The inbox gets hit with a ton of opportunities for continuing education, new research studies, and the who’s who of the dental industry. A last-minute email came in recently for an event that piqued my interest. It was a webinar of sorts, calling itself a review meeting concerning something called a compact. The way I read it, this could be the beginning of license portability and a chance to work in other states without the crazy hoops-jumping currently in place.
The Council of State Governments (CSG) National Center for Interstate Compacts (NCIC) is a facilitator. This group “collaborates with state, federal and stakeholder partners to provide dedicated resources and technical assistance in policy areas supported by compacts.” Right-O. English, please. For dentists and dental hygienists, it means an interstate transferability for our license. If you are part of the compact, follow the rules of each state, have an already existing unencumbered license, and pay some TBA fees, it may be possible.
Talk about mind-blowing. The CSG has partnered with the American Dental Association (ADA), the American Dental Hygienists’ Association (ADHA), and the Department of Defense (DoD) already, and the initial draft is available for review.1 There is a lot to unpack in that sentence: Both the ADA and ADHA working together for one goal, and how did the DoD get involved?
Don’t get me wrong, I love it, all three, but it’s not a usual combo. The DoD has been involved and working for license portability because the active military can move from state to state. Their spouses have careers that are uprooted, and they are up against difficulties getting licensed in the new state. It isn’t just time-consuming; it’s fees and delays. In 2021, there was an approval of a series of grants that helped military spouses with issues of professional license portability. It was through a cooperative agreement with the CSG.2
Right now, 42 states and territories have enacted occupational licensure compacts for nurses, physicians, physical therapists, emergency medical technicians, psychologists, speech therapists/audiologists, occupational therapists, and counselors. The CSG is also developing compacts for massage therapists, school psychologists, dieticians and nutritionists, social workers, K-12 teachers, physician assistants, cosmetology, barbering, and dentistry.
What Does It Look Like
The Dentist and Dental Hygienist Compact is an interstate occupational licensure compact that is constitutionally authorized, legally binding, and legislatively enacted as a contract among states. It would allow practice in participating states rather than getting an individual license in every state.
There are steps to follow. You must be already licensed in a participating compact state. The way I understood it is if your state isn’t in the compact, it’s a no-go. If you are licensed in Iowa, and they haven’t joined the compact, then you can’t join the rest of the states that did join. The dental practitioner will next go through an FBI background check, and then the application is reviewed. The practitioner will pay fees, complete any jurisprudence requirements, and the privilege is issued.
If your licensed state allows local anesthesia and the compact state you are applying to does not, you follow the state rules you are going to be working in.
The other question that I am not sure there is an answer to currently is yearly dues for each state. I am licensed in Oklahoma (the original state of my licensure), Texas, and Colorado, and I pay dues. If Texas or Colorado join the compact, I am already licensed there, and would I continue to pay those dues?
For continuing education requirements, you would only need to complete those units in the state where they hold a qualifying license to maintain the qualifying license. You would not need to complete units for states where they hold compact privileges. This may be tricky. States have different requirements, such as human trafficking, medical errors, ethics, OSHA/infection control, and domestic violence courses that some states may not have.
There are many more things to learn, but I believe this could be a step in the right direction, which I never thought we would see.
Who Can Use the Compact?
- An active, unencumbered license in any state participating in the compact.
- Passed the National Board Examination or other exam accepted by the compact commission.
- Completed a clinical assessment.
- Graduated from an education program accredited by the Commission on Dental Accreditation.
- No disqualifying criminal history.
There are benefits for licensees, regulators, and states. For licensees, it would allow for multistate practices, expand employment opportunities into new markets, reduce the burden of maintaining multiple licenses, enhance portability when moving, and improves continuity of care when patients or providers relocate.
For regulators, it reduces administrative burdens, enhances public safety through shared data systems, and facilitates mobility during public health emergencies. According to the CSG, it can ensure retention of jurisdiction over practitioners working in their state and expands state licensure board cooperation on investigations and disputes. Basically, the state retains control over its own practice acts. They also keep the ability to discipline a provider who violates their practice act. The compact requires that states work together on disciplinary investigations that occur across state borders.
The benefits of the compact for states may include workforce development and strengthening labor markets, expanding consumer access to highly qualified practitioners, preserving state sovereignty, and increasing collaboration among states.
Other than the ADA and ADHA, more groups were involved in the development process. Perhaps this means they would be on board with joining the compact?
- Alaska Board of Dental Examiners
- Arizona State Board of Dental Examiners
- Idaho Board of Dentistry
- Iowa Dental Board
- Louisiana State Board of Dentistry
- Minnesota Board of Dentistry
- North Carolina Dental Board of Dental Examiners
- Ohio State Dental Board
- University of Colorado School of Dental Medicine
- University of Connecticut School of Dental Medicine
- Washington Dental Quality Assurance Commission
- Washington Department of Health
The news brings such hope for our profession, and I, for one, can’t wait to see how it plays out. Please click here if you are interested in learning more about the stakeholder review process.
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References
- Dentist and Dental Hygienist Compact (Draft). (2022). National Center for Interstate Compacts. https://compacts.csg.org/wp-content/uploads/2022/07/Dentist_Dental-Hygienist-Compact-Draft.pdf
- DOD Receives Approval for Grants to Develop Interstate Compacts for Licensure Portability. (2021, March 15). U.S Department of Defense. https://www.defense.gov/News/Releases/Release/Article/2537098/dod-receives-approval-for-grants-to-develop-interstate-compacts-for-licensure-p/
