Luring out-of-state professionals is just the first step in solving Montana’s health worker shortage

Jenna Eisenhart spent nearly six years as a licensed therapist in Colorado before deciding to move to a place with a greater need for her services. She researched rural states facing a shortage of behavioral health providers and accepted a job as a lead clinical primary therapist at Shodair Children’s Hospital in Helena, Montana, in January 2018.

But she couldn’t start her new job right away because state officials denied her application for a license to practice in Montana on the grounds that her master’s degree program required only 48 credits to complete instead of 60.

Eisenhart spent nearly $7,000 to earn 12 more credits to meet the requirement, something she acknowledged not every provider would be able, or want, to do.

“I’m coming here as a licensed therapist to provide services that Montana desperately needs and you’re saying, no, you’re educationally deficient, when that’s not actually true,” said Eisenhart, now the director of clinical services at Shodair. “It kind of made me feel unwanted.”

Eisenhart’s difficulties are an example of the problems that health professionals can have in obtaining a Montana license to practice. State lawmakers are considering proposals to make it easier for professionals with out-of-state licenses to work in Montana. The need to attract more workers is particularly acute amid a national mental health crisis and a worker shortage, both heightened by the covid-19 pandemic. But lawmakers, behavioral health advocates, and providers say the need is so great, they doubt that lowering barriers for out-of-state practitioners will be enough.

One measure, House Bill 101, sponsored by Republican Rep. Jane Gillette and drafted by the Children, Family, Health and Human Services Interim Committee, covers social workers, professional counselors, addiction counselors, marriage and family therapists, and behavioral health peer support specialists. It would let the Department of Labor & Industry automatically license those providers in Montana if they meet certain requirements, like having an active license from another state for at least a year and having proper educational credentials.

Eisenhart said if the bill had been in effect in 2018, she wouldn’t have had to jump through as many hoops to work in Montana.

Another, House Bill 152 sponsored by Republican Rep. Bill Mercer and requested by the state Department of Labor & Industry as part of Gov. Greg Gianforte’s “Red Tape Relief” initiative, aims to streamline the licensing process for all occupations regulated by the department, from nurses to real estate appraisers.

HB 152 is designed to simplify the process for licensing the more than 50 professions and 150 types of licenses under the purview of the labor department, Eric Strauss, administrator of the department’s Employment Standards Division, said in a Jan. 18 committee hearing on the bill.

Last year, the department received more than 21,300 applications for licensure across professions, and half of those were from out-of-state professionals, said Dave Cook, the department’s deputy administrator of professional licensing. Health care-related licenses had an even higher share of out-of-state applicants — 60%, he said.

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