House oversight committee urges changes to State Board of Nursing after testimony on lapsed licenses and discipline

The Kansas House Select Committee on Government Oversight on Sept. 8 voted to send a set of recommendations to the Legislature and to the Kansas State Board of Nursing (KSBN) after several hours of public testimony alleging inconsistent discipline, long investigations and punitive use of consent agreements.

The committee’s work session, which included state board staff and more than a dozen nurses and family members who testified, focused on three recurring themes: failures in KSBN license-renewal communications and software, how KSBN disciplines nurses for lapses and other conduct, and the state-contracted monitoring program (KNAP) used in some disciplinary outcomes. The committee approved recommendations including a three‑month renewal grace period, modernization of renewal notices and digital alerts, and a review of consent‑agreement use. It also asked the board to review and report back on the specific cases raised in testimony.

Why it matters: Kansas relies on licensed nurses for rural and hospital care and testimony at the hearing tied KSBN practices — particularly how the board enforces unlicensed practice and the content and public reporting of consent agreements — to stress among nurses and, in several cases, financial hardship. Committee members said the panel’s recommendations are intended to reduce administrative errors that remove clinicians from the workforce while preserving patient safety.

Most important votes and next steps - The committee approved a package of recommended actions to the Legislature and KSBN. Among items passed: a recommendation that KSBN implement a three‑month grace period for license renewal and that KSBN modernize renewal notifications (digital/text/email) and provide clearer, step‑by‑step reinstatement instructions. The committee also asked the board to review the KNAP program and to audit its consent‑agreement policies and reporting practices. - The committee additionally directed staff to produce a consolidated, edited version of the recommendations and to ask KSBN for written responses and a review of the individual cases named during testimony.

What witnesses said and KSBN response - Dozens of people testified in two sessions. Several nurses described short renewal lapses (days to weeks) that led to investigations, consent agreements and placement on public disciplinary lists. Amy Bridal, a nurse who said she was taken to court by KSBN, told the committee that lawyers had advised practitioners to sign consent agreements because the legal and professional cost of a court case can be greater than accepting an agreement. “If the judge rules in my favor, the Board of Nursing can still bring action against my license,” Bridal said.

- Members of the public described harms they say resulted when nurses lost prescribing or practice privileges during disciplinary or verification processes. Michael Schomer described the impact on his adult son when a nurse he saw lost prescribing authorization during a KSBN process and the family had difficulty reestablishing continuity of care.

- Several nurses described long waits to get reinstated and poor communications from KSBN staff. Hospice nurse Erin Harris told the committee she discovered her license had lapsed by nine days, followed KSBN instructions, paid the reinstatement fee and then waited six weeks for her reinstatement. She said she had to hire an attorney and go on unpaid leave while the case was pending.

KSBN and staff responses - Carol Moreland, KSBN executive director, and disciplinary counsel Rachel Kenny Townsend described reforms the board has initiated: expanded automated notifications through the National Council of State Boards of Nursing systems, a task force to recommend changes to discipline policies, and a planned board policy on discipline for unlicensed practice. “We listened very closely about the concerns… and the board has had a couple of special board meetings to look at things,” Moreland said.

- KSBN provided the committee with a packet of documents: renewal and discipline metrics, 10‑year budget/expenditure summaries for health licensure boards, a packet of KSBN responses to the committee’s written questions, and lists of disciplinary orders and consent agreements. Staff said the board’s FY2024 ending fund balance was reported in KSBN materials and provided the committee figures for past fiscal periods.

Consent agreements, the KNAP program and reporting - Testimony raised repeated concerns about consent agreements (settlements that typically end disciplinary cases and are reflected in public records). Witnesses said they felt coerced to sign agreements to avoid lengthy legal fights, and several asked for limits on which kinds of incidents trigger public discipline reporting. The committee’s recommendations ask KSBN and the Legislature to restrict consent‑agreement use to matters involving clinical or willful misconduct relevant to patient safety and to require clearer disclosures when an agreement will be reported to national or state databases.

- Multiple witnesses criticized KNAP, the state‑affiliated monitoring program used in some cases, saying the program can require costly, lengthy monitoring even when assessments show no substance‑use or mental‑health disorder. Several witnesses described years of monitoring and costs that they said were disproportionate to the findings. The committee asked for a legislative and audit review of KNAP to examine costs, oversight and outcomes.

KSBN process and oversight concerns - Witnesses and several committee members urged clearer, standardized procedures for delegated board decisions (some investigative decisions are made by a single delegated board member to allow quick action on applications). Public board member Brenda Sharp described the investigative committee’s workload and defended the committee’s reliance on investigative summaries, but she acknowledged the need for consistent guidance to delegated members.

- Several legislators and witnesses asked for more peer review and mediation options early in the process, and for enhanced training for investigators. The committee recommended both: use of peer‑review/safe‑harbor frameworks for workplace assignments and expanded training for investigators to ensure clinical expertise is applied when reviewing clinical‑practice allegations.

What the committee recommended (high level) - A three‑month grace period for license renewal. - Modernize renewal communication: recurring automated digital notices (email/text), clearer step‑by‑step reinstatement instructions and a confirmation notice after successful renewal. - Review KSBN consent‑agreement practices and reporting (restrict use to clinical or willful misconduct relevant to patient safety; require disclosure of which state and federal databases would receive a report before a signature is sought). - Review KNAP (audit and legislative review of outcomes, costs, and oversight) and expand review of state contracts. - Ask KSBN to collect and report more granular performance measures (e.g., types of complaints, timelines for investigations and consent agreements, counts of reinstatements) and to review the specific cases raised in testimony. - Explore board governance changes and oversight (committee recommended the Legislature consider allowing some legislative appointments to the board and asked KSBN for a review of its rules and procedures).

Bottom line and next steps - The committee did not enact law; it approved nonbinding recommendations for the Legislature and directed KSBN to respond in writing and to review the cases raised in testimony. Several items will require statutory changes; those will be the subject of legislation should the House majority or board move forward. - Committee staff will deliver a consolidated, edited draft of the recommendations to committee members and will request a written response from KSBN on the specific cases that witnesses identified.

Ending: The committee’s action leaves open multiple next steps — legislative drafting, potential audits, and a KSBN review — aimed at balancing public protection and a more predictable, less punitive process for licensing and discipline.