Check out our The Facts: Why the NLC is Right for Alaska summary!

Is the Nurse Licensure Compact (NLC) a threat to public health and safety?
No. The standards to qualify for a multistate license are higher than Alaska’s standards.

• To obtain a multistate license in any of the participating jurisdictions, a nurse must have graduated from a board-approved education program; passed an English proficiency exam, the national NCLEX exam, and a state and federal fingerprint-based criminal background check; and cannot have been convicted, found guilty, or entered into an agreed disposition or a felony offense under state or federal criminal law, have any misdemeanor convictions related to the practice of nursing, or be participating in an alternative program.
• The Board of Nursing (“board”) retains the right to govern nursing practice in Alaska and to revoke practice privileges for any nurse practicing in the state, regardless of the type of license they hold.
• No states were grandfathered into to the enhanced compact, meaning all states were required to adopt legislation with the same language agreeing to the higher standards to obtain licensure if they wanted to remain in the compact.
• Multistate nurses are required to comply with the practice laws of the state in which the client is located at the time service is provided.

Will the NLC result in a loss of state sovereignty?
No. The board retains the right to govern nursing practice in Alaska and revoke practice privileges for any nurse practicing in the state, regardless of the type of license a nurse holds.

• Passing a bill enacting the NLC in Alaska means the Legislature and State of Alaska enter into an agreement with the NLC based on the current terms and requirements only and would not be handing over important decisions to any out-of-state entity.
• The NLC language and license requirements cannot be changed without the Alaska State Legislature taking action to adopt the changes. If the NLC language or requirements were to change, each participating state’s legislature would review those changes and determine if they were willing to adopt them. If the Alaska State Legislature opted not to adopt the changes, Alaska would no longer be a member state in the NLC.
• The board voted unanimously to support joining the NLC because it does not result in loss of control over the practice of nursing in the state.
• To date, the NLC language and requirements have only been changed once, and ratification required action by each participating state legislature.

Will joining the NLC increase license fees for Alaska nurses?
No. In fact, we believe license fees could go down due to a decrease in out-of-state nurse applications.

• The nurse licensing program is receipt supported, so if there are fewer applications to process, the program is less expensive to run and therefore the cost to the licensees may decrease.
• We’ve seen a huge increase in the number of nursing license applications submitted over the last few years. The NLC will reduce workload and allow qualified nurses to bypass the state licensing process because they have been pre-vetted through their compact qualifications.
• Further, the Alaska-only and multistate nursing programs would be managed separately, so any costs of investigations conducted for multistate license holders would be covered by multistate license fees and would not create an increase in Alaska-only nurse fees.

If there’s a nationwide nursing shortage, how will joining the NLC solve Alaska’s workforce needs?
NLC will reduce immediate cost and time barriers that are preventing nurses from working in Alaska. Further, only seven (7) U.S. states are predicted to have nursing deficits by 2030, but we’re expected to have the largest vacancy rate (over 22%). See here.

• Facilities have stated on the record that they lose new hires due to the time and cost of obtaining an Alaska license. Removing those barriers will help fill these vacancies in our health care workforce, making the NLC essential for Alaska.
• During the surge created by the COVID-19 Delta variant, state hospitals and long-term care facilities have identified more than 300 critical vacancies. DHSS is working to bring nurses up to Alaska to fill these vacancies through FEMA relief programs. When these nurses are identified, they can either pay $475 and wait days or weeks to be licensed. However, if we join the NLC, nurses that hold a multistate license can go to work immediately.
• The NLC significantly increases Alaska’s ability to find and hire out-of-state nurses to fill vacancies and provide high standards of care to Alaskan residents.

If Alaska joins the NLC, does that result in an inability to monitor where nurses are employed?
The Board of Nursing currently has no way of knowing who is working in the state or if/where they’re employed.

• This is not a matter within the board’s jurisdiction, rather, it is up to facilities to ensure their employees are properly licensed.
• The board will have access to licensing and disciplinary information on all multistate license holders.

Shouldn’t Alaska just “grow our own” nurses, rather than bringing in nurses from other states?
That would be ideal, but Alaska’s nursing programs do not produce enough nurses to fill all of the current or projected future vacancies.

• Based on the number of nursing graduates from the UA School of Nursing and Charter College over the last few years, even if all of Alaska’s nursing graduates stay in the state and obtain employment here, we will still have hundreds – if not thousands – of nursing vacancies in a few years.
• Many of Alaska’s nursing graduates leave the state because we are not a member of the NLC. Without membership, graduates must pay additional licensing fees and get behind other compact nurses in line for jobs in compact states.
• Many Alaskans require skilled nursing care in specialized areas that are not taught in the state. Nurses must obtain specialty experience through education or experience outside of Alaska.
• Joining the NLC will allow Alaska graduates more flexibility and allow them to return to Alaska, if they opt to practice elsewhere at some point, without any hassle or additional cost.
• Currently, there are around 1,500 of nursing vacancies across the state, and projections show that number will grow to 5,400 by 2030.

Do Alaska nurses support the NLC?
Overwhelmingly. The board conducted a survey in 2019 which indicated dramatic support from Alaska’s nursing workforce.

• 92% of the responding nurses stated they are in favor of joining the NLC, while only 3% opposed and 4% had no opinion.
• 87% of nurses who are members of a labor union stated they are in favor of the NLC, while only 8% opposed and 6% had no opinion.
• The survey was sent to all Alaska-licensed nurses (over 16,000) and received 3,573 responses – a statistically significant 22% response rate. The full results of the survey are available upon request and below.

Check out the Alaska Hospital & Healthcare Association’s one-pager on the NLC here.

Joining the NLC is a win-win. It allows us to maintain our current licensure options while increasing access to quality health care across Alaska’s communities by helping fill the hundreds of nursing vacancies across the state by allowing “squeaky clean” nurses (i.e., nurses that meet standards higher than Alaska’s nurse licensure requirements) to practice in the state without having to apply, pay, and wait for an Alaska-specific license.

This legislation is strongly supported by Alaska’s nurses, the Alaska Hospital and Healthcare Association, AARP, Alaska’s healthcare facilities, the U.S. Department of Defense, and many others.

Additional benefits:

• Access to Care: Expands access to nursing services across the country quickly and efficiently, which is essential for the health of many rural and underserved communities.
• Telehealth: Enables nurses to practice in person or provide telehealth nursing services to patients located across the country without having to obtain additional licenses.
• Disaster Relief: Allows nurses to immediately cross state borders and provide vital services in the event of a natural disaster or other emergency, without the need to wait for a declaration of emergency.
• Military Families: Allows military spouse nurses to seamlessly continue working without having to obtain a new license each time they relocate.
• Online Education: Facilitates online nursing education by reducing educators’ need for multiple licenses.
• Cost Effective: For Nurses: Nurses do not have to obtain additional nursing licenses, making practicing across state borders affordable and convenient. For Employers: The NLC also removes a burdensome expense for organizations that employ nurses and may share the expenditure of multiple licenses.
• Greater Efficiency: Eliminates redundancy, duplicative regulatory processes and unnecessary fees. It will reduce the number of applications that have to be processed by the Board of Nursing staff, therefore reducing the processing times and workload, while increasing the number of qualified nurses eligible to work in the state.
• Flexible Licensure: Allows nurses who do not wish to have a multi-state license or those who are ineligible for a multistate license to still obtain a single state license based on their state’s requirements and statutes.

Had the Legislature passed Governor Dunleavy’s bills to enact the NLC in Alaska before or while the COVID pandemic hit Alaska, the cost to healthcare facilities, individual health care providers, and state government could have been reduced; while nursing vacancies could have been filled more quickly, providing better access to healthcare and treatment to Alaskans.

The NLC will allow high-quality registered and practical nurses in any of the 39 participating U.S. jurisdictions to practice in Alaska without having to go through a time-consuming, redundant licensing process. It would reciprocate the privilege, providing Alaska nurses with a multistate license to practice in any participating state as well. This legislation will not affect certified nurse aides, advanced practice registered nurses, or any nurse who wishes to practice under an Alaska-only nursing license.

Alaska would become a member of the compact commission with rulemaking, enforcement, and financial assessment provisions. However, the commission does not in any way dilute or detract from the Alaska Board of Nursing’s ability to oversee and enforce nursing practice in Alaska. The State of Alaska and Board of Nursing will retain it’s full jurisdictional authority and state sovereignty.

The single-state and multi-state nurse licensing programs would have separate receipt support funding, which means the multistate licensing program will not impact the costs for the single-state licensees.

• Airlift Northwest
• Alaska APRN Alliance
• Alaska Association on Developmental Disabilities
• Alaska Behavioral Health Association
• Alaska Behavioral Health Services
• Alaska Board of Pharmacy
• Alaska Chamber of Commerce
• Alaska Department of Commerce, Community, and Economic Development
• Alaska Department of Health and Social Services (now Department of Health and Department of Family and Community Services)
• Alaska Department of Military and Veterans Affairs
• Alaska Hospital and Healthcare Association (AHHA; previously ASHNHA)
• Alaska Municipal League
• Alaska Native Health Board
• Alaska Native Medical Center
• Alaska Native Tribal Health Consortium
• Alaska’s Nurses!
• Alaska Pacific Regional Hospital
• Alaska Pacific University School of Nursing
• Alaska Primary Care Association
• Alaska Psychiatric Institute (API)
• Alaska Public Health Association
• Alaska Regional Hospital
• Alaska State Medical Association
• Alliance for Connected Care
• Alzheimer’s Resource of Alaska
• American Academy of Ambulatory Care Nursing
• American Association of Colleges of Nursing
• American Association of Occupational Health Nurses
• American Association of Retired Persons (AARP)
• American Telemedicine Association (ATA)
• Anchorage Chamber of Commerce
• Asian American/Pacific Islander Nurses Association
• Association of Mature American Citizens (AMAC)
• Bartlett Regional Hospital
• Bristol Bay Area Health Corporation
• Central Peninsula Hospital
• Charter College School of Nursing
• City of Seward
• Cordova Community Medical Center
• Denali Center Fairbanks
• Eleventh Air Force, Joint Base Elmendorf-Richardson (JBER)
• Emergency Nurses Association
• Fairbanks Memorial Hospital
• Fairbanks North Star Borough
• Foundation Health Partners
• Fresenius Kidney Care
• Heritage Place
• Kodiak Island Borough
• Maniilaq Health Center
• Maple Springs Palmer
• Maple Springs Wasilla
• Mat-Su Health Foundation
• Mat-Su regional Medical Center
• MODA
• National Council of State Boards of Nursing (NCSBN)
• National Governor’s Association Center for Best Practices
• National League for Nursing
• National Military Family Association
• National Patient Safety Foundation
• National Student Nurses’ Association
• North Star Behavioral Health
• Norton Sound Health Corporation
• PeaceHealth Ketchikan Medical Center
• Petersburg Medical Center
• Population Health Alliance
• Premera Blue Cross Blue Shield Alaska
• Prestige Care and Rehabilitation of Anchorage
• Providence Alaska Medical Center
• Providence Extended Care
• Providence Horizon House
• Providence Kodiak Island Medical Center
• Providence Seward Medical Center
• Providence St. Elias Specialty Hospital
• Providence Transitional Care Center
• Providence Valdez Medical Center
• Quyanna Care Center
• SEARHC Mt. Edgecumbe Hospital
• SEARHC Sitka Long-Term Care
• SEARHC Wrangell Medical Center
• South Peninsula Hospital
• Southeast Alaska Regional Health Consortium (SEARHC)
• Tanana Valley Clinic Fairbanks
• The Alaska State Board of Nursing
• U.S. Department of Commerce
• U.S. Department of Defense
• U.S. Renal Care
• UAA School of Nursing
• Wildflower Court
• Yukon-Kuskokwim Health Corporation

Yes! A December 2019 survey issued to all Alaska-licensed nurses by the Board of Nursing and National Council of State Boards of Nursing showed that 92% of Alaska-licensed nurses want Alaska to join the NLC, including 89% of nurses with primary residency in Alaska, and 87% of nurses that are members of a union.

Click here to see the full survey results.

Talk to your Legislators! The best way to voice your support for adopting the NLC in Alaska is to reach out to you legislators via email, phone, or in-person meetings to voice your support for HB 149 and Alaska joining the NLC. You can send a support letter via email to the committee(s) the bill has been referred to, with a cc to your legislator, so save you the time of emailing each of them individually if you’d like.

HB 149 has been referred to the House Labor & Commerce Committee and the House Military and Veterans Affairs committees, so you can send an email to both. Email addresses for these committees are House.Labor.And.Commerce@akleg.gov and House.Military.And.Veterans.Affairs@akleg.gov. You can determine which legislators represent you by entering your address into the “Who Represents Me?” box at the bottom left-hand side of the Alaska State Legislature’s website.

If you are interested in calling in to testify on HB 149, we recommend signing up to receive email notifications when HB 149 is scheduled for hearings or moves in or out of committees. When “public testimony” is listed, you’ll be able to call in and be given two (2) minutes to voice your support. Please utilize the Alaska Legislature’s Bill Tracking Management Facility system to sign up to receive these email notifications here.

For additional guidance on identifying, contacting, or addressing a letter to your legislators, visit the Alaska State Legislature’s Frequently Asked Questions.

• General Information on the NLC:
  • The Facts: Why the NLC is Right for Alaska
  • DCCED-CBPL NLC One-Pager
  • AHHA's NLC Flyer
  • NLC Website
  • States with Largest Nursing Shortages (Alaska’s at the top)
  • 2019 Survey of Alaska Nurses’ View on the NLC
  • NLC Fact Sheet
  • NLC Legislator FAQs
  • NLC Map
  • NLC Uniform Licensure Requirements for a Multistate License
  • NLC Key Provisions
  • Alaska's COVID Response and the NLC
• How the NLC Supports the Military & Military Spouses:
  • Federal/Military Nurses and Spouses: What You Need to Know
  • U.S. Air Force Support of Military Veterans: Professional Licensure Portability in Basing Decisions
  • U.S. Department of Defense – Military Spouse Licensure: State Best Practices and Strategies for Achieving Reciprocity Report
  • Council of State Governments: U.S. Air Force to Evaluate State Occupational Licensing Policies for Future Basing Decisions
  • Professional Licensing Report: U.S. Partially Bases Choice of Sites for Military Bases on States’ Success in Improving Reciprocity
  MilitaryTimes: Here’s What DoD Wants States To Do To Help Military Spouses with Their Occupational Licenses