Report on Health Licensing Boards and Governance Structure

CLEAR received a copy of the Minnesota Health Licensing Boards' report on "Health Licensing Boards and Governance Structure" (Anna Bonelli, Research Analyst, Minnesota Health Licensing Boards, December 1, 2003).  Looking at governance structure for regulating health professionals, the report's purpose was to 1.) explore and clarify models of professional regulation; 2.) define what it means for regulating bodies to be "effective"; and 3.) describe models of occupational regulation in terms of the criteria for effectiveness.  Based on known research and case studies of five states representing the standard governance structure classifications and four states with distinctive features, the report offers the following findings:

    * No consensus exists on the most effective board governance structure.  There are no universally recognized "best practices," that is, no studies have taken a comprehensive look at evaluating board performance.

    * The existing evidence and expert opinions points towards the advantages of independent boards in part because of the inconclusiveness of cost savings from consolidation, and evidence showing that independent boards take somewhat more or about the same number of disciplinary actions.

    * Boards' disciplinary actions are discussed frequently because of the sensational qualities and because of the accessibility of data.  However, conclusions on the effectiveness of various models in disciplinary matters remain speculative.

    * Scope of practice disputes between professions, sometimes playing out in "turf battles," can result in a reduction of access to care for consumers.  Although there is some speculation regarding the advantages of a consolidated agency or some type of oversight board in mitigating these disputes, evidence remains scant.

    * Public participation and awareness of boards' actions are minimal.  The consensus of opinion indicates that centralized access to board information can help to mitigate these concerns for consumers, whereas consumers may be confused by multiple, discreet agencies.

    * Politics infuse health licensing boards on many levels, from the initial regulation of professions to changes in the scopes of practice.  Boards' structure should attempt to minimize political bias among board members and staff by having clear lines of accountability and efficacious public representation.  

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