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Licensure: In each state a unique set of challenges


This edition of "Licensure Corner" offers background information to bring up to speed those who have entered the profession since the flurry of licensure activity more than twenty years ago. A new generation of practitioners will be at the forefront of the movement for patients' access to quality care performed by properly educated and trained professionals through the adoption of licensure.

Each state's journey toward licensure is unique, fraught with different challenges, players, and statutory hurdles. There is no one prescription that can lead to adoption of licensure in every state. States pursue licensure on an individual basis. Measures taken on a federal level typically pertain to reimbursement and offer little proactive regulatory guidance on who is able to provide care.

Sue Stout, president and CEO of the Amputee Coalition explains, "States license professionals from physicians to plumbers, and each state takes a slightly different approach," Stout continues. "The only federal approach to this issue would be to require that certain professionals have certain credentials to be eligible for reimbursement from Medicare or other federal programs. However, this does not constitute licensure, because it would not set up a structure for removing a license from someone who breaks the law nor would it address the training requirements and mandatory adherence to specific practices that are spelled out in licensure laws."

"The Amputee Coalition supports licensure of prosthetists because the standards of training required to earn a license help guarantee quality care for amputees. In addition, licensure laws that include a mechanism for consumers to lodge official complaints against licensed providers who cause harm can lead to the revocation of a license from a practitioner who practices in an unsafe manner. This is a key consumer protection," Stout concludes.

The protection of consumers is the crucial component of a convincing argument in favor of licensure. It is the safety of the patient that is truly at stake in discussions about licensure. Movements undertaken solely by practitioner groups may seem self-serving, no matter how unified, and will ring hollow without the voices of those who need their services. Grassroots efforts are more effective when the testimonials of patients and the legitimate concerns of providers are balanced. Licensure's emphasis on professional qualifications satisfies the concerns of patient, payers, and licensing entities.

States with licensure have generally developed an energetic organization committed over the long haul to attaining licensure. The assistance of lobbyists, while costly, is also effective. The August Academy Advantage Licensure Corner will feature perspectives on discussing licensure with state legislators, including the use of a professional lobbying group.

Have a question, comment, or a suggestion for future article topics? Email licensure@oandp.org.

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