Current eNLC States and the Impact on Nurses

The eNLC Breaks Down Licensure Barriers for Telehealth Nurses

For the past eighteen years, the Nurse Licensure Compact (NLC) has predominantly operated out of twenty-five states. The NLC was a big success for nursing eighteen years ago because it effectively allowed nurses to maintain their license from the state where they were residing, while working in another state without getting an additional nursing license. This progressive leap forward helped nurses find work more easily, while also addressing the nursing shortage in a collaborative manner—nurses could then practice in other participating states.

Telehealth however is something new. The NLC didn’t account for technology playing such a key role in the actual delivery of healthcare. So while nurses were allowed to practice across state lines, they weren’t able to do it using Telehealth until now.

Using Telehealth Transforms Healthcare Delivery

Since the NLC was initially launched there have been great strides in the advancement of technology, telecommunications, a more mobile nursing force and a growing patient population. All of these factors have contributed a need to further break down state barriers to practice.

Telehealth is a result of that need and is transforming healthcare by extending care outside of hospital doors and into people’s homes, no matter the distance. Even though we have Telehealth technology, nurses and other medical professionals are stopped by state laws that prevent them from practicing without applying for a license in that state. The eNLC however is a contract between states that have all set the same standard.
If you can maintain a license in your home state, you can practice in a fellow participating state.
This removes licensure barriers for more than 4 million telehealth nurses!

A Call to Push the Nurse Licensure Compact Forward

The NLC provides nurses the freedom to cross state lines and helps fill the gaps in patient care; it’s a solution and a good one. Sadly, after the last eighteen years, progress has stalled. A little better than half of the country belongs to the NLC and that’s remarkable, but to continue advancing and providing seamless patient care to the ever growing population, all fifty states need to join.

The National Council of State Boards of Nursing Draft the Enhanced Nurse Licensure Compact

In 2015, The National Council of State Boards of Nursing (NCSBN) and the executive directors from each state board gathered to discuss possible solutions to expand multi-state licensure to include all states. Board members passionately reviewed existing legislative challenges and barriers with regards to every state joining in the NLC. Members were able to reach an agreement and draft a solution now known as the enhanced Nurse Licensure Compact (eNLC).

The Enhanced Nurse Licensure Compact Has 11 New Licensure Requirements 

For the most part, the eNLC and the NLC mirror one another in their mission to reduce regulatory requirements and provide solutions to practicing across state lines. In order to satisfy multi-state tastes, a few changes were adopted to the original NLC. New nurses (those who obtained a license after July 20, 2017) must meet these 11 requirements before qualifying for a multi-state license:

  • Proof of identity~ The nurse must possess a valid social security number.
  • School & education~ The nurse must graduate from a board-approved school of nursing.
  • Board examination~ The nurse must pass the National Council Licensure Exam (NCLEX).
  • Home state~ The nurse must meet their home states’ nursing licensure requirements.
  • English proficiency~ If the nurse is a foreign graduate, the nurse must pass an English proficiency exam.
  • Disciplinary action~ The nurse must possess a license that is currently not under disciplinary action.
  • Disciplinary program ~ The nurse cannot be currently enrolled in an alternative-to-discipline program.
  • If they are in an alternative to discipline program, they are required to self-disclose this information.
  • Criminal record~ The nurse cannot have a felony record.
  • Additionally, the nurse must not have a misdemeanor related to their nursing practice on their record.
  • Background check~ The nurse must be willing to submit to a federal criminal background check.

Which States Are Part of eNLC?

Twenty nine states have enacted eNLC legislation and implemented it this year (January 19, 2018), meaning nurses are now able to practice in any participating state. Nurses with a NLC license who are currently working in a eNLC member state have nothing to worry about regarding this transition; they are grandfathered in and protected by legislation. The following are eNLC states:

Arizona Arkansas Colorado
Delaware Florida Georgia
Idaho Iowa Kentucky
Maine Maryland Mississippi
Missouri Montana Nebraska
New Hampshire New Mexico North Carolina
North Dakota Oklahoma South Carolina
South Dakota Tennessee Texas
Utah Virginia West Virginia
Wisconsin Wyoming

Striding Forward

Telehealth breaks through geographical boundaries and helps providers deliver high-quality healthcare and especially so in underserved areas. With this licensure compact, twenty-nine states made the practical decision to come up with a singular set of requirements that works for them all. Because of this decision, providers have the freedom to relocate while maintaining their livelihood and they can use Telehealth to consult virtually to a broader patient base. The flexibility on them will greatly address the shortage of nurses in an area and patients in need will benefit.

The combination of the eNLC and Telehealth is a powerful tool for patients and nurses. If you’re a nurse looking to use Telehealth, contact us or test out our free trial.