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What’s in Sununu’s plan to change occupational licensing in New Hampshire?

Courtesy of Dave Warrender
Huot Career and Technical Center
Licensed nursing assistant (LNA) students at Huot Career and Technical Center in Laconia took socially distanced licensing exams in the early months of the COVID-19 pandemic.

NHPR's Mara Hoplamazian and Josh Rogers contributed reporting.

New Hampshire would eliminate more than 30 occupational licenses, reorganize a number of professional boards and universally recognize professional licenses from other states under a set of changes included in Gov. Chris Sununu’s budget proposal, state officials announced this week.

Officials said these moves would cut down on red tape and make it easier for people to start working in New Hampshire at a time when employers across the state are struggling to hire enough workers, though professionals in some of the affected industries raised questions or concerns about eliminating certain licenses.

Sam Evans-Brown
The governor proposed repealing 34 professional licenses, including foresters.

The proposal comes after the state’s Office of Professional Licensure and Certification (OPLC) reviewed more than 50 professional licensing boards and various requirements, looking for ways to improve efficiency and lower barriers to entering the workforce, according to a news release announcing the proposed changes.

“The State’s licensing requirements should not impose unnecessary barriers to workforce opportunities or be the reason someone decides not to move here,” Lindsey Courtney, the office’s executive director, said in the release.

Among other changes, it would establish universal license recognition, allowing professionals in good standing in other states to quickly obtain licenses in New Hampshire.

The proposal would also make some professional licensing boards advisory and eliminate or combine others. The three separate boards that now regulate alcohol and substance-use counselors, psychologists and other mental-health professionals, for instance, would be rolled into one Board of Mental Health Practice.

Sununu also wants to repeal 34 professional licenses, including wetland and soil scientists, foresters, athletic agents, barbers and cosmetologists within an already licensed facility, landscape architects and “hawkers and peddlers.”

The proposal would also get rid of licenses for certain medical occupations, including for licensed nursing assistants, medical technicians and various jobs related to medical imaging and radiology.

Sununu told NHPR this week that he sees some of the state’s requirements are unnecessary or outdated — asking why sports agents, for instance, needed licenses.

“I don't know why. I've never even heard of that,” he said. “You know, landscape architect. Why? Why do you need to be licensed to plant trees?”

When asked for comment on the preliminary details about the governor’s proposals, professionals in some fields expressed concern that removing licenses could lower standards. Karen Bennett, a retired forester, helped set up the licensing process for that profession. She was disappointed to see it on the chopping block.

“Taking care of forests just isn't about cutting trees and removing a commodity. It’s really about taking care of a very complex system,” she said. “And so I think you need professionals that are educated, experienced and held to a standard.”

In her view, the quality of forestry has gone up since licensing was implemented.

"There's no doubt that for a lot of professions, especially the natural resource professions, that we have a shortage of young people coming into our community or our industry,” she said. “But licensure isn't the barrier at all.”

"It is understanding — though unfortunate — that some of the professions that have operated for years under protectionist fiefdoms are now upset that Governor Sununu is breaking down barriers to employment, reducing red-tape, lowering costs, and increasing commonsense."
Ben Vihstadt, spokesman for Gov. Chris Sununu

Ben Vihstadt, a spokesman for the governor’s office, pushed back on those concerns in a statement.

“The idea that removing certain licenses lowers standards is categorically false,” he said. “It is understanding — though unfortunate — that some of the professions that have operated for years under protectionist fiefdoms are now upset that Governor Sununu is breaking down barriers to employment, reducing red-tape, lowering costs, and increasing commonsense.”

He said many of those licenses “are already duplicated at the national level through various certifications.”

Courtney, the OPLC director, said private certifications through professional associations are enough to protect consumers in many cases. Health care organizations, for instance, already require those credentials when hiring medical imaging and radiology professionals and many states don’t require licensure on top of that, she said.

She argued that having them go through an additional licensing process to verify those credentials is often unnecessary and slows down hiring — especially if a board can’t meet every month because it lacks a quorum.

An earlier study committee advised against LNA licensing reforms

Some health care professionals expressed concern about removing licensing for nursing assistants, who provide direct personal care and perform some basic medical tasks, saying it could lower standards without doing anything to address New Hampshire’s ongoing shortage of nursing aides.

Under federal rules, New Hampshire would still have to maintain a registry of people certified to work as nursing assistants after completing training and passing an exam, though the federally required training hours are lower.

A legislative study committee looked at the issue in 2019 and recommended against removing the state licensing requirement. The committee — chaired by Republican Sen. Ruth Ward of Stoddard, a retired nurse practitioner — concluded it would lead to less training and oversight, and a perceived loss of professional standing among LNAs.

“The concern that licensing fees and redundant background checks were contributing to the workforce shortage of Licensed Nursing Assistants in the state was not validated by this study,” the committee said in its report. “Fees were found to be minimal, and not a burden to the LNAs that appeared before the committee.”

Roxie Severance, a health care consultant advising the Sector Partnerships Initiative, private workforce development effort, said many LNAs take pride in being a licensed profession, which is often a stepping stone to a career in nursing. She said they could see the change as a “demotion.”

To Severance, the biggest barrier for aspiring LNAs is the cost of training, which she said can run anywhere from $1,800 to $2,500. Most candidates don’t have that kind of money lying around.

“A lot of them, you know, either count on family members to help pay,” she said, “or if they don't have any family members, then they just don't get into the field.”

Paul Cuno-Booth covers health and equity for NHPR. He previously worked as a reporter and editor for The Keene Sentinel, where he wrote about police accountability, local government and a range of other topics. He can be reached at pcuno-booth@nhpr.org.

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