Lawmakers Say Consistency, Efficiency Needed In Boards Licensing Health Professionals

By Bryan P. Sears, Maryland Matters

October 24, 2025

A legislative panel on Wednesday signaled an interest in making changes to dozens of professional oversight boards housed within the Maryland Department of Health, after complaining of a lack of accountability and repeated findings on the boards by auditors.

Members of the Joint Audit and Evaluation Committee noted that some findings by their audit team go back decades. Legislative Auditor Brian S. Tanen said the findings, published in April, point to a lack of accountability when it comes to boards rectifying deficiencies found in previous audits.
In two cases, the findings were more than 20 years old.

“One board implements, another one doesn’t. It becomes challenging, because each one of them are sort of responsible for setting up their own controls in each of the areas that are put in this report,” Tanen said. “Sometimes they get together … and address some of the controls or some of the processes.”

Tanen said there is “no one single person” who is responsible or accountable for the plethora of findings, which is both challenging on our end and, importantly, for the department in implementing the recommendations.”

The majority of the boards are technically independent. Even though they are housed within the state health department, the agency and its leaders have little to no oversight role.

Legislative Auditor Brian Tanen. (File photo by Bryan P. Sears/Maryland Matters)

Tanen’s office issued a report in April detailing problems within 20 different boards and commissions that oversee and license health care facilities and practitioners including nurses, pharmacists, dentists and others.

Among the findings of the report, which covered the period from September 2019 to July 2023, was that the agencies often failed to investigate complaints against licensees in a timely manner — a problem the auditors said could be due to staffing shortages during that period.

“There are some that do run well, and there are many that do not,” said Sen. Shelly Hettleman (D-Baltimore County), the co-chair of the joint audit committee. “I think it is worth taking a deep dive to figure out where those holes are because we’ve had a history of there being so many problems. Look at the Board of Nursing. We don’t want other boards to hit bottom before we actually put in a system.”

The report said that the 20 boards and commissions it studied had a total of 4,916 open cases as of February 2024, but that 3,051 of those had been open for more than two years. The Board of Nursing, the largest by far of all the boards, had 2,411 cases that had been open for more than two years, it said.
Included in the list of findings was a patchwork of policies regarding criminal background checks for professionals seeking state licensure.

Auditors found six boards that do not require any criminal background checks to obtain a license. Ten others do not get alerts on criminal activity involving licensees.

Auditors matched individuals licensed by the pharmacy and dental examiners boards with criminal conviction records. They found 16 licensed dental professionals and 14 licensed pharmacy professionals who had been convicted of a crime.

Two of the dental professionals were convicted of assault which should have triggered a one-year suspension of their licenses, auditors said.

Hettleman and Del. Jared Solomon (D-Montgomery), House co-chair of the committee, said they were immediately concerned with having a consistent policy on criminal background checks.

Del. Jared Solomon (D-Montgomery) and Sen. Shelly Hettleman (D-Baltimore County) co-chair the Joint Audit and Evaluation Committee. (File photo by Bryan P. Sears/Maryland Matters)

“The board of pharmacy — you’re not doing background checks on pharmacists? I mean, come on,” Hettleman said. “That needs to happen.”

Auditors also raised concerns about the Board of Nursing.

A 2023 federal investigation into fraudulent nursing credentials found 287 people who may have used a scheme to obtain a license in Maryland. Auditors said the board could not document that it had investigated 259 of those individuals, 131 of whom were working in Maryland facilities. Six of those worked in state-run facilities.

The audit also found that roughly 3,600 of 4,900 licensing complaints to various boards remained open for two years. One allegation of sexual abuse received by the Board of Nursing in December 2021 had not been investigated as of February 2024.

Auditors also identified issues common to a lot of boards related to handling payments and other functions that are duplicated across all the boards. Tanen suggested the boards might benefit from “efficiencies” that come from centralizing some of those duties.

“We could look within the state, and the model that the Department of Labor has for their occupational professional licensing,” Tanen said.

Members of the committee seem keen on exploring that idea.

“At the end of the day in a time when we’re making government work better for the state, for our residents, for the practitioners, we have to figure out how we get the inefficiencies solved to make these systems work better, to make everybody’s life easier,” Solomon said.

“Some of this is efficiency and again, figuring out where those holes are to (Hettleman’s) point and how we can, we can fix those and patch them, but also some system of accountability,” Solomon said.
Sen. Clarence Lam (D-Howard and Anne Arundel), a licensed physician, agreed with the need for reform but said the effort was too large to undertake without a more formal review.

Sen. Clarence Lam (D-Howard and Anne Arundel). (File photo by Bryan P. Sears/Maryland Matters)

“I’m thinking potentially we may have to have a study done, or as you saw, there was one of the boards that had an outside consultant brought in to do a complete look-over and give us recommendations,” Lam said.

Initially, Lam and other lawmakers said they believed that review was being conducted by former Health Secretary Laura Herrera Scott.

Scott left earlier this year. Health department officials were unable to provide an update on the review or if it was mothballed since Scott’s departure.

“I thought that’s what the secretary was doing before she left, but now it looks like it didn’t go anywhere, or the knowledge wasn’t handed off to someone else,” Lam said.

“And so here we are, but I think we may need someone to be dedicated to this effort,” he said. “This is complicated. There’s a lot of health occupations. How do we come up with a good plan and structure? Sounds like a good consulting project to do? That’s what management consultants do.”