Down goes a jurisdictional barrier to telehealth: Nurses interested in expanding their practice can now practice via telehealth in multiple states under the Enhanced Nursing Licensure Compact (eNLC) multistate license.
The National Council of State Boards of Nursing announced the implementation of the Enhanced Nursing Licensure Compact on January 19, 2018. The eNLC is a multistate agreement between 29 states (and counting) that creates an interstate commission to oversee the rulemaking and issuance of a multistate nursing license.
The eNLC was initially approved in July 2017, with sights set on a January 2018 implementation. After passing its final stage, the eNLC allows nurses to practice in person, or via telehealth, across states that are a part of the compact. The types of nurses covered by the eNLC include registered nurses, licensed practical nurses and vocational nurses (there is a separate compact for advanced practice nurses called the Advanced Practice Registered Nurse Compact.)
With eNLC’s passing, a new set of uniform licensure requirements are established for nurses to obtain the multistate license that requires nurse applicants to meet their home state’s licensure qualifications, graduate from an approved nursing education program, pass a background check and hold an active unencumbered nursing license. Nurses interested in practicing across state lines can apply for the multistate license through the nursing board of their home state.
The eNLC is a follow up to its first iteration, the Nursing Licensure Compact, that went in to effect in 2000. Nurses currently with multistate licenses under the original compact will be grandfathered into the eNLC and its compact states, and do not need to meet the new eNLC licensure requirements.
Some of the compact states in the eNLC include Kentucky, Tennessee, Texas, and West Virginia. Among the non-participating states are Ohio and Pennsylvania, which show no sign of joining the compact. Opponents to the eNLC, like the Washington State Nursing Association (WSNA), disagree with the interstate commission, created by the eNLC, and its authority to make binding decisions on compact states. The WSNA also pointed out that nurses may not be aware of the different scopes of practice between the states, which may be an issue when practicing across state lines via telehealth.
With the implementation of the eNLC, a licensed nurse residing in compact states may treat a patient located in any of the compact states under one multistate license. Nurses are further enabled to provide services via telehealth with the added protection and standards of the eNLC. Of course, whether these services will be reimbursed is another question.