1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 83rd OREGON LEGISLATIVE ASSEMBLY--2025 Regular Session A-Engrossed Senate Bill 476 Ordered by the Senate April 2 Including Senate Amendments dated April 2 Sponsored by Senator JAMA (Presession filed.) SUMMARY The following summary is not prepared by the sponsors of the measure and is not a part of the body thereof subject to consideration by the Legislative Assembly. It is an editor’s brief statement of the essential features of the measure. The statement includes a measure digest written in compliance with applicable readability standards. Digest: The Act says staff of licensing boards must have culturally responsive training. The Act also allows OMB to give a doctor trained in another country a license to practice in Oregon under some conditions. The Act also tells DHS to make a grant program to help people who went to school out of state get jobs in this state. (Flesch Readability Score: 67.8). [Digest: The Act says licensing boards have to train their staff and that the OMB cannot set a time limit for someone to complete the USMLE. The Act also tells DHS to make a grant program to help people who went to school out of state get jobs in this state. (Flesch Readability Score: 78.2).] Requires professional licensing boards to provide culturally responsive training to specified staff members and publish guidance on pathways to professional authorization for internationally edu- catedindividuals. [Prohibits the Oregon Medical Board from imposing a time limitation on the completion of the United States Medical Licensing Examination. Allows the board to issue a limited license to practice medicine to specified individuals for practice under the supervision of another licensed physician.] Al- lows the Oregon Medical Board to issue a provisional license to a qualified internationally trained physician. Requires the holder of a provisional license to practice under the super- vision of a licensed physician for four years prior to applying for full licensure. Directs the board to submit a report every odd-numbered year to the interim committees of the Legis- lative Assembly related to health care on the provisional licensure of internationally trained physicians. Establishes the Internationally Educated Workforce Reentry Grant Program within the Depart- ment of Human Services to award grants to specified entities that provide eligible career guidance and support services to internationally educated residents of Oregon who are seeking to enter the Oregon workforce in certain professions. Declares an emergency, effective July 1, 2025. A BILL FOR AN ACT Relating to professional workforce; creating new provisions; amending ORS 677.010 and 677.100; and declaring an emergency. Be It Enacted by the People of the State of Oregon: PROFESSIONAL LICENSING BOARDS SECTION 1. (1) As used in this section: (a) “Occupational or professional service” means a service: (A) That an individual must possess a license, certificate or other form of authorization to provide under the laws of this state; and (B) Over which a professional licensing board has regulatory oversight. (b) “Professional licensing board” means a state agency or board that licenses, certifies or otherwise authorizes individuals to provide an occupational or professional service. (2) A professional licensing board shall: NOTE:Matter in boldfaced type in an amended section is new; matter [italic and bracketed] is existing law to be omitted. New sections are in boldfaced type. LC 3398 A-Eng. SB 476 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 (a) Ensure that any staff of the professional licensing board who interact with interna- tionally educated individuals through the licensure, certification or other authorization pro- cess receive culturally responsive training approved by the Office of Immigrant and Refugee Advancement. (b) Develop and publish on a website operated by or on behalf of the professional licensing board clear and easily understandable guidance regarding pathways to licensure, certification or other authorization issued by the professional licensing board for internationally educated individuals. The guidance developed under this paragraph must include information on eligi- bility requirements, processes, costs and timelines for licensure, certification or other au- thorization. (3) A professional licensing board may adopt rules to carry out the provisions of this section. SECTION 2. A professional licensing board shall publish the guidance described in section 1 of this 2025 Act not later than July 1, 2026. SECTION 3.(1) Section 1 of this 2025 Act becomes operative on January 1, 2026. (2) A professional licensing board may take any action before the operative date specified in subsection (1) of this section that is necessary to enable the professional licensing board to exercise, on and after the operative date specified in subsection (1) of this section, all of the duties, functions and powers conferred on the professional licensing board by section 1 of this 2025 Act. SECTION 4. Sections 5 and 6 of this 2025 Act are added to and made a part of ORS chapter677. SECTION 5.Not later than February 1 of each odd-numbered year, the Oregon Medical Board shall report, in the manner provided in ORS 192.245, to the interim committees of the Legislative Assembly related to health care, on the provisional licensure of internationally trained physicians under section 6 of this 2025 Act. The report must include the following information from the two immediately preceding calendar years: (1) The number of applications for provisional licensure received; (2) The numbers of provisional licenses issued or denied; (3) An aggregated list of employers that employed provisionally licensed internationally trained physicians; and (4) Any disciplinary or remedial actions taken against provisionally licensed interna- tionally trained physicians. SECTION 6. (1) The Oregon Medical Board may issue a provisional license to a qualified internationally trained physician. To be considered for a provisional license under this sec- tion, an internationally trained physician must have: (a) Graduated from a school of medicine with a degree substantially similar to a degree of Doctor of Medicine or Doctor of Osteopathic Medicine, as determined by the board; (b) Completed a training program that is substantially similar to an approved training program, as determined by the board; (c) Obtained certification from the Educational Council for Foreign Medical Graduates, or its successor organization, as approved by the board; (d) Practiced medicine in another country or jurisdiction for at least three years; (e) An offer of employment at a clinical facility located in this state that will provide supervision and assessment of the applicant in accordance with standards established by the [2] A-Eng. SB 476 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 board by rule; (f) Complied with all board rules that apply to similar applicants for a license to practice medicine in this state; and (g) Provided evidence, as determined sufficient by the board, that the applicant is of good moral character consistent with the requirements of ORS 677.100 and in good standing in each country or jurisdiction in which the applicant practiced and received education and training. (2) An applicant for a provisional license under this section shall: (a) Apply to the board in the form and manner required by the board; (b) Pay the fee established by the board by rule; and (c) Provide to the board any further information required by the board. (3) An internationally trained physician provisionally licensed under this section shall practice: (a) Under the supervision of a physician licensed under ORS 677.100 who is in good standing with the board and meets the requirements established by the board relating to supervision;and (b)(A) In a facility in this state with an approved training program; (B) In a federally qualified health center that provides primary care and other services to underserved populations, as determined by the board; or (C) In any other clinical location that demonstrates that the location meets the require- ments established by the board by rule. (4) An internationally trained physician provisionally licensed under this section: (a) Is considered a fully licensed physician in this state for all purposes, including but not limited to credentialing and insurance billing; (b) Is subject to all the provisions of this chapter and to rules of the board adopted under this chapter; and (c) Has the same duties and responsibilities, and is subject to the same penalties and sanctions, as any other physician licensed under this chapter. (5) An internationally trained physician provisionally licensed under this section may, after completion of four years of full-time equivalent practice under subsection (3) of this section, successful completion of a clinical assessment evaluation as determined by the board by rule and satisfaction of the requirements for licensure under ORS 677.100, apply for licensure under ORS 677.100. (6) The board may adopt rules as necessary to carry out this section. SECTION 7. ORS 677.010 is amended to read: 677.010. As used in this chapter, subject to the exemptions in ORS 677.060 and unless the con- text requires otherwise: (1) “Approved internship” means the first year of post-graduate training [served in a hospital that is approved by the board or] that is accredited by the Accreditation Council of Graduate Medical Education, the American Osteopathic Association or the Royal College of Physicians and Surgeons of Canada, and approved by the Oregon Medical Board . (2) “Approved school of medicine” means a school offering a full-time resident program of study in medicine or osteopathic medicine leading to a degree of Doctor of Medicine or Doctor of Osteopathic Medicine, [such program having been] if the program of study is fully accredited or conditionally approved by the Liaison Committee on Medical Education, or its successor agency, or [3] A-Eng. SB 476 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 the American Osteopathic Association, or its successor agency, or the Committee on Accredi- tation of Canadian Medical Schools, or its successor agency, or [having been otherwise] has otherwise been determined by the board to meet the association standards as specifically incorpo- rated into board rules. [(3) “Board” means the Oregon Medical Board.] (3) “Approved training program” means a residency program that is accredited by the Accreditation Council of Graduate Medical Education, or its successor organization, the American Osteopathic Association, or its successor organization, or the Royal College of Physicians and Surgeons of Canada, or its successor organization, and approved by the board. (4) “Diagnose” means to examine another person in any manner to determine the source or na- ture of a disease or other physical or mental condition, or to hold oneself out or represent that a person is so examining another person. It is not necessary that the examination be made in the presence of such other person; it may be made on information supplied either directly or indirectly by such other person. (5) “Dispense” means the preparation and delivery of a prescription drug, pursuant to a lawful order of a practitioner, in a suitable container appropriately labeled for subsequent administration to or use by a patient or other individual entitled to receive the prescription drug. (6) “Dispensing physician” means a physician or podiatric physician and surgeon who purchases prescription drugs for the purpose of dispensing them to patients or other individuals entitled to receive the prescription drug and who dispenses them accordingly. (7) “Drug” means all medicines and preparations for internal or external use of humans, in- tended to be used for the cure, mitigation or prevention of diseases or abnormalities of humans, which are recognized in any published United States Pharmacopoeia or National Formulary, or otherwise established as a drug. (8) “Fellow” means an individual who has not qualified under ORS 677.100 (1) and (2) and who is pursuing some special line of study as part of a supervised program of a school of medicine, a hospital approved for internship or residency training, or an institution for medical research or ed- ucation that provides for a period of study under the supervision of a responsible member of that hospital or institution, such school, hospital or institution having been approved by the board. (9) “Intern” means an individual who has entered into a hospital or hospitals for the first year of post-graduate training. (10) “Internationally trained physician” means a physician who graduated from a medical school that is not an approved school of medicine and who completed a training program that is not an approved training program. [(10)] (11) “License” means permission to practice, whether by license, registration or certifica- tion. [(11)] (12) “Licensee” means an individual holding a valid license issued by the board. [(12)] (13) “Physical incapacity” means a condition that renders an individual licensed under this chapter unable to practice under that license with professional skill and safety by reason of physical illness or physical deterioration that adversely affects cognition, motor or perceptive skill. [(13)] (14) “Physician” means a person who holds a degree of Doctor of Medicine or Doctor of Osteopathic Medicine, or a person who holds a degree of Doctor of Podiatric Medicine if the context in which the term “physician” is used does not authorize or require the person to practice outside the scope of a license issued under ORS 677.805 to 677.840. [(14)](15) “Podiatric physician and surgeon” means a physician licensed under ORS 677.805 to [4] A-Eng. SB 476 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 677.840 to practice podiatry. [(15)(a)] (16)(a) “Podiatry” means: (A) The diagnosis or the medical, physical or surgical treatment of ailments of the human foot, ankle and tendons directly attached to and governing the function of the foot and ankle, and treat- ment involving the use of a general or spinal anesthetic if that treatment is performed in a hospital licensed under ORS 441.025 or in an ambulatory surgical center licensed by the Oregon Health Au- thority and is under the supervision of or in collaboration with a podiatric physician and surgeon; (B) Assisting in the performance of surgery, as provided in ORS 677.814; and (C) The treatment of skin, skin-related structures and subcutaneous masses, and wounds involv- ing skin, skin-related structures and subcutaneous masses, on the human leg no further proximal than the tibial tubercle. (b) “Podiatry” does not include administering general or spinal anesthetics or the amputation of the entire foot. [(16)] (17) “Prescribe” means to direct, order or designate the use of or manner of using by spoken or written words or other means. [(17)] (18) “Resident” means an individual who, after the first year of post-graduate training, in order to qualify for some particular specialty in the field of medicine, pursues a special line of study as part of a supervised program of a hospital approved by the board. SECTION 8. ORS 677.100 is amended to read: 677.100. (1) An applicant for a license to practice medicine in this state, except as otherwise provided in subsection (2) of this section, must possess the following qualifications: (a) Have attended and graduated from a school of medicine. (b) Have satisfactorily completed the following post-graduate requirement: (A) Satisfactory completion of an approved rotating internship if a graduate of an approved school of medicine; (B) One year of training in an approved program if a graduate of an approved school of medi- cine; [or] (C) Three years of training in an approved program if a graduate of an unapproved school of medicine;or (D) Four years of provisional licensure under section 6 of this 2025 Act . (c) Have complied with each rule of the Oregon Medical Board which applies to all similar ap- plicants for a license to practice medicine in this state. (d) Have provided evidence sufficient to prove to the satisfaction of the board that the applicant is of good moral character. For purposes of this section, the lack of good moral character may be established by reference to acts or conduct that reflect moral turpitude or to acts or conduct which would cause a reasonable person to have substantial doubts about the individual’s honesty, fairness and respect for the rights of others and for the laws of the state and the nation. The acts or conduct in question must be rationally connected to the applicant’s fitness to practice medicine. (2) If an applicant establishes that the applicant is of good moral character and has qualifica- tions which the board determines are the equivalent of the qualifications required by subsection (1)(a) to (c) of this section, the applicant satisfies the requirements of subsection (1) of this section. (3) An applicant for a license to practice medicine [must make written application] shall apply to the board in a manner showing compliance with this section, ORS 677.110, 677.120 and the rules of the board, and containing [such] any further information as the rules of the board may require. SECTION 9. (1) Section 5 of this 2025 Act and the amendments to ORS 677.010 by section [5] A-Eng. SB 476 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 7 of this 2025 Act become operative on January 1, 2026. (2) Section 6 of this 2025 Act and the amendments to ORS 677.100 by section 8 of this 2025 Act become operative on January 1, 2027. (3) The Oregon Medical Board may take any action before the operative dates specified in subsections (1) and (2) of this section that is necessary for the board to exercise, on and after the operative dates specified in subsections (1) and (2) of this section, all of the duties, functions and powers conferred on the board by sections 5 and 6 of this 2025 Act and the amendments to ORS 677.010 and 677.100 by sections 7 and 8 of this 2025 Act. INTERNATIONALLY EDUCATED WORKFORCE REENTRY GRANT PROGRAM SECTION 10. (1) The Internationally Educated Workforce Reentry Grant Program is es- tablished within the Department of Human Services. (2) Under the program, the department shall award grants to not-for-profit organizations, post-secondary institutions of education and employers who provide eligible career guidance and support services to internationally educated residents of Oregon who are seeking to en- ter the Oregon workforce in an eligible profession. In determining grant amounts under this subsection, the department, in consultation with the Office of Immigrant and Refugee Ad- vancement, shall develop a formula that uses factors including, but not limited to, the ge- ographic distribution of internationally educated individuals and the regional availability of resources and services for internationally educated individuals. (3) In administering the program, the department shall: (a) Collaborate with the office to establish requirements for contracting and reporting by grant recipients under subsection (2) of this section; (b) Use the program to assist in coordinating the planning, development and implemen- tation of a comprehensive system for integrating individuals who are internationally edu- cated in eligible professions; (c) Partner with community organizations that work with internationally educated pop- ulations to develop and maintain a voluntary roster of internationally educated populations entering the Oregon workforce; and (d) Make publicly available summary reports that show the aggregate number and dis- tribution, by geography and specialty, of the internationally educated population in Oregon. (4) The department, in consultation with the office, may adopt rules necessary to imple- ment this section. (5) As used in this section: (a) “Eligible career guidance and support services” means: (A) Educational and career navigation services, including but not limited to information on training and licensing requirements for an eligible profession; (B) Guidance on determining best career pathways, based on individual skills, experience, resources and interests; (C) Support in becoming proficient in eligible industry-specific English; (D) Support in becoming proficient in the use of information technology, including but not limited to computer skills and the use of electronic technology; (E) Support for increasing knowledge of and familiarity with health care and educational systems; [6] A-Eng. SB 476 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 (F) Support for trauma-informed care; (G) Support for clinical preparation; (H) Culturally responsive training; (I) Support for job placement; and (J) Financial support for internationally educated residents. (b) “Eligible profession” means: (A) Certified nursing assistant, licensed practical nurse or registered nurse; (B) Physician; (C) Pharmacist; (D) Behavioral health and mental health worker; and (E) Nurse, school counselor or teacher at a school. (c) “Financial support” means: (A) Tuition, fees and other costs incurred in relation to training, licensing or creden- tialing; (B) Living wages during the training, licensing or credentialing process; (C) Costs associated with exam preparation, including but not limited to review courses and study and exam materials; and (D) Application fees. SECTION 11. No later than June 30, 2026, the Department of Human Services shall begin to award grants under the Internationally Educated Workforce Reentry Grant Program es- tablished under section 10 of this 2025 Act. SECTION 12.Section 11 of this 2025 Act is repealed on January 2, 2027. SECTION 13.No later than September 1, 2028, the Department of Human Services shall prepare and submit a report in the manner provided in ORS 192.245 on the implementation and success of the Internationally Educated Workforce Reentry Grant Program established in section 10 of this 2025 Act, which may include recommendations for legislation, to the in- terim committees of the Legislative Assembly related to labor and business. The report submitted under this section must include information regarding: (1) The total number of internationally educated professionals who were served by the program; (2) The specific types of direct services provided to professionals, including but not lim- ited to the costs of providing the services and the number of professionals who received the services; (3) The total amount of financial assistance provided to professionals; (4) The types of financial assistance that were provided to professionals; and (5) Any identified barriers that prevent internationally educated professionals from par- ticipating in the Oregon workforce. SECTION 14. Section 13 of this 2025 Act is repealed on January 2, 2029. SECTION 15.In addition to and not in lieu of any other appropriation, there is appro- priated to the Department of Human Services, for the biennium beginning July 1, 2025, out of the General Fund, the amount of $10,000,000 for the purpose of operating the Interna- tionally Educated Workforce Reentry Grant Program established in section 10 of this 2025 Act. CAPTIONS [7] A-Eng. SB 476 1 2 3 4 5 6 7 8 9 10 SECTION 16. The unit captions used in this 2025 Act are provided only for the conven- ience of the reader and do not become part of the statutory law of this state or express any legislative intent in the enactment of this 2025 Act. EFFECTIVE DATE SECTION 17.This 2025 Act being necessary for the immediate preservation of the public peace, health and safety, an emergency is declared to exist, and this 2025 Act takes effect July 1, 2025. [8]