California's Little Hoover Commission, which investigates government agencies and focuses on efficiency, is out with a thoughtful new report on the state's stem cell agency and its governing board.

The report concludes that the board of the California Institute for Regenerative Medicine (CIRM) is too large and that the initiative that created the agency, Prop 71 in 2004, is "overly prescriptive" and locks in place too many inefficiencies. I reported as much last month in the Scientific American.

Among the major recommendations, from a summary released by Little Hoover:

The California Institute for Regenerative Medicine -- the state's stem cell agency -- was created by Prop 71, and is still governed under its rules. For more than six months, the Little Hoover Commission -- a California body that studies government structure and reform -- has been investigating CIRM, which has struggled with governance issues. (I reported on this last month in the Scientific American).

Last week, Little Hoover staff disclosed some of its preliminary recommendations for changing the agency, as reported at the California Stem Cell Report. At first blush, the proposed changes, which have not been formally released, make sense to me. Reducing the size of the board. Concentrating executive power in one official of the agency (currently, the president and the board chair share executive power). And changing the quorum rule, which often has hamstrung the agency's board.

The difficult part will be enacting such measures. It's far from clear that the board has the power, or inclination, to make these changes. Under Prop 71, making changes to the agency requires a 70 percent vote of the legislature (or another vote of the people). Neither will be easy to achieve.