The ANA-Michigan Board of Directors voted to accept the recommendation of the Public Policy Council to support of HB 4938, sponsored by Representative Mary Whiteford, RN. HB 4938 is a bill that would permit Michigan to join the current 30 states who are part of the “enhanced nurse licensure compact”. The Council studied and discussed in-depth strengths and weaknesses of HB4938. The Council and Board members held a “learning session” on the eNLC with a presentation by a representative from the National Council of State Boards of Nursing. The Council recommended SUPPORT of HB4938 with the provision that the MI Department of Licensing and Regulatory Affairs (MI-DLARA) does not pass on the costs of implementation of the eNLC through another increase in the nurse licensure fees. The legislature doubled Michigan nurse licensure renewal fees in 2017.
WHAT IS THE NURSE LICENSURE COMPACT?
The NLC allows a registered nurse (RN) or licensed practical nurse (LPN) to possess a multistate license, which permits practice in both their home state and other compact states, while maintaining the primary state of residence. Unless the nurse is under discipline or restriction, a multistate license permits practice (physically or telephonically/electronically) across state lines in all NLC states.
WHAT IS THE RATIONALE’ FOR ANA-MI’s SUPPORT OF eNLC?
The Council first considered: Is this bill consistent with the tenets of ANA-MI’s Policy Platform?
FACTORS INFLUENCING SUPPORT FOR THE BILL
- There is an increase in nursing practice and patient care access across state lines (care coordination, occupational health, etc.)
- Regional or national health crises require rapid deployment of nurses to areas of need.
- There is need to move nurses with highly specialized skills to states with medical crises for patient populations. A recent example is the number of Michigan residents who required specialized care available only through nurses employed in multiple states across a national healthcare system who were experienced in this specialized care. This care was related to contaminated injections prepared at a compounding pharmacy in Massachusetts.
- There are increasing national and international infectious disease outbreaks that require movement of nurses to meet patient and community needs (Ebola, flu, etc.).
- New nurse graduates will have more flexibility with a Michigan “home state” license if there are not sufficient available nursing positions in Michigan.
- Nursing faculty and students are sometimes engaged in clinical placements across state lines.
- Nurses move across states to support family care needs. These nurses may desire to continue nursing employment. They may be delayed in their ability to obtain a new state license.
FACTORS INFLUENCING CHALLENGES OF THE BILL
- Nurses are responsible to know multiple state requirements for ongoing licensure. For example, Florida requires continuing education for infection control.
- Nurses must be knowledgeable about and abide by varying state laws and regulations.
- In cases of nurses providing care through technology (telephonic, web site, etc.), it is not clear in which state the nursing practice is located (the state of the nurse or the state of the patient receiving care). There does not appear to be ongoing monitoring, data collection, or an evaluation plan to inform policies related to eNLC.
- eNLC membership does not provide assurance that nurses will in fact be knowledgeable of laws that pertain to nursing practice within those jurisdictions prior to engaging in practice in member states.
The Michigan Organization of Nurse Leaders (MONL) who are predominately hospital chief nursing officers are in support of HB4938. If the bill is passed, Michigan nursing education programs will need to include information about nurse licensure compacts and, as importantly, prepare faculty with this information for teaching.
NEED MORE INFORMATION?
For more information on the enhanced NLC, visit firstname.lastname@example.org
For a current map of eNLC states, visit www.nursecompact.com