When Marylanders go to the doctor or see a nurse, they expect that the professionals treating them have been properly vetted by state officials, and their facilities meet health and safety standards.
But after state audits reported inadequate response times by some licensing boards to complaints about licensees, and other boards that were behind on annual inspections of healthcare facilities, lawmakers responded with a new commission to iron out the challenges contributing to those oversight issues.
After an organizational meeting this summer, and a second where board directors laid out the issues they are facing, the Maryland Health Centralization Commission met virtually on Monday to discuss the first of those issues, information technology challenges.
The commission has until Dec. 1 to report on ways to improve “efficiency, transparency and accountability” of the occupational licensing boards, a report that will be required annually thereafter.
“Everyone comes into these commissions with the end goal of doing good and right … so far in our two meetings, I’ve learned a lot of positives,” said Del. Anne Kaiser (D-Montgomery), co-chair of the commission, which includes members of the state health department and executive directors of a number of licensing boards.
I hope to get to a point where people are willing to share maybe some of the negatives … so there could be opportunities to learn best practices from each other,” she said. “But that will never happen if someone doesn’t say, ‘Hey, we’re struggling with this or that.’”
In Maryland, 20 state occupational boards oversee health professions, each operating differently and each facing their own set of problems and possible solutions. But common challenges involving information technology, inadequate staffing levels and other issues will help inform the commission’s work going forward.
Kaiser is currently the sole leader of the commission, as the Senate has not named a senator to serve as the other co-chair.
The commission was created this year under House Bill 1372 to improve operations at health occupation boards, ensure that boards issue licenses, respond to complaints and conduct required facility inspections in a timely manner. It’s related to a larger legislative push to crack down on audits that repeatedly identify the same issues in oversight and fiscal documentation of state agencies.
A 2025 report by the Office of Legislative Audits found several issues at various occupational boards, including delayed investigations of complaints against licensees and backlogs of annual inspections at various healthcare facilities.
The boards’ focus spans healthcare fields and related industries, overseeing the licensing of physicians, dentists, long-term care facility administrators, psychologists, morticians and funeral directors. Other boards cover fields such as social work, acupuncture and occupational therapy, among others.
During Monday’s meeting, Board of Nursing Executive Director Rhonda Scott noted that high educational requirements in Maryland, while important to ensuring that healthcare professionals create safe environments, can also slow down licensing approval.
Scott also referenced the FBI’s Operation Nightingale, a Florida-based fraud scheme investigation announced in January 2023 by the U.S. Department of Health and Human Services Office of Inspector General. That probe linked three Florida nursing schools to bogus nursing degree diplomas and transcripts sold to aspiring registered nurses and licensed practical/vocational nurses so they could qualify for the national nursing board exam. More than two dozen nursing license applicants in Maryland were implicated.
“Yes, timeliness is important, but safety is paramount,” Scott said. “We have to make sure our review is conducive of public protection and ensuring these people are actually qualified to be licensed.”
Christine Farrelly, executive director of the Board of Physicians, said that communication challenges from the Maryland Department of Information Technologies also contributed to computer system delays, which can be “very, very frustrating.”
Tiffany L. Smith-Williams, executive director for the Maryland Board of Acupuncture, noted that some boards are working to improve their legacy computer systems, but need more funding to upgrade those antiquated technologies.
“Sometimes we stretch the dollar or the value of what we have, because it helps us control cost,” Smith-Williams said.
Kaiser said in an interview last month that the work of the commission is needed.
“These professional boards have a great responsibility to ensure that our licensed medical professionals across the state meet certain standards,” she said. “They also deal with discipline and other measures…. We, the legislature, can’t sit on the side when we’ve been told for years that the board needs better oversight.”
The issue of funding for occupational licensing boards and fees for licensing will be the focus of the next commission meeting, slated for mid-October.
“Hopefully, I have a Senate co-chair by then,” Kaiser said.
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