Nurses now joined by physical therapists in growing interstate licensing compacts
A push toward multistate licensure for healthcare professionals began with the nursing industry and has expanded to include physical therapists and physical therapy assistants.
Thus far, 26 states have joined the Nurse Licensure Compact (NLC), while 14 states have approved the Physical Therapy Licensure Compact. The compacts will augment the existing system that requires these healthcare professionals to be separately licensed in each state where they practice, allowing for interstate recognition of licensure in states where specific legislation is enacted.
The “why” behind multistate licensure
For years, the need to be licensed in each state has hampered the ability of nurses and physical therapists to easily take up residence and begin working in another state or to travel across state lines to provide care.
Organizations representing nurses and physical therapists that support multistate compacts say they will give patients greater access to quality care, facilitate telemedicine across state lines, and provide healthcare organizations with larger numbers of qualified professionals.
Multistate licensure may eventually bring uniformity to practice standards. Under the current system, individual states have their own scope-of-practice definitions for licensing of nurses and physical therapists.
While the NLC has been in operation for many years, the Physical Therapy Licensure Compact still has details to be worked out prior to full implementation.
Overview of the Nurse Licensure Compact
The idea for multistate licensure agreements dates back to 1997, with the original adoption of the NLC and its implementation in 2000.
Sponsored by the National Council of State Boards of Nursing, the NLC gives registered nurses and licensed practical/vocational nurses the ability to practice in other nursing compact states without having to secure an additional license. The multistate nursing license is issued by the nurse’s primary state of residence, which must also be a compact state.
Over the years, some states expressed concern about joining the nurse licensing compact, primarily due to differences in background check rules. This led the National Council of State Boards of Nursing to develop an “enhanced” nursing compact in May 2015, based on higher standards. The enhanced Nurse Licensure Compact (eNLC) includes state and federal criminal background checks, restrictions from acquiring a multistate license if ever convicted of a felony, and a variety of uniform licensure requirements, including for renewal and reinstatement.
All states, including those participating in the existing NLC, must introduce legislation in the coming years to enter into the enhanced NLC, according to a press release by the National Council of State Boards of Nursing. Nurses with an original NLC multistate license will be grandfathered into the eNLC, according to the National Council.
Overview of the Physical Therapy Licensure Compact
The Federation of State Boards of Physical Therapy began exploring the development of an interstate licensure compact for physical therapists and physical therapy assistants in 2010, and by 2014, the Physical Therapy Licensure Compact was adopted. In developing the Compact, the Federation cited a need to increase consumer access to physical therapy services by reducing regulatory barriers to interstate mobility and cross–state practice.
In March 2016, Oregon became the first state to sign the physical therapy compact into law, and since that time 13 states have followed suit. Implementation of the Physical Therapy Licensing Compact is based on the establishment of a commission—a governing body composed of representatives from every participating compact state. The Commission will oversee rules, applications and the issuing of multistate licenses.
Once the system is up and running, physical therapists and physical therapy assistants will be able to apply for multiple state licensing privileges, while maintaining licensure in their home compact state.
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