Ohio state lawmakers passed six bills allowing healthcare professionals to enter into licensure compacts with national organizations that make it easier for Ohioans to work or provide services in other states and for qualified out-of-state workers to move to and work in Ohio.
State Sen. Kristina Roegner, a Hudson Republican, was the driver behind state Senate bills focused on removing "unnecessary and overbroad licensing regulation," which she contends erect barriers for healthcare professionals who cannot easily bear the costs or efforts of redundant state-by-state relicensing — a process, she adds, that also restricts access to trained physicians, nurses and therapists in underserved areas.
"People, when they learn certain skills don't forget them when they cross state lines," Roegner said. "When you get a driver's license in a particular state, you don't have to get a new license in each state to drive to Florida."
She said she's now determined to tackle Ohio's more than 650 different occupational licenses that she said are onerous for residents and deter licensed professionals from moving to the state.
Roegner was the primary sponsor or co-sponsor of Senate Bills 2, 3, 5, 6 and 7 — legislation permitting Ohio's enrollment in interstate compacts, which are formal reciprocity agreements between states. The compacts create a centralized database for the validation and recognition of professionals licensed in one state, allowing them to work without acquiring a new license in other participating states. The organizations also track any disciplinary-action license forfeiture and report it to all members.
"These bills get government out of the way of trained professionals doing their jobs," Roegner said.
Senate Bill 3, signed into law by Gov. Mike DeWine in July and set to take effect in 2023, allows Ohio nurses to apply to practice in all of the Nurse Licensure Compact's 34 states, while also allowing nurses from those states to move here without needing to obtain new certifications.
The Ohio Organization for Nursing Leadership originally opposed the bill, Roegner said. But after recommending some changes, the group eventually supported the legislation, which it said facilitates "telehealth care, home health, long-distance monitoring of patients, hospital follow-up care and the increased mobility of the nursing workforce."
Two similar laws took effect in June. Senate Bill 5 permitted the state to join the Physical Therapy Licensure Compact, which extends reciprocity privileges in more than 30 other states. Senate Bill 7, the Occupational Therapy Licensure, will offer the same rights to occupational therapists once the interstate professional licensing compact is formalized in 2024.
"Ohio is going to be one of the first states involved in the occupational therapy license compact, so we will be at the table for the initial rulemaking," Roegner said.
Another bill signed into law in late April, and co-sponsored by Roegner, authorizes Ohio's participation in the Psychology Interjurisdictional Compact, which regulates the practice of telepsychology and limited in-person, face-to-face practice of psychology across state boundaries for up to 30 days a year. The law, Senate Bill 2, was introduced by Theresa Gavarone, R- Bowling Green, and took effect in early August.
Ohio audiologists and speech-language pathologists also are permitted to join the Audiology and Speech-Language Pathology Interstate Compact and apply to work in another compact member state as result of the passage of House Bill 252 in June.
Roegner said the pandemic and a new reliance on telehealth helped demonstrate the need for flexible healthcare. During the pandemic, Ohio legislators enacted a series of emergency rules facilitating telehealth provisions for home health, hospice, dental and behavioral health practitioner services. Even with loosened telehealth rules, most medical professions are not permitted to consult with patients out of state if the treating physician is not licensed in the state where the patient resides.
"With telehealth, the nurse or the doctor can easily get on a Zoom or video chat and communicate with their patients across state lines easily," Roegner said. "That's really been a driving force and really helped push things along."
The medical license portability legislation was proposed as a means to strengthen access to healthcare for rural and underserved areas but has gained a sense of urgency during the COVID-19 pandemic when the need for healthcare providers increased.
"There are areas that are struggling (with COVID-19 Delta variant outbreaks) and could use physicians," said Dr. Baruch Fertel, an emergency medicine physician at the Cleveland Clinic and chair of the government affairs committee with the American College of Emergency Physicians Ohio Chapter.
The new laws are widely supported in part because of that emergency need, he said.
"Wouldn't it be convenient if there was an easy way for people to get licensed in different states? They would be able to go there to help out," Fertel said.
"It is all the same board certification," he added. "We all have the same standards to be a physician. This bill just makes a uniform process to apply."
Fertel and the Cleveland Clinic support Ohio joining the medical compact and the potential it provides to offer specialized care in underserved areas.
"There are a lot of areas that don't have emergency physicians and areas that don't have access to the full complement or levels of care needed, and if there are areas struggling, we need to allow telemedicine services to bring in the specialists and subspecialists," Fertel said.
Roegner is not done yet. In the fall session, she hopes to see more hearings and a possible vote on Senate Bill 204, which would create licensure portability for professional counselors with membership in the Counseling Compact.
She also is a primary sponsor of Senate Bill 131, a comprehensive licensure reciprocity bill that would permit any out-of-state licensee with two or three years of experience in their field to obtain an Ohio license to practice their profession. That bill is expected to have a third hearing in committee in June, she said.
In Ohio, nearly 18% of workers require a license for an occupation, Roegner said. It's not feasible to transfer those credentials, she said, which hurts the state's push for skilled workers.
"If we truly want to expand Ohio's workforce, we need to get these regulatory roadblocks out of the way," she said.