BRN executive officer reports 56 IEC reviews, clarifies work and narcotics guidance for nurses in recovery

Loretta Melby, executive officer of the California Board of Registered Nursing, told the board on Aug. 21, 2025, that 56 Intervention Evaluation Committee (IEC) recommendations have been sent to her office for review, 19 have been approved and 31 have been returned to IECs for reconsideration.

The reviews grew out of a board motion to reassess IEC recommendations that required intervention participants to complete direct patient care hours and to be permitted to pass controlled substances. "Direct patient care is not required. Working as an RN may be required, but direct patient care is not required," Melby told the Board.

The clarification matters because IECs across the state had reached differing conclusions about whether nurses in recovery must return to the exact clinical setting where the conduct occurred. Melby said the committee focus should be on recovery and safety rather than a blanket requirement that participants return to a high‑risk direct patient care role. "What the IEC really needs to focus on is how are they doing on recovery, not how are they doing on recovery and are they able to pass narcotics?" she said.

Melby described operational challenges that slowed consistent implementation. The board has nine IECs; under the Bagley‑Keene Open Meeting Act training or group briefings would have to be publicly noticed and could require dozens of committee members to meet in one place. "We would need 3 members of each of the 9 committees, which would be 27 people to be in 1 location at 1 time," Melby said, calling it a "scheduling nightmare." To address the training gap, staff will begin allotting 30 to 45 minutes at the start of each IEC open session so Melby or other board staff can provide education to that committee.

Melby also summarized program statistics and statutory timing. Of the 56 reviews sent to her office, 14 involved reviews that extended beyond three years. "The law is 3 to 5 years," she said, adding that national evidence cited by the National Council of State Boards of Nursing shows recovery often spans a longer period: "statistical evidence based data says it's about an 8‑year process for recovery." Melby said participants who successfully complete the program may re‑enter if they relapse later and reapply to the program.

Board member Patricia Wynne noted that only 14 of the 56 cases reviewed exceeded three years, and Melby explained that staff had begun corrective work a year before the EO's formal review, reducing the backlog. Melby said many of the cases that exceeded three years did so by months rather than years, often to allow time for missing evaluations or additional clinical information.

Melby said the IECs will continue to use worksite monitors and phased returns (part time progressing to full time) where appropriate. She reiterated a caveat that passing narcotics should be required only where there is evidence of patient harm or a clear safety risk.

The board also heard that the BRN is participating in an NCSBN (National Council of State Boards of Nursing) pilot to gather longer‑term data on recidivism and outcomes, and that staff will bring regulatory and operational proposals back to the board after additional IEC education is provided.

Melby said she plans to continue attending IEC meetings and that staff will report on the program as the new education approach is implemented.