Dentists, hygienists among latest professions considered for interstate license reciprocity

Nevada lawmakers last year passed legislation making it easier for teachers and emergency medical services personnel licensed in other states to practice in the Silver State. Now, they are already eyeing another industry for occupational reciprocity: dentistry.

The American Dental Association and the National Center for Interstate Compacts on Thursday presented to state lawmakers on the Interim Committee on Commerce and Labor a new compact for dentists and dental hygienists.

Proponents say occupational license compacts allow for increased mobility across states, which makes it easier for people to begin working in their field after relocating. Approximately 15% of recent dental school graduates relocate within the first five years of entering the profession, according to the American Dental Association.

Interstate compacts also make things simpler for licensees who want to practice in more than one state — maybe because they can work remotely, or because they live near a state border.

NCIC, part of the Council of State Governments, early last year finalized model legislation establishing the Dentist and Dental Hygienist Compact. The compact will begin only after seven states have agreed to enter it. So far, only five states have, but nearly a dozen others have legislation pending.

Nevada’s first chance to formally consider joining the compact will be next year during the 2025 Legislative Session.

NCIC representatives cautioned against seeing any occupational compact as a silver bullet that will fix labor shortages, but proponents say they could offer some relief.

Once seven states enter the dental compact, a commission composed of representatives for those states will be formed to oversee the formation of rules and the application process.

The Nevada Dental Association and the Nevada Dental Hygienists Association support the compact.

Occupational license compacts can be especially beneficial to military spouses, said Kelli May Douglas, the Pacific Southwest liaison for the U.S. Department of Defense, who gave a separate presentation to lawmakers.

Douglas noted that President Joe Biden last year signed, as part of a larger veterans bill, the Military Spouse Licensing Relief Act that is meant to reduce the red tape military spouses encounter when relocating due to military orders, but to what extent states and their licensing boards are implementing the spirit of the act varies wildly.

A recent survey conducted by the DOD of military spouses found that roughly 40% have occupational licenses, said Douglas. Many report experiencing issues transferring their licenses.

Common occupational licenses include cosmetology, massage therapy, nursing, paramedic, pharmacy, real estate agent, and social worker.

Nevada had 5,341 active-duty military spouses in 2022, according to the DOD, as well as 4,356 National Guard and reserve spouses.

In 2023, legislation to have Nevada join the Nurse Licensure Compact faced strong opposition from labor unions like SEIU 1107 and failed to advance out of an Assembly committee. Earlier attempts to join that compact, which has been around for more than two decades, also fell short.

A separate proposal to join the Physical Therapy Licensure Compact died in the same Assembly committee, though it passed the full Senate unanimously.

But the Legislature did join Emergency Medical Services Personnel Licensure Interstate Compact and Interstate Teacher Mobility Compact.

SEIU and other labor organizers at the time argued that joining the nursing compact would exacerbate working conditions for employees and weaken collective bargaining power by allowing employers to break strikes.

An NCIC representative told lawmakers Thursday they’ve seen no evidence of such claims being true.

All 50 states (as well as Washington DC, Guam and the U.S. Virgin Islands) have adopted at least one occupational licensing interstate compact, according to NCIC, and 41 have at least three. Midwestern and Southern states have adopted more of them than the coastal states.

Compacts covering nursing, medical and psychology licenses are the most widely adopted, each with 41 states signed.

Nevada has joined five occupational license compacts: emergency medical services (EMS), massage, medicine, psychology, and teaching.

Nevada is also one of 20 states that has some form of universal license recognition. Established in 2017, according to the Institute for Justice, Nevada’s version allows a person licensed by another state to be granted a license only if the home state’s requirements are “substantially equivalent” to Nevada’s.