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Committee hears APRN compact debate; supporters say it will increase access, opponents cite readiness concerns
Summary
House Bill 5 26 would join Montana to an interstate compact allowing certain advanced practice registered nurses to hold a multistate license; supporters said it would ease recruitment and cross‑state care, while nurse groups urged caution over eligibility standards and implementation details.
Representative Amy Regier presented House Bill 5 26 to adopt the Advanced Practice Registered Nurse (APRN) Interstate Compact. Supporters described the compact as a tool to improve access to health care in rural Montana by reducing duplicative licensing burdens for APRNs who practice across state lines or provide telehealth to patients in other compact states.
Supporters included the governor's policy director Rachel Green, Todd O'Hare of the Montana Chamber of Commerce, Heather O'Hara of the Montana Hospital Association, the Department of Labor and Industry, AARP Montana, the Montana Board of Nursing and others. Proponents said the compact would allow employers to recruit experienced APRNs more efficiently, reduce the administrative cost and time for providers who currently maintain multiple state licenses, and help continuity of care for rural patients and mobile providers. Kristen McCauley (APRN member of the Board of Nursing) described existing regulatory safeguards and said about 94 percent of Montana APRNs would meet the compact's 2,080 hours practice eligibility requirement.
Opponents — including the Montana Nurses Association and the American Association of Nurse Practitioners (AANP) speaker testimony — urged the committee not to advance this version of the compact yet. They argued that the APRN compact differs from previous licensure compacts (such as the Nurse Licensure Compact) and has unresolved issues including licensure eligibility, prescribing authority, and representation on compact governance. Opponents noted the compact has failed to pass or to reach enactment stage in multiple states and recommended more national standardization before Montana adopts the compact.
Committee members questioned witnesses about the 2,080‑hour practice requirement, how the compact interacts with residency and a state of domicile, expedited emergency licensure mechanisms and whether compact membership would immediately create practical benefits given only a few states had enacted the compact. Department of Labor and Industry staff said current compacts simplify qualification and that implementation would follow established compact processes used in other professions.
Ending: The hearing closed with the sponsor urging a due‑pass; committee members requested additional information on practice patterns, staffing impacts and how expedited emergency authorizations compare to the compact's portability benefits.
