The recent proliferation of health occupations requiring licensure has focused attention on the inadequacy of present licensing laws. There is increasing evidence that current laws are overly restrictive and fragmented. They do not provide protection to the public by insuring adequately prepared practitioners and excluding incompetents. Licensing laws in most instances do not consider the need for continued competence of health professionals despite the increase of knowledge, mobility, and changing career patterns. In addition, the variation in laws and their interpretation inhibits the opportunity for qualified individuals to contribute to the delivery of health services.
At present the whole concept of the delivery of health care is in a rapid state of transition. That very rapidity has implications for false directions. For example, new legislation establishing additional categories of health personnel may, as in the past, continue to restrict the utilization of manpower by delimiting the scope of functions to specific types of training and/or to specific tasks. Service goals of the health system, resting on
- standards of quality,
- accessibility,
- protection of the public interest,
- protection of practitioners, and
- assurance of health career opportunity for all Americans, require a flexible future mechanism for the credentialing of health personnel.
In order to take a broad view of such possible mechanisms and to encourage the development of new careers as the antithesis of the elitism of the past, APHA recommends that during the next two years the following actions be completed:
- A national commission which includes all health occupations and consumers should be convened either under the leadership of APHA or with the committed involvement of APHA, since it is an association unique in its concern both for a wide spectrum of health occupations and for the general public, to complete the following:
(a) An examination of licensure regulations in all the states
(b) The development of guidelines and standards which bear on the quality and delivery of health services and which aim at reduction of the wide licensure variations now existing from state to state
(c) The foundations of recommendations to broad opportunities in health careers for all Americans, including the development of national credentialing procedures; - APHA should encourage any state action presently underway, as well as initiate new efforts to make existing licensure and certification statutes more flexible, or to provide for innovation and experimentation in the utilization of health personnel. APHA should support strongly efforts of its state affiliates and membership to influence their respective legislatures on these issues.
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