The scene was quite striking: Maryland nurses lined up outside in the cold last January to either get or renew their licenses with the state’s licensing board. The lines stretched on, down the street and around the corner – lines made up of qualified nurses, ready to practice and lacking only the updated licenses to make it legal.
And the lines only marked the start of the process: after lining up, would-be practicing nurses were provided with a ticket containing a number and asked to go wait in their parked vehicles for up to several hours, if they were lucky enough to have their license application processed the same day.
“I’m going to have to sit in my car,” one frustrated nurse waiting in line on her birthday told local news at the height of the problem, adding, “This is the only place that we can go to renew our license, and it’s cold out here.”
Another nurse opined bluntly: “Something has to change because…you’re going to have lines every day and you’re going to lose nurses. You’re going to lose nurses because nobody wants to deal with this.”
All this in a state which, like many others, was in the midst of a deepening nursing shortage made worse by a stubborn global pandemic. The implications were clear: people were sick or dying in hospitals understaffed with nurses in a state with no shortage of nurses and a licensing process kindly described as inefficient.
Consensus born of crisis
To its credit, Maryland’s Department of Health came to the defense of the state’s licensing board for nurses, noting a December cyberattack that knocked its computer system down for a few days, creating delays and roadblocks. Even Gov. Larry Horgan stepped in by calling in additional help, declaring a state of emergency, mobilizing the National Guard, briefly extending certain licenses, and allowing for more interstate reciprocity for health care licensure.
Notably, Horgan made these moves with broad support from both sides of the state’s partisan divide. And the spirit of a common goal – to reduce barriers to licensure in order to get skilled health care workers to the front lines – carried itself into a recent and sweeping ‘bill of bills’: in April he signed 103 bipartisan bills into law covering everything from employment (More Jobs for Marylanders Act) to justice (Judicial Transparency Act) to the environment (Conservation Finance Act) and many, many other areas.
To the casual observer of federal politics, passage of a set of bipartisan bills like this would be viewed as fantastical. Since around 2010, Congress has been notoriously partisan, with only rare and exceptional shades of compromise and agreement, notably with regards to support of Ukraine through Russia’s ongoing invasion. It’s a dynamic that brought The Michigan Daily’s Sam Schmitz to wonder why we keep using the word “bipartisan” when bipartisanship is dead. The Atlantic’s Ronald Brownstein lamented that democracy is already dying in the states due in part to failed bipartisanship. And last week’s passing of Orrin G. Hatch, the longest-serving Republican in history and a vocal advocate of cross-party cooperation, was viewed by some as a symbolic nail in the coffin of bipartisanship.
Examples of bipartisanship abound
While there is much truth to the alarm bells Brownstein rings over restrictive licensing laws, and while fierce partisanship does characterize the national scene, bipartisanship is alive and well at the state level, at least when it comes to issues less socially and politically contentious – such as getting qualified professionals licensed in a timely manner. While it may not often make national headlines, legislators coast to coast are putting partisan grievances aside in the name of more efficient licensing.
Take Louisiana’s House Commerce Committee, which recently passed occupational licensing reforms to help ex-criminals get back into the workforce. Committee members unanimously approved bills that would, among other things, allow the once-incarcerated to ask licensing boards whether past convictions may disqualify them from obtaining a license.
Such cross-party consensus has become commonplace in Pennsylvania, whose General Assembly has repeatedly and unanimously extended the suspension of hundreds of state regulations related to things like professional licensing. And last fall, state legislators unanimously passed bills easing the professional licensing process for veterans while naming more veterans and their spouses to licensure boards, expediting application review processes, and waiving licensing fees for relocating military spouses. All sensible stuff.
Licensing efficiency was also the name of the game in Wisconsin, which expedited occupational licensing in the state with a law allowing the Department of Safety and Professional Services to provision the state’s 280 professional licenses and address a critical licensing backlog. The law was signed and passed into law with widespread bipartisan support, in a state that has since started regulating naturopathy, also with broad support across the aisle.
Sightings of bipartisanship have also been reported in Colorado, where the Senate Business, Labor, and Technology Committee unanimously approved a bipartisan bill to expedite occupational licensure by allowing professionals licensed in other states to work in Colorado. And Tennessee could soon allow thousands of DACA recipients and people with protected status to obtain professional licensure through the Workforce Expansion Bill, which also enjoys vocal bipartisan support.
Such moves also extend from broader, strategic licensing reform down to more tactical, profession-specific changes. For example, Iowa’s House and Senate unanimously passed a bill that eliminated licensure hair threading, and its onerous requirements – which included 600 hours of education and $12,000 in fees – along with it. And similarly, North Carolina lawmakers supported a bipartisan bill to curb educational requirements for cosmetologists.
Common ground found in efficient licensing
Instances of bipartisanship can be found in all corners of America, and if there’s any trend at play here, it’s about making licensing laws more sensible and licensing processes more efficient, even if that doesn’t get a lot of attention. Maybe that’s because the gears of licensing happen at the state level. Maybe it’s because occupational licensing isn’t particularly sexy and doesn’t make national headlines, which tend to fuel political theatrics, which tend to, in turn, bolster partisan divisions.
Or maybe it’s just because efficiency isn’t partisan. The changes to professional licensing from state to state share a common spirit of relieving, not adding, barriers to licensure. While the spectrum of professional licensure may warrant nuanced and justifiably partisan conversations around the who, what, and how of licensing, people and politicians across party lines will agree a surgeon should probably have a license. Not to mention the nurses tending to sick family members. And while Maryland (and other states such as Pennsylvania) may still have work to do to get its nurses licensed, it at least ended its recent legislative session with a bipartisan budget that allocates $570 million for another important area that should be nonpartisan right to its core: cybersecurity. After the December ransomware attack on the state’s health department, which ultimately exacerbated nursing shortages, it’s not hard to see why.
