Guide to Nurse Licensure Compact Updates - 2023
For those who don't know, the enhanced nurse licensure compact (eNLC) was implemented in 2018 as an agreement between participating states for their licensed nurses to practice in other member states. A compact license is also referred to as a multistate license. In this article, we'll give a quick summary of how the eNLC works, which states are currently part of the nurse licensure compact in Q4 of 2022, which states plan to join the eNLC in 2023, the most recent states to join the agreement, and a look at the reasons the remaining states are reluctant to join the compact.
How Does a Compact Nursing License Work?
Nurses holding a compact license can practice nursing within other close member states. The agreement allows a smoother transition for nurses who wish to travel to other states to practice without applying for another nursing license (which will cost you time and money). The key here is that the compact support and its benefits only use in and among close member states.
States Currently Part of the Nursing Compact - 2022
As of 2022, there are 39 member states of the eNLC:
- Alabama
- Arizona
- Arkansas
- Colorado
- Delaware
- Florida
- Georgia
- Idaho
- Indiana
- Iowa
- Kansas
- Kentucky
- Louisiana
- Maine
- Maryland
- Mississippi
- Missouri
- Montana
- Nebraska
- New Hampshire
- New Jersey
- New Mexico
- North Carolina
- North Dakota
- Oklahoma
- South Carolina
- South Dakota
- Tennessee
- Texas
- Utah
- Vermont
- Virginia
- West Virginia
- Wisconsin
- Wyoming
Which States Have Pending Legislation or Implementation for Nursing Compact in 2023
- Alaska - In February of 2021, Alaska introduced legislation for the state to join the NLC as bills S.B. 67 and H.B. 83, but no action was taken. Interestingly, this isn't the first time legislation has been introduced for Alaska lawmakers to review. In February 2020, the same topic was introduced as bill SB 179, again with no action. According to survey results, Alaska nurses overwhelmingly support legislation (92%). We will have to see what happens in the upcoming year's legislative session.
- Guam - In March of 2021, Guam became the first U.S. territory to join the eNLC. It is in a status of "partial implementation," meaning that nurses with a compact license are currently allowed to practice via telehealth or in person in Guam. Nurses who are residents of Guam can obtain the compact license once full implementation is in place. This was expected to occur this year, but information has yet to be released regarding the subject.
- Illinois - In February of 2022, HB 4269 was introduced to the Illinois legislature. As in the case of Alaska, so too, have Illinois lawmakers seen prior attempts at compact legislation.
- Massachusetts - S. 163 traces back to 2021 and August of 2022 when Massachusetts was placed in "Orders of the Day for the next session."
- Michigan - HB 4046 was introduced for the 2021-2022 session for Michigan lawmakers. The year prior, HB 4042 was introduced and passed through the legislature but was ultimately vetoed by the Michigan governor. No new action to report on the bill.
- Minnesota - Introduced in March of 2021, SF 2302 received senate approval in March 2022 and was referred to the Health Finance and Policy Committee in Minnesota.
- New York - Introduced in July 2022, bill AB 10615 was referred to the Higher Education Committee in the State of New York.
- Ohio - In July 2021, the Ohio governor signed S.B. 3 into law bringing Ohio to the list of eNLC states. According to the Ohio State Board of Nursing, "Effective January 1, 2023, the Compact allows R.N.s and LPNs to practice in other Compact states if they are issued a multistate license by the nurse's home state. Please note that the law establishes January 1, 2023, as the implementation date of the Compact in Ohio. We will not be able to answer questions until closer to the implementation date. The Board will be working on NLC implementation which is dependent on integration and upgrades in the State of Ohio eLicense system. Our expectation is that the Board will begin issuing multistate licenses beginning on January 3, 2023."
- Pennsylvania - In July of 2021, the Pennsylvania governor signed Act 68 into law for the state to join the eNLC. The state remains in a status of "awaiting implementation." According to the Pennsylvania State Board of Nursing, implementation is waiting on "FBI approval of the NLC language so that it can provide the criminal background check; regulations implementing the NLC, including promulgation of fees for the licenses; and technological changes to the licensure system so that Board information can be transmitted to the Interstate Commission of Nurse Licensure Compact Administrators." As it stands, Pennsylvania nurses do not hold a compact license, and compact nurses from other states cannot practice in Pennsylvania under the multistate license.
- Rhode Island - In February 2022, bill H 7268 was introduced to the Rhode Island House legislature and passed Sub A in June 2022. In April 2022, a senate committee recommended SB 2472 be tabled "for further study."
- Virgin Islands - In December 2021, the Virgin Islands passed legislation into law for the territory to join the Nursing Licensure Compact. The territory is currently awaiting implementation, which means "an implementation process must be completed before its residents will be able to apply for a multistate license and before nurses in other NLC states who hold a multistate license will be able to practice there. The implementation date has not been set."
- Washington - SB 5247 was initially introduced in 2021 and reintroduced in January 2022. No further action has been documented for now in the State of Washington.
More on the eNLC is Coming Soon
Stay tuned for our follow-up article, where we'll dive into the benefits member states and nurses gain from the Nurse Licensure Compact and the review arguments the hold-out states have presented for not joining. It's a complex topic, and each state that isn't a member of the eNLC has its reasons which we should work to understand.