Discipline under the Nurse Licensure Compact
In 2018, Missouri implemented the Enhanced Nurse Licensure Compact (eNLC).
The Law Offices of Kevin J. Dolley has effectively counseled clients regarding
the impact disciplinary actions may have on their Missouri license under
the Compact. We continue to fight for nurses' rights as the law changes
The eNLC has been touted as an agreement that will enhance the profession of nursing and allow for increased mobility for nurses. However, provisions in the new law may prohibit nurses on probation from working in other eNLC states and affect the confidentiality of complaints that are resolved without public discipline. Similarly, nurses practicing in Missouri on out-of-state licenses could face discipline from their home states as well as restrictions on their ability to practice in Missouri under the eNLC. For nurses facing probation, this means any complaint could potentially have a debilitating effect on their ability to earn income.
eNLC Provisions Relevant to Missouri Nurses
The eNLC is an updated version of the original Nurse Licensure Compact (NLC). It allows RNs and LPNs to have one multistate license with the authority to practice in their home state and participating states. Currently, more than 30 states are members of the eNLC, including all states bordering Missouri except Illinois. Missouri nurses with multi-state Compact privileges may cross state borders to practice in those states under his or her Missouri license, without having to apply for licensure in the other state.
Missouri nurses who are placed on probation lose their ability to practice in other states using their Missouri license while on probation. This is because the eNLC requires a nurse’s home state license to be active and unencumbered to have multistate privileges. Entering into a probation agreement with the Board in effect means converting your multistate license to a Missouri-only license. If you are a Missouri nurse who works in other states using your Missouri license, contact the Law Offices of Kevin J. Dolley before agreeing to probation with the Missouri Board.
Missouri nurses who face discipline in other states could also face discipline in Missouri. If a state board takes adverse action against a nurse, the board must report such action to the Missouri Board. This includes revocation, suspension, probation, or any other disciplinary action. The Missouri Board may then take disciplinary action against the nurse’s Missouri license, even if the case in the other state is resolved. Missouri may impose a higher level of discipline than the other state for the same conduct. If you are a Missouri nurse who is facing disciplinary action in another state, contact the Law Offices of Kevin J. Dolley for representation with respect to your Missouri license. Our attorneys are available to consult with your attorney in the other state to provide comprehensive representation that protects your home state license and ability to practice.
Other states may also issue “cease and desist” orders preventing Missouri nurses from practicing in their state. These are considered adverse actions and are reported to Missouri. The Missouri Board may then seek to discipline the Missouri license based upon the information received from the other state. Missouri nurses have rights to a hearing in these situations, which includes the right to review evidence, call witnesses, testify on their behalf, and make legal arguments. If the Missouri nurse is disciplined, his or her multistate privilege is deactivated, greatly limiting future employment opportunities. Missouri nurses who receive cease and desist orders from other states should contact the Law Offices of Kevin J. Dolley to protect their Missouri license and multistate privileges.
eNLC Provisions Relevant to Nurses Working in Missouri
Nurses practicing in other states with their Missouri license are subject to the other states’ disciplinary statutes and regulations. This is also true of out-of-state nurses practicing in Missouri. Each state has its own disciplinary regime, so it is important for traveling nurses to be aware of the other state’s requirements when accepting work outside of their home state. The Law Offices of Kevin J. Dolley is available to consult with nurses coming to Missouri regarding Missouri nursing law.
Missouri may issue “cease and desist” orders preventing nurses licensed in other states from practicing in Missouri. These actions frequently start as typical complaints received in the mail and requiring a written response. The Board’s investigator then interviews the nurse and reports the results of the investigation to the Board. If the Board unilaterally determines the nurse has violated the Nursing Practice Act, it will issue a “cease and desist” letter revoking the nurse’s privilege to practice in Missouri under another state’s license.
Nurses who receive “cease and desist” letters have the right to a hearing before the Administrative Hearing Commission (AHC). The time to request a hearing is limited and certain procedural requirements must be met. Nurses who do not request a hearing are barred from working in Missouri and may face discipline in their home state. Under the eNLC, Missouri will report this adverse action to the nurse’s home state, which may trigger additional discipline and loss of the nurse’s multistate privileges. If you are an out-of-state nurse facing a disciplinary complaint in Missouri, contact the Law Offices of Kevin J. Dolley for representation and counsel regarding how such a complaint could affect your home state license and ability to work in eNLC states.
Confidentiality and Information Sharing under the eNLC
eNLC states participate in a coordinated licensure information system containing information about all RNs, LPNs, and APRNs in their states. Boards must report adverse actions, license denials, participation in intervention (diversion) programs, and current significant investigatory information to the coordinated system. This information is reported even if it is deemed confidential or nonpublic under state law. Significant investigatory information includes information showing the nurse is a threat to public safety and information that, if true, would constitute more than a minor infraction. Under the eNLC, nurses whose complaints are dismissed or not pursued by the Board may face discipline from another state in which they are licensed. Contact the Law Offices of Kevin J. Dolley for a consultation regarding your rights under the eNLC and the potential impact of discipline on your ability to practice in more than one state.
If you are a nurse and have questions about how the eNLC could impact you as part of a licensing disciplinary action, contact the Law Offices of Kevin J. Dolley by phone at (314) 645-4100 or by email at firstname.lastname@example.org. All legal consultations are held strictly confidential.