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Why Nurse Practitioners Don’t Have Multi-State Licensure Compacts… Yet

Posted on August 9, 2019   |   by   |   Advanced Practice Structure, Credentialing, Employers, Job Seekers

Multistate licenses, also known as licensure compacts, are making it easy for Registered Nurses to work across state lines without the hassle of getting a new license. That’s great, so why don’t Nurse Practitioners and other APRNs have the same advantage? We explain. 

If you’re an RN who lives in one of 34 states, you can apply for a license once and practice in all other states that have adopted the Nurse Licensure Compact (NLC). This legislation makes managing licensing requirements easier and more cost-effective for nurses their employers. Nurses can cross state borders and provide safe, quality care without unnecessary delays and restrictions. The NLC has been in effect for over 18 years, giving nurses the same flexibility in licensing that EMTs, physical therapists, and physicians also enjoy. 

The Nurse Licensure Compact (NLC) applies to RNs and LPNs only. So what about Advanced Practice Registered Nurses (APRNs)? Right now, there is no multistate license available for APRNs. Nurse Practitioners, Clinical Nurse Specialists, and Nurse Midwives must hold individual state licenses for every state in which they practice. The good news is that the National Council of State Boards of Nursing (NCSBN) is working hard to change that. 

The Debate Over APRN Compact Legislation

A license compact for APRNs was proposed in 2015 by the National Council of State Boards of Nursing (NCSBN). Under the APRN Compact, APRNs could legally provide care to patients across state lines without having to obtain additional licenses. This act would save time and regulatory processes for APRNs, employers, and state licensing boards. It also promises to benefit patients and the nation as a whole by increasing access to licensed APRNs for telehealth and disaster relief. Additionally, the APRN Compact would also open new career opportunities for APRNs to travel for work, especially those who are faculty and military spouses.

As proposed, the APRN Compact would allow APRNs with a multistate license to practice independently of a supervisory or collaborative relationship with a physician. This is a point of contention for several national and state medical associations, as it would likely supersede state laws that currently reduce or restrict APRN scope of practice. 

The American Medical Association (AMA) currently opposes the APRN Compact, citing patient care concerns. In  2017, the AMA passed a resolution calling for action to “effectively oppose the continual, nationwide efforts to grant independent practice to non-physician practitioners.” 

Proponents, including the American Association of Nurse Practitioners (AANP), argue that the APRN Compact would increase patient access to high-quality care in nearly “every community in the country and every health care setting.” The AMA position rests on studies that consistently show APRNs provide care that is safe, effective, and similar in outcome to care provided by physicians. 

The Future of the APRN Licensure Compact

The APRN Compact requires a minimum of ten states to pass the law for it to become active in those states. Currently, three states have signed APRN Compact legislation: Idaho, Wyoming, and North Dakota. These states are 3 of the 22 in the nation (plus the District of Columbia) who grant full practice authority. The APRN Compact may be difficult to achieve as long as state legislation exists that creates barriers to APRN practice. However, we remain hopeful that it represents the future for Advanced Practice, for both APRNs and PAs.

For More Information

If you’d like to stay up to date on The APRN Compact, sign up for updates at APRN Compact.com. Learn more by reading this fact sheet. You can also contact your legislators to advocate for the APRN Compact and encourage lawmakers to pass the law in your state.

If you’re not sure if your RN license is single state or multistate, use Quick Confirm at www.nursys.com at no cost. You can also learn about the process of becoming licensed in another with this fact sheet from NCSBN.

Are You Ready to Start a Job Search?

Melnic is a nationwide search firm focused on Advanced Practice placements for APRNs and PAs. To take advantage of our specialized job matching services review our current job opportunities and join the Melnic network. The best part? There is never a fee for candidates to work with us!

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