A Labor Day Warning: Make Up Artists and the erosion of consumer protection

Certified Seal A bill, AB 409 passed the Nevada Legislature last term, which illustrates the way opponents of consumer protection and professional licensure are moving to erode those public protections.  Superficially, the bill sponsored by Assembly members Seaman, Shelton, and Fiore, removed the requirement for make up artists to complete a nationally recognized written examination for work in a licensed cosmetological establishment.  Sounds simple enough, what could go wrong?  Oh, how about inflammatory dermatitis, folliculitis, and hives? [MedNet]  Or, inducement of an immune-mediated allergic response? [MedNet]

And, then there was another “simple” bill, SB 68.  Ostensibly, the bill would make it easier to recruit health care professionals to the state by creating an expedited licensing process.  Amendment 65 (adopted) included those subject to the Board of Medical Examiners, State Board of Nursing, State Board of Osteopathic Medicine, State Board of Podiatry, State Board of Examiners for Audiology and Speech Pathology, State Board of Pharmacy, State Board of Physical Therapy Examiners, the Board of Occupational Therapy, the Board of Massage Therapists, the Board of Psychological Examiners, the Board of Examiners for Marriage and Family Therapists, and Clinical Professional Counselors, the Board of Examiners for Social Workers, and the Board of Examiners for Alcohol, Drug, and Gambling Counselors.  The following item specifying nursing applicants stands as illustrative of the others:

“3. Not later than 15 business days after receiving an application for a license by endorsement to practice as a professional nurse pursuant to this section, the Board shall provide written notice to the applicant of any additional information required by the Board to consider the application. Unless the Board denies the application for good cause, the Board shall approve the application and issue a license by endorsement to practice as a professional nurse to the applicant not later than: (a) Forty-five days after receiving the application; or (b) Ten days after the Board receives a report on the applicant’s background based on the submission of the applicant’s fingerprints,  whichever occurs later.

The other fine print in the bill as enacted is the change from a board which “may” issue the expedited license to the requisite “shall” issue such a license to practice. (See Sect. 8) Thus the appropriate board “shall” issue an license within 45 days; 45 days during which the board must determine the applicant is a citizen of the U.S., has not been disciplined and is currently not under investigation (for malpractice?), has not been civilly or criminally held liable for malpractice, submits finger prints, professes in an affidavit that everything in the application is true.  The corresponding board has 15 days to review the application before telling the applicant more information is needed, and another 30 to make a decision.

Expediting licensure, especially to fill vacancies in rural areas and in specialties which are understaffed, is a valid rationale for this legislation. However, what happens when the licensure requirements are less in another state than in Nevada?  For example, Nevada requires a college degree for drug, alcohol, and gambling addiction counselors – California does not. [SB 68 testimony]

The resolution to this is asserted to be “interstate reciprocity” agreements, including some 20 states including Nevada which have or supposedly will have legislation in place in the near future.  This is the intent of SB 251, which ratifies the “Interstate Medical Licensure Compact.” (Introduced by: Hardy, Roberson, Brower, Farley, Harris, Oscarson, R. Titus, and co-sponsored by Ford, Goicoechea, and Gustavson.  Thus far the members of the Compact are: Nevada, Utah, Idaho, Wyoming, Montana, South Dakota, Minnesota, Iowa, Illinois, Alabama, and West Virginia. [LicensePort]  Frankly, this is a far cry from the universal portability of a medical license the original proponents imagined?

For those keeping score, Nevada now may exempt make-up artists from cosmetology examinations, and may issue expedited licenses to counselors and certain other health care service providers  who may have lesser academic credentials from other states but have active (and presumably unblemished) licenses to practice in another state.

Portability is a fine idea in theory in this interconnected modern environment, and given the mobility of the populace, probably a positive thing, provided – that the licensure (expedited or not) doesn’t impinge on standards already established for the protection of clients and customers.  Also, given the scramble to recruit certified individuals to fill health care positions – and the expansion of the definition of health care providers [SB 84]  – it behooves Nevada consumers to keep an eye on the Nevada Medical Practices Act (NRS 630) and other statutes which concern the licensure and reciprocity of professional providers – of all manner of services in which there is the possibility of injury to Nevada patients, clients, and customers.

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