CMSA Today, (6). Nurses who live in a compact state can apply for a multistate license if they meet the licensure requirements. B. Discover a compact nursing states list here. Misdemeanor offenses are viewed on a case by case basis. Imagine if the Driver License Compact included only half of the states in the country! The relevant parts of Article III require that nurses must comply with the practice laws in each state where they practice. Here are answers to some of the most frequently asked questions. Now consider what laws, regulations, and political bodies influence those things. The Nurse Licensure Compact: A Historical Perspective Please try again soon. Key provisions of the enhanced NLC [PDF file]. In addition, we know that telehealth services can bridge the access gap created by health disparities, location, and other factors. To learn more APRN Compact | NCSBN. In many circles, it is difficult to discuss or even mention political issues. January 19, 2018 marked the date that multistate licensure practice via a compact would no longer be available to nurses whose states did not switch to the eNLC. Finally, one case demonstrates the impact of a BON investigation on a nurses ability to continue practice. This is exemplified in Case #1, an LVN with a license from South Carolina and a PTP in Texas. Telehealth licensing requirement and interstate compacts. (2017, March). Compact Nursing States List 2023 | Licensure Map - Nurse.org Bergman E. (2021). Under the NLC, nurses can practice in other NLC states/territories, without obtaining additional licenses. Implications of the Compact for EducatorsEducators are not exempt from licensure requirements.Educators are not exempt from licensure requirements. They were displeased that the state would not only have to pay for annual membership in the NLC but also lose the ability to collect licensing fees directly from nurses seeking to practice in their state. Nurse Licensure Compact: Your Guide to Multistate License Most states that were a . Evans S. The Nurse Licensure Compact: A historical perspective. The 2011 Uniform Licensure Requirements [PDF file]. They must: meet the requirements for licensure in the home state (state of residency) graduate from a board-approved nursing education program or an international nursing education program (approved by the authorized accrediting body in the applicable country and . Home | NURSECOMPACT 35. have a valid U.S. social security number. This short video helps explain the Nurse Licensure Compact to all nurses.  It explains what a NLC multistate license is and provides a broad overview of steps nurses need to take when permanently changing their home states. The One Primary Residence Requirementthe state in which nurses obtain a license is considered the primary residence or home state.Article III of the NLC requires that a nurse follow the rules of the compact state. Nurse Licensure Compact Short title. Impact of Automatic Reporting on Disciplinary ActionArticle VI of the eNLC requires that states share freely any information that pertains to disciplinary actions. The applicants criminal history should not contain a conviction, a plea, or an agreed disposition of a felony offense at the state or federal level, or a misdemeanor offense committed during the practice of nursing. In this modern age of technology, telehealth, and the lessons learned from the COVID-19 pandemic, interstate practice compacts are a vital piece of the healthcare continuum. Furthermore, they expressed concern about some inconsistency between some state regulations and the NLC requirements. The significance of the implementation date is that it was the date by which nurses who possessed multistate licenses were able to begin practicing in eNLC states (NCSBN, 2018a). Your email address will not be published. Employers may not require such from their employees, nor should they require that prospective employees using a PTP also apply for a license in the employers state. Under the NLC, a nurse holding a multistate license can practice telehealth in all NLC-member states without needing a separate nursing license in each state. Furthermore, a compact state may issue a single-state license to a nurse who resides in its jurisdiction but does not qualify for a multistate license, such as a nurse whose permanent address is in a foreign country (Ridenour, 2011; NLC Administrators, 2012). The eNLC became effective on July 20, 2017, when North Carolina became the 26th member (NCSBN, 2018a). The Nurse Licensure Compact: A Historical Perspective At that time, her home state of Illinois was working toward becoming the 25th state to join the NLC. Key provisions of this compact are reviewed with examples of how it has impacted individual nurses. At the time of this writing, thirty-one states have joined the eNLC. Frequently asked questions - licensure. Key Disciplinary ProvisionsIn addition to the eligibility requirements, the eNLC contains key provisions that are explained in eleven articles. Click a state to access each board's contact information. All rights reserved. As of this writing, the deadline has been changed from 30 days to 90 days in Texas and in most compact states. All applicants must also have passed the applicable licensing examination and be eligible to hold an unencumbered license (NCSBN, n.d.j). Since my move to Virginia was permanent, and both Texas and Virginia were compact states, I could only hold a license in my state of residence. It is noteworthy, however, to understand that a nurse with a felony plea or conviction may still obtain a single state nursing license. Amidst concerns that the NLC did not successfully guarantee the competence of nurses who practiced across state lines, membership in the compact stalled after the twenty-fifth state joined. For example, the NLC did not require applicants to undergo state and federal fingerprint-based criminal background checks, whereas the new eNLC does. (NCSBN, 2017). The health and safety of the public are affected by the degree of compliance with and the effectiveness of enforcement activities related to state nurse licensure laws. To help streamline the process for nurses, the Enhanced Nursing Licensure Compact (eNLC) was implemented in 2018 and included standards for licensure which the original compact license was lacking. Abstract This article examines the provisions of the Nursing Licensure Compact (NLC). Learn more about how the compact affects you and your practice. (2015b). Disciplinary Impact of a Criminal ConvictionAs stated in the eNLC uniform license requirements, a state or federal felony conviction or plea precludes an applicant from obtaining a multistate license. In other words, the PTP is only used in a state other than the primary residence. Article III also grants compact states the authority to take disciplinary action against a nurses privilege to practice (PTP) status when the nurse violates the state laws and the state nurse practice act. NURSE LICENSURE COMPACT ACT - ENACTMENT. They also believed that there was a lack of clarity regarding how to check on nurses disciplinary infractions in remote states. She was sanctioned by the BON (Texas BNE, n.d.). Nurse Licensure Compact. Each member state may issue a single state license to such an applicant, upon consideration of each individual case. Enhanced Nurse Licensure Compact (eNLC) implemented Jan. 19, 2018 [News release]. The decision to grant such a license is at the discretion of each state (Texas BON, 2017). About | NURSECOMPACT The NLC is an initiative aimed at increasing access to patient care across state lines by streamlining multistate licensure requirements. Another scenario concerns the impact of the automatic reporting of disciplinary actions on an individual nurses license. This prompted the National Council of State Boards of Nursing (NCSBN) to take some corrective action. I moved to FL two year ago, and applied for a APRN license in FL. Nurse Licensure Compact and Mobility | SpringerLink State-level bills include Colorado (House Bill 21-1187: Long Term Services and Support Case Management Redesign) and New York Assembly Bill A114 (amends the social service law to include accountable care organizations/managed care providers) as just a few examples. Legal memorandum to employers [PDF file]. How to Apply Participating Jurisdictions 41 jurisdictions are currently part of the NLC. All rights reserved. Some states may still be in the process of changing, so each nurse must do due diligence to confirm a specific state's regulations (NCSBN, n.d.a). The provisions of the eNLC highly reduce the likelihood that public safety will be compromised. The sections below will briefly describe the uniform license requirements and the background checks, key disciplinary provisions, and the process for reporting disciplinary actions against the licenses and privileges of nurses with multistate licenses. Wolters Kluwer Health This study was a cross-sectional analysis of secondary data from multiple sources. For example, the length of time for which she was barred from practice was different from state to state respectively. Finally, the ONA opposed the NLC because of the belief that it would shift power and influence from the nurses and the state nurses associations to the Interstate Commission of Nurse Licensure Compact Administrators. The Nurse Licensure Compact explained video transcript [PDF file]. Of those, two have enacted the legislation but are preparing for implementation. TEXAS COMPACT LICENSE 2. Uniform licensure requirements for a multistate license [PDF file]. Improving health equity through the Nurse Licensure Compact. may email you for journal alerts and information, but is committed When nurses extend practice into another compact state, they do not obtain another license, but will work under a PTP. (2011). Furthermore, because the multistate compact is a fairly new concept, nursing educators should begin to include in program courses information about multistate practice and its potential impact on licensure and practice. This will also ensure that the local Jeep dealer and bank cannot use the term case manager when providing a contact person to manage non-health care affairs. Definitions. The location of the nursing practice is defined by the physical location of the patient receiving the care of the nurse, not the state where the nurse is physically located. The licensure, certification, and regulation of healthcare professionals was to be examined, with the goal of recommending new approaches. Retrieved from https://www.ncsbn.org/Key_Provisions_of_New_APRN_Compact.pdf, National Council of State Boards of Nursing. This ensures that a license to practice has not been compromised or encumbered at a remote location. You can then practice in any of the compact states. Retrieved from https://www.ncsbn.org/NLC_What_Nurses_Need_to_Know.pdf, National Council of State Boards of Nursing. Retrieved from https://www.ncsbn.org/Leader_to_Leader_NLC_Issue2017.pdf, National Council of State Boards of Nursing. Pages - Nurse Licensure Compact - New Jersey Division of Consumer Affairs Students need to know about how they might prevent actions that could cause disciplinary sanctions. These states, in alphabetical order, are: Arizona, Arkansas, Colorado, Delaware, Florida, Georgia, Idaho, Iowa, Kansas, Kentucky, Maine, Maryland, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Mexico, North Carolina, North Dakota, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, and Wyoming (NCSBN, n.d.e). It is noteworthy that the nursing profession led the way, among the healthcare professions, in establishing and implementing an interstate practice model.Three years later, on January 1, 2000, NLC officially began when Maryland, Texas, Utah, and Wisconsin passed it into law (Texas BON, 2013b). The Enhanced NLC: Unlocking Interstate Nursing Practice in the 21st Century. The state must also have the capacity to conduct a federal criminal background check (NCSBN, 2016). the 50 states entry-to-practice requirements were not standardized, thereby creating unreasonable barriers to interstate mobility for many professionals.In this report, the Pew Commission noted that the 50 states entry-to-practice requirements were not standardized, thereby creating unreasonable barriers to interstate mobility for many professionals. Telehealth.HHS.gov. The only non-participants were Alabama and Michigan. These requirements are as follows: applicants must have graduated from a program approved by a board of nursing, and must qualify for licensure in their home state (NCSBN, n.d.j). After she changed her primary residence to Texas, she continued to practice under a PTP for 3 years. Upon moving to the Commonwealth of Virginia, and not being aware of the nursing compact rules, I tried to renew the Texas license. The nurse licensure compact is adopted and enacted into law as follows: Article I Findings and Declaration of Purpose A. J Nurs Reg. The report included 10 recommendations to promote healthcare provider mobility (Donaho, Mudge, & Price, 1997; Pew, 1995). Licensure compacts. This article underwent peer review and no bias was found. (2017). The NLC also helps facilitate telehealth, which expands access to care for patients across the country. She faced sanctions with multiple states in 2016 based on an event that happened in a telemedicine practice in West Virginia. As part of the measures to protect the public, the uniform license requirements also state that when an applicant seeks initial licensure or licensure by endorsement, the states must obtain the applicants criminal history record through fingerprints or biometric data from the Federal Bureau of Investigation (FBI), and the state (NCSBN, n.d.j). . She was given the liberty, however, to seek a single-state license from a non-compact until she had fulfilled the conditions of her disciplinary sanctions. Fast forward, 19 years and alas, Illinois is still working on joining the NLC, with hopes of becoming the 39th state to join. The following year, the National Council of State Boards of Nursing (NCSBN) Delegate Assembly made a move toward licensure uniformity by unanimously endorsing a mutual recognition model of nursing regulation (NCSBN, n.d.b). (2021). First, check the map on nursecompact.com; your state already may be a member. Currently, the law states that a nurse must be licensed in any state where the nurse practices. Unlocking access to nursing care across the nation [Brochure]. Under the nurse licensure compact (NLC), state boards of nursing may issue registered nurses (RNs) and licensed practical nurses (LPNs) with a multistate license, which allows them to practice both in the state where they legally reside and in all other compact states. However, if the faculty is in a compact state, and the student is in a remote compact state, the multistate license will suffice. Therefore, there is no reason for such a nurse to be concerned about disciplinary provisions of the multistate compact. Youll still need to apply for a license in your home state, but if you want to obtain a multistate license, youll need to meet the ULRs outlined in the NLC, most of which are probably already required under your existing state law. 1https://www.themorgan.org/exhibitions/the-great-experiment. States have complete autonomy when it comes to their state licensure; the NLC applies only when determining whether an applicant is able to receive a multistate license. Since then, many other professionsincluding physicians, physical therapists, psychologists, and emergency medical technicianshave recognized the need for licensure compacts to facilitate borderless practice. Retrieved from https://www.ncsbn.org/transcript_NurseLicensureCompact.pdf, National Council of State Boards of Nursing. It provides clear examples and definitions of the work done by case managers to help codify our work and protect us in the same way the other legislation protects the practice of nursing, social work, and medicine by RNs (registered nurses), LSWs (licensed social workers), and MDs. Some error has occurred while processing your request. (n.d.) Discipline & complaints Nurse Licensure Compact disciplinary action. The Nurse Licensure Compact requires that all applicants for a multistate license must meet 11 uniform licensure requirements. Please try after some time. You can find the model NLC language as well as other resources at nursecompact.com, or contact your state board of nursing for further information. A-1. Where prelicensure nursing programs offer courses to students outside of their jurisdiction, nursing faculty may need to obtain a license in every state in which the students are enrolled for didactic or clinical courses. Just like you can drive anywhere in the country under your state-issued drivers license, the NLC allows you to practice nursing in any NLC state under one state-issued multistate nursing license. Retrieved from http://www.ohnurses.org/wp-content/uploads/2017/02/Multi-State-Compact-Licensure-Compact-Statement.pdf, Pew Health Professions Commission, Taskforce on Health Care Workforce Regulation. Disclosure: The NCSBN drafted the NLC guidelines. This means that an event in another state could have an impact on the practice and availability of their nursing employees (NCSBN, n.d.d). The compact allows registered . (2020, June 10). South Dakota joined the NCL in 2001 and the Enhanced Nurse Licensure Compact in 2018. BILL NUMBER: S7579 SPONSOR: HANNON TITLE OF BILL: An act to amend the education law, in relation to enacting the interstate medical licensure compact (Part A); and to amend the education law, in relation to enacting the nurse licensure compact (Part B) PURPOSE: This bill adopts model language enabling New York to . In addition to helping nurses working near state borders to practice seamlessly in both NLC states, the NLC also helps nurses practicing telephonically and electronically. For example, Case #4 was a registered nurse with a license from Kentucky and a PTP in Texas, who was convicted of DUI and possession of marijuana, both of which were misdemeanor offenses. It can be argued that the unions are wrong for many reasons, but from the perspective of case managers, many of us are suffering significant injury by not getting all states into the compact, but much of our work, and some of the highest paid most desirable case management work, involves telemedicine that crosses state lines. If we are going to continue the great American experiment in democratic self-governance, we will have to continue our growth toward speaking about politics in civilized and productive ways. The main accomplishment of the NLC was that there would be one license by which a nurse may practice in multiple states, physically and by distance, without any additional application requirements or fees. Key provisions of this compact are reviewed with examples of how it has impacted individual nurses. (n.d.f). Rebecca Fotsch is the director of state advocacy and legislative affairs at the NCSBN in Chicago. However, by 2015, the trend had stopped. (2013a). Applicants for the eNLC license must not have pled guilty to or have been convicted of a felony.Not only will a felony conviction prevent an applicant from obtaining an initial multistate nursing license, it will most certainly lead to disciplinary sanctions for a nurse who is already licensed (NCSBN, n.d.d). Although quite similar to the original NLC, the eNLC was designed to repeal and replace the existing NLC and implement requirements that would improve confidence and address the issues raised by reluctant stakeholders (Evans, 2015). At the time of this writing, fifty-five jurisdictions, comprising states and territories, were participating in eNotify. In 2021 alone, Ohio, Pennsylvania, and Vermont each passed the NLC in states that historically did not garner much support for it. Implications for NursesThis section includes some important reminders for nurses regarding license compacts. For example, the case relating to the 'one primary residence' rule highlights the extended reach of the nursing licensure compact. Licensure is the process by which boards of nursing grant permission to an individual to engage in nursing practice after determining that the applicant has attained the competency necessary to perform a unique scope of practice. An Act . Luxury Homes for Sale in Strasbourg, Grand Est, France However, even when nurses practice in a remote location from the patient, they are subject to disciplinary measures both by the state where the patient is located, and by their home state (NCSBN, 2017). Additionally, North Dakota, Vermont, Oregon, and Washington, also took disciplinary action against her license; and she also voluntarily surrendered her license in those states (NCSBN, n.d.h; Texas BNE, 2016). (2013b). Managed care case managers have been doing exactly this for years, effectively and efficiently. Is nursing the only profession with a licensing compact? ULRs protect the public by setting consistent standards and promoting a health care system that is fluid and accessible . Licensure | NCSBN - National Council of State Boards of Nursing (n.d.j). Identification of the nurses involved have been replaced by assigned numbers (e.g. The author concludes that most nurses provide competent care, and that outside of this compact, the few who violate laws and regulations are usually disciplined by their individual state board of nursing. Retrieved from https://www.bon.texas.gov/discipline_and_complaints_policies_and_guidelines.asp, Texas Board of Nursing.
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