State Representative

Licensure Mobility

One of the primary goals of NAB since its incorporation in 1970 has been licensure mobility. Federal licensure requirements of Nursing Home Administrators delegated standards development to the states and District of Columbia resulting in 51 different standards across the United States, each one very different than the next. As part of the OBRA 87 legislation, the secretary was required to establish common standards by July of 1988. As of this time, the secretary has failed to carry out this legislative mandate.

With an increasingly mobile workforce, mobility has become an important issue across all licensed professions. For senior living and aging services professionals, licensure has expanded into assisted living and home and community-based services, adding additional complexity when crossing jurisdictions and/or lines of service. In addition, existing unreasonable barriers to mobility still exist and must be addressed.

The groundbreaking NAB 2017 practice analysis conducted across multiple lines of service laid the foundation for the development of the NAB HSE Standard and HSE Qualification now adopted in more than half of all US jurisdictions providing licensure mobility to HSE-qualified candidates.

Recognizing the importance of mobility, the Federal Trade Commission issued its 2018 “Policy Perspectives; Options to Enhance Occupational License Portability”, and the White House issued an “Executive Order on Promoting Competition in the American Economy” on July 21, 2021. The FTC is particularly interested in assuring that licensure requirements are not in conflict with Antitrust Law.

Adoption of the NAB HSE Standard is designed to enhance occupational mobility across state lines and across lines of services and to remove unnecessary barriers to licensure.