Nicole Fox joins to discuss occupational licensing–a form of government regulation that requires a person to obtain a license in order to pursue a particular profession or vocation for pay. Nearly 30% of jobs in America require this permission slip, yet many states are pushing back saying that doing so places unnecessary and burdensome barriers on people just trying to earn a living.
Nicole serves as Director of Government Relations at the Platte Institute. She joined the Platte Institute in 2017 after serving in the Nebraska Legislature from 2015-2016, where she was appointed by the Governor to represent Legislative District 7. During her time in the Legislature, she passed Nebraska’s first occupational licensing reform bill to exempt natural hair braiding from cosmetology licensing. One of her areas of focus at the Platte Institute is occupational licensing reform, and she has seen several bills to reduce the burdens of licensing cross the finish line.
Transcript
Beverly:
And welcome to She Thinks, a podcast where you are allowed to think for yourself. I’m your host, Beverly Hallberg, and on today’s episode we’re discussing occupational licensing, a form of government regulation that requires a person to obtain a license in order to pursue a particular profession or vocation for pay. Nearly 30% of jobs in America require this permission slip yet many states are pushing back saying this places unnecessary and burdensome barriers on people just trying to earn a living.
Joining us to talk about this is Nicole Fox. Nicole serves as director of government relations at the Platte Institute. She joined the Platte Institute in 2017 after serving in the Nebraska legislature from 2015 to 2016 where she was appointed by the governor to represent legislative district seven. During her time in the legislature, she passed Nebraska’s first occupational licensing reform bill to exempt natural hair braiding from cosmetology licensing. This is one of the areas, occupational licensing, that she focuses on at the Platte Institute and she has seen several bills to reduce the burdens of licensing cross the finish line in Nebraska. It is a pleasure to have you on, Nicole.
Nicole:
Thank you. I’m so glad to be on today. Thank you for inviting me.
Beverly:
I gave a general overview of occupational licensing but I think it would be good for our listeners to hear it from you. This is an issue you work on a lot. Tell us the definition of occupational licensing and how pervasive it is in the country.
Nicole:
Well, to me, occupational licensing in a nutshell … I think the best definition is a little bit too bold. First of all, it is … As you said earlier, it is a permission slip from the government to work. Secondly, it is a tax on workers because frequently with occupational licensing comes educational requirements and a variety of fees that one must pay in order to obtain that license.
Beverly:
Of course, on the surface when people hear this they would say, “Well, people required to get training, people retired to get a certificate … For a lot of occupations, I’d want that. I’d want that, let’s say, for my doctor.” Are you saying that these types of regulations need to be reduced as a whole or it should just be limited to occupations where there could be harm to the person?
Nicole:
Correct. Occupational licensing back when it originally started … And we were looking at licensing those individuals that it’s very obvious that we want to protect public from harm such as doctors. We were talking maybe one in 20 occupations required an occupational license. If you fast forward to today, you see that approximately one in three, one in four … Depending on exactly which report you’re looking at, one in three to one in four workers are required to obtain an occupational license. And what we’re really seeing is, of course, when a group approaches their government official, whether it’s at a local or a state level or even federal level, usually what they are saying is, “We’re trying to protect the public.”
But really, what it is is either one of two things. It’s a turf war, meaning they want to be able to provide a certain service or operate within a certain scope of practice and they’re trying essentially to shut others out. I think the other thing, too, is that it’s also … For some people it’s about profit because again, when you are requiring certain occupations to obtain certain levels of education, those educational institutions are making money off of that tuition.
Beverly:
Let’s talk about some of the occupations where you think that this is a burdensome regulation. Maybe it’s just because a union wants to protect their own workers. What are some of the occupations that require a license, how are they supposed to obtain that license? Just give us the breakdown of how burdensome it is for certain people.
Nicole:
I think as far as occupations that frequently require licenses … First of all, probably one of the most prevalent is healthcare. Agreed that health and healthcare professionals … Definitely there could be some issues where we are worried about safety, we are worried about training. But I think we’re starting to see some things more for, again, groups of people are wanting to keep other people out.
For example, something that we’re seeing here in Nebraska in the healthcare world would be things like art therapy and music therapy. We’ve got individuals that are already licensed as either a social worker or a psychologist but they want to keep others out and they want to make the practice or the … Yeah, I’ll say the practice, say, of art therapy or music therapy under their umbrella so that it forces people, again, to attend school, to obtain accreditation that maybe is not very necessary.
Another example would be what I would call the personal care services. And that would be like the cosmetology industry, massage therapy. We see very, very frequently where individuals are required to obtain extraordinary number of hours of education. For example, in Nebraska we have some of the highest requirements in the country. Actually, we have the highest requirement in the country for massage therapy. We require 1000 hours where the national average is about 500-600 hours. But what we’re seeing is the massage schools that the industry is very much … Or their boards are made up of school owners and so they are definitely protecting their financial interest and people here in Nebraska that want to be a massage therapist have to essentially get twice as much training as what many states throughout the country require.
More specifically yet here in Nebraska, we have a group of women who are wanting to practice reflexology. Reflexology is an ancient art similar to hair braiding. And our licensed massage therapy association is trying to keep them from practicing massage … Or, I’m sorry, practicing reflexology unless they have a license as a massage therapy. And again, that 100 hours. Well, if you look at their curriculum, and I have looked at the curriculum over and over and over again to make sure I have not missed anything, there is no training for reflexology. And we have had reflexologists in our state that have gotten cease and desist orders from the Department of Health and Human Services saying, “You must stop practicing or we will charge you with a class three felony.” And in Nebraska, a class three felony could lend you up to four years in jail or a $25,000 fine. So yes, lots of red tape.
Beverly:
My goodness. I didn’t realize the felony aspect to that. And I’ve wondered with … With 1000 hours that you said, of course it’s not just the time, it’s the cost. It’s often asking people to fork out a lot of money in order for them to do something that they do well. And preventing people from just finding somebody who wants to purchase their services, they provide it from them. If people aren’t happy with their service, they don’t have to go back. How much money are people having to fork out? I know it depends on the occupation, but what would be the average cost for $1000 of massage therapy courses?
Nicole:
In Nebraska, some of our massage therapy schools are charging well over $20,000 for the 1000 hours that are required. Again, if you look at other states, half as much education … So, if we’re talking $20,000, maybe if we could get our requirements down they’d only be charging $10,000. It’s a lot. We’re talking a lot of money. And that doesn’t include, again, some of the fees that they have to pay in order to then get the license, to maintain continuing education, because that’s the other thing, too, is once you are licensed then you have to maintain that license. And some professions continuing education if they’re needing, say, 30 hours a year and the average cost of a continuing education unit is $25, do the math. It’s hundreds of dollars every year that these people are being taxed not only to get into the profession but also to be able to continue to work.
Beverly:
And the type of professions that are usually … Have to get some type of licensing … Again, we can put the medical profession in its own category. We want people to be licensed in order to perform surgeries and practice medicine. But when it comes to some of these other crafts and skills, are you often looking at more low-income workers trying to get into these professions so this is especially damaging to our low-income communities who want to use a skill that they do well in order to learn a living for themselves?
Nicole:
Yes. The research is out there. It’s well known that oftentimes occupational licensing does hit those of a lower income level much more prevalently than, say, those of a higher income level. And that’s another reason why it’s so important to cut this red tape because people … Part of what our country is about is to become more upwardly economically mobile; to provide an opportunity for themselves to have a better life; to be able to provide for their families. And when we are disproportionately creating burdens for them that create, again, these unnecessary taxes on workers, that’s counterintuitive to what this country is about.
Beverly:
Tell us about some of the victories you have had in Nebraska. What specifically were the reforms that were rolled back and how are you able to convince the legislature that this was a positive thing for the state and Nebraska?
Nicole:
Well, kind of moved back to … The first occupation that we tackled here in Nebraska was hair braiding. To us, it was a no … I personally sponsored that bill. To me, it was a no brainer. First of all, hair braiding is an ancient skill, it’s an ancient art, it’s been practiced for centuries and why we need to require someone to go to cosmetology school … When I talked to people and I looked at the curriculum, hair braiding was not even covered. Again, I think those arguments right there made it a no brainer. Also, with that, starting a hair braiding business requires very little capital. You can start … It’s easy to start up a business like that. You don’t have to worry about taking out a huge business loan. So, that was where it all started.
From there, we’ve tackled a variety of things. We’ve tackled things like fee waivers. So those of lower income, younger workers, military, we’ve done fee waivers for them. We’ve tackled some unique occupations such as equine massage or horse massage. We had some women here in Nebraska that live in very rural parts of the state; areas where there’s limited ways to earn a living. And in that situation, they were going to be required not only to get a massage license, which obviously didn’t cover horse massage. But also, they were supposed to obtain veterinary license. So obviously, very, very expensive.
We found ways to allow cosmetologists and massage therapists at least to be a little bit more creative and mobile in the ways that they pursue services. In Nebraska, at one point you had to have a brick and mortar business and now we allow them to operate more mobiley. Probably one of our biggest victories was in 2018. We did what we call The Occupational Licensing Board Reform Act and what this did was say over a five year period, we have to review all occupational licenses in the state of Nebraska and look at is it creating unnecessary burden? Are we out of sync with other states throughout the country? And we just finished year one of those reviews in 2019, so those reviews did bring forth some legislation here in this state.
For time’s sake, I’m going to fast-forward. With the COVID pandemic, we have seen, as many other states have seen, some changes that we hope that will remain permanent. Our governor has allowed for some reciprocity for healthcare workers to address needs. If you’re coming here, you can come here and work from another state and start working immediately. We also were successful in working with him to get some volunteer work to be allowed. For example, if a retired nurse wanted to go to a hospital because maybe there’s a shortage of nurses because people are self-quarantining or they’ve been officially confirmed to have a case of the virus, they can go to work and volunteer their hours and not have to worry about the liability.
We are seeing some really neat ways to remove some burdens as a result of the COVID pandemic and we’re hoping that when this is over we can convince the state to consider keeping some of these changes permanent.
Beverly:
And of course, some of that is going to be challenge. And so, over this time …
Nicole:
Of course.
Beverly:
… Whether it was starting with the hair braiders to begin with, now to where we are with COVID-19, who are the people or what has the opposition been like? Because I know as we hear you talk about it, we think, “Oh, that makes sense. Why should somebody who wants to give a horse a massage need to get a veterinarian license? That doesn’t make any sense.” But yet you do face fierce opposition to this. What have you faced in the past and what do you potentially expect in the future?
Nicole:
I think some of it is, well, I had to go through this. I had to go through schooling and therefore you should, too, which I think it’s very unfortunate mindset. Because to me, I see it as … If I had … Because I am, actually, a licensed professional. Before I was in the legislature and before I worked at Platte Institute, I was a dietician so I was registered and license and I do maintain that license. And so, I think a lot of it is, I had to go through this so everyone else should, too.
In the healthcare realm, I think a lot of it is people are hoping that insurance will reimburse them. A lot of times when we have these groups coming in and they’re wanting to be licensed, they are saying that they want to be able to bill for their services. And they can bill for their services but what it really is all about is that they’re helping the insurance companies will reimburse them. And I know my conversations with insurance companies is they don’t like those types of mandates and so they’re fighting it. But unfortunately, the insurance companies have led some of these healthcare groups to believe that if they get licensed that that will help them get reimbursed. I know that that is one very big argument.
And a lot of times, it’s just instilling this fear. It’s instilling a fear of the potential for harm. And I think what we really have to do to counter that is to step back and, as you have mentioned, think about how we go about picking … Whether it’s our doctor or the person that cuts our hair, we’re looking at things like Yelp reviews or Google reviews or we’re talking to somebody. It’s word of mouth. And so, if I see a certain professional, whether it’s a healthcare professional or a personal care service professional, if I have a really good experience and develop a really good rapport with that person, when my neighbor, when my friend or my family member comes along and asks for a recommendation, I’m going to recommend that person.
And the opposite is true if I have a bad experience. If somebody comes to me wanting a recommendation for … “Oh, who do you see for your health maintenance?” Or “Who do you see for your haircut?” It’s going to be that word of mouth, whether or not I had a good experience or, “Hey, whoever you end up seeing, don’t go to this person because I had a bad experience.”
Beverly:
Right. And we see that you’ve had such great traction in Nebraska but other states as well. I know Arizona with their governor there has been pushing for reforms in this area. And it makes me wonder if there is a big trend of re-looking at these laws because of our advances in technology. Has technology brought a lot of this to the surface because people can do so much … Like you were even saying, we can go on Yelp and see reviews. It doesn’t have to be just word of mouth. Word of mouth is fantastic, my favorite form of figuring out who do work with, but you can go online and figure this out. So, is it partially because of technology that you even instituted into your laws in Nebraska to review this every five years?
Nicole:
Now that you said that, my brain is going in a couple of places. First of all, yes. Technology is a great way to communicate the services that we’re willing to provide and it’s a great way to be more accessible. For example, I’ll go back to the COVID crisis or the COVID pandemic. One of the other reforms that we’re seeing in a lot of states and Nebraska is telehealth because people are not mobile. We’re needing to stay home so that definitely gives providers … Or it gives patients greater access to providers. Also, it can often be at a lower cost. But then outside of the COVID pandemic, in Nebraska where we’ve got a lot of rural pockets in our state where there’s a lack of providers, it allows us a most cost effective way to get care to them.
And I think also, too, with technology we do have … There is some gray area and what I mean by that is, for example, in my world of nutrition it seems as though if I start up a blog post or if I post nutrition advice on social media, nobody comes after me. But if I decide to provide one-on-one personal nutrition counseling in my home or I decide to rent office space to do nutrition counseling and I’m not … Let’s pretend I was not licensed, the Department of Health and Human Services would be after me very quickly. So, technology, I think is very good as far as accessibility and decreasing cost and also it provides a convenience factor. But technology also provides a little bit of interesting gray area and I think that might be something to be watching out for is are they going to try and go after those people that are trying to do things whether, again, it’s through a blog or through social media and those types of outlets?
Beverly:
Final question for you, if there is one of our listeners today, whether it’s them personally or somebody that they know who finds that they’re running into an issue with licensing wanting to know whether or not they can start up their business, any recommendations you would give to them to try to get help or find out more information?
Nicole:
Most definitely. And I know here in Nebraska we are very out there, whether it’s on social media or just through the media. We have a lot of relationships with policy makers. So yeah, I would say definitely if you are an individual that is concerned about that turf war, that gray area of here’s my business model, my business idea and I’m wondering do I really need a license to practice this? I’d say reach out to a local policy making official, whether it’s your state legislator … But yeah, I think that there are a lot of us out there that are in it and on both sides of the aisle. There’s a lot of people realizing that some of these government regulations, the licensing requirements, are doing more harm than good in their … It’s keeping people out of the workforce.
Beverly:
And like you said, with COVID-19 and the regulations that have been rolled back for our healthcare professionals, I think it’s going to become a topic of discussion even more. So thank you …
Nicole:
Yeah.
Beverly:
… For all the groundwork you have laid on this issue in Nebraska. It’s definitely, I think, going to be helping other states as well as we hope that they follow suit. But Nicole, thank you so much for joining us.
Nicole:
Yes, thank you for having me on today.
Beverly:
And thank you for joining us. Before you go, we wanted to let you know that during this time of uncertainty and unprecedented challenges do to COVID-19, it’s more important than ever to show what America is made of. That’s why Independent Women’s Forum is highlighting American ideals of ingenuity, generosity, thoughtfulness and kindness. From everyday Americans donating masks and donating blood to companies providing free food and housing to those on the front lines, it’s a beautiful reminder that we’re in this together. Visit IWF.org or check us out on Facebook and Twitter and follow our campaign using #InThisTogether to learn more about the campaign.
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