ASA Urges Revisions to APRN Compact

ASA joined nearly 80 other national specialty and state medical associations in a May 10 American Medical Association (AMA) letter to the National Council of State Boards of Nursing(NCSBN) urging the removal of independent practice language from the Advance Practice Register Nurse (APRN) Compact. Specifically, the letter urged NCSBN to remove or substantially revise those provisions within the APRN Compact which would supersede state laws governing scope of practice. 

ASA strongly opposes the APRN Compact’s provisions that usurps state law and takes many licensing decisions away from state legislatures and state boards of nursing.  In November of 2017, the American Medical Association (AMA) adopted a resolution championed by ASA that effectively engages the entire house of medicine in a strategic initiative to oppose the efforts of non-physicians at the state and federal level to dismantle physician-led team-based models of care and, specifically, to oppose the harmful APRN Compact. 

In 2015, the NCSBN approved state model legislative language entitled the “APRN Compact.” The APRN Compact would create multistate licensure for APRNs. It would authorize APRNs who hold this multistate license to practice in other party states without going through state-by-state licensing. 

The APRN Compact usurps state law regarding APRN scope of practice, licensure and other areas that would be dangerous to patient safety. It automatically eliminates physician involvement requirements for APRNs who practice under a multistate license. The language of concern is Article III, Section (h), which says: “An APRN issued a multistate license is authorized to assume responsibility and accountability for patient care independent of a supervisory or collaborative relationship with a physician. This authority may be exercised in the home state and in any remote state in which the APRN exercises a multistate licensure privilege.”

The APRN Compact requires a minimum of ten states to pass the law for it to become active in those states. The Compact has been signed in three states: Idaho, North Dakota and Wyoming. Four states (Iowa, Minnesota, Nebraska, and West Virginia) considered APRN Compact legislation this year but did not pass it into law. For questions about the APRN Compact, please contact Erin Mahrt, J.D., ASA State Affairs Associate, at [email protected].