being subjected to some form of unspecified discipline by the licensing board of another, unspecified state. That was all the state of Iowa was willing to say publicly about the case.

In New Mexico, however, the specific allegations against Perry, as well as the details of that state’s disciplinary action, had been treated as public record for most of the previous year.

The New Mexico licensing board told the public it had compiled “credible evidence” that during a January 2020 medical appointment, Perry grabbed a female patient’s buttocks in a sexual manner; told her she should have his child; called himself a “whore;” stated that he was cheating on his wife because she couldn’t satisfy his sexual needs; and asked to see the patient’s vagina.

The New Mexico board also disclosed that it had launched a second investigation into Perry in July 2020 when a different patient alleged Perry told her he wanted to have sex with her in his office; engaged with her in an intimate and sexual manner during an office visit; and encouraged her to leave her husband so they could be together.