LICENSURE MOBILITY

            Over the years, psychology's elected leadership has increasingly called for focused attention upon the importance of facilitating licensure mobility.  Stan Moldawsky obtained the endorsement of the APA Council of Representatives slightly over a decade ago and mobility was a significant topic at James Bray's 2009 Presidential Summit on the Future of Psychology.  James notes: "Australia implemented national licensure in 2010 – it was a challenge to get it started, but initial reports indicate that it has helped psychologists practice across the vast country and better serve the broadly dispersed population from the cities to the outback.  The Australia Psychological Society was the key mover of this legislative change."  This Spring, HRSA submitted its report to Congress on licensure portability, assessing the level of cooperation among the various licensing boards and evolving models.  "Licensure portability is seen as one element in the panoply of strategies needed to improve access to quality health care services through the deployment of telehealth and other electronic practice services (e-care or e-health services) in this country….  Overcoming unnecessary licensure barriers to cross-state practice is seen as part of a general strategy to expedite the mobility of health professionals in order to address workforce needs and improve access…."

            Steve DeMers, Association of State and Provincial Psychology Boards (ASPPB): "In addition to our Credentials Bank, Disciplinary Data System and Certificate of Professional Qualification programs that promote mobility, we are also pilot testing in two jurisdictions a Uniform Application for Psychology Licensure system.  In these two jurisdictions, applicants for licensure will actually apply through ASPPB and we will both primary source verify and store the applicant's licensure related information before transmitting it to the jurisdiction for a licensure decision.  We are largely following the Federation of State Medical Boards (FSMB) model of expedited licensure rather than the Nursing Compact approach.  ASPPB is planning on seeking a federal (HRSA) grant to support model programs to expedite licensure as a means of promoting telepractice."

Examples of the magnitude of change just over the horizon: HHS has proposed regulations to assist rural patients, under which practitioners credentialed at one hospital would be allowed to utilize telemedicine – interacting with a patient over interactive video devices – even if they are not credentialed at the hospital where the patient is receiving care.  The House of Representatives Department of Defense (DoD) authorization act includes a provision expanding the state licensure exception to include qualified and credentialed contractor and civilian health care professionals, in order to allow the National Guard, reserves, veterans, and retirees quicker and more efficient access to care.  "This amendment will allow for new technologies in telephone and Internet communications to expand into the [DoD], which will greatly expand access, especially in rural America.  It will also allow more specialists to be involved in providing care….  (Quoting the Vice Chief of Staff of the Army): 'The Army, like the larger American society, is suffering from a shortage of behavioral health specialists, and that is, in fact, a national crisis.  Efforts in tele-behavioral health – allowing specialists to meet with patients through teleconferencing technology, for instance – could increase the effectiveness and reach of a limited number of providers….  There are challenges regarding the credentialing and licensing of specialists to work across State lines.'"

We would rhetorically ask: Have our State Association members engaged in discussions with their own licensure board in order to ensure that licensure mobility becomes a significant priority?  Currently, 24 States have adopted the Nursing Compact approach; 37 States are in some phase of implementation of the FSMB Uniform Licensure Application approach.  Where are your State Association and Licensing Board in this important discussion?  Aloha,

 

Pat DeLeon, former APA President – Division31 – June, 2011