Executive Summary
Since 2000, when the original Nurse Licensure Compact (NLC) was created, 25 states adopted the compact, which allows nurses to possess a multistate license for practice in NLC states. Now the compact has been updated, and only a handful of states have pending bills to approve the compact.
- The compact applies to registered nurses or licensed practical/vocational nurses.
- The NLC simplifies practice across state lines for case managers with nursing degrees.
- Without the NLC, CMs and nurses would need a license for every state in which they practice.
A new Nurse Licensure Compact (NLC) would allow registered nurses or licensed practical/vocational nurses to possess a multistate license that permits them to practice in their home states and other NLC states.
Case managers who have nursing licenses could be affected by the compact because their jobs sometimes can include working with patients across state borders — whether through telemedicine, workers’ comp, or in multistate health organizations, says Connie Sunderhaus, RN-BC, CCM, vice president of CXJ Corporation in Glen Ellyn, IL.
The NLC originally was created in 2000 by the National Council of State Boards of Nursing (NCSBN) and in 2015, it included 24 states with an additional state — Montana — added this year. The NCSBN’s goal was to base a mutual-recognition model on state driver’s licenses so nurses could practice in states other than the state where their license was issued, according to NCSBN’s Nurse Licensure Compact article, which can be found at http://bit.ly/1XpOonK.
But the new version, adopted May 4, 2015, also has to be approved through legislation in each state that previously approved the compact. So far there are bills pending in Illinois, Massachusetts, Minnesota, New Jersey, New York, and Oklahoma. Montana has passed a bill approving the new NLC, and it will be implemented Oct. 1, 2015.
There are 24 states that previously supported the NLC, but have not acted on the new compact, and those states are where case managers could have a big effect in public policy, Sunderhaus says.
“That’s an issue that’s very close to case managers because they’re very often the ones that have to deal with patients in other states,” Sunderhaus says. “They’re following patients to an appointment or with telephonic support.”
For instance, CMs who work on workers’ comp cases might not even realize that if they have a patient who lives in a neighboring state, they personally would need licensure from the patient’s home state to be able to work with that patient, she says.
“I’ve heard of nurses getting up to 20 licenses in different states,” Sunderhaus says.
This is very complicated because each state has different rules regarding continuing education units and other criteria, she says.
In other cases, nurses might practice in other states without realizing that they needed a license in each state of practice unless the states were all part of the NLC, she adds.
“As recently as five or six years ago, some employers would tell nurses [who practice in multiple states with no NLC], ‘Don’t worry about it,’” Sunderhaus says. “But the nurse is the one at risk.”
The NLC simplifies things for all nurses, including CMs with nursing licenses. This is why case managers need to advocate for their states to pass the new NLC, Sunderhaus adds.
“Case managers’ voice is important,” she says. “They can call their state legislators, write letters, send emails, and stop by and visit each one.”
The NCSBN website provides information about the NLC and talking points to use when speaking with state legislators about why it should be adopted.
For example, the NLC “clarifies the authority of nurses currently practicing telenursing or interstate practices,” the policymaker sheet says.
Another benefit to point out to legislators is that the compact improves “state and facility access to licensed nurses during a disaster or other times of great need for qualified nursing services,” it says.
More than two dozen professional organizations support the NLC, including the Case Management Society of America and the Case Management Leadership Coalition.
The states that implemented the previous NLC, but still need to act on the new one, include: Arizona, Arkansas, Colorado, Delaware, Idaho, Iowa, Kentucky, Maine, Maryland, Mississippi, Missouri, Nebraska, New Hampshire, New Mexico, North Carolina, North Dakota, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, and Wisconsin.
A new Nurse Licensure Compact would allow registered nurses or licensed practical/vocational nurses to possess a multistate license that permits them to practice in their home states and other NLC states.
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