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Task force would tackle Oregon health care licensing delays

Legislation intended to provide a short-term fix for staffing shortages has turned into an effort to dig into oft-cited problems in Oregon’s certification agencies
State Rep. Ed Diehl, R-Scio, shown at the Oregon State of Reform Health Policy Conference on Nov. 14, 2023 in Portland. Diehl is sponsoring a bill to overhaul the state’s health care professional licensing process. (Left) State. Rep. Rob Nosse, D-Portland, and (right) Rep. Thuy Tran, D-Portland. | JAKE THOMAS/THE LUND REPORT
February 22, 2024

Oregon lawmakers have dropped an effort to give out-of-state health care workers temporary licenses in favor of a proposed new task force to streamline health care licensing. 

The House Behavioral Health and Health Care Committee on Monday reworked  House Bill 4071, which is intended to hasten the licensing and hiring of needed health care workers. State Rep. Ed. Diehl, R-Scio, said he sponsored the bill after hearing of “hundreds of examples” of the state’s licensing boards keeping qualified people from jobs due to approval or confusing requirements.

“I think every legislator that has connected with healthcare in any way knows that our licensing process needs to be modernized,” he told Oggys Online. 

The original bill would have required the state’s health professional licensing boards to issue temporary licenses to applicants who are licensed in other states with similar requirements and are in good standing. The applicant would then have a year to complete Oregon’s licensing requirements. 

Oregon’s health care providers, unions, lawmakers and others have broadly recognized the state faces a shortage of health care workers. But the bill sparked criticism as well as concerns, including  from the state’s licensing boards. 

Nicole Krishnaswami, executive director at Oregon Medical Board, told the health committee last week that the bill would weaken scrutiny of applicants’ records. 

“Applicants with a history of impairment in the workplace or long periods of time since they last practiced clinically would be able to enter our state without any ability for the boards to put protective measures in place and ensure that they transition into Oregon safely,” she testified. “As a result, the opportunity for predatory providers to come in undetected drastically increases.”

The committee on Monday voted for an amendment to the bill to remove those provisions and instead set up a 20-member Task Force on Health Professional Licensing Modernization. The task force’s members would include representatives from licensing boards, as well as professionals and employers. 

The bill directs the group to produce three reports to lawmakers between September and December 2025 on how to improve licensing for the Oregon Medical Board, as well as the professional boards that regulate social workers, dentistry, physical therapy and nursing. 

The committee unanimously voted to send the bill to the Legislature’s budget-writing committee. That spares the bill from falling victim to legislative deadlines, potentially allowing more time for it to be reworked before the session’s scheduled end on March 10. . 

But despite rewriting the bill, the committee didn’t vote to recommend its passage. Diehl said that does not bode well for its prospects.  

State Rep. Rob Nosse, a Portland Democrat who chairs the health committee, thanked Diehl for spotlighting the issue. 

“It has sort of voluntarily made the boards examine what they are dealing with and how things are going or not going,” he said. “It’s made them a lot more responsive to concerns from the public.”

However, he questioned whether having people from different professions together on the task force was the right way to address the problems at different licensing boards. 

Growing need

Tom Holt, a lobbyist for ZoomCare and Willamette Dental, told lawmakers last week that the health care worker shortages have been present since the 1970s and could get worse. He cited Oregon Employment Department statistics showing that 25% of the health care workforce is over the age of 55 and 90% of job openings between now and 2032 will be to replace retiring workers. Nearly a third of job vacancies are in health care, he said. 

“The task force idea is really for us to step back and take a look at what (licensing requirements) have we accumulated over time. Are all of these things really necessary?” he said. 

Holt said that Washington is moving forward with an overhaul of its health care licensing that includes IT upgrades to let applicants track their applications’ progress through the process.  

The committee also heard from leaders of Oregon’s health care licensing boards who defended their processes and said they’re already seeking to improve things. 

Rachel Prusak, executive director of the Oregon State Board of Nursing, pointed to a recent fraudulent nursing diploma scheme that she said resulted in unqualified people working as nurses across the country. However, she said Oregon saw relatively few because of its rigorous vetting process. 

She said that the board is already granting temporary licenses for nonresident nurses. In 2022, the board issued over 3,000 temporary licenses and has seen fewer since then, she said. In 2022, the board saw an average of 39 requests per week for temporary licenses, which declined to 27 per week the following year and just 12 per week in 2024. 

Ray Miller, executive director of the Oregon Board of Licensed Social workers, told lawmakers he has focused on decreasing licensing times and customer services since taking the position in November. 

He said the board has decreased total licensing processing time by 23%. Since August, it has cut licensing times for clinical social workers by over half, he said. 

“I have heard the message loud and clear, believe me, every single day,” he said. “We must immediately improve customer service and responsiveness to address the challenges facing our practice with the state of behavioral health care in Oregon.”

Diehl unsuccessfully tried to add amendments to the bill that would have entered Oregon into interstate licensure compacts that would allow social workers and counselors to practice in Oregon from out of state. He said he introduced the amendments after hearing from people in the professions who supported the idea. He said social workers are already in short supply and will be even more needed if lawmakers recriminalize possession of small amounts of drugs. 

Miller told lawmakers that the effort to set up a compact hadn’t been collaborative, which he said was needed to make it viable. Charles Hill, executive director for the Mental Health Regulatory Agency (which oversees licensing of psychologists and counselors), said his organization hadn’t been consulted.

You can reach Jake Thomas at [email protected] or via X @jakethomas2009.