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BRN reports contractor-led overhaul cut RN licensing backlogs and processing times
Summary
Board staff told the Board of Registered Nursing that a Department of Consumer Affairs contract with Horn LLP cleared a large endorsement backlog, sped approvals and left new tools and procedures for continuing improvements.
The California Board of Registered Nursing on May 28 received a post-contract report showing a private contractor and DCA staff cut a backlog of endorsement applications and reduced processing times for out-of-state applicants.
The report, presented by Cindy Wolston and Yvonne Leonard Taps of BRN staff, said the Department of Consumer Affairs (DCA) awarded Horn LLP a contracted engagement after a general-fund allocation from the Health Care Access and Information (HCAI) workforce initiative. Horn worked on licensing workflows, introduced a concierge applicant-contact model, built a Power BI dashboard (ERAS) for near‑real‑time workload data, and helped create a quality-assurance approach for licensing reviews.
Wolston said the HCAI award to DCA was originally $10 million across multiple years but was reduced; $3.75 million ultimately funded the BRN effort and Horn’s contract. Horn began onsite work in mid‑October 2023 after fingerprinting requirements delayed the start and the contract term ran through December 2024, Wolston said.
According to the presentation, Horn licensed or approved 10,045 nurse applications and cleared a backlog of 7,798 endorsement applications that had accumulated after a 2022 surge of out‑of‑state endorsement filings. Processing times for out‑of‑state endorsement applications fell from 174 calendar days to 52 days on average; out‑of‑state exam‑applicant processing fell from 77 to 19 days where school codes were already established. The report said some applications were abandoned, and Horn helped identify and remove those from the backlog.
Wolston and staff described the “concierge” approach as proactive application triage: evaluators review an application, contact applicants by phone or email to obtain missing documents, and follow strict timelines for outreach. BRN staff said they implemented a similar concierge service before Horn’s contract expired.
The Horn team also built ERAS, a Power BI tool that provides refreshed licensing metrics during the day. Staff said ERAS replaced a heavy batch report that previously had to run in early morning hours and sometimes crashed systems. The project also prompted creation of a dedicated QA function; BRN said it is now developing an internal, scaled QA pilot for licensing given current fiscal constraints.
Board members praised the partnership in questions that followed, describing the work as a long‑term improvement rather than a temporary fix. Board member Allison Cormack noted a clear performance curve between October 2023 and December 2024. Wolston and staff said remaining steps include refining daily data refreshes and scaling a quality‑assurance team as resources permit.
Staff cautioned that some of the HCAI funding will revert to HCAI because not all originally projected funds were spent. Wolston closed by saying the contract work was “a historical event” for DCA and BRN and that staff hoped future investments would follow similar models.
The presentation was information only; there was no board motion tied to the report.
