The Honorable Bill Nelson

United State Senate

1301 Riverplace Blvd.
Suite 2010
Jacksonville, FL 32207

RE: Interstate Nurse Licensure Compact

Dear Senator Nelson,

The legislation addressing Interstate Nurse Licensure Compact is of paramount interest to

me because I am a Register Nurse practicing in the state of Florida. This issue directly impacts,
my profession, the way we as professionals will be able to function in relocating from one state
to another with the endorsing practices of each stated. Traditionally in the U.S., health care
professionals wishing to practice within a state or territory are required to be licensed by that
jurisdiction or multiple jurisdictions if crossing borders.

The regulatory landscape began to change in 2000 when Maryland signed into law the
first health care compact, the Nurse Licensure Compact (NLC). Created by the National Council
of State Boards of Nursing (NCSBN), the NLC reflects an interstate agreement permitting
registered nurses (RNs) and licensed practical/vocational nurses (LPN/LVNs) to have one
license. The license issued by the primary state of residence gives the nurse the privilege to
practice in other compact states (both physically and via technology) without having to secure an
additional license. Similar to the drivers license model, should the nurse change the state of
residence, a new license must be secured in the new state while surrendering the former
multistate license.

I am primarily concerned about the State of Florida not actively participating in this
scope of practice. Since the inception of the NLC, 25 states have joined. In May 2015, the
National Council of State Boards of Nursing (NCSBN) adopted two new Compacts: the
enhanced RN Compact and the APRN Compact. The enhanced Compact is intended to
replace the NLC and must be advanced through state legislatures and signed by the Governor to
go into effect. The NCSBN reports the newer version is based on higher standards which
include: (1) required criminal background check (CBC) (state and federal) on initial licensure
and (2) restriction from acquiring a multistate license if ever convicted of a felony. (3)
Additionally the enhanced Compact must include the NCSBNs Uniform Licensure
Requirements (ULRs). The ULRs establish consistent standards for initial, endorsement; renewal
and reinstatement licensure needed and must be adopted by any Compact state.

In 1997, the National Council of State Boards of Nursing Delegate Assembly established
the Nurse Licensure Compact. Under the compact, licensed practical and registered nurses enjoy
the privilege of practicing in all member states by maintaining a single license in their primary
state of residence. The Nursing Licensure Compact removes complications for nurses practicing
in multiple states. Nurses from NLC states are able to work across state lines without having to
worry about applying for licensure in each state or being burdened by multiple renewal
requirements and fees. With more nurses practicing across state lines, state boards of nursing are
coordinating and advocating for more than ever before helping to expand the mobility of nurses
as part of the nations wider healthcare system.

As of July 24, 2017 North Carolina Gov. Roy Cooper signed legislation making his state
th
the 26 to join the enhanced Nurse Licensure Compact (eNLC), triggering enactment of a
compact that allows registered nurses (RNs) and licensed practical/vocational nurses (LPN/VNs)
to have one multistate license, with the ability to practice in person or via telehealth in both their
home state and other eNLC states. Lets make Florida as part of this historic moment for all
nurses working within your states of Florida

Although I have read reports of your position in the newspapers, I realize this may not
fully represent your viewpoint. Therefore, I will look forward to your reply expressing your
opinions, and your current stance on the issue. Thank you for your consideration of my
viewpoint on this matter. I believe it is an important issue, and would like to see the legislation
pass, to ensure effective educational services for all nurses throughout the state of Florida.

Sincerely,

Jacksonville University Student

2800 University Blvd N.
Jacksonville, FL 32211