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Latest Policy Briefings News See All Policy Briefings /policy/policy-news/policy-news.page ncsbn news [Policy Briefing] [Policy Briefing] [x-request-id] = [d0158026690b0474e58ba51412b09ad3] [x-real-ip] = [35.191.19.250] [x-forwarded-scheme] = [https] [x-original-forwarded-for] = [3.14.6.194,34.144.206.224] [x-cloud-trace-context] = [a01dfc4dd6d01f3b29f7a7bce20fb523/12366250233914005290] [host] = [lsds] [connection] = [close] [x-forwarded-for] = [10.1.96.76] [x-scheme] = [https] [accept] = [*/*] [user-agent] = [Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)] [via] = [1.1 google] policy/policy-news 4 en_US l6oiwrxn /default/main/NCSBN true ncsbn/News manual 2022-09-20 16:46:14 /default/main/NCSBN/STAGING 2022-08-06 10:26:53 en_US templatedata/ncsbn/News/data/2021/the-future-of-nursing-report-20202030-charting-a-path-to-achieve-health-equity.xml templatedata/ncsbn/News/data/2021/the-future-of-nursing-report-20202030-charting-a-path-to-achieve-health-equity.xml /default/main/NCSBN/WORKAREA/default l6oiwrxn 2022-08-06 10:26:53 l6oiwrxn l6oiwrxn templatedata/ncsbn/News/data/2021/the-future-of-nursing-report-20202030-charting-a-path-to-achieve-health-equity.xml l6oiwrxn 2021-05-27 07:54:00 /default/main/NCSBN Policy Briefing l6oiwrxn l6oiwrxn 1661192730138 2022-09-20 16:46:14 /default/main/NCSBN/WORKAREA/default/templatedata/ncsbn/News/data/2021/the-future-of-nursing-report-20202030-charting-a-path-to-achieve-health-equity.xml the-future-of-nursing-report-2020-2030 l6oiwrxn l6oiwrxn 1

The Future of Nursing Report, 2020-2030: Charting a Path to Achieve Health Equity

Policy Briefing

2021-05-27 07:54:00

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On May 11, 2021, the National Academies of Sciences, Engineering and Medicine released their report The Future of Nursing, 2020-2030: Charting a Path to Achieve Health Equity (the “FON Report”).

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On May 11, 2021, the National Academies of Sciences, Engineering and Medicine released their report <a href="https://nam.edu/publications/the-future-of-nursing-2020-2030/" target="_blank" rel="noopener">The Future of Nursing, 2020-2030: Charting a Path to Achieve Health Equity</a>  (the “FON Report”). The FON Report, sponsored by the Robert Wood Johnson Foundation builds upon the 2011 Institute of Medicine report, <a href="https://pubmed.ncbi.nlm.nih.gov/24983041/" target="_blank" rel="noopener">The Future of Nursing: Leading Change, Advancing Health</a>. The report committee outlines the importance of nurses and how the role of nurses will be forced to adapt to the needs of society with a strong focus on social determinants of health. , The committee believes that health equity can be achieved through the strengthening of nursing, both in capacity and expertise.   The report references multiple initiatives of NCSBN, linking the initiatives toward the goal of achieving health equity. The report recommends removing barriers to <a href="https://nursingamerica.org/" target="_blank" rel="noopener">APRN full practice authority</a> and calls for the nationwide adoption of the <a href="compacts.page">Nurse Licensure Compact</a> as well as for the use of federal authority to supersede restrictive state laws related to scope of practice.  Also recommended by the committee is the adoption of a National Nurse Identifier, such as the NCSBN ID, to provide better measurements of the value of services provided by RNs.   The committee calls on NCSBN to ensure that the licensing exam contains questions to assess nurses’ ability to address social determinants of health and the needs of the community. In response to public health emergencies and disasters, the committee recommends that the nursing workforce be both strengthened and protected to address health inequities. NCSBN is called upon to include more content in licensing examinations to cover potential responsibilities of nurses in disaster response.  NCSBN research projects are highlighted throughout the report. The <a href="/sites/ncsbn/research/recent-research/workforce.page">National Nursing Workforce Survey</a> is used to demonstrate the racial and ethnic diversity within the newer classes of LPNs, an important step towards achieving health equity according to the committee. The results of the <a href="/sites/ncsbn/research/recent-research/simulation-study.page">National Simulation Study</a> was used to promote the committee’s belief that poverty and other health inequities can be addressed through simulation-based education. Additionally, the committee used research from <a href="https://www.journalofnursingregulation.com/article/S2155-8256(20)30075-2/fulltext" target="_blank" rel="noopener">NCSBN’s Regulatory Guidelines and Evidence-based Quality Indicators for Nursing Education Programs </a>to support their vision for a broader understanding of quality nursing education.   Lastly, the report addresses substance use disorder among nurses, citing <a href="https://www.journalofnursingregulation.com/article/S2155-8256(20)30107-1/pdf" target="_blank" rel="noopener">NCSBN’s Outcome of Substance Use Disorder Monitoring Programs for Nurses</a> as a resource for best practices for alternative to discipline program completion as well as the NCSBN’s <a href="https://www.journalofnursingregulation.com/article/S2155-8256(20)30106-X/fulltext" target="_blank" rel="noopener">Components of Nurse Substance Use Disorder Monitoring Programs</a> which highlights the need for additional research into alternatives to discipline programs and more consistency across states. Successfully addressing substance use disorder is essential in prioritizing the health and well-being of the nursing workforce.  A full summary is available on the <a href="https://hive.ncsbn.org/KnowledgeNetwork-Policy/Pages/Home.aspx" target="_blank" rel="noopener">Policy Knowledge Network</a>.

The National Council of State Boards of Nursing (NCSBN) is a not-for-profit organization whose purpose is to provide an organization through which boards of nursing act and counsel together on matters of common interest and concern affecting the public health, safety and welfare, including the development of licensing examinations in nursing.

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en_US l6oiwrw3 /default/main/NCSBN true ncsbn/News manual 2023-10-23 13:08:31 /default/main/NCSBN/STAGING 2022-08-06 08:05:16 en_US templatedata/ncsbn/News/data/2020/members-of-congress-introduce-legislation-to-address-health-professional-license-portability-during-a-public-health-emergency.xml templatedata/ncsbn/News/data/2020/members-of-congress-introduce-legislation-to-address-health-professional-license-portability-during-a-public-health-emergency.xml /default/main/NCSBN/WORKAREA/default l6oiwrw3 2022-08-06 08:05:16 10/01/2022 12:00 AM (GMT-05:00) America/Chicago l6oiwrw3 l6oiwrw3 templatedata/ncsbn/News/data/2020/members-of-congress-introduce-legislation-to-address-health-professional-license-portability-during-a-public-health-emergency.xml l6oiwrw3 2020-08-21 14:50:00 /default/main/NCSBN Policy Briefing l6oiwrw3 l6oiwrw3 1663692696601 2023-10-23 13:08:31 /default/main/NCSBN/WORKAREA/default/templatedata/ncsbn/News/data/2020/members-of-congress-introduce-legislation-to-address-health-professional-license-portability-during-a-public-health-emergency.xml members-of-congress-introduce-legislation-to-address-health-professional-license-portability-during-a-public-health-emergency l6oiwrw3 l6oiwrw3 1

Members of Congress Introduce Legislation to Address Health Professional License Portability During a Public Health Emergency

Policy Briefing

2020-08-21 14:50:00

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New bills in Congress aimed at improving with provider mobility and interstate telehealth would allow providers to practice anywhere in the country with one state license…but there are critical exceptions.

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In the early days of the COVID-19 pandemic, many patients turned to telehealth to continue receiving care from the safety of their homes. At the same time, <a class="tx-icon_before_container" href="https://www.nursing.upenn.edu/live/news/1725-wide-variation-across-hospitals-in-nurse-staffing" target="_blank" rel="noopener" aria-label="External Link, states that were being hit the hardest by the virus were beginning to experience provider shortages, especially nurses, opens in new window" data-matches="offsite">states that were being hit the hardest by the virus were beginning to experience provider shortages, especially nurses</a>, forcing hospitals and health systems to seek assistance from out of state. The <a class="tx-icon_before_container" href="/sites/ncsbn/compacts/nurse-licensure-compact.page" aria-label="External Link, Nurse Licensure Compact (NLC), opens in new window" data-matches="offsite">Nurse Licensure Compact (NLC)</a> and other interstate compacts allowed providers in many states to quickly relocate or reach patients using telehealth, however the response was slower in states that had not already joined compacts, a complication that was at least partially due to lack of health provider license portability. As a result, governors across the country used emergency authority to issue executive orders waiving state licensing requirements for health care providers, opening the door for providers to deliver in-person and telehealth services outside of their states of licensure and improving patient access to care under unprecedented circumstances. But these regulatory changes, many stakeholders argue, happened too slowly and were inconsistent from state to state, complicating any telehealth response to patients from out of state. Some healthcare advocates began to argue that the federal government should intervene by preempting state licensing laws and allowing providers to practice across state lines with as long as they have one state license, however, as many discovered for the first time, the federal government does not currently possess the legal authority to do so.   In an effort to address these challenges, members of Congress have introduced pieces of legislation that would temporarily allow providers to practice across state lines when a Public Health Emergency (PHE) has been declared.   Equal Access to Care Act (S.155)  The <a class="tx-icon_before_container" href="https://www.congress.gov/bill/117th-congress/senate-bill/155/cosponsors?q={%22search%22:[%22S155%22]}&r=1&s=3&searchResultViewType=expanded" aria-label="External Link, Equal Access to Care Act (S.155), opens in new window" data-matches="offsite">Equal Access to Care Act (S.155)</a>, sponsored by Senators Ted Cruz (R-TX) and Marsha Blackburn (R-TN), was introduced on February 2, 2021 and would allow health care providers to deliver telehealth services in any U.S. jurisdiction with only one license. A companion bill (<a class="tx-icon_before_container" href="https://www.congress.gov/bill/117th-congress/house-bill/688/actions?q=%7B%22search%22%3A%5B%22HR688%22%5D%7D&r=1&s=4" aria-label="External Link, H.R. 688, opens in new window" data-matches="offsite">H.R. 688</a>) was introduced by Rep. Ted Budd (R-NC) in the House of Representative on February 2, 2021.  The provider would not need to be licensed in the state where the patient is located to deliver telehealth services. It would move the location of care to the location of the provider, requiring the provider to follow the practice laws and regulations in the state where they are licensed as opposed to the state where the patient is located. By making these changes at the federal level, the bill would legally preempt the Nurse Licensure Compact (NLC) and other compacts as it pertains to location of care during telehealth interactions. If it were to become law, the Equal Access to Care Act would go into effect immediately and expire 180 days after the President declares an end to a federal emergency declaration under National Emergencies Act authority. NCSBN is opposed to the Equal Access to Care Act becoming law.   Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act (S. 168)  U.S. Senators Chris Murphy (D-CT) and Roy Blunt (R-MO) introduced the <a class="tx-icon_before_container" href="https://www.congress.gov/bill/117th-congress/senate-bill/168?q=%7B%22search%22%3A%5B%22S168%22%5D%7D&s=1&r=1" aria-label="External Link, Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act (S. 168), opens in new window" data-matches="offsite">Temporary Reciprocity to Ensure Access to Treatment (TREAT) Act (S. 168)</a> on February 2, 2021. A companion bill (<a class="tx-icon_before_container" href="https://www.congress.gov/bill/117th-congress/house-bill/708?q=%7B%22search%22%3A%5B%22HR+708%22%5D%7D&r=1&s=2" aria-label="External Link, H.R. 708, opens in new window" data-matches="offsite">H.R. 708</a>) was introduced by Reps. Bob Latta (R-OH) and Debbie Dingell (D-MI) in the House of Representatives on February 2, 2021. The bill seeks to provide temporary licensing authority for health care professionals to practice in-person or via telehealth anywhere in the U.S. with a license in good standing in only one jurisdiction during a period where both a Public Health Emergency has been declared by the Secretary of Health and Human Services (HHS) and a national emergency has been declared by the President. The bill would remain in effect for a period of up to 180 days after these emergency periods conclude. When practicing telehealth, health care professionals would be required to follow the practice laws and regulations in their jurisdiction of licensure, not the jurisdiction where the patient is located.   Unlike the Equal Access to Care Act, the TREAT Act addresses concerns related to state-based licensure, discipline, and the Nurse Licensure Compact (NLC) through the addition of three critical provisions in Section 4 of the bill:  <ul role="list"> <li role="listitem" aria-setsize="-1" data-aria-level="1" data-aria-posinset="1" data-font="Calibri" data-leveltext="%1." data-listid="1"> Subsection (f) – Investigative and Disciplinary Authority – this provision would allow jurisdictions to investigate and take disciplinary action against a provider by precluding him/her from practicing in their jurisdiction, and then require such as preclusion to be reported to the licensing authority in the provider’s state of licensure.  </li> <li role="listitem" aria-setsize="-1" data-aria-level="1" data-aria-posinset="1" data-font="Calibri" data-leveltext="%1." data-listid="1"> Subsection (g) – Multiple Jurisdiction Licensure – this provision would require a provider to follow the practice laws and regulations in the jurisdiction where the patient is located if the provider holds a license in that jurisdiction, alleviating legal confusion about which license would apply in these situations.  </li> <li role="listitem" aria-setsize="-1" data-aria-level="1" data-aria-posinset="3" data-font="Calibri" data-leveltext="%1." data-listid="1"> Subsection (h) – Interstate Licensure Compacts – this provision would exempt providers that hold a multistate license or privilege to practice in multiple jurisdictions through an interstate compact from being subject to this bill.  </li> </ul> The inclusion of these provisions seeks to better preserve state-based public protection regulatory models and address the bill’s inherent legal conflicts with the NLC and APRN Compact.  In response to the provisions included, NCSBN has decided to remain neutral on this legislation. While NCSBN does not support federal preemption of state licensing under any circumstances, the inclusion of the provisions listed above demonstrate congressional support for interstate compacts and offer states an opportunity to maintain their regulatory authority under emergency circumstances by adopting interstate compacts to facilitate license portability. NCSBN will continue to serve as an educational resource for Congress and the Administration on this bill and other licensure matters.

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NCSBN Letter to CMS Outlines Regulatory Priorities Post COVID-19 Public Health Emergency

Policy Briefing

2020-06-23 18:48:00

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On June 18, 2020, the National Council of State Boards of Nursing (NCSBN) submitted a letter to the Centers for Medicare and Medicaid Services (CMS) outlining NCSBN’s regulatory priorities once the federal Public Health Emergency has ended..

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On June 18, 2020, the National Council of State Boards of Nursing (NCSBN) submitted a <a class="tx-icon_before_container" href="/public-files/NCSBN_Letter_CMS_COVIDBlanketWaivers_FINAL_06.18.2020.pdf" target="_blank" rel="noopener" aria-label="PDF File, letter, opens in new window" data-matches="pdf">letter</a> to the Centers for Medicare and Medicaid Services (CMS) outlining NCSBN’s regulatory priorities once the federal Public Health Emergency has ended. CMS is considering the future of <a class="tx-icon_before_container" href="https://www.cms.gov/files/document/summary-covid-19-emergency-declaration-waivers.pdf" target="_blank" rel="noopener" aria-label="External Link, blanket waivers, opens in new window" data-matches="offsite">blanket waivers </a>for healthcare providers that the agency issued over the past few months in response to the COVID-19 pandemic. Those waivers include allowances for audio-only telehealth visits and non-physician providers to bill for some telehealth services. CMS also took steps to remove scope of practice restrictions, waiving the physician supervision requirement for CRNAs and allowing NPs and CNSs to deliver certain services independently. CMS also waived their requirement that practitioners be licensed in the patient’s location in order to receive reimbursement. NCSBN’s letter outlines which waivers NCSBN would like to see remain in place at the conclusion of the Public Health Emergency and which waivers should expire. NCSBN’s letter follows a presidential executive order released in May that aims to address regulatory burdens that could harm the economic recovery following COVID-19. The executive orders directs government agencies to look at the waivers that were issued during the COVID-19 pandemic and determine if the waivers should remain in place once the public health emergency has ended.

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en_US l6oiwrwc /default/main/NCSBN true ncsbn/News manual 2023-10-23 13:08:31 /default/main/NCSBN/STAGING 2022-08-06 07:54:32 en_US templatedata/ncsbn/News/data/2020/hhs-sends-letter-guidance-to-states-encouraging-state-licensing-waivers-relaxation-of-scope-of-practice-requirements.xml templatedata/ncsbn/News/data/2020/hhs-sends-letter-guidance-to-states-encouraging-state-licensing-waivers-relaxation-of-scope-of-practice-requirements.xml /default/main/NCSBN/WORKAREA/default l6oiwrwc 2022-08-06 07:54:32 10/01/2022 12:00 AM (GMT-05:00) America/Chicago l6oiwrwc l6oiwrwc templatedata/ncsbn/News/data/2020/hhs-sends-letter-guidance-to-states-encouraging-state-licensing-waivers-relaxation-of-scope-of-practice-requirements.xml l6oiwrwc 2020-03-27 16:52:00 /default/main/NCSBN Policy Briefing l6oiwrwc l6oiwrwc 1663692696594 2023-10-23 13:08:31 /default/main/NCSBN/WORKAREA/default/templatedata/ncsbn/News/data/2020/hhs-sends-letter-guidance-to-states-encouraging-state-licensing-waivers-relaxation-of-scope-of-practice-requirements.xml hhs-sends-letter-guidance-to-states-encouraging-state-licensing-waivers-relaxation-of-scope-of-practice-requirements l6oiwrwc l6oiwrwc 1

HHS Sends Letter, Guidance to States Encouraging State Licensing Waivers, Relaxation of Scope of Practice Requirements

Policy Briefing

2020-03-27 16:52:00

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On March 24, Secretary of Health and Human Services (HHS) Alex Azar sent a <a class="tx-icon_before_container" href="/public-files/HHS_Secretary_Letter_to_States_Licensing_Waivers.pdf" target="_blank" rel="noopener" aria-label="PDF File, letter, opens in new window" data-matches="pdf">letter</a> and <a class="tx-icon_before_container" href="/public-files/HHS_Guidence_to_States_on_Regulations_on_Healthcare_Workers.pdf" target="_blank" rel="noopener" aria-label="PDF File, guidance, opens in new window" data-matches="pdf">guidance</a> to governors outlining the steps he would like to see states take to “extend the capacity of the health care workforce” to properly manage the growing crisis created by the COVID-19 pandemic. These recommendations include temporarily waiving licensing requirements for health care providers, who are licensed, registered or certified in good standing in other states or territories. The letter encourages states to waive regulations related to telehealth, including the establishment of patient-provider relationships, and restrictions on the settings where health care professionals can see patients. In states that require advanced practice registered nurses (APRNs) and physicians assistants to collaborate with a physician, HHS recommends that states relax physician collaboration requirements, waive any geographic restrictions, and allow supervising physicians to do so remotely if states are unwilling to waive collaboration requirements. In their guidance document, HHS recommends states utilize either the Uniform Emergency Volunteer Health Practitioner Act, the Emergency Management Assistance Compact (EMAC), or other mutual aid compacts to facilitate license reciprocity. In an effort to allow retired healthcare providers to quickly reenter the workforce, HHS recommends that states waive licensing fees for re-licensing or re-certifications during this emergency.

HHS Sends Letter, Guidance to States Encouraging State Licensing Waivers, Relaxation of Scope of Practice Requirements The National Council of State Boards of Nursing (NCSBN) is a not-for-profit organization whose purpose is to provide an organization through which boards of nursing act and counsel together on matters of common interest and concern affecting the public health, safety and welfare, including the development of licensing examinations in nursing.

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Latest Policy Briefings

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Policy Briefing

The Future of Nursing Report, 2020-2030: Charting a Path to Achieve Health Equity

On May 11, 2021, the National Academies of Sciences, Engineering and Medicine released their report The Future of Nursing, 2020-2030: Charting a Path to Achieve Health Equity (the “FON Report”).

Posted 05/27/2021

Members of Congress Introduce Legislation to Address Health Professional License Portability During a Public Health Emergency

New bills in Congress aimed at improving with provider mobility and interstate telehealth would allow providers to practice anywhere in the country with one state license…but there are critical exceptions.

Posted 08/21/2020

NCSBN Letter to CMS Outlines Regulatory Priorities Post COVID-19 Public Health Emergency

On June 18, 2020, the National Council of State Boards of Nursing (NCSBN) submitted a letter to the Centers for Medicare and Medicaid Services (CMS) outlining NCSBN’s regulatory priorities once the federal Public Health Emergency has ended..

Posted 06/23/2020

HHS Sends Letter, Guidance to States Encouraging State Licensing Waivers, Relaxation of Scope of Practice Requirements

Posted 03/27/2020