Policy issue – 1 p & 5-p pamphlet to AK Congressional member against nursing compact license in AK
You are a lobbyist for an issue that you find important. For example, you would like to see the banning of smoking in federal buildings (Note: This policy has already been enacted.) You are going to make an informational pamphlet to highlight your points to prominent members of Congress. Research members of Congress that you will target in your lobbying. Explain why these members are critical to your goal. Make a plan of action and produce a pamphlet supporting your cause. Who will you be reaching out to? Why? Write a cover letter to a Congressional member and include your reasoning for reaching out to them in particular in the letter. Remember a lobbyist is only as good as the information they provide. A lobbyist who provides incomplete or unreliable information will soon be unemployed, or lose access to officials.
This needs to include a 1 page letter to an Alaska state congressional member (I am not sure who would be the best congress member to reach out to, but governor Dunleavey proposed a bill for compact nursing licensure in Alaska, which I believe is not in the best interest of the state), and include a 5 page pamphlet on opposition for nursing compact licensure in the state of Alaska (HB238). I have included the grading rubric, instructions, and material I have already done or compiled. Additionally, I have included links for the governors bill (HB238) and the bill actions for legislature.
http://www.akleg.gov/basis/Bill/Detail/31?Root=HB%20238
http://www.akleg.gov/basis/Journal/Pages/31?Chamber=H&Bill=HB%20238&Page=01541#1541
This may also be a good resource for information – http://www.aknurse.org/index.cfm/Issues/Nurse-Licensure-Compact/305
Nurse Licensure Compact
Name
Institution Affiliation
Course
Professor
Date
The Honorable Don Young
House of Representatives
Anchorage District Office
471 W. 36th Avenue, Suite 201
Anchorage, AK 99503
Dear Representative,
As a student and a constituent, I am writing to urge you to act on a very important issue to me and the people of Alaska: Nurse Licensure Compact. Specifically, I urge you not to allow Nurse Licensure Compact in the state of Alaska.
As you are aware, Governor Dunleavey has introduced two bills HB 238 and SB 179 seeking to add the state of Alaska to the interstate nursing compact so as to allow nurses to practice between participating states.
As the longest member of Congress, you have represented the people of Alaska well over many decades and helped uphold the current status whereby the state has not adopted Nurse Licensure Compact. The people of Alaska wish to continue with the status quo.
The move initiated by the Governor to join the Nurse Licensure Compact is counter-productive. I have numerous concerns and I strongly oppose the adoption of Nurse Licensure Compact in our state.
Local Alaskan experts are best suited to make local decisions. Under the Compact arrangement, the people of Alaska will lose state sovereignty. We will hand over important decision making to a private trade group. The state also stands to lose out on revenue. Nurses from other states wouldn’t be required to pay the license fee to work locally. This would be a huge loss of revenue.
I ask your office to liaise with the Alaska Board of Nurses and other interested parties to formulate workable and realistic regulatory measures, offer solid solutions, and protect the sovereignty of the State of Alaska.
Sincerely,
(Signature)
Your Name
Nurse Licensure Compact
Overview
The Nurse Licensure Compact allows shared recognition of the nursing license between participating states in the nation. The agreement allows nurses to practice with patients in member states. It was developed by the National Council of State Boards of Nursing and reflects an agreement allowing nurses to have one license. The license is issued by the state of residence permitting a nurse to practice other states under the agreement. It is a form of mutual recognition whereby licensing authorities from different states voluntarily agree to accept licensure policies and processes of the licensee’s state of residence.
Problem
The Alaska Nurses Association is opposed to the Nurse Licensure Compact. AaNA has evaluated the Compact and concluded that registered nurses in Alaska will experience new complications were Nurses Licensure Compact adopted. The agreement is not a good option for nurses in Alaska, their patients, and the state. Under Nurse Licensure Compact, Registered Nurses are expected to follow the nursing practice laws of the state where the patient is located. The home state is nevertheless responsible for any discipline against a nurse. The Compact has a Coordinated Licensure Information System and a verification database (Oyeleye, 2019). As of June 2020, there are 34 states enlisted in the Compact. Alaska is not on that list but the state’s governor has introduced bills to join the Compact.
Why Nurse Licensure Compact is a Bad Option for Alaska
Loss of Sovereignty
Alaska enjoys complete autonomy in regard to nursing regulation allowing local professionals to make the best decisions tailored for the state. Joining the Compact will take away this autonomous decision making capability eroding the state’s sovereignty. The interstate arrangement imposes complicated regulatory mechanisms. Although the Compact’s Interstate Commission has rules and decisions that are binding on all participating states, an independent oversight lacks to check accountability (AaNA, 2019). Furthermore, nurses are concerned that NCSBN’s interstate commission activities are not transparent. It holds non-public closed meetings and has immunity to lawsuits.
There are no timelines for procedures for rule-making. The Compact also enjoys privileges such as calling for emergency rule-making. Approaches to determine when such rules are set only by NCSBN. Provisions for emergency rule-making may in fact violate Alaska Open Meetings Act and the Alaska Constitution. Adopting the Nurse Licensure Compact means ceding our responsibility and right to define and enforce the nursing standards of practice set out by our policymakers formulated to protect the public.
Threat to Public Safety
- Lack of ability to monitor nurses
The Alaska Board of Nursing regulates the practice of nursing in the state to safeguard the health and safety of the people of Alaska. Once the Compact agreement is formulated, the board loses the ability to track out-of-state nurses who come to practice. This hinders the board’s ability to protect the Alaskan public. All nurses must apply for the Alaska nursing license to practice in the state. Few nurses from the other 49 states have attempted to surpass this requirement. The board has been able to deny them from practice until they obtain the Alaska nursing license. The board will lose this power if Alaska adopts the Nurse Licensure Compact. It will effectively be unable to enforce its high standards for quality nursing practice.
The board also investigates complaints against nurses and hearings with state or federal law judges. States do not have uniform disciplinary standards and procedures, they vary. Conduct that may be considered malpractice in one state may not be so in another. If the local board investigates a claim and finds cause for disciplinary action but NLC does not agree, no disciplinary action will be taken against the nurse. This puts the people of Alaska at risk.
- Lower standards for nurses
Uniform licensure requirements from the NCSBN are often less rigorous than individualized state licensing requirements. For instance, the State of Alaska requires a nurse to have graduated from a nationally accredited school. Some states in the Compact do not have this requirement.
Loss of State Revenue
The board of nursing in Alaska is required to be financially independent. It receives no funds from the Legislature to fund its activities. Operations are funded through the licensing fees collected. Fees collected from non-resident nurses contributes a substantial proportion. Non-resident nurses and travel agency nurses would not be required to apply for the Alaska nursing license. This would be a substantial loss of revenue for the board. Joining the Compact also means an increase in expenses to the Alaska Board of Nursing. Expenses incurred during a disciplinary investigation are borne by the local board. Disciplinary fines go to the Alaskan general fund and not to the state nursing board. This puts the board in an unfair situation. The Compact is financially beneficial to out of state companies but a financial burden to local boards (AaNA, 2019). According to estimates by the Alaska Board of Nursing, the current RN two-year license renewal fee of $200 will increase by $46 to $83 if the state joined NLC.
The Compact Proponents
The need to solve workforce needs is one of the main justifications given by those supporting the Nurse Licensure Compact. There is no evidence that has been provided to support this claim. Another claim is that states take a lengthy time to issue licenses to nurses (Qualivis, 2018). This is not true for Alaska. The state Board of Nursing figures shows that around 90% of applicants are issued with licenses within 90 days upon application (AaNA, 2019). It is also important to dispel assumptions that NLC will somehow create an immediate pool of nurses to fix staffing challenges. It would not. Out of state nurses who wish to practice on a temporary basis in the state are free to do so anyway as travel nurses. Hurting the financial stability of the Board of Nursing for an arrangement that has not provided any evidence of addressing nurses’ needs is an unnecessary undertaking.
Conclusion
There are only two options left to states that are not in the Nurse Licensure Compact. They can either find ways to resolve the nursing challenges faced locally independently through their local Board of Nursing or bow to pressure and join the Compact. The Alaskan people, interested parties, the state legislature, the nurses’ association, and other stakeholders should cooperate to strengthen the Alaska Board of Nursing and offer effective regulatory measures that are realistic and workable. Such collaboration will develop real solutions and respect the sovereignty of the state. They should collectively reject the Nurse Licensure Compact. Adopting to the Compact means ceding the opportunity and the right to guide the Alaskan nursing practice future. It is possible to work together and offer solutions that put the people of Alaska first.
References
AaNA. (2019). The Nurse Licensure Compact: A Bad Option for Alaska Position Statement
by the Alaska Nurses Association. Alaska Nurses Association. file:///C:/Users/user/Downloads/AaNA%20Nurse%20Licensure%20Compact%20Position%20Paper.pdf
Boerger, E. (2020). Health bills to watch in Alaska’s 2020 legislative session. State of
Oyeleye, O. (2019). The nursing licensure compact and its disciplinary provisions: what
nurses should know. The Online Journal of Issues in Nursing. https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-24-2019/No2-May-2019/Articles-Previous-Topics/What-Nurses-Should-Know.html
Qualivis. (2018). Nurse licensure compact analysis report. Hanover Research.
https://www.qualivis.com/wp-content/uploads/2018/06/Qualivis_WhitePaperUpdate_18.pdf
