Advanced Practice Registered Nurse (APRN) Compact Resource Page

Welcome to the MD Chesapeake NAPNAP Advanced Practice Registered Nurse (APRN) Compact Resource page.

 
In an attempt to streamline the flow of information, we have created this page to provide you with the resources you need to understand the APRN Compact as proposed by the NCSBN in 2020.
 
It is imperative to ACT NOW!
 
Click here to email your Maryland elected officials of your opposition to the APRN Compact.
 
The pre-formatted e-communication allows you to add your personal experiences so feel free to add relevant information to your note.

History of the APRN Compact and how it affects your practice and your patients: 

The National Council of State Boards of Nursing (NCSBN) is a US not-for-profit organization whose membership that includes the boards of nursing in the 50 states, the District of Columbia, and four US territories — American Samoa, Guam, Northern Mariana Islands and the Virgin Islands.  They developed the Consensus Model in 2008 which:
 
  • Identified the four APRN roles (CRNP, CRNA, CNM and CNS)
  • Stated APRNs should practice to their full level of education
  • And called for the removal of practice barriers
National Council of State Boards of Nursing (NCSBN) has been trying to pass an APRN Compact since 2002.  This is the third version of the APRN compact they have introduced.  Additionally, over 22 professional nursing organizations asked the NCSBN to revise this version of the Compact.
 
The APRN compact involves your scope of practice. It requires 2080 hours of practice before an APRN can apply for a compact license. These hours directly impact new graduate APRNs. These hours are not evidence based and are a political compromise to mitigate concerns in states that have trepidations about full practice authority for APRNs.
 
The inclusion of minimum practice hours as a requirement for a multistate APRN license directly conflicts with the Consensus Model and with evidence APRNs are prepared to safely enter practice after graduation from an accredited program and passage of a national certification board examination.
 
This APRN Compact opens Maryland APRNs to losing our “Fully Practice Authority”.  We fought to gain full practice authority and autonomy for over 10 years.  Additionally, since the COVID-19 pandemic 27 states and DC have full practice authority. 
 
This version of the APRN compact does not address prescribing controlled substances including ADHD medications across state lines.  You will still need to know all the states laws for the state you are in and the state the patient is in. Also, this APRN Compact would not authorize you to prescribe medications you can prescribe in Maryland, if the state that patient is in doesn’t let you.
 
There is no guarantee of an APRN on the oversight board or administration, meaning an APRN does not have a seat at the table of those overseeing our practice.   It is essential that the compact administrators have a full understanding of each APRN role, and the compact itself should require that a majority of the compact administrators be APRNs, and, that the compact include an APRN Advisory Committee, representing all four APRN roles, include representation from accreditation, certification, education and practice, as well.
 
The state legislators cannot amend this bill; it must be passed with the current language. The APRN Compact cannot be modified or changed later unless every state who has adopted the compact approves the amendment during their legislative session.
 
We stand with our colleagues and respectfully request that this version of the compact not move forward:
 
  • The National Association of Pediatric Nurse Practitioner (NAPNAP)
  • The American Academy of Nurse Practitioners (AANP)
  • The Nurse Practitioner Association of Maryland (NPAM)
Click here to find NAPNAP’s official statement opposing the APRN compact:  Official Statement Opposing New APRN Compact Requirements
 
Click here to find the NP Roundtable’s Statement opposing the APRN compact.
 
Click here to find the AANP position statement and information opposing the APRN compact:  APRN Compact: Get It Right, Then Get It Started
 
Click here to find the NPAM position statement opposing the APRN compact: https://www.npamonline.org/page/APRNCompact

MD: Chesapeake NAPNAP Chapter Official Statement Opposing the new APRN Compact Requirements

 
The Maryland Chesapeake Chapter of the National Association of Pediatric Nurse Practitioners (NAPNAP) protests the National Council State Boards of Nursing (NCSBN) passage of the 2020 version of the APRN Compact and will not support efforts to enact Maryland state legislation necessary for the implementation of this version of the APRN compact.
 
The MD Chesapeake Chapter of the National Association of Pediatric Nurse Practitioners includes over 200 primary and acute care pediatric nurse practitioners (PNPs) and pediatric advanced practice registered nurses (APRNs) who are committed to improving the health of and advocating for Maryland’s pediatric patients.
 
The inclusion of minimum practice hours as a requirement for a multi-state APRN license directly conflicts with the evidence that APRNs are prepared to safely enter practice after graduation from an accredited program and passage of a national certification board examination.  The minimum practice hour requirement hinders care access, increases health care costs, and does not improve patient outcomes. Conversely, removing APRN practice barriers like this could help increase health care access in underserved areas across the state, thereby improving health outcomes.
 
In addition, we cannot support this version as it fails to specifically include an APRN advisory committee to counsel Compact Administrators which is detrimental to advanced practice nursing as a profession. The perspectives and expertise of APRNs are essential to support and assist administrative entities governing the regulation of advanced nursing practice.
 
The COVID-19 public health pandemic has exposed oppressive barriers created by arbitrary inconsistencies and unnecessary restrictions in APRN licensure.  We realize the need for APRN compact licensure but cannot support this version with the current requirements including the minimum practice hours and omission of specific language stating an APRN will be on the advisory committee.
 
For these reasons the Maryland Chesapeake Chapter of NAPNAP opposes this version of the Advanced Practice Registered Nurse Compact.  We strongly support the concept of an APRN compact to enable advanced practice nurses to provide quality care across state lines. However, we cannot support this version.   We look forward to working to develop a version of the APRN compact we can support.  
 
 You can find our national organization’s statement by clicking here.