Maryland’s system to license nurses was broken. The $4 million fix didn’t help.

Two years ago, nurses from across Maryland trekked in person to a Northwest Baltimore storefront day after day in hopes of getting or renewing their licenses.

The state’s online system was bogged down, and no one was answering their calls. Things got so bad that state health department officials took over the independent Maryland Board of Nursing. New leadership came aboard, consultants weighed in, and recently, advanced technology was deployed.

But this summer, the complaints returned.

“The system didn’t recognize any of my information,” Brenda Mathews-Vitello, a veteran nurse practitioner, said when she tried to renew her license recently. “They weren’t answering the phone; they weren’t returning my emails.”

The state acknowledges that the new technology unveiled in June to “modernize” licensing has had hiccups. They said they are tackling problems with the $4 million system called the Centralized Health Accreditation and Registration Tool, or CHART, and officials are currently prioritizing other statewide boards that could roll out the licensing software.

“As with any new system implementation, we recognize that some users are experiencing challenges, particularly when registering for or logging into the system,” Amanda Hils, a spokeswoman for the health department, said in a statement.

Officials blamed a common problem: license holders without a current email address on record.

She said staff has been providing “individualized assistance” to applicants while the technical team addresses ”system enhancements and resolve reported issues.”

Hils said if applications are complete, they are processed in three days.

She suggested that applicants register for the system well before their licenses expire and consult the frequently asked questions and step-by-step instructional videos.

The board’s troubles go back years. Major delays in nursing licensing may have exacerbated staffing shortages that, according to the Maryland Hospital Association, leave one in five hospital nursing positions vacant.

Half of all Maryland’s health occupational licenses are issued by the board, and non-nurses have faced similar troubles. The board told the legislature in 2021 there were more than 9,000 applicants who waited at least 15 months for a certified nursing assistant or medical technician license, the highest backlog since 2005.

The latest problems didn’t go unnoticed by employers.

Jane Krienke, the hospital association’s assistant vice president for government affairs and policy, said the transition to the new licensing system has created challenges.

But she said in a statement that the association was “encouraged by the progress to modernize and create a more efficient licensing process.”

Mathews-Vitello knew to start the process weeks before her license was set to expire in July. She’s retired, but keeps up to date for humanitarian missions, and she had one planned in Vietnam.

With $1,000 in airfare and travel accommodations on the line, she drove an hour from her home near Annapolis to the Reisterstown Road Plaza.

She said it was hot and crowded and when she had to use the bathroom she was directed to the Home Depot across the parking lot, which would have cost her her place in line.

Mathews-Vitello thought her account would be ready to go after waiting for several hours. She said she immediately went outside, logged on, applied for a license and paid from her phone.

But the system said she hadn’t paid.

In desperation, she paid again. That’s because she learned she needed to renew her registered nursing license in addition to one for her more advanced nurse practitioner license. And she’d not paid for both.

To resolve the matter, she trekked back to the storefront where she heard others with similar frustrations.

“Unfortunately, despite assurances made more than two years ago that the board’s problems were being addressed, my recent experience demonstrates that little has actually improved,” she wrote in a letter to state lawmakers about the experience, citing The Banner’s coverage of previous issues.

One lawmaker who routinely logs complaints is the Senate’s lone medical doctor, Sen. Clarence Lam, a Democrat representing parts of Anne Arundel and Howard counties. He said the new technology doesn’t appear to have helped.

He said state lawmakers had sought a study last year of possible ways to restructure the boards, but the effort was unsuccessful.

“That study is still probably important because I’m not sure they’ve found the best and most efficient way right now,” he said.

In the meantime, nurses need licenses to work and care for patients. And Mathews-Vitello was able to renew — but not in time for her medical mission.

“Maryland continues to face a nursing shortage,” she said, “Yet it is allowing bureaucratic dysfunction to prevent qualified nurses from practicing.”