Colorado is one of more than 20 states taking a centralized approach to regulation, where one or two “umbrella agencies” are charged with oversight of the state’s individual occupational licensing boards. Officially created in 1968, the Department of Regulatory Agencies (known as “DORA”), the state’s regulatory umbrella agency, is charged with managing licensing and registration for multiple professions and businesses, implementing balanced regulation for Colorado industries, and protecting consumers.

DORA is comprised of 10 distinct divisions, more than 312 board members, and over 600 professional regulatory staff. The Division of Professions and Occupations (DPO) provides consumer protection through its regulation of over 500,000 licensees, registrants, certificants, and permit holders for more than 55 professions, occupations, and businesses in the state. 

Ascend Magazine Editor-in-Chief Paul Leavoy sat down with Ronne Hines, who served as director of DPO, to talk about her work at DORA as well as her experience serving as president of the Council on Licensure, Enforcement, and Regulation (CLEAR). They began by discussing DORA’s mandate, the benefits and drawbacks of regulatory centralization, how CLEAR fosters inter-agency collaboration, and lessons learned from her time as CLEAR’s president. Their conversation concludes with a look at the role regulatory agencies can play in alleviating labor shortages, digital transformation and regulatory resilience during the COVID-19 pandemic, regulatory reform and challenges, and more. 

Note: this conversation has been edited for length and clarity.

What can you say about the role that regulatory agencies play in either alleviating or contributing to labor shortages?

One of my colleagues had an interesting lens on this, that the regulator isn’t necessarily going to fix labor shortages, but we are an influencer and a convenor of the conversation. I think there are ways that we can contribute to helping address the shortages across state lines in particular. We’ve seen compacts expand, which improve mobility. We have thought about – especially during the pandemic – how we might bring additional workforce in. You don’t necessarily want to reduce licensing requirements, but you want to be thoughtful about whether they’re appropriate. We have a sharp focus recognizing that it’s not just a state issue or a local issue – it’s an international issue that everyone is talking about.

Colorado has done a few things to find ways to help with labor shortages. We’ve worked with the military community; we’ve focused on making sure that we have pathways that might help veterans come out of the military and not have to start from scratch, they might be able to just take some classes and take the exam. We’ve seen particular success with this in our nursing program, where we might see someone have their military experience evaluated and be able to test to be a CNA or an OPN – and successfully, which is amazing. We even won a governor’s award for that, which is called our VOCAL Program – the Veterans Occupational Credentialing and Licensing Program. The other thing that we’ve seen in that space is recently there was a bill passed that we supported where we were able to give military spouses the ability, if they had a license in another state, to come in and have a license for three years for free.

The other work that Colorado, and I think many other states are doing, is focusing on the rehabilitative community. We see trainings in different correctional facilities; we see the rehabilitative workforce getting trained as they come out, and we’re making sure they have a pathway to licensure. We have focused on that collateral consequence piece, and I think that’s a huge piece for workforce.

The last piece that I really want to focus on where a regulator might have the ability to influence workforce is looking at internationally trained folks. Obviously, there’s a challenge if it’s a displaced refugee, as they might not be able to demonstrate their qualifications, but we do have a role there, and we’ve done some work with our medical boards to make sure that internationally trained medical folks can get a license. And we’re continuing to do that work; we’re analyzing profession by profession to see where we might influence that and continue to expand that workforce.

What were some of the biggest challenges and successes you encountered in getting all agencies digitized back in 2020 when the pandemic arose?

We’ve had this conversation a lot. If this pandemic had happened any earlier, we would have probably been in a different place and I’m sure other states have faced different challenges. Fortunately, we were already online – our complaints were online, our licenses were online, our applications were online – so we were able to still be very accessible to the public from the technology standpoint. That was a great place to be, and then we were able to move our workforce home remotely very quickly. So we had a continuity of service that I think was a challenge other states faced that we didn’t face in the same way. That said, obviously we had to pivot how we do work. We’ve always been a very office-oriented agency, so our staff has done a great job pivoting there. But I think for the most part we’ve been able to just pivot to doing the work at home because we were still very accessible.

However, there were still challenges. I think that we obviously faced workforce as a challenge and making sure we kept that pipeline going as exam vendors shut down and testing facilities shut down and schools shut down, so figuring out how best to support that. We did the best that we could and found temporary solutions during the pandemic.

In terms of long-term resilience, what new technologies and processes have agencies been implementing?

Our agency demonstrated amazing resilience during the pandemic and continues to do that. In an ongoing way, we’re going to see agencies continue to prove their ability to be nimble, innovative, and pivot to make sure that we’re continuing the work. But for future public emergencies, we have new processes. Where we probably struggled the most was where current law prevented us from doing some of the things we needed to do. Executive orders addressed some of those issues so that we could work a little more nimbly and address the pandemic, whether it was issuing temporary licenses or expanding scope where appropriate. As we move forward, I think we’ve had a lot of lessons learned to do a better job with forecasting our resourcing and thinking about where we might need to rely on technology in a different way, whether that’s allowing more telehealth, proctoring exams remotely, training remotely, and just finding new ways to use technology in ways that we might not have been as open to in the past.

How do we improve the resilience of regulatory agencies for future public health emergencies?

I think that in the past we had emergency plans that were localized in thought process. The emergency planning and long-term planning continues. We’re seeing that long-term work of how we get these emergency health care workers into a core group so we can access them faster. There’s a lot of work still to be done, but it’s happening now. If we should ever experience a larger-scale pandemic again, those emergency plans will be more scaled to size.

What are your thoughts on the need for regulatory reform and universal licensing?

Colorado constantly looks at regulatory reform a little bit differently. We’re always very open to finding ways to streamline. I don’t have thoughts on universal licensure per se, but I do think that we focus on mobility. We’ve always had a version of endorsement or allowing for mobility that’s very quick. The bill that I mentioned for military spouses was focused on reducing as many barriers as we could to improve mobility. I think a lot of states are looking at that and how similar our licensing requirements are and how we can make sure that we allow people to move from state to state. That’s the intent of compacts.

One of the interesting things in mobility is we want to make mobility easy, but it also allows workforce to leave your state just as easily. I had never thought of it quite that way. Obviously, we want mobility and to be able to do that. Thinking about telehealth, it might be expanded so we’re able to serve other states but keep the workforce we need in our own state as well.

How do you address educational requirements and ensure they remain relevant and effective?

Interestingly, our educational requirements are focused on a minimum barrier to entry where they’re still competent but it’s not the gold standard. Our legislature looks at that whenever they look at our practice acts through the sunset process. But I agree they should be looked at; they need to stay relevant. I think for many professions, they are the same across states – but not all professions. And that’s where some of the challenges can arise for mobility and transferability.

What do you think are the biggest regulatory challenges facing states today?

One of the biggest challenges is which professions get regulated. We see more and more professions that maybe don’t necessarily need formal regulation. Colorado has the focus of minimum regulation, so you don’t need that burden to practice but you can still make sure that they’re safe to practice, There are professions that we have suggested not to regulate, but often the profession wants regulation and so for Colorado, that’s a challenge. I don’t think all states have that same lens, but we definitely look at that through sunrise processes and whether regulation is needed or appropriate.

Over the years, how has it been challenging to navigate the changing of the guards when a new party or appointee comes in?

Colorado is in a great spot because of our sunrise process, so even though you might see a changing of the guard so to speak, the department does a great job, and the administration (whatever party) has done a great job of educating the general assembly of what that looks like and why regulation may or may not be appropriate. There’s clear criteria in the statute that the evaluation undergoes of why regulation might be important or appropriate. It’s less of a challenge because we have that sunrise process.

When you look 10-15 years ahead and think about the regulatory function as it ought to be, what does that vision look like and how do we get there?

I think that we’ll see some of the same issues we’re facing today. I think regulators will have to continue engaging in workforce discussions. Mobility will likely still be an issue. Finding ways to improve the utilization of technology – not just for regulation but how people access care. The broad and universal view is people’s relationship with technology will just deepen. Everybody will come to rely on digital connections, and I think that’s a necessity. It’s going to be a necessity for how states might share information to make sure they’re protecting consumers across state lines. We could see using technology in different ways, even for transferable licenses – whether that’s bitcoin, blockchain. Very few regulators have engaged in that conversation in a practical way, making it easy to have an enforceable document that is tracked and time stamped and thinking about how we could use that across state lines.

The other thing that we’ve talked a lot about is – whether it’s algorithm decision-making or emerging AI – thinking about if licensing decisions could become automated in some respect. I think we’re going to see certain professions want to maintain their autonomy in that decision-making.

The other piece for the next 10 to 15 years will be seeing the results of some of the work agencies are doing now around DEI and making sure we’re focusing on partnerships, like with CLEAR, to support that innovation and how it can inform decisions and regulation as well. I think that in some ways it’s going to be the same, but in some ways that deepened reliance on technology will definitely be there.

To hear Paul Leavoy’s full conversation with Ronne Hines, listen to this recent episode of the Ascend Radio podcast.