The demand for highly skilled healthcare providers continues to grow. Proposed legislation regarding APRN Compact licensing would allow the industry to expand nursing care with fewer barriers. 

According to the Bureau of Labor Statistics, employment for nurse practitioners and other advanced practice registered nurses (APRNs) is projected to grow 40 percent between 2023 and 2033, outpacing other healthcare professionals, including registered nurses (RNs). 

The APRN Compact legislation would help meet these growing needs by allowing APRNs to practice in multiple states under a single state license. 

As the APRN Compact is being considered, the healthcare community is exploring the legislation and its challenges, how it would benefit health care providers and communities, and how to move it forward.  

What is the APRN Compact?

The APRN Compact is the proposed interstate licensure agreement that would allow APRNs to obtain a multistate license to practice in all compact states. 

The APRN Compact was drafted by the National Council of State Boards of Nursing (NCSBN) in 2020 to increase access to care, provide more choices for patients and providers, and deliver better emergency response. 

Currently, APRNs must obtain licensure in every state where they want to practice, which is extremely time-consuming and expensive. 

The APRN Compact would change that by increasing opportunities for APRNs to care for patients in-person or electronically in every compact state. This would improve access to high-quality healthcare for rural and underserved areas and enable APRN locum tenens and telehealth providers to expand their practice areas to help communities in need. 

The APRN Compact requires seven states to approve the legislation before it is authorized. As of November 2024, four states have enacted the APRN Compact – Delaware, North Dakota, South Dakota and Utah. Other states have introduced APRN Compact legislation, but often, the legislative process requires several tries before a bill is finally passed. 

Challenges facing the APRN Compact’s approval

Aspects of the APRN Compact have faced challenges in the nursing community and states’ regulatory and legislative processes. 

Proponents of the APRN Compact point to its similarities with the Nurse Licensure Compact (NLC), which was passed in 2018. The NLC allows registered nurses, licensed practical nurses (LPNs) and licensed vocational nurses (LVNs) to care for patients in more than 40 U.S. states and territories under one license. 

Those who oppose the current version of the APRN Compact, including some professional organizations, question the high practice hour requirement and lack of an APRN advisory committee. 

The current version of the ARPN Compact includes a requirement of 2,080 hours of clinical practice for eligibility – approximately one year of full-time work. The American Association of Nurse Practitioners (AANP) argues that APRNs have enough training and practice at graduation and certification. 

Benefits of the APRN Compact license

The APRN Compact offers many benefits for healthcare providers and communities in need, including: 

• Greater professional flexibility and mobility. It would enable APRNs to respond quickly to changing healthcare needs and serve where they are needed most.
• Simplification of state licensing, saving time and money. Maintaining one license is less burdensome for both providers and regulatory bodies, offering cost-savings and lower time requirements. 
• Expanded reach to rural and underserved populations. Access to quality care is a significant issue in rural areas. The APRN Compact would extend support for telehealth and locum tenens providers to care for these communities.
• Ensure consistent, safe, high-quality care for all patients. The APRN Compact would require states to adhere to consistent regulations about patient care, ensuring higher-quality care for all populations.

A recent NCSBN study found that 86 percent of APRNs support the current APRN Compact legislation. They believe it will increase patients’ access to high-quality care.

APRNs can help improve mobility and access

The benefits of an APRN Compact for both APRNs and underserved populations are clear. Patients need high-quality, consistent healthcare, and a Compact would enable APRNs to provide that care. 

Being informed and advocating for APRNs and patient access to care is important. Take time to consider both the benefits and concerns of the current version of the APRN Compact. Then, contact your state’s nursing association and state board of nursing to learn about their positions and share your thoughts.

Consider contacting your legislators as well. Many are unaware of what APRNs do, the growing need for highly skilled care and why flexibility and mobility matter to APRNs, locum tenens and telehealth providers.

More information about the APRN Compact legislation can be found by visiting the NCSBN’s APRN Compact website.