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Healthy Changes for the Health Division

By Wendy Simons


   Many of you may recall the shocking news that some outpatient surgery centers, specifically some surgical centers providing endoscope services, came under investigation earlier this year for practices not acceptable to the public well being.   As a result of the revelation that they had not come under regulatory scrutiny for several years by the Bureau of Licensure and Certification (BLC), dramatic changes are now occurring within the state Health Division and more specifically the BLC. 


   What many of you may not know, is that the BLC does not operate with any general fund budgets (allocated by the Governor and the legislature).  It is only supported by fees from the entities it surveys and licenses, and has to meet some mandated (either by the legislature or federal agencies) survey responsibilities.   It’s mission and purpose has always been facility survey and licensure, certification (of Medicare reimbursed facilities) and complaint investigations; and to protect the health and welfare of all citizens who reside in or access the facilities they license.  


   The scope of responsibility for this Bureau is huge, covering 33 different facility types and over 1073 facilities statewide, including hospitals, skilled nursing facilities, hospice agencies, ambulatory surgical centers, intermediate care facilities for the mentally retarded, home health agencies, personal care agencies, residential care facilities, homes for individual residential care and the list goes on and on……!  This bureau has approximately 65 employees and 29 surveyors trying to cover federally mandated inspections, as well as state legislated inspections.  A skilled facility survey, mandated by legislation and Medicare can take 4-5 surveyors a week of time.  This is just one of the 33 different facility types the Bureau surveys.  It doesn’t take a math genius to recognize there are only so many hours in a day and week to accomplish their tasks.


   So, let’s go back to some of the major changes now occurring in the BLC. 


   The first is a name change. January of 2009, the Bureau of Licensure and Certification will become the Bureau of Health Care Quality and Compliance (BHCQC). This will take some getting used to.


   Marla McDade-Williams, the new Bureau chief has also created more transparency with regard to the facilities surveyed, beginning August 2008. If you check on the website for the Health Division,  , and click on the link to the Bureau of Licensure and Certification it will take you to their web location. Once there look to the right and you will see a starred notice of “Facility Surveys”.  This is a new report of survey results for facilities under the Bureau’s licensure list and a wonderful opportunity to see how providers are doing.


   The next change will be the implementation of the “Grading System” for Residential Facilities for Groups. Effective January, 2009, at the completion of a facility’s annual survey, a grade of “A”, “B”, “C” or “D” will be issued and must be posted in the facility.    This system has been in regulations for 2 years, but will finally be available for the public to view as they select a facility.  The grade is a result of a total of the survey “scope and severity” deficiency scores accrued at the time of survey.


   Several supervisors within the BLC have been reassigned and several new Health Division entities have come under the prevue of the Bureau.  The whole intent of the changes within the Bureau is to create a fresh look at old issues, streamline some of the processes within the Bureau and generate consumer confidence.


   While change is not always easy and requires a learning curve, I remain impressed with the commitment of the Bureau  personnel to assure the public that they are listening to concerns and will provide the best oversight possible regarding the entities they license.


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