Maryland House of Delegates approves bill to join Advanced Practice Registered Nurse Compact


James Sklar


On March 20th, Maryland’s House voted 112-21 to pass HB 475, the Advanced Practice Registered Nurse Compact Act. The act would enter Maryland into the Advanced Practice Registered Nurse Compact (APRNC).


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The APRNC allows advanced practice registered nurses to have a multistate license that would allow those with a license to practice in states that are a part of the compact. The APRNC establishes criteria for participating states and sets requirements to obtain and retain an APRN license.

Three statesDelaware, North Dakota, and Utahare part of the APRNC, while seven statesArizona, Hawaii, Kentucky, Maryland, Montana, New York, and Texas—have pending legislation to become part of the APRNC.

“This bill addresses the manpower shortage with Advanced Practice Registered Nurses,” Del. Samuel Rosenberg (D – Baltimore City) said in a previous committee hearing. “This would create a voluntary option for those Advanced Practice Nurses who choose to enter the compact, both those residing in Maryland who may wish to perform their services elsewhere and making it easier for Advanced Practice Nurses to come to Maryland to address our needs here.”

HB 475 would establish a licensing board in Maryland to regulate the practice of APRNs. This board would have the power to approve applicants for the APRNC, investigate claims, or take adverse action against APRNs.

“Healthcare is growing more mobile, patients are turning to telehealth services more than ever, and [patients] are traveling to Maryland to receive excellent care here—APRN—delivered care here,” Nicole Livanos, director of state affairs for the National Council of State Boards of Nursing, said during the same hearing.

“The board of nursing conducted a survey, in 2022, looking at APRNs and state licensees looking for their opinions on the compact to see what the need was for a compact here. That survey found that 94% of APRNs, who responded, support the compact and want it as an option for their licenses. The survey also found that over 70% of APRNs practice across state lines in the past 24 months. Obviously, we had the COVID pandemic at that time. This demonstrates the need for the compact.”

Since HB 475 passed the House on March 20th, “Crossover Day,” HB 475 is now guaranteed to be considered in the Senate during the final three weeks of the legislative session, which ends April 10th.

APRNC is modeled after the Nursing Licensure Compact, which Maryland was the first state to join in 1999. The NLC currently has 25 participating states.