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.
Originally developed in 2000, by 2015, the license had grown to include 25 states. Maryland, the first state to sign into law, saw an immediate need for nurses and looked to nurses in neighboring states to help fill the gaps.
To help streamline the process for nurses, the Enhanced Nursing Licensure Compact (eNLC) was implemented in 2018 and included standards for licensure, which the original compact license lacked.
For example, the NLC did not require applicants to undergo state and federal fingerprint-based criminal background checks, whereas the new eNLC does.
As of January 2024, there are currently 41 states part of the eNLC. Here’s a comprehensive list of all of the states that have enacted multi-state compact licensing, either fully or partially, or are awaiting legislation:
- Guam (Guam is allowing nurses who hold active, unencumbered, multi-state licenses issued by Nurse Licensure Compact member states to practice in Guam under their multi-state licenses.)
- Louisiana (Registered Nurse and Practical Nurse)
- New Hampshire
- New Jersey
- New Mexico
- North Carolina
- North Dakota
- Pennsylvania (Partial implementation)
- Rhode Island (Partial implementation)
- South Carolina
- South Dakota
- Virgin Islands (eNLC enacted, awaiting implementation)
- Washington (Partial implementation)
- West Virginia (Registered Nurse and Practical Nurse)
Currently, nurses who hold an active compact license may practice in the following states: Guam, Pennsylvania, Rhode Island, U.S. Virgin Islands, and Washington. However, nurses who reside in the aforementioned states may not apply for a compact license quite yet. Guam, Pennsylvania, and the U.S. Virgin Islands have yet to determine a date for this. Rhode Island is set for a January 8th, 2024 implementation while Washington is listed as January 31st, 2024.
Seven additional states, as well as the District of Columbia, have pending legislation waiting for approval before joining the eNLC.
- Alaska – HB149 | SB130
- District of Columbia – B430
- Hawaii – HB667 | HB1264 | SB670
- Illinois – HB1622 | SB41
- Massachusetts – HB122 | HB1251 | SB747
- Michigan – HB4935
- Minnesota – HB1005 | SB3287
- New York – AB3391 | AB6421 | AB7946
For many states, the COVID-19 pandemic illustrated the need to lessen regulatory burdens on nursing licensure. Because of this, many states were able to start legislation toward implementation. Furthermore, some state nursing associations have supported bills that previously they were against.
Since the last update, several key states have put out legislation to implement the eNLC. Alaska and Hawaii both have legislation pending. This is monumental as both are key states for travel nurses. With the implementation of the eNLC, Alaska will be able to easily get much-needed staff, especially in remote communities. The Alaska Board of Nursing, at one point, did not favor the compact license; however, after overwhelming support from nurses within the state – the board now supports the legislation. Alaska specifically has had pending legislation for years, but it has never successfully passed and been implemented.
Hawaii has never had concerns with finding nurses, as it is highly desirable for travel nurses, so the implementation of the eNLC might make it more difficult to secure nursing positions in Hawaii.
According to a survey conducted in 2019 by the Alaska Division of Corporations, Business, and Professional Licensing, 89% of Alaskan resident nurses are in favor of joining the compact license, and 87% would apply for a compact nurse license if available. Alaska most recently sent a new survey to all nurses licensed in Alaska in October 2023, and new survey results are pending.
Executive Director of Nursing Care Quality Assurance Commission Paula R. Meyer MSN, RN, FRE, said, “The Nursing Care Quality Assurance Commission has supported the NLC for more than 25 years. The passage of the bill further protects the public through the coordination of all boards of nursing in the compact working together to protect the public. The public protection measures in the compact include FBI background checks on all nurses who receive a multistate license and sharing of significant investigative information.”
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Goals were developed for every state to become a member of the NLC, but there has been ongoing resistance from some states regarding the requirements for licensure. While the eNLC continues to grow, there are still states that still do not want to be included in the license. Even in states that have legislation pending, there is some pushback from the state nursing association.
The eNLC will continue to increase access to health care, reduce overall costs to insurance companies, hospitals, and individual patients, and support efficient and strong health care delivery.
The eNLC became effective on July 20, 2017, which allowed the Interstate Commission of Nurse Licensure Compact Administration to begin drafting appropriate rules and regulations for the new licensure.
In January 2018, new multi-state licenses were issued to all nurses who applied to transition from the old license. New nurses getting their first license in an eNLC state will be able to practice in all eNLC states without delay. This option is highly effective for travelers who do not wish to waste time between contracts. Furthermore, it helps reduce costs on application fees and license renewals. Unfortunately, Hawaii is not currently part of the eNLC and does not have any pending legislation. Hawaii is one of the most desirable states for travel nurses in the U.S.
Each eNLC state is responsible for notifying nurses by mail of the changes to the license and the process to obtain an enhanced compact license. As more states continue to join the eNLC, additional nurses will have the option to streamline if they hold multiple licenses.
So what does this mean for nurses? Nurses who currently practice in states with pending legislation do not have to do anything until the bill(s) are passed. Once the state becomes a part of the eNLC, the state board will reach out to all nurses registered with the state. Nurses then will be required to ensure their permanent address is up to date with the state board to determine compact license eligibility.
Nurses who are NOT due for license renewal will not be required to pay an additional fee to transition to the eNLC. A new license will be issued to all nurses that meet the requirements for the eNLC.
It is important to note that you must claim residency in an eNLC state to apply for a compact license. As a non-resident of an eNLC state, you can apply for licensure by endorsement for the state but will only be issued a single-state license instead of the compact license. Nurses can hold multiple single-state licenses.
Newly licensed nurses will still need to apply for a license via the state website. Applicants will then have the option to apply for the eNLC with their permanent address or apply for a single-state license. If at any time your permanent address moves to a non-eNLC, you are required to submit this to the state nursing board, and your eNLC could potentially be revoked.
Nurses are highly encouraged to sign up for the Nursys e-Notify system, which delivers real-time notifications about updates to the eNLC. It also will deliver information regarding expirations, renewals, and disciplinary actions. This service is free of charge and is a patient safety initiative that is supported by the U.S. Board of Nurses and NCSBN. More information can be found at www.nursys.com.
In terms of continuing education (CE) requirements, a nurse holding an eNLC must meet the CE requirements for his or her own state. Each state, regardless of the eNLC, requires specific CE courses and a specific number of hours. Renewal requirements are only related to the state that issued the eNLC, not the state in which the nurse practices.
Interestingly, nurses who are federal, veterans administration, military, and Indian Health Services nurses are exempt from licensure in the state of practice when they hold an active nurse license in any state. This does not apply to those who work in civilian facilities in a non federal role.
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- American Samoa
- District of Columbia
- Mariana Islands
Since the last update, California no longer has legislation for the eNLC. It was denied at both the statehouse and senate levels.
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The Commission has developed 11 uniform licensure requirements for a multistate license.
- Meets the requirements for licensure in their 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 exam (applies to graduates of an international education program not taught 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
- 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
- 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.
An applicant must meet each of the aforementioned requirements to apply for the eNLC. These requirements are specific only to the eNLC and were developed in hopes that all states would eventually join the eNLC.
The Board carefully reviewed each state’s requirements for licensure and included specifics to increase eNLC participation.
The NLC and eNLC are supported by many organizations throughout the country. A few of these include:
- American Association of Colleges of Nurses
- American Association of Neuroscience Nurses
- American Association of Occupational Health Nurses
- American Association of Poison Control Centers
- Association of Camp Nurses
- Association for Vascular Access
- Commission for Case Manager Certification
- Cross Country Healthcare
- Emergency Nurses Association
- Hospital Corporation of American Healthcare
- National Governors Association Center for Best Practices
- National League for Nursing
- National Military Family Association
- National Patient Safety Foundation
- National Student Nurses Association
- Organization for Associate Degree Nursing
- Oncology Nursing Society
- Population Health Alliance
- Telehealth leadership Council
- U.S. Department of Commerce
Unfortunately, some states and organizations do not support eNLC. Interestingly, a study conducted in 2014 indicated 70% of nurses were in favor of their state joining the compact license.
Major concerns from states unwilling to join the eNLC at this time are:
- Disciplinary actions under the eNLC
- Growth of Telemedicine and telenursing
- Loss of state revenue for new single-state licensees
- Privacy of patients
While some states are hesitant to enact the eNLC, according to the NCSBN there are over 2 million nurses currently residing in eNLC states that have the opportunity to practice in other compact states. Nurses holding compact licenses are more desirable as they can take immediate job vacancies without waiting for licensure. The NCSBN also stresses that nurses with a compact license can:
- Practice via telenursing in other eNLC states
- Respond to national disasters and staffing shortages in other eNLC states
- Educators can teach via distance learning in other eNLC states
If you reside in any of the states affected, you should stay updated on the latest developments as individual state boards begin the transition.
Here are a few helpful resources:
Official Website of the Nurse Licensure Compact
Twitter – @NurseCompact