Health & Occupational Licensure Compacts

Interstate Occupational Licensing Compacts

Interstate occupational licensing compacts are legislative agreements between states that facilitate the mobility of licensed professionals across state lines. These compacts have become the de facto standard for occupational, health and medical licensure portability in the United States. By joining these compacts, states create a collaborative framework that benefits both professionals and the public.

What is an Interstate Compact?

Interstate compacts are legislative contracts between two or more states that create agreements on specific policy issues, adopt certain standards, or cooperate on regional or national matters. They are powerful, durable, and adaptive tools for ensuring cooperative action among the states. Unlike federally imposed mandates, interstate compacts provide a state-developed structure for collaborative and dynamic action while building consensus among the states.

How is an Interstate Compact Created?

Compacts are essentially contracts between or among states. They must satisfy customary requirements for valid contracts, including offer and acceptance. An offer is made when one state adopts the terms of a compact, requiring approval by one or more other states to become effective. Other states accept the offer by adopting identical compact language. Once the required number of states has adopted the pact, the contract among them is valid and becomes effective. Congressional consent may be required for some compacts.

The Compact Development Process

  1. Advisory Group: Composed of state officials and other critical stakeholders, this group examines the problem, suggests possible solutions, and makes recommendations for the interstate compact. Typically, it includes around 20 representatives from various groups and states.

  2. Drafting Team: This team pulls together the Advisory Group's ideas into a draft compact. Composed of 5 to 8 experts, they craft the recommendations into a draft that is reviewed by state officials, stakeholders, and the public. The compact is revised as needed before final approval.

  3. Education: The compact is available to states for legislative approval. During this phase, technical assistance and on-site education are crucial. Legislative briefings educate state officials on the compact's solutions.

  4. Enactment: Compacts typically activate when a pre-set number of states join. This process can take up to 7 years to reach critical mass.

  5. Transition: After enactment, the compact becomes operational. Transition activities include state notification, planning for initial meetings, and developing rules and standards for operation.

Benefits of Interstate Compacts

  • Establish formal, legal relationships among states to address common problems or promote common agendas.
  • Create independent, multistate governmental authorities (e.g., commissions) that address issues more effectively than states acting independently.
  • Establish uniform guidelines, standards, or procedures for member states.
  • Create economies of scale to reduce administrative and other costs.
  • Respond to national priorities in partnership with the federal government.
  • Retain state sovereignty in matters traditionally reserved for the states.
  • Settle interstate disputes.

List of Occupational Interstate Compacts

Interstate occupational licensing compacts provide a structured, efficient way to manage multi-state licensure, ensuring that professionals can practice across state lines while maintaining high standards and protecting public safety. By participating in these compacts, states help streamline the licensure process and enhance the mobility of licensed professionals.