Topic:
MEDICAL PERSONNEL; LICENSING;
Location:
NURSING;

OLR Research Report


March 1, 2004

 

2004-R-0229

LICENSING NURSES BY ENDORSEMENT IN CONNECTICUT AND FLORIDA

By: Saul Spigel, Chief Analyst

Patricia O'Rourke, Legislative Fellow

You asked for a comparison of nurse licensure requirements in Connecticut and Puerto Rico; whether Connecticut nurses must carry liability insurance; and why Connecticut permits registered nurses (RNs), but not practical nurses (LPNs), licensed in U.S. territories to be licensed here without taking an examination. You also asked about Florida's cost of implementing its new license by endorsement law for nurses, whether it has experienced any problems with implementation, and if its criminal history record check for nurse applicants includes records from Puerto Rico.

CONNECTICUT AND PUERTO RICO RN LICENSING REQUIREMENTS

Table 1 compares the requirements in Connecticut and Puerto Rico to obtain a license to practice as an RN.

Table 1: Connecticut and Puerto Rico RN Licensing Requirements

Requirement

Connecticut

Puerto Rico

Education

Graduated from a state-approved program consisting of theory and clinical practice in physical, biological, behavioral, and social sciences and nursing

Same

Examination

Successfully complete the National Clinical Licensure Exam (NCLEX)

If educated in Puerto Rico, successfully complete the commonwealth's licensing exam

If educated outside Puerto Rico, successfully complete NCLEX

MALPRACTICE INSURANCE FOR NURSES

Under Connecticut law only advanced practice registered nurses (APRN) who provide direct patient care services must carry malpractice liability insurance. Their minimum coverage must be at least $500,000 per occurrence and $1.5 million in the aggregate. An APRN who maintains current certification from the American Association of Nurse Anesthetists who provides such services under a licensed physician's direction does not have to carry malpractice insurance (CGS 20-94c).

Most nurses work in institutional settings, such as hospitals, nursing homes, and home health care agencies, or in physician's offices. Typically, their malpractice coverage is part of the institution's or corporate employer's insurance.

LICENSE BY ENDORSEMENT FOR NURSES FROM U.S. TERRITORIES

Connecticut law allows registered nurses who are licensed in a U.S. territory that has standards equivalent to or higher than Connecticut's to become licensed here without taking the state's nurse licensing exam. But, as you know, this licensure by endorsement alternative does not extend to practical nurses (CGS 20-94 and 97).

These differences have been in existence for several decades. The legislative record does not explain them, and no one at the Department of Public Health recalls a reason for them. The Public Health Committee has raised a bill at the department's request, which would eliminate this discrepancy. The bill is currently being drafted.

FLORIDA LICENSE BY ENDORSEMENT LAW

We have been unable to obtain any of the information you requested about Florida's new license by endorsement law. We contacted the Florida Nursing Board, the Department of Health, the Legislative Service Agency and the Legislative Office of Program Policy Analysis and Government Accountability, and the Florida Center for Nursing, but none of these entities returned our phone calls or responded to our email inquiries. We will continue our efforts and will forward to you any information we receive.

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