What are Interstate Compacts?

Interstate compacts are formal agreements between two or more states that bind them to the compacts’ provisions. The Compacts Clause of the Constitution—Article I, Section 10, Clause 3—grants states the authority to enter into interstate agreements to achieve a common purpose. 

Compacts provide states the opportunity to cooperatively address policy issues, ensure state agreement on complex policy issues, establish state authority over areas reserved for states, and allow states to speak strongly with one unified voice.

Interstate compacts do several important things, including:

    • Establish a formal, legal relationship among states to address common problems or promote a common agenda.
    • Create independent, multistate governing authorities (such as commissions) that can address issues more effectively than a state agency acting independently could or when no state has the authority to act unilaterally, or beyond its border.
    • Establish uniform guidelines, standards, or procedures for agencies in the compact’s member states.
    • Assist states in developing and enforcing stringent standards while providing an adaptive structure that, under a modern compact framework, can evolve to meet new and increased demands over time.

As we become more integrated socially, culturally and economically, the volume of policy issues will only increase and interstate compacts may well prove to be an apt mechanism for developing state-based solutions.

CSG and Occupational Licensure Compacts

CSG has been a part of helping to drive change in state occupational licensure policy in recent years. Based on this experience, CSG believes interstate compacts provide the most effective means for achieving borderless practice for licensed practitioners and military spouses relieving the burdens of maintaining multiple state licenses.

Since January 2016, 146 separate pieces of licensure compact legislation have been passed by the states. To date, 42 states and territories have enacted occupational licensure compacts for nurses, physicians, physical therapists, emergency medical technicians, psychologists, speech therapists/audiologists, occupational therapists, and counselors. The map below shows the widespread use of interstate compacts among professions who offer multistate practice to their practitioners. Although interstate compacts have been primarily utilized by healthcare professions, any profession may consider the development of an interstate compact for occupational licensing portability.

The current single-state licensure model is often inadequate for today’s mobile society. Traditional methods to support portability are inefficient for state licensing boards, and costly and burdensome for practitioners. Interstate compacts allow for an alternative regulatory structure that benefits practitioners, regulators, and consumers alike. Compacts promote license reciprocity and reduce the barriers to portability for licensees including military spouses who, due to frequent relocation, face higher barriers to entry in state-licensed professions:

    • Practitioners benefit from greater ability to practice geographically due to the opportunity to hold one multistate license valid for practice in all compact states, streamlined licensure requirements, reduced expenses associated with obtaining multiple single-state licenses and the creation of systems that enable electronic license application processes.
    • State licensure boards benefit by maintaining control over the state practice act and licensure processes, a centralized database of disciplinary action records, authority to require submission to FBI fingerprint-based criminal background checks and from economies of scale due to reduced administrative costs.
    • Consumers benefit from a more efficient distribution of services, increased availability of qualified practitioners and elevated safety standards.

Currently, the CSG National Center for Interstate Compacts is managing and/or advising the drafting, development and implementation of numerous professional licensure interstate compact programs, including:

    • Interstate Medical Licensure Compact (IMLC)
    • Nurse Licensure Compact (NLC) & Advanced Practice Nurse Compact
    • Emergency Medical Service Officials Licensure Compact (EMS Compact)
    • Physical Therapists Licensure Compact (PT Compact)
    • Psychology Interjurisdictional Compact (PSYPACT)
    • Audiology and Speech-Language Pathology Interstate Compact (ASLP-IC)
    • Occupational Therapy Interstate Licensure Compact (OT Compact)
    • Counseling Interstate Licensure Compact

NCIC’s extensive experience has enabled development of a comprehensive and proven methodology for successfully working with states to develop and enact compacts and working with organizations like the Insurance Compact to manage compacts.below

The CSG National Center for Interstate Compacts

The National Center for Interstate Compacts (NCIC) is a policy program developed by The Council of State Governments (CSG) to assist states in developing interstate compacts, which are contracts between states. State governments often prefer to direct themselves collaboratively when addressing problems that span boundaries, and compacts have proved to be an effective mechanism for states to jointly problem-solve, often avoiding federal intervention. NCIC serves as an information clearinghouse, a provider of training and technical assistance and a primary facilitator in assisting states in the review, revision and creation of new interstate compacts to solve multi-state problems NCIC was a program borne from the more than 85-year history CSG holds for  promoting multi-state problem solving and advocating the role of the states in determining their respective futures. During that time, CSG began tracking the progress of more than 200 active interstate compacts, researching innovative solutions for the states and bringing the states together to build consensus on national issues.

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