Abstract
State legislations play a critical role in supporting local endeavors and integrating national-level ideas into a regional context. The emergence of the National Licensure Compact opened many opportunities for nurses across the nation, and many states immediately became part of it. The state of New Jersey is also willing to become a part of the compact, and bill A1597 was proposed to serve this purpose. This paper explores the details of the bill and what consequences there will be in terms of benefits and disadvantages. Considering the experience of other states and the number of states joined, numerous decisions can be made. While some local healthcare institutions may object to the state’s decision, it is definitely a favorable idea to join the NLC. It will have a positive impact on the nursing profession and practicing nurses.
Introduction
The New Jersey State Bill NJ A1597, first presented at the beginning of 2018, will have the state enter the Nursing Licensure Compact (NLC) (2019). The compact allows practicing nurses to obtain a single license and provide their services across the states that are parties of the NLC. Currently, A1597 is stated to be in the committee review, but on May 20, 2019, it was substituted by a similar bill, S954, which made several amendments to the original proposal (2019). The latter bill has already been enacted, and the state is currently working towards implementing the necessary steps provisioned by the NLC. When New Jersey passes all phases of implementation, nurses residing in the Garden State will have an opportunity to work in other parts of the country with a single license. This paper intends to provide details on both the bill and the legislative process of the state of New Jersey.
New Jersey Legislative Process
The New Jersey Legislative process is similar to how a Federal bill becomes law. Legislature in the state of New Jersey is comprised of the Senate with 40 members and the Assembly with 80 members. Only after both chambers approves a bill and the governor signs is the proposal accepted as law. However, a bill passes through numerous phases before being ratified or vetoed.
There are sponsors, usually, legislators, who decide to develop an idea, but the suggestion may come from interest groups, the governor, or other public officials. Other legislators in the same chamber may join the group as cosponsors. Then, the legislator directs the Office of Legislative Services to research the issue at hand and provide drafting assistance. This non-partisan agency of the legislature helps put the idea to a proper and technically correct format.
The introduction of the bill happens during its first reading, when a senate secretary, or an assembly clerk, reads the bill’s title aloud during a session. Then, the bill is released to the public in print form. There is usually a review on behalf of a committee, but the Senate President may choose to send the bill to the second reading without initiating a review process. However, if the review takes place, the committee may introduce amendments or substitute them entirely.
Amendments can also be made during the second reading and must be returned to the second reading from subsequent phases for any additional modifications. The third reading usually may not take place on the same day as the previous, except for emergencies when 75% percent of the members vote for immediate proceedings. A majority of authorized members of the Senate or the Assembly must approve the bill for it to be passed. After the voting process, the bill is given to the other chamber. The second house may make amendments, in which case the bill is returned to the initiator for approval of changes. The final legislative endorsement is given after both chambers agree on the bill and amendments are made.
As the final stage, the governor receives the bill for review. They may sign it, in which case the bill becomes law on the specified day or on the 4th of July if no date is indicated. The governor may also veto the bill conditionally and return it for changes or impose an absolute veto. If the governor chooses to take no action, the bill becomes law after 45 days. The legislature may also override the governor’s veto if 67% percent of the members approve it.
Differences between the Senate and Assembly Versions
Both the Senate and the Assembly may introduce their own changes to a bill at hand. However, for a bill to be finally approved and move to the subsequent phase, both chambers must agree on each other’s amendments. In the case of the bill NJ A1597, which was proposed by the Assembly members, the Senate has not yet had the chance to review and make its amendments because the bill has not reached the third reading. The committee proposed numerous changes, and NJ S954 eventually substituted the bill. The difference between NJ A1597 and NJ S954 bills is that the Senate’s bill adds details to NLC’s interaction with the New Jersey Revised Statutes Title 45. The original bill states that NLC will not supersede the provisions of Title 45 on any occasion. However, S954 indicates that, in cases of conflict between chapter 11 of Title 45 and the NLC, the regulations of NLC will be superior. NJ S954 is also more technical and precise in terms of the language used and the formatting it follows.
The Rationale for Choosing NJ A1597
The main objective of nursing is providing quality support and care and enhancing patient outcomes. For many years, nurse licensing has been a primary method for ensuring a nurse meets minimum requirements for providing care. However, complex procedures and the necessity to obtain a license in each state where they want to practice pose a hindrance to many nurses across the country. The initiative of the NLC is a comprehensive solution to challenges associated with nurse licensing, and the bill that will have New Jersey enter the compact is, therefore, appealing to study.
Impact on Health and Welfare of the Public
Licensing is a necessary component of contemporary nursing because it protects the public from incompetent specialists that may pose a threat to human health and increases the quality standards. When the state of New Jersey joins the NLC, there is going to be an enhancement in patient outcomes because more experienced nurses from other states will have an opportunity to provide care in New Jersey. The presence of visiting nurses will increase competitiveness in the local healthcare market because the local nurses will have to pursue higher education and experience standards set by the NLC. In summary, the people of New Jersey will have access to a broader range of nursing services and a higher number of professionals.
Benefits and Limitations of the Bill
The bill will provide New Jersey access to resources of the NLC. The nursing market will experience an uplift because more nurses will come from other parts of the country, resulting in a more diverse range of services and a higher level of skills and expertise. Nurses residing in New Jersey will also be in an advantageous position – they will have access to more job opportunities than before and possibilities for professional growth and advancement. However, there are also potential downsides for nurses in New Jersey. Because the NLC uses a centralized system for storing nurse data, there may be complications and challenges in terms of job opportunities and licensing obtainment and renewal. For instance, any mistake made by a nurse will be recorded in the system, which may later pose a hindrance when the nurse will seek employment. Licensing and renewal may be subject to bias because the nurse’s history may adversely influence the opinion of the licensing board on the subject nurse.
My Views and Position on the Legislation
As the majority of the states are already a part of the NLC, I am confident that this bill is the right step towards improved healthcare and quality patient services. New Jersey already has experience in being a member of the NLC because, until 2007, it was considered as an NLC party. I am curious why the state legislature waited for more than a decade to initiate hearings on re-entering the NLC on a permanent basis. Because New Jersey will provide enhanced access to care while maintaining protection at its own level under the NLC, I do not see any adverse implications in joining the compact.
There are several ways how the NLC may benefit patient outcomes in New Jersey. First, there are specific requirements that each state must adhere to, and these provisions are set to facilitate the responsibility of each state to protect the safety and health of the public. In other words, New Jersey will improve its regulation processes by setting higher standards proposed by the compact. New Jersey will also have access to a diverse and vibrant amount of information regarding nursing practice, licensure, and regulation. These and other benefits proposed by the NLC make entering the compact not only a favorable idea but also a necessary step for advancements in the nursing industry.
As part of the NLC, New Jersey will increase its operational efficiency because redundant processes associated with licensing will be eliminated. These improvements may result in more efficient resource use in terms of financial supplies. The state will have an opportunity to invest saved funds into other vital areas of nursing practice, such as education and professional development. In summary, I believe the bill is not debatable because there are more benefits than risks.
Impacted Stakeholders
Because this bill is only state-level and is about joining an initiative that has been functioning for a prolonged period of time, many healthcare stakeholders may not pay a substantial amount of attention to it. However, the American Nurses Association (ANA) has had fundamentally different views since the establishment of the NLC. More specifically, the ANA considers the region of practice to be where the nurse is resided, whereas the compact states it to be the patient’s location. There are other places in the NLC’s rules and provisions that need more clarity from the perspective of the ANA. Therefore, this association might present its recommendations regarding New Jersey’s bill in terms of the set of possible implications and challenges.
The New Jersey State Nursing Association (NJSNA) might come out with its objections because of several reasons. First, the NLC may become more appealing to nurses than membership in the NJSNA, in which case, the NJSNA will experience a lower number of applicants and lower profit. Second, the NJSNA is an official representative of the ANA in New Jersey and may share the same concerns about the compact as the ANA.
If it were possible, I would contact both the ANA and the NJSNA to request their opinion about the bill. It is interesting to know what the current position of these stakeholders is, as they may share the details and some implications on the compact that are not known to the public. There may be hidden complications and disadvantages that may impact both the nurses and the patients. Having comprehensive information on the current issues is necessary to provide an unbiased opinion and make objective judgments.
Impact on Nursing and Nursing Profession
The bill is going to have an influence on both individual nurses and nursing as a profession. Currently, there is an inevitable gap in education quality between the different regions of the United States. Enforcing the uniform licensing requirements throughout the country will have an impact on nursing training because most institutions will strive to provide the same degree of preparation as the NLC parties expect from the prospective licensees.
As already mentioned, joining NLC will provide practicing nurses with additional employment and education opportunities. The time that nurses used to spend for the obtainment of licenses in each state they wanted to work in will be spared for professional development and growth. Nurses from other states will come to New Jersey, which will increase competitiveness and contribute to the higher quality of care and support.
On the national level, the nursing profession will experience many improvements. First, access to various nursing resources in terms of educational materials and growth opportunities will be easier because the NLC requirements are the same for all states. In other words, the promotion of the idea of equal opportunity for all nurses around the country will have positive effects on the motivation of nurses. The professionals who travel to different states for work will facilitate mutual understanding and knowledge sharing. Such possibilities will contribute to the versatility of nurses and their professionalism.
Government Officials
As of 2019, New Jersey’s state senators are Bob Menendez and Cory Brooker, and they both represent the Democratic party. The U.S. representative for my congressional district, which is the 9th, is William James Pascrell Jr., who has been serving this district since 2013. The two assemblymen I have identified are Clinton Calabrese and Gary Steven Schaer. They are both Democrats and represent the legislative district 36.
Conclusion
There are significant changes that are coming to the nursing industry in New Jersey. Many complications related to licensing and interstate work will be eliminated, which will pave a road to additional benefits both for the prospective and practicing nurses. Bill A1597, which was later substituted by S954, suggests the state of New Jersey join the NLC, which is a vital initiative in nursing licensure. This endeavor will mostly result in benefits and favorable opportunities.
Reference
A1597, Assemb. Reg. Sess. 2018-2019. (N.J. 2019).