Multistate Licensure

Avoiding Liability Bulletin – September 15, 2014

You may have applied for and were granted nursing licenses in several states as you moved to a new state, started a new job, or advanced your career. Indeed, many practicing nurses today hold several professional nursing licenses in different states, and this is quite common when the states of the granted licenses are close to each other, such as Illinois and Indiana or New York and New Jersey, allowing for more job opportunities nearby your home.

Prior to the acceptance of the Nurse Licensure Compact (NLC) developed by the National Council of State Boards of Nursing in 2000, you had to apply for a license in each state in which you practiced. With the NLC, an RN and LPN/LVN can possess one multistate license in the nurse’s primary state of residency (the “home state”) and practice in other states that are part of the NLC (the “party states”).¹ With the multistate license, the nurse can practice across those state lines physically or electronically.²

Each state that adopts the NLC must do so through its state legislative process. The state board of nursing then administers the NLC through its powers to grant nursing licenses.³

Advanced Practice Nurses (APNs) are not included in the current NLC. As a result, they must apply for a license to practice advanced practice nursing in each state they elect to practice. The National Council has developed a Consensus Model for APN Practice and it is currently being evaluated by state legislatures and APN professional associations.⁴

RN and LVN/LPN eligibility for a multistate license requires that the nurse legally reside in a compact state and affirm that state as the primary state of residence. A separate application for a multistate license is not needed. Nor are fees or an additional application required when practicing in a party state. The home state license is accepted by the party state as a privilege to practice in other compact states.⁵ A nurse can only hold one multistate license at a time, however.

Despite the ease with which the multistate license provides for nursing practice in different states, the nurse with a multistate license must not only conform to the home state’s practice act and rules but also meet the requirements of the party state. These requirements include meeting continuing education mandates and adhering to the requirements of both nurse practice acts and their rules.

In addition, a nurse who holds a multistate license can be disciplined by either state if there is a violation of the applicable nurse practice act and rules. If a discipline does occur in one of the states, multistate privileges may be discontinued and the nurse’s practice restricted to the home state. ⁶

To avoid any potential liability for practicing without a required license when holding a multistate license, be sure to:

1. Know the requirements of the multistate license in terms of properly declaring your home state;
2. Only practice in party states that are members of the NLC;
3. If deciding to work in a non-party state, remember that you must apply for a license to practice nursing in that non-party state as the multistate license is not applicable there;
4. Remember that a violation of the nurse practice act in any of the states in which you practice under a multistate license can result in discipline in all of those states;
5. If declaring a new home state (of residency), follow the guidelines and valuable information available at https://www.ncsbn.org/nurse-licensure-compact.htm; and
6. Continually utilize the additional resources about the NLC , member states and other details at https://www.ncsbn.org/nurse-licensure-compact.htm.

FOOTNOTES

1. National Council of State Boards of Nursing (nd). “Nurse Licensure Compact(NLC): Fact Sheet For Licensees and Nursing Students”.

2. Id.

3. National Council of State Boards of Nursing (nd). “Nurse Licensure Compact(NLC): Fact Sheet for Legislators”.

4. National Council of State Boards of Nursing (nd). “The APRN Consensus Model.” Available at www.ncsbn.org. Click Policy and Legislative Affairs tab.

5. “Fact Sheet for Licensees and Nursing Students”, supra note 1.

6. Id.

THIS BULLETIN IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT TO BE TAKEN AS SPECIFIC LEGAL ADVICE OR ANY OTHER ADVICE BY THE READER. IF LEGAL OR OTHER ADVICE IS NEEDED, THE READER IS ENCOURAGED TO SEEK ADVICE FROM A COMPETENT PROFESSIONAL.