solutions to these issues is imperative to successfully address workforce shortages and improve public health. The American Dental Hygienists’ Association (ADHA) supports licensure portability and has been working diligently to promote initiatives that improve licensure mobility.1 The ADHA maintains the Dentist and Dental Hygienist Compact (DDH Compact) is the best option for license mobility for dentists and dental hygienists. Presently, three states have enacted the DDH compact legislation. The DDH Compact aims to reduce the time it takes for licensed dental hygienists to begin practicing in new states. COMPACT BACKGROUND Like all licensed professionals, dentists and dental hygienists are limited to providing care within state borders. Interstate compacts are specific to each occupation and can be used by all eligible licensees who meet the requirements within the compact, allowing providers to cross state lines to practice their profession. The rise in compacts, which establish mutual agreement between member states for professional licensure, offer state legislatures an opportu- nity to safeguard state sovereignty while also ensuring the quality and safety of services. Since 2016, 289 pieces of licensure compact legislation have been enacted and, to date, 46 states, Washington, DC, and three territories have enacted licensure compact legislation. Fifteen professions cur- rently have a compact available to states for enactment including medi- cine, nursing, physical therapy, and psychology. In 2023, 54 pieces of compact legislation were enacted, with six new compacts becoming available for states to enact, including the DDH Compact. The United States Department of Defense (DoD) sought to sup- port the development of interstate compacts to ensure the porta- bility of military spouses with professional licenses. Since military families move often, spouses of military members frequently must navigate the license regulatory systems. DoD wants to ease some of this burden. In September 2020, the DoD entered into a cooper- ative agreement with the Council of State Governments (CSG) to establish new interstate compacts, strengthening occupational dimensionsofdentalhygiene.com SUPPLEMENT TO Dimensions OF DENTAL HYGIENE 25 licensing portability. The CSG is a non- profit organization that serves states. The National Center for Interstate Compacts at CSG has been involved in the creation, implementation, or management of all active licensure compacts. FORMATION OF THE DDH COMPACT In collaboration with the DoD, the CSG developed and adminis- tered a competitive application process to select the professions for initial compact development. The American Dental Association (ADA) and the ADHA applied together to partner with CSG in the development of a compact for dentists and dental hygienists. The DoD ultimately chose the final professions for compact develop- ment, including dentistry. Then, CSG and members from the selected occupations transitioned to drafting the model compact legislation. To develop recommendations guiding the drafting of a compact, the CSG, ADA, and ADHA brought together a technical assistance group made up of state board members, board administrators, mem- bers of professional associations, licensees, and other stakeholders. The group met over the course of several months to determine the needs of the profession and the compact model, mobility patterns, and current licensure systems. A separate, smaller drafting team tran- sitioned the recommendations and model from the technical assis- tance group into a full draft of the compact model legislation. Once a draft was written, the CSG managed a public comment period that included educational presentations and an extensive survey process. This review was open to the public. More than 400 comments were received. After gathering responses, the CSG reconvened the drafting and technical assistance group to finalize the draft, leading to the publication of the model legislation in Jan- uary 2023. An overview of the development process as well as a list of group members who participated in the technical assistance group and the drafting team can be found at ddhcompact.org. To be eligible to join the compact, states must accept the National Board Examinations of the Joint Commission on National Dental Examinations and the requirement that applicants graduate from a predoctoral dental education program, leading to the Doc- tor of Dental Surgery or Doctor of Dental Medicine degree, or a dental hygiene education program accredited by the Commission on Dental Accreditation, but they may allow other routes to licen- sure to remain open. States must also require the successful completion of a clinical Jessica Thomas is the policy analyst for the Center of Innovation at the Council of State Governments in Lexington, Kentucky. JoAnn Gurenlian, RDH, MS, PhD, AAFAAOM, FADHA, is the director of education, research, and advocacy for the American Dental Hygienists’ Association and professor emerita of the Department of Dental Hygiene, at Idaho State University in Pocatello. She is also a member of the Dimensions of Dental Hygiene Editorial Advisory Board. LICENSURE Compacts
