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Updated List of Nurse Licensure Changes by State in Response to COVID-19

Mar 18, 2020
The Trusted Team

Think you can practice anywhere in an emergency? It’s still a state decision.

Yesterday morning (Wednesday, March 18th), 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 5/21):

Note that some states are no longer following Emergency Declaration licensing and WILL require a local state license.

Alabama

  • Submitted 1135 waiver; Licensed nurses can work in Alabama without a state-specific license for a period of 30 days after the Governor declares a state emergency
  • Licensure wait time <1 day
  • Nurse Licensure Compact: Yes
  • Alabama Board of Nursing Link

Alaska

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Requiring healthcare workers to complete 14 days of quarantine 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

  • Submitted 1135 waiver; "temporary waiver of professional licensure requirements necessary[...] to address the state of emergency."
  • Nurse Licensure Compact: Yes
  • Arizona Board of Nursing Link

Arkansas

  • Implemented an expedited licensing process (single-state and valid for three months)
  • Current 1135 waiver status
  • Licensure wait time ~24 hours
  • Nurse Licensure Compact: Yes
  • Arkansas Board of Nursing Link

California

  • Submitted 1135 waiver; Any state license is welcome but must be registered by the facility (requires 2-4 business days)
  • Nurse Licensure Compact: No
  • BON Verification Link
  • California Board of Nursing Link

Colorado

  • Any compact license (multi or single-state) will be accepted
  • Nurse Licensure Compact: Yes
  • BON Verification Link
  • Colorado Board of Nursing Link

Connecticut

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Licensure wait time <1 day
  • Nurse Licensure Compact: No
  • Connecticut Board of Nursing Link

Delaware

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Nurse Licensure Compact: Yes
  • Licensure wait time <1 day
  • Delaware Board of Nursing Link

Washington, D.C.

  • Submitted 1135 waiver; Licensed nurses can work in D.C. without a state-specific license
  • Licensure wait time <1 day
  • Nurse Licensure Compact: No
  • Washington, D.C. Board of Nursing Link

Florida

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Licensure wait time <1 day
  • Nurse Licensure Compact: Yes
  • BON Verification Link
  • Florida Board of Nursing Link

Georgia

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Licensure wait time ~24 hours
  • Nurse Licensure Compact: Yes
  • Georgia Board of Nursing Link

Guam

  • Submitted 1135 waiver; Licensed nurses can work in Guam without a state-specific license
  • Nurse Licensure Compact: No
  • Guam Board of Nursing Link

Hawaii

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Licensure wait time <1 day
  • Requiring healthcare workers to complete 14 days of self-quarantine before working following US travel
  • Nurse Licensure Compact: No
  • Hawaii Board of Nursing Link

Idaho

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Expedited online process
  • Licensure wait time ~1-2 days
  • Nurse Licensure Compact: Yes
  • BON Verification Link
  • Idaho Board of Nursing Link

Illinois

  • LPNs, RNs, and APRNs can receive a temporary practice permit good until September 30th, 2020, if they have an active license in another US state
  • Licensure wait time ~1 week
  • Nurse Licensure Compact: No
  • Illinois Board of Nursing Link

Indiana

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Licensure wait time <1 day
  • Nurse Licensure Compact: No
  • Indiana Board of Nursing Link

Iowa

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Nurse Licensure Compact: Yes
  • Iowa Board of Nursing Link

Kansas

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Offering exemption: "An exempt license shall be granted only to a registered professional or practical nurse who meets these requirements: (1) Is not regularly engaged in nursing practice in Kansas, but volunteers nursing services or is a charitable health care provider..."
  • Nurse Licensure Compact: No
  • Kansas Board of Nursing Link

Kentucky

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Licensure wait time ~1-2 days
  • Nurse Licensure Compact: Yes
  • Kentucky Board of Nursing Link

Louisiana

  • Submitted 1135 waiver; Temporary licensing and credentialing for healthcare providers willing to assist from out of state
  • Licensure wait time ~1 week
  • Nurse Licensure Compact: Yes
  • Louisiana Board of Nursing Link

Maine

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Nurse Licensure Compact: Yes
  • Maine Board of Nursing Link

Maryland

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Licensure wait time <1 day
  • Nurse Licensure Compact: Yes
  • BON Verification Link
  • Maryland Board of Nursing Link

Massachusetts

  • Submitted 1135 waiver; adopted a policy to expedite the processing of reciprocal license applications for nurses that are licensed in another state to meet needs in the event of a declared public health emergency
  • Expedited online process of "reciprocal licensure" (requires 1 business day)
  • Licensure wait time ~24 hours
  • Nurse Licensure Compact: No
  • BON Verification Link
  • Massachusetts Board of Nursing Link

Michigan

  • Submitted 1135 Waiver; Valid license from another state can apply with the state's BON
  • Licensure wait time <1 day
  • Nurse Licensure Compact: No
  • Michigan Board of Nursing Link

Minnesota

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Licensure wait time <1 day
  • Nurse Licensure Compact: No
  • Minnesota Board of Nursing Link

Mississippi

  • Valid license from another state can apply with the state's BON
  • Temporary license FAQ
  • RN/LPN Disaster Waiver Application; APRN Disaster Waiver Application
  • Licensure wait time ~1-3 days
  • Nurse Licensure Compact: Yes
  • Mississippi Board of Nursing Link

Missouri

  • Submitted 1135 waiver; Expedited licensure applications: anyone who graduated nursing school after December 16, 2019 but has not yet taken the NCLEX (has not been denied licensure) can practice as a graduate nurse pending the results of their first licensing exams or 180 days (whichever comes first)
  • Nurse Licensure Compact: Yes
  • Missouri Board of Nursing Link

Montana

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Nurse Licensure Compact: Yes
  • Montana Board of Nursing Link

Nebraska

  • Submitted 1135 waiver; Requiring healthcare workers to complete 14 days of quarantine before working following inter-US travel (especially travelers from Denver; Kansas City, Missouri; and Chicago, as well as other national and international places with high numbers of people infected with COVID-19)
  • Nurse Licensure Compact: Yes
  • Nebraska Board of Nursing Link

Nevada

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Nurse Licensure Compact: No
  • Nevada Board of Nursing Link

New Hampshire

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Expedited online process
  • Nurse Licensure Compact: Yes
  • BON Verification Link
  • New Hampshire Board of Nursing Link

New Jersey

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Partially implemented nurse licensure compact: nurses holding compact licenses will currently find their licenses valid in New Jersey (for at least 180 days)
  • Any valid multi-state license from any state will be accepted
  • Licensure wait time ~24 hours
  • Nurse Licensure Compact: No
  • New Jersey Board of Nursing Link

New Mexico

  • Submitted 1135 waiver; Any valid license from any state will be accepted and will not need a New Mexico license until upwards of 30 days thereafter
  • Any travel nurse entering New Mexico for assignment must self-quarantine for 14 days before showing up to work
  • Licensure wait time <1 day
  • Nurse Licensure Compact: Yes
  • BON Verification Link
  • New Mexico Board of Nursing Link

New York

  • Submitted 1135 waiver; Any valid/active license from any state will be accepted, does not need to register with the New York Board of Nursing
  • Licensure wait time <1 day
  • Nurse Licensure Compact: No
  • BON Verification Link
  • New York Board of Nursing Link

North Carolina

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Retired nurses (within five years) can return to work, and nursing students who have graduated but not yet taken the NCLEX can practice as graduate nurses
  • Licensure wait time <1 day
  • Nurse Licensure Compact: Yes
  • BON Verification Link
  • North Carolina Board of Nursing Link

North Dakota

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Licensure wait time <1 day
  • Nurse Licensure Compact: Yes
  • North Dakota Board of Nursing Link

Northern Mariana Islands

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Nurse Licensure Compact: No
  • Northern Mariana Islands Board of Nursing Link

Ohio

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Licensure wait time <1 day
  • Nurse Licensure Compact: No
  • Ohio Board of Nursing Link

Oklahoma

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Licensure wait time <1 day
  • Nurse Licensure Compact: Yes
  • Oklahoma Board of Nursing Link

Oregon

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Licensure wait time ~1 week
  • Nurse Licensure Compact: No
  • Oregon Board of Nursing Link

Pennsylvania

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Licensure wait time ~1-3 days
  • Nurse Licensure Compact: No
  • Pennsylvania Board of Nursing Link

Puerto Rico

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Nurse Licensure Compact: No
  • Puerto Rico Board of Nursing Link

Rhode Island

  • Submitted 1135 waiver; Any valid license from any state will be accepted (permits 90-day license to practice that can be extended once)
  • Requiring healthcare workers to complete 14 days of quarantine before working following inter-US travel
  • Licensure wait time ~1-2 days
  • Nurse Licensure Compact: No
  • Rhode Island Board of Nursing Link

South Carolina

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Expedited online process (requires 1 business day)
  • Licensure wait time <1 day
  • Nurse Licensure Compact: Yes
  • BON Verification Link
  • South Carolina Board of Nursing Link

South Dakota

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON (license to be honored for 90 days)
  • Licensure wait time ~24 hours
  • Nurse Licensure Compact: Yes
  • South Dakota Board of Nursing Link

Tennessee

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Licensure wait time <1 day
  • Nurse Licensure Compact: Yes
  • BON Verification Link
  • Tennessee Board of Nursing Link

Texas

  • Submitted 1135 waiver; Any valid license from any state will be accepted, nurses must be submitted using this process via the Texas Board of Nursing
  • Requiring healthcare workers to complete 14 days of quarantine before working following inter-US travel (especially travelers from Louisiana, Miami, Atlanta, Detroit, Chicago or anywhere from California or Washington state, as well as other national and international places with high numbers of people infected with COVID-19)
  • Licensure wait time <1 day
  • Nurse Licensure Compact: Yes
  • BON Verification Link
  • Texas Board of Nursing Link

Utah

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON to receive a DOPL Time-limited Emergency License (lasting for up 180 days)
  • Licensure wait time ~1-2 days
  • Nurse Licensure Compact: Yes
  • Utah Board of Nursing Link

Vermont

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON (licensure lasts 90 days and can be renewed until the state of emergency is over)
  • Licensure wait time <1 day
  • Nurse Licensure Compact: No
  • Vermont Board of Nursing Link

Virgin Islands

  • Nurse Licensure Compact: No
  • Virgin Islands Board of Nursing Link

Virginia

  • Submitted 1135 waiver; Government waives requirements of fees, CEUs, and reactivation of licenses for APRNs, RNs, and LPNs
  • Nurse Licensure Compact: Yes
  • Virginia Board of Nursing Link

Washington

  • Submitted 1135 waiver; Any valid license from any state can submit, nurse needs to acquire WA license before starting; expedited licensure process direct through the Washington Board of Nursing
  • Nurse Licensure Compact: No
  • BON Verification Link
  • Washington Board of Nursing Link

West Virginia

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Nurse Licensure Compact: Yes
  • West Virginia Board of Nursing Link

Wisconsin

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Nurse Licensure Compact: Yes
  • Wisconsin Board of Nursing Link

Wyoming

  • Submitted 1135 waiver; Valid license from another state can apply with the state's BON
  • Licensure wait time <1 day
  • Nurse Licensure Compact: Yes
  • Wyoming Board of Nursing Link

*We'll be adding more information for each state as it becomes available.

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.

If you would like help moving through any of these modified processes, you can sign up in only a few minutes to speak with a Nurse Advocate today.