Good afternoon, members of the Board.

I am submitting this public comment to raise a broader accountability question concerning Virginia’s safeguards for students and the public when allegations involving licensed healthcare professionals arise within healthcare education.

Virginia Department of Health Professions Guidance Document No. 76-34 explains reporting requirements under Virginia Code § 54.1-2400.6 involving certain healthcare entities and practitioners regulated by Virginia health regulatory boards. The guidance identifies registered nurses and practical nurses among the professionals regulated by the Board of Nursing.

Importantly, the guidance identifies as a potential reporting trigger a determination by the responsible CEO, chief of staff, administrator, or director that there is a reasonable probability that a regulated practitioner may have engaged in unethical, fraudulent, or unprofessional conduct, as defined by the applicable licensing laws and regulations.

The guidance also demonstrates why documentation matters.

When the Department investigates an allegation of failure to report, its process may include reviewing relevant records, obtaining the organization’s rationale for not reporting, determining whether a reporting policy existed at the time of the event, obtaining that policy, and interviewing relevant witnesses.

That raises an important public-policy question for nursing education:

When concerns involving the professional conduct of a licensed healthcare practitioner arise within an educational institution, who is responsible for determining whether those concerns implicate mandatory-reporting requirements—and what documented safeguard verifies that the determination was actually made?

Students should not have to determine the answer to that question themselves.

Nor should accountability depend solely upon an institution reviewing its own conduct without a clear, documented pathway for determining whether an outside regulatory body must be notified.

I respectfully encourage the Board and the Department of Health Professions to examine whether Virginia’s existing guidance provides sufficient clarity for situations involving licensed healthcare professionals working in nursing and other healthcare-education programs, including clarity about which entities and officials have reporting responsibilities and how students or members of the public can raise concerns about possible noncompliance.

Accountability requires more than good faith.

It requires a process capable of documenting, verifying, and independently reviewing the decisions made under that process.

Thank you for your consideration.

Ashley Garrison