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Skilled to Work: Legislature approves bill bringing Alabama into Enhanced Nurse Licensure Compact

With Indiana, Louisiana and Kansas joining in July, Alabama is the only state in the Southeast that is not part of the compact.

Posted: May. 2, 2019 2:57 PM
Updated: May. 3, 2019 12:11 PM

If you want to work as a nurse here in Alabama, right now you need an Alabama license. However, new legislation heading to Governor Kay Ivey’s desk is about to change that.

“It will open up doors that have previously been barricaded or have been harder to open for travel nurses,” said Dr. Sarah Wilkinson-Buchmann, president of the Alabama State Nurses Association.

The “it” refers to the Enhanced Nurse Licensure Compact (ENLC). The ASNA was one of the strongest proponents of Alabama joining the 31 other states that are currently part of the compact.

“Most importantly, it will allow flexibility for practice,” said Wilkinson-Buchmann

Nurses in compact states receive one license that allows them to work in any other compact state.

Right now, there are 31 states in the compact, with Indiana, Louisiana and Kansas set to join on July 1, 2019. According to the National Council of State Boards of Nursing, Alabama is one of eight states with pending legislation as of last month.

States with no plans to join the compact, like Ohio and California, list concerns like “growth of telemedicine and telenursing” and the “loss of state revenue for new single state license.”

Chief Nursing Officer of Decatur Morgan Hospital Anaita Walden predicts the states remaining outside of the compact may have a more difficult time moving forward.

“When the majority of the states have this, it’s going to be difficult for states that don’t. Very difficult. Because the nurses are going to go to the states where they can easily go with one license,” said Walden.

The Alabama House of Representatives unanimously passed the senate version of the bill last Thursday. It got through it part thanks to the efforts of Rep. April Weaver, a registered nurse.

“She understood the true implications of it and could explain that in a way that somebody non-clinical would not be able to do,” said Walden.

She added that once Alabama joins the compact, it will help attract more talent to combat the nursing shortage some hospitals are seeing.

“I think that this is the smartest thing that we could do to make sure that we make it as easy as possible for nurses to not only work here and travel if they want to, but for travelers from other states to more easily come into our state,” said Walden.

Wilkinson-Buchmann said it will also allow Alabama nurses to readily help during natural disasters. And it will aid one of the largest groups here in Huntsville: military families.

“Military spouses will be able to readily transition into a work setting without having to apply for licensure in the State of Alabama,” said Wilkinson-Buchmann.

There’s also a hope that by putting Alabama on the same level as most other states, this can drive a legislative change to raise wages for nurses.

“Alabama is the lowest reimbursed state in the United States. So when you’re getting low reimbursement, it’s very difficult to keep up with wages the way we want to,” said Walden.

A bipartisan congressional delegation letter was sent to Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma in March. The letter encouraged Verma to increase the reimbursement rate for Alabama.

Last week, CMS proposed a new rule that “could help address the unfair Medicare Wage Index reimbursement formula,” according to Senator Doug Jones’ office.

In a statement on April 24, Jones said, “These hospitals provide care to all Alabamians, regardless of their insurance status, and they have to absorb the costs when that care isn’t reimbursed. That puts the entire system on slippery financial footing and can hurt the broader community if a hospital is forced to close its doors.”

Jones serves on the Senate Health, Education, Labor and Pensions Committee.

Governor Ivey's office told WAAY 31 on Thursday that the bill is in the review process. They haven't said when the bill would be signed if she approves it, but National RN Recognition Day falls on Monday, May 6, which kicks off National Nurses Week.

To learn more about the ENLC, click here.

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