Will Interstate Compacts turn into National Licensure?

POSTED BY AMN HEALTHCARE

Whether you’re in Maine or Hawaii, Florida or Alaska, all people deserve the same high-quality healthcare. So, shouldn’t the quality standards for the physicians, nurses and other healthcare professionals — who provide patient care — be the same no matter where you live?

A movement is slowly progressing for healthcare professionals to be licensed in multiple states through a single, simplified process. Nursing is way ahead of other professions in interstate licensure. If you qualify for the Nurse Licensure Compact, you can practice in all 31 compact states. It’s the only true multistate license.

The physician compact includes 24 states so far. However, under the medical licensure compact, applicants must apply separately for multistate privileges and pay for individual licenses in each state.

For physical therapists and physical therapist assistants, if you meet all the requirements in a compact state, you can purchase compact privileges in other compact states. So far, only six states accept compact privileges, but more than a dozen other states have enacted.

A model for an interstate Advanced Practice Nurse Compact recently began and will be implemented when ten states have enacted legislation. For all other healthcare professions, licensure is strictly state by state.

While progressing slowly, the interstate compacts could eventually lead to nationwide licensure instead of state-by-state. While the path to that goal will still take years, there is growing recognition that national licensure would be a big improvement for patients, patient care facilities and healthcare professionals themselves.

There’s no evidence that healthcare professionals in one state are better or worse than in other states. Yet, in most parts of the country, healthcare professionals who can commute to several states in an hour or two must have separate licenses to work in each state. For example, if you live anywhere in the New York metropolitan area, you must have separate licenses to practice in Connecticut, New York, New Jersey or Pennsylvania, even though you could commute to those states to pick up shifts or take patients in an hour or two — or much less time.

The national licensure movement should gain steam as more states join interstate compacts. Greater flexibility for clinicians and providers, improved patient access to care, and reduction in costs and redundancy could be strong arguments in state legislatures considering licensure compact legislation. State lines would no longer block telemedicine. Underserved areas in rural and urban areas would be able to draw upon more healthcare professionals. As more and more states join in, national licensure could become inevitable.

National licensure is a popular concept. A 2017 survey of registered nurses by AMN Healthcare found that 68% supported national licensing instead of state-by-state, and among Millennial nurses, 77% supported it. Instead, resistance to this change is probably just the inertia of bureaucracy. Plus, passing state-by-state legislation on anything is a cumbersome process.

In the conversation about the evolution of healthcare in the United States, and particularly the movement to value-based care, interstate compacts -- and eventually national licensure for all healthcare professionals — should be an important factor. It’s win-win for all involved — especially the patient.

By Ryan Anholt, Vice President of Travel Recruiting
Provided by NATHO Member, The Delta Companies

It has been said that the best defense is a good offense—why wouldn’t this theory extend to patient care? For facilities utilizing healthcare traveler services, the best defense against the risk of liability is to employ providers with up-to-date licensure, background records, and training. When choosing to partner with a staffing agency in the search for such providers, accreditation from The Joint Commission is the quarterback of the healthcare-staffing field, providing a comprehensive evaluation of a staffing firm’s ability to present qualified and competent staffing services. 

In order to maintain The Joint Commission’s Healthcare Staffing Services Certification, staffing firms undergo rigorous and systematic onsite surveys, which ensure the firm is achieving all requirements set in place to qualify for certification. Certified firms are responsible for verifying licensure; conducting education and training programs related to infection control, cultural diversity, and The Joint Commission’s National Patient Safety Goals; assessing competency; performing background checks; and ensuring all personnel records are up to date. 

As a certified firm, Delta Healthcare Providers requires the following documents from all travelers on contract assignment: 

• Resume 
• Summary of all licenses active and inactive 
• Excluded parties list search 
• Office of inspector general search 
• Online verification of state licensure needed for this assignment 
• Annual Self Assessment Skills Checklist 
• Criminal Background check by county 
• CPR Basic Life Support for Healthcare Providers 
• Annual 9-Panel Drug Screen 
• Annual TB screening 
• 3 Professional References 
• Certificate of Professional Liability 
• Certificate of Worker’s Compensation 

These are the minimum requirements set to maintain The Joint Commission certification. Delta Healthcare Providers offers copies of these documents to clients prior to a traveler’s assignment. If a client requires additional documentation for an assignment, Delta Healthcare Providers has a prepared list of vendors ready to fill these needs.  

In addition to maintaining certification, tracking the above materials also holds a staffing organization and the talent they represent accountable to unwavering standards. This parallel creates a mutually beneficial relationship between a hiring facility and healthcare traveler. Facilities engaging in staffing services can be assured that the healthcare providers represented by an accredited agency are screened and fully oriented prior an assignment. 

Additionally, since all documentation and personnel records are in order, incoming healthcare providers can begin an assignment fully focused on their work, instead of the fine print. 

A database of certified healthcare-staffing agencies associated with The Joint Commission can be found at qualitycheck.org. By partnering with an agency prepared to hold themselves accountable to nationally recognized standards, hiring facilities relinquish the threat of liability in travel opportunities to a team prepared to evaluate and administer all necessary requirements specific to each assignment. This structure allows facilities and providers the peace of mind necessary to continue being all-stars in their field, and to focus on exceptional patient care.