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Career Sphere

The enhanced By James Puente, MS, MJ, CAE

member states by 2010. From 2010 to 2015, only one more state joined. A primary reason for the slowed • adoption was the lack of uniform criminal background These changes may affect your practice. check (CBC) requirements. As a result, the eNLC re - quires that all member states implement CBCs for all ap - , licensed practical nurses (LPNs) and reg - plicants upon initial licensure or licensure by endorse - SINCE 2000 istered nurses (RNs) in the Nurse Licensure Compact ment. This revision, along with other uniform licensure (NLC) states have enjoyed the advantage of a multi - requirements, will remove barriers to joining. (See Stay state license. Under the NLC, an eligible nurse with informed .) The goal is to get all states to join the eNLC. primary residence in a compact state can hold one multistate license issued by the home state granting Q What’s the difference between the effective date the nurse the authority to practice in any of the 25 and the implementation date? NLC states in person or via telehealth. The compact A Based on the legislation, the effective date of the improves nurses’ mobility by making it easier for them eNLC is “the earlier of the date of legislative enactment to practice in different states and eliminates the need of this Compact into law by no less than twenty-six (26) to obtain multiple licenses. (See Who bene - states or December 31, 2018.” The eNLC was fits from multistate licenses? ) enacted in the 26th state on July 20, In 2015, the NLC underwent a 2017, making it the effective date. comprehensive revision that On that date, the compact’s resulted in a new compact governing body, the Inter - known as the enhanced state Commission of Nurse NLC (eNLC); the original Licensure Compact Ad - NLC is anticipated to be ministrators (the Com - phased out in the near mission) was formed future. For a state to and began meeting and join the eNLC, it must performing the work of enact legis lation. the compact—drafting The eNLC will be rules, developing poli - implemented on Janu - cies, and setting an im - ary 19, 2018. To date, plementation date. 26 states have enacted The implementation the eNLC. Of the 25 origi - date, set by the Commis - nal NLC member states, 21 sion as January 19, 2018, is are transitioning to the eNLC when eNLC states begin receiv - and withdrawing from the origi - ing applications for multistate li - nal NLC. The four states remaining censes and when nurses holding these in the original NLC include Colorado, New licenses can start practicing in eNLC states. Mexico, Rhode Island, and Wisconsin. Q When will nurses have multistate licenses in eNLC Questions and answers states? To ensure that you’re up-to-date with the changes A Nurses in the original NLC states that joined the occurring as a result of the eNLC, you need to stay in - eNLC are grandfathered into the eNLC and can practice formed. The following Q & A will help. in those states as of January 19, 2018. Nurses in new states that joined the eNLC (Florida, Georgia, Oklaho - Q Why was the original NLC changed to the eNLC? ma, West Virginia, and Wyoming) can begin practicing A The original NLC began in 2000 and grew to 24 (continued on page 52)

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Who benefits from multistate nursing licenses? Since the original National Licensure each state where a nurse practices is • nurses engaged in remote patient Compact (NLC) was introduced in costly and time-consuming. The list of monitoring 2000, support in the nursing commu - nursing professionals who benefit • nurses living on state borders nity has been overwhelming. Accord - from multistate licenses is long; here ing to 2014 National Council of State are a few: • nurses who are military spouses Boards of Nursing surveys, 80% to 90% • call-center nurses • online nursing faculty of nurses and more than 90% of em - • case managers • school nurses ployers want their state to join the compact. • home health nurses • telehealth nurses Obtaining individual licenses in • nurse executives • travel nurses.

in eNLC states when they receive nal NLC that haven’t yet joined the their multistate license. Each eNLC he eNLC will be eNLC. These states plan to intro - state will notify its licensees by T duce legislation in 2018 or sooner. mail of the implementation date implemented on January and the process for obtaining a Q What happens to the original multistate license. 19, 2018. To date, 26 NLC after the eNLC starts? states have enacted the A When the eNLC is implemented, Q Which nurses are grandfathered the original NLC will continue to op - into the eNLC and what does that eNLC. Of the 25 original erate until there are fewer than two mean? state members, at which time it will A Nurses in eNLC states who NLC member states, 21 end. As of January 19, 2018, the 21 were members of the original NLC states in the original NLC that enact - before the July 20, 2017, effective are transitioning to the ed the eNLC will cease to be mem - date will be grandfathered into the bers of the original NLC. This means eNLC. They won’t have to meet eNLC and withdrawing that a nurse in Colorado, New Mex - the requirements for an eNLC mul - from the original NLC. ico, Rhode Island, or Wisconsin tistate license. Nurses issued a mul - (original NLC states that have not yet tistate license after July 20, 2017, will be required to passed eNLC legislation) will then hold a multistate li - meet the eNLC multistate license requirements. cense valid in only those four states; they’ll need to ob - tain additional licensure to practice in any of the eNLC Q What happens to nurses in the original compact if states. Conversely, nurses in the eNLC will need to obtain their state doesn’t pass eNLC legislation? additional licensure to practice in the four NLC states. A NLC states that don’t pass the eNLC will remain in the original NLC until the state enacts the eNLC, with - Q Who are the primary proponents of a state to join draws from the original NLC, or the original NLC ends the compact? due to having fewer than two state members. At the A Most states have joined the compact through the time of this writing, Colorado, New Mexico, Rhode Is - supportive efforts of the state nurses association, the land, and Wisconsin are the only members of the origi - state hospital association, or the state board of nurs - ing. A number of other stakeholder organizations (such as the American Association of Retired Persons, American Organization of Nurse Executives, and Na - NLC changes tional Military Family Association) have played signifi - On January 19, 2018, the number of states covered under the cant roles in advancing the legislation. original Nurse Licensure Compact (NLC) will shrink from 25 to 4. Q How will the NLC-to-eNLC transition affect employ - ers of nurses? A The transition may affect employers in eNLC states RI who have nurses practicing in the four states that re - main in the original NLC. As of the implementation date, those nurses with an eNLC multistate license won’t have the authority to practice in those four states without applying for a single state license.

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Stay informed that joined the eNLC. As of January 19, 2018, those Take these actions to stay up-to-date with the latest informa - nurses with an original NLC multistate license won’t tion about the enhanced Nurse Licensure Compact (eNLC): have the authority to practice in eNLC states without applying for a single state license in those states. • Subscribe at nursecompact.com to receive email up - dates. Nurses residing in eNLC states who aren’t eligible to be grandfathered in may not have a multistate license • Review state boards of nursing websites and newsletters. on the January 19, 2018, implementation date until • Regularly visit implementation pages on the National they’ve completed the eligibility process. This process Council of State Boards of Nursing site at ncsbn.org/ de termines if the licensee meets the requirements for a enhanced-nlc-implementation.htm . multistate license. In some eNLC states, the nurse may Uniform licensure requirements need to proactively engage in this eligibility process. By The uniform licensure requirements (ULRs) were enacted October 2018, nurses in all eNLC states should receive a as part of the eNLC to eliminate barriers to joining. You can letter from their with more information. find a full list of ULRs at ncsbn.org/107 .htm. For a fact sheet that identifies the key provisions of the Expanding nurse mobility eNLC legislation and highlights the differences between The eNLC will affect nurses currently practicing in the the two compacts, visit nursecompact.com/about.htm . original NLC states as well as some nurses who have Effective date vs. implementation date never been in a state that was part of the compact. To understand the difference between the eNLC effective And if the changes made to the eNLC encourage addi - date and implementation date, visit ncsbn.org/Differ - tional states to join, many more nurses will have an ence_Between_Effective_Implementation.pdf . opportunity to participate, enhancing their mobility. All nurses need to understand the benefits of the eNLC and stay informed. The eNLC transition also may affect employers in the four states that remain in the original NLC who James Puente is the director of the Nurse Licensure Compact, National Council of have nurses practicing in the 21 original NLC states State Boards of Nursing in Chicago, Illinois.

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