Nurse Licensure Compact Celebrates 25 Years of Multi-State Practice

• The Nurse Licensure Compact released its annual report alongside its celebration of 25 years of multi-state practice. 
• Connecticut joined the NLC in fiscal year 2024, with Massachusetts joining just a couple months later. 
• The NLC hopes to include all U.S. states and territories in its ranks. 

The Nurse Licensure Compact has helped streamline the nursing profession for a quarter century and is only a handful of states away from including the entire country. 

“The NLC … has been of great assistance to regulators, nurses, patients, and to military families, earning the formal support of the U.S. Department of Defense,” NCSBN CEO Phil Dickison, PhD, RN, stated in a news release. “The NLC also provides the best possible preparation in the event of emergencies, natural disasters, and national events because a workforce that is already vetted and immediately available can be called upon.” 

In fiscal year 2024, Connecticut became the 42nd state to join the NLC, and “significant progress” with advocacy efforts was made in Alaska and Massachusetts, according to the NLC’s 2024 Annual Report. The National Council of State Boards of Nursing recently released the report, which spans from Oct. 1, 2023, to Sept. 30, 2024. 

Significance of the NLC’s Multi-State Practice

The Nurse Licensure Compact was established to make multi-state practice — virtually and in person — easier for registered nurses and licensed practical nurses.

It also: 

• Facilitates online nursing education;  
• Removes “burdensome expenses” on employers;  
• Facilitates speedy disaster response across state lines;  
• And “makes practicing across state borders affordable and convenient,” according to the NLC.  

The response to natural disasters like the hurricanes that swept over the east coast in 2024 relied, in at least some capacity, on the NLC to assist with medical care. 

A survey published in 2024 in the Journal of Nursing Regulation found that 96% of respondents who had practiced using their multistate license indicated the compact was “beneficial to their nursing practice.”  

“These high rates of support for the NLC were consistent across study states, as well as across most demographics, including respondents’ state of residency, practice patterns, and union membership,” the study authors stated. 

Connecticut Joins the NLC

Last May, Gov. Ned Lamont signed into law Connecticut’s addition to the NLC, with membership beginning this October and running through Jan. 1, 2028. 

“Nursing shortages have put tremendous pressure on the nursing workforce throughout our country, and if we want to improve access to care we must do more to encourage workers to enter this profession and help hospitals and health facilities fill their staffing needs,” Lamont stated in a news release. “By entering into this compact with our fellow states, we can eliminate burdensome red tape faced by nurses and aspiring nurses and expand the pool from which hospitals and health facilities can hire.” 

The Connecticut Nurses Association opposed joining the NLC, citing a loss of confidentiality for nurses using the Health Assistance InterVention Education Network (HAVEN), the state’s confidential program for nurses that provides support to individuals with a chemical dependency, emotional/behavioral disorder, or physical/mental illness. 

FY24 NLC Progress

Efforts were made in the following states to enter the NLC, but the annual report stated that legislation stalled or failed to pass: 

• Hawaii: A bill that would have established the NLC failed to advance out of the conference committee. The Hawaii chapter of the American Nurses Association opposes the state entering into the NLC. 
• New York: Gov. Kathy Hochul allocated for the state joining the NLC in her 2025, but the bill was held for consideration. New York’s ANA chapter supports the state joing the NLC, while the New York State Nurses Association is opposed. 
• Alaska: Efforts have been ongoing since 2020 to add the Last Frontier to the NLC, but to no avail. However, legislation was introduced once again for the 2025-26 legislative session. 
• Massachusetts: Entering the NLC was part of an economic development omnibus bill, but no movement occurred. However, Gov. Maura Healy signed legislation last November enacting the NLC — just a couple months into the next fiscal year. 
• Minnesota: Amendments to licensure compacts would have included the NLC, but “they failed by one vote,” according to the annual report. 

The Bottom Line

The Nurse Licensure Compact, which celebrates its 25th anniversary this year, added Connecticut to its list of compact states during the last fiscal year. It was the only state added in that timeframe, but forward movement occurred in a handful of other states as the NLC works to bring all U.S. states and territories into the compact. 

Read More