(1) the health and safety of the public are affected by the degree of compliance with and the effectiveness of enforcement activities related to state nurse licensure laws; (2) violations of nurse licensure and other laws regulating the practice of nursing may result in injury or harm to the public; (3) the expanded mobility of nurses and the use of advanced communication technologies as part of our nation's health care delivery system require greater coordination and cooperation among states in the areas of nurse licensure and regulation; (4) new practice modalities and technology make compliance with individual state nurse licensure laws difficult and complex; (5) the current system of duplicative licensure for nurses practicing in multiple states is cumbersome and redundant for both nurses and states; and. In spite of these concerns, as many as 25 states did join the NLC. The decision to grant such a license is at the discretion of each state (Texas BON, 2017). Once the Virginia license was granted, the Texas license became invalid. (l) The commission may direct revisions to a previously adopted rule or amendment for purposes of correcting typographical errors, errors in format, errors in consistency, or grammatical errors. Their home state licenses would be accepted in all of the NLC states and they would be subject to the laws and nurse practice acts of all the state(s) in which they practiced (NCSBN, 2011, 2016). Such was Case #6, a registered nurse licensed in the Commonwealth of Virginia, with a PTP in Texas. (g) Any nurse holding a home state multistate license, on the effective date of this compact, may retain and renew the multistate license issued by the nurse's then-current home state, provided that: (1) a nurse, who changes primary state of residence after this compact's effective date, must meet all applicable Article III(c) requirements to obtain a multistate license from the new home state; or. The Nurse Licensure Compact explained video transcript [PDF file]. If a party state takes such action, it shall promptly notify the administrator of the coordinated licensure information system. If a PTP is revoked in one compact state, that will preclude the nurse from practicing in other compact states. A compact state is a state that has passed the interstate compact. 304.0015. The implementation date was six months from the effective date: January 19, 2018 (NCSBN, 2018a). For example, this authors original nursing license was obtained in the State of Texas. The Commission would also evaluate the effectiveness of regulations from the perspective of protecting the public. Sept. 1, 2001. Registered nurses (RN) or licensed nurses (LPN/VN) are only considered to be moving to a new state if they have the intent to stay (i.e., you are not just taking a temporary travel nursing assignment for a few months). (3) The commission shall not incur an obligation of any kind prior to securing the funds adequate to meet the same; nor shall the commission pledge the credit of any of the party states, except by and with the authority of such party state. (n.d.d). (g) Any information contributed to the coordinated licensure information system that is subsequently required to be expunged by the laws of the party state contributing that information shall also be expunged from the coordinated licensure information system. This is exemplified in Case #1, an LVN with a license from South Carolina and a PTP in Texas. First, it is important to remember that the multistate NLC does not change anything for a nurse who obtains one license and does not seek to move to or to practice in another state (NCSBN, n.d.d). Since my move to Virginia was permanent, and both Texas and Virginia were compact states, I could only hold a license in my state of residence. (n.d.) Discipline & complaints Nurse Licensure Compact disciplinary action. (1) Each party state shall enforce this compact and take all actions necessary and appropriate to effectuate this compact's purposes and intent. Case #1). While nurses may have the privilege to practice in many compact states, they can have only one nursing license. In so doing, the home state shall apply its own state laws to determine appropriate action. Retrieved from https://www.ncsbn.org/12_ULR_table_adopted.pdf, National Council of State Boards of Nursing. What is an interstate compact? West Virginia suspended her license immediately and scheduled a hearing. Sept. 1, 2001. The Compact Does Not Affect Everybody. Acts 2017, 85th Leg., R.S., Ch. Sec. When I moved back to Texas permanently a few years later, the reverse was the case. (2017). Please note: Prior to becoming an attorney, Kevin Keaney earned his BSN from UT Austin and practiced as a nurse for four years. The revision shall be subject to challenge by any person for a period of thirty (30) days after posting. (g) "Licensing board" means a party state's regulatory body responsible for issuing nurse licenses. The rules shall have the force and effect of law and shall be binding in all party states; (2) to bring and prosecute legal proceedings or actions in the name of the commission, provided that the standing of any licensing board to sue or be sued under applicable law shall not be affected; (3) to purchase and maintain insurance and bonds; (4) to borrow, accept, or contract for services of personnel, including, but not limited to, employees of a party state or nonprofit organizations; (5) to cooperate with other organizations that administer state compacts related to the regulation of nursing, including, but not limited to, sharing administrative or staff expenses, office space, or other resources; (6) to hire employees, elect or appoint officers, fix compensation, define duties, grant such individuals appropriate authority to carry out the purposes of this compact, and to establish the commission's personnel policies and programs relating to conflicts of interest, qualifications of personnel, and other related personnel matters; (7) to accept any and all appropriate donations, grants, and gifts of money, equipment, supplies, materials, and services, and to receive, utilize, and dispose of the same; provided that at all times the commission shall avoid any appearance of impropriety or conflict of interest; (8) to lease, purchase, accept appropriate gifts or donations of, or otherwise to own, hold, improve, or use, any property, whether real, personal, or mixed; provided that at all times the commission shall avoid any appearance of impropriety; (9) to sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property, whether real, personal, or mixed; (10) to establish a budget and make expenditures; (12) to appoint committees, including advisory committees comprised of administrators, state nursing regulators, state legislators or their representatives, consumer representatives, and other such interested persons; (13) to provide and receive information from, and to cooperate with, law enforcement agencies; (14) to adopt and use an official seal; and. The administrator of the coordinated licensure information system shall promptly notify the home state of any such actions by remote states. The Texas Board of Nursing Bulletin is the official publication of the Texas Board of Nursing and is published four times a year: January, April, July, and October. State boards of nursing provide the information through the Nursys eNotify program. Therefore, the aim of this manuscript is to examine the NLC and its disciplinary provisions and to discuss the potential consequences and implications of violating those provisions. Reddit and its partners use cookies and similar technologies to provide you with a better experience. When nurses are disciplined in a compact state, the action directly impacts their practice in all the compact states (NLC Administrators, 2012; Texas BNE, n.d.). (d) The commission shall publish its bylaws and rules, and any amendments thereto, in a convenient form on the website of the commission. (2) issue cease and desist orders or impose an encumbrance on a nurse's authority to practice within that party state. Under this rule, the state in which nurses obtain a license is considered the primary residence or home state. However, she failed to complete all steps necessary to endorse her license to Texas. The inability to practice when under investigation and the burden of having to defend ones license and ones privilege to practice could take a great toll, both financially and otherwise. Not every nurse or nursing organization greeted the news with excitement. Discipline. Services provided by Nursys include automated license status updates, and regular updates to institutions regarding any changes to their nurses licenses. COORDINATED LICENSURE INFORMATION SYSTEM AND EXCHANGE OF INFORMATION. Applicants for the eNLC license must not have pled guilty to or have been convicted of a felony. The States of Illinois and California also brought charges against her based solely on the Texas action (Texas BNE, n.d.). 2.023, eff. Amended by Acts 2003, 78th Leg., ch. (2) Venue is proper and judicial proceedings by or against the commission shall be brought solely and exclusively in a court of competent jurisdiction where the principal office of the commission is located. (2) Each administrator shall be entitled to one (1) vote with regard to the promulgation of rules and the creation of bylaws and shall otherwise have an opportunity to participate in the business and affairs of the commission. Identification of the nurses involved have been replaced by assigned numbers (e.g. She faced sanctions with multiple states in 2016 based on an event that happened in a telemedicine practice in West Virginia. Exemplifying telehealth discipline is Case #5, an RN with a Tennessee license and also an advanced practice registered nurse (APRN) license from many states, including Texas and West Virginia. each one of the states took a disciplinary stance, their stipulations and sanctions differed.An important point in this case is that while each one of the states took a disciplinary stance, their stipulations and sanctions differed. For more information visit the Texas licensing page. Key Words: multistate compact, disciplinary actions, enhanced Nursing Licensure Compact, Nursing Licensure Compact, Texas Board of Nurse Examiners, out of state, Nursys, privilege to practice, National Council of State Boards of Nursing (NCSBN), telemedicine. September 1, 2017. However, if the faculty is in a compact state, and the student is in a remote compact state, the multistate license will suffice. Therefore, it is prudent to verify nursing licenses for all employees at Nursys.com, both at the beginning of employment and at intervals. (6) The defaulting state may appeal the action of the commission by petitioning the U.S. District Court for the District of Columbia or the federal district in which the commission has its principal offices. (b) A nurse may hold a multistate license, issued by the home state, in only one party state at a time. Although the NLC limits the nurse to only one license at a time, this does not apply to non-compact states. Key Disciplinary ProvisionsIn addition to the eligibility requirements, the eNLC contains key provisions that are explained in eleven articles. Retrieved from https://www.ncsbn.org/2016NLC_JPuente.pdf, National Council of State Boards of Nursing. (c) Prior to promulgation and adoption of a final rule or rules by the commission, and at least sixty (60) days in advance of the meeting at which the rule will be considered and voted upon, the commission shall file a notice of proposed rulemaking: (1) on the website of the commission; and. The Nurse Licensure Compact is enacted and entered into with all other jurisdictions that legally join in the compact, which reads as follows: ARTICLE I. She was sanctioned by the BON (Texas BNE, n.d.). New comments cannot be posted and votes cannot be cast. It recommended, among other things, that States should standardize entry-to-practice requirements and limit them to competence assessments for health professions to facilitate the physical and professional mobility of the health professions, (Pew, 1995, p. ix). All rights reserved. Any vacancy occurring in the commission shall be filled in accordance with the laws of the party state in which the vacancy exists. Feb. 1, 2004. This article examines the provisions of the Nursing Licensure Compact (NLC). Established in 1989, the Commission mission was to assist healthcare professionals, workforce policy makers, and educational institutions manage the challenges of an increasingly changing healthcare system. Compact nursing states refer to the Nursing Licensure Compact (NLC), which is an agreement between states that allows nurses to have one compact state nursing license that gives them the ability to practice in other states that are part of the agreement. The issuing authority shall pay any witness fees, travel expenses, mileage, and other fees required by the service statutes of the state in which the witnesses or evidence are located. 1. The eNLC became effective on July 20, 2017, when North Carolina became the 26th member (NCSBN, 2018a). The head of the state licensing board or a designee shall be the administrator of this compact for each party state. EFFECTIVE DATE, WITHDRAWAL, AND AMENDMENTS. 553, Sec. Amended by Acts 2003, 78th Leg., ch. The Texas Board of Nursing is the state agency responsible for taking action against registered and vocational nurses practicing in this state under a license issued by a state that is a party to the Nurse Licensure Compact as authorized by the Nurse Licensure Compact. Retrieved from https://www.bon.texas.gov/faq_licensure.asp, Texas Board of Nursing. It is not enough to initiate paper work to start the process. Article III also grants compact states the authority to take disciplinary action against a nurses privilege to practice (PTP) status when the nurse violates the state laws and the state nurse practice act. Sept. 1, 2001. Disciplinary Impact on Telehealth PracticeOne of the advantages of the multistate nursing privilege is that nurses can be physically located in one state while engaging in nursing practice in another state through technology and telehealth services. (2013a). 1420, Sec. It demonstrates the concept that under the NLC, nurses are disciplined regardless of which compact state was the location of the infraction. (c) The commission shall, by a majority vote of the administrators, prescribe bylaws or rules to govern its conduct as may be necessary or appropriate to carry out the purposes and exercise the powers of this compact, including but not limited to: (1) establishing the fiscal year of the commission; (2) providing reasonable standards and procedures: (i) for the establishment and meeting of other committees; and. 2.027, eff. Amended by Acts 2003, 78th Leg., ch. CONSTRUCTION AND SEVERABILITY. Acts 2007, 80th Leg., R.S., Ch. Retrieved from https://www.ncsbn.org/70.htm, National Council of State Boards of Nursing, Inc. (n.d.c). Notwithstanding any civil service or other similar laws of any party state, the bylaws shall exclusively govern the personnel policies and programs of the commission; and. Additionally, North Dakota, Vermont, Oregon, and Washington, also took disciplinary action against her license; and she also voluntarily surrendered her license in those states (NCSBN, n.d.h; Texas BNE, 2016). When nurses extend practice into another compact state, they do not obtain another license, but will work under a PTP. Subscription price for residents within the continental U.S. is $15.00, plus tax. However, all receipts and disbursements of funds handled by the commission shall be audited yearly by a certified or licensed public accountant, and the report of the audit shall be included in and become part of the annual report of the commission. (7) take adverse action based on the factual findings of the remote state, provided that the licensing board follows its own procedures for taking such adverse action. In other words, the PTP is only used in a state other than the primary residence. If the revision is challenged, the revision may not take effect without the approval of the commission. References, The Regulatory Dilemma Surrounding Interstate Practice, Nursing Regulation for the New Millennium: The Mutual Recognition Model, The Utah Experience: Adopting the Nursing Regulation Interstate Compact. 1420, Sec. The Board: protects the public from unsafe nursing practice, provides approval for more than 200 nursing education programs, issues licenses to more than 27,000 nurses per year by examination to new graduates and by endorsement to licensees from other states seeking a Texas license, as well as providing nursing practice and education guidance to. Reforming health care workforce regulation: Policy considerations for the 21st century: Report of the Taskforce on Health Care Workforce Regulation. As has been shown above, there can be a domino effect of disciplinary actions against nurses licenses. (d) Current significant investigative information and participation in nonpublic or confidential alternative programs shall be transmitted through the coordinated licensure information system only to party state licensing boards. 553, Sec. (2018a, January 19). The author concludes that most nurses provide competent care, and that outside of this compact, the few who violate laws and regulations are usually disciplined by their individual state board of nursing. Amidst concerns that the NLC did not successfully guarantee the competence of nurses who practiced across state lines, membership in the compact stalled after the twenty-fifth state joined. (1) The nurse may apply for licensure in advance of a change in primary state of residence. Omobola Awosika Oyeleye, EdD, JD, MSN, MEd, BSN, BA, RN-BC, CNE, CHSE, CPHQEmail: Omobola.a.oyeleye@uth.tmc.edu. 509 (H.B. Texas nursing licensing fees. Licensure compacts. Feb. 1, 2004. The practice of nursing is not limited to patient care, but shall include all nursing practice as defined by the state practice laws of the party state in which the client is located. . (ii) the decision of a majority of the arbitrators shall be final and binding. Retrieved from https://www.ncsbn.org/NLC_What_Nurses_Need_to_Know.pdf, National Council of State Boards of Nursing. (a) On request and payment of a reasonable fee, the Texas Board of Nursing shall provide a registered or vocational nurse licensed by this state with a copy of information regarding the nurse maintained by the coordinated licensure information system under Article VI of the Nurse Licensure Compact. An administrator shall vote in person or by such other means as provided in the bylaws. After she changed her primary residence to Texas, she continued to practice under a PTP for 3 years. 2950), Sec. The Texas Board of Nursing explained to me that I could only continue to practice with a Texas license if Texas was my state of residence. The relevant parts of Article III require that nurses must comply with the practice laws in each state where they practice. Such procedures shall include the submission of fingerprints or other biometric-based information by applicants for the purpose of obtaining an applicant's criminal history record information from the Federal Bureau of Investigation and the agency responsible for retaining that state's criminal records. (6) uniformity of nurse licensure requirements throughout the states promotes public safety and public health benefits. Added by Acts 2001, 77th Leg., ch. Below are the fees for becoming a nurse in Texas whether you are a first-time nurse or are moving to Texas from another state. Sec. The provisions of this compact shall be severable, and if any phrase, clause, sentence, or provision of this compact is declared to be contrary to the constitution of any party state or the United States, or if the applicability thereof to any government, agency, person, or circumstance is held invalid, the validity of the remainder of this compact and the applicability thereof to any government, agency, person, or circumstance shall not be affected thereby. This case clearly invalidates the notion that the NLC allows nurses to fly under the radar when they practice on a compact license. While living in Tennessee, she contacted West Virginia residents by phone and wrote prescriptions for patients with whom she had no provider/patient relationship.