- Nurses will be able to apply for a license to practice telehealth in multiple states in five months.
The National Council of State Boards of Nursing (NCSBN) has set Jan. 19, 2018 as the go-live date for the Enhanced Nurse Licensure Compact (eNLC). At that time, registered nurses (RNs) and licensed practical/vocational nurses (LPN/VNs) can apply for a license to practice in the 26 states that have ratified the compact.
Those states are Arizona, Arkansas, Delaware, Florida, Georgia, Idaho, Iowa, Kentucky, Maine, Maryland, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia and Wyoming.
According to NCBSN officials, eNLC states have aligned their licensing standards so that applicants for a multistate license need only meet one set of standards, which include federal and state fingerprint-based criminal background checks.
Four other states – Colorado, New Mexico, Rhode Island and Wisconsin – have approved the original NLC but not the eNLC. According to NCBSN officials, nurses in those states won’t be able to practice in eNLC member states, nor will nurses in the eNLC member states be able to practice in those four states without applying for a license in each of those states.
The eNLC became a reality last month, when North Carolina became the 26th state to ratify the compact, passing the threshold set by the NCBSN in 2015 when it launched the new compact.
The original NLC was designed to make it easier for nurses to work across state lines; the eNLC specifically targets “the growing need for nurse mobility and clarification of the authority to practice for many nurses currently engaged in telenursing or interstate practice.”
“We have made great strides in unlocking access to nursing care across the nation and are thrilled to begin this process,” NCSBN President Katherine Thomas, MN, RN, FAAN, executive director of the Texas Board of Nursing, said in July following North Carolina Gov. Roy Cooper’s signing of legislation approving the state’s entry into the compact. “Even as we work on implementing this first phase our efforts continue to aid other states in passing eNLC legislation so our ultimate goal of having all 50 states in the compact is realized.”
“Boards of nursing were the first healthcare profession regulatory bodies to develop a model for interstate licensure, and we are looking forward to the implementation of this new phase of nursing regulation,” added NCSBN CEO David Benton, RGN, PhD, FFNF, FRCN, FAAN. “Patient safety was of paramount importance in the development of eNLC leading to the addition of new features found in the provisions of the model legislation.”
Not everyone feels a licensing compact is a good thing. In an August 2016 article in DailyNurse, Chris Hinz highlighted the differing arguments raised in Minnesota, which hasn’t joined the compact.
Hinz quoted Sharon Prinson MSN, RN, NEA-BC, a clinic nurse administrator for the Mayo Clinic, which supports Minnesota joining the enhanced compact:: “How we’ve cared for patients in the past isn’t the way we’ll do it in the future so we need to prepare for new models. The compact breaks down state barriers that are no longer relevant for providing safe, quality care.”
On the other side of the coin was Laura Sayles, a government affairs specialist for the St. Paul-based Minnesota Nurses Association, which has opposed both the NLC and the eNLC. ‘The big umbrella issue for us is patient safety,” she told Hinz. “We believe that having a license in the state where you’re actually working so that you understand the scope of practice is very important for protecting patients and working to the best of your ability.”
The eNLC is the third such licensing compact to be ratified this year.
The Interstate Medical Licensure Compact for physicians, overseen by the Federation of State Medical Boards, went live on April 6, though it has been plagued by a dispute with the FBI over access to criminal records for background checks. To date, some 25 states have signed onto that compact, but only a few are processing license applications.
On April 25, Washington became the 10th state to sign onto the Physical Therapy Licensure Compact, overseen by the Federation of State Boards for Physical Therapy (FSBPT), enabling that compact to go live. In all, 13 states have now joined that compact.
Other groups of healthcare providers, most notably those in the mental health field, have also discussed or are seeking licensing compacts to facilitate multi-state and telehealth services.