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Georgia considering occupational licensing reform
ATLANTA — As Georgia grapples with a severe workforce shortage, a Senate committee is looking at changing laws and policies that keep skilled professionals, including doctors and nurses, waiting a year or more to get to work.
The Senate Study Committee on Occupational Licensing heard this week from several experts with insights into the bureaucratic barriers plaguing skilled workers.
Many occupational licenses in Georgia are issued by one of 43 licensing boards housed in the Professional Licensing Boards Division of the secretary of state’s office. They cover 197 license types, including cosmetologists, nurses, social workers, foresters, architects and plumbers. Other professions are regulated by independent state boards, including doctors, engineers and realtors.
About 30% of U.S. workers need a license to work, said Marc Hyden, director of state government affairs for R Street Institute, a public policy think tank based in Washington, D.C.
Hyden praised recent laws passed in Georgia that have expedited the process for veterans and military spouses with professional skills to obtain licenses when they move into the state. But he said more reforms are needed.
The licensing division is understaffed and underfunded, Hyden said, and receives only $8.5 million of the $24 million it generates from licensing fees. This lack of resources prevents some boards from providing timely and efficient service, he said, creating a backlog of prospective skilled workers.
About 27% of professional license applications administered by the Professional Licensing Board Division take a year or more to process, according to the secretary of state. The rest can take up to six months. Some boards are relying on paper applications, mail service and manual processes to handle applications.
Why It Matters
Hyden noted that other states manage to issue licenses within 30 days, in part because their boards are better staffed and meet more often — monthly, instead of quarterly, as with some Georgia boards.
Georgia is enjoying record economic growth. Over the last four years, the state has attracted over 1,700 economic development projects, $65 billion in investment and 165,000 jobs, according to the Georgia Chamber of Commerce.
But the state’s workforce can’t supply enough workers to meet the growing number of job opportunities. There is only one job seeker for every three job postings, the Chamber said.
Among jobs in highest demand in Georgia are registered nurses, pharmacists, accountants, construction contractors and truck drivers – all of which require state licenses. Many workers now in these fields are nearing retirement.
According to the Georgia Health Care Workforce Commission, 20% of health care workers are over age 55 and looking to retire in the next 10 years. About 4% of the health care workforce leaves annually and is not being replaced by new graduates.
Most of the state is medically underserved, with 65 of Georgia’s 159 counties without a pediatrician, 82 counties without an obstetrician and 90 without a psychiatrist.
To draw more people into skilled professions, “we need to think creatively … and improve licensing,” said Daniela Perry, vice president of the Chamber.
One area ripe for reform is how the state handles licensing of professionals who come to Georgia from other states and countries.
Since 2019, 22 U.S. states have adopted universal license recognition laws that establish a streamlined process to recognize professional licenses issued by another state. If the applicant holds a license in good standing and has no pending disciplinary actions or a disqualifying criminal record in one state, they can practice in another.
This year Georgia passed HB 155, which allows licensing boards to grant licenses to some out-of-state professionals if the license they hold is “substantially similar” in qualifications and scope to what Georgia requires.
The Georgia law is more restrictive than those in other states, which only call for “similar” qualifications and don’t require residency, said Austen Bannan, an employment expert with Americans for Prosperity. Other states allow years of professional experience to stand in for some training requirements. Georgia doesn’t, mandating seasoned skilled tradespeople pursue hundreds or thousands of hours of additional training.
“The idea is not to force people to relearn their skill set,” Bannan said.
Georgia is also missing out on the skills of many foreign-trained professionals due to its stringent licensing requirements, said Darlene Lynch, who chairs the Business & Immigration for Georgia Partnership, which works to enhance economic development by tapping into the skills of immigrants.
Georgia’s foreign-born population has grown by 90% over the last 20 years, and 10% of Georgians — more than a million people — are now foreign born, she said, adding that half are naturalized citizens, and a third have college or graduate degrees.
Though 1 in 5 doctors in Georgia is foreign-born, Lynch said, “Too often we’re watching doctors driving Ubers, dentists working behind a CVS counter, a welder working at a poultry plant — they’re not going back to the field where they have the most experience.”
She urged the committee to adopt the licensing practices of other states, which recognize the medical credentials of foreign-born physicians and other health care professionals, and develop expedited pathways for other skilled immigrants to become licensed.
“We have a pool of talent that other states don’t have to draw upon,” Lynch said.
Sen. Larry Walker III, R-Perry, chair of the occupational licensing committee, said many of the issues raised at the meeting this week have come up at the GA WORKS Commission, an effort led by Secretary of State Brad Raffensperger this year to slash bureaucratic barriers in occupational licensing. That includes a total revamp of the application process, which is projected to be fully digitized by spring 2024.
“We’ve got to get into the modern world with this licensing issue if we’re going to continue to grow our economy,” Walker said.
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Header photo: Some foreign-trained doctors and other health professionals wait for years for approval to practice in Georgia, due to the state's demanding occupational licensure requirements. (Credit: baona)
A study committee of Georgia senators took a decisive step Tuesday toward ending a longstanding and contentious law that regulates how and where new medical facilities are located in the state.
The committee’s decision centers on the 44-year-old Certificate of Need law. It was created to control health care costs and cut down on duplication of services and unnecessary expansions. It determines when, where and if hospitals need to be built. Opponents have said the law prevents competition and enables big hospitals to have a monopoly, often shutting out small and private medical outlets.
On Tuesday, the Senate Study Committee on Certificate of Need Reform effectively said the law needs to be repealed. The committee approved, in a 6-2 vote, nine recommendations.
“Based upon the testimony, research presented, and information received, the Study Committee on Certificate of Need Reform has found that the problem Georgia’s CON law was intended to combat no longer exists,” the report said.
However, the head of the Georgia Alliance of Community Hospitals said Tuesday that repealing the law would be a bad idea.
“It would have a devastating financial impact on hospitals and the quality and access to health care,” Monty Veazey, the alliance’s chief executive, told State Affairs.
Veazey said he has not seen the recommendations yet but his organization has sent its own set of recommendations to the senate and house study committees.
“We believe that the certificate of need really does need some modernization and we look forward to working with the committee to work through those recommendations and see if we can reach a compromise position during the upcoming legislative session,” Veazey said. “We still want to see what the House committee recommends before moving forward.”
Here’s what the senate study committee recommends, according to a draft:
- Repeal CON requirements for obstetrics services, neonatal intensive care, birth centers and all services related to maternal and neonatal care across Georgia.
- End requirements for hospital-based CON on Jan. 1, 2025.
- Reform CON laws to eliminate CON review for new and expanded inpatient psychiatric services and beds that serve Medicaid patients and the uninsured.
- Repeal all cost expenditure triggers for CON.
- All medical and surgery specialties should be considered a single specialty, including cardiology and general surgery.
- Multi-specialty centers should be allowed, particularly in rural areas.
- Remove CON for hospital bed expansion.
- Revise freestanding emergency department requirements such that they must be within 35 miles of an affiliated hospital.
- Remove CON for research centers.
The committee will present its recommendations to the Georgia General Assembly when it reconvenes in January.
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ATLANTA — The first step in the 2023 electoral redistricting process occurred Monday when Sen. Shelly Echols, R-Gainesville, chair of the Senate Reapportionment and Redistricting Committee, released a draft proposal of new Senate district maps.
Last month, U.S. District Judge Steve Jones ordered Georgia to redraw its state House, Senate and congressional district maps, adopted in 2021 by a majority-Republican-led Legislature, after finding they violated the Votings Rights Act by diluting the power of Black voters. The Georgia General Assembly is charged with submitting new maps to comply with Jones’ order by Dec. 8, and will be meeting in an eight-day special legislative session to do so, starting on Wednesday.
The proposed Senate maps would create two Black-majority voting districts while eliminating two white majority districts in metro Atlanta now represented by Democrats. The districts of state Sen. Elena Parent, chair of the Senate Democratic caucus, and Democratic Sen. Jason Esteves, a freshman, would become majority-Black if the redrawn maps make it through the redistricting process, a change that could invite considerably more primary challenges.
The proposed maps do not significantly alter the district lines for Sen. Valencia Seay, D-Riverdale, and Sen. Marty Harbin, R-Tyrone, whose districts Jones ruled did not comply with the Voting Rights Act. It will be up to Jones to decide if the new maps pass muster.
As it stands, the proposed Senate map will leave Republicans with a 33-23 advantage in the Senate.
On Wednesday legislators will plunge into their redistricting work during a special session at the Capitol. In addition to the state Senate maps, lawmakers must also redraw electoral maps to create Black majorities in one additional congressional district in west-metro Atlanta, and in five additional state House districts in Atlanta and the Macon-Bibb County area.
The proposed Senate maps (and all proposed maps to be submitted by legislators) are available on the Legislative and Congressional Reapportionment Office’s website. Written comments can be submitted (and viewed) by the public through the portal available on the Georgia General Assembly website. Most of the reapportionment and redistricting committee’s hearings are open to the public; the daily legislative schedule is available here.
“The committee encourages public participation and values the input of the community in this vital democratic process,” Echols said in a statement released on Monday.
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