New Report Weighs Costs, Benefits Of Vermont Joining Nursing Compact
Vermont’s Office of Professional Regulation released a new report that found the state could see many benefits from joining the Nursing Licensure Compact, but also noted the change would have a large financial impact. Sen. Virginia Lyons introduced a nursing compact licensure bill on February 22 which would allow for Vermont to join the NLC. If approved, Vermont would become the 32nd state to join the compact. Registered nurses and licensed practical nurses from Vermont nurses could obtain a compact license, and current out-of-state compact license holders could work in Vermont without paying for a single-state license. In terms of regional impact, Vermont nurses would have easier access to New Hampshire and Maine, which are current NLC member states, and potentially Massachusetts, which also has NLC legislation in the works. The report found the benefits of joining the NLC “large and singular.” “The removal of the licensure barrier to practice in Compact States carries particular benefits for traveling nurses and military spouses, as well as in cases of disaster, labor action, or other surges in demand for nurse inflow,” the report finds. “Compact licensing also facilitates e-health and telehealth access, thereby improving the continuity of care.” The report also noted improving license mobility could potentially relieve pressure on healthcare facilities caused by nursing shortages, specifically during emergency situations. “If Vermont joins the eNLC, nurses from other Compact States will be able to provide services in Vermont without encountering the deterrent of obtaining an additional license,” the report finds. “Without these barriers to practice, nurses may be more likely to fill nursing vacancies in Vermont; however we find no studies or other data conclusively demonstrating that participation in the eNLC will alleviate state nursing shortages.” Potential costs of joining the NLC include a hit to the state nursing board’s annual revenue. The report estimated about 4,705 RNs and LPNs would no longer need a single-state license, which would cause a loss of nearly $1 million from the board’s $4 million annual revenue. “Nurses seeking Vermont-only licenses are likely to see licensing fees increase as these licensees bear a greater proportion of the State licensing administration and enforcement costs,” the report finds. “Due to the anticipated revenue loss the Office can forecast that prior to Compact adoption or shortly thereafter the Office will need to see a fee increase in this profession even after the proposed fee increase in the 2019 Legislative Session.” The current annual renewal fee for Vermont state RN and LPN licenses are $140, but if the proposed fee increase and NLC legislation are approved, the report estimates license costs will jump to $280 for RNs and $245 for LPNs. The report also pointed to costs in other areas, including increased administrative needs, staffing needs, the adaptation of licensing software, and the annual $6,000 membership fee owed to the National Council of State Boards of Nursing. Members of the state nursing board voted in support of the state joining the NLC in 2017, and the report noted many of the state’s nurses and major healthcare organizations support the legislation as well. The full report can be viewed here.
Alabama Legislators Introduce Nursing Compact License Bill
Alabama legislators introduced two bills Tuesday that could allow the state to join the nationwide Nursing Licensure Compact, according to data from Legiscan. House Rep. April Weaver and Sen. Gregg Reed pre-filed and introduced House Bill 44 and Senate Bill 38, respectively, during the first special session of 2019. Both bills were referred to House and Senate health committees for further discussion. If approved, Alabama would become the 32nd state to join the Nursing Licensure Compact, which allows for registered nurses and licensed practical nurses to practice in multiple states without having to apply for a single-state license. It would also allow Alabama nurses easier access to jobs across state lines, as Florida, Georgia, Kentucky, Mississippi and Tennessee are all members of the Nursing Licensure Compact. The Alabama Board of Nursing voiced support for the compact license legislation last Thursday on social media and in their organization’s newsletter, stating that the board decided to pursue the legislation after “very intense, detailed analysis” last September. “This was not an easy decision, as the Board was careful to pay special attention to protecting Alabama’s regulatory prerogatives and to ensure that Compact participation would not negatively impact patient care in the state,” the newsletter statement reads. “The Board is honored to recognize Representative April Weaver, RN (R-Alabaster) and Senator Greg Reed (R-Jasper) for sponsoring the historic bills (House Bill 44 and Senate Bill 38) that would enact the Compact in Alabama. Part of the reason the board wants this legislation to pass is because of the growing nursing shortage in Alabama, according to the statement. Analysts project Alabama will have a surplus of nurses by 2030, according to a 2017 labor study by the Health Resources and Services Administration, but healthcare leaders in the state say they are having problems finding and retaining nurses. Many Alabama healthcare leaders have pointed to common factors affecting the nursing shortage at a national level, including higher demand with an aging population and workforce, a lack of available educators to train more new nurses faster, and issues with pay and working conditions. Alabama is on the lower end for compensation—the average nursing salary in the state is $57,890, according to Bureau of Labor Statistics data. This also includes travel nursing pay, where the average contract ranges from $1,400-1,500 weekly, according to the most recent StaffDNA job board data. Despite this, Alabama remains a fairly popular destination for travelers, and nursing professionals in the state have said travel nursing is also a factor contributing to staff retention issues, according to a WFSA 12 report.
New Jersey Compact Nurse License Bill Passes Senate
A New Jersey compact nurse license bill is one step closer to becoming law after state Senate members passed it last Thursday. The bill passed unanimously, 35-0, with five senators abstaining. The bill would allow New Jersey to join the Nursing Licensure Compact. If approved, New Jersey would be the 32nd state to join the new enhanced NLC which was fully implemented in January 2018. Currently, seven other states also have pending legislation to join the NLC. It would also provide access for New Jersey nurses to practice in its neighbor state Deleware, as well as several other compact states in the Northeast region including Maryland, New Hampshire, Maine, Virginia and West Virginia. Some business associations and nursing groups have thrown their support behind compact nurse license bill in recent weeks, including the New Jersey Business and Industry Association. “I want to first thank Senator Singleton for recognizing the nursing shortage in New Jersey and for introducing legislation that would simplify the process for out-of-state nurses to work in New Jersey,” NJBIA vice president Tony Bawidamann said in a press release. “As a result of his great work, nurses will only need to obtain a license from the state they reside in to be permitted to work in New Jersey, instead of having to go through the whole licensing process again.” One of the largest nursing and healthcare labor unions in the state, Health Professionals and Allied Employees (HPAE), has not endorsed the bill, citing concerns that it could lower the bar for workforce qualifications, according to a report by NJ Spotlight. This is the third time an NLC bill has been introduced since 2015, but the first time that it has made it out of committee and passed through a Senate vote. Senators Troy Singleton, Joseph Vitale and Fred Madden, Jr., sponsored the most recent bill. A companion bill in the New Jersey General Assembly is currently in committee and awaiting a final vote in the Assembly before moving to Gov. Phil Murphy’s desk. The next full Assembly session is scheduled for March 25, according to the state legislature’s website.
Hawaii, Indiana, Washington Introduce Nursing Licensure Compact Legislation In 2019
Exactly a year and one month ago, the National Council of State Boards of Nursing (NCSBN) enacted the enhanced Nursing Licensure Compact—referred to as the NLC—with the goal of streamlining the compact license requirements and adding an extra layer of security by requiring federal background checks for all applicants. A total of 31 states have joined the NLC since January 19, 2018, including Kansas and Louisiana, which both passed legislation to join last year and are expected to fully implement their NLC programs by July 1. They weren’t the only states interested in joining the NLC last year. Illinois, Michigan, New York, Vermont, Massachusetts, Rhode Island and New Jersey all had pending legislation last year to join the NLC. Of those states, only New Jersey, Massachusetts, Indiana and Michigan still have legislation pending. Three new states—Hawaii, Indiana and Washington—have all introduced some form of legislation related to the NLC earlier this year that could result in three new compact states. While it’s unlikely that these states will implement NLC programs this year, we’ve provided a breakdown of the issues surrounding each piece of legislation, and if they will realistically pass muster with their state governments. Breakdown of potential new nursing compact license states Hawaii What legislation is in the works? Hawaii does not have a bill to actually join the NLC, but on January 24, House Rep. Ichiyama Takumi introduced a bill that would establish a study to identify potential issues that could arise if the state joins the NLC. How much progress has it made so far? As of February 16, the bill has been recommended for approval almost unanimously by every House committee assigned to review it, including the Consumer Protection and Commerce, Health and Intrastate Commerce committees. The bill is scheduled for a final review with the Finance committee on February 21. Why is this a big deal? While it’s not technically legislation to join the NLC, it’s still big news that Hawaii lawmakers are considering joining in the first place. If the results of the study are favorable and NLC legislation is introduced, Hawaii could become the first non-continental state to join the compact. Hawaii is already an incredibly popular destination state for travel nurses, but it could be even more popular if its made accessible for compact license holders. It could incentivize native Hawaii nurses to travel as well since they would gain more than 30 additional states to practice in if NLC legislation is approved. What are the chances it will actually pass? Very high. Almost every committee assigned to review it has recommended it for approval and are moving it quickly through the House, so there is a solid chance the bill could pass through the House by the end of February. Indiana What legislation is in the works? House Bill 1344, introduced on January 14 by Republican Rep. Edward Clere, would allow for Indiana to join the Nursing Licensure Compact. How much progress has it made so far? The NLC legislation passed unanimously in the Indiana House on January 31 and is making its way through various committees in the state Senate as Senate Bill 436. Why is this a big deal? If Indiana passes legislation to join the NLC, not only would compact license travelers have access to a new state, but it would allow for Indiana nurses to practice across the Indiana-Kentucky state line in Louisville—an issue that is frequently brought up by compact license advocates when addressing gaps in nursing service. It would also allow for nurses without a single-state license but who have a compact license to possibly start jobs quicker, as it can currently take several weeks to obtain a permanent nursing license in Indiana. What are the chances it will actually pass? Very high. This is the second time Rep. Ed Clere has introduced NLC legislation after his first attempt in 2018 with House Bill 1317, which urged legislators to conduct a study into the impact of joining the compact, among several other provisions. The bill went into a legislative study over last summer to address any concerns, and since then has gained significant momentum and support among lawmakers, according to a Komoko Tribune report. The current NLC bill also has the support of several healthcare associations and interest groups, including Baptist Health Floyd, One Southern Indiana, the Indiana Hospital Association and the Coalition of Advanced Practice Nurses of Indiana, according to the Indiana Chamber. Washington What legislation is in the works? Washington House Bill 1882 and Senate Bill 5460 were both introduced this year and would allow Washington to join the NLC. How much progress has it made so far? Both bills have moved to committee for further discussion and debate. The Senate Health & Long Term Care Committee public hearing on February 1 can be found here. Why is this a big deal? If implemented, Washington would be the first state on the West coast to join the NLC. It would also allow for Washington nurses to practice across the Washington-Idaho state line, as Idaho is already a part of the NLC. What are the chances it will actually pass? Mixed. Some members of the business and military sector in Washington, as well as the NCSBN, support the state joining the NLC, according to several testimonies given on February 1 during a Senate Health and Long Term Care Committee hearing. “We have, as a state, already passed the Physical Therapy Licensure Compact and the [Interstate] Medical Licensure Compact, and we’ve done so because we know the compacts are effective,” Sen. Annette Cleveland, a sponsor for the bill, said during the hearing. “31 other states…already have nurse licensure compacts, others are also considering joining, and I want to ensure our state is also having that conversation.” The Washington State Nurses Association (WSNA) opposes the bill, according to a Senate committee testimony by Melissa Johnson, a spokesperson for the WSNA. Some of the concerns of the WSNA include a lack of need for the compact with the state board’s
Traveler Tips: Is The PT Compact License Worth It For Travel PT?
By Stephen Stockhausen, PT, DPT, OCS, Contributing Writer, Founder of PT Adventures Having the freedom to take different jobs in various parts of the country is by far the best, and the most obvious, perk of being a travel physical therapist. But it comes at a cost of the occasionally arduous task of obtaining a new state license. There are the jurisprudence exam, state license fee, FSBPT test score verification fee, and license verification letters—with subsequent fees that need to be sent to any state you have ever held a license. Whew! That’s exhausting just to type out let alone piece together and mail off. Oh, and then you have to wait anywhere from two to six months to find out if you’re new license has been granted or not. But fear not—the Physical Therapy Compact license is designed to fix all of that! In case you haven’t heard about the Physical Therapy Compact license here is a quick summary. Enacted in 2017, the Physical Therapy Compact Commission was created to provide a vehicle for improved interstate license accessibility while maintaining the safety of the public consumer as set forth by each state’s practice act, according to their website. The PT Compact Commission has since built up an impressive list of 21 states willing to recognize the validity of physical therapist and physical therapist assistant licenses from other participating states. The first privileges were then officially granted in July of 2018. While all 21 states have passed legislation to be members, not all states are currently issuing compact license privileges at this time and are still resolving internal issues—or just dragging their feet. At the time of this writing, nine states are active participants in the compact license process, with more joining every month! Pros and Cons of the Physical Therapy Compact License for travelers Pros: Therapy privileges can be granted in minutes rather than months Once you take the jurisprudence exam for your new state—often completed online—and pay the necessary fees, you are eligible to begin working in the new state Low Fees The fees involved with the new PT Compact are very minimal compared to sending out license verification fees for each state you have ever had a license. $45 goes to the PT Compact Commission, and then each state has their own fee. Most range from $45-60, with the exception of Mississippi at $150. (Come on, Mississippi!) One set of Continuing Education Units (CEUs) to manage Since you do not have a full state license in every state that you obtain privileges for, you do not have to maintain their Continuing Education Units. The only set of CEUs that you absolutely must follow is that of your home state. Gone are the headache-inducing hours of cross-checking CEU dates with license expiration dates! Renewal This is one of the coolest aspects of the Compact system. 60 days before your home license expires they will email you a reminder. Once you renew your license at home, the Compact will automatically notify you that you are eligible to renew your Compact privileges as well, typically within a week. Responsive Admin Team When I was doing research for this article, I had a few questions that I could not find on their website. Opting to call instead of email, I was quickly connected with the lead administrator who thoroughly answered my questions and was exceedingly friendly. This was a pleasant surprise compared to the typical experience I have come to expect when dealing with licensing staff at the various states I have worked. Telehealth? While not entirely applicable to the traveler, based on the language written into the Compact it appears that Compact privileges can also be used to treat remotely via telehealth. In a burgeoning field, this is super exciting news! Especially for the therapist looking to mix in some patient care in a state where they previously worked as a traveler or will soon work as a traveler. Instead of being limited to one license per job, multiple licenses can be utilized all at once depending on the patient’s location, independent of where the PT is located. Cons: Few states fully participating Obviously, if your home state is not a participant you are fully excluded from the entire process… bummer. For those of you who are fortunate enough to have a home state proactive enough to join up, your options for states to travel to may be slim pickings. Currently, only nine states are fully active. On the positive side they are some pretty cool states. Oregon, Utah, New Hampshire and North Dakota all have some great outdoor experiences. Texas Tennessee, Missouri and Mississippi all have some killer food and Southern hospitality. As for Iowa…well, Field of Dreams is there. That’s something! There are 11 other states on the doorstep to full participation so check the site often to see if your home state or dream location is up and running. When you renew your home license you have to renew ALL of your Compact Privileges This will negatively impact folks living in a home state that requires yearly license renewal. These therapists will now have to pay all of the Compact fees again as well as fees to the state where they are working. Now, compared to paying all of the other fees typically involved in maintaining multiple licenses, this could still end up saving you money, but you will have to do the math on your specific situation to be sure. Overall the PT Compact License is—or is going to be—a huge improvement in the logistics of being a travel therapist, especially if more states get involved. If every state were to join the Compact, it would mean one license to worry about, one set of CEUs, and only paying fees to the states where you are actively working. Stephen Stockhausen is a doctor of physical therapy, a traveler, and a founder of PT Adventures—a blog created with his wife Ellen to help travel PTs take control of
Enhanced Nursing Licensure Compact Update: Questions Answered
After we posted our story about how new enhanced Nursing Licensure Compact states are handling the transition process, we got some specific questions from readers about the topic. We are still working to answer some of those, but we did want to answer what we could. Q: “I was told some Florida hospitals are still requiring travel nurses to have an actual FL license. I was planning on not renewing my Florida license because I have an Iowa compact license.” -Madonna A: Thanks for writing in, Madonna. We’ve got some good news and bad news. The bad news is that rumor seems to be correct. Some hospital systems in Florida are not accepting nurses who have multi-state licenses at this time. We’ve reached out to them to figure out why. The good news is if you are from out of state and hold an active single-state license for Florida, it’s still valid. There are also no shortages of hospitals to choose from when looking for places to work in the state. It’s important to remember, however, that once your single state license expires, you won’t be able to renew as long as you have a multi-state license from a compact state, according to eNLC rules. Do you need answers to your burning enhanced Nursing Licensure Compact questions? Check out our enhanced Nursing Licensure Compact coverage for more info, or send us an email with your question. Got a great story or news tip about the travel healthcare industry? Reach out to us today.
Nursing Licensure Compact Update: More Questions, More Answers
After we posted our story about how new enhanced Nursing Licensure Compact states are handling the transition process, we got some specific questions from readers about the topic. Last week, we answered the first one about whether some Florida hospitals are still requiring single state licenses despite being a eNLC state, and today we’ve got another question from a Florida-native nurse. Q: “I have Florida, North Carolina, and Massachusetts licenses. My home state is Florida. Do I still have to renew my North Carolina single state license even though it lapsed? ” — Stephanie M. A: That’s a good question, Stephanie. Whether or not to renew a license depends on your home state. Nurses who received their primary license in a non-eNLC state are still required to obtain single state licenses as usual, according to the National Council of State Nursing Boards. This rule was carried over from the old NLC. Luckily, since your home state is in Florida, you don’t have to renew your single state in North Carolina as long as you meet the qualifications for a multistate license. In fact, North Carolina wouldn’t be allowed to give you a single state license if you already have a multi-state, under Section 401 of the official eNLC rules. For reference, here are the new uniform requirements to qualify for a multistate license: Meets the requirements for licensure in the home state (state of residency) Has graduated from a board-approved education program; or has graduated from an international education program approved by the authorized accrediting body in the applicable country and verified by an independent credentials review agency Has passed an English proficiency examination (applies to graduates of an international education program not taught in English or if English is not the individual’s native language) Has passed an NCLEX-RN or NCLEX-PN examination or predecessor exam Is eligible for or holds an active, unencumbered license (i.e., without active discipline) Has submitted to state and federal fingerprint-based criminal background checks Has no state or federal felony convictions Has no misdemeanor convictions related to the practice of nursing (determined on a case-by-case basis) Is not currently a participant in an alternative program Is required to self-disclose current participation in an alternative program Has a valid United States Social Security number. Keep in mind that every state will most likely have a fee to upgrade your single state license to a multi-state. Florida charges a one-time fee of $100. If you don’t qualify for a multi-state license, don’t fret–you may still be eligible for that state’s single state license requirements. Got another enhanced Nursing Licensure Compact question, or just a question about traveling? Check out our eNLC coverage for more info, or send us an email with your question. Want to share a great story or industry news tip? Reach out to us today.
Compact License Update: Kansas Makes Progress; Low Demand for Wyoming Licenses
The Kansas legislature has moved quickly on HB 2496 in the past two weeks, meaning Kansas could join the 29 other states in the enhanced Nursing Licensure Compact as early as next year. The bill was introduced to the House on Jan. 17 and promptly moved to the Committee on Health and Human Services the next day. After a small amendment bumping up the implementation date, the bill passed the House with almost unanimous support last Thursday. The Senate pushed the bill to the Committee on Public Health and Welfare this week, and legislators will resume session after the weekend. If the bill passes, Kansas nurses could potentially obtain new compact nursing licenses by January 1, 2019, according to the bill supplement. Kansas is one of seven states attempting to pass legislation to join the eNLC, which went into effect on Jan. 19 this year. The other states are Illinois, Michigan, Massachusetts, New York, New Jersey, Rhode Island and Vermont. Wyoming: Low demand makes for easy eNLC transition Wyoming’s had an easier time addressing multi-state license demand compared to the others as one of the five new states to join the compact, Jennifer Burns, practice and education consultant for the Wyoming State Board of Nursing, said there have been less than 100 applications for new compact nursing licenses or upgrades from normal licenses. There are approximately 13,000 registered nurses and 1,100 licensed professional nurses in the state as of December 2017. “We’re a small state in number of licensees,” Burns said. “We’re not seeing any delays in processing applications. We were well prepared. To be honest, most of our home-state nurses like to live in the communities where they work.” Despite the low numbers, Burns said the state still sees traffic from travelers on a fairly consistent basis. Wyoming jumped significantly in the rankings for most applications submitted from travelers by state for February, moving from the 45th most popular state to the 37th, according to StaffDNA data. “I don’t know if there will be an increase in opportunity for travel nurses, but it will certainly decrease the time it takes for travelers (with compact nursing licenses) to come here,” Burns said. “A lot of travelers come to our state, so there’s the benefit of that for us being a part of the eNLC.”