A Primer on Emergency Occupational Licensing Reforms for Combating COVID-19 Appendix: Details on Enacted Licensing Reforms
A Primer on Emergency Occupational Licensing Reforms for Combating COVID-19
March 26, 2020
Nation Can Learn from Virginia’s Precedent
April 22, 2020
**This will be updated as new reforms are put into place during this pandemic
A Primer on Emergency Occupational Licensing Reforms for Combating COVID-19
Appendix: Details on Enacted Licensing Reforms
By Ethan Bayne, Conor Norris, and Edward Timmons
Alaska– A bill extending the governor’s disaster emergency declaration, SB 241, is in House Rules and is expected to pass. An important provision of the bill is that it gives the state emergency authority to recognize professional licenses in key fields, such as nursing, from other states. A governor’s bill allowing Alaska to join a multi-state nurse license compact is bogged down in the Senate after many Alaska nurses opposed it and is effectively considered dead. With similar language now in the emergency disaster bill the governor is essentially doing an end run around the Legislature on this issue.
“PROFESSIONAL AND OCCUPATIONAL LICENSING. (a) Notwithstanding any other provision of law, during the public health disaster emergency declared by the governor under AS 26.23.020 on March 11, 2020, as extended by sec. 2 of this Act, a professional or occupational licensing board listed in AS 08.01.010, or the director, with respect to a profession regulated by the Department of Commerce, Community, and Economic Development, may grant a license, permit, or certificate on an expedited basis to an individual who holds a corresponding license, permit, or certificate in good standing in another jurisdiction to the extent necessary to respond to the public health disaster emergency. A license expedited under this section expires on the earlier of (1) November 15, 2020; or (2) the date the governor determines, under sec. 2 of this Act, that the public health disaster emergency no longer exists. (b) Notwithstanding any other provision of law and to the extent necessary to respond to the public health disaster emergency, a board listed in AS 08.01.010, the commissioner of commerce, community, and economic development, or the director, as applicable, may take additional action necessary to protect public health, safety, and welfare, including (1) temporarily waiving or modifying the continuing education requirements required for licensees to renew a professional license, permit, or certificate in calendar year 2020; (2) regulating the scope and duration of any license, permit, or certificate issued under this section; (3) requiring any individual granted a license, permit, or certificate under this section to arrange and agree to supervision, in-person or by other means, by an individual who holds a license, permit, or certificate in good standing for the applicable profession or by an administrator of a facility licensed under AS 47.32;
(https://www.anchoragepress.com/news/coronavirus/covid–restrictions-hit-alaska-s-economy-but-federal-state/article_739f7986-6faf-11ea-a536-b33b021251f7.html , http://www.akleg.gov/Basis/Bill/Detail/31?Root=SB%20241#tab6_4 , http://www.akleg.gov/PDF/31/Bills/SB0241E.PDF)
Arizona—“A state agency or board that licenses individuals or entities as indicated herein shall:
- Defer requirements to renew licenses that have an expiration date between March 1, 2020 and September 1, 2020 by six months from the expiration date, unless those requirements can be completed online;
- Defer requirements to complete continuing education by six months, unless those requirements can be completed online or due to the nature of the license is not practical;
- Any fees required to be collected by the state agency or board may be waived at the state agency or board’s discretion
- This order applies only to those boards or agencies listed below:
- Acupuncture Board of Examiners; b. Department of Agriculture; c. Arizona Board of Osteopathic Examiners in Medicine and Surgery; d. Arizona Board of Technical Registration; e. Arizona Medical Board; Arizona Regulatory Board of Physician Assistants; g. Arizona State Board of Nursing; h. Arizona State Board of Pharmacy; i. Arizona State Veterinary Medical Examining Board; j. Board of Athletic Training; k. Board of Behavioral Health Examiners; l. Board of Barbers; m. Board of Certified Public Accountants; n. Board of Cosmetology; o. Board of Examiners of Nursing Care Institution Administrators and Assisted Living Facility Managers; p. Board of Homeopathic and Integrated Medicine Examiners; q. Board of Massage Therapy; r. Board of Occupational Therapy Examiners; s. Board of Physical Therapy.; r. Board of Respiratory Care Examiners; u. Department of Environmental Quality; v. Department of Insurance; w. Department of Financial Institutions; x. Department of Real Estate; y. Department of Liquor Licenses and Control; z. Naturopathic Physicians Medical Board; aa. Department of Public Safety; bb. Registrar of Contractors; cc. State Board of Chiropractic Examiners; dd. State Board of Dental Examiners; ee. State Board of Dispensing Opticians; ff. State Board of Funeral Directors and Embalmers; gg. State Board of Optometry; hh. State Board of Podiatry Examiners; ii. State Board of Psychologist Examiners; and jj. Department of Transporation
The Emergency Declaration provides the following tools to address the spread of COVID-19: Allows ADHS to waive licensing requirements to provide healthcare officials with assistance in delivering services during times of heightened demand.”
(file:///C:/Users/Workstation/Downloads/eo_2020-17%20(2).pdf , https://azgovernor.gov/governor/news/2020/03/governor-doug-ducey-issues-declaration-emergency-executive-order-combat)
Arkansas—“Suspended the provisions of the Telemedicine Act at Ark Code Ann. 17-80-401, et seq., requiring an in-person encounter, or a face to face examination using real time audio and visual means to establish a professional relationship. “
(https://governor.arkansas.gov/images/uploads/executiveOrders/EO_20-05.pdf)
California—Any out-of-state personnel, including, but not limited to, medical personnel, entering California to assist in preparing for, responding to, mitigating the effects of, and recovering from COVID-19 shall be permitted to provide services in the same manner as prescribed in Government Code section 179.5, with respect to licensing and certification.
(https://www.gov.ca.gov/wp-content/uploads/2020/03/3.4.20-Coronavirus-SOE-Proclamation.pdf , https://www.ocregister.com/2020/04/07/nursing-rule-waiver-is-finally-approved-to-help-deal-with-coronavirus-outbreak/)
Colorado—“In order to scale up our health care workforce capacity, I have asked the Colorado Department of Regulatory Agencies to cut through the red tape on licensing our medical professionals so that medical professionals – including pharmacists, nurses, doctors – who are licensed in other states but residing here can be immediately licensed in Colorado as quickly as possible to address this shortage,” the Governor said at the Capitol.
The Division of Professions and Occupations (DPO), which falls under DORA’s umbrella structure, today issued guidance to qualified health care practitioners who may not be licensed to practice in Colorado, but can take advantage of current statutory provisions and exemptions in order to immediately enter the workforce and assist in testing, treating, and caring for Colorado patients.
Governor Polis also has directed DPO to remove impediments to licensure for medical professionals from both inside and outside Colorado, allowing for faster insertion into the state’s health care workforce and provide the ability to backfill positions, as necessary. The Division plans to release emergency measures aimed at expediting the licensure process for individuals in the health care in the coming days.
This includes the temporary suspension of the application of laws, rules, and policies which will allow the State to expand testing capacity for Coronavirus and ensure continuity in healthcare services.
The emergency measures include provisions for renewal waivers, expedited licensure, waiver of supervision requirements, and expanded scope of practice for physicians, physician assistants, nurses, pharmacists, pharmacy techs, and respiratory therapists. The full list is at the Colorado Department of Regulatory Agencies website.”
(https://drive.google.com/file/d/1d0YxbrxbgWDmVsJkHnsnoC1YfgW5hH38/view https://www.colorado.gov/pacific/dora/news/dora-guidelines-for-healthcare-workforce-coronavirus , https://www.kdnk.org/post/colorado-expedites-licensing-effort-expand-healthcare-workforce)
Connecticut—“Temporary Permits for Certain Health Care Providers Extended and Fees Waived. Sections 20-65k, 20-12b(b), 20-74d, 20-162o(c) and 20-195t of the Connecticut General Statutes are modified to waive any application fees for temporary permits and to extend the duration of the temporary permits for the health care professions governed thereunder (Athletic Trainer, Respiratory Care Practitioner, Physician Assistant, Occupational, Therapist/Assistants, Master Social Worker), for the duration of the public health and civil preparedness emergency, unless earlier modified or terminated. The Commissioner may issue any implementing order she deems necessary to effectuate this order. 3. Practice Before Licensure for Certain Health Care Profession Applicants and Graduates. The provisions in Sections 20-70(b)(1), 20-70(b)(2), 20-74bb(f), and 20- 101 of the Connecticut General Statutes that permit practice prior to licensure by applicants and graduates for the health care professions governed thereunder (Physical Therapist, Physical Therapy Assistant, Radiographer, Registered Nurse, Nurse Practitioner, Clinical Nurse Specialist, Nurse Anesthetist), are modified to permit such practice for the duration of the public health and civil preparedness emergency, unless earlier modified or terminated. The Commissioner of Public Health may issue any implementing orders she deems necessary to effectuate this order”
Delaware—“ The latest modification to the state of emergency declaration allows people who previously held a medical license to now provide health care services on a volunteer basis here in Delaware after registering with the Medical Reserve Corps.
So long as these workers have been trained and are in good standing with their medical license for the five-year period before it expired or lapsed, they will be able to practice in Delaware with the approval of the Public Health Authority, according to the governor.
This applies to pharmacists, respiratory therapists, physician assistants, paramedics, emergency medical technicians and nurses
https://governor.delaware.gov/health-soe/twelfth-state-of-emergency/ , https://www.delawareonline.com/story/news/coronavirus-in-delaware/2020/04/23/delaware-governor-lifts-restrictions-for-out-state-health-workers/3016089001/
District of Columbia–Business/License Division: Any business licenses, professional/occupational licenses, vending licenses, etc. that expire during the declared emergency will be considered valid, and people will have until 45 days after the declared emergency is over to renew their licenses. Please note all of the following can be done online at any time: apply for/renew a business license, register a corporation, and form an LLC.
Florida—“Section 7. Medical professionals and workers, social workers, and counselors with good and valid professional licenses issued by states other than the State of Florida may render such services in Florida during this emergency for persons affected by this emergency with the condition that such services be rendered to such persons free of charge, and with the further condition that such services be rendered under the auspices of the American Red Cross or the Florida Department of Health.”
(https://www.flgov.com/wp-content/uploads/orders/2020/EO_20-52.pdf)
Georgia—“In response to the Governor’s declaration of a Public Health State of Emergency, the Board has enacted Policy 1.16 which provides for the issuance of temporary permits for licensed practical nurses, registered nurses and advanced practice registered nurses who have an active, unencumbered license in any other U.S. jurisdiction who are entering into the state to respond to the declared emergency. The Board is hereby waiving any application fee for the temporary permit during the State of Emergency for those applying to practice for the purpose of responding to the declared emergency. The temporary permit is valid for thirty (30) days. The Board may extend the expiration date of the temporary permit.
The Georgia Composite Medical Board announced today that it may approve and issue ‘emergency practice permits’ to physicians, physician assistants, advanced practice registered nurses, and respiratory care professionals who wish to practice medicine during the public health emergency response to novel coronavirus, known as ‘COVID-19’… The Georgia Board of Nursing, under the Professional Licensing Boards, a Division of the Office of the Secretary of State, will begin issuing temporary permits to nursing professionals licensed in other states who come to Georgia in response to the declaration of a public health state of emergency in Georgia. These licenses will receive expedited review, less than 24 hours for a temporary license and less than seven days for a regular application, to better respond to the public health threat.”
(https://sos.ga.gov/index.php/licensing/plb/45/emergency_temporary_permits , https://medicalboard.georgia.gov/press-releases/2020-03-16/gcmb-emergency-practice-permittemp-license-response-covid-19)
Hawaii— “Chapter 453, HRS, medicine and surgery, and chapters 16-85 and 16-93, HAR, medical examiners and osteopaths, to the extent necessary to allow out-of-state physicians, osteopathic
physicians, and physician assistants with a current and active license, or those previously licensed pursuant to chapter 453, HRS, but who are no longer current and active, to practice in Hawaiʻi
without a license; provided that they have never had their license revoked or suspended and are hired by a state or county agency or facility, or by a hospital, including related clinics and rehabilitation
hospitals, nursing home, hospice, pharmacy, or clinical laboratory.”
“Chapter 457, HRS, nurses, and chapter 16-89, HAR, nurses, to the extent necessary to allow out-of-state licensed practical nurses, registered nurses, advanced practice registered nurses, and
advance practice registered nurses with prescriptive authority with a current and active license, or those previously licensed pursuant to chapter 457, HRS, but who are no longer current and active, to
practice in Hawaiʻi without a license; provided that they have never had their license revoked or suspended and are hired by a state or county agency or facility, or by a hospital, including related
clinics and rehabilitation hospitals, nursing home, hospice, pharmacy, or clinical laboratory.”
Idaho—“State licensing agencies and departments are authorized to temporarily exercise enforcement discretion, implement temporary rules, and waive licensing and related requirements to maximize access to health care services and provider support in response to COVID-19.”
(https://gov.idaho.gov/wp-content/uploads/sites/74/2020/03/covid-19-declaration_final.pdf , https://gov.idaho.gov/pressrelease/governor-signs-proactive-emergency-declaration-to-further-prevent-coronavirus-spread-in-idaho/ , https://boisedev.com/news/2020/03/16/idaho-healthcare-system-covid-19 , https://www.kivitv.com/news/local-boards-of-nursing-working-to-bolster-medical-personnel-workforce)
Illinois—“The state regulatory agency has granted a series of variances for physicians, nurses, physician assistants and respiratory care therapists whose license status is inactive, non-renewed or expired to restore their licenses temporarily after satisfying specific criteria.
Physicians and physician assistants whose licenses are expired, inactive or non-renewed for less than three years can have them restored temporarily for no fee or continuing education requirement to work under the direction of the Illinois Emergency Management Agency, Illinois Department of Public Health or in a long-term care facility, hospital or federally qualified health center.
Out-of-state physicians, nurses, physician assistants, pharmacists and respiratory care therapists also may practice in Illinois, if licensed in another state and in good standing. This temporary practice approval expires Sept. 30.”
(https://www.dailyherald.com/news/20200324/state-relaxes-rules-so-retired-medical-workers-can-help-with-covid-19-response , https://www.wglt.org/post/illinois-considers-temporary-roles-student-nurses-help-covid-19-fight#stream/0)
Indiana—“Individuals who seek to provide health care in the State of Indiana in response to this public health emergency who are not currently licensed to practice in the state, either because their Indiana license is no longer active or they are licensed by another state, may obtain temporary authorization to provide health care services as outlined” by Executive order 20-13.
(https://www.in.gov/gov/files/Executive%20Order%2020-13%20Medical%20Surge.pdf)
Iowa—“SECTION NINE. Pursuant to Iowa Code § 29C.6 (6), I temporarily suspend the regulatory provisions of Iowa Code § 147.137 and Iowa Admin. Code rule 653-13.11, rule 641-155.2, and other implementing administrative rules establishing preconditions, limitations, or restrictions on the provision of telehealth or telemedicine services, and I temporarily suspend the regulatory provisions of Iowa Admin. Code rules 641-155.21(19) and 155.23(4) and other administrative rules which require face-to-face interactions with health care providers and impose requirements for residential and outpatient substance use disorder treatment and for face-to-face visitations.
SECTION TEN. Pursuant to Iowa Code § 29C.6 (6), I temporarily suspend the regulatory provisions of Iowa Code § 147.10 and Iowa Admin. Code rules 653-9.13(6) and 9.14, rules 655-3.7(5), rules 645-261.8, and rules 645-326.9(8), and all other implementing administrative rules which prohibit the practice of medicine and surgery, osteopathic medicine and surgery, nursing, respiratory care, and practice as a physician assistant, by a licensee whose license is inactive or lapsed. Suspension of these provisions is limited to licenses which have lapsed or expired within the five (5) years prior to this Proclamation and is further limited to the provision of medical and nursing care and treatment of victims of this public health disaster emergency and solely for the duration of this Proclamation.”
“Governor Kim Reynolds has suspended “any provisions of the Iowa Administrative Code . . . to the extent they impose requirements for in-person continuing education as a condition of professional license renewal.”
(https://idph.iowa.gov/News/ArtMID/646/ArticleID/158309/Gov-Reynolds-issues-a-State-of-Public-Health-Disaster-Emergency-31720 , https://idph.iowa.gov/News/ArtMID/646/ArticleID/158309/Gov-Reynolds-issues-a-State-of-Public-Health-Disaster-Emergency-31720 , https://governor.iowa.gov/sites/default/files/documents/Public%20Health%20Proclamation%20-%202020.03.22.pdf)
Kansas—“The Board is accepting applicants seeking temporary licensure for the purpose of preparing for, responding to, and mitigating any effect of COVID-19. The Emergency Temporary License for the COVID-19 response is available for all health care professions regulated by the Board. Those who hold an emergency temporary license are limited to engaging in the practice of their profession for healthcare services relating to COVID-19 response efforts and/or mitigating any effect of COVID-19.”
http://www.ksbha.org/documents/misc/3-20-20_Guidance_for_Healthcare_Professionals.pdf , https://kansaspolicy.org/gov-kellys-decision-to-waive-regulations-amid-covid-19-will-help , https://www.ksn.com/top-stories/governor-kelly-issues-executive-orders-to-aid-kansans-during-covid-19-pandemic/ , https://governor.kansas.gov/wp-content/uploads/2020/04/EO-20-19-Executed.pdf , https://governor.kansas.gov/wp-content/uploads/2020/04/EO-20-26-Executed.pdf
Kentucky—“During the State of Emergency under Executive Order 2020-215, KRS 314.042(8), KRS 314.042 (10), and 201 KAR 20:057 , Section 7 are suspended. These statutes and the regulation require that Advanced Practice Registred Nurses (APRNs) have collaborative agreements with physicians as a prerequisite for the prescribing of legend drugs and controlled substances within the Commonwealth. KRS 413.101(1) (a, e) and the GoodSamaraitan Act of 2007, KRS 39A.350-366, authorize APRNs licensed to practice in other states to provide medical care to patients in Kentucky during the current state of emergency.”
(https://governor.ky.gov/attachments/20200331_Nursing-Documents.pdf)
Louisiana—“Existing legislation for emergency temporary permits for out of state individuals to practice as a physician or allied health care practitioner, valid for a period of not more than 60 days. No information regarding expedited processing.” (https://www.lsbme.la.gov/ , https://www.lsbme.la.gov/sites/default/files/documents/In%20The%20News%20Items/Excerpts%20of%20Physician%20Law%20or%20Rules%20Regarding%20Public%20Health%20Emergency.pdf)
Maine—“Omnibus Coronavirus Response: The measure also allows the governor to modify or suspend requirements for professional or occupational licensing if strict compliance with the requirements would hinder an effective emergency response.”
“Governor Janet Mills announced an executive order Tuesday to expand health care access for Mainers during the COVID-19 pandemic.
The order is building off of the governor’s “Stay Healthy at Home Mandate,” bolstering the health care workforce, expanding telehealth service and alleviate certain licensing requirements.
“As the demands on our health care system grow, it is critical that we ensure Maine people have access to the health care services they need in the face of COVID-19,” Governor Mills said. “This executive order allows nonresidents and retired Maine health care providers, such as respiratory therapists, to serve Maine people during the pandemic.”
(https://www.themainewire.com/2020/03/maine-legislature-acts-on-covid-19-gives-gov-mills-broad-authority-to-respond/ , http://legislature.maine.gov/legis/bills/bills_129th/chapters/PUBLIC617.asp , https://wgme.com/news/coronavirus/gov-mills-announces-expansion-of-health-care-access-for-mainers , https://www.maine.gov/governor/mills/sites/maine.gov.governor.mills/files/inline-files/EO%2016%20An%20Order%20Suspending%20Provisions%20of%20Certain%20HC%20Professional%20Licensing.pdf)
Maryland—“Pursuant to the Governor’s authority under the Constitution and Laws of Maryland, on March 12, 2020, the Governor issued an Executive Order extending the expiration date of all licenses, permits, registrations, and other authorizations issued by any agency of the State of Maryland, including, but not limited to, the Maryland Board of Nursing, until the 30th day after the date by which the state of emergency is terminated and the catastrophic health emergency is rescinded.”
“Any person who holds a valid, unexpired license as a health care practitioner that is issued by another state may, at a health care facility in Maryland, engage in the activities authorized under such license without first obtaining a license or practice letter from the applicable Maryland licensing agency or board.”
“Any inactive practitioner may, at a health care facility in Maryland, engage in activities that would have been authorized under his/her inactive license without first reinstating his/her inactive license.”
“A health care practitioner may engage in activities that are not authorized by his/her license at a health care facility in Maryland if: doing so is necessary to allow the health care facility to meet required staffing ratios or otherwise ensure the continues and safe delivery of health care services.”
(https://mbon.maryland.gov/Documents/executive-order-extending-expiration-dates.pdf , https://governor.maryland.gov/wp-content/uploads/2020/03/Licenses-Permits-Registration.pdf , https://governor.maryland.gov/wp-content/uploads/2020/03/Executive-Order-Health-Care-Matters.pdf , https://www.eagletribune.com/news/mass-expands-scope-of-nurse-practitioners/article_de2d90b3-d04d-5e72-ad72-72bde52e594f.html)
Massachusetts—“Supporting Expedited Licensing of Health Care Professionals: The Administration today announced four new emergency orders to expedite the onboarding of more licensed health care professionals during the COVID-19 emergency. Changes as a result of these orders include:
Licenses of physicians who have retired within the last year, without complaints at the time of retirement and in good standing, may be reactivated, and licenses that would otherwise be up for renewal may be extended for 90 days after the end of the public health emergency.
Providers in good standing licensed in other states may obtain emergency licenses to practice in person or through telemedicine.”
“The state is working with Massachusetts medical school deans to graduate students early, Sudders said, and is prepared to offer “almost automatic” 90-day licenses to those graduates. Boston University announced Thursday afternoon it will graduate its medical students early in response to the request. There will also be expedited license renewal for physicians and other care providers in “good standing,” Sudders said, to “increase the cadre” of medical personnel on the frontlines.
In addition, the state is allowing pharmacists to remotely process prescription orders, and allowing pharmacists “who are licensed in other states and in good standing” to practice in Massachusetts.
Notwithstanding subsection (g) of section 7 of chapter 94C of the General Laws or any other general or special law to the contrary, a nurse practitioner, nurse anesthetist, nurse midwife or psychiatric nurse mental health clinical specialist may be registered pursuant to subsection (f) of section 7 of chapter 94C of the General Laws and, if registered, shall have independent practice authority to issue written prescriptions and medication orders and order tests and therapeutics pursuant to said subsection (f) of said section 7 and section 9 of said chapter 94C; provided, however, that such authority shall only apply if the nurse practitioner, nurse anesthetist, nurse midwife or psychiatric nurse mental health clinical specialist has completed not less than 2 years of supervised practice following certification from a certifying body recognized by the board of registration in nursing; provided, however, the board of registration in nursing may reduce the 2-year period of supervised practice for nurse practitioners, nurse anesthetists, nurse midwives or psychiatric nurse mental health clinical specialists if it deems that it is necessary to ensure safe and adequate access to nurse practitioners, nurse anesthetists, nurse midwives or psychiatric nurse mental health clinical specialists. (passed Senate vote, awaiting House vote)
(https://www.mass.gov/doc/expedited-processing-of-reciprocal-license-applications-in-the-event-of-a-declared-public/download , https://www.mass.gov/news/baker-polito-administration-announces-changes-to-expedite-health-care-licensing-increase , https://www.wbur.org/news/2020/03/26/baker-massachusetts-coronavirus , https://malegislature.gov/Bills/191/S2615 , https://www.mass.gov/doc/march-17-2020-registration-of-health-care-professionals-order/download)
Michigan—“Effective immediately and continuing through April 14, 2020 at 11:59 pm, LARA may issue a temporary registration as a certified nurse aide to an applicant, regardless of whether the applicant demonstrates to LARA that they have successfully completed the examination requirements of sections 21911 and 21913 of the Public Health Code, 1978 PA 368, as amended, MCL 333.21911 and MCL 333.21913. A temporary registration issued under this section shall be valid for 28 days and may be renewed by LARA until the termination of the state of emergency under section 3 of Executive Order 2020-4.
Effective immediately and continuing through April 14, 2020 at 11:59 pm, LARA may renew a license to practice under Part 170, 172, 175, 177, or 187 of the Public Health Code, 1978 PA 368, as amended, regardless of whether the licensee has satisfied the continuing education requirement applicable to their license.
Effective immediately and continuing through April 14, 2020 at 11:59 pm, the Department of Health and Human Services (“DHHS”) may issue an emergency certificate of need to an applicant and defer strict compliance with the procedural requirements of section 22235 of the Public Health Code, 1978 PA 368, as amended, MCL 333.22235, until the termination of the state of emergency under section 3 of Executive Order 2020-4.
Any and all provisions in Article 15 of the Public Health Code, 1978 PA 368, as amended, MCL 333.16101 et seq., relating to scope of practice, supervision, and delegation, are temporarily suspended, in whole or part, to the extent necessary to allow licensed, registered, or certified health care professionals to provide, within a designated health care facility at which the professional is employed or contracted to work, medical services that are necessary to support the facility’s response to the COVID-19 pandemic and are appropriate to the professional’s education, training, and experience, as determined by the facility in consultation with the facility’s medical leadership.”
(https://www.michigan.gov/whitmer/0,9309,7-387-90499_90705-522016–,00.html , https://content.govdelivery.com/attachments/MIEOG/2020/03/29/file_attachments/1413927/EO%202020-30.pdf , https://www.mlive.com/coronavirus/2020/03/gov-whitmer-lessens-restrictions-for-healthcare-workers-during-coronavirus-outbreak.html , https://www.mlive.com/coronavirus/2020/03/gov-whitmer-lessens-restrictions-for-healthcare-workers-during-coronavirus-outbreak.html)
Minnesota—“ I authorize the Minnesota health-related licensing boards, listed in Minnesota Statutes 2019, section 214.01, subdivision 2 (“health-related licensing boards”), to defer continuing education requirements until the first reporting cycle following termination of the peacetime emergency declared in Executive Order 20-01.
I authorize the Minnesota Emergency Medical Services Regulatory Board, established pursuant to Minnesota Statutes 2019, section 144E.01, to extend the March 31, 2020 expiration date for any registrations or certificates issued by the board to June 30, 2020, and to allow for such registration or certificate holders to complete their continuing education requirements through distance learning.
I authorize the health-related licensing boards to accept and process applications for licensure without submission by the applicant of a full set of fingerprints, provided all other information required as part of the criminal background check process by Minnesota Statutes 2019, section 214.075, or otherwise, is submitted to the board. Individuals who are granted a license without submission of fingerprints pursuant to this Executive Order shall undergo a new criminal background check as part of their first license renewal application following termination of the peacetime emergency declared in Executive Order 20-01, including submission of a full set of fingerprints to their respective health-related licensing board or designee in the manner and form specified by the board, pursuant to Minnesota Statutes 2019, section 214.075, subdivision 3(a).
Pursuant to Minnesota Statutes 2019, section 12.42, I authorize and request Out-ofState Healthcare Professionals who hold an active, relevant license, certificate, or other permit in good standing issued by a state of the United States or the District of Columbia to render aid in Minnesota during the peacetime emergency declared in Executive Order 20-01 (including any extensions of that peacetime emergency).”
(https://www.leg.state.mn.us/archive/execorders/20-23.pdf , https://www.leg.state.mn.us/archive/execorders/20-46.pdf)
Mississippi—“Until action is taken by the Governor to lift the state of emergency, out-of-state APRNs may utilize telehealth when treating patients in Mississippi without the necessity of securing a license to practice in this State, provided the out-of-state APRN holds an unrestricted license to practice in the State in which the APRN practices and currently is not the subject of an investigation or disciplinary proceeding and so advises in writing to the board.
Every APRN who is currently not licensed in the State of Mississippi and who wishes to practice in this State shall complete the disastrous/emergency waiver found on the Board of Nursing’s website
https://www.msbn.ms.gov/sites/default/files/Board%20of%20Nursing%20Proclamation_1.pdf
The Advanced Practice Registered Nurse (APRN) Disaster/Emergency Waiver is intended for any APRN temporarily practicing in Mississippi during the state of emergency. This Waiver is effective contingent on the State Emergency Declaration status at the time of application
https://www.msbn.ms.gov/sites/default/files/temporary%20Disaster%20Relief%20Permit%20APRN_0.pdf
Until action is taken by the Governor to lift the state of emergency, out-of-state physicians may utilize telemedicine when treating patients in Mississippi without the necessity of securing a license to practice medicine in the state, provided the out of state physician holds an unrestricted license to practice medicine in the state in which the physician practices and currently is not the subject of an investigation or disciplinary proceeding and so advises the Board.” While Mississippi is under an emergency declaration, the Mississippi Board of Nursing has found a way to allow retired or student nurses to work.
https://www.msbml.ms.gov/sites/default/files/news/20200324161355.pdf
“During this emergency declaration period, they would be able to get a temporary license to practice nursing if they go to the Board of Nursing website,” said Phyllis Jordan, Mississippi Board of Nursing Executive Director.
The temporary permit would last up to 120 days, or until the emergency declaration is lifted by the governor.”
https://www.wapt.com/article/board-of-nursing-offering-temporary-nursing-permits-for-retired-nurses-students/31942921 , https://www.sos.ms.gov/content/executiveorders/ExecutiveOrders/1471.pdf
Missouri— “The Director of the Department of Commerce and Insurance and the Division of Professional Registration and its Boards are hereby vested with authority to temporarily waive or suspend the operation of any statutory requirement or administrative rule under their purview, upon approval of the Office of the Governor, in order to best serve public health and safety during the period of the emergency and subsequent recovery period.”
(https://www.sos.mo.gov/library/reference/orders/2020/eo4 , http://www.webstercountycitizen.com/news/article_7cef5e38-6d58-11ea-bf00-1fe6e23983eb.html)
Nevada—“All licenses and permits issued by the State of Nevada, Boards, Commissions, Agencies, or political subdivisions of the State of Nevada that expire or are set to expire during the period of Declaration of Emergency dated March 12, 2020 is in effect shall be extended for a period of 90 days from the current expiration date, or 90 days from the date the state of emergency declared on March 12, 2020 is terminated, whichever is later, if reduced government operations due to the state of emergency makes timely renewal of the license or permit impracticable or impossible.”
http://gov.nv.gov/uploadedFiles/govnewnvgov/Content/News/Emergency_Orders/2020/2020-03-31%20-%20Declaration%20of%20Emergency%20Directive%20009.pdf , http://gov.nv.gov/News/Emergency_Orders/2020/2020-03-20_-_COVID-19_Declaration_of_Emergency_Directive_004/
New Hampshire—“Any out-of-state personnel, including, but not limited to, medical personnel, entering New Hampshire to assist in preparing for, responding to, mitigating the effects of, and recovering from COVID-19 shall be permitted to provide services in the same manner as prescribed in RSA 21–P:41 and any other applicable statutory authority with respect to licensing and certification regarding mutual aid during emergencies for a period of time not to exceed the duration of this emergency.”
“Over the weekend, the Board of Nursing Administrator spoke by phone with the Board of Nursing Chair and Vice Chair in tandem with the OPLC Director, and the decision made to request an emergency rule to address the concerns related to the current state of emergency in New Hampshire. The Board Administrator drafted a rule defining “clinical experience” and adding changes to requirements during a state of emergency:
Nur 101.04 “Clinical Experience” means practice in an inpatient, ambulatory care, or community setting where the student provides care to patients under the guidance of a nursing instructor or preceptor.
(a.)Clinical Experience may be substituted with simulation and lab work during a State of Emergency Declared by the Governor that impacts clinical site availability; provided, however, the Board of Nursing is notified within twenty-four (24) hours of such substitution. “Simulation” means a technique, not a technology, to replace or amplify real experiences with guided experiences that evoke or replicate substantial aspects of the real world in a fully interactive manner.
The Board of Nursing had an emergency meeting at 4:30 pm Monday March 16th, 2020 and passed the above 101.04 rule, which was submitted and accepted by the State of NH, and is now in effect for 180 days. The rule relaxes the requirement for clinical experience during the course of a declared state of emergency, and allows the 60 hours of clinical experience to be substituted with 60 hours of simulation and lab work during the state of emergency. It also permits LPN and RN programs to substitute in person clinical with simulation. The Board must be given 24 hours’ notice of such substitution because the Board wishes to be aware of the requirements of each program. Such notice can come in the form of an email to the Board.”
(https://www.oplc.nh.gov/nursing/)
New Jersey—“Under the regulatory waivers announced today, individuals who hold current healthcare licenses and certifications in good standing in other jurisdictions, and have been practicing within the last five years, will be able to secure New Jersey licenses by completing a simple form.”
“Folks who are licensed in other states who can automatically be licensed in New Jersey for health care. Retired workers. School nurses. Particular expertise from the National Guard. Specific talent within the Department of Defense. (The Department of Health) is in the process of doing a big inventory of those types of people,” the governor said.
“The Executive order supplements the State’s existing health care workforce by:
Temporarily waiving certain scope of practice restrictions on Advanced Practice Nurses (APNs) related to physician collaboration, including a rule requiring that an APN enter into a joint protocol with a collaborating physician and a rule requiring APNs to obtain authorization from a collaborating physician in order to dispense narcotic drugs.
Temporarily waiving certain scope of practice restrictions on Physician Assistants (PAs) related to physician supervision, including a rule requiring PAs to obtain physician authorization prior to prescribing a controlled dangerous substance.
To facilitate the temporary licensure of such physicians, the following statutory provisions are suspended and waived for the duration of the State of Emergency or Public Health Emergency, whichever is longer: the requirements of N.J.S.A. 45:9-6 pertaining to examination for licensure; the requirements of N.J.S.A. 45:9-7 pertaining to premedical education; the requirements of N.J.S.A. 45:9-8 pertaining to additional education; the requirements of N.J.S.A. 45:9-12 pertaining to examination and other fees; and the requirements of N.J.S.A. 45:9-19.17 pertaining to medical malpractice insurance coverage.”
https://www.capemaycountyherald.com/lifestyle/health_and_wellness/article_1c923062-6aef-11ea-8fa2-4fc071f7690c.html , https://www.ems1.com/coronavirus-covid-19/articles/nj-puts-out-call-for-retired-paramedics-doctors-nurses-to-assist-during-covid-19-qr3YZ7C8oefcVZqS/ , https://www.insidernj.com/press-release/governor-murphy-signs-executive-order-remove-barriers-health-care-professionals-joining-new-jerseys-covid-19-response-provide-protections-front-line-health-care-responders/ , https://nj.gov/infobank/eo/056murphy/pdf/EO-112.pdf
New York—“Sections 6512 through 6516, and 6524 of the Education Law and Part 6o of Title 8 of the NYCRR, to the extent necessary to allow physicians licensed and in current good standing in any state in the United States to practice medicine in New York State without civil or criminal penalty related to lack of licensure;
Section 6502 of the Education Law and Part 59.8 of Title 8 of the NYCRR, to the extent necessary to allow physicians licensed and in current good standing in New York State but not registered in New York State to practice in New York State without civil or criminal penalty related to lack of registration;
Sections 6512 through 6516, and 6905, 6906 and 6910 of the Education Law and Part 64 of Title 8 of the NYCRR, to the extent necessary to allow registered nurses, licensed practical nurses, and nurse practitioners licensed and in current good standing in any state in the United States to practice in New York State without civil or criminal penalty related to lack of licensure;
Sections 6512 through 6516, and 6541 of the Education Law and Part 6o.8 of Title 8 of the NYCRR 8 NYCRR, to the extent necessary to allow physician assistants licensed and in current good standing in any state in the United States to practice in New York State without civil or criminal penalty related to lack of licensure;”
North Carolina—“The North Carolina Medical Board voted today (March 11) to allow recently retired or inactive licensees to return to practice, in response to Gov. Roy Cooper’s declaration of a state of emergency related to North Carolina’s response to coronavirus disease 2019 (COVID-19).
NCMB’s actions support Gov. Cooper’s March 10 Executive Order by helping to increase the supply of qualified medical professionals available to assist with a COVID-19 outbreak in North Carolina.
Temporary and emergency rules approved by the Board would allow a physician or PA who inactivated his or her NC medical license within the past 24 months to quickly obtain a temporary license. Under the emergency rules, the physician or PA would be entitled to practice for whichever period is shorter: 90 days or 30 days from the point at which the state of emergency in North Carolina is declared over.
With the concurrence of the Council of state, I hereby temporarily waive North Carolina licensure requirements for health care and behavioral health care personnel who are licensed in another state, territory, or the District of Columbia to provide health care services whithin the Emergency Area”
(https://www.ncmedboard.org/images/uploads/article_images/21_NCAC_32B_.1707.Emergency_Rule_.Coronavirus_Emergency_.pdf , https://www.ncmedboard.org/resources-information/professional-resources/publications/forum-newsletter/notice/ncmb-approves-path-for-retirees-to-help-with-covid-19 , https://files.nc.gov/governor/documents/files/EO116-SOE-COVID-19.pdf , https://www.ncmedboard.org/images/uploads/other_pdfs/Order_-_Postponing_Step-Level_2_for_RTL_Applicants.pdf , https://www.ncmedboard.org/resources-information/professional-resources/publications/forum-newsletter/notice/ncmb-acts-to-reduce-licensure-barriers)
North Dakota—“Now Therefore, Dough Burgum, Governor of North Dakota, by virtue of the authority under Article V, Section 1 of the North Dakota Constitution and North Dakota Century Code (NDCC) Chapter 37-17.1, and in consultation with the State Health Officer and the Director of Emergency Services, hereby temporarily suspends certain licensure requirements under the health care and behavioral health licensing statutes set forth in Executive Order 2020-05.1, to allow competent professionals with inactive or lapsed licenses to return to the workforce and provide much needed resources for the State’s response to the COVID-19 epidemic”
(https://www.governor.nd.gov/sites/www/files/documents/executive-orders/Executive%20Order%202020-20.pdf , https://www.governor.nd.gov/sites/www/files/documents/executive-orders/Executive%20Order%202020-05.pdf)
Ohio—“Ohio Governor Mike DeWine issued Executive Order 2020-01D declaring a state of emergency in Ohio to protect the well-being of the citizens of Ohio from the dangerous effects of COVID-19. The Board recognizes that an adequate and safe nursing workforce is vital.
OHIO LAW AUTHORIZES NURSING PRACTICE IN EMERGENCIES WITHOUT AN OHIO NURSING LICENSE, including deployment of licensed nurses from other states to Ohio during this state and national emergency, as well as the deployment of Ohio licensed nurses to similar declared emergency areas. Specifically, the Nurse Practice Act, Section 4723.32(G)(7), Ohio Revised Code (ORC), allows nurses who hold an active, valid license in another state to practice in Ohio without an Ohio nursing license for the duration of any declared disaster, including the current COVID-19 declared emergency.
TO FURTHER ASSIST WITH NURSE MOBILITY, THE BOARD IS EXPEDITING THE ISSUANCE OF TEMPORARY PERMITS AND ALL LICENSE TYPES. Temporary permits authorize nurses to begin practicing in Ohio within 3 business days or less of the Board’s receipt of an application for reciprocity. In addition, the Medical Reserve Corp (MRC)/Red Cross (ARC) has negotiated reciprocal licensing agreements with each state, so if nurses with active, valid licenses in one state are activated through ARC, they are able to practice in other states without having a license to practice in that state.
Emergency Licensure The Medical Board will partner with the Ohio Emergency Management Agency (EMA) or other necessary government entity if the need arises to temporarily license out-of-state physicians and physician assistants.
Effective March 9, 2020 – March 1, 2021, SMBO will suspend enforcement of CE requirements for all license renewals, including physicians
State lawmakers have temporarily relaxed licensing requirements to get newly graduated nursing students on the job immediately. They’ve permanently expanded the duties of certified registered nurse anesthetists to include ordering and administering drugs and IV fluids, ordering diagnostic tests, and directing nurses to administer drugs.
Under the Coronavirus Omnibus Legislation (HB197) signed March 27, the Ohio Board of Nursing examination required to approve an RN or LPN license has been suspended during the declared national emergency. To become licensed, all nursing education students will still need to provide documentation from a completed nursing program and criminal records checks.
According to the board, this means between 4,000 and 5,000 students in the state would be eligible to obtain their licenses in the expedited process.”
(https://nursing.ohio.gov/ , https://nursing.ohio.gov/wp-content/uploads/2020/03/OBN-Statement-Nurses-and-COVID-19.pdf , https://med.ohio.gov/Portals/0/Resources/COVID-19/3_18%20Special%20Meeting%20Factsheet%20.pdf?ver=2020-03-18-215407-857 , https://www.toledoblade.com/local/Coronavirus/2020/04/01/Ohio-relaxing-licensing-requirements-for-nurses-to-boost-number-of-medical-professionals/stories/20200331092 , https://www.limaohio.com/news/404868/nursing-students-gain-access-to-expedited-licensures)
Oklahoma—“All occupational licenses issued by any agency, board, or commission of the State of Oklahoma that expire during this emergency shall be extended so long as this Order is in effect. All occupational licenses extended during this Order will expire fourteen (14) days following the withdrawal or termination of this Order.
The preexisting patient relationship requirement for telemedicine, as required by 50 O.S. 478.1, is hereby waived so long as this Order is in effect.
Any medical professional who holds a license, certificate, or other permit issued by any state that is a party to the Emergency Management Compact evidencing the meeting of qualifications for the practice of certain medical services, as more particularly described below, shall be deemed licensed to practice in Oklahoma so long as this Order shall be in effect, subject to the following conditions: a. This shall only apply to Medical (MD) and Allied Licenses issued by the Board of Medical Licensure and Supervision, Licenses issued by State Board of Osteopathic Examiners, and Licenses and Certificates issued by the Board of Nursing, all three shall collectively be referred to as ‘Boards’”.
“In Oklahoma, the health emergency gives Stitt and Commissioner of Health Gary Cox broad powers to help the state respond to COVID-19.
Under the declaration, Stitt will be able to waive statutory and regulatory requirements and redirect state agency or state employee efforts to respond to the COVID-19 crisis. Stitt also will be able to activate the Oklahoma National Guard and transfer up to $50 million in state funds to respond to the crisis.”
House Majority Floor Leader Jon Echols, R-Oklahoma City, acknowledged that approving the declaration gives Stitt an incredible amount of power. Legislators are putting their faith in Stitt to do what’s best for the state, he said. (https://www.sos.ok.gov/documents/executive/1914.pdf , https://www.sos.ok.gov/documents/executive/1914.pdf , https://oklahoman.com/article/5659571/legislature-approves-emergency-declaration-gives-stitt-unprecedented-power)
Oregon—“Per ORS 678.031(4), the Board is allowing nurses and nursing assistants licensed in another state or US jurisdiction to provide care in Oregon under special provisions until April 8.”
(https://www.oregon.gov/OSBN/Pages/index.aspx , https://www.oregon.gov/osbn/Pages/LicenseExceptions.aspx )
“During a state of emergency, the Oregon Medical Board (OMB) allows physicians and physician assistants licensed in another state to provide medical care in Oregon under special provisions. Out-of-state health care professionals who wish to provide care in Oregon during this time must complete this authorization application. See OAR 847-010-0068 for more information.”
(https://www.oregon.gov/omb/Topics-of-Interest/Pages/COVID-19.aspx , https://secure.sos.state.or.us/oard/viewSingleRule.action?ruleVrsnRsn=214060)
Pennsylvania—“The Department of State has suspended certain administrative requirements for nurses, including temporarily extending license expiration dates and waiving associated fees during the coronavirus emergency.”
“Nursing school graduates who have yet to graduate and have been unable to sit for the licensure examinations due to COVID-19 can immediately apply for a graduate permit so they can assist in the COVID-19 response. These permits will expire if the graduate permit holder fails the examination.”
“Nursing school graduates who have yet to graduate and have been unable to sit for the licensure examinations due to COVID-19 can immediately apply for a graduate permit so they can assist in the COVID-19 response. These permits will expire if the graduate permit holder fails the examination.”
The Department of State’s Bureau of Professional and Occupational Affairs requested, and Governor Wolf approved, suspensions of several regulations related to the state boards of Medicine, Osteopathic Medicine, and Nursing and Pharmacy for the duration of the coronavirus emergency.
These new regulation suspensions increase the number of available and qualified health care practitioners in PA by allowing retired practitioners to re-enter their field without paying reactivation fees.
State Board of Medicine licensees who are in active/retired status for less than four years can apply for reactivation of their license. Their continuing education (CE) requirements and license reactivation fees will be suspended. This measure allows these practitioners’ licenses to become active unrestricted until Dec. 31, 2020. If a licensee wishes to continue practicing beyond Dec. 31, 2020, the licensee will need to renew the active-unrestricted license and meet all current requirements at that time.https://local21news.com/news/local/pennsylvania-suspends-nurse-licensing-requirements , https://local21news.com/news/local/pa-department-of-state-extends-license-renewal-time-for-medical-professionals , https://local21news.com/news/local/pa-to-allow-retired-healthcare-providers-to-aid-in-the-coronavirus-response
South Carolina—“The Medical Board can expedite temporary licensure for out-of-state physicians, physician assistants, and respiratory care practitioners within 24 hours. There is no fee for these 90-day temporary licenses. Additionally, the Board of Nursing can expedite licensure of advanced practice registered nurses (APRNs), as well as RNs and LPNs from non-compact states. The expedited licensure only requires information from the hospital or other health provider or organization that is requesting the additional nursing staff from another state. The license is good for 15 days, but may be renewed.”
WHEREAS, S.C. Code Ann. § 44-4-570(B)(2) provides that “[t]he appropriate licensing authority may waive any or all licensing requirements, permits, or fees required by law and applicable orders, rules, or regulations for health care providers from other jurisdictions to practice in this State;”
NOW, THEREFORE, effective immediately, the Board hereby waives any and all South Carolina licensing requirements for advanced practice registered nurses, licensed practical nurses, and registered nurses licensed in good standing in another state and whose services are determined to be necessary by DHEC. This waiver of licensing requirements shall remain in effect for the duration of the declared public health state of emergency, unless otherwise modified, amended, or rescinded by subsequent order.
(https://llr.sc.gov/nurse/pdf/Nursing%20Board%20Order%203-14-2020%20Signed.pdf)
LLR and its health professional boards are fully committed to expediting licensure during the public health emergency to ensure South Carolinians have access to all needed healthcare resources.
Below are those links regarding expedited licensure as well as other helpful links providing information about measures being taken by LLR’s other professional and occupational licensing boards.”
(https://llr.sc.gov/coronavirusllr/)
COLUMBIA, S.C. – Effective immediately, the South Carolina Department of Labor, Licensing and Regulation (LLR) is extending the license renewal deadline for licenses, registrations, and permits scheduled to renew during the months of April, May, June, July, and August. The new renewal deadline is extended to September 30, 2020.
“We recognize the toll that this virus is taking on South Carolinians, and we are committed to doing all that we can to support them during these challenging times,” said Gov. Henry McMaster. “Director Farr and her team recognized a need, acted quickly to address it, and South Carolinians are better off because of their work.”
“The Agency recognizes and appreciates the sacrifices our licensees are making during this difficult time, and we want to do our part in making things easier for them,” LLR Director Emily Farr said.
Additionally, continuing education requirements may be obtained throughout the entirety of this extended renewal period.
(https://governor.sc.gov/news/2020-04/sc-llr-extends-renewal-deadlines-during-health-emergency)
South Dakota—“I temporarily suspend the statutory provisions of SDCL 36-4-11.1, 36-4A-8.2, 36-5-22. 36-6a-44.1….requiring a complete criminal background check to be obtained prior to permanent licensure”
“I temporarily suspend the statutory provision of SDCL 36-4A-26.1 and the regulatory provision of ARSD 20:61-01:04 requiring supervision of physician assistants and advanced life support personnel when caring for or treating COVID-19 positive patients during the COVID-19 State of Emergency”
“I temporarily suspsned the statutory provisions of SDCL 36-4A-26.1….requiring applicants or licensees to submit proof of completing continuing education requirements to prevent delaying license renewal during the emergency.”
(https://sdsos.gov/general-information/executive-actions/executive-orders/assets/2020-16.PDF)
Tennessee—“The relevant provisions of Tennessee Code Annotated, Titles 63 and 68, and related rules are hereby suspended to the extent necessary to give the Commissioner of Health the discretion to allow a health care professional who is licensed in another state, and who would otherwise be subject to licensing requirements under Title 63 or Title 68, to engage in the practice of such individual’s profession in Tennessee, if such individual is a health care professional who is assisting in the medical response to COVID-19”
“The provisions of Tennessee Code Annotated, Titles 63 and 68, and related rules and policies are hereby suspended to the extent necessary to suspend the requirement that individuals complete or submit proof of completing continuing education requirements or otherwise demonstrate continuing competence as a condition of reinstating a license, certification, or registration”
“The relevant provisions of Tennessee Code Annotated, Titles 9, 63, and 68, and related rules are hereby suspended to the extent necessary to suspend the requirements that applicants for an initial license pursuant to Titles 63 or 68 pay fees, including any state regulatory fee, as part of the application process. This suspension will apply to initial application fees due to the Department of Health between March 12, 2020, and May 18, 2020. Fees already collected will not be refunded. The deadline to pay initial application fees originally due during this period is hereby extended to June 17, 2020; provided, however, that licenses and fees shall return to their original schedules in subsequent years.”
“The provisions of Tennessee Code Annotated, Titles 63 and 68, and related rules and policies are hereby suspended to the extent necessary to give the Commissioner of Health the authority to grant a license, certificate, or registration to a healthcare professional, such as a retired healthcare professional, who has been out of practice for a period of time without requiring that individual to demonstrate continued competency or submit to an interview before a licensing board or other licensing authority, provided that the individual satisfies all other requirements for licensure, certification, or registration.”
(https://publications.tnsosfiles.com/pub/execorders/exec-orders-lee14.pdf , https://publications.tnsosfiles.com/pub/execorders/exec-orders-lee15.pdf , https://publications.tnsosfiles.com/pub/execorders/exec-orders-lee20.pdf)
Texas—“On March 14th, Governor Abbott directed the Texas Board of Nursing (TBON) to fast-track the temporary licensing of out-of-state nurses, and other license types to assist in Texas’ response to COVID-19.
In accordance with Section 418.171 of Texas Government Code, any out-of-state nurse may practice in Texas for the purpose of rendering aid, provided the nurse holds a current license in good standing in their home state. Therefore, any out-of-state nurse with a license in good standing* is not required to hold a Texas license in order to practice nursing in a disaster relief effort operation setting. Additionally, Texas is a member state of the Nurse Licensure Compact. As such, any LVN or RN holding an active compact license already holds a privilege to practice in Texas.
Pursuant to Texas Medical Board Rule 172.21, APRNs practicing in the context of a disaster declaration are not required to maintain documentation describing supervisory arrangements and instructions for prescriptive authority as otherwise required by Chapter 157, Texas Occupations Code. “
(https://www.bon.texas.gov/FastTrackOutofStateLicensing.asp , https://www.woodlandsonline.com/npps/story.cfm?nppage=65803 , https://www.texastribune.org/2020/03/21/coronavirus-updates-texas-nursing-license-regulations-waived-304-cases/ , https://gov.texas.gov/news/post/governor-abbott-removes-licensing-barriers-for-advance-practice-registered-nurses)
Vermont—“The law relaxes occupational licensing for health care providers, and rules governing hospitals, nursing homes, child care, public assistance, and foster care. It extends drivers’ license expirations and tax filing deadlines. It relaxes the onerous certificate of need (CON) procedure and provider budget review requirements for facilities needed to cope with emergencies. It suspends the health care provider tax, a too-slick idea from 1992 that was first adopted to extract more Medicaid funds from Washington, and after a decade became just a scheme for financing Medicaid through hidden taxes on health insurers, customers, and patients.
Perhaps most significantly, the new law knocked down barriers to out of state physicians practicing in Vermont. It authorizes temporary licenses and expanded scope of practice rules for physician assistants and nurse practitioners. It allows doctors to examine and assist patients via telemedicine and emails.”
(https://vtdigger.org/2020/04/07/john-mcclaughry-emergency-deregulation-and-mutual-aid/ , https://vermontbiz.com/news/2020/april/13/health-care-professionals-can-get-expedited-temporary-license-practice)
Virginia—Executive Order 57 issues the following directives in order to allow a greater number of medical professionals to help combat COVID-19 in Virginia:
- Deems out-of-state medical licenses to be valid for practice in Virginia, provided that they are in good standing in their home state.
- Licensed nurse practitioners with two or more years of clinical experience may practice in the field in which they are licensed without a practice agreement with a physician.
(https://www.governor.virginia.gov/media/governorvirginiagov/executive-actions/EO-57-Licensing-of-Health-Care-Professionals-in-Response-to-Novel-Coronavirus-(COVID-19).pdf , https://www.galaxgazette.com/content/governor-expand-healthcare-workforce)
Washington—“The Department of Health is supporting enrollment and activation of emergency volunteer health practitioners for the COVID-19 response. The department can do this under the authority of the Uniform Emergency Volunteer Health Practitioner Act (Chapter 70.15 RCW). Under RCW 70.15.050, while an emergency proclamation of the Governor is in effect, a volunteer health practitioner who is licensed in another state may practice in Washington without obtaining a Washington license if he or she is in good standing in all states of licensure and is registered in the volunteer health practitioner system. These emergency volunteers will help meet emerging demands for health practitioners in areas impacted by COVID-19.”
“FURTHERMORE, based on the above situation and under the provisions of RCW 43.06.220(2)(g), I also find that strict compliance with the following statutory and regulatory obligations or limitations will prevent the Washington State healthcare system from meeting the demand for healthcare staffing to meet the demands of the COVID-19 State of Emergency under Proclamation 20-05, and that the language of each statutory and regulatory provision specified below is hereby waived and suspended in its entirety, except as otherwise provided herein, until midnight on April 25, 2020: A. Barriers to continued and uninterrupted healthcare practice, including continuing education and other training requirements and license renewal deadlines. Licensed health profession rules restricting the practice of retired active licensees.”
(https://www.doh.wa.gov/Emergencies/NovelCoronavirusOutbreak2020COVID19/HealthcareProviders/EmergencyVolunteerHealthPractitioners , https://www.governor.wa.gov/sites/default/files/proclamations/20-32%20-%20COVID-19%20DOH%20Healthcare%20Worker%20Licensing%20%28tmp%29.pdf , )
West Virginia—“The first two provisions of the order grant additional discretion to the Board of Nursing to waive requirements that may hinder the delivery of necessary medical procedures as the Board may determine necessary.
Requirement for certified registered nurse anesthetist (CRNA) licensure as follows: to permit the Board, in their discretion, to suspend or modify the requirement for the administration of anesthesia (W. Va. Code § 30-7-15);
Requirement for advanced practice registered nurse (APRN) licensure as follows: to permit the Board, in their discretion, to temporarily suspend or modify the requirements for the authorization for prescriptive authority, collaborative requirements for prescriptive authority, prescriptive formulary limitations, prescriptive refill and supply limitations, and other prescriptive limitations including continuing education and renewal requirements (W. Va. Code §§ 30-7-15a, 30-7-15b, 30-7-15c);
The third provision of the order allows physicians with a pre-existing relationship with a patient to refill an existing prescription for a Schedule II opioid medication without an “in-person” examination but still mandates that the physician evaluate the patient by other means and determine whether a refill is safe and appropriate in the physician’s judgment.
Requirement that a practitioner is required to conduct an in-personal physical examination every 90 days prior to prescribing a refill for a Schedule II opioid medication to an existing patient for chronic pain treatment (W. Va. Code. § 16-54-4(h)), provided that the provider utilizes other appropriate tools to evaluate the patient at these intervals and assesses whether continuing the course of treatment would be safe and effective for the patient.
“Hereby declare and order that, the following statutory regulations are to be suspended for the duration of the State of Emergency: 1. Requirement that any medical provider “hold an active, unexpired license” issued by the Board of Medicine, with the exception of those with pending complaints, investigations., consent orders, board orders, or pending disciplinary proceedings”
(https://apps.sos.wv.gov/adlaw/executivejournal/readpdf.aspx?DocID=89564 , https://therecorddelta.com/article/gov-justice-signs-executive-order-suspending-some-statutory-regulations-at-the-request-of-the-boards-of-nursing-medicine , https://apps.sos.wv.gov/adlaw/executivejournal/readpdf.aspx?DocID=89501 , https://apps.sos.wv.gov/adlaw/executivejournal/readpdf.aspx?DocID=89755)
Wisonsin—“Any health care provider with a valid and current liucense issued by another state may practice under that license and within the scope of that license in Wisconsin without first obtaining a temporary or permanent license from the Department of Safety and Professional Services (DSPS), so long as the following conditions are met:
- The practice is necessary for an identified health care facility to ensure the continued and safe delivery of health care services;
- The health care provider is not currently under investigation and does not currently have any restrictions or limitations placed on their license by their credentialing state or any other jurisdiction;
- The identified health care facility’s needs reasonably prevented in-state credentialing in advance of practice;
- The health care provider practicing under this section must apply for a temporary or permanent health care license within 10 days of first working at a health care facility in reliance on this Section; and
- The health care facility must notify DSPS at dsps@wisconsin.gov within 5 days of a health care provider practicing at its cacility in reliance on this section.”
(https://content.govdelivery.com/attachments/WIGOV/2020/03/27/file_attachments/1413356/DSPS%20_%20Reduced.pdf , https://www.wpr.org/gov-tony-evers-relaxes-rules-boost-health-care-workforce-during-coronavirus-pandemic , https://evers.wi.gov/Documents/COVID19/EMO16-DSPSCredentialingHealthCareProviders.pdf)
Wyoming—“The Wyoming Board of Medicine is temporarily streamlining procedures for licensing health care professionals amid the COVID-19 pandemic and extending licensure expirations.
The board also moved the expiration time for licensing from June 30 to Sept. 30 for professionals whose expiration was coming up this year. Executive Director Kevin Bohnenblust said taking licensure renewals off doctors’ plates right now is the least the board can do.
