Removing licensure barriers for immigrant health workers to be a priority for Maryland lawmakers next session

Aug 18, 2022

State of Reform

In the midst of a severe workforce shortage, some Marylanders looking to become health workers are facing a major barrier to registering for their licenses.

Occupational boards require an individual to provide a Social Security number (SSN) when applying for licensure or certification. Immigrants who are not yet citizens and don’t have an SSN are barred from licensure, regardless of their education or certification qualifications.

The restriction doesn’t align with other state policies that provide immigrants who are not yet citizens with in-state tuition and legislative scholarships for health education and training programs, according to Sen. Cheryl Kagan (D-Montgomery County).

“The point is that we are facing a crisis in health care personnel and we’ve got to address it,” Kagan, Vice Chair for the Education, Health and Environmental Affairs Committee, told State of Reform. “…[Immigrants] live in our neighborhoods. They are going to our schools. We are supporting their training and yet by the time they’re ready to launch their careers, we’re slamming the door in their face. That makes no sense. If grandma’s in an assisted living home, or your child, God forbid, is in a hospital and needs care, you want someone who is compassionate and trained and dedicated to providing the best service possible and you’re not really going to be asking about their citizenship.
Other states have opened the door and allowed folks to get licensure. Maryland has not yet done that, so we’re losing a competitive advantage. We’re making this investment in these young people, and then they are leaving the states, starting their family, paying taxes, buying property in other states. It seems silly and vitally important that we fix it.”

Maryland is facing a critical health workforce shortage, exacerbated by the COVID-19 pandemic. Research from the Maryland Hospital Association (MHA) shows a statewide shortage of about 5,000 full time registered nurses and 4,000 licensed practical nurses. Without intervention, shortages could double or even triple by 2035, according to MHA.

Several other states have enacted legislation to address barriers to immigrants gaining professional licensure and certification. Minnesota established the Foreign Trained Physician Task Force in 2014 to help integrate immigrant physicians into the state health delivery system. Both Nebraska and  Indiana passed laws in recent years that opened licensure for certain occupations, such as nursing, to immigrants.

Kagan attempted to address the licensure barrier in Maryland during the 2022 legislative session by sponsoring SB 523. The bill would have prohibited health occupations boards from denying a license, certification, or registration to an immigrant if they meet all educational, training, or professional requirements. The bill passed the Democrat-led Senate, but the session adjourned before it could pass the House.

Those who opposed the bill argued the policy would increase competition for health care jobs.

“The reality is that the jobs are vacant,” Kagan responded. “We don’t have people filling them. We need health care workers. There’s a consensus that folks who are not US citizens who are trained and certified and otherwise completely eligible and ready to serve would do a great job and help address our shortage. The other reality is that people coming from other countries can help provide care for patients for whom English is not their primary language.”

Kagan said she fully intends to sponsor the bill again in the 2023 session, and may pre-file it to ensure it has a lower bill number and earlier hearings. Kagan said she will also work with colleagues in the House of Delegates, such as Health and Government Operations Chair Del. Joseline Peña-Melnyk (D-Anne Arundel) to move the bill through both chambers.