State occupational boards resist push for greater executive branch oversight
A legislative attempt to establish a state Division of Occupational Licensing brought together practitioners of oriental medicine, athletic trainers and cosmetologists on Thursday — all of whom oppose greater executive branch oversight.
The push to create the division builds off of a critical state audit from 2019 that called for greater oversight of the boards, and the effort comes after both Gov. Steve Sisolak and former Gov. Brian Sandoval previously raised issues with the independence and noncompliance of the occupational licensing boards.
The bill, SB335, would abolish five different occupational licensing boards — the Board of Homeopathic Medical Examiners, State Board of Oriental Medicine, State Board of Athletic Trainers, State Board of Massage Therapists and Board of Dental Examiners of Nevada — and bring those groups under the regulatory authority of a new division within the Department of Business and Industry. Combined, the five boards control more than 11,000 licenses across the state.
The bill would also allow for the appointment of advisory boards to assist in oversight of the occupations licensed by the division, including dentists, homeopathic medical examiners and athletic trainers. At least one member of the advisory board would have to hold a license in that profession, though the bill does not require any advisory boards to be appointed.
Opponents of the bill raised concerns that it would interfere with the practice of alternative medicine in the state, as the majority of those who testified in opposition during the hearing of the bill were members of the Oriental medicine board or advocates of homeopathic medicine. Oriental and homeopathic medicine can involve treatments such as acupuncture and herbal medicine.
“Abolishing the board and subsuming alternative medicine to allopathic medicine runs the risk of diluting the independence and legitimate effectiveness of this profession,” Lisa Grant, secretary-treasurer of the Oriental medicine board, said during the hearing.
Others in opposition expressed concerns that the new division would create unnecessary government oversight beyond the work of the Sunset Subcommittee, which reviews each state board and commission during the legislative interim and recommends which should be retired. And some bill opponents simply voiced general dismay.
“The board of athletic training recently progressed through the Sunset Subcommittee with a positive review,” Tedd Girouard, chair of the athletic trainers board, said during the hearing. “We are concerned that our board has been unjustly and unfairly, I guess, put into this situation to be abolished, and really don't understand what the metrics were that put us… in this bucket.”
Despite an overwhelming negative response to the bill — of 289 opinions filed on the bill so far, 284 are in opposition — the movement to overhaul the state’s occupational board system has been several years in the making.
In 2017, Sen. Keith Pickard (R-Henderson) sponsored a bill that he said during the Thursday hearing was aimed at addressing some of the “procedural and structural problems” of the occupational licensing boards. And a 2018 audit found that more than half of the boards were ignoring a 2010 directive on salary caps for state employees.
During the hearing, the bill’s sponsor, Sen. Joe Hardy (R-Boulder City), who also serves as a physician licensed by the state medical board, said the measure was aimed at ensuring that medical boards and practitioners within the state are adhering to the standards of care and are showing integrity.
The bill was primarily supported by members of the Nevada Dental Association, a branch of the American Dental Association that advocates for oral health care. In recent years, the state’s dental board, which licenses the dentists in the association, has dealt with resignations amid criticism from the governor, on top of issues with board operations and conflicts of interest that were revealed through a state audit.
“As many members of this committee are aware, the Nevada dental licensing board has had a history fraught with controversy and abuses,” Eddie Ableser, a lobbyist for the association, said during the hearing. “And the Nevada Dental Association stands with the efforts to change and reform boards across the state.”
Michael Brown, executive director of the Governor’s Office of Economic Development, explained that he and Terry Reynolds, director of the state’s business department, learned a lot from Utah’s occupational licensing division that informed the decision-making on introducing a similar division in Nevada.
Brown said that Utah has been able to reduce licensing barriers through the division, making it easier for professionals from other states to receive a license in a reasonable amount of time.
Previous attempts to overhaul the occupational boards have noted the potential high cost for establishing new oversight measures, such as the Division of Occupational Licensing, but no agency has yet submitted a fiscal note with an estimated price tag for the bill.
The measure does, however, call for 5 percent of fees received by various boards in the state — including the Board of Medical Examiners, State Board of Nursing and other health care licensing boards — to be deposited into an Occupational Licensing Account that would be used to fund the activities of the division.
Members of several boards that would not be abolished by the bill, including the Chiropractic Physicians' Board of Nevada and the Board of Osteopathic Medicine, testified in neutral during the hearing, calling for more conversations between the stakeholders and the sponsor of the bill.
“[The department’s] mission is the promotion of business and industry, which we are concerned might actually cause a lessening of consumer protection for Nevada's patients,” said Dan Musgrove, a lobbyist for the chiropractic board.
Thursday’s meeting marked the first hearing for the bill. The committee did not hold a vote on the measure.
Correction: This story has been updated at 3:35 p.m. on Friday, April 2 to reflect that the Board of Homeopathic Medical Examiners did not testify in opposition to the bill and did testify in neutral.