The letter also explains that under current practice, only federal hospitals and nursing homes that are part of health plans have access to the bank's data, which is under the jurisdiction of the federal Health Resources and Services Administration.
Last October, language for the desired regulation was submitted to the Office of Management and Budget for review. But it was held up because of the presidential transition, and was to be re-submitted after the inauguration.
"Although the [proposed] regulation had been previously cleared by HHS prior to being submitted to OMB, HHS staff has advised us that the regulation will now have to go through departmental clearance once again," delaying final regulation until "2010 or beyond," the Public Citizen letter explained.
The proposed language "is not controversial" and "has considerable support and places no additional reporting burden on anyone."
Wolfe's letter to Sebelius comes five weeks after a series in the Los Angeles Times pointed to the failure of California's licensing agencies to discipline nurses with behaviors that put patients at risk of harm.
Hospitals have long wanted access to disciplinary action about such practitioners, especially in cases where multiple reports have been filed on their problem behaviors. Public Citizen's letter to Sebelius draws on information from a former HHS employee "whose job required him to read many of the reports and perform statistical analysis on all of them." Some reports involved serious lapses in judgment that hospitals that might employ them would want to know, according to Public Citizen.
"HRSA has the following disciplinary reports on nurses in its possession that are not available to non-federal hospitals and many nursing homes."
While 21,725 nurses have one disciplinary report, 10,509 have two or more, and 32 have 10, Public Citizen added.
The letter details numerous examples of nurses who continued to practice despite conviction of criminal offenses related to alcohol abuse, petty theft, methamphetamine possession, drunk driving, other drug possession offenses, and prescription forgery.
Wolfe also proposes a practical, cost-saving solution. When the regulation is implemented, he wrote, it would allow all such information to be folded into the National Practitioner Data Bank (NPDB), thus eliminating the need to continue subsidies required for the Healthcare Integrity and Protection Data Bank, which would need at least $900,000 annually. By folding the data into the NPDB, HIPDB could be shut down and those expenses to the taxpayer avoided.