Washington misses chance to streamline moves for out-of-state nurses, some experts say

Amid a shortage of health care professionals in Washington, some believe the state may have missed its opportunity to easily expand its nursing workforce this year.

A Senate bill that would have permitted Washington to join 31 other states in the Nursing Licensure Compact died in committee, despite overwhelming support at the public hearing for the bill. SB 5460 was heard in the Senate Committee on Health & Long Term Care on Feb. 1 but never advanced to executive session.

The compact is an agreement between states that allows nurses to use one license to practice in other states instead of applying for separate licenses to practice in each separate state, according to the National Council of State Boards of Nursing.

The legislation would be especially helpful for military spouses who work in health care to start working in a new state immediately upon relocation, some people contend.

“The enhanced NLC is the gold standard for military spouses to be able to move from state to state without the challenges and cost of relicensing,” said Tammie Perreault, Department of Defense regional liaison for Military Community and Family Policy. “Of the 19 States that have not yet joined the enhanced NLC, Washington has the second largest military population — this policy decision really impacts military families.”

In a Feb. 23 memorandum to the National Governor’s Association, the secretaries of the Navy, Army and Air Force urged lawmakers to consider the implementation of such legislation.

“Spouses in professionally licensed fields such as medical, legal, engineering, education, accounting or the cosmetic arts face challenges due to delays or cost of transferring licenses to a new state or jurisdiction. Eliminating or mitigating these barriers will improve quality of life for our military families and ease the stress of transferring duty stations with consideration for long-term career implications,” they said.

It also would be beneficial to travel nurses or nurses who work in telemedicine across state lines, said Kathleen Carter, a travel nurse in Washington. Licenses can be expensive when nurses transfer to other states, and they take time to obtain, Carter said.

That is especially problematic during a time when the state needs people who are able to practice medicine, she said.

A 2014 report by the U.S. Department of Health and Human Services estimated that Washington would have a shortage of 7,000 nurses by 2025.

Additionally, the NLC could be immensely helpful during times of emergency, both in Washington and in other states, said Paula Meyer, executive director for Nursing Commission, Washington State Department of Health.

Nurses from other states would be able to get to work immediately during moments of crisis. On the flip side, Washington nurses who are part of the compact would be able to assist in other states with the compact if they were experiencing an emergency, she added.

The commission licenses and performs disciplinary actions for more than 100,000 nurses in Washington.

Meyer said the bill would be helpful for employers as well. She also agreed that the NLC would be helpful in tele-medicine and would have a positive impact on military families looking to relocate to the state.

According to the DOH, the total wait time for an application to be processed for nurses entering the state from other places is about eight to nine weeks. For military spouses, the expedited wait time is about six weeks.

Licensing fees cost $154.25 for registered nurses. Licensed practical nurses fees are $119.25. If Washington state was part of the NLC, no additional fees would be required from nurses who are relocating.

Meyer added that the Nursing Commission has been supportive of the NLC for 20 years.

Sen. Annette Cleveland, D-Vancouver, was the bill’s primary sponsor. She said it failed to pass committee because the Washington State Nurses Association lobbied against it, and without association approval, there wasn’t enough support for the bill.

Only one person testified in opposition to SB 5460 during a public hearing. Melissa Johnson, who represents the WSNA, said that there were concerns about the authority the compact commission would have in the state. She also said other nursing associations had expressed concerns about the compact.

On its website, the WSNA calls the NLC “a bad option for Washington” and urges lawmakers to reject it. The association argues the compact doesn’t provide public protection like the NCSBN claims and that the few protections promised can be achieved through less “overreaching means.”

WSNA adds that “complicated regulatory mechanisms” would be imposed by the compact and that there would be no oversight or accountability on those commissions. The association also argues the compacts will have an effect on revenue because out-of-state nurses would no longer have to pay licensing fees.

WSNA officials did not return calls to The News Tribune seeking elaboration on their position.

In an email they said they would use the time between legislative sessions to talk to people and look at the NLC experience in other states. They declined to comment further.

This story was originally published March 4, 2019 at 11:52 AM.