Contractor Horn helped BRN clear RN licensing backlog, cut processing times dramatically, staff say
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Summary
A Department of Consumer Affairs contract with Horn LLP sped California registered-nurse licensing by clearing a backlog of nearly 7,800 applications, approving more than 10,000 licenses and introducing a concierge review service and a Power BI reporting tool, presenters told the Board of Registered Nursing May 28.
A contractor hired under a Department of Consumer Affairs (DCA) grant helped the California Board of Registered Nursing (BRN) eliminate a long-running backlog of endorsement applications and sharply reduce licensing processing times, a BRN presentation said.
Cindy Wolston, identified in the meeting agenda as the presenter of the DCA post-contract report, told the board the Horn LLP contract helped clear a backlog of 7,798 registered-nurse applications and resulted in the approval of 10,045 nurse licenses as of Dec. 31, 2024. “Processing times for out-of‑state endorsement applications reduced from 174 days to 52 days,” Wolston said, citing Horn project figures; she said out‑of‑state exam processing fell from 77 days to 19 days for applicants from schools with an NCSBN school code.
The changes stemmed from a DCA award of HCAI (Department of Health Care Access and Information) general‑fund monies intended for workforce initiatives. The BRN received a reduced allocation of $3,750,000 (down from an originally planned larger amount), Wolston said; about $2,350,000 funded the Horn contract and roughly $1,430,000 supported reassigned DCA staff. Horn’s work is projected to come in under budget and about $1.2 million will revert to HCAI, she said.
Why it matters: the licensing improvements affect how quickly newly licensed nurses — including nurses endorsing their California licenses from other states — can begin work in California hospitals and clinics. Board members praised the project at the meeting as an example of process and technology investment improving licensing performance.
What Horn did: Wolston described three major deliverables the contract produced. First, a concierge application‑review service that performed an early, proactive review of applications and contacted applicants by phone and email to obtain missing documents. That service, Wolston said, “helped obtain missing information and documents required to complete the licensure process in a faster time frame.” She said BRN staff adopted a similar concierge model prior to Horn’s contract expiration.
Second, Horn delivered an enterprise reporting and analytics system (ERAS) built on Power BI that provides data refreshed throughout the day for supervisors and managers. Wolston said the tool replaced an earlier large overnight report that sometimes crashed systems and that DCA is working to increase refresh frequency to multiple times per day.
Third, Horn recommended and helped stand up a licensing quality‑assurance (QA) function. Wolston said Horn formed an independent QA team to audit samples across application types and statuses; BRN staff are researching how to implement a sustained QA team within current fiscal constraints and are retraining some internal staff to begin smaller QA work immediately.
Board reaction and context: Lisonbee Cormack, a BRN board member, told staff the tool and the contractor’s approach appeared to deliver sustained improvements: “When you look at that graph from October 2023 to December, you can see the dramatic achievements.” Trisha Winn, another board member, praised BRN licensing staff for adopting Horn’s recommendations and implementing the concierge service before the contract ended.
Limits and next steps: Wolston said some applications were abandoned rather than completed and that the Horn team audited and removed abandoned files from the backlog. She also said the QA rollout will begin on a small scale because hiring new positions is difficult given current fiscal constraints. The DCA and BRN will continue to refine ERAS and the concierge model, Wolston said.
Discussion vs. decision: the presentation was information only; the board took no formal action on the Horn contract or its findings during the May 28 open meeting.
For follow up: board members asked staff to continue reporting on post‑contract QA staffing, ERAS performance, and whether the licensing improvements are sustained in the months after contractors depart.
