Updated List of Nurse Licensure Changes by State in Response to COVID-19
Think you can practice anywhere in an emergency? It’s still a state-by-state decision.
Back in March (March 18, 2020), Vice President Mike Pence announced that Health and Human Services (HHS) are preparing to suspend federal regulations that prevent medical professionals (nurses and doctors alike) from practicing across state lines given the current pandemic (i.e. removing the need to have state-specific or compact state licensure).
That said, as announced last Friday, states will need to apply directly with the Centers for Medicare & Medicaid Services (CMS) for a licensure waiver, and there will remain processes in place within each state to ensure proper licensure and the safety of the public. Following President Trump's signing of National Public Emergency (NPE), state governors will be able to sign an 1135 waiver that will allow their state to accept medical practitioners with licenses from other states.
When the President declared a national emergency on March 13th, the HHS Secretary was also granted “the power to waive certain federal licensing requirements so that doctors from other states can provide services in states with the greatest need.”
In other words, “requirements that physicians and other health care professionals be licensed in the State in which they provide such services, if they have equivalent licensing in another State and are not affirmatively excluded from practice in that State or in any State a part of which is included in the emergency area.”
This currently extends to “physician[s] or other health care practitioner[s] or professional[s].”
The CMS shared a press release clarifying this decision. The main takeaway: this is not a “de facto” one-license model that is immediately available; but rather, states that have declared a state of emergency can apply to the CMS for a state licensing waiver.
This will allow “providers with an active license in good standing from any state to service patients in their state and be reimbursed for those services by Medicare and Medicaid,” with the primary objective being to increase telehealth capabilities, and the secondary one being to increase numbers of local, in-person medical personnel.
What These Licensure Changes Mean for You
If you are a practicing physician, registered nurse, or other medical professional currently licensed in one state, given the current conditions dictated by the government’s response to the COVID-19 pandemic, you may have the opportunity to practice within any other state in need of additional medical personnel, as long as said state has applied to the CMS for a licensing waiver.
These changes apply primarily to telehealth initiatives (meaning you are able to perform remote services from your home state to any other state) but are also extended to in-person support.
For nurses specifically, this means that whether you currently possess a single-state or multi-state (compact) license, you will -- for the time being -- be fast-tracked through the state licensure process in any state that is included in the “emergency area” (currently the whole United States). This pertains to both telehealth functions as well as travel nursing roles.
How States Have Responded So Far
So far, according to the NCSBN and CMS, at least 45 states and territories have submitted to the CMS to waive certain medical provider licensing requirements. However, note that while the following changes have occurred, each healthcare facility is managing differently what their exact requirements entail; facilities facing a rapid-response crisis may be implementing these waiver changes, but generally, licensing is still required and in most cases will be expedited.
You can see the status of all states below (Updated and republished on 12/15/2020):
NOTE: some states are no longer following Emergency Declaration licensing and WILL require a local state license.
Alabama
- Nurse must initiate licensure application
- Licensure wait time: 48 hours
- Nurse Licensure Compact: Yes
- Alabama Board of Nursing Link
Alaska
- Nurse must initiate licensure application
- Licensure wait time: 10-15 days; potentially expedited
- Note: 14 days of quarantine may be required before working following inter-US travel
- Nurse Licensure Compact: No
- Alaska Board of Nursing Link
American Samoa
- Nurse Licensure Compact: No
- American Samoa Board of Nursing Link
Arizona
- Any active nursing license
- Licensure wait time: 30 days
- Nurse Licensure Compact: Yes
- Arizona Board of Nursing Link
Arkansas
- Any active nursing license, if sufficient time to process application (see wait time)
- Licensure wait time: 2 weeks; potentially expedited
- Nurse Licensure Compact: Yes
- Arkansas Board of Nursing Link
California
- Nurse must have active CA nursing license
- Licensure wait time: 8-10 weeks
- As of December 18, 2020, the following have been waived (for CA licensees):
- Examination and continuing education requirements for current healthcare licensees
- Reactivation requirements for inactive, retired, or canceled licensees - Nurse Licensure Compact: No
- California Board of Nursing Link
Colorado
- Any active license from a compact license (multi or single-state) accepted
- Licensure wait time: 8 weeks
- Nurse Licensure Compact: Yes
- Colorado Board of Nursing Link
Connecticut
- Any active nursing license
- Licensure wait time: 15 days
- Nurse Licensure Compact: No
- Connecticut Board of Nursing Link
Delaware
- Any active nursing license
- Licensure wait time: 7 days
- Nurse Licensure Compact: Yes
- Delaware Board of Nursing Link
Washington, D.C.
- Any active nursing license
- Licensure wait time: 3-6 weeks
- Nurse Licensure Compact: No
- Washington, D.C. Board of Nursing Link
Florida
- Nurse must initiate licensure application
- Licensure wait time: 10-30 days
- Nurse Licensure Compact: Yes
- Florida Board of Nursing Link
Georgia
- Any active nursing license, if sufficient time to process application (see wait time)
- Licensure wait time: 15 days
- Nurse Licensure Compact: Yes
- Georgia Board of Nursing Link
Guam
- Submitted 1135 waiver; any active nursing license can apply with the state's BON
- Nurse Licensure Compact: No
- Guam Board of Nursing Link
Hawaii
- Any active nursing license
- Licensure wait time: 1 day
- Note: 14 days of quarantine may be required before working following inter-US travel
- Nurse Licensure Compact: No
- Hawaii Board of Nursing Link
Idaho
- Nurse must initiate licensure application
- Licensure wait time: 7-10 days; potentially expedited
- Nurse Licensure Compact: Yes
- Idaho Board of Nursing Link
Illinois
- Nurse must initiate licensure application (current emergency application)
- Licensure wait time: 2-4 weeks; potentially expedited
- Nurse Licensure Compact: No
- Illinois Board of Nursing Link
Indiana
- Any active nursing license
- Licensure wait time: 2 weeks
- Nurse Licensure Compact: No
- Indiana Board of Nursing Link
Iowa
- Any active nursing license, if sufficient time to process application (see wait time)
- Licensure wait time: 5 days
- Nurse Licensure Compact: Yes
- Iowa Board of Nursing Link
Kansas
- Any active nursing license, if sufficient time to process application (see wait time)
- Licensure wait time: 2-4 weeks
- Nurse Licensure Compact: No
- Kansas Board of Nursing Link
Kentucky
- Any active nursing license, if sufficient time to process application (see wait time)
- Licensure wait time: 2 weeks
- Nurse Licensure Compact: Yes
- Kentucky Board of Nursing Link
Louisiana
- Any active nursing license
- Licensure wait time: <1 day
- Nurse Licensure Compact: Yes
- Louisiana Board of Nursing Link
Maine
- Nurse must initiate licensure application
- Licensure wait time: 7 days; potentially expedited
- Nurse Licensure Compact: Yes
- Maine Board of Nursing Link
Maryland
- Any active nursing license
- Licensure wait time: 5 days
- Nurse Licensure Compact: Yes
- Maryland Board of Nursing Link
Massachusetts
- Nurse must initiate licensure application
- Licensure wait time: 2-4 weeks; potentially expedited
- Nurse Licensure Compact: No
- Massachusetts Board of Nursing Link
Michigan
- Any active nursing license, if sufficient time to process application (see wait time)
- Licensure wait time: 3-5 weeks
- Nurse Licensure Compact: No
- Michigan Board of Nursing Link
Minnesota
- Any active nursing license, if sufficient time to process application (see wait time)
- Licensure wait time: 1-2 days
- Nurse Licensure Compact: No
- Minnesota Board of Nursing Link
Mississippi
- Any active nursing license, if sufficient time to process application (see wait time)
- Licensure wait time: 7-10 days
- Note: temporary license FAQ
- Nurse Licensure Compact: Yes
- Mississippi Board of Nursing Link
Missouri
- Any active nursing license, if sufficient time to process application (see wait time)
- Licensure wait time: 7-10 days
- Nurse Licensure Compact: Yes
- Missouri Board of Nursing Link
Montana
- Any active nursing license, if sufficient time to process application (see wait time)
- Licensure wait time: 10 days
- Nurse Licensure Compact: Yes
- Montana Board of Nursing Link
Nebraska
- Any active nursing license, if sufficient time to process application (see wait time)
- Licensure wait time: 2-3 weeks
- Note: 14 days of quarantine may be required before working following inter-US travel
- Nurse Licensure Compact: Yes
- Nebraska Board of Nursing Link
Nevada
- Any active nursing license, if sufficient time to process application (see wait time)
- Licensure wait time: 7-10 days
- Nurse Licensure Compact: No
- Nevada Board of Nursing Link
New Hampshire
- Nurse must initiate licensure application (current emergency license)
- Licensure wait time: 1-2 days (after criminal background check); potentially expedited
- Nurse Licensure Compact: Yes
- New Hampshire Board of Nursing Link
New Jersey
- Nurse must initiate licensure application
- Licensure wait time: 8-12 weeks; potentially expedited
- Note: Partially implemented nurse licensure compact — nurses holding compact licenses will find their licenses valid in New Jersey (for at least 180 days)
- Nurse Licensure Compact: No
- New Jersey Board of Nursing Link
New Mexico
- Any active nursing license, if sufficient time to process application (see wait time)
- Licensure wait time: 5 days
- Note: 14 days of quarantine may be required before working following inter-US travel
- Nurse Licensure Compact: Yes
- New Mexico Board of Nursing Link
New York
- Any active nursing license
- Licensure wait time: 4-6 weeks; potentially expedited
- Nurse Licensure Compact: No
- New York Board of Nursing Link
North Carolina
- Any active nursing license
- Licensure wait time: 2-3 weeks
- Nurse Licensure Compact: Yes
- North Carolina Board of Nursing Link
North Dakota
- Any active nursing license, if sufficient time to process application (see wait time)
- Licensure wait time: 3-5 days
- Nurse Licensure Compact: Yes
- North Dakota Board of Nursing Link
Northern Mariana Islands
- Submitted 1135 waiver; any active nursing license can apply with the state's BON
- Nurse Licensure Compact: No
- Northern Mariana Islands Board of Nursing Link
Ohio
- Any active nursing license, if sufficient time to process application (see wait time)
- Licensure wait time: 1-2 weeks
- Nurse Licensure Compact: No
- Ohio Board of Nursing Link
Oklahoma
- Any active nursing license, if sufficient time to process application (see wait time)
- Licensure wait time: 1-5 days
- Nurse Licensure Compact: Yes
- Oklahoma Board of Nursing Link
Oregon
- Any active nursing license
- Licensure wait time: 3-6 weeks
- Nurse Licensure Compact: No
- Oregon Board of Nursing Link
Pennsylvania
- Nurse must initiate licensure application
- Licensure wait time: 1-2 weeks; potentially expedited
- Nurse Licensure Compact: No
- Pennsylvania Board of Nursing Link
Puerto Rico
- Submitted 1135 waiver; any active nursing license can apply with the state's BON
- Nurse Licensure Compact: No
- Puerto Rico Board of Nursing Link
Rhode Island
- Any active nursing license, if sufficient time to process application (see wait time)
- Licensure wait time: 4 weeks
- Note: 14 days of quarantine may be required before working following inter-US travel
- Nurse Licensure Compact: No
- Rhode Island Board of Nursing Link
South Carolina
- Nurse must initiate licensure application
- Licensure wait time <1 day; potentially expedited
- Nurse Licensure Compact: Yes
- South Carolina Board of Nursing Link
South Dakota
- Any active nursing license, if sufficient time to process application (see wait time)
- Licensure wait time: 2 days
- Nurse Licensure Compact: Yes
- South Dakota Board of Nursing Link
Tennessee
- Any active nursing license
- Licensure wait time: 6 weeks
- Nurse Licensure Compact: Yes
- Tennessee Board of Nursing Link
Texas
- Any active nursing license
- Licensure wait time: 15 days
- Note: 14 days of quarantine may be required before working following inter-US travel
- Nurse Licensure Compact: Yes
- Texas Board of Nursing Link
Utah
- Any active nursing license, if sufficient time to process application (see wait time)
- Licensure wait time: 3 weeks
- Nurse Licensure Compact: Yes
- Utah Board of Nursing Link
Vermont
- Any active nursing license, if sufficient time to process application (see wait time)
- Licensure wait time: 5 days
- Nurse Licensure Compact: No
- Vermont Board of Nursing Link
Virgin Islands
- Nurse Licensure Compact: No
- Virgin Islands Board of Nursing Link
Virginia
- Any active nursing license, if sufficient time to process application (see wait time)
- Licensure wait time: 10 days
- Nurse Licensure Compact: Yes
- Virginia Board of Nursing Link
Washington
- Nurse must initiate licensure application
- Licensure wait time: 3 weeks; potentially expedited
- Nurse Licensure Compact: No
- Washington Board of Nursing Link
West Virginia
- Any active nursing license, if sufficient time to process application (see wait time)
- Licensure wait time: 7 days
- Nurse Licensure Compact: Yes
- West Virginia Board of Nursing Link
Wisconsin
- Any active nursing license, if sufficient time to process application (see wait time)
- Licensure wait time: 30 days
- Nurse Licensure Compact: Yes
- Wisconsin Board of Nursing Link
Wyoming
- Any active nursing license, if sufficient time to process application (see wait time)
- Licensure wait time: 15 days
- Nurse Licensure Compact: Yes
- Wyoming Board of Nursing Link
Most of the above states have granted temporary out-of-state licensure to applied and submitted healthcare professionals; while others have enacted an extension of the Nurse Licensure Compact, allowing out-of-state nurses in good standing to work locally. Some states have also announced an expedited, single-day licensure process.
All of the above as been done in response to recent events and state-of-emergency statuses. Coincidentally, some states, such as Arizona, Pennsylvania, and Montana extended various iterations of out-of-state licensure to help assimilate workers with "occupational licensure" (inclusive of physicians, nurses, and OTs) back in 2019, ahead of recent events.
While these impromptu modifications to state licensure allow support to be delegated to where it is needed most, we should have been better prepared to mobilize our health services prior to the inception of a national emergency. In the future, our hope is that more states will become compact states and that state-by-state licensure regulation allow for a more effective means of intra-state work.
Looking for a Travel Nursing Job in Another State?
You can create a free Trusted profile to begin browsing open nursing jobs in any of the above states and receive support moving through any of their modified licensure processes.
