Nearing its fifth birthday, California's stem cell research institute is now an established state agency and a major force in biomedical science.

Since its inception through a 2004 ballot initiative, the institute has distributed more than $700 million in grants, making it the world's largest financier of embryonic stem cell research.

Yet being established and being mature are two different things. For far too long, this institute and its leadership have been secretive, defensive and unwilling to acknowledge a flawed management structure, the legacy of a flawed ballot initiative.

Maturity involves being able to consider outside criticism and engage in self-evaluation. Sadly, the leaders of the stem cell institute have developed a bunker mentality that continues to hurt the agency's mission.

The institute's reaction to a recent report by the Little Hoover Commission is the latest demonstration.

An independent oversight board created by the Legislature, the Little Hoover Commission was tasked last year by former Sen. Sheila Kuehl and Sen. George Runner to examine the California Institute for Regenerative Medicine. This is the name for the stem cell agency that voters created in 2004 to distribute nearly $3 billion in grants for research and laboratory construction.

In its report and an accompanying letter by chairman Daniel Hancock, the Little Hoover goes out of its way to praise the mission of CIRM, with Hancock noting that California "has made an investment in innovation that is the envy of the world."

Yet the report goes on to detail many of the deficiencies in the agency's structure that this page and other observers have noted. In particular, the Little Hoover Commission concluded that the institute's 29-member oversight board is overly large and unwieldy, and should be reduced to 15 members. It also recommends an appointment process that would result in fewer board members whose employers stand to benefit from research grants.

"Criticism that CIRM's governing board remains an insiders' club undermines the legitimacy of the agency," the report states. "Some 80 percent of the funds to date have been awarded to institutions with representatives on the (oversight board)."

The Little Hoover Commission also notes the need to rewrite the job description and appointment procedures for the institute's chairman. The current chair is Robert Klein II, who wrote the 2004 ballot initiative so that he, and only he, would serve as board chairman, and have unusual management authority normally given to an institute's chief executive officer.

Such a governance structure, with key positions created for specific individuals, "does not serve the best interests of the mission of the agency or the state of California," the report states. "Such a situation distorts accountability and succession planning."

The commission's report urges a more transparent process for reviewing grant proposals. Connecticut, the report notes, has operated its stem cell institute in a more transparent fashion, with no apparent impact on the number of applicants seeking funds.

If adopted by CIRM and the Legislature, these recommendations and others could go a long way toward helping the stem cell institute operate more effectively, with greater accountability of taxpayer dollars. Yet instead of taking a few days to absorb the report and discuss it with his board, Klein immediately dismissed it in a press release.

The agency's spokesman dismissed the Little Hoover's process as "ludicrous," and Klein threatened a court challenge if the Legislature attempted to act on the recommendations.

Fortunately, Klein is just one of 29 members of the institute's oversight board. Many others are distinguished academics and patient advocates who have greater candor, and less pride of parenthood, in acknowledging CIRM's flaws.

Now is the time for their voices to be heard, in public meetings, as the institute approaches its five-year mark.

The Little Hoover Commission's report and other documents can be found online at www.lhc.ca.gov/.