On Jan. 19, 2018, the enhanced Nurse Licensure Compact (“eNLC”) was implemented, expanding, and in some cases limiting, the ability of nurses to practice across state lines. The eNLC is an update to the Nurse Licensure Compact (“NLC”), which was originally implemented in 2000.

Nursing licensure is regulated on a state-by-state basis, by state statute and by each state’s Board of Nursing. Each individual state has the power to regulate health care practitioners within its borders and the provision of health care services within the state.

In recent years, telenursing, the provision of nursing services where a large physical distance exists between the patient and nurse, has become more prevalent. In the interest of increasing access to care while maintaining public protection at the state level, the National Council of State Boards of Nursing created the NLC to allow for mutual recognition of licensed nurses.

Under the eNLC, a nurse who secures a license in his or her home state can then practice in any state participating in the compact without obtaining additional licenses, provided he or she follows that state’s laws and regulations with respect to the practice of nursing. Licensing standards are aligned across eNLC states, so all applicants for a multistate license are required to meet the same standards, which include, among other requirements, federal and state fingerprint-based criminal background checks.

In original NLC states that enacted the new eNLC legislation, a nurse who held an NLC multistate license is grandfathered into the newly implemented eNLC. Nurses in eNLC states who did not hold an NLC multistate license, and nurses in eNLC states that were not original NLC states, will need to meet the eNLC uniform licensure requirements and submit a new application.

In NLC states that have not enacted eNLC legislation, the NLC multistate license will now cover the license-holder’s practice only in those NLC states that are not also eNLC states. Such a nurse wishing to provide nursing services in eNLC states will then have to apply for a license there.

In states that have not adopted either the NLC or eNLC, including Ohio, a nurse must still obtain a state-specific nursing license in order to provide nursing services.