Occupational Licensing Executive Summary
Occupational licensing has grown exponentially over the last 60 years, comprising nearly 25% of the U.S. workforce, up from 5% nearly 60 years ago. The increase in occupations that require government permission to work, while meant to protect consumer health and safety, has also created many discrepancies in requirements across state lines and barriers to work for certain population groups. Since early 2017, the National Conference of State Legislatures (NCSL), in partnership with The Council of State Governments (CSG) and the National Governors Association (NGA Center) for Best Practices, has produced numerous resources. These resources are designed to help state policymakers better understand the variances in licensing laws and the challenges they present for many workers. The partner organizations worked with teams from 11 states (consortium states) to help them address their goals around licensing access and portability.
This report summarizes the four-year project’s key deliverables; the legislative, executive and regulatory trends the partners observed across the country and in consortium states; and lessons learned throughout the project. Below are the main highlights from each section of the report.
Key Project Deliverables
At the heart of the project was the Multi-State Occupational Licensing Learning Policy Consortium, which, through a competitive application process in 2017, brought together 11 states: Arkansas, Colorado, Connecticut, Delaware, Illinois, Indiana, Kentucky, Maryland, Nevada, Wisconsin and Utah. Stakeholders from these states attended partner-facilitated meetings, where they developed state goals, heard from national experts, and exchanged ideas and promising practices. State highlights, trends and lessons learned from the states are outlined throughout the report.
Partners also developed multiple online resources and tools, including the National Occupational Licensing Database. The first-of-its-kind database highlights the education, training, exam and fee requirements for over 30 occupations in all 50 states and the District of Columbia. This database has nearly 30,000 data points and to date has had over 21,000 website hits.
The partners also produced numerous reports outlining historical and current trends in occupational licensing and regulation, including a “Barriers to Work” series, which outlines the challenges of four different population groups: military veterans and their spouses, people with a criminal record, foreign-trained workers, and low-income and dislocated workers. Resources on different types of portability options were also created, including interstate compacts. A full list of partner activities can be found in Section III, Key Activities of the Partners.
Trends in Occupational Licensing
Legislation: NCSL has tracked legislation introduced in all 50 states since the beginning of the project, categorizing them into 16 topic areas and 34 occupations. To date, NCSL has tracked more than 3,500 occupational licensing bills across various categories, listed in the trends section of this report. The topic receiving the most attention was altered fees or requirements, with 122 bills enacted between 2017 and 2019. When looking at licensing policy and practice through a critical lens, legislation covering clarification of requirements and increased transparency were the most popular, with 182 bills introduced. Of the four population groups listed above, states most frequently enacted bills affecting people with a criminal history, with over 80 bills enacted in 30 states.
In terms of comparing consortium states to other states, NCSL found that although non-consortium states introduced more bills on average than consortium states, the rate of enactment was 60% in consortium states compared to 42% in other states. These statistics indicate that consortium states are bringing together the right stakeholders to have meaningful conversations about licensing legislation. Other legislative trends between 2017 and 2019 included reducing licensing fees and requirements, clarifying licensing requirements, creating a new license for a previously unlicensed occupation, and studying or instituting reciprocity agreements between states.
Population Groups: Of the four population groups the project examined, people with a criminal history and military veterans and spouses received the most attention from consortium and other states in terms of targeted licensing reform. Fewer legislative or executive actions focused on immigrants with work authorization and low-income and dislocated workers during the project. Between 2017 and 2019, unemployment rates were at record lows and states were focused on getting more workers into licensed occupations by removing unnecessary barriers or complications in licensing requirements and regulations. Actions such as removing “moral turpitude” clauses for people with a criminal history and allowing temporary licensure for a military spouse entering a new state with an out-of-state license were agreeable policy options in many states. Between 2017 and 2019, 176 bills that sought to ease barriers for people with a criminal record were introduced by states across the country. States introduced 120 bills focusing on military veterans and spouses, 33 on immigrants with work authorization, and 14 on low-income and dislocated workers.
Bills Considered by Topic
Executive Actions: Governors also played a significant role in occupational licensing trends in their states. NGA found that governors mentioned occupational licensing as a priority in eight state of the state addresses in 2019. That legislative session saw licensing bills in all eight of those states, with six states ultimately enacting legislation, indicating the strong influence of a governor’s priorities in setting legislative agendas and building stakeholder support and momentum behind legislation.
Governors have also used executive orders to set occupational licensing priorities, including establishing statewide reviews of licensing systems, as governors of four states did during this project. Prior to the 2020 COVID-19 pandemic, three governors had used executive orders to temporarily lift licensing requirements to solve workforce shortages related to an emergency, such as a natural disaster.
Licensure Portability: Consortium and non-consortium states alike have expressed interest in licensure portability over the last few years. During the project, the consortium states examined different means of portability from licensure by endorsement, reciprocity agreements, expedited and temporary licensure, and interstates compacts. One of the most prevalent means of portability is interstate compacts. CSG has tracked 42 states that enacted 137 separate occupational licensure compact bills. The partners saw an increased interest in universal licensure bills in 2019, with enactments in Arizona, Montana, New Jersey and Pennsylvania. Several other states introduced bills in 2020, including Missouri and Colorado, a consortium state, both enacting them.
Over the course of the project, the consortium states gained knowledge about promising occupational licensing policies, defined goals for their state, and made progress toward or achieved many of those goals. The partners also gained valuable insight on strategies that were most successful for states in accomplishing their goals and challenges that arose among the teams. Below are some of the lessons learned through the consortium process.
- Importance of messaging: Nearly every state struggled to effectively communicate the consortium’s work to certain stakeholders. State teams found success with messages that highlighted the work as protecting consumer health and safety while also addressing critical workforce needs. Often the messages had to be tailored for different stakeholder groups.
- Stakeholder engagement: Consortium states that experienced pushback on goals or sponsored legislation struggled with engaging the right stakeholders from early in the process. States that did not have buy-in from the legislature early on failed to enact legislation and states that experienced changes in leadership had a hard time maintaining momentum. States that found meaningful ways to engage stakeholders of all kinds were much more successful at enacting changes and advancing their work.
- Importance of third-party facilitator: Changes to licensing and regulatory structures are often bipartisan issues, appealing to both Democrats and Republicans for many of the same reasons. However, the partisan nature of many state legislatures and executive offices and distrust from regulatory agencies or boards created tension in many consortium states. Most states found that having a neutral third-party convener, such as NCSL, NGA and CSG, helped bring all stakeholders to the table, diminish feelings of mistrust or partisanship, and support meaningful and thoughtful licensing and regulatory changes. Furthermore, the partner staff also brought background knowledge on licensing policy and practice to the table, allowing each state team to work one-on-one with an expert facilitator.
- Peer-to-peer learning: Throughout the project, state teams consistently ranked peer-to-peer discussions, whether through meeting breakouts, facilitated phone calls or unstructured networking, as extremely valuable to their work. Hearing from their peers in other states on challenges, successes and hiccups helped many state teams address problems before they arose or identify new approaches to their outlined goals.
- State technical assistance: Along with annual multistate convenings, the consortium states also received in-state convenings and technical assistance. Led by the state teams, the technical assistance was often an opportunity to bring together a larger stakeholder group from the state to hear from experts and other states. Multiple times, experts or partner staff were brought in to testify before legislative committees.
- Sunrise and sunset processes: States with sunrise and sunset measures provide policymakers with valuable tools to evaluate proposed and existing regulations. The processes examine costs and benefits and state-by-state comparisons and feature data-driven analysis. Multiple consortium states without such measures in place pursued creating them during the project.
- Institutionalizing efforts: Realizing that changes in leadership and staff happen often, several states found ways to institutionalize their efforts. They did so either through formal approaches, such as creating sunset and sunrise review commissions, or informal approaches, such as regular stakeholder meetings or working groups.
- Focus on targeted occupations: Although many states have experienced success in enacting broad policy actions, impacting nearly all licenses in a state, others found success in focusing their work on tailored approaches to reducing barriers. Political challenges and industry-specific factors create obstacles in moving broad licensing efforts. Consortium states found that focusing on a handful of occupations ensured they had the right people at the table and enough resources to ensure all considerations and policy options were considered.
- Efforts for population groups: Most consortium states identified population groups for which they aimed to reduce barriers early in the project. The two groups that received the most attention were military veterans and spouses and people with a criminal record. Although the barriers may differ, states learned that a best practice for one population group, such as reduced or waived fees, can often also be a successful approach for another.
Letter from the Executive Directors
Occupational licensing has emerged as a chief policy issue for state leaders in recent years. While licensing serves as a tool to safeguard public health and safety, it can come with economic and social costs. States are uniquely tasked with harmonizing the competing interests of maintaining high standards of public health and safety and ensuring that occupational licensing policies do not unduly inhibit economic growth, prevent workforce mobility or disproportionately limit opportunity for certain individuals.
States must also consider how occupational licensing policies impact workforce development, criminal justice reform, immigration, military affairs and unemployment. Most importantly, because of the cooperative nature in which occupational licensing policy is developed and implemented, this policy area serves as an example in which cross-state collaboration and bipartisanship truly flourish.
The Occupational Licensing: Assessing State Policy and Practice project represents a four-year, joint effort by the United States Department of Labor’s Employment and Training Administration, the National Conference of State Legislatures, National Governors Association Center for Best Practices and The Council of State Governments. The 16 states that participated in the project consortium were ultimately the drivers of their own success. The results of the project as described in this report demonstrate how state-led efforts, with financial and programmatic support from the federal government, result in successful, effective partnerships that facilitate meaningful reform and advance state policy.
The following report serves as both a record and a collection of lessons learned throughout the project. It also highlights the resources and policy findings of the organizational partners. Each element of the report is designed to guide other states and stakeholders in their own efforts to better understand and positively affect meaningful dialogue and action in the occupational licensing arena.
But this work is far from over. Although we have been working with roughly a third of the states, all states may benefit from the type of bipartisan efforts, policy assistance and resources of the last four years to reduce barriers for workers. For the consortium states, the work continues as they must maintain diligence in their continued assessment of occupational licensing policy practices as they navigate the new economy and the effects of the COVID-19 pandemic. By continuing the collaborative, nonpartisan and evidence-based approaches described in this report, states will be well-positioned to unlock new opportunities to engage key segments of their workforce in high-demand licensed occupations.
Executive Director, NCSL
Executive Director, NGA
Executive Director, CSG
Occupational Licensing Trends
Summary of Legislative Trends
NCSL tracked and analyzed all legislation introduced in state legislatures across the country from 2017 to 2019 that addressed occupational licensing. Over the three years, at least 2,018 pieces of legislation relating to occupational licensing were considered by state legislatures in all 50 states. NCSL categorized bills based on 12 topics and four population groups. Legislative activity was also broken down based on the project’s original 11 consortium states compared to non-consortium states.
Of the 12 topics tracked, the most common topic addressed in state legislatures were related to fees or requirements, with 122 bills enacted from 2017 to 2019. Licensing for ex-offenders received the most attention among the populations tracked. While non-consortium states introduced more bills in total than consortium states, the rate at which those bills were enacted was substantially higher among the consortium states.
Analysis by Year
Many factors can affect legislative activity, including elections, changes in partisan majorities, evolving political priorities, and the fact that four states only hold session in odd years. When looking at legislative activity over each of the project’s three years, 2018 saw the fewest bills introduced. In 2019, there was a significant increase in the number of bills introduced. Further analysis would be required to explain the reason for this increase. Despite the spike in introduced bills, the number of bills signed into law was less than in 2017—the year most bills became law.
Increasing or decreasing licensing fees or requirements, and reciprocity, were the top issues addressed in state legislatures in 2017. Requirement clarification, increasing fees or requirements, and reciprocity were the top issues in 2018. And requirement clarification, modifying the scope or exemptions of licenses, and both increasing and decreasing licensing fees and requirements topped the list in 2019.
Increasing licensing fees and requirements were the most addressed topics in state legislatures from 2017 to 2019, with 122 enactments out of 218 introduced bills. States also considered high numbers of bills that clarified requirements, addressed reciprocity across states, and reduced fees or requirements.
Of the four population groups tracked, states gave the most attention to licensing for ex-offenders, with 73 enactments out of 176 bills introduced. States were also active on licensing for veterans and military spouses. States spent less time addressing immigrants with work authorization and low-income workers.
One of the major legislative trends over the past few years has been the creation and adoption of interstate compacts to facilitate licensure portability. Since 2014, seven licensure compacts have been established through the associated compact legislation. Over the course of the project (2017-2020), 106 individual pieces of compact legislation have been passed by states.
Governors’ Role in Occupational Licensing
Governors can play a significant role in advancing a state’s occupational licensing efforts by elevating the issue as a statewide policy priority and taking direct action through the use of executive order. Occupational licensing has been a priority for many governors over the past several years, as evidenced by significant gubernatorial interest and action on the topic across the country.
Elevating Occupational Licensing as Statewide Policy Priority
Governors can use their state of the state address to establish a sense of priority for taking action to improve occupational licensing policies. Eight governors mentioned occupational licensing in their state of the state addresses in 2019. During legislative sessions that year, relevant legislation was introduced in every state in which the governor mentioned occupational licensing in his or her state of the state address, and relevant legislation was passed in six of the eight states. This indicates a strong influence of a governor’s priority setting on legislative action.
|State of State Mentions
|Relevant Legislation Introduced
|Relevant Legislation Passed
Governors’ 2020 state of the state addresses have demonstrated that the emphasis on occupational licensing as a policy priority for governors is an enduring trend. As of March 1, 2020, 13 governors mentioned occupational licensing in their 2020 address. Many of these governors used their address to celebrate accomplishments in licensing policy over the past year. Governors also used their remarks to urge policy action in the coming year. Improving license reciprocity and recognizing and alleviating burdens for special populations, like those with a criminal record and military families and veterans, emerged as key themes in these addresses.
In addition to setting priorities for the legislature to act on, governors can use their executive order authority to address occupational licensing policy reforms in a variety of ways. From 2016 to 2019, 10 governors issued 15 executive orders taking action on issues related to occupational licensing.
The most common way governors have used their executive authority in the 2016-2019 time period has been to mandate a statewide review of their occupational licensing system, often by establishing a dedicated task force. During this time, four governors—Arizona Governor Doug Ducey, New Mexico Governor Susana Martinez, Oklahoma Governor Mary Fallin and Pennsylvania Governor Tom Wolf—have used their executive power to call for such a review. These reviews are used to identify challenges within the state’s licensing systems and processes and can be used to inform subsequent policy action. Mandating this type of review may be a politically palatable way for governors to initiate the process of improving occupational licensing rather than changing policies directly without engaging the legislative process.
Other governors have used executive orders to make more systemic changes to licensing policy and procedures. For example, Governor Brad Little of Idaho and Governor Charlie Baker of Massachusetts both used their executive order power to establish sunrise and sunset processes in the state. Governor Mary Fallin of Oklahoma signed an executive order in 2018 requiring the creation of a database to serve as a central source of statewide information related to occupational licensing. These executive orders demonstrate how governors can make more systematic and permanent changes to occupational licensing policies and procedures in accordance with their priorities. All these examples demonstrate how executive action can be a powerful tool that governors can use to make timely policy changes.
||Number of Executive Orders
||Number of Executive Orders
|Statewide Review/Task Force
||Arizona, New Mexico, Oklahoma, Pennsylvania
||North Carolina, Massachusetts, New Hampshire
Gubernatorial Engagement by the Consortium
All states participating in the consortium had a representative from their governor’s office on their team in order to align the group’s work with executive priorities and garner support from the executive branch. Through this liaison, participating states leveraged their governors’ offices in their work in a variety of ways. For example, in Indiana, the consortium core team worked closely with Governor Eric Holcomb’s Health Workforce Council to improve licensing policies and processes to address a labor shortage in the health sector. The alignment of the consortium team’s priorities with this initiative led by the governor was a catalyst for Indiana joining the Nurse Licensure Compact. The Indiana core team has identified its collaboration with the working group as a key strategy for keeping momentum in this work moving forward beyond the end of the grant.
In Arkansas, Governor Asa Hutchison established the Governor’s Red Tape Reduction Working Group (RTRWG) in 2019. Arkansas’ consortium home team was appointed by Hutchison to form the Occupational Licensing Advisory Group, which was tasked with advising the RTRWG. This collaboration led to The Red Tape Reduction Sunrise and Sunset Act of 2019 being passed and enacted. This legislation reflected Hutchison’s and the consortium home team’s priorities and was informed by the information-sharing the home team engaged in through the consortium.
States maintained executive support through gubernatorial transitions by actively engaging top executive officials early on in the new administration. For example, in Nevada, the director of the Governor’s Office of Workforce Innovation (OWINN) under the Sandoval administration was an active participant in the Nevada core team. When a new director was appointed under the Sisolak administration, the core team immediately reached out to engage him in its work. This led to consistent participation from the executive branch amid a gubernatorial transition, allowing the team to maintain momentum in its work, even with an executive branch party change.
Population Highlights Deep Dive
As mentioned earlier in the Trends section on page 37, the project examined the ways different population groups were disproportionately affected by licensing regulations. During the application process, consortium states were asked to identify which population groups they aimed to focus on. Although certain population groups did receive more attention than others, all were addressed by at least one state. Many consortium states also realized that policy solutions to address one population often benefited multiple population groups. This finding will be addressed further in the Lessons Learned section, beginning on page 55. Below is a deep dive into a few specific actions taken by consortium states. The examples draw from both legislative actions and executive/regulatory actions.
People With Criminal Records: Delaware
Addressing barriers for people with criminal records was a topic that saw a significant amount of attention both nationally and among the consortium states. Generally, state action on this issue falls into a few broad categories. These categories include, but are not limited to, limiting the length of time criminal convictions can prevent licensing, specifying the types of disqualifying criminal convictions, and allowing for predetermination (or early ruling) if an applicant’s criminal history will disqualify them for licensure. Seven consortium states paid special attention to this population, devoting significant time and resources to reviewing potential barriers to licensure and areas for improvement.
In 2016, Delaware Governor Jack Markell signed Executive Order 60. This order created a committee to review the state’s current licensing requirements. One of the committee’s recommendations was to reduce barriers for justice-involved individuals by creating a list of crimes that are substantially related to the profession.
In 2018, the Delaware legislature passed HB 97 (now Act 214). This bill states that a person can only be denied a license based on a criminal record if the conviction happened in the last 10 years and is “substantially related” to the practice of cosmetology or barbering. The board could also provide a waiver for a felony conviction for a crime against a person if the conviction happened over three years prior to licensing, and for all other felony convictions if they happened more than two years ago. The applicant also cannot be actively completing a sentence parole, or any other court- required actions like community service before applying.
After Act 214 was signed into law, Carney signed an executive order creating the Delaware Correctional Reentry Commission. This commission is responsible for creating and implementing efficient and effective reentry initiatives that are rooted in evidence. In 2019, following the passage of Act 214, four more pieces of similar legislation were introduced for massage therapists; electricians; heating, ventilation and air conditioning (HVAC) operators;, plumbers; and real estate agents
Delaware’s work to improve access to licensure for workers with a criminal record was achieved through a combined effort by the legislature and the governor’s office. The research and coordination from the governor’s committees and commissions helped inform the legislation championed and passed by the legislature. Act 214 passed with no opposition. Though the other four pieces of legislation encountered some opposition, it was minimal. HB 124 and HB 43 each passed with only one “no “vote in the House. HB 7 passed with only one “no” vote in the Senate.
Veterans and Military Families: Utah
Addressing barriers for veterans and military families was another topic that saw significant interest among both consortium and non-consortium states. Nine consortium states focused specifically on this population group, as outlined in their action plans. National legislative trends focused on expediting licensure processes, creating temporary licensure or exempting veterans and military spouses from state licensure requirements if they were previously licensed in another state.
A study by the National Conference of State Legislatures noted that the military trains people in skills applicable to at least 962 civilian occupations. The burden of achieving different licensing standards in different states make the transition from military to civilian life even more onerous, the study said.
– U.S. News, July 22, 2019
In 2018, the Utah Legislature passed SB 227, one of the first pieces of legislation of its kind. The bill provides exemptions from licensure for a variety of professions for both individuals serving in the military and spouses of those serving in the military if the applicant has a valid existing licensing in another jurisdiction. The bill also exempts certain military spouses and those actively serving in the military from paying licensing fees in Utah.
To qualify for this exemption, applicants must:
- Either be actively serving in the military or be the spouse of someone actively serving.
- Hold a valid and active license to practice in another state.
- Be in good standing in the state or jurisdiction where they hold the license.
SB 227 passed with no opposition. The bill was intended to build off similar legislation from 2011: HB 384. This bill created exemptions for veterans and active-duty military for professions that fell under Utah’s Division of Occupational and Professional Licensure. SB 227 expanded the occupations covered under the exemption. In Utah, the legislative-dominant approach worked exceedingly well.
Immigrants With Work Authorization: Colorado
Addressing barriers for immigrants received less attention than people with criminal records or veterans and military families. Four consortium states, however, ultimately focused closely on this population. One of the most significant pieces of legislation on this issue came from Colorado.
Similar to Delaware’s efforts, Colorado’s work on reducing burdens for immigrants was a joint effort between executive branch officials and legislators. The work started in Colorado’s Immigrant Gap Analysis Committee, a committee the consortium team formed to better understand licensing barriers for this population and to help drive policy. The committee found that barbers and cosmetologists in Colorado have some of the highest numbers of immigrant applicants. The committee convened stakeholders and led focus groups on the topic. From its research and convenings, the committee helped create and advocate for the passage of HB 1290.
HB 1290, which was considered during the 2019 legislative session, allows an applicant to substitute the required hours of training for licensure as a barber or cosmetologist with work experience gained in a foreign country. The applicant must submit documentation of their foreign work experience to qualify. The experience conversion allowed three months of documented experience to substitute for every 100 required hours of training. However, required hours related to health, safety and disinfection cannot be substituted. This bill does not reduce requirements for passing the exam for licensure.
Low-Income, Dislocated and Unemployed Workers: Wisconsin
Addressing barriers for low-income, dislocated and unemployed workers saw the smallest amount of attention both nationally and from consortium states. Legislation for this population generally looked at addressing fees and the initial cost of licensure. This population group did not receive as much attention, overall, from consortium states, mainly because it is a harder population group to define and these individuals often fall into one of the other population groups. Additionally, this project largely took place from 2017 to 2019, years featuring nationwide economic growth.
Wisconsin passed AB 733 (now Act 319) in 2017. This act allowed license applicants making less than 180% of the federal poverty level to pay only 10% of licensure fees. The bill only applies to certain licensed professions. Act 319 initially waived all fees for applicants making less than 180% of the federal poverty level. However, this version of the bill received pushback in the Legislature. By changing the amount of fees paid to 10%, the bill received bipartisan support and was enacted. Act 319 was also part of Wisconsin’s larger consortium participation goal of reducing licensing barriers for populations disproportionally affected by licensure requirements.
Trends: Licensing Boards and Portability Options
The inclusion of state licensing boards during the project proved to be an integral part of the design and success of consortium state action plans. Licensing boards and their staff can act as the primary purveyors of licensure regulations and often serve as the direct points of interaction between license holders and applicants. Though licensing regime structures vary by state, licensing boards are commonly tasked with issuing and renewing licenses, overseeing licensure examinations and continuing education, hiring and managing staff, promulgating rules, and communicating and conducting outreach to the legislature and other stakeholders.
These regulating entities therefore serve as key stakeholders for states that are seeking to enact licensure reforms. For example, licensing boards can provide legislative input and support during the policymaking process or they can enact regulatory changes themselves through rulemaking. Recognizing their importance, consortium states have cited licensing board education and involvement as a key contributor to the success of licensure reforms.
Board Inclusion in State Teams
During the project, consortium states were given the opportunity to include licensing board members in their state core and home teams. Some states, such as Arkansas and Nevada, had substantial participation from their licensing boards. Arkansas’ home team, named the Occupational Licensing Advisory Group, consisted of members from the nursing, medical, real estate, barbering, cosmetology, contractors and veterinary boards.
Nevada engaged the state’s cosmetology, physical therapy, contractors and nursing boards regularly in its core team’s work. This partnership proved particularly beneficial in supporting legislative attempts to pass the Enhanced Nurse Licensure Compact and Physical Therapy Compact and simplify and modernize the licensing process for the contractor’s board.
Other states added board members with the assistance of the project’s second phase of funding. The 2018 Consortium Meeting in Clearwater, Fla., brought together newly invited state board members to existing state teams. A preconference half-day session and the facilitated state team sessions during the conference aided the incorporation of board members into the work of the consortium states.
Board Organization and State Supervision
States employ varying designs in the structure and level of autonomy provided for their licensing boards. At one end of the spectrum, boards can be largely autonomous and assume most of the functions necessary to implement licensure laws and maintain a state agency. At the other end, boards may exist only in an advisory capacity and the entirety of their functions may be assumed by the state’s umbrella agency itself.
States commonly use a mix of these two polarities for their licensing boards with the understanding that there are benefits and trade-offs associated with how boards are organized. Where more autonomous boards may benefit from efficiency gains and greater professional expertise, centralized boards may enjoy lower administrative costs, higher levels of coordination and the liability protection that is associated with state oversight. However, the benefits and trade-offs of each structure are not necessarily exclusive and can vary based on the profession, specific design of the board and other considerations.
States have recently taken a renewed interest in ensuring that licensing boards are properly prepared against the prevailing criticisms of industry “protectionism” and antitrust liability concerns. In 2015, the United States Supreme Court decided in the landmark case, North Carolina State Board of Dental Examiners v. Federal Trade Commission, that licensing boards could only claim immunity from federal antitrust actions if the board was subject to active supervision by the state. The Federal Trade Commission has also released subsequent guidance for states to further review potential liability for licensing boards and the preventive measures states may implement.
In response to these concerns, the partners hosted several technical assistance opportunities throughout the project regarding board liability, including a general session at the 2019 Consortium Meeting and a 2019 webinar on antitrust liability.
State teams have also been proactive in considering the organization of their licensing boards. Kentucky’s project team established a goal in its action plan to “Reorganize all occupational licensing boards under the appropriate functional model to effectively and efficiently provide administrative support, enhanced communication between regulators and policymakers, and consistency of regulations and administrative procedures.” The idea for this goal stemmed from both the North Carolina dental examiners case as well as a gubernatorial priority to establish efficient, coordinated and ethical regulatory structures.
The project goal resulted in a multi-year effort by the state team to assist in the legislative efforts to organize boards under the state’s Department of Professional Licensing to establish active state supervision. Though the effort ultimately was unsuccessful in both the 2018 and 2019 legislative sessions, the state did reorganize its four real estate licensing boards under the Kentucky Real Estate Authority.
Board Engagement During Policy Reform Efforts
Board member education and involvement in the policy process was seen by consortium state teams as both a crucial step and challenge to building support for the proposed regulations. The team from Delaware said engaging the state’s 34 boards and securing buy-in for policy efforts was a prominent challenge. Kentucky’s state team reflected on the importance of engaging licensing boards early in the policy process to garner better input and participation. Early and frequent engagement can help foster support for legislative and/or rule changes and ensure that the proposed changes account for the specific needs and situations of professions and their licensing boards.
The Kentucky team hosted a training event in 2019 for the state’s licensing board members on regulatory best practices and strategies to mitigate antitrust liability. The event, attended by over 100 board members, was a key opportunity to build better relationships and minimize any potential misunderstandings with boards, especially in relation to the state’s reorganization efforts.
Arkansas’ home team deployed a survey to every state licensing agency and board to assist its policy efforts. The survey included a self-assessment tool to account for the practices, processes and requirements that the agencies and boards employ for credentialing. The state team found the survey to be valuable tool in its overall efforts, as boards were asked to suggest potential policy changes.
Maryland’s state team pursued policy reforms at the board level in the hope of quicker results than the legislative process typically allows. Specifically, the established goal of the state team was to “educate boards on best practices for the least restrictive licensing processes.” To accomplish this, state team members developed and implemented a board outreach strategy that included the presentation of reform ideas specific to their profession.
A priority of several consortium states, including Delaware, Indiana and Kentucky, was to enhance licensure portability, broadly defined as the ability of a licensed individual to align and transfer their qualifications to meet the licensing requirements of another state.
Where barriers to portability do exist, there can be significant financial costs to the licensed individual, such as those incurred by meeting additional exam or training requirements. Further, states have an interest in ensuring licensing standards do not unnecessarily conflict with interstate migration and broader workforce strategies that seek to address labor shortages.
States possess a number of policy options to improve licensure portability. These can range from individual state-by-state reciprocity agreements to formal interstate compacts. In instances where an individual’s circumstances might warrant further assistance, states are employing measures such as expedited and temporary licensure to ensure workers are able to mitigate delays and more quickly acclimate to the state’s workforce.
Each portability policy, however, is based on the understanding that workers who are otherwise qualified to practice in one state should have options that facilitate their mobility and reduce the time it takes to obtain licensure in another state.
Licensure by Endorsement
A licensure by endorsement model allows states to consider the qualifications of an individual licensed in another jurisdiction in respect to their own requirements. At what level these qualifications are recognized can vary by state and the discretion of a licensing board or agency. For example, some states prescribe that the licensing qualifications of an individual applying for endorsement must be substantially “equal to or greater” than their state’s standards. Licensing requirements, including training and educational requirements, however, can vary widely from state to state.
Consequently, the transferability of a licensed individual’s qualifications can likewise vary when considered by quantitative or other specific standards. For example, states may consider and accept different exams that qualify an individual for licensure. To address these differences and improve the mobility of out-of-state workers, a state may use tools such as the project’s occupational licensing database to look at outliers in its licensing standards that may make this process particularly onerous. Should a state affirm that public health and safety will still be protected, reducing licensure requirements to better align with the averages of other states can improve the portability of licenses.
For example, in the cosmetology profession, eight states have recently reduced the required hours for initial licensure. This included the consortium state of Kentucky, which in 2017 reduced its training requirements from 1,800 hours to 1,500 hours, 50 hours fewer than the national average.
Other states, like Utah, have recently streamlined their licensure by endorsement process. Utah SB 23 (2020) directs the state’s Division of Occupational and Professional Licensing to grant licensure without examination to applicants who have at least one year of experience, with their license maintained in good standing, in another state. In addition, the division must determine that the scope of practice is similar to the license being sought in Utah. Previously, the licensure by endorsement model specified the division had to determine that requirements substantially equal to Utah’s were met by applicants in their home state.
Reciprocity agreements between states serve as another way to formalize portability standards. Typically, these may be used by neighboring states where mobility between licensed workers is more likely to occur. However, states can formulate these agreements regardless of geography. A reciprocity agreement does not necessarily mean the licenses granted by the participating states are interchangeably recognized, like a driver’s license. Rather, it sets up a formal process and understanding between the states of how recognition is to occur. This can reduce the time it takes for licensed individuals to be granted authorization to work in a participating state. It is common for states to statutorily allow licensing boards to enter into these agreements at their discretion.
Expedited and Temporary Licensure
To reduce the time to it takes to be granted a license, most states have adopted some use of expedited and temporary licenses. Expedited licensing policies instruct the appropriate licensing entity to prioritize the processing of an out-of-state license holder’s application. Some state policies allow the board discretion on what constitutes an expedited process, while others have established a certain maximum threshold of days. States may also employ temporary licensure provisions, such as meeting additional licensing requirements, to grant individuals the authority to work under certain conditions.
These policy options may be used separately or in conjunction with each other. For example, some states specifically mandate an expedited process for those holding temporary licenses. These provisions are also typically afforded to certain population groups, such as military spouses, who face specific challenges to licensure mobility and reciprocity because of the frequency of their relocations.
States and professions have increasingly turned to occupational licensure interstate compacts to mitigate challenges faced by workers as they navigate various state licensing requirements, rules, regulations and fee structures. Since January of 2017, 40 states have enacted 106 separate occupational licensure compact bills. In total, 42 states have enacted at least one occupational licensure compact and 28 states have enacted three occupational licensure compacts. These compacts create reciprocal professional licensing practices between states while still ensuring the quality and safety of services and safeguarding state sovereignty.
While other reciprocity mechanisms, such as bilateral agreements and universal recognition models, are also used by states to improve licensure mobility, interstate occupational licensure compacts are an attractive and trending policy option for states. This is because of their ability to establish formal, binding coordination among state licensing boards and require investigative information-sharing, which enhances public protection.
It is important to note that interstate compacts leave the state licensure process in place, are not mandatory for licensees to participate and that state practice acts are not affected. The Nurse Licensure Compact, established in 1999, served as the first occupational licensing interstate compact and has since been adopted by 34 states under its revised iteration, the Enhanced Nurse Licensure Compact. Seven additional occupational licensing compacts have been formed in recent years, including for medical doctors, physical therapists, emergency management service personnel, advanced practice registered nurses, audiologists, language pathologists, occupational therapists and occupational therapy assistants, and psychologists.
As an example of the trending nature of interstate compacts, other professions are currently in various stages of developing their own compact, including dietitians, physician assistants, counselors and teachers.
One of the primary goals of the project was to provide educational and policy support for the consortium states interested in prioritizing interstate compacts as a part of their state’s licensing reform strategies. Interstate compacts, therefore, were commonly included as session topics during the project’s various convenings, including individual state team meetings. The partners also authored written and web-based resources to aid the consortium states’ understanding of the mechanics and differences between existing interstate compacts.
- Several consortium states, including Delaware, Indiana, Maryland, Nevada and Wisconsin, chose to specifically prioritize and receive project support on interstate compacts.
- Other consortium states, while not specifically adding interstate compacts to their action plan, were provided assistance on interstate compacts through project outputs and the subject-matter expertise of The Council of State Governments’ National Center for Interstate Compacts.
Consortium States Compact Participation
Every consortium state* is a member of a least one occupational licensing interstate compact and, compared with non-consortium states on a proportional basis, have adopted more occupational licensing compacts:
Original Consortium States: 8
Arkansas, Colorado, Delaware, Indiana, Kentucky, Maryland, Utah and Wisconsin
Added Consortium States: 4
Idaho, New Hampshire, North Dakota, Oklahoma
Non-consortium States: 22
Alabama, Arizona, Florida, Georgia, Iowa, Kansas, Louisiana, Maine, Mississippi, Missouri, Montana, Nebraska, New JerseJ, New Mexico, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Virginia, West Virginia and Wyoming
- Original Consortium States (72%)
- All Consortium States (75%)
- Non-consortium States (62%)
Original Consortium States: 7
Colorado, Illinois, Kentucky, Maryland, Nevada, Utah and Wisconsin
Added Consortium States: 5
Idaho, New Hampshire, North Dakota, Oklahoma, Vermont
Non-consortium States: 17
Alabama, Arizona, Georgia, Iowa, Kansas, Maine, Michigan, Minnesota, Mississippi, Montana, Nebraska, Pennsylvania, South Dakota, Tennesse, Washington, West Virginia and Wyoming
- Original Consortium States (64%)
- All Consortium States (75%)
- Non-consortium States (52%)
Original Consortium States: 7
Arkansas, Colorado, Delaware, Kentucky, Maryland, Utah, Wisconsin
Added Consortium States: 3
New Hampshire, North Dakota, Oklahoma
Non-consortium States: 18
Arizona, Georgia, Iowa, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Jersey, North Carolina, Oregon, South Carolina, South Dakota, Tennesse, Texas, Virginia, West Virginia
- Original Consortium States (63%)
- All Consortium States (63%)
- Non-consortium States (53%)
Original Consortium States: 4
Colorado, Delawa, Indiana, Utah
Added Consortium States: 3
Idaho, New Hampshire, North Dakota
Non-consortium States: 13
Alabama, Georgia, Kansas, Mississippi, Misouri, Nebraska, Sout Carolina, Southakota, Tennessee, Texas, Virginia, West Virginia, Wyoming
- Original Consortium States (36%)
- All Consortium States (43%)
- Non-consortium States (41%)
Original Consortium States: 0
Added Consortium States: 2
Idaho, North Dakota
Non-consortium States: 1
- Original Consortium States (0%)
- All Consortium States (13%)
- Non-consortium States (3%)
Original Consortium States: 5
Colorado, Delaware, Illinois, Nevada, Utah
Added Consortium States: 2
New Hampshire, Oklahoma
Non-consortium States: 5
Arizona, Georgia, Missouri, Nebraska, Texas
- Original Consortium States (46%)
- All Consortium States (44%)
- Non-consortium States (24%)
Interstate compact adoption information current as of April 2, 2020.
* A second round of funding from the Department of Labor allowed additional states to join the project consortium in 2018. These states are included in this analysis as they have received technical assistance on interstate compacts by the partners.
* Six states, including two consortium states (Oklahoma and Utah), adopted audiology and speech-language pathology in 2020.
Consortium Lessons Learned
Through the partners’ and states’ experience with the consortium project, we discuss a number of lessons learned in this section. We look at the lessons most states grappled with at one time or another, including some that ultimately led to success and others that continued to present challenges throughout the project. Project messaging, stakeholder engagement and managing potential perceptions of market control were challenges nearly all states ran up against in their consortium work and we cover the variety of approaches states pursued below. Changes in leadership only occurred in some states but were dramatic and produced some important lessons learned. We also report on lessons regarding the type of occupations, processes like sunrise and sunset, and population groups states worked on over the course of this project.
Having a third-party facilitator enabled us to do a lot more than we likely would have done on our own, even given our current structure. We were able to connect with states and leverage some of the work they had already done.
– Ronne Hines, director, Division of Professions, Colorado Department of Regulatory Agencies
Messaging was a challenging area for all the consortium states, requiring each state team to problem-solve the issue. Consortium states regularly had to consider both internal messaging to legislators, administrators and licensing boards, and external messaging to members of the public, private industry and professional associations.
Across the consortium states, regular themes around messaging emerged. These themes included using messaging to build stakeholder engagement, address or preempt fears of deregulation; educating legislators on licensure policy and regulation; and connecting licensure policy to larger workforce and labor issues.
Messaging was consistently a challenge for consortium states. Building a consistent message was especially difficult due to the large variety of audiences and stakeholders with whom state teams needed to communicate. The state teams also were not allowed to have marketing campaigns or lobbying teams. Team members often had to have their messaging compete with a barrage of messaging from both internal and external sources. This could come from lobbying firms and professional organizations that opposed a piece of legislation and/or from boards and legislators. Each state team adopted a different strategy when messaging its work.
Maryland focused its efforts on four primary occupations: barbers, cosmetologists, HVACR (heating, ventilation, air conditioning, and refrigeration) and plumbing. The broad goal in focusing on these occupations was to reduce barriers to entry for workers and to make changes to the board member vetting process and training programs.
Resistance to changes from the licensing boards was the most consistent obstacle faced by the Maryland team. The team would regularly meet with and work to educate board members on its concerns, and to present individual boards with potential ways to reduce barriers to entry into the profession. Board members were also invited to present their ideas for reform. The messaging centered around the reduction of barriers but was received with mixed results. Some suggested proposals were adopted by the boards. More commonly, boards would respond with concerns of their own—specifically fears of reductions in public safety, increased labor market or provider competition, and a lack of recognition about issues that needed to be addressed.
Maryland’s team members faced obstacles in adapting their strategy when they came up against resistance to proposed reforms. They regularly tried to change the source of the message to help the message gain political footing. They tried to gain legislative involvement but consistently hit obstacles in gaining legislative support or a legislator to champion their priorities and policy recommendations. The Maryland team worked to achieve this goal by providing proactive education to legislators at committee meetings. After recommendations presented to the boards in 2019 were poorly received, the Maryland team again adapted the source of messaging with a letter to boards from the state’s secretary of labor. Since receiving this letter, which was written to address boards’ concerns while also promoting the priorities of the consortium team, the boards have demonstrated a slight increase in openness to discussion of potential changes.
Stakeholder Engagement, Institutionalism, Perceptions of Market Control
Occupational licensing reform efforts in consortium states have not been without opposition, but states that have meaningfully involved the associations and practitioners in the process have experienced greater success. A broader, more diverse set of stakeholders leads to a stronger buy-in to the process and achieves greater results.
Institutionalization of Approaches
Over the three years of work under the consortium project, the partners saw several ways that states have institutionalized their efforts to review and update their occupational licensing requirements. Broadly, these approaches fall into one of two camps: formalized approaches, which consist of newly founded committees, processes and other entities in state government bound by statute, and informal approaches, which consist of strengthened ties between government offices, venues for stakeholder input and other strategies not codified in state government.
Through the creation of a sunrise or sunset review process, a new legislative committee or new board practices, consortium states have created formalized processes to review and evaluate their occupational licensing policies and practices.
Sunrise and sunset reviews are standardized processes by which the executive branch, legislative branch or both have a chance to review occupational licensing rules and regulations. To read more about these processes, see the Sunrise and Sunset in the States section on page 62. New legislative committees are legislative bodies responsible for reviewing and evaluating occupational licensing regulation. They are also responsible for evaluating new legislation for occupational licensure. Finally, formalized board trainings and other board-related processes are a way regulatory entities can help shape the conversation around occupational licensing in their state.
Consortium states have also employed informal approaches to thoroughly ingrain and institutionalize their occupational licensing work. Many states pulled together stakeholder committees to solicit feedback and to drive their work around given populations or professions. Other states worked to institutionalize their licensing changes by fostering relationships, some existing and some new, between different state agencies and regulatory bodies. Finally, some state governor’s offices helped institutionalize their commitment to occupational changes by being involved in the process, communicating with the core and home teams, and taking executive actions consistent with the goals of the state’s consortium team.
When it comes to institutionalizing licensing changes, one of the most successful approaches consortium states implemented was to build and use stakeholder work groups. Often informal, these stakeholder committees typically consisted of a diverse group of members representing a variety of interests, including:
- Local nonprofits that work with individuals with criminal records.
- Nonprofits that work with veterans.
- Nonprofits that work with immigrants.
- Local business owners.
- Church groups and faith leaders.
- Refugee resettlement groups.
- Members of local government.
- Members of state government.
- Professional association representatives.
Many entities have influence over licensing policies and processes in most states, but sometimes there is a lack of communication between the players involved. Another informal approach that assisted with institutionalizing licensing efforts in consortium states was an emphasis on cross-agency communication and collaboration. A great example of this comes from Delaware, where the state’s Department of Labor and Department of Corrections shared very similar goals in getting more individuals with criminal records back to work in the state. It was through the resources and technical assistance provided by the partners that the two agencies were able to come together and formulate a strategy in which both played a role in reducing licensing barriers for individuals with criminal records in the state. Another example of the increased communication between licensing entities comes from Arkansas. Through the technical assistance and resources provided by the partners, the home team was able to bring together board members from more than 20 different licensing boards to discuss common challenges and participate actively in the state’s occupational regulation conversation. Ultimately, Arkansas’ core team constructed a significant report of recommendations on how to improve occupational regulation in the state based on the feedback and data from the home team of more than 20 members.
Avoiding Perceptions of Market Control
A major focus for the consortium states was ensuring that their occupational licensing boards were operating in the interest of public safety and without the perception of market control. As the collaborative occupational licensure project progressed and grew, compliance with the recent Supreme Court decision in North Carolina State Board of Dental Examiners v. Federal Trade Commission and a renewed examination of state licensing requirements became centerpieces of the work with the consortium states.
While reasonable measures protecting public health and safety through the licensure process are within the purview of occupational licensing boards, these same boards must be careful not to take action that might be viewed as anti-competitive or unfair competition.
In Delaware, Governor Jack Markell issued an executive order that established the Delaware Professional Licensing Review Committee. The order directs the committee to provide state oversight to Delaware licensing boards; conduct an analysis of “the composition, state oversight and licensing requirements” of each commission, board and agency; and deliver a report that recommends action to remove unnecessary burdens and “alleviate the risk of antitrust liability identified” by NC Dental.
In 2017, Mississippi passed the Occupational Board Compliance Act to help boards and their members “avoid liability under federal antitrust laws.” It sets board policy of using the least restrictive regulation available and in accordance with public safety and provides a range of regulatory options from market competition (least restrictive) to occupational license (most restrictive).
These state actions are examples of a nationwide movement to avoid anti-competitive action and remove unnecessary barriers to entering the workforce. As states navigate a changing regulatory environment, state leaders continue to provide innovative solutions that balance public safety with the promotion of a robust, competitive economy.
The Nevada State Board of Nursing (NSBN) in 2017 supported legislation to join the Enhanced Nurse Licensure Compact (ENLC). Despite receiving support from AARP, the Nevada Nurses Association, Sunrise Hospital and Medical Center, and others, the bill did not pass out of committee. The bill was opposed by the service employee’s international union, the Working Families Party, and Clark County Education Association. The NSBN did not have a broad enough base of support from enough stakeholders to help get its bill through committee. In 2019, the NSBN decided to adapt its strategy. The Nevada team sent out a survey to nurses working in Nevada. The survey found that of the 43,000 nurses surveyed, 90% supported joining the compact. With the help of consultant Michael Hillerby, the Nevada team began meeting with legislators. The meetings had a variety of purposes: to educate legislators on the compact, identify possible sponsors for the bill, gauge concerns and assess possible strategies for getting the bill passed.
After meeting with legislators, the Nevada team uncovered common themes of concern among lawmakers. They centered around skepticism toward telehealth, compact disciplinary actions, and labor unions’ apprehension about flooding the labor market and making it easier to hire strikebreakers during union strikes. The meetings with legislators, coupled with a change in governor and inability to find a bill sponsor, led the Nevada team to decide not to introduce the bill again in 2019.
The team is instead planning to introduce the legislation during the next legislative year, which begins in 2021, using the time between now and then to implement a new detailed strategy of engaging stakeholders at the grassroots level. Team members plan to focus on networking and educating as many stakeholders as possible before their next attempt. Learning from its first attempt in 2017, the team is working to hear stakeholder concerns and educate legislators well before introducing the legislation. By engaging with stakeholders in a more robust way, the team is hoping the combined support of legislators, NSBN and nursing stakeholder groups will help make the legislation more successful.
The Colorado team was able to engage many external stakeholders early in its process. However, the team faced difficulty in building engagement from legislators.
Part of the Colorado team’s strategy for stakeholder engagement was forming three working groups. Each group focused on one of the three populations the Colorado team was hoping to address in its reform efforts: the Veterans Occupational Credentialing and Licensing committee (VOCAL) focused on veterans and military families, the Immigrant Gap Analysis committee focused on immigrants, and the Collateral Consequences committee focused on people with criminal records. Over the course of Colorado’s participation in the consortium, the committees held multiple focus groups with industry members and town halls with state legislators and the public. Those helped the committees draft potential new rules, policies, laws and reports related to occupational licensing in Colorado. The committees also hosted webinars and meetings to help educate board members, legislators and industry stakeholders on their proposed changes.
This effort to engage stakeholders from the beginning helped the Colorado team successfully get legislation passed that streamlined part of the application process for cosmetology licensure based on experience gained overseas. This process also helped aid the promulgation of many new rules, creation of draft policies for people with criminal records, and the translation of 12 licensing applications into Spanish. It also led to the research and publication of a guide for immigrants on the licensure process, and the creation of numerous rules to streamline the application process for veterans.
The Colorado team, however, encountered difficulty engaging state lawmakers in its larger goals. The team invited lawmakers to workshops, meetings and conferences on the subject. However, they often struggled to build bipartisan legislative support or find lawmakers to champion their cause. This lack of engagement from lawmakers created an obstacle for the reforms beyond the promulgation of rules or the publishing of board policies and recommended best practices.
Stakeholder Engagement Lessons learned
Both the case studies from Nevada and Colorado demonstrate the value of engaging stakeholders early in the process. They also demonstrate the importance of building legislative relationships through continual education and networking with state lawmakers. Through regular meetings, workshops, educational events, town halls and listening sessions, key stakeholders can be meaningfully involved in the process. This allows for a broader base of support for various proposed changes and reforms.
Changes in Leadership
Many players involved in state government have critical roles in occupational licensing reform, including governors and state legislators. It is important for leadership at the state level to prioritize occupational licensing for reform to happen, but it is also a challenge to implement reform when there is a change in leadership.
Governors can play a leadership role in occupational licensing reform by issuing executive orders to direct agency action on licensing reforms, providing support and leadership to get legislation passed, and appointing representatives to serve on a licensing board. They can also serve as a public champion for occupational licensing review and reform by giving speeches or supporting efforts from legislators, interest groups and the general public. One best practice learned from the consortium was to have a consistent representative from the governor’s office on the core team. For example, the director of Nevada’s Governor’s Office of Workforce Innovation’s (OWINN) was a member of the core team. OWINN’s goal is to drive a skilled workforce in the state by encouraging collaboration across entities. When Nevada had a gubernatorial party change in 2018, a new OWINN director was appointed. But by ensuring the core team continued to have representation from OWINN, the new director was able to help the team bridge the administration change and keep the work progressing.
State legislators play an important leadership role by introducing, endorsing and passing legislation on occupational licensing. One best practice for navigating legislative turnover is to remain focused on stakeholder engagement. While the state leaders may face turnover, external stakeholders often bridge changes. These external stakeholders may include licensing boards, colleges, lobbyists, other state agencies, nonprofit agencies and citizens. For example, Colorado focused on reaching out to immigrants, nonprofits and other stakeholders to inform and advance its work on reducing burdens for skilled immigrants. Colorado’s core team found that engaging various stakeholders helped inform and advance policy when legislators were busy in session or facing internal changes. As a result of these strategies, Colorado’s Department of Regulatory Agencies proposed a bill that would allow Deferred Action for Childhood Arrivals (DACA) recipients to receive occupational licenses.
The consortium partners also assisted in minimizing the effects of leadership turnover during the duration of the project. As third-party facilitators, the partners were able to make introductions, provide context and resources, and send reminders about planned events to new staff. For example, in Illinois, the Department of Financial and Professional Regulation was originally leading the work but due to a change in administration, it moved under the governor’s office. The consortium partners were able to work with all parties and help bridge the handoff and information gaps.
Sunrise and Sunset
Sunrise and sunset measures were of immediate interest among consortium states. Sunrise reviews, which occur before legislation is enacted, and sunset reviews, which occur once legislation has been passed and implemented, can be powerful tools for policymakers to evaluate occupational licensing measures for continued relevancy. Both processes examine the existing or proposed costs and benefits of licensure, compare regulation with other states and provide policymakers with a data-driven analysis to assist them in decision-making. A handful of states are well-known for using these processes for a variety of purposes to audit state government agencies, programs and regulations. Some consortium states began the action-planning process hoping they may be able to emulate the lessons learned from other states.
The major licensing reform laws states are considering include ‘sunrise’ and ‘sunset’ provisions,” Hultin said, “which either establish a cost-benefit test to be conducted before a new license can be enacted, or require review of all existing licenses to examine the costs and benefits.
– Idaho Press, August 28, 2019
As the project progressed, consortium states’ appetite for access to information about these processes and related technical assistance grew. At the 2018 Consortium Meeting in Clearwater, Fla., the partners held a session on sunrise and sunset reviews with experts from Colorado, Texas and Vermont explaining how the reviews work in their states. Of the consortium member states, Arkansas, Illinois, Indiana and Wisconsin all received specialized technical assistance from the partners on this topic. Of these states, Arkansas is the only one so far to have successfully built a formal process into its regulatory structure. In 2020, Wisconsin pursued adopting a sunrise process via legislation with the partners providing testimony. However, it did not ultimately pass. It is worth noting that Idaho, a state that joined the consortium in 2018 but was not part of the original cohort, also successfully formalized its use of these processes as a result of its work with the partners.
For these four states, there are a few lessons learned on which to report. Tracking down as much information as possible on these processes, including examples of how they do or do not work in other states, was a critical first step. In Indiana’s exploration of sunrise and sunset processes, the team held programming at its 2019 Health Workforce Summit (in-state meeting). After being introduced to the topic in an earlier session entitled, “Why we regulate,” participants took a deep dive into both processes—hearing from an expert from Colorado on sunset and an expert from Vermont on sunrise. Participants were most interested in learning more about how each state was making the process work for them, asking the speakers specific questions about implementation, process, structure and stakeholder buy-in.
Once the information was made available, securing significant buy-in from multiple stakeholders in government was necessary for states to successfully adopt one—or both—of these processes. Identifying strong champions who believe in the promise of the processes and would be willing to take the message to their peers was equally critical. Strong legislative and executive advocates were necessary, as well as a strong proponent from the state’s regulatory community willing to discuss the details and recruit colleagues on behalf of process implementation. Arkansas was able to coalition-build effectively, a strategy that ultimately led to the successful adoption of both sunrise and sunset legislative review. According to AIR’s case study of Arkansas’ work in the consortium, the Red Tape Reduction Working Group (RTRWG) and the Occupational Licensing Advisory Group (OLAG) were key coalitions of important stakeholders working in parallel with one another. OLAG was a 25-member group representing various regulatory boards and departments in the state. It was tasked with researching the state’s licensing requirements and collecting data on all licensing entities to create a thorough picture of licensing regulations in the state. OLAG’s data then helped to inform the RTRWG, which was a governor-appointed stakeholder group tasked with making policy and research recommendations to the legislature.
Early and frequent collaboration among these stakeholders resulted in a common vision and mission that were crucial to OLAG’s success. Sunrise and sunset are both complex regulatory review processes with many factors to consider.
With so many factors to consider, strong advocates who have a united vision are necessary for successful implementation. Arkansas OLAG and RTRWG worked together to generate a report of recommendations in the fall of 2018. The list of recommendations included that the legislature should consider “establishing systematic processes of sunrise review for creation of new licensing entities and sunset review of existing licensing entities.”
Arkansas was able to secure strong buy-in from the majority of its legislators and the governor’s office, and was able to get many of the occupational licensing boards in the state to agree to adopt the processes. By contrast, the Illinois team was only able to secure buy-in for its proposal to adopt a sunrise process from its Department of Financial and Professional Regulation and one party in the state legislature. Ultimately, its proposals failed in the legislature in 2018 and 2019 due to a lack of cross-ranch collaboration and bipartisan stakeholder involvement.
Types of Occupations Considered
Some state occupational licensing reforms are implemented through broad policy actions. But obstacles such as political challenges, concerns for expediency, industry-specific factors, state workforce strategies and differences in regulatory structures can require states to develop more tailored approaches for licensure reform.
Many consortium state action plans targeted policy changes to where they may be the most effective, and therefore occupation-specific policy reforms were a common consideration. Of these, state teams commonly cited interest in addressing disproportionately affected populations in the occupations, state workforce shortages and the regulatory structure of the boards. Some teams also considered these factors in tandem. For example, Maryland targeted the in-demand occupations of cosmetology, HVAC and plumbing for board-initiated reforms that involved improving accessible pathways to licensure. Regardless of the structure, a lesson from the consortium’s work is that states can spur policy momentum and sometimes be more successful when taking tailored and specific approaches.
It is common for states to consider how their licensing requirements in specific industries compare with other states when considering reform strategies. The resulting data can establish how closely a state aligns with national averages and reveal outliers in licensing fees, training requirements or other barriers specific to an occupation. To address this information need, the partners created the Occupational Licensure Database to compare licensing requirements in high-employment, high-growth occupations that have lower educational attainment barriers to entry. The database is currently comprised of 48 occupations, including electricians, massage therapists, cosmetologists, plumbers and dental hygienists. This selection also served as the suggested occupations for the consortium states to consider during the development of their action plans.
The database continues to assist state efforts in comparing how similar or dissimilar their licensing structures and requirements are regionally and nationwide. In addition to more capably targeting their overly burdensome regulations, states can improve their understanding of how well their licensing requirements align for reciprocity, including through bilateral reciprocity agreements, interstate compacts and the effect that “equal to or greater than” clauses can have on licensure mobility.
For example, information in the database about cosmetology shows that the training hour requirements vary from 1,000 to 2,100 hours, 33 states do not require continuing education and licensure fees range from $18 to $263. The significant variabilities in these database metrics represent a sample of the licensing requirements that could be investigated further by a state. Examined on a regional level, states can see how overly burdensome requirements may particularly put them at a disadvantage when trying to attract workers for certain occupations.
If the legislature’s action stands and plumber’s licenses are no longer needed, Texas would join the four other most populous states in the country—California, Florida, New York and Pennsylvania—in relying on local codes rather than a state plumbing license law, according to an occupational licensing database kept by the National Conference of State Legislatures.
– Texas Monitor, June 6, 2019
Workforce Strategy Alignment
When state occupational reform efforts are combined with broader workforce strategies, states can prioritize actions that address licensing barriers or overly burdensome regulations that inequitably affect certain occupations. For example, the Nevada state team targeted licensure reform for occupations that were included in the Governor’s Office of Workforce Innovation report of in-demand occupations, as well as the project partners’ list of targeted occupations (see page F1). These included HVAC contractors, plumbers/pipefitters/steamfitters, nurses and nursing assistants. In particular, the state team noted the projected shortages of licensed practical nurses and the need for further analysis. This priority was shared by the Indiana state team, which also recognized a shortage of nurses and other health care occupations in the state. This focus in particular helped support the state’s effort to join the Enhanced Nurse Licensure Compact during the course of the project.
States may consider how either their regulatory structures can present challenges or facilitate their ability to implement policy reforms. For example, licensing boards are organized with varying levels of autonomy from a state supervising entity. For the occupational boards located in more centralized structures within state departments, there may be an opportunity to advance reforms based on the close organizational relationships and designations of authority. For example, Maryland’s project team took this approach with its targeted occupations, knowing that the associated boards were organized in its Department of Labor, Licensing and Regulation. Even though the boards were ultimately the decision-makers regarding the reform strategies presented by the state team, the regulatory structure facilitated the interactions and helped secure buy-in for some of the measures.
Regulations to Address Targeted Populations
A strategy employed by states to mitigate the disproportionate effects licensing regulations can have on certain population groups is to target certain occupations. For example, some states focused on occupations that more commonly matched the career choices for immigrant populations. The Colorado state team, for instance, found that barbering and cosmetology had one of the largest numbers of foreign applicants among its licensing programs. The state team therefore prioritized finding ways to streamline regulations that could address the situations specific to that population group, such as language barriers and the need to recognize experience gained outside the United States.
Levels of Regulation
States can also consider whether the form of credentialing assigned to an occupation best meets its related public health and safety risks. For example, the Utah Legislature passed HB 290 (2020) to lower regulations for hunting guides and outfitters. Specifically, it was determined that there was a more relevant need to identify who these practitioners are, rather than require standards more familiar to licensure. HB 290 therefore required each practitioner to file personal identifying information with the state. This information in turn is useful where investigations into adverse practices may be warranted.
As mentioned in the previous Partner Resources: Population Report section of this report, using the population-specific lens to examine occupational licensing policy helped focus this project for consortium states when they were beginning to formulate an action plan. Particularly during the first year of the project, the partners often framed meeting sessions, publications and specialized technical assistance in terms of a population group. While there were several key lessons learned from each of the unique populations, overall, it was determined that a best practice for one population group can often also be a successful approach for another.
Some of the populations ultimately received more attention than others. Veterans and military spouses were the most popular of the four populations among consortium states for the duration of the project. Several states began their work looking at what licensing-related changes they could make that would benefit veterans and military spouses specifically. Individuals with criminal records can be considered a close second, particularly in the second and third years of the project. Immigrants with work authorization were popular among about half the states that had larger immigrant populations while the long-term unemployed and dislocated workers received the least attention among consortium states.
It’s also important to acknowledge that some states chose not to structure their work around a specific population. These states often still made changes that ultimately were beneficial for one or more population groups, but they were not framing their action plan in terms of a specific population.
Veterans and Military Spouses
Out of each of the four target populations, veterans and military spouses are perhaps the easiest for states to rally behind. Many of the states in the consortium began their work securing buy-in from policymakers, governor’s office staff and regulators on policies related to veterans and military spouses as a way to introduce licensing reform as a tool to benefit this population. The experiences of consortium states show that for military families, policies addressing uneven licensure requirements across states and the related lack of licensure mobility are best practices. Meanwhile, for veterans, policies ensuring that military experience and education can be considered when applying for licensure is a clear best practice.
For many states approaching licensing reform for military spouses, improving mobility and getting this population to work as soon as possible were typically the focus. For some states this meant granting a military spouse a license through an expedited process, with a board issuing a permanent license without further examination for applicants who already held a valid license in good standing in another state. Kentucky HB 323 from 2019 exemplifies this type of approach by requiring licensing authorities in the state to issue a license to military spouses within 30 days of submission of an application, provided certain criteria are met. This legislation builds off Kentucky HB 319 from 2018, which required the same 30-day application processing guarantee but for active duty military members and their families. Both pieces of legislation stem directly from Kentucky’s participation in the consortium and were identified by the state team and fleshed out as policies during the 2017 and 2018 Multi-State Learning Consortium meetings. The Kentucky team was particularly interested in what it could do to improve the licensing process for military spouses in the state and, during the 2018 Multi-State Consortium Meeting, was able to construct HB 323 through facilitation by the partners.
Some states grant temporary licenses to military spouses while they are applying for a regular license in their new state . This could be 90 days or longer, depending on the state. Others decide to recognize licenses from other states for military spouses, allowing them to practice in the state immediately, without going through the licensure process, provided certain criteria are met. Utah arguably started this trend in 2018 with SB 227, which allows military spouses who move to the state to practice immediately, providing their home-state license is current, in good standing and they pay any applicable fees. Similar to Kentucky, with the assistance of the partners’ facilitation during state team time, the Utah team identified military spouses as a population it wanted to assist by pursuing policy change. Over the duration of the 2018 Multi-State Consortium Meeting, the team focused on action planning for this population group, ultimately forming the SB 277 (2018) legislation.
Veterans and Service Members
States interested in improving their licensing processes and policies to benefit veterans often must figure out how to translate military education and experience to state-specific licensure requirements. Colorado, for example, passed legislation (prior to the consortium’s formation in 2016) requiring the state’s Department of Regulatory Agencies to review all the occupations it regulates for potential ways in which military experience could be translated into state-required experience for an associated license. The state expanded its efforts by working with the consortium and with the partners’ support, developed an advisory group of local stakeholders within the military and veteran’s community to provide input and expertise. This led to the team tasked with comparing and matching each licensed occupation in the state for military equivalence being able to crowdsource information from experts close to each branch of the military as well as those who work with veterans.
Another example of a similar approach comes from Delaware, where the legislature passed HB 112 in 2018 allowing licensing boards to recognize military education, training and experience when reviewing credentials and issuing licenses. During its partner-facilitated state team time at the consortium meeting in 2017, the Delaware team identified the need for licensing boards to be able to compare and match military experience for applicants. Through the action planning process, the Delaware team developed a strategy for formalizing this recognition and the legislation was ultimately passed in the subsequent legislative session.
The key challenge consortium state teams faced in considering and crafting solutions for military spouses and veterans was the sheer amount of information and the vast number of different stakeholders that needed to be included. Different policies and procedures cutting across branches of the military and across bases in the same state can make it difficult for policymakers. They have to gather and digest all the information to figure out how to translate military experiences into state licenses or understand how to make the process easier for military spouses. State teams were able to address this by developing strong ties with local military bases and organizations working with veterans and military spouses. For example, the Delaware team solicited input from representatives of Dover Air Force Base to craft its 2018 legislation and Kentucky worked closely with representatives from Fort Knox in developing its 2018 and 2019 legislation. In cultivating a wide net of stakeholders in this community, the Colorado team worked with representatives from military installations in the state, as well as with numerous local nonprofits working with military veterans and their families. These connections directly to the military and the people whose lives are most directly impacted by service benefitted consortium states through increased communication and information sharing.
Individuals With Criminal Records
Individuals with criminal records tend to face a number of collateral consequences, which is why there was considerable energy among consortium states to explore licensing solutions for this population. While occupational licensing can create hurdles for certain workers, individuals with criminal records can face additional challenges finding and maintaining employment—a critical aspect of reducing recidivism. Consortium states addressed blanket bans, good moral character clauses and the overall cost of licensure to help improve employment outcomes for workers with criminal records. The need for cross-branch collaboration in state government and for ties to and buy-in from the corrections community are two key lessons from consortium states’ work with this population. Although consortium states have been able to make some significant progress on addressing licensing barriers for this population, it is too soon to tell the extent to which their efforts have been successful in reducing recidivism and improving employment outcomes.
Blanket bans are one common policy barrier for individuals with criminal records that consortium states worked on. Blanket bans broadly prevent anyone with a criminal record from getting a license, particularly those with felony criminal convictions. Illinois approached this issue by passing HB 2670 in 2019. The legislation goes beyond simply removing blanket ban language and requires that mitigating factors associated with an offense may not be a bar to licensure, but instead should provide guidance in considering the applicant for licensure. Illinois’ key to success on this issue was the collaboration that occurred between energized champions for the measure both from the legislature and the state’s Department of Financial and Professional Regulation. Particularly for a state team that faced challenges with some of its other desired reforms, the partnership that developed between the legislature and the state regulatory agency on this issue was crucial to the passage of HB 19-2670.
Related to the removal or modification of so-called blanket bans in statute, consortium states have also been interested in the practice of pre-qualification to assist this population. Pre-qualification is when a licensing board lists the specific convictions that will disqualify an applicant from being eligible for a license in a given occupation. Or, in some states, pre-qualification allows prospective applicants to petition the board for a review of eligibility based on their criminal record before pursuing the formal application process. Among consortium states, those able to secure buy-in from regulators on pre-qualification standards were able to adopt them.
Nevada passed AB 319 on this topic in 2019, authorizing those with a criminal background to seek pre-determination on whether or not a past conviction would disqualify them from licensure. Nevada has a decentralized, board-dominated regulatory structure in place. The lack of connection and communication among regulatory boards is often cited as one potential drawback of these decentralized regulatory systems. The Nevada consortium team was able to overcome this challenge by bringing numerous licensing boards in the state together for regular check-in calls to discuss the reform ideas the team had identified. By bringing the State Board of Nursing, the Contractors Board, the Board of Cosmetology, the Physical Therapy Board and others to the table, the team was able to include these different board voices in the conversation and harness their expertise to craft the pre-qualification legislation.
Connections to Corrections Community
Among all consortium states, the Delaware team perhaps had the most success forging a close relationship with its corrections community. From the outset, given the expertise of some of its core team members, criminal justice and licensing issues were a priority for the team. The Delaware team identified reducing or removing unnecessarily burdensome licensing requirements for justice-involved individuals as a key goal of its action plan from the first consortium meeting in 2017. One of the team’s main accomplishments was the passage of legislation reducing the amount of time an individual with a felony conviction would have to wait to be eligible for licensure. Beginning with HB 97 from 2018, the state Board of Cosmetology and Barbering was allowed to grant waivers for applicants with felony convictions who previously would have had to wait two to three years to become eligible for a license after a conviction. With support from the partners, Delaware was able to host in-state meetings and invite members from the Department of Corrections, Department of Safety, Department of Health and Human Services and others. The team was then able to present the action plan and solicit expertise and feedback.
Bringing these partners to the table and passing HB 97 set off a chain of events, allowing for further reduction of licensing barriers for this population. In late 2018, after the passage of HB 97, Delaware Governor John Carney signed an executive order creating the Delaware Correction Reentry Commission and tasking it with overseeing the implementation and creation of efficient and effective reentry initiatives. The state’s Correctional Reentry Commission worked in partnership with the core team from the consortium to continue to advance the team’s action plan. Some members of the commission also served on the core team to ensure collaboration between groups. Subsequent legislation was introduced in 2019, providing the boards overseeing licensing for plumbers, HVACR operators and electricians with the same authority to grant waivers to applicants with felony convictions. This legislation, HB 124 from 2019, ran against some opposition, but with the connections the Delaware team had made in the corrections and regulatory communities, it ultimately passed.
A key challenge to working on licensing issues that directly impact individuals with criminal records is the employability of these individuals once they receive a license. States can pursue a variety of approaches to make it easier for those with criminal records to secure a license. Once that license is obtained, however, many consortium states, including Colorado, Delaware, Maryland and Nevada, reported that the challenge continues in that there is no guarantee a licensee will find employment. Unfortunately, even with the reduction of statutory and regulatory barriers, individual employers may still be hesitant to hire someone with a criminal record. Some licensed occupations, particularly those related to the trades, such as electricians or plumbers, require entering homes, schools, health care facilities and other places. This may make anyone with a criminal record working in these jobs controversial for some employers. This concern was outside of the scope of the project, but the partners recognize it as an important issue and a potential area for continued improvement in breaking down barriers to work for individuals with criminal records.
Immigrants With Work Authorization
Immigrants with work authorization received a good deal of attention, but only from a handful of consortium states. There are a variety of explanations for this, including the size of the foreign-born population in a state and the political will of policymakers to take on licensing issues impacting them. While there are some population-specific best practices from consortium states for this population, perhaps the biggest lessons learned are that communication to potential applicants is key and many of the policy solutions to assist some of the other populations can be applied to immigrants seeking licensure as well.
Improved Communication to Licensees
Improved communication from licensing entities can improve outcomes for all types of applicants. Consortium states learned this to be particularly true for immigrants with work authorization. Maryland and Colorado are two examples of states that sought to improve communication with these applicants. Maryland sought to improve the accessibility of its licensure exams for non-native English speakers by allowing interpreters and/or translation dictionaries on exams for certain occupations. The Maryland team identified this as a goal for its action plan and was able to complete it through regulatory policy. As a result, applicants for licensure in cosmetology are now able to take the licensing exams with an interpreter present to assist in translating terms. Applicants for licensure in HVACR and plumbing are also now able to use translation dictionaries on their exams.
The Colorado consortium team identified reducing licensure barriers for immigrants as a top priority during the 2017 Multi-State Consortium Meeting. With significant assistance from the partners, the team was able to form a committee of community stakeholders to provide input on which parts of the licensure process were hardest for immigrants to navigate and to crowdsource ideas on how to address these barriers. Unlike some of the other populations, the policy tools that appeared to be most helpful for immigrants included more communication and messaging approaches, rather than big changes to legislation or regulation. The team was able to solicit feedback from this group of stakeholders to help drive its reforms in specific ways. One reform that came from the committee’s feedback was a licensure guide for immigrants interested in pursuing a barber or cosmetology license. With best-practice information provided by the project’s national experts, the team was able to identify licensing guides as an optimal solution to some of the most common communication problems for immigrants seeking state licensure. The team hopes to construct guides for many more occupations in the future.
Borrowing Best Practices from Other Populations
The other major takeaway from consortium states’ experience working with the immigrant population is that best practices for other populations can often be borrowed to create helpful policies for immigrants. One major example comes from the Colorado team’s successful passage of HB 1290 from 2019. The legislation allows applicants for licensure in the barbering and/or cosmetology occupations to substitute foreign work experience for the required hours of instruction. Applicants may substitute work experience obtained in a foreign country at a ratio of three months for every 100 required instruction hours. Applicants still must complete any hours or other requirements related to protecting public health and safety. The legislation enables immigrants, particularly those from countries where records may not be readily available, to submit other forms of proof, including a signed and notarized attestation of work experience. In crafting this policy, the Colorado consortium team borrowed from what it already learned about substituting military experience for licensure requirements and was able to successfully implement a solution impactful to the state’s immigrant community.
Successful communication between stakeholders critical to the immigrant community and licensing entities was one challenge consortium states faced. There are many local nonprofits assisting immigrants with job searching and placement services, but there is a level of decentralization that makes it difficult to communicate with all groups uniformly.
Furthermore, common practices that could help cut down on information asymmetry in licensing, such as making information readily available on websites, is often overlooked by state licensing entities. Coalescing a core group of community stakeholders working with the immigrant population who could then pass on the message from the state licensing body was an effective approach in both Colorado and Maryland to improve communication between the two sides. These efforts were both possible through the facilitation and convening expertise brought to the table by the partners. Unfortunately, despite best efforts, it is likely that parts of this population, perhaps those with less access to technology or who face other conflating circumstances, still aren’t receiving the critical licensing information they need.
Although consortium states set out to remove licensing barriers for immigrants with work authorization, immigration status ultimately cropped up as a challenge for several states. Illinois and Nevada both passed legislation during their time as consortium members prohibiting licensing entities from refusing an applicant a license based on immigration status alone. Illinois’ 2017 legislation, SB 3109, prohibits the state’s Department of Professional and Financial Regulation from denying a license based solely on one’s citizenship or immigration status. It also allows individuals to provide a taxpayer identification number on an application as an alternative to a social security number. Nevada’s legislation, AB 275 (2019), is very similar. Arkansas also dealt with immigration status in HB 1552 (2019). The legislation is narrowly targeted to allow the state board of nursing to license recipients of the national DACA policy. The policy is intended to help the state with a shortage of skilled nursing professionals.
Low-Income, Unemployed and Dislocated Workers
Finally, of the four target populations in the consortium’s work, states focused the least on the low-income, long-term unemployed and dislocated workers. In working with the states, the partners often heard that while policymakers and regulators would like to devote attention to this population group, they were constrained by their resources and ultimately chose to focus more on the other three groups. This project took place over the course of four years, three of which were during an economic expansion in the United States. The states that did pursue policy changes for this population had some success, and states that did not directly focus on this population addressed some of the issues it faced. For example, improving the portability of licenses, whether aimed at another population group or all license holders, still affected this population, which perhaps would benefit from moving to a region or state with more jobs.
Moving Beyond 2020
Finding the right balance of occupational regulation will remain an ongoing effort for all states beyond this project. Though most of the formal activities of the consortium project are wrapping up in December 2020, the partners will continue to serve as a resource to the state teams through their regular membership services, including policy research, analysis, and regularly scheduled conferences and events. The resources and information produced by the partners and other organizations have given clarity and transparency to the kinds of barriers and challenges that many people face in entering a licensed occupation or moving across state lines.
The successes and momentum delivered by the consortium project established the groundwork for additional state reform efforts and peer learning opportunities. To this effect, the U.S. Department of Labor continued its support with additional grants awarded to the states and partners, which are scheduled to conclude June 30, 2021. You can find the states that were awarded the grants in the appendix along with the work of the partners.
The grants will be used to review and streamline licensing requirements and address licensure challenges for veterans and transitioning service members. Kentucky is one of 11 member states in the Occupational Licensing Policy Learning Consortium, a program established by the Council of State Governments, the National Governor’s Association, and the National Conference of State Legislatures.
– Morehead State Public Radio, June 30, 2018
There remains a lot of interest and momentum in the consortium states to continue the work, evaluate current licensing regulations, examine the portability of licenses and propose ways to reduce barriers for all workers. Similarly, states that were not involved have shown interest and movement in addressing many of the licensing challenges and opportunities listed in the report. The online resources and lessons learned from this report will continue to be useful for all states as a model for action.
Key Activities of the Partners
Through the course of the project, the partners published new research and reports, developed comprehensive databases to track legislative actions related to occupational licensing, and worked directly with consortium states to achieve their individual licensing goals. Key partner activities included:
- State Engagement through the Occupational Licensing Policy Learning Consortium
The partners convened a series of three annual Multi-State Occupational Licensing Policy Learning Consortium meetings. These gatherings offered participating states the opportunity to develop and refine detailed action plans concerning occupational licensing. They also allowed state team members to engage with leading experts on topics related to occupational licensing, such as alternatives to licensure, national best practices and population-specific impacts. The meetings facilitated peer-to-peer learning experiences, allowing state team members the opportunity to share best practices and lessons learned.
- Development of Research, Publications and Occupational Licensing Resources
The partners created numerous online and printed resources throughout the course of the project, tailored to state policymakers and regulators. These included two policy and literature scans outlining the current research on occupational licensing and a series of briefs focused on the unique challenges different population groups face in obtaining a license or working across state lines. They also included promising action states have taken to improve the portability of licenses across states. Numerous blog posts and newsletters were also compiled highlighting legislative and executive trends on licensing regulation. The resources are highlighted in more detail in the following Partner Resources section.
The partners hosted three webinars each year of the project, totaling nine in all. The webinars highlighted partner resources and legislative and executive order tracking in the states, innovative state actions from the legislative or regulatory sides, and emerging trends for 2020 and beyond.
- National Occupational Licensing Database
This one-of-its-kind searchable resource for policymakers and the public provides transparency in the discrepancies of licensing requirements across states. The National Occupational Licensing Database contains licensing data for 48 occupations across all 50 states and Washington, D.C., including education requirements, experience requirements, fee information and portability options.
- Occupational Licensing Legislation Database
NCSL created an online database of licensing bills and laws on 34 occupations, four different population groups and other licensing trends for all states and territories that is searchable by topic, occupation and state. This database tracks introduced and enacted bills from 2017 through 2020 and is updated weekly. To date, NCSL has tracked over 3,000 pieces of legislation.
- Consortium State Technical Assistance
Consortium state teams received in-depth technical assistance and action planning facilitation throughout the three years of the project. The technical assistance included partner facilitation at the annual Multi-State Learning Consortium meetings, continual follow-up, and facilitation and coordination of in-state meetings. The third-party facilitator role, played by the partners, was integral to keeping momentum in the states. This will be further discussed in the Lessons Learned section of the report.
- Occupational Licensing Programming at National Partner Meetings
The partners regularly host large, annual or biannual meetings, which bring together legislators, legislative staff, and staff from governors’ offices and departments and agencies. Occupational licensing resources and consortium state activities were highlighted at numerous meetings throughout the project. This gave attendees insight into the numerous policies consortium states were undertaking and emerging trends around licensure policy.
- Project Clearinghouse Page
NCSL created the National Occupational Licensing Project webpage and URL shortcut, www.ncsl.org/stateslicense, to house all the partner resources, blogs, databases and webinars. The webpage is updated on a regular basis and often featured on NCSL’s homepage.
In 2019, the partners consulted with the American Institutes of Research (AIR) in conducting case studies on the 11 original consortium states. AIR conducted multiple interviews with stakeholders from each of the original 11 consortium states. Each case study provides a deep dive into key obstacles and successes each state faced in pursuing specific licensing policy goals.
- Arkansas: The effect of building a coalition on the achievement of results within the occupational licensing initiative.
- Connecticut: The process of developing and passing the Minority Teacher Recruitment and Retention bill (PA 18-34) and how it was identified as a goal.
- Colorado: The successes and challenges of using a regulatory approach to affect licensure policy.
- Delaware: The effect of HB 97 on addressing and reducing barriers to licensing for justice-involved individuals.
- Illinois: The approach adopted to pass the sunrise/sunset legislation and the challenges overcome in the process.
- Indiana: The processes, challenges and lesson learned from passing nursing compact legislation and the barriers that prevented the passing of emergency medical services compact legislation.
- Kentucky: The challenges and barriers encountered when attempting to reform a decentralized occupational licensing system.
- Maryland: The reasons for successful regulatory reform for the state’s cosmetology field but not other occupations—specifically plumbers and heating, ventilation, air conditioning and refrigeration professionals.
- Nevada: The processes and challenges involved in attempting to pass the nursing compact legislation and how the need to join a nursing compact was identified as a goal.
- Utah: The process of developing SB 227 and how the need to reduce barriers to occupations for military spouses was identified.
- Wisconsin: The process and impact of the 2017 Wisconsin Acts 278 and 319 on disproportionately affected populations.
Methodology of Database
States are commonly interested in better understanding their own licensure framework and learning how it compares with others. When states are equipped with this knowledge, they are better positioned to identify areas for improvement where existing regulations may be overly burdensome and impede market entry or licensure mobility.
Prior to the start of the project, third-party state-by-state comparisons of licensing policies and occupation-specific requirements were limited in scope. Further, it is a duplicative and time-consuming process for each state to conduct its own licensure review, which can include analyses of state statutes and administrative rules and surveys of state licensing boards. States can also experience difficulties navigating the varying definitions, classifications and requirements for licensure across states. Contractors, for example, are commonly licensed by states with segmented scopes of practice. Additionally, information included in available state licensing resources may be incomplete, difficult to find and/or outdated.
Given the need for quality state licensure data, the partners developed the National Occupational Licensing Database, which allows states to quickly compare the licensing requirements for commonly licensed and in-demand occupations across all 50 states and District of Columbia. The initial iteration of the database included 17 licensing metrics for 32 occupations. In 2018, the database was expanded to 48 occupations. The new occupations are listed in the Appendix E. Notably, the database offers a comparative look at the highs, lows, means and medians of the numerical-based licensing metrics. States can also see how frequently policy options, such as good moral character clauses and criminal conviction restrictions, are used.
- General Contractors
- Teacher Assistants
- Respiratory Therapists
- Dental Hygienists
- Radiologic Technologists
- Emergency Medical Technicians
- Pharmacy Technicians
- Veterinary Technicians
- Licensed Practical and Licensed Vocational Nurses
- Certified Nursing Assistants
- Occupational Therapy Assistants
- Physical Therapy Assistants
- Massage Therapists
- Private Detectives and Investigators
- Security Guards
- Hairdressers, Hairstylists and Cosmetologists
- Manicurists and Pedicurists
- Skin Care Specialists (Estheticians)
- Insurance Sales Agents
- Pipefitters and Steamfitters
- Plumbers (Journeymen)
- Construction and Building Inspectors
- Security and Fire Alarm Systems Installers
- Heating, Air Conditioning, and Refrigeration Mechanics and Installers
- Drinking Water Treatment Plant and System Operators
- Bus Drivers (City/Transit)
- Bus Drivers (School)
- Heavy and Tractor-Trailer Truck Drivers
- Real Estate Sales Agents
- Real Estate Appraisers
The database proved to be a critical resource that assisted the consortium states with their project-related analyses. Wisconsin, for example, used the database in its 2018 “Occupational Licensing Study Legislative Report,” a comprehensive review of the state’s occupational credentials. Specifically, the database allowed the state to identify which of its licensing requirements for specific occupations were particularly onerous when compared to other states and where reciprocity of out-of-state licenses was allowed.
Another consortium state, Indiana, used the database to review the project team’s targeted occupations: certified nurse aides, licensed practical nurses, emergency medical technicians and dental hygienists. Specifically, the review focused on how Indiana’s regulations of these occupations compared to its neighboring states—Illinois, Kentucky, Michigan and Ohio. For the full methodology of how occupations were selected, please refer to the appendix.
But people have mistaken the focus on the 34 professions for a ‘hit list’ for deregulation,” Hultin said. “You could argue that, if it’s licensed in 30 or more states, chances are there’s a reason for that. It’s more the occupations that are licensed in one or two states that people tend to question a little bit more.”
– American Veterinary Medical Association, Nov. 28, 2018
Literature Scan: The State of Occupational Licensing
Throughout the course of the multi-year project, two major literature reviews were conducted to survey the existing research in the field.
The first review, “The State of Occupational Licensing,” served to ground the work of this project in existing research conducted and literature written up through 2017. Much of the research examined and cited was published between 2015 and 2017, indicating the growing interest and focus on occupational licensing in academic and policy arenas. The report provides an overview of trends and policy issues related to occupational licensing and summarizes best practices and recommendations for licensing policies. State policymakers are the focus of several of these recommendations as legislators serve multiple functions in licensing policy and practice. These include establishing requirements, authorizing boards to oversee compliance and reviewing the merits of current requirements for licensure for various occupations.
“The State of Occupational Licensing” begins with a brief summary of the characteristics of occupational licensing in the United States in 2017, where more than 1 in 5 occupations required a license, up from 1 in 20 in the 1950s. The growth in licensing can present significant barriers to labor market entry for both specific occupations and for four distinct population groups. In addition to these barriers, some trends in licensing policy over time are worth noting. Of the roughly 22% of workers with occupational licenses, the majority work in health care, with a significant number also working in transportation, technical work, personal care and the service industry. The likelihood of holding a license increases with educational attainment and women are slightly more likely to work in licensed professions than men. Finally, white workers are more likely to be licensed than workers of color.
When considering these trends, it is important to evaluate the potential benefits and deficiencies of licensing policies. One of the longest-standing justifications for occupational licensure is to protect public health and safety. When considering that about three-quarters of licensed workers are employed in a health-care-related field, that justification remains evident. In addition to protecting public health and safety, licensure can provide a clearer career development path and ensure higher earning potential for licensed workers. Conversely, these wage gains for licensed workers represent a cost increase for consumers and reduced employment in licensed occupations. This, in addition to the disproportionate burden on the population groups and the decrease in interstate mobility for licensed workers, has led to numerous calls to reexamine licensing policies across states.
The report concludes with best practices and recommendations for policymakers and stakeholders to consider when evaluating licensing policy and potential reforms. It recommends that any new policy or changes to existing policy begin with legislators and stakeholders asking questions and reviewing existing evidence. Following this, it advises that policy should be tailored to the minimum level of occupational regulation deemed necessary to protect the public (certification, registration, licensing, etc.) and its impact on both interstate mobility and the target populations outlined earlier be considered. Finally, it recommends that an analysis of the costs and benefits of licensing be weighed and that policymakers maintain broad oversight of regulatory boards and work to enact broad reforms where possible and deemed appropriate.
The second edition, “The Evolving State of Occupational Licensing,” picks up where the first report left off. It highlights the growth in research between 2017 and 2019 in addition to the work of the Occupational Licensing Research Consortium project. The report begins with a brief overview of the various roles of state policymakers and the considerations they weigh when deciding occupational licensing policy. Among these roles and considerations are:
- Convening stakeholders.
- Authorizing and overseeing regulatory boards.
- Reviewing existing and proposed licensure requirements.
- Establishing and modifying licensing requirements.
In addition to discussing the potential benefits and deficiencies of licensing as the first review did, this version also includes some state-specific variation in licensing and highlights the difficulties in translating training, education and experience across state lines.
Perhaps the most significant update in the second edition of the review is the summary of occupational regulation options and policy best practices. The section offers recent examples from both consortium and non-consortium member states to highlight the work accomplished in this policy field in the last three years. This includes state actions such as Nebraska’s Legislative Bill 299, which established a two-step process to review existing licensing regulations, and Arizona’s HB 2569, which recognizes out-of-state licenses.
In an update to the four population groups discussed in the first review, “The Evolving State of Occupational Licensing” looks at a new population affected by occupational licensing policy. In 2017, student loan borrowers who defaulted on their loan payments faced having their license suspended or revoked in 19 states. Since then, at least four states have repealed these laws and more have considered similar legislation. These reforms are in addition to statutes aimed at easing the burden of licensure for immigrants with work authorization, members of the military and their families, low-income and long-term unemployed workers, and those with criminal records.
Back in 1990, the U.S. Department of Education recommended states “deny professional licenses to defaulters until they take steps to repayment.” Many states soon followed the federal government’s lead and began enacting their own laws. Around 2010, at the height of this legislative trend, the National Conference of State Legislatures found that “roughly half of states had some form of license suspension for default law in place.
– Forbes, March 4, 2019
In 2018, the partners wrote and published a set of population reports, each focusing on one of the four target populations for the project. Occupational licensing is complex, and by breaking down this large policy issue into four different groups and examining it through each lens, the partners were able to deliver more easily digestible information to consortium states. Policymakers are also able to break down the complexity of licensing by framing their work in terms of population. The population reports took a deep dive into the unique challenges and barriers specific to each population group that wishes to enter a licensed occupation and practice that occupation across state lines.
The partners divided the research and writing of the publications evenly among organizations. They spent several months compiling research on population best practices, writing and editing the reports. All three organizations were involved in the final editing of the reports, with NCSL taking the lead on design. For each of the four reports, staff from NCSL combed through legislation from 2015 to 2018 on best practices for each population, then included this list of legislation at the end of the report. NGA provided the same expertise, ensuring that a list of relevant, recent executive orders were included in each report. NCSL designed the report, with input from the partners, and made web-compatible versions, posting them on NCSL’s licensing website. Hundreds of physical copies of the report have been distributed to policymakers from consortium and non-consortium states across the country, and NCSL’s corresponding webpages have been visited over 26,000 times.
- NGA and NCSL partnered on the Veterans and Military Spouse report. Military service members face barriers to licensure when it comes to getting their military education and experience counted toward a license. Military spouses face barriers associated with frequent moves across state lines, including having to retake exams and reapply for licensure with each move.
- CSG and NCSL partnered on the Individuals with Criminal Records report. The rehabilitated workforce faces barriers to licensure related to previous convictions that may wholly bar them from a license or prevent a board from giving their application a deeper look.
- NCSL took the lead on the Immigrants with Work Authorization report, while the partners all contributed to the editing process. Immigrants often experience challenges with having their foreign training and education count toward a license and can have a particularly difficult time navigating a state’s regulatory framework if they are unfamiliar with the process.
- NGA and NCSL partnered on the Low-income, Unemployed and Dislocated Workers report. The biggest barriers unemployed and dislocated workers often face in obtaining a license are the fees associated with licensure and the difficulty of moving to a different state or region once licensed in one state.
Compact Reports and Resources
Occupational licensure interstate compacts are increasingly common tools used by states to eradicate barriers to license portability. Interstate compacts afford states the ability to address many of the challenges associated with state-level licensing through flexible, state-developed collaboration and without federal preemption. Through its National Center for Interstate Compacts (NCIC), CSG has facilitated the development of numerous interstate compacts and tracked the progress of more than 200 active compacts.
To promote awareness and clarity of interstate compacts as a policy tool, the partners developed several resources that serve as primers on occupational licensure interstate compacts and provide an overview of their mechanics.
The partners have distributed and presented these documents at numerous meetings pertaining to the Occupational Licensing Project, such as the panel of experts meetings, the annual consortium meetings, the annual NCIC Summit of the States, compact development meetings and in-state consortium team meetings. These resources aim to facilitate the understanding of an emerging policy lever, the presence of which is increasingly felt by states and professions/occupations.
Multistate Problem-Solving with Interstate Compacts
The first compact resource, entitled “Multistate Problem Solving with Interstate Compacts,” outlines the origins of interstate compacts and how they operate, reviewing at length both their challenges and benefits. The report discusses how compacts fit within the existing legal environment to convey the legitimacy and historical precedent for interstate compacts. The report also provides a description of best practices and outlines a process for developing regulatory compacts. Lastly, a summary of the services offered by NCIC—such as education, administration and resources, and training—is provided for further assistance.
Occupational Licensure Interstate Compacts in Action
The second compact resource, “Occupational Licensure: Interstate Compacts in Action,” successively details the existing occupational licensure interstate compacts and explores the questions frequently asked by stakeholders. This document serves as a fitting follow-up to the first compact resource by exploring how states put compacts into practice and navigate the key decisions that shape how compacts function.
Specifically, the compact resource addresses:
- Compact origination.
- Professions/occupation included in compact.
- States that have adopted the compact.
- Difference in compact models.
- Scope of practice and adverse action procedures.
- Requirements to obtain a license through the compact.
- Requirements for states to join a given compact.
Occupational Licensure Compact Membership Map
The Occupational Licensure Compact Membership Map is a visual and spatial supplement to the more textual compact documents. This map illustrates total occupational licensure compact membership by state, easily conveying to readers where licensing compacts are heavily (or lightly) used. The map also includes a comprehensive list of states that are members of the existing licensing compacts.
News Coverage of the Consortium and Collaboration with External Organizations
There have been 11 news articles written about the consortium since 2018. The articles appear in a variety of publications and cover a broad swath of licensing topics. Relevant quotes from these articles are interspersed throughout this report.
NCSL shared data from the National Occupational Licensing Database with external organizations— including think tanks, universities and state government officials conducting their own analysis of occupational licensing policy—over 40 times.
The Organization for Economic Co-operation and Development (OECD) published a report in December 2019 on occupational licensing and job mobility in the United States. OECD used licensing data from the National Occupational Licensing Database for 31 occupations in their analysis of how licensing requirements can affect job mobility in the United States. The NCSL licensing team met with the OECD researchers via conference call several times, answering questions about database data and providing feedback on data interpretation. Results from the study show that both more extensive and stricter licensing are associated with lower job mobility. In the publication, OECD noted that the “dataset is of high quality and used to construct indicators of the share of licensed employment and for the strictness of licensing.”
Regulatory Structures Resource
The Council on Licensure, Enforcement and Regulation (CLEAR) teamed up with the partners in 2019 and 2020 to publish a report on the regulatory structures states employ to govern their occupational licensing laws and practices (see appendix for full report). The report, “Professional and Occupational Regulation: U.S. State Regulatory Structures” is informed by over 160 survey responses from regulators in 45 states and the District of Columbia. Using prior research that found regulatory models in states can generally be grouped into one of five types, respondents were able to indicate which model(s) best represented their current regulatory organization. Those models are:
- Fully autonomous/independent (Model A).
- Autonomous but with a central agency responsible for housekeeping/administrative functions (Model B).
- Autonomous/independent decision-making authority but with a central agency responsible for housekeeping/administration, budget, personnel, investigations and discipline (Model C).
- Central agency with decision-making authority on all substantive matters while boards are delegated responsibility for some functions (Model D).
- Central agency, commission or council with final decision-making authority and boards serving only in an advisory capacity (Model E).
The report’s findings emphasize common knowledge in the licensing world that every state approaches this topic slightly differently. Results show that of the 46 jurisdictions surveyed, 20 indicated only one single regulatory model was in use, while 15 indicated the use of two different models and 11 jurisdictions indicated the use of three or more. Of the 20 single-model jurisdictions, Model C was most frequently identified as the single model in use. From there, the report goes on to describe the dozens of combinations of models state use to regulate professions and occupations.
The Occupational Licensing Project was a collaboration between the three partner organizations―the National Conference of State Legislatures (NCSL), The Council of State Governments (CSG), and The National Governors Association Center for Best Practices (NGA Center)―and the U.S. Department of Labor’s Employment and Training Administration. Together, the partners planned and facilitated three multi-state learning consortium meetings, held multiple in-state convenings, wrote and researched dozens of resources, collected and analyzed over 100,000 data points for an extensive database, and presented on the project numerous times. The project was managed by Suzanne Hultin, program director, and Luke Martel, group director, with NCSL’s Employment, Labor and Retirement Program. Iris Hentze, policy specialist, Zach Herman, policy associate, and Linnette Vasquez, staff coordinator, also with the Employment, Labor and Retirement program, staffed the project. Other NCSL staff contributors include Josh Cunningham, Saige Draeger, Jon Jukuri, Anne Morse, Jennifer Schultz, Andrew Smalley and Laura Tobler.
CSG project leads were Daniel Logsdon, program director, Heather Shaffer, deputy director, both with the Center of Innovation, and Elizabeth Whitehouse, chief public policy officer. Other CSG staff contributors were Max Morley, policy analyst, Matt Shafer, program manager, Carl Sims, senior policy analyst, and James Tatum, policy analyst, with the Center of Innovation. Additionally, Chidi Umez, project manager, and Josh Gaines, senior policy analyst, with the Criminal Records Project at the CSG Justice Center, contributed to the work.
NGA Center project staff were Kristin Baddour, policy analyst, Madelyn Rahn, policy analyst, and Rachael Stephens, program director, all with the Workforce Development & Economic Policy program.
The partners extend deep appreciation to Pam Frugoli, project director from the U.S. Department of Labor’s Employment and Training Administration. Pam’s knowledge of occupational licensing and guidance on the project was immensely valuable to the success of the work. In addition, we would like to thank Daniel Greenberg, senior policy advisor at the U.S. Department of Labor, for his assistance with the project.
Numerous experts on the topics of occupational regulation, workforce development, people with criminal records, foreign-trained workers, low-income and dislocated workers, and military veterans and spouses contributed to the research and meetings held over the course of the project. We would like to acknowledge their time and assistance.
- Rebecca Haw Allensworth, professor of law, Vanderbilt University
- Michael Armstrong, chief executive officer, National Council of Architectural Registration Board
- Dale Atkinson, executive director, Federation of Associations of Regulatory Boards
- Daryl Atkinson, staff attorney, Southern Coalition for Social Justice
- Beth Avery, senior staff attorney, National Employment Law Project
- Marcus Beauregard, director, State Liaison Office, Department of Defense
- David Benton, chief executive officer, National Council of State Boards of Nursing
- Skip Braziel, vice president for State Regulatory and Legislative Affairs, American Institute of CPAs
- W. Stephen Cannon, chairman and managing partner, Constantine Cannon LLP
- Elizabeth A. Carter, Ph.D., executive director, Virginia Board of Health Professions
- James M. Cox, associate director, State Regulation & Legislation, American Institute of CPAs
- State Representative Martin Daniel, Tennessee
- Wayne Denny, bureau chief, Idaho Bureau of Emergency Medical Services & Preparedness
- Mike Dugan, chief operating officer, Federation of State Medical Boards
- Laura Ebke, former state senator
- Shelly Edgerton, Michigan Department of Licensing and Regulatory Affairs
- Cory Everett, board member and president, Council on Licensing Enforcement and Regulation
- Erick Fajardo, review director, Texas Sunset Advisory Commission
- Paul Feltman, deputy executive director, World Education Services
- Svetlana S. Gans, chief of staff, Federal Trade Commission
- Joe Garcia, Chancellor, Colorado Community College System
- Daniel Greenberg, senior policy advisor, U.S. Department of Labor
- Erica Groshen, visiting senior scholar, Cornell University School of Industrial and Labor Relations
- Col. William “Bill” Hampton, U.S. Air Force (retired), deputy chief, Office of the Deputy
Assistant Secretary of Defense for Military Community and Family Policy
- Mark Jansen, director of Child Care Licensing, Michigan Department of Licensing and Regulatory Affairs
- Nahale Kalfas, legal counsel, The Council of State Governments
- Morris M. Kleiner, professor, Humphrey School of Public Affairs, University of Minnesota
- Lisa Knepper, director of Strategic Research, Institute for Justice
- Joe Marino, executive director, Veterans Florida
- Rick Masters, special counsel, National Center for Interstate Compacts
- Senator John McCollister, Nebraska State Senate
- Matthew D. Mitchell, senior research fellow, Director of the Equity Initiative Mercatus Center at
George Mason University
- Ryan Nunn, fellow, Brookings Institution
- Karen Phillippi, director, New Americans Office of Global Michigan, state of Michigan
- Jim Puente, MS, MJ, CAE, director of Nurse Licensure Compact, National Council of State Boards of Nursing
- Myra Y. Irizarry Reddy, director of Government Affairs and Industry Relations, Professional
- Fatima Sanz, policy strategist, World Education Services
- Robert Smart, chief executive officer, Vametric
- Marshall Smith, executive director, Interstate Medical Licensure Compact Commission
- Kaitlyn Spehar, executive correspondent, Commonwealth of Pennsylvania
- William H Stanley, executive secretary-treasurer, Southern Nevada Building and Construction
- Kathy Thomas, executive director, Texas Board of Nursing
- Adam Weinberg, director of communications, Platte Institute
- Shoshana Weissmann, senior manager, of Digital Media & Communications, R Street
- Alanna Wilson, vice president of Government Affairs and Public Relations, Knee Center for the Study of Occupational Regulation at St. Francis University
- Bryan Wilson, state policy director, National Skills Coalition
- Marta Zaniewski, assistant director for External Engagement, National Council of Architectural Registration Board
- Michael Zimmer, senior policy consultant, World Education Services, Global Talent Bridge
Finally, the partners would like to extend great appreciation to the teams from the original 11 consortium states: Arkansas, Colorado, Connecticut, Delaware, Illinois, Indiana, Kentucky, Maryland, Nevada, Utah and Wisconsin. More information on the teams can be found in the state profiles section on page 25. We thank you for your time and dedication to making this project a success in your states.