Is New Jersey Going to Join the Nurse Licensure Compact?

Is New Jersey Going to Join the Nurse Licensure Compact?

Nursing shortages are a grave threat to public health and affect nearly every state across the nation. New Jersey is certainly no exception to this rule. Experts predict that by the year 2030, the workforce in NJ is going to be lacking about 11,400 nurses in order to meet the demand for medical services in the state.

Impeding worsening of this nursing shortage has caused the two-decade-old debate over whether New Jersey will join the enhanced Nurse Licensure Compact (eNLC) to re-emerge. Just last month, a big step was taken in the direction of adding New Jersey to the agreement that will allow nurses licensed in the state to freely practice in the 29 other states already in the agreement – and it will also open the doors for those same nurses in compact states to practice in New Jersey.

New Legislation that Adds the Garden State to the eNLC has been Introduced

On February 21, 2019, the New Jersey State Senate approved in a unanimous vote a piece of legislation that will authorize the state to participate in the multi-state Nurse Licensure Compact which is known as the eNLC. This is a national program that provides mobility and freedom for nurse professionals to work in multiple states in order to combat the plague of nursing shortages affecting the US. Other technology is also propped up by the nursing license compact through the support of telemedicine and other care delivery that crosses state borders.

How Does the Enhanced Nurse Licensure Compact Work?

While there is still a final vote needed in the Assembly, the eNLC model that has been outlined in the NJ legislation would require nurses to meet the licensing qualifications set forth by the state in which they reside, whether that be NJ or another member state.

When any travel nurse in the compact is working and providing care, they must still meet all of the regulations set forth by the state in which they are practicing. Furthermore, the multi-state compact also has a shared database in which all states must enter any nursing violations into the system.

What are the Concerns Over NJ Entering the eNLC?

While many are in full support of the Garden State becoming the next to join the eNLC, there are some nursing groups who remain opposed to the change. What are their reasons?

New Jersey is a bit heavy when it comes to the requirements needed from its nurses. In some cases, the standards for nurse licensing in New Jersey are higher than other participating jurisdictions. Could allowing nurses from other states who adhere to fewer restrictions diminish the quality of care provided to patients in the Garden State? This is a valid question which concerned parties have expressed.

What are the Benefits of New Jersey Joining the eNLC?

The official New Jersey Business and Industry Association is in strong support of the bill as it will help make it easier to recruit the much-needed nursing staff. A nurse and clinical professor at Rutgers School of Nursing and also a lead for the New Jersey Collaborating Center for Nursing (which studies workforce issues), Edna Cadmus stated:

“I see this as a very positive step. It allows for greater mobility, and greater mobility will help us in dealing with shortages. It also really helps reduce some of the duplication in licensing.”

How Supply and Demand Affects Nurses Working in New Jersey and Nationwide

If a nurse who currently holds a license in New Jersey wants to work in another state, they must seek out licensure in that state. Vice versa, if a nurse wants to take a job position in New Jersey, they must obtain Garden State credentials. Either way, the New Jersey Board of Nursing already oversees the credentials of more than 220,000 healthcare professionals, of which, more than half are registered nurses or RNs. It’s this same board of nursing that is in charge of processing all this licensing and managing all the aspects of education and regulations in the profession.

Some people insist that the management concerns and staff shortages at the board have made it much more challenging to obtain nursing certification in New Jersey. Those who are critics of the multi-state compact in the state of New Jersey argue that by adding this increased workload to the nursing board, the problem with delays will only be exacerbated.

Several years ago, lawmakers and advocates brought these issues of the board being overburdened to attention and the former Gov. Chris Christie appointed additional board members at that time. Regardless, the state officials at that time suggested that the board had appropriate staffing. The state nursing board falls under the Department of Consumer Affairs in New Jersey.

Supply and Demand for Nurses Nationwide Varies

Substantial variability exists in the supply and demand of the workforce of nurses from state to state according to a report from the national Health Resources and Services Administration (which is a division of the U.S. Department of Health and Human Services) from July 2017.

As an example of this supply and demand variables, it’s estimated that by 2030 New Jersey will be short by about 11,400 nurses (which will make it one of four states looking at 10,000-plus deficiency) – but at that same time, it’s estimated that New York will have at least 18,000 nurses in surplus.

History of the Nurse Licensure Compact

The very first multi-state compact involved Texas and Wisconsin in 2000, and the National Council of State Boards of Nursing helped organize the arrangement. Since then, the agreement has gained steam and there are currently 29 states involved in the compact, with more that have agreed to join soon and several others with pending legislation.

Nurses Unions have Concerns Regarding Multi-State Licensure

There are 11 states that have not gotten involved in the talks regarding joining the compact such as New York and Pennsylvania, and this also includes labor-friendly states such as Ohio and California. There are nurses unions, such as the Health Professionals and Allied Employees (which is the largest group of this kind in New Jersey), who have not shown support for the plan because they are concerned that this could lower the standards for workfoce qualifications. Earlier versions of the bill raised concerns like this with the New Jersey State Nurses Association, but the compact in its current form is fully supported by this body.

The criminal background check processes are at the core of these types of concerns. There are several states which are part of the compact that do not have the same level of requirements when it comes to checking the criminal background history of a nurse. The argument, therefore, is that this agreement could allow nurses with dangerous backgrounds to work in the Garden State.

In 2001, it was this very concern that was mostly responsible for the failure of the previous attempt made for New Jersey to join the eNLC. However, since 2006, there has been bi-partisan support to re-start the process. Groups such as HPAE have been urging lawmakers to include requirements that would mandate any out-of-state nurse to meet the requirements according to the standards in New Jersey, but so far none of those efforts made it through the committees and floor votes.

If the governor were to sign the latest version of the law (S-954), it would immediately go into effect. The legislation is “led by Sens. Joseph Vitale (D-Middlesex), the longtime health committee chairman, Troy Singleton (D-Burlington) and Fred Madden (D-Gloucester) and co-sponsored by Sen. Declan O’Scanlon (R-Monmouth). Assemblyman Herb Conaway (D-Burlington), a physician and chair of that house’s health committee, heads up the companion version, which cleared several Assembly panels last month.”

If it goes through, New Jersey will be able to participate in the compact and share nurses from the license pool. The state will also be required to participate in the interstate commission that operates the compact.

Under the proposed agreement, if a nurse working in the Garden State violates the regulations set forth by the state, New Jersey would be allowed to revoke or suspend the license of any nurse in the pool, regardless of where they live or where they are licensed. Any adverse actions such taken by the state would need to be logged in the shared database. There is also an operating fee of $6,000 annually that would need to be paid by the officials of the state for the expenses of the compact.

Furthermore, the agreement will require the New Jersey Attorney General to evaluate how the participation in the compact is doing after one year’s time and report the pros and cons to the governor and Legislature. If the evaluation made by the AG suggests that states with lower standards for licensing have joined the group (which could allow less-qualified caregivers to work in New Jersey) – the state would be allowed to withdraw from the compact at that time.

At Elite Specialty Staffing, we follow and report on the issues that matter most to travel nurses. Stay posted to our blog as we cover these topics and more.