What are Interstate Compacts?

Interstate compacts are formal, legislatively enacted agreements between two or more states that bind them to the compacts’ provisions. 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, multi-state 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.

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, 170 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.

    • 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 (APRN 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. To learn more about the law and use of interstate compacts, click on the resources below.