Nearly a quarter of Oregonians face a shortage of nearby dental health professionals. Many hospitals struggle to fill nursing jobs. Scarce public school psychologists serve twice the recommended number of students.
And despite efforts to increase behavioral health treatment beds, Oregon still doesn’t have enough workers to staff them.
Though state agency directors say they’ve taken steps to address widespread complaints about licensing delays, state Rep. Ed Diehl, R-Scio, said he keeps hearing about qualified professionals waiting months to receive a license so they can work in Oregon.
And that’s why Diehl, a hospital board member and Catholic Community Services volunteer, has become the Legislature’s biggest advocate for interstate agreements that make it easier for out-of-state health care professionals to come work in Oregon.
“Every employer wants them. Every employee wants them,” Diehl said of the interstate compacts. “When the public hears about this, they’re saying, ‘What? Why are we blocking this?’”
When lawmakers formally begin the legislative session next week, Diehl will try again to advance bills that would enter Oregon into several of the interstate agreements, known as “compacts.”.
His previous attempts failed in the Democratic-led Legislature after facing opposition from professional associations, unions and licensing boards. That opposition is why he’s stopped pushing for Oregon to join the interstate compact for nurses, shifting to other areas of staffing shortages instead.
Diehl told The Lund Report he’s optimistic that the political winds are changing as the public becomes more aware of the issue. Also, influential Democratic lawmakers are showing interest.
So far, Diehl has introduced bills that would enter Oregon into interstate compacts for dentists and dental hygienists, physician associates, school psychologists and social workers. He intends to do the same for mental health counselors and psychiatrists later in the session.
While officials at at least two boards have raised concerns about entering the compacts, several of the bills have garnered support from professional associations as well as Democratic lawmakers.
Nursing effort won’t be back
As health care work force shortages continued after the pandemic, Diehl co-sponsored a bill during the 2023 session that would have entered Oregon into the Nurse Licensure Compact, making it easier for nurses to cross state lines for work.
The state nursing board had streamlined out-of-state nurses in emergency situations, such as efforts backed by Gov. Tina Kotek to keep a maternity ward open in Baker City.
But the bill went nowhere as the politically connected Oregon Nurses Association argued it would mean less oversight and that the state was already producing more nurses.
“Every employer wants them. Every employee wants them. When the public hears about this, they’re saying, ‘What? Why are we blocking this?’”
Following that defeat, Diehl introduced a bill last year that would have required health care licensing boards to issue temporary licenses to applicants who’d already been licensed in other states. But the bill was amended to instead create a new task force on licensing before it died in committee.
Based on those experiences, Diehl decided to focus his efforts in different areas, he told The Lund Report.
School psychologists, Democrat join new effort
During the run-up to the 2025 session Diehl was approached by Rep. Courtney Neron, a Wilsonville Democrat who chairs the House Education Committee, he said.
Neron asked him to co-sponsor what is now House Bill 2596, which would enter Oregon into the School Psychologist Interstate Licensure Compact, a new multistate agreement that currently has Colorado and West Virginia as its only members.
Oregon has higher rates of mental illness than other states. Neron told The Lund Report in an emailed statement, and the state needs “to do everything we can to respond to the youth mental health crisis and support our behavioral health workforce.”
Neron added, “This bill is supported by school psychologists and is a critically needed component of Oregon’s wider response to youth mental health needs.”
Oregon increased its number of non-special education school psychologists from 66 to 84 over the last five years, according to a new report on the state’s health care work force.
However, the report referenced an analysis from Hopeful Futures Campaign, a national advocacy group, that found that Oregon has one school psychologist for every 3,400 students, less than half the recommended ratio.
The Oregon School Psychologists Association. did not immediately respond to a request for comment from The Lund Report.
Melissa Goff — interim executive director of the Teacher Standards and Practices Commission, which licenses school psychologists — told The Lund Report in an email that her organization did not have a position on the bill but would be monitoring it.
Other compact bills seek to increase behavioral health providers
Diehl is the sole sponsor of House Bill 2554, which would enter Oregon into the interstate Social Work Licensure Compact, which includes roughly half of all states.
Oregon is one of the worst among states at meeting residents’ behavioral health needs, according to one national survey. And programs and providers are scrambling to meet the state’s behavioral health care crisis.
The state report found that the number of behavioral health providers rose to 1.25 per 1,000 Oregonians last year, up from the 1.15 the year before.
Ray Miller, executive director of the state Board of Licensed Social Workers, did not immediately respond to a request for comment from The Lund Report.
Delmar Stone, executive director of the Oregon chapter of the National Association of Social Workers, told The Lund Report that his group supports the bill. With telehealth becoming common, he said that people of color, LGBTQ individuals and others would have better access to counseling offered by social workers in the compact.
Additionally, he said that Oregon social workers who specialize in eating disorders or other areas would have access to more clients through the compact.
The bill, he said, would have an immediate impact on Oregon’s mental health crisis.
Diehl plans to sponsor two additional bills that would enter Oregon into compacts for psychiatrists and counselors.
Elisabeth Herrera, president of the Coalition of Oregon Professional Associations for Counseling and Therapy, told The Lund Report in an email that her organization supports Diehl’s efforts regarding counselors, along with the Oregon Counseling Association.
The bill would enter Oregon into the Counseling Compact, which 37 states have joined.
“We believe that it will ultimately lead to an increase in mental health access for Oregonians,” Herrera said.
Dentists and physician associates
Diehl is also sponsoring House Bill 2676, which has Democratic cosponsors. The bill would enter Oregon into the Dentist and Dental Hygienist Compact, a recent interstate agreement that 10 states so far have joined.
The state health care workforce report found that Oregonians’ access to dental care has remained fairly steady over the last eight years. However, it found that rural residents had far less access and roughly 1 million Oregonians lived in areas designated by federal authorities as having shortages of dental health professionals, spanning 33 of the state’s 36 counties.
Dr. Barry Taylor, executive director of the Oregon Dental Association, told The Lund Report in a statement that his group supports the bill.
“The compact, which is broadly supported by the dental community, will help address workforce issues in dental offices by increasing mobility and multistate practice for licensed dentists and dental hygienists by allowing them to practice in all states participating in the compact, rather than going through the time-consuming, cumbersome, and duplicative process of getting an individual license in every state in which they want to practice,” he said.
Stephen Prisby, executive director of the Oregon Board of Dentistry, told The Lund Report in an email that the board did not have a position on the bill. However, he shared a paper he authored stating that interstate compacts would decrease the board’s revenue, would create more red tape for the board and people seeking licensees and would reduce oversight.
House Bill 3060, another of Diehl’s bills that would enter Oregon into the PA Licensure Compact, is supported by Senate Health Care Committee Chair Deb Patterson, a longtime health care administrator and leader. The compact covers physician assistants, which last year were renamed associates in Oregon. Their numbers in Oregon increased by 14% over the last four years to nearly 800, according to the recent state workforce report.
So far a dozen states have joined the PA Licensure Compact, which is still in the process of becoming operational.
Leadership of the Oregon Medical Board, which licenses physician associates, has been critical of the Interstate Medical Licensure Compact, a similar compact for physicians. Nicole Krishnaswamy, the board’s executive director, has previously said that the compact would reduce the board’s ability to evaluate the employment history of out-of-state physicians, including malpractice claims against them.
Elizabeth Ross, the board’s legislative and policy analyst, told The Lund Report in an email that the board does not have a position on the PA bill. However, she referred to a board white paper that described its concerns with the compact for physicians.
“It is our understanding that the PA Licensure Compact is similar to the Interstate Medical Licensure Compact and will share many of the same concerns identified in the white paper,” she wrote.
Alisa Gifford, president of the Oregon Society of Physician Associates, told The Lund Report in a statement that her group is supportive of the bill.
“Our members knows that licensure compacts help ensure continuity of care for patients and expand access to the high-quality health care PAs provide, and we look forward to advocating for this bill,” she wrote.