The Nurse Licensure Compact – Update on IT

Kathy Quan RN BSN PHN

Kathy Quan RN BSN PHN

Update to What is the Nursing License Compact and How Does it Impact Nursing?

As 2020 approaches a close, there are 33 states participating in the Nurse Licensure Compact (eNLC). One state (New Jersey) was a member of the original NLC and allows nurses who have unencumbered eNLC licenses to continue using them as the state considers new legislation to rejoin the eNLC. There is pending legislation in Michigan, Ohio Pennsylvania, Vermont, Rhode Island, New Jersey and the territory of Guam. 

The Emergency Management Assistance Compact (EMAC) has been enacted at some point in 2020 by all 50 states and US territories, except for America Samoa. With the COVID-19 pandemic spreading in waves across the US since March 2020, governors have had to request and recruit nurses and other health care workers to help meet the demand and emergency. The governors have the power to deem out of state licenses as valid during a disaster declaration.  The EMAC is a law and can only be set aside by the governor in an executive order. 

National Emergency Declared

As the President declared a National Emergency on March 13, 2020 due to the pandemic, he enacted the EMAC and granted power to the Health and Human Services Secretary to waive certain federal licensing requirements for doctors so that they could deploy to areas most in need without licensing encumberment. Social Security and the Centers for Medicare and Medicaid (CMS) made certain waivers and lifted restrictions to meet the needs of the public despite never being a proponent of the eNLC. 

During this pandemic, many agencies have had to waive certain restrictions and embrace additional services in order to provide the best possible care to Americans. One instance of this is Medicare’s waiver allowing for NPs and PAs to order home health care for their patients. Legislation to make this change has been before Congress for several years and never seemed to get out committees. Now it has become a permanent change that will make a huge difference for patients and home health care companies. It could be possible in the near future to see the other 16 states and US territories quickly pass legislation to join the Nurse Licensure Compact after experiencing the equivalent for multiple months.

NLC doesn’t change state licensing standards

It is important to note that the NLC and enacting the EMAC did not make any changes to the state licensing rules. Those remain intact. It only makes changes to allow states to accept the licenses of nurses and other health care workers from other states without having to seek additional licenses during the state of emergency. 

The National Council of State Boards of Nursing (NCSBN) established and oversees the eNLC. Under the eNLC, nurses can now hold a license in their home state and apply for a multistate license that now allows them to practice in any of the other 33 states that belong to the eNLC. 

Prior to January 2018, the NLC was a much more complicated process and nurses could only be licensed in a limited number of NLC states at one time. The implementation of the eNLC has particularly opened up opportunities for travel nurses. With the EMAC enactment, it has made it possible for nurses to follow the waves of the COVID-19 pandemic and help to save more lives. Nurses in non-eNLC states should contact their state legislators to encourage adoption of this plan permanently. 

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