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Can one size fit all? 65% of survey respondents either neutral or negative on value of universal licensure recognition

Reporting in January on a new survey of licensing officials in states that recently adopted Universal License Recognition (ULR) or related license portability policies, the Council of State Governments found no majority consensus that ULR is valuable and concluded that a one-size-fits-all solution may not be enough to enhance licensees’ ability to engage in interstate practice.

“Thirty-five percent of respondents either agreed or strongly agreed that the universal recognition policy has positively contributed to the state’s workforce. However, 55% of respondents were neutral,” the report notes. Ten percent disagreed.

Universal License Recognition policies apply endorsement or reciprocity provisions across multiple professions to ease and speed licensing of practitioners moving into a state. Eighteen states adopted some variety of these policies between 2018 and October 2021, and CSG surveyed license officials in seven of them: Arizona, Colorado, Idaho, Iowa, Missouri, Montana, and Pennsylvania. Some of the survey results:

• Asked if they agreed that the universal recognition policy has positively contributed to the state’s workforce, 35% said they agreed, 10% disagreed, and 55% were neutral.

• Among those expressing neutrality, many felt there was no need for a ULR policy because the same mechanisms were already in place with the licensure process. A few noted that changes to their state’s online platform were necessary to implement ULR policy, putting “burdens on boards to overhaul information technology and website systems for increased traffic from out-of-state practitioners.”

• Some negative respondents noted their state’s ULR policy requires applicants to first establish residency in the state, which discourages many from utilizing the process. One said the process was made more confusing for applicants and one believed the policy led to licensing people from other states with lesser requirements and qualifications, including different scopes of practice.

• Some respondents who were neutral mentioned the only challenge was determining the competency standards to use when evaluating out-of-state licensees. In one profession, some six states, in response to inquiries, are refusing to verify that out-of-state applicants do not have pending complaints or investigations, one respondent said.

• Many positive respondents stated the pandemic increased the need for licensed professions and thus increased the need for portability and telehealth.

The CSG report noted that one of the primary concerns for board members surveyed was the lack of need for a ULR law. Several respondents said that existing reciprocity agreements and licensure by endorsement policies made an additional pathway for out-of-state practitioners unnecessary.

“ULR policies allow states to reduce barriers to licensure for out-of-state professionals already licensed in another jurisdiction. However, the burden of implementation and use by practitioners could be eased through the inclusion of clearer language to determine substantial equivalence, digitized licensing sys-tems, and provisions to explicitly exclude interstate compacts,” CSG concluded.

“Enhancing the ability of practitioners to engage in interstate practice requires more than a one-size-fits all approach. States should account for industry-tailored reciprocity mechanisms such as interstate compacts when crafting universal recognition laws.”