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Decompressing The Enhanced Nurse Licensure Compact Changes

The following provides an overarching summary of the changes to the Enhanced Nurse Licensure Compact (eNLC). The eNLC provides select registered nurses (RNs), licensed practical nurses (LPNs) and vocational nurses (VNs) in states that have implemented its licensure requirements with the ability to provide care to patients who are in other eNLC states without the need to take an additional licensing step. The eNLC came about as the result of a 2014 summit attended by executive officers from the Board of Nursing (BON). The purpose of the summit was to update and enhance the current NLC. These changes were approved by the BON in 2015 as a model of licensing to meet future needs. In addition to replacing the original NLC, the eNLC offers additional protections to patients. It was also designed to address issues and concerns that states expressed as reasons for their inability to join the original NLC. 

Details of the eNLC

For more than 100 years, the Nurse Licensure Compact (NLC) model has been in place to provide a framework that allows nurses to work across state lines with ease. At the cornerstone of this compact was the ability to do so using only one license from a members state without requiring a nurse to undertake the cumbersome step of having to obtain additional licensure. Not only is the NLC cost effective for nurses and the organizations that employ them, it also facilitates the use of telehealth services that bring healthcare to those populations that might not be able to easily reach medical care otherwise or that are underserved in other ways. The NLC also eases the way for nurses to move across state lines to deliver care in person and to provide nursing education to patients online. 

The eNLC Governing Body

An interstate commission that is a public agency has been established as the governing body of the eNLC. It is comparable to the Nurse Licensure Compact Administrators (NLCA) that is the governing body of the current compact. This agency is empowered to adopt rules that are legally binding for all states that are members of the compact. There are no requirements that these rules must first be ratified or adopted by individual states before they are enacted. The current interstate compacts that are already in place in all 50 states also have this same rulemaking authority.    

The procedure to adopt rules comprises certain requirements. These include notification to the public of those rules that are proposed as well as those that were adopted. In addition, there is to be an opportunity for the public to comment on these proposed rules as well as a public hearing pertaining to them. Responses to the comments received are noted and addressed by the interstate commission. Consideration and voting on the rules are also procedural requirements.

The areas of oversight, dispute resolution and enforcement will become more transparent with the eNLC for both states and the nurses involved. If the proper procedures are not followed, technical assistance that is designed to address issues with noncompliance is offered and dispute resolution processes are followed. If compliance is not achieved, termination from the compact is possible. 

Differences Between NLC and eNLC

In an effort to ensure that all states enact the NLC, the eNLC has a number of new provisions that are designed to bring additional protections to the public. Of particular note are the uniform licensing requirements that all states must agree to in order to enact the enhanced compact. Nurses must meet the following requirements in order for their application for a multistate license to be considered: 

1. Must meet the requirements of their state of residence;

2. Must have graduated from one of the following:

  • a board-approved education program or 
  • an international education program that has been approved and verified by the pertinent agencies

3. Must pass a proficiency exam in English if English is not the applicant’s first language or if the applicant’s international program was not taught in English;

4. Must pass the NCLEX-RN or the NCLEX-PN or another predecessor exam;

5. Either currently holds, or is eligible for, an active license that is unencumbered by blemishes such as active disciplinary action in any state;

6. Has submitted to both federal and state criminal background checks that are fingerprint-based; 

7. Is free of federal or state felony convictions;

8. Has no misdemeanor convictions that relate to nursing as determined on a case-by-case basis by the interstate commission;

9. Does not currently participate in an alternative program;

10. Must self-disclose current participation in an alternative program; and

11. Must have a valid United States social security number.

Grandfathered Provisions

There are also several provisions that are grandfathered in place with the eNLC. If a nurse is holding a multistate license that is issued by his or her home state, that nurse can retain that license and renew it as long as the requirements of the new state of residence are met should that location change. If an event that disqualifies the nurse from satisfying the requirements of the eNLC occurs after the compact’s effective date, that nurse becomes ineligible from renewing or retaining a multistate license. States that enact the eNLC will recognize multistate licenses obtained under the original NLC for a period of six months after the compact becomes effective. 

Other differences between the original NLC and the eNLC include the establishment of an interstate commission with rulemaking provisions by that commission. It is also designed to improve dispute resolution and termination if these actions become necessary. The eNLC also grants the governing body the authority to obtain and submit criminal background checks (CBCs). These can be quickly and promptly assessed by using the Nurses system. Nurses that are participating in alternatives to discipline programs will also have their information entered into that system. 

States and the Implementation of the eNLC

The 25 states that originally were part of the compact are transitioning to the eNLC by enacting state legislation. Other states that were not part of the original NLC are also putting legislation on the table so they can become compact members as well. As of this writing, 24 states have enacted the legislation that includes the enhanced version of the NLC. Because language contained within the eNLC indicates that it will come into effect by December 31, 2018 or when 26 states pass the appropriate legislation, it’s likely that it will become effective at some point in the fall of 2017. 

A state that wants to join the NCL must enact legislation that makes the enhanced model into law. In addition, the state must be able to conduct a federal criminal background check on each nurse that applies for an initial multistate license or who desires to be licensed by endorsement. 

  • Arizona: March 13, 2017
  • Arkansas: March 13, 2017
  • Florida: May 10, 2016
  • Georgia: May 9, 2017
  • Idaho: March 16, 2016
  • Iowa: April 21, 2017
  • Kentucky: March 22, 2017
  • Maine: June 27, 2017
  • Maryland: May 4, 2017
  • Mississippi: March 20, 2017
  • Missouri: July 5, 2016
  • Montana: X
  • Nebraska: April 25, 2017
  • New Hampshire: June 10, 2016
  • North Dakota: X
  • Oklahoma: April 26, 2017
  • South Carolina: May 11, 2017
  • South Dakota: February 26, 2017
  • Tennessee: X
  • Texas: June 9, 2017
  • Utah: March 15, 2017
  • Virginia: X
  • West Virginia: April 26, 2017
  • Wyoming: X

North Carolina, a current NLC state, has two pending bills that contain legislation pertaining to the eNLC. Massachusetts, which is not currently a NLC state, has pending legislation in the form of one bill each in its House and Senate. New Jersey is also not a current NLC state. The state’s legislators have introduced legislation for the purpose of enacting the eNLC. 

The following states are current members of the NLC but do not have legislation on its books that is geared toward the adoption of the eNLC: 

  • Colorado
  • New Mexico
  • Rhode Island
  • Wisconsin

The states that comprise the following list are not current members of the NLC nor do they have any pending eNLC legislation:

  • Alaska
  • California
  • Connecticut
  • Illinois
  • Indiana
  • Kansas
  • Michigan
  • Minnesota
  • Nevada
  • New York
  • Ohio
  • Oregon
  • Pennsylvania
  • Vermont
  • Washington

The original NLC has been successfully in place and working for more than 15 years. However, there were reasons that indicated that an enhancement of the compact was necessary to make it a strong and compelling mandate that is designed to address current nursing issues and those in the future. Previously, several states expressed reservations about joining the original NLC for a variety of reasons. Healthcare officials in Nevada, for example, was opposed to the lack of Uniform Licensure Requirements that were absent from the original NLC. The enhanced version of the NLC includes exactly this set of requirements. 

The 25 states that were already members of the compact noted the need for enhancements in order to position the NLC for long-term growth and viability in the future. An important aspect of this push is the need to facilitate interstate nursing as the practice continues to expand to offer high-quality healthcare to people in underserved areas and within underserved populations. With almost exclusive emphasis given to pending changes in the Affordable Care Act, most institutions and caregivers have yet to prepare or create a strategy for the implications on their contingent labor markets.

Nurse Licensure Compact Changes FAQs

How Can A Nurse in A No-Compact State Access A Multi-State License?

Only the nurses that declare LPN compact states will be able to use the license. However, those that are not part of the nursing compact states 2019 list can still apply for a license by endorsement in the compact states. The license will only work in the state. For you to be eligible, you will need to apply in each of the nursing compact states 2019 individually.

Where Is The Application Located And What Is The Application Fee?​

Use the nursing compact states list 2019 state board for the nursing application via exam or endorsement.The fees vary from state to state. If you are a resident of a given state that joined after January 19, 2018, and you have a single state license, then you can complete your application for the multistate license on the BON site. The states that joined after January 19, 2018, are GA, FL, WY, and WV.

How does the eNLC pertain To the APRNs?

The eNLC pertains to PLN and RN licenses only. All APRNs need to have a state license in the state of their APRN practice.

What Are the Nurses Grandfathered In The eNLC and what is the Implication?

Nurses in the nursing compact states 2019 list, who were part of the original NLC might be grandfathered into the eNLC. The nurses who had multi-state licenses on the eNLC starting on July 20, 2017, in the previous NLC state can also be grandfathered.

To check where you are allowed to practice in multiplied states, you can follow these steps:

1. Visit nursys.com and go to Nursys QuickConfirm

2. Search for your license number, name, or the NCSBN ID

3. Press “View Report.”

4. On the new page, press, “Where can the nurse practice as an RN and/or PN?”

If you do not own the multi-state license and you wish to change your license to a multistate license, get in touch with the BON. They might need proof of residence such as the driver’s license before they issue you with the new license.

What Are The Requirements Before Moving To Another State?

For non-compact nurses, they have to apply for endorsement in the compact state. For those moving from a compact to a non-compact state, it is their duty to apply for endorsement in their new state.

The former NLC license now becomes just a single-state license. It is their job to notify the BON of the former state about their new residence. When shifting to a new eNLC state, they have to apply for licensing by endorsement. This can be done after they move and there should not be any delays. They can continue to use the license of their former state.

How Will Compact Work For Those With A Military Spouse Or The Military Members?

A nurse who works in a remote nursing compact states list 2019 and are in the military may practice using their single state license issued by that state. He or she does not have to get a multistate license from their home eNLC state. A nurse that works for the military and holds a multistate license form their state of residence may not hold a single state license in the remote NLC state.

The multistate license allows the nurse to practice in any of the nursing compact states. For those whose spouses and nurses, they may change or maintain their primary state of residence at will. If they decided to maintain legal residence in other NLC states and have a multistate license and a military spouse in the other NLC state, they may practice under the home state license from other compact states without needing to get extra licensure on other states.

What Is The Meaning Of The Primary State Of Residence?

For the purposes of the eNLC, the primary state of residence is not in any way related to ownership of property. It has to do with the status of your legal residency. Each one has legal documents like the voter’s card, driver’s licenses, federal income tax return, or W2 form from the primary state of residence.

If a nurse has a compact state as their primary state of residence, they are eligible for the multistate license. If a nurse does not have a compact state as the primary state of residence, they cannot get the eNLC license. They may, however, apply for a single state license.

What’s he Difference between a Multistate License and Compact License?

There is no real difference between these two terms. These terms are used to reference interchangeably in reference to the eNLC license. They are used to allow a nurse to use just one license to practice in all LPN compact states that are part of the eNLC agreement.

How Can Those Living In An eNLC Get Access a Multistate License?

When you applied for your single state license and you declared the state as the primary state of residence and met all requirements for licensing, that license is already an eNLC license.

However, it will only work if you are already in good standing. If you wish to check whether you have a single state or multistate license, you can easily confirm that at nursys.com free.

What Happens When You Shift To Another eNLC State?

When you relocate to nursing compact states 2019, you may apply for licensing by endorsement and complete the Declaration of Primary State of Residence form inside the application. The application is located in the BON site.

You can begin the process before or after you move. It should not be delayed once you move. However, there is no grace period. If you are from a non-compact state, you need to apply in advance of your move. You will receive a single state license or the application will be held until you offer proof that you have moved into the new state legally. Then, you will get the multistate license.

The above facts should help you understand the enhanced eNLC agreement for 2019. However, you can also seek clarification if there is anything that is not clear to you in any way. This way, you do not end up paying unnecessary fees or having the application delayed because of one or two clumsy mistakes that you might have made in the process.

If you wish to gain more insight into the eNLC or any other changes that might affect those that are in the healthcare sectors and the facilities, call us at (877) 667-7726 or email us at information@pulseca.com

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