There's an amendment to the Senate Ways & Means Committee budget being debated this week that can improve patient care and simultaneously save nurses money by reducing the burden of holding and paying for multiple licenses in several states. It's amendment #622, filed by Sen. Don Humason (R-Westfield), which would adopt the National Nurse Licensure Compact here in Massachusetts.
Similar to a driver's license, which allows someone to be licensed in one state and also have the privilege of driving in other states, the Nurse Licensure Compact allows nurses to receive a multistate license in the state they reside, with the privilege to practice in both their home state and all other states that are members of the NLC.
Massachusetts has long been an innovator and model when it comes to providing high quality patient care. But on this effort, Massachusetts is lagging badly. Twenty-five states have already adopted the NLC, including Rhode Island, New Hampshire and Maine. But our commonwealth notably remains on the sidelines.
Membership in the NLC would reduce licensure costs and streamline the process for Massachusetts nurses looking to work across state lines, as well as for nurses from other Compact states looking to work here. Such licensure in the commonwealth is currently done by endorsement, and the process can be administratively burdensome, time-consuming, resource-intensive, and may unnecessarily delay registered nurses from starting a new job, joining a new patient care team and providing care.
For example, an organization that employs nurses working telephonically in multiple states has found that seeking licenses state-by-state (licensure by endorsement) costs double what it costs to employ nurses from Compact states. And local nurses seeking licensure by endorsement for their work in a telemedicine program had a nine-month lag between their initial application and the time they received their licenses. That is a huge time and resource burden for both nurses and healthcare organizations.
Over 14,000 nurses in Massachusetts would directly benefit from joining the NLC by eliminating the burden of maintaining multiple, costly licenses for every state that they practice in. The nursing community strongly supports this legislation and it has been endorsed by the Organization of Nurse Leaders of Massachusetts, Rhode Island, New Hampshire and Connecticut (ONL) and the American Nurses Association of Massachusetts. Even union nurses – many who work in case management programs providing critical follow-up care to patients – support the amendment. According to a survey from the National Council of State Boards of Nursing, 60% of union nurses in Massachusetts support joining the Nurse Licensure Compact.
By joining the NLC, Massachusetts can help ensure the availability of licensed nurses during natural or man-made disasters, which do not recognize state lines. Membership in the NLC clarifies the authority to practice for nurses currently engaged in tele-nursing, interstate practice, or other models of contemporary nursing practice that are part of the healthcare reform efforts of the Affordable Care Act and the commonwealth's Chapter 224 cost containment law. Eliminating existing regulatory barriers and uncertainties allows nurses to provide patient-centered care across the continuum of care, wherever patients need it and in a manner that is cost-effective.
The Massachusetts Board of Registration in Nursing's role in patient safety and public protection is also enhanced through the NLC by ensuring earlier identification of nurses facing adverse actions in other states, as only NLC member states can access the database of actions that may be pending against a licensed nurse in other states. This information-sharing also facilitates an accurate understanding of the nursing population. When we know how many nurses we have regionally, and where and when they work, employers and other stakeholders can design appropriate strategies for education, recruitment, employment, training and retention. This will improve healthcare quality and patient safety both now and in the future.
Massachusetts should join the Nurse Licensure Compact. It is the right thing to do to ensure patients receive the best possible care. Joining the NLC aligns with our state's proud history, current reality and future aspiration as a leader in healthcare quality and innovation.