The call of duty: How can we make licensure portability easier for spouses of military personnel?

By Lisa Dowst-Mayo, RDH, BSDH, and Lauren Ray

Moving can mean so many things to so many different people: a fresh start, a new home, a new job, and new friends. Sounds pretty exciting, doesn't it? However, for the 100,000 United States military spouses whose jobs require licensing,1 a move can mean roadblocks. Licensure portability can pose a major issue for their families' livelihoods.

When dental professionals move, they all have to deal with an inevitable job hunt, which can be a daunting and overwhelming experience-especially if licensure portability is an issue. It is easy to sympathize with this challenge that is all-too-real for military spouses because they happen to move a lot!

The authors of this article have unique perspectives on this subject: Lauren Ray speaks from her experience as a military spouse, and her dental hygiene mentor and instructor, Lisa Mayo, offers the insight of a seasoned hygienist. Lauren can attest and speak to the challenges of relocation and what that means to earning and maintaining licensure. In 2013, she and her active-duty husband were moved from Pensacola, Florida, to San Antonio, Texas, by the United States Air Force on official military orders. She had to wait until after relocation to apply for the dental hygiene program at Concorde Career College in order to ensure that she would be residing there long enough to complete the coursework.

This article will discuss the challenges licensed military spouses face when they are forced to relocate with duty station changes, as well as the legislation that was proposed in 2012 by the First Lady of the United States, Michelle Obama, and the Second Lady, Jill Biden, to improve licensure portability.¹

Authors' Note: It is not our intention to evoke negative sentiments about being a military spouse, because just as service members take an oath to love and honor their country, so too do their spouses. You may hear the quiet percussion of the "Star Spangled Banner" rising in the background as you read this article, and rightfully so. At the conclusion of this piece, we hope you will have gained insight into the life of a military family, and how the spouse's sacrifice for their country affects others in the household.

The Military Family Licensing Act

In early 2012, Michelle Obama and Jill Biden asked U.S. state governors to relieve some of the financial burdens that military families face during relocation by improving licensure portability for service members' spouses.¹ They urged state legislatures to pass laws aimed at easing licensure portability with this call to action.¹ First Lady Michelle Obama stated that this Act would provide more families with the "income they need and the financial security they deserve," and that, "above all, military families [would] know that America has their back."²

In 2012, there were almost 1.4 million active-duty service members in the United States military.³ Of those, 52% reported being married,3 and 35% of those spouses required a professional license or certification for their employment.¹ Military spouses move 10 times more frequently than their civilian counterparts.⁴ With these statistics in mind, it is easy to see how many licensed military spouses are affected by varying state portability laws and, in turn, the fiduciary implications this has for many American families.

By June 2012, Illinois became the twenty-third state to recognize this call to action in its passing of the Military Family Licensing Act.² In other words, by the middle of 2012, only half of the United States had acted on the First and Second Ladies' call to action, which still left half of the states in the country using their own broken and individualized systems.¹ According to Kersey, as of 2012, "States with substantial military populations had made no action on their own to address the issue of license portability. But, by February 2014, a majority of states had passed legislation addressing license portability for military spouses."¹

Modes of licensure portability

There are three common modes of licensure portability available to dental professionals who move to states other than the ones in which they were originally licensed.¹ Since other modes may be available, dental professionals should check with their state dental boards to discover all of the available modes of transfer.

1. Licensure through endorsement, reciprocity, recognition, credentials, or criteria-According to the American Dental Association (ADA), "In granting licensure by credentials, the Board of Dentistry makes a determination that the applicant is currently licensed in a state that has equivalent licensure standards."⁵ Typically, state boards require "continuous practice for a specified period of time (typically five years) in another jurisdiction" for dental professionals to qualify for this mode of portability.⁵ Some states require applicants to demonstrate recent work experience to qualify for this mode of licensure portability. This can be especially challenging for military spouses who have been unable to practice in recent years, due to overseas assignment or temporary relocation resulting from their spouses' deployment. Currently, there are 27 states that have passed legislation and eight states that have active bills in support of licensure portability through endorsement.⁶

In 2013, the ADA House of Delegates strongly supported freedom of movement through licensure by credentials.⁵ According to Kersey, "licensure by endorsement should provide the quickest method for professionally licensed military spouses to return to work following relocation to a surrogate state."¹

2. Temporary licensure-This mode allows applicants to be employed while they fulfill all of the requirements for permanent licensure, such as examinations, endorsements, applications, and/or additional fees.¹ This mode is typically nonrenewable and strictly time-limited.⁵ Currently, 30 states have passed legislation and nine states have active bills in support of temporary licensure.⁶
3. Expedited-According to the National Military Family Association, "This process will accelerate the review of a military spouse's license application."⁷ For example, in Utah, military spouses may work using a current, out-of-state license for the length of their service-member spouses' assignments.⁶ Currently, 22 states have passed legislation and nine have active bills that support expedited licensure.⁶

New graduates who are looking into the "wild blue yonder" of possibilities may find relocation the most challenging, as they likely do not have the years of experience required for licensure by credentials or endorsement. Lauren reports that "after many sleepless nights, incapacitating stress, night sweats, and time away from my loved ones to study and pass my clinical and theoretical boards, I am doing my best not to get discouraged by this complicated license portability process." Thankfully, the Military Family Licensing Act provides hope that future licensure issues may not be as complicated as they seem today.

With the current military climate in the United States, it's important for military spouses to be able to maintain their careers. According to Kersey, "Family support is central to retention, readiness, and mission successes of service members."1 So, as the patriotic rhythm chiming in the background begins to fade into the silence of this article's conclusion, here is one last thought: Licensed military spouses must adapt to their service-member spouses' pledge so that they can adequately fulfill their role as partners, aiding in financial support to their families and ensuring that the freedom of all Americans remains protected. The United States depends on this. RDH

Lisa Dowst-Mayo, RDH, BSDH, graduated magna cum laude with a bachelor's degree in dental hygiene from the Caruth School of Dental Hygiene at the Baylor College of Dentistry in 2002. She is currently pursuing a master's degree in health-care administration from Ohio University. She has held numerous leadership roles in dental hygiene associations at the local, state, and national levels, and she is currently the website designer for the Dallas Dental Hygiene Association. She is an author, clinician, educator, and national speaker, as well as a full-time dental hygiene professor at Concorde College in San Antonio, Texas. She currently resides in Boerne, Texas, with her husband and children. Lauren Ray graduated from Texas A&M University in College Station, Texas, in 2007 with a bachelor's degree in communications and journalism. She is currently pursuing an associate's degree in dental hygiene at Concorde Career College in San Antonio, Texas, and will graduate in January 2016. Lauren is an active leader at her school and a member of the campus's student leadership team, Lamplighters, which honors students with high GPAs and leadership qualities. Lauren, her husband, Drew, and their three dogs plan to return to their hometown of Dallas, Texas, upon Drew's retirement from the United States Air Force.

References

1. Kersey AW. Ticket to ride: Standardizing licensure portability for military spouses. Military Law Review. 2013;218: 115-169.
2. Illinois Department of Military Affairs. Illinois passes Military Family Licensing Act. U.S. Army website. https://www.army.mil/article/82716/Illinois_passes_Military_Family_Licensing_Act/. Published June 28, 2012.
3. Department of Defense. 2012 Demographics Profile of the Military Community. http://download.militaryonesource.mil/12038/MOS/Reports/
4. 2012_Demographics_Report.pdf. Published 2012.
5. Cronk TM. Efforts Continue for Spouse Professional License Portability. U.S. Department of Defense website. http://archive.defense.gov/News/NewsArticle.aspx?ID=119605. Published March 22, 2013.
6. American Dental Association Office of Student Affairs. Understanding Licensure. American Student Dental Association website. https://www.asdanet.org/uploadedFiles/The_Issues/understandinglicensure_2013.pdf. Published 2012.
7. Military One Source. State Licensing and Career Credentials Initiative. Military One Source website. http://www.militaryonesource.mil/seco?content_id=271758.
8. National Military Family Association. Certificate + License Information. National Military Family Association website. http://www.militaryfamily.org/spouses-scholarships/licensing-certification.html.