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Interstate Nurse Licensure Compact

Traditionally, health care professionals in the U.S. have been licensed by the state or jurisdiction in which they practice—this means licensure is necessitated in multiple jurisdictions if their practice crosses state / territorial lines. This regulatory landscape first began to shift in 2000 when Maryland signed into law the first health care compact – the Nurse Licensure Compact (NLC). The original NLC was updated in 2015, necessitating states that had adopted the original, return to the legislature for approval of the new, “enhanced” NLC. More recently other health professions have created interstate compacts, though differing from the NLC.

How does the Nurse Licensure Compact (NLC) work?

Created by the National Council of State Boards of Nursing (NCSBN), the NLC reflects an interstate agreement permitting registered nurses (RNs) and licensed practical/vocational nurses (LPN/LVNs) to have one license. The license issued by their primary state of residence allows the nurse to practice in other compact states without having to secure an additional license.

Under the NLC, Registered Nurses (RN) are obliged to abide by the nursing practice laws in the state where the patient is located (party state when crossing into another jurisdiction) – and are subject to having the privilege to practice revoked in that state if deemed necessary. However, the RN’s home state is ultimately responsible for any discipline against the license of the nurse.

The Compact requires state nursing boards to participate in a national database, Coordinated Licensure Information System (CLIS), or Nurses License Verification database. This allows states to share information for verification of nurse licensure, discipline, and practice privileges.

Which states participate in the NLC?

For a current list Nurse Licensure Compact (NLC) | NCSBN  

What about the APRN Compact?

The APRN Compact, adopted by NCSBN August 12, 2020, allows an advanced practice registered nurse to hold one multistate license with a privilege to practice in other compact states. The APRN Compact will be implemented when 7 states have enacted the legislation. To learn more APRN Compact | NCSBN

Generally, nurses surveyed favor the NLC, which does afford greater mobility. Some remain unaware of the nuances associated with implementation – such as a change in residence (from the home state) necessitates application for licensure endorsement in the new home state or the potential for necessary increase in licensure fees.  While the NLC has been in existence for several years, click here for a more in-depth analysis which may be helpful.

Last updated 4/2021

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