A plea for the Nurse Licensure Compact

A nurse dons protective gloves in a unit dealing with coronavirus cases. (Photo: David Herraez Calzada)

COVID-19 has been a life changing event for all – and it’s not nearly over.

We have all witnessed the chaos which has enveloped healthcare facilities as they try to respond to such an unprecedented calamity. State governments have been critically challenged with developing measures to ensure public health and safety.

Nurses who reside in NLC states and meet the uniform licensure requirements may obtain a multistate license which is valid for practice in all 34 NLC states.

A vital tool to help California respond to healthcare needs is the enactment of the Nurse Licensure Compact (NLC) legislation, SB 1053 by Senator John Moorlach.

What is the NLC?
The Nurse Licensure Compact, which began in 2000, is a public protection model of licensure for RNs and LVN/PNs which allows a nurse to have one license, in the state the nurse lives, and use that one license to practice in any of the Compact states.

Currently, 34 states are members of the NLC.  Nurses who reside in NLC states and meet the uniform licensure requirements may obtain a multistate license which is valid for practice in all 34 NLC states.  Such cross-border practice may be in-person or via telehealth.  The goal of the NLC is a 50-state compact nation.

If this becomes a reality, states and territories in need of nurses during a disaster will have immediate access to the millions of nurses in the country who hold an active multistate license.

Protecting the public
The NLC model legislation includes certain requirements of all NLC states:

–Each state must be a full participant in Nursys, the national database for nurse licensure and disciplinary data. The public portal of this database enables the public to have one place to look-up information on all licenses that a nurse may hold or has held.

–Each state is required to conduct state and federal fingerprint-based criminal background checks upon initial license and license by endorsement.

–Each state is authorized to take action against a nurse’s ability to practice in that NLC state. So, if a nurse from another NLC state commits a violation while practicing in your state, your state is able to protect the public by taking action on the nurse’s ability to practice in your state.

–Each state is required to share licensee investigation and disciplinary information with other member states. This information sharing is vital in keeping the public safe.

–A nurse who is under discipline (for example, probation, suspension or revocation) is ineligible for a multistate license.

–A nurse who is a participant in an alternative to discipline program (e.g., for substance use disorder) is not eligible for a multistate license until they have successfully completed the program.

–Applicants who do not meet the uniform licensure requirements cannot receive a multistate license but may still be eligible for a single state license in the state the nurse is applying to.

Several Facts About the NLC
–NLC states continue to issue licenses and have the authority to protect the public by disciplining unsafe in-state and out-of-state licensees, according to state laws.

–The NLC is governed by a Commission which is a joint public agency made up of the member states. Each member state has a voice and a vote on policies, rules and bylaws.  Meetings are open to the public.

–NLC states pay an annual $6,000 fee to the Commission but generate and retain additional revenue from application fees for multi-state licenses.

Moving Forward
SB 1053 (which would enact the NLC in California) will be considered by the California Senate shortly.  Disaster preparedness is a nonpartisan issue.  It’s imperative that appropriate measures are put in place to mitigate any ongoing or future public health crisis. NLC is a solution to modernizing licensure and responding to disaster.

I encourage you to read about the NLC at https://www.ncsbn.org/nlc-toolkit.htm.  The NLC has a 20-year history of success.  Take a moment to read some of the NLC success stories at  https://www.ncsbn.org/nlc-stories.htm.

Editor’s Note: Jim Puente,  MS, MJ, CAE, is director of the Nurse Licensure Compact. He can be reached at nursecompact@ncsbn.org.


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