(Refer to the Nurse Practice Act - page 17- for the Nurse Licensure Compact)
The North Carolina Board of Nursing has participated in the Nurse Licensure Compact since July 1, 2000. This interstate compact is the basis for the mutual recognition model of nursing regulation among states whose legislatures have enacted the compact. These states are called compact (party) states. Arizona, Arkansas, Colorado, Delaware, Idaho, Iowa, Kentucky, Maine, Maryland, Mississippi, Missouri (effective 06-01-2010), Nebraska, New Hampshire, New Mexico, North Carolina, North Dakota, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia and Wisconsin are participating in this interstate compact. Each of these compact states "recognizes" or honors the nursing licenses issued by other compact states. In order for nurses to have a better understanding of this new model for nursing regulation, the following questions are addressed:
Q: How will the Nurse Licensure Compact affect nurses who live in North Carolina?
A: Nurses who live in North Carolina no longer obtain (or renew) a license in any of the other states that have enacted the interstate compact. A nurse who resides in our state and holds an unencumbered North Carolina nursing license will have the ‘privilege to practice’ in any of the other compact (party) states. Only when a nurse moves to one of the other compact states will he/she be required to apply for and obtain a nursing license in that state.
Q: Where will nurses obtain/renew their license under this mutual recognition model of licensure?
A: Nurses will obtain or renew their nursing license in their primary state of residence. Primary state of residence as defined in the Compact means "the person's fixed permanent and principal home for legal purposes; domicile".
Q: Will the nurse who lives in a non-compact state and practices in North Carolina still need to have a license to practice in North Carolina?
A: Yes. Nurses who practice nursing in North Carolina but live in a non-compact state, such as Florida or Georgia, must continue to hold a license issued by the North Carolina Board of Nursing. The Nurse Licensure Compact will not change how they obtain/renew their North Carolina license. However, their North Carolina nursing license will not include the multistate licensure privilege to practice in other compact states. This privilege is extended only to those nurses who reside in North Carolina and can claim North Carolina as their primary state of residence.
Q: What does a multistate licensure privilege mean?
A: Similar to the driver's license model, this is the mechanism in the Nurse Licensure Compact that allows a nurse who is licensed in one compact state (home state/primary state) to legally practice in another compact state (remote state). It is important to understand that the Nurse Licensure Compact requires the nurse to adhere to the practice laws and rules of the state in which he/she practices. In the case of electronic practice (telenursing), the nurse must adhere to the practice standards of the state in which the client(s) receives care.
Q: How will primary residency for licensure purposes be determined?
A: Compact rules and regulations will require each nurse to declare in writing his/her primary state of residence upon initial application and renewal of the nursing license. ‘Primary state of residence’ as defined by the Compact means the "person’s declared fixed permanent and principal home for legal purposes; domicile". Sources of proof that boards of nursing may use to verify primary residence include one’s IRS tax return, voter registration or driver’s license.
A nurse changing primary state of residence from one compact state to another compact state may continue to practice under the former home state license for a period not to exceed thirty (30) days.
Q: How will employers and other members of the public verify licensure status of nurses under this mutual recognition model?
A: For nurses who hold a license issued by the North Carolina Board of Nursing, employers will continue to verify licensure status via the internet (www.ncbon.com) or through our automated telephone verification system at (919) 881-2272. Please note that verification through the internet and automated phone verification will include multistate privilege to practice information for those nurses who reside in North Carolina. Our electronic licensure databases are updated daily and serve as the primary source for nurse licensure information.
For those nurses who are licensed in another compact state and are seeking employment in NC, employers may verify the compact license via the internet using the nationally coordinated licensure information system called NURSYS. Basic licensure information as well as disciplinary history for a licensee is provided through this system at no charge. NURSYS website for license verification is www.nursys.com.
Q: How will complaints about nurses be handled within this mutual recognition model?
A: The compact authorizes the nurse licensing board of any compact state (home or remote) to investigate allegations of unsafe practice by any nurse practicing in that state. Based upon the outcome of the investigation, a remote state licensing board may deny the nurse’s privilege to practice in that state. Only the nurse’s home state (state of residence) licensing board may take action against the nurse’s license. States will continue to apply the same administrative and due process procedures for imposing discipline as they have always done. However, compact states will have more timely access to information, including current significant investigative information and the disciplinary history of nurses, through the coordinated licensure information system (NURSYS).
Q: Will nurse practitioners (NPs), certified nurse midwives (CNMs) and certified registered nurses anesthetists (CRNAs) be affected by the Nurse Licensure Compact?
A: In North Carolina, the NP, CNM and CRNA must hold a current license in NC or another compact state to practice as a registered nurse in order to be granted approval to practice as a NP or CNM or to meet requirements for practice as a CRNA. The Compact only affects where the RN license is obtained, i.e. in the NP or CNM or CRNA’s state of residence. The Compact will not affect any other aspects of the initial or renewal process for approval to practice as a NP or CNM or verification of CRNA. For additional assistance with NP or CNM, contact Jean Stanley at (919) 782-3211 ext 252.
Q: How do I get more information about mutual recognition and the Nurse Licensure Compact?
A: The Nurse Licensure Compact (Article 9G of the Nursing Practice Act) and other information related to the mutual recognition of nursing regulation is available on our website (www.ncbon.com). The National Council of State Boards of Nursing (NCSBN) also has a website (www.ncsbn.org) that offers further information on the Mutual Recognition model. This website may be accessed directly or through the NC Board of Nursing’s website. If you have specific questions about this new model of nursing regulation or wish copies of the Nursing Practice Act, including Article 9G, you may call the Board office at (919) 782-3211 or email us at ncbon.com.
Q: What other states are planning to implement the Nurse Licensure Compact in the next year?
A: Other states are planning to seek legislation for implementing the Compact in the next few years. You may visit the National Council of State Boards of Nursing website for further updates.