Health center tells senators scope-of-practice debates should prioritize public protection and rural access

Dr. Joe Thompson, presenting for the Arkansas Center for Health Improvement, told members the center provides research and comparative examples but "do not advocate for or against specific scope of practice" except in extreme public-protection cases. He summarized the institutional landscape: the General Assembly delegates occupational regulation to licensing boards, the governor appoints board members, credentialing organizations and member associations influence practice, and payers determine who they will reimburse.

Thompson emphasized that public protection must take precedence over professional self-interest and that the health system is trending toward team-based care. "We are moving towards team based care," he said, and added that many services are shifting from single-provider models toward collaborative practice.

Lawmakers pressed him on rural workforce solutions. Thompson said Medicaid has a uniform fee schedule across the state while private payers can negotiate different rates, and that prior state loan-forgiveness programs have had mixed results because recipients sometimes relocate after completing service obligations. On recruiting and retention he observed that rural residency training and stronger local linkages can help. "We need to find ways that we have lasting linkages for individuals in those rural communities," Thompson said.

The session included sustained questioning from members about licensing-board composition, the possible protection of professional turf for financial reasons, and whether exceptions should be made for underserved areas. Thompson acknowledged the tension and said such exceptions would be significant policy decisions for the legislature, not the boards, because boards currently license uniformly across the state.

Committee members thanked Thompson and were told the center would be available as a resource and could share its statewide workforce assessment.