Like the rest of the nation, Alaska is experiencing a workforce shortage in virtually every industry.  We see help wanted signs, long lines, and pleas for patience everywhere.  Unfortunately, Alaska’s healthcare system is no exception. 

While we all grapple with how to “solve” these workforce shortages over the long term for healthcare, there are immediate, commonsense actions we can and should take.  At the top of this list is joining the multistate nurse licensure compact, which is an agreement used by 39 states and jurisdictions in the U.S. that allows qualified nurses to practice across state lines with a single license.

Why is this important?  Based on Alaska Department of Labor Occupational Employment statistics, approximately 6,300 healthcare workers must be hired across Alaska every year to keep up with service needs.  The nursing profession alone requires more than 1,400 new recruits annually.  Clearly, there are more than enough job opportunities for all.  Even if we were to employ all the nurses graduating from our programs in state, Alaska is nowhere near filling this hole for the nursing profession, which means we must also bring nurses from out of state to help fill the gap. 

Unfortunately, Alaska’s licensing process is a deterrent for nurses interested in practicing here.  Due to workforce shortages with licensing examiners, growing backlogs, and other process challenges, it takes months to get a nursing license in Alaska.  With Governor Dunleavy’s support, the State’s licensing team has been working hard to streamline processes and cross train staff.  These efforts have been vital, but Alaska needs to take the next step and join the compact, especially when we hear stories of individuals waiting months for a license, and recruits turning down jobs in Alaska due to the long, onerous licensing process.  For example, we recently encountered a travel nurse on assignment in Alaska who wanted to stay here for the long term. She ultimately had to decline the position and leave Alaska because she did not want to give up her multistate license by opting to reside in a non-participating state such as Alaska. 

To make matters worse, many of Alaska’s hard-working nurses are closer to retirement age. A national study completed in 2019 – before the COVID-19 public health emergency hit and put additional stress on our healthcare system and workers – predicted Alaska would have 5,400 nursing vacancies by 2030.

Given the magnitude of the healthcare workforce shortage, we cannot afford to lose even a single nurse candidate, and we could avoid all this bureaucratic pain by simply aligning with a vast majority of the country and joining the nurse licensure compact. 

To be clear, the nurse licensure compact is the gold standard for safety and efficient licensing.  Following uniform practice standards and criteria will modernize our licensing process and take it from months to a matter of days.  This is a safe, proven approach that allows competent and qualified nurses to get to work quickly and efficiently, which is essential for the health of many rural and underserved communities.  It also supports our military community by allowing military spouse nurses to seamlessly continue working without having to obtain a new license each time they relocate.

Some have suggested that Alaska is too unique and joining a compact is an affront to our sovereignty.  This simply is not the case.  The nurse licensure compact is administered by the National Council of State Boards of Nursing, which is a not-for-profit organization consisting of the nursing regulatory bodies from all 50 states, the District of Columbia and four U.S. territories, meaning Alaska already is a participant in this organization.  Additionally, Hawaii, which arguably is the only other state that faces healthcare delivery challenges as “unique” as ours, is signaling that it may be joining the compact.  The head of a prominent labor union—the Hawaii Nurses Association—came out in strong support of the compact just last week.

Enacting the nurse licensure compact requires the Legislature to adopt the compact into law, meaning there is no ability to change any part of it without the scrutiny and approval of our legislators.  Additionally, Alaska’s Board of Nursing would still maintain full control of nursing regulations, the scope of nursing practice, and have the authority to suspend nurses who break the rules from working within our state.  The Board of Nursing would also still issue a single state license to those nurses who do not wish to have a multistate license or who do not meet certain criteria.

Finally, Alaska nurses overwhelmingly support joining the compact.  Based on a survey conducted in 2019 of over 3,500 Alaska nurses, 92% of respondents favored the compact.  Joining the compact is also widely supported by the Alaska Board of Nursing, Alaska’s hospitals, Alaska’s nursing homes, a variety of healthcare providers, and policymakers from both sides of the aisle.  While workforce challenges will always be with us and require long-term strategies, we should not let this stop us from taking an immediate, proven approach that will vastly improve Alaska’s healthcare workforce overnight.  The time to act is now.  Come January in Juneau, let’s make the right decision, pass legislation, and join the multistate nurse licensure compact.

Jared C. Kosin, J.D. M.B.A. is the President & CEO of the Alaska Hospital & Healthcare Association.  For 70 years, the Alaska Hospital & Healthcare Association has served as a non-profit trade association representing Alaska’s hospitals, nursing homes, and other healthcare partners across the continuum of care.

Julie Sande is the Commissioner of the Alaska Department of Commerce, Community and Economic Development (DCCED), which houses the Division of Corporations, Business and Professional Licensing (CBPL).

  compact, healthcare, licensure, nurses, shortage, workers