The Intervention Evaluation Committee of the California Board of Registered Nursing heard an update Oct. 8 from Loretta Melby, the board's executive officer, on recent reviews of requests that intervention program participants be allowed to work in direct patient care or to handle narcotics, and on requests to extend participation beyond three years.

Melby said the board in August moved to suspend imposition of requirements that participants work in direct patient care or pass narcotics-handling duties "unless there's additional evidence of patient safety." She told committee members she has reviewed recommendations referred from IECs since that motion and is checking for evidence supporting any requests that would alter the board's suspension.

"My goal is not to overturn the motion. My goal is not to change the motion, but to simply review that we have evidence there to support to those requests," Melby said.

Melby reported she reviewed 56 IEC recommendations tied to (1) requiring participants to work in direct patient care, (2) requiring participants to pass narcotics, or (3) extending program participation beyond three years. Of those 56, she said, 19 recommendations "were approved" because evidence supported them; 31 were referred back to IECs to gather more evidence or to be altered because supporting documentation could not be found. She also said 22 of the reviews occurred in the first three months of the review period and that the board will provide updated information in November.

Melby framed the board's approach as rehabilitative: the board "believes that the intervention program is here to rehabilitate the nurses that have been affected by substance use disorder or mental health issue," and that many participants "were competent nurses" before the incidents that led them into the program.

Committee chair duties were conducted by Vice Chair Glenda Lando during the meeting. Members asked no questions during Melby's update; Melby invited committee feedback and said she would continue to attend open-session IEC meetings to provide background and accept questions via email.

The committee also received routine staff updates. Board staff and Premier Health Group are attending IEC meetings to provide education and identify regulatory gaps; staff reported outreach materials were distributed to individual nurses this quarter and that the board is updating outreach brochures and posters. The regulations governing IEC procedures were identified for committee reference as California Code of Regulations, Title 16, sections 1446'through 1449.

Votes at a glance

- Motion to approve IEC meeting minutes from July 16, 2025: Moved by Glenda Lando; seconded by Elizabeth Clark. Roll-call votes: Glenda Lando ' yes; Elizabeth Clark ' yes; Dave Granovetter ' yes. Outcome: approved.

- Motion to approve proposed 2026 IEC meeting schedule: Moved by Glenda Lando; seconded by Dave Granovetter. Roll-call votes: Glenda Lando ' yes; Elizabeth Clark ' yes; Dave Granovetter ' yes. Outcome: approved.

Closed session

The committee recessed to closed session at 9:23 a.m. "pursuant to Business and Professions Code section 2270.1 and Government Code section 11126, subdivision (c)(2)," the committee announced, to discuss and vote on matters related to intervention program applicants and participants. The committee reconvened in open session and announced quorum thereafter; no actions taken in closed session were reported in open session minutes provided in the public transcript.

Why it matters

Decisions about whether intervention program participants may return to direct patient care or handle controlled substances directly affect patient-safety risk, the occupational futures of nurses in the program, and the oversight burden on the board and IECs. The board's review process and its request for evidence before imposing work-related requirements aim to balance rehabilitation goals with safety considerations. Melby's report indicates many IEC recommendations lacked documentation sufficient to meet that standard and were sent back to IECs for further information.

What comes next

Melby said the board will provide an updated report in November. Committee members were asked to continue reviewing IEC guidance and to raise regulatory-change suggestions where the IECs identify gaps.