State risks nurse loss without compact

New rules to kick in 3 days after Legislature convenes in January; failure to sign on could force some out of job

For some nurses at Gila Regional Medical Center in Silver City, home is to the west — across the Arizona state line.

Since 2004, New Mexico has been part of a compact with 24 states allowing nurses to move from one to another without going through the rigmarole of getting a separate license in each.

But nearly all of those states have elected in the last few years to join a new compact.

And New Mexico is not among them. At least, not yet.

The new compact will be implemented Jan. 19, and if the state does not sign on by then, many nurses could be

left unable to practice in New Mexico.

“For a small hospital, that’s quite a percentage of our nursing staff,” said Peggy White, chief nursing officer at Gila Regional Medical Center.

With this hard deadline approaching, the relatively arcane issue of licensing nurses has become one of the most pressing for legislators as they head into a 30-day session that begins at noon Jan. 16. Lawmakers and the governor will have only a few days to enact the new compact or risk disrupting a health care system that is already grappling with a shortage of nurses.

While New Mexico government may not be known for speed, the issue has nonetheless fostered unusually wide-ranging bipartisan consensus.

“It’s unfortunate that this issue was not brought to the Legislature prior to the looming deadline,” Senate Majority Leader Peter Wirth, D-Santa Fe, said in a statement. “But the important thing is that we are going to address it swiftly and with broad bipartisan support, ensuring that New Mexico nurses as well as those from other states currently serving our communities will be able to continue practicing without interruption.”

The new compact has been in the works for years and updates rules on background checks for nurses as well as the process for managing the agreement.

Known as the Enhanced Nurse Licensing Compact, it was designed to be implemented either at the end of 2018 or sooner if approved by 26 states.

The new compact crossed that threshold by mid-July, putting in place the earlier deadline that falls only a few days after the next legislative session begins.

Some legislators have grumbled state officials should have brought up the issue during the 60-day session earlier this year.

“It wasn’t that people were laying on the oars,” countered Deborah Walker, executive director of the New Mexico Nurses Association.

Instead, she said, policymakers expected to have until the end of 2018.

The association has played host to meetings about the new compact around the state, and while there are concerns about some of the details, the urgency to sign on points to the popularity of such agreements with some nurses and particularly with rural hospitals.

Walker said there is a dearth of data on how many nurses with New Mexico licenses are practicing outside the state or how many nurses from other members of the compact are working in the Land of Enchantment.

But the compact has allowed, for example, school nurses in West Texas to work at schools in Southern New Mexico. And in a state with a shortage of nurses, the compact makes it easier for rural hospitals to draw on traveling nurses from around the country.

That can have a downside, too, Walker added. Traveling nurses can be costly. And many in nursing argue that communities deserve steady, reliable staff at their local hospitals rather than constant turnover.

But Walker argues dropping out of the compact altogether will not solve those issues.

New Mexico remains in the existing compact with just three states: Colorado, Wisconsin and Rhode Island. But Wisconsin is moving to join the new compact.

And some major states, such as California and New York, never joined the compact.

If the state does not meet the January deadline, however, nurses from states in the new agreement will not be able to practice in New Mexico until it joins.

To join, legislators would have to pass the compact as a bill, without amendments. And the governor would have to sign it.

Thirty-day sessions are usually dedicated to the budget, but observers expect Gov. Susana Martinez will add the issue to the agenda.

And Sen. Gay Kernan, R-Hobbs, said Friday she intends to sponsor the bill in the Senate.

“I think everyone understands the importance of getting this passed,” she said.

Though a sheet of “frequently asked questions” from the state Board of Nursing suggest labor unions in other states have opposed such compacts, the leader of a major union representing nurses around New Mexico said she is not opposed to it.

“We need nurses in the state,” said Lorie MacIver, president of District 1199 of the National Union of Hospital and Health Care Employees.

MacIver said she would prefer the compact include a sunset clause that would require legislators to renew it. Such a provision would prompt lawmakers to assess whether the compact — and some of its more controversial provisions — are working, she argued.

For example, the compact would require states use only one particular nursing exam. And a new organization would oversee the compact, though observers say they have not seen its bylaws or otherwise understand how exactly it will function.

In Silver City, White said Gila Regional Medical Center is trying to prepare its staff for a lapse in the compact, just in case.

“If they get a New Mexico license, we’ll pay for it,” she said.

That may not help with finding traveling nurses in an emergency. But still, White added: “We’ve given everybody a heads up.”