New interstate compact aims to address critical health care shortages

New interstate compact aims to address critical health care shortages

Universal licensing reform legislation currently being considered by Florida, Nebraska and other state legislatures — which would recognize out-of-state occupational licenses so that recently relocated workers can start earning a living and help address labor shortages more quickly — Shows how occupational licensing reform, one of the key policy trends of this decade, will continue through 2024.

Over the past five years, legislators and governors in nearly 25 states have enacted universal licensing reform (ULR) legislation, also known as universal licensing. The ULR’s rapid expansion was aided by its proven ability to garner bipartisan support and pass in both blue and red states. However, as lawmakers recently demonstrated in divided government Wisconsin, ULRs are not the only way state policymakers are addressing labor shortages by loosening regulatory barriers.

On January 16, members of the Wisconsin Assembly and Senate voted to finally pass Senate Bill 692, which would make Wisconsin the fourth state to join the Dentists and Dental Hygienists Compact (DDHC). By joining this interstate compact, Wisconsin legislators aim to increase the number of oral health professionals able to provide care to Wisconsin residents.

This new interstate compact is supported by the American Dental Association (ADA), the American Dental Hygienists Association (ADHA), the Association of Dental Support Organizations (ADSO), the Council of State Governments (CSG), and the U.S. Department of Defense. According to the official website of the Compact of Dentists and Dental Hygienists, its goal is to “create reciprocity among participating states and reduce barriers to license portability.”

The Interstate Compact has been used and proven effective in many other fields and professions, including many health care professions. There are already fifteen interstate compacts for other licensed occupations.

“Since January 2016, states have passed 170 separate pieces of licensing compact legislation,” said the National Interstate Compact Center. “To date, 42 states and territories have developed occupational licensure compacts for nurses, physicians, physical therapists, emergency medical technicians, psychologists, speech therapists/audiologists, occupational therapists and counselors.”

“As occupational licensing requirements increase, so does interest in interstate compacts,” wrote reporter Anthony Henney, who has covered pending DDHC legislation in Pennsylvania, Ohio, New Jersey and elsewhere. “According to the National Conference of State Legislatures, approximately 25 percent of the U.S. workforce now must obtain a work permit, compared with 5 percent 60 years ago.”

The number of states joining DDHC is expected to continue to climb in the coming weeks and months. That’s because DDHC legislation is also currently under consideration and advancing in Missouri and Kansas statehouses.

On January 18, Missouri senators held a committee hearing on the DDHC bill (Senate Bill 778) and subsequently voted to recommend passage of the bill. Kansas lawmakers followed suit, holding a hearing on Jan. 25 on House Bill 2453, which would add Kansas to the DDHC.

As of November 2023, more than 590,000 people in Kansas lived in one of the state’s 174 dental health professional shortage areas, according to the Kaiser Family Foundation. Meanwhile, in Missouri, more than 2,000,000 people live in one of the state’s 338 official dental care shortage areas.

Given the dental health care shortages faced in many areas of the country, coupled with the connection between oral health and overall health, more states are expected to join the Dentist and Dental Hygienist Compact in the coming months and years.

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