Nurse Licensure Compact Gets Important Hearing on Tuesday

An important piece of legislation that was close to passing pre-pandemic is once again receiving attention, and the hospital community – beset by unprecedented staffing shortages – is hoping that the Massachusetts legislature is able to quickly pass the law that will allow Massachusetts to join 38 other states in entering the Nurse Licensure Compact (NLC).
On Tuesday, the Joint Committee on Health Care Financing will hear testimony on H.1284/S.163, An Act Relative to Nurse Licensure Compact in Massachusetts. The NLC allows R.N.s to have one multistate license from the state in which they reside, with the privilege to practice in their home state and all others that are members of the Compact. Nurses must go through stringent licensing requirements – including criminal background checks – to join the Compact. Currently, nurses applying for licensure in Massachusetts are not required to undergo a background review (although many hospitals use resources to conduct their own background checks). In New England, Maine and New Hampshire are Compact states and Vermont will be in 2022.
In non-Compact states such as Massachusetts, R.N.s wishing to practice must go through a lengthy, resource-intensive review by the state licensing board. Hospitals report that a lengthy state review often results in a nurse who is offered a job in Massachusetts ultimately choosing to immediately practice elsewhere as opposed to waiting for the Massachusetts approval. (Emergency executive orders during the pandemic allowed some flexibility on the nurse licensing approval process, but those orders are scheduled to expire.)
In May 2021, the state’s Health Policy Commission (HPC) voted to recommend that Massachusetts join the Nurse Licensure Compact. An HPC study, which was mandated by a provision in the FY2021 budget, found that Massachusetts will experience slower growth in the RN labor market in coming years, meaning it may need to find nurses from other states to fill vacancies. The NLC would also help Massachusetts “react more dynamically to unforeseen and sudden changes in nursing needs, during pandemics and other emergencies,” the HPC found.
A recent study from the Mercer group on the U.S. labor market projects that Massachusetts is one of the top five states that are projected to experience the greatest gap between nursing demand and supply over the next five years. Mercer projected that by 2026, if current trends continue – that is, many nurses leaving the profession and a paucity of new entrants – Massachusetts will have an R.N. vacancy rate of more than 7,500.
“While we know that the NLC is not a cure for the current nationwide nursing shortage and that all healthcare providers have struggled to maintain a robust workforce during the pandemic, if Massachusetts were to adopt the Compact it would allow providers to staff up quickly in times of an endemic event or flu outbreak,” said Patricia Noga, R.N., MHA’s vice president of Clinical Affairs. “During certain times of the year, healthcare facility staffing is stressed, not only due to increased patient volume but also loss of healthcare workers due to the spread of illness. Lacking our participation in the Compact, nurses licensed in contiguous states would be unable to immediately assist Massachusetts facilities during flu season.”
Another benefit of Massachusetts joining the NLC is that it will allow Massachusetts-based nurses “to follow” their patients by telemedicine over state lines into other Compact states. Because so many patients come from out of state to seek the renowned medical care Massachusetts hospitals offer, those patients want to maintain contact with their trusted caregivers – their nurses – when they return home. “The COVID-19 pandemic highlighted the importance of and potential for telehealth and demonstrated the need to remove barriers to cross-state practice in order to strengthen the ability of the healthcare system to adapt care delivery modes and respond to needs more flexibly in a post-COVID-19 world,” the HPC wrote in its May report.
In addition to MHA’s strong endorsement of the NLC over the years, the Compact is endorsed by many other healthcare groups, including Organization of Nurse Leaders, MA-RI-NH-CT-VT; American Nurses Association Massachusetts; National Council of State Boards of Nursing; Massachusetts-Rhode Island League for Nursing; Emergency Nurses Association Massachusetts State Council; Conference of Boston Teaching Hospitals; Case Management Society of New England; Night Nurse, Inc.; Maxim Healthcare Services; AARP Massachusetts; Home Care Alliance of Massachusetts; Atrius Health; and Fresenius Medical Care North America.