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  • 1.  Compact Licensure Question

    Posted 11-19-2024 09:23

    Good morning!

    This question is related to operationalizing when nurses must be licensed in multiple states in order to provide telehealth services/advice/nurse triage.

    My questions are specifically related to how you operationalized this multiple state licensure requirement.

    For example:

    1. If your state is a compact state, and your nurses provide telehealth care to patients out of state, do you license ALL of your nurses in ALL of the non-compact states?
    2. Does your organization pay for this?
    3. Are the individual nurses personally responsible to ensure they meet all of the licensure requirements for multiple states, or do you provide support from Human Resources to assist with this?
    4. Do you routinely ask and document where patients are physically located each time a nurse is providing telehealth advice?

    I wonder if this might be a good topic for a "community call"?

    Thank you,

    Joni

     

    Joni B. Menard, DNP, RN, CENP

    Vice President, Ambulatory Nursing

    Telephone (603) 650-6423

     

    Administrative Support

    Juliet M. Valela

    Juliet.M.Valela@hitchcock.org

    Telephone (603) 650-6002

     

    Dartmouth Hitchcock Medical Center

    Dartmouth-Health-org

     

     

     



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  • 2.  RE: Compact Licensure Question

    Posted 11-20-2024 08:31
      |   view attached

    Joni,

    We do cover calls for multiple states but only those that are compact states.  Initially we did license our nurses in noncompact states and our hospital paid for those licenses but it became a logistical nightmare.  We created a non-compact state caller guideline and standard work of ruling out any emergent or urgent symptoms with symptom based guideline and then utilizing the Non-Compact State Guideline to give a final disposition and advice. Please see the attached. 



    ------------------------------
    Teresa Baird BSN RN CPN
    Nursing Quality Specialist
    Children's Hospital Colorado
    Elizabeth CO
    (720) 777-3537
    ------------------------------

    Attachment(s)

    pdf
    Non-Compact State Caller.pdf   152 KB 1 version


  • 3.  RE: Compact Licensure Question

    Posted 11-21-2024 07:24
    hello Teresa,
    thank you for sharing the attached protocol. I have a question regarding this guideline, is this an EPIC triage protocol?
    thank you!
    M


    Melissa Taylor, MSN, RN, AMB-BC, NE-BC

    Director of Ambulatory Nursing – Primary Care

    Elliot Medical Group

    Phone: 603-663-3503

    Email: mtaylor@elliot-hs.org

     

     

    This document contains information constituting records and/or testimony relating to activities of a quality assurance committee and is therefore protected from direct or indirect means of discovery, subpoena, or admission into evidence in any judicial or administrative proceeding, pursuant to NH RSA 151:13-a and/or RSA 329:29-a.

     






  • 4.  RE: Compact Licensure Question

    Posted 11-20-2024 16:30
    We recently became a compact state, but the organization decided not to finance this. One of the reasons is because our providers do not have a compact license and therefore we would not have a supervising provider to support the triage and provide Rx, appts, recommendations. 

    Sharon Watts, MN, RN
    RN Supervisor, Ambulatory Virtual Teams
    Virginia Mason Franciscan HealthTM 
    Seattle, WA 

    "The most impactful leaders are those who listen with intention and act with compassion" 

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  • 5.  RE: Compact Licensure Question

    Posted 11-21-2024 11:10

    Our clinics span the state of Washington but we pull patients from Idaho and Oregan as well with rural ourtreach clinics we do. Most of our providers are licensed in Washington and Idaho and some have additional licensure in Oregon. These rural clinics all stem out of our Eastern Washington location. Because of this we have all RNs working out of the Eastern Washington locations maintain their Washington, Idaho, and Oregon license. Luckily Idaho and Washington are Compact states so we have had them all move to the Multi-State licensure so they are actually licensed in a lot more states if calls come in from any of those states. Our leadership this year elected to pay for the full Oregon licensure process for our RNs. We only have about 9 of them but the Oregon process is pricey which is why they did not opt to pay for the the RNs working in our Western Washington locations for the same requirement. This was a push this year. Moving forward it is the RNs responsibility to maintain the licensures. 



    ------------------------------
    Kristie Hills
    Clinical Nurse Specialist
    Spokane WA
    ------------------------------