Medical Board opposes LAO proposal to exempt out-of-state mental‑health clinicians from California licensure

The Medical Board of California voted to oppose a Legislative Analyst Office recommendation that the Legislature exempt out‑of‑state mental‑health providers from California licensure when working for the Department of Corrections and Rehabilitation.

Dr. Yip introduced a summary of the LAO report, which described growing needs in the prison mental‑health system and noted nearly 35,000 incarcerated people with diagnosed mental‑health conditions. The LAO recommended several options for boosting the workforce, including temporarily allowing clinicians licensed in other states to practice in California correctional settings without obtaining a California license.

Board staff told members that licensure is a fundamental form of consumer protection that enables the board to know who is treating patients in California and to take disciplinary action when necessary. Staff recommended directing the board’s staff to send a letter to the LAO, copying the governor’s office and relevant legislative committees, stating the board’s opposition to a broad licensure exemption and offering to meet to discuss alternatives.

Board members pressed both the scope of the workforce crisis and the limits of a licensure exemption. Multiple members cited the LAO figures — including an extreme clinician‑to‑patient ratio described in the report — and urged that workforce shortages be addressed without stripping the board’s oversight authority. Dr. Tolbert and others said the board should pursue expedited, targeted pathways (for example, streamlined licensing for clinicians committed to correctional practice, interstate compact options, or temporary provisional processes coupled with safeguards) rather than an unconditional exemption.

Public commenters echoed the board staff position. Lucas Evensson, speaking for the California Medical Association, said the CMA "supports the board's thoughtful discussion and work to incorporate diversity, equity, inclusion, and accessibility" and urged the board to adopt the staff recommendation to oppose exemptions. George [to] Osborne, representing the Union of American Physicians and Dentists, told the board that allowing unlicensed doctors to practice in California would undermine standards and accountability.

A motion to adopt the staff recommendation passed on a roll‑call vote. The board instructed staff to convey opposition to the LAO proposal, to offer to work with the LAO and legislative offices on alternative solutions, and to explore expedited licensing pathways and other workforce strategies that preserve California oversight.

Next steps: board staff will draft the letter to the LAO and consult with the governor’s office and relevant legislative committees, and the board signaled interest in working on targeted licensure pathways and recruitment/compensation measures to address the CDCR workforce shortage.