Little Rock, AR – To encourage case managers and CM employers to support compliance with Multistate Nursing Licensure, the CMSA Board of Directors revised an earlier position statement on Multistate Nursing Licensure in Case Management. According to CMSA President, Susan Rogers, RN, BSN, CCM, "CMSA's fundamental position on this topic remains unchanged. What's different is a more assertive position in support of appropriate safeguards for our members and case managers nationwide."  CMSA's view on multistate licensure is clearly stated in the organization's standards.

"The case manager practices in accordance with applicable local, state, and federal laws. The case manager has knowledge of applicable accreditation and regulatory statutes governing sponsoring agencies that specifically pertain to delivery of case management services."
— The CMSA Standards of Practice for Case Management – Revised 2002^©

Nurse licensure is regulated on a state-by-state basis with State Boards of Nursing requiring nurse case managers to be licensed within the states where patients reside whenever telephonic or on-site interactions occur with patients. When nurses provide case management services telephonically or onsite without a license to practice in the state of the patient's residence, he/she is violating the law. The violation is punishable with penalties of up to $1000, permanent loss of licensure, and up to one year in jail. 

Of additional concern to nurse case managers is the fact that no professional liability insurance carrier will cover an improperly licensed or non-licensed nurse in the event of actions which are deemed damaging to the patient. Therefore, case managers would be personally responsible for payment of damages if they are assessed. 

Through the National Council of State Boards of Nursing (NCSBN), 20 states have entered into a compact to recognize other states' licensing of nurses. A listing as of August 2005 is included below. The compact is tied to the state of the nurse's residence, not the state of practice or the patient's location. Therefore, if a nurse resides in and is licensed by a state that participates in the Nurse Licensure Compact, the nurse's licensure will be recognized by other states participating in the compact. 

Jeanne Boling, MSN, CRRN, CDMS, CCM, CMSA Executive Director explained, "The purpose of the CMSA position statement is to alert and to persuade individuals and organizations to aggressively encourage non-Compact State Boards of Nursing to join the Compact and to encourage federal legislation mandating recognition of nurse licensure across state lines in the same manner as drivers licenses are recognized." 

According to Rogers, "In response to this issue, CMSA is encouraging case managers and case manager employers to work aggressively with the State Boards of Nursing to encourage compliance and entry into the NCSBN as Compact States so that appropriate multi-state nursing licensure might continue appropriately and cost effectively.  In addition, or as an alternate step, CMSA is encouraging the enactment of federal legislation mandating the recognition of nurse licensure in all states. Finally, CMSA has added its name to the growing list of those organizations supporting and endorsing the Nurse Compact." 

To view the position paper or for more information on the Nurse Licensure Compact, click here.