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Dr. Terry Rabinowitz, right, talks with nurse Leslie Orelup at Helen Porter Nursing Home in Burlington, Vt.

The House passed a bill 55-50 that, if signed into law, will allow nurses who meet uniform licensing requirements to work in person or through telemedicine in more than 30 states.

State Rep. Mary Whiteford, a Casco Township Republican, sponsored House Bill 4042.

The legislation seeks to allow Michigan to enter the Nurse Licensure Compact (NLC), which would enable nurses to practice in the 34 states currently in the compact without having to gain a license in each state.

“These young nurses who want the flexibility to be a travel nurse, or go to different parts of the country, are choosing to go and get licenses in a Compact state, and not in Michigan,” Whiteford told The Center Square.

Whiteford, who chairs the House Appropriations Subcommittee on Health and Human Services, said that applying for multiple licenses to work across state lines is time-consuming and that entering the NLC would increase access to care, protect patients, and reduce healthcare costs.

“This is an advantageous program for Michigan to be a part of, especially along border communities where nurses will be able to more freely work across state lines as we work to improve convenient access to care,” Whiteford said in a statement. Whiteford previously worked as a nurse.

A 2017 U.S. Department of Health and Human Services study projects varied supply and demand of full-time equivalent registered nurses (RN) in different states.

The study projected seven states would have an RN shortage in 2030, including California, 44,500; Texas, 15,900; and New Jersey, 11,400.

Other states were projected to have an excess RN supply in 2030, including Florida, 53,700; Ohio, 49,100; and Virginia, 22,700.

The NLC could even those disparities with enacted or pending legislation in all but seven states.

Each NLC state can still revoke, suspend or place a nurse’s multi-state license on probation if warranted.

The Michigan Health and Hospital Association told The Center Square it supported the bill “because of the cost effective benefits it provides to both nurses and our members in regards to telehealth services and making practicing across state lines convenient.”

“In addition, HB 4042 allows nurses to quickly travel to other states to provide vital services in the event of a disaster or public health emergency.”

Bill critics argue the NLC licensure would be too complex, that the quality of medical care could suffer because of state training differences, and that the state would bear additional fees.

"The Michigan Nurses Association Board has voted to oppose Michigan becoming a compact state because we want to maintain the high standards that Michigan has for nurses who practice here," MNA President and RN Jamie Brown told The Center Square in a statement. "In the compact, it’s a matter of the lowest common denominator among states. Patients deserve better than that."

Brown said that nurses who want to be licensed in multiple states can follow the current process, instead of one that's riskier and more complicated. 

The Department of Licensing and Regulatory Affairs (LARA) opposed the bill.

LARA estimated $115,000 in total associated costs for investigating complaints against nurses who live in other states but practice in Michigan, processing licenses, and monitoring investigation repayment costs.

LARA estimated an annual $250,000 rule enforcement cost for the Attorney General and the Michigan Office of Administrative Hearings and Rules.

The bill has moved to the Senate for consideration.

“This bill empowers nurses to go and be their own best person, whether they work in Michigan or travel to other states,” Whiteford said.

– The Center Square

Staff Reporter

Scott McClallen is a staff writer covering Michigan and Minnesota for The Center Square. A graduate of Hillsdale College, his work has appeared on and Previously, he worked as a financial analyst at Pepsi.