(NLC) /
Talking Points – Related Background
The state of practice rather than the state of residence holds greater logic for licensure.
The National Council of State Boards of Nursing (NCSBN) states that the state of residency was selected rather than the state of practice, given there is greater authority over a resident versus non-resident; paralleling the driver’s license compact.
ANA’s long standing position identifies the state of practice as where the nurse is located (1999) since the intent behind licensure is to grant the nurse authority to practice while protecting the health and safety of the citizens of the state in which the license is held.
There are inconsistencies between states’ licensure / re-registration requirements.
The NCSBN reports more than decade of experience without identified problems. The NLC, a mutual recognition model for licensure, accepts the variations between states, trusting the home state has performed due diligence.
Regardless, licensure standards and qualifications vary between states, including: frequency & requirements for re-licensure and re-registration; continuing education; criminal background checks (CBC)*; recognition of non-traditional education programs particularly with regard to number of clinical hour requirements for entry into practice; how nurse diversions & addictions are addressed; and what constitutes an infraction and resultant actions.
*Type and depth to which the CBC is performed varies. As of April 2013, 19 of the 24 NLC states require a CBC.
Additionally, Boards of Nursing resources differ from state to state, all of which can result in delayed processing for licensure; investigation of complaints and subsequent disciplinary actions.
Continued
Nurse Licensure Compact (NLC) ANA Talking Points Continued
Background
The NLC allows a nurse to have one license (in his / her state of residency) and to practice in other states (both physically and electronically) of which participate in the Compact. Should the state of residence change, a new license must be obtained. The universal acceptance of drivers’ licenses granting the privilege to drive in any state is a familiar example of the use of mutual recognition agreements.
Regardless of the origin of the license, nurses are held accountable to the laws, rules and regulations associated with their practice in every state in which they practice.
The NLC includes registered nurses (RNs) andlicensed practical or vocational nurses (LPN/LVNs). Advanced practice registered nurses (APRNs) arenot included in the NLC.
A separate APRN Compactoffers states the mechanism for mutually recognizingAPRN licenses and authority to practice.
The NLC has systems in place to identify nurses who are subject to discipline or monitoring agreements. Nursys® is the national nurse licensure database, which alerts other NLC states when a licensee is under investigation. Non NLC states have the ability to subscribe to Nursys® for licensure verification and disciplinary tracking as well. All but four Boards of Nursing participate (Alabama, Hawaii, Louisiana Practical Nurse Board, and Oklahoma. (NCSBN 2013) As of 2013, an expanded e-alert feature to Nursys® is available to deliver directly to interested subscribers, any real-time changes, regarding license status, renewals, expirations; as well as disciplinary action and resolve.
24 states have joined theNLC. A map of current NLC states can beviewed by visiting (NCSBN April 2013)
At least three state Attorneys General have rendered opinions that the NLC interferes with state sovereignty (Florida, Indiana, & Oklahoma).
Reviewed / Updated
ANA Board of Directors
April 2013
American Nurses Association, Department of Government Affairs
8515 Georgia Ave, Ste 400, Silver Spring, MD 20910, Phone: 301-628-5094, Fax: 301/628-5348
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