A report by the Texas Sunset Advisory Commission seeks to focus on "areas of true state interest" by eliminating 15 occupational licensing programs that, according to the Commission, could be deregulated with "little impact on public health safety."
The report addresses four primary questions in assessing the necessity and legitimacy of occupational licensing programs:
• Does the program serve a meaningful public interest and provide the least restrictive form of regulation needed to protect the public interest?
• Could the program's regulatory objective be achieved through market forces, private certification and accreditation programs, or enforcement of other law?
• Are the skill and training requirements for a license consistent with a public interest, or do they impede applicants, particularly those with moderate or low incomes, from entering the occupation?
• What is the impact of the regulation on competition, consumer choice, and the cost of services?
Certain programs, the Commission states in the May 2014 report, “distract DSHS (Department of State Health Services) from its primary public health responsibilities and would be better placed at the Texas Department of Licensing and Regulation (TDLR).” Among programs facing elimination are those regulating opticians, respiratory care practitioners, dyslexia therapists, dietitians, and x-ray technicians.
Licenses are not needed for occupations like X-ray technicians, according to the Commission, since such technicians operate in highly regulated environments. Professions operating in healthcare facilities are already “subject to numerous federal and state requirements, including separate regulation of the machines themselves, have private accreditation programs, and work in conjunction with several other highly trained healthcare professionals,” the report stated.
Another reason for deregulating and transferring occupational programs is the fact that fewer healthcare facility inspection are conducted, due to the licensee population’s having doubled from 2002 to 2012, the Commission says.
As a result, when inspections should occur every two to three years according to the report, many facilities now operate for up to “eight years without receiving an inspection from state regulators.” Eliminating many programs becomes a necessity for proper safety and functionality, the Commission believes.
The Commission’s report projects that the recommended deregulation will result in elimination of more than 55,000 licenses, along with an estimated loss to the General Revenue Fund of $1.6 million per year until 2020.
A two-phase transfer plan, the Commission proposes, would move certain additional occupational programs to TDLR (Texas Department of Licensing and Regulation). The first phase would transfer six programs (chemical dependency counselors, fitters and dispensers of hearing instruments, marriage and family therapists, orthotists and prosthetists, professional counselors, and social workers) from DSHS to TDLR between September 1, 2015 and August 31, 2017.
The second phase would transfer six more programs between September 1, 2017 and August 31, 2019 (athletic trainers, laser hair removal, massage therapists, midwives, sanitarians, and speech-language pathologists/ audiologists).
Despite the recommendations for deregulation, increased regulation in some programs is needed, according to the report. The Commission makes several recommendations concerning EMS (emergency medical services) to increase protection against criminal and fraudulent behavior:
- Require an EMS provider to have a physical location for its business establishment to obtain a license;
- Authorize DSHS to require jurisprudence examinations for all EMS licensees;
- Expand DSHS’ authority to verify the license status of EMS providers;
- Require all local registrars to submit a self-assessment report to DSHS annually;
- Develop a formal desk audit policy and increase the use of desk audits in monitoring local registrars’ offices;
- Expand DSHS’ authority to require fingerprint-based criminal history background checks for anyone with access to the state’s electronic registration system. “DSHS should work with licensing agencies such as the Texas Medical Board to verify the status of individuals who have passed a fingerprint-based background check as part of their licensure requirements, and could accept proof of current licensure as meeting this requirement.”