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UPDATED DIRECTIONS RELATED TO THE SUSPENSION OF PROVISIONS OF THE PROFESSIONAL AND PRACTICAL NURSING LAWS AND THE STATE BOARD OF NURSING REGULATIONS DUE TO COVID-19

On March 18, 21, 25, 27, 2020, Governor Wolf suspended various provisions of the Professional Nursing Law and the Practical Nurse Law as well as the Board's regulations, enabling applicants and licensees to practice during the COVID-19 Emergency Declaration.      

March 18, 2020 Press Release
March 21, 2020 Press Release
March 25, 2020 Press Release
March 27, 2020 Press Release  

             

Follow the directions below for each of the suspended provisions:

RENEWAL and REACTIVATION

  • Registered Nurse (RN), Clinical Nurse Specialist (CNS), and Certified Registered Nurse Practitioner (CRNP) licenses and CRNP Prescriptive Authority approval (NPPA) renewal deadlines, including completion of continuing education, have been extended from April 30, 2020, to July 29, 2020.  The Practical Nurse (PN) license renewal deadline has been extended from June 30, 2020, to September 28, 2020.

    LICENSEE ACTION NEEDED
    • Online renewal for RNs, CNSs, CRNPs and NPPAs will continue to be available in PALS at www.pals.pa.gov through July 29, 2020. 
    • While the status of the RN and CNS licenses, CRNP certificates and NPPA approvals will remain ACTIVE in PALS through July 29, 2020, the expiration dates will continue to reflect April 30, 2020.
    • In addition to reflecting ACTIVE status in PALS, April 30, 2020 will also be reflected through NURSYS at www.nursys.com.
    • Continuing education does not have to be completed until the extended deadline.
  • RNs, CNSs, CRNPs, and Licensed Dietitian Nutritionists whose licenses/certifications have been expired or inactive for LESS than FIVE years can apply for reactivation without needing to complete any continuing education (including Child Abuse) or paying any fees.  PNs may also apply to reactivate licenses that are expired or inactive for LESS than FIVE years without completing Child Abuse continuing education and paying any fees.


    LICENSEE ACTION NEEDED
    • Specific COVID-19 Reactivation Applications are available at www.dos.pa.gov/nurse. 
    • Verify your license expiration date at www.pals.pa.gov/verify before applying with the COVID-19 Reactivation Application.
    • Email the completed COVID-19 Reactivation Application to the Board at ST-Nurse@pa.gov.  In the subject line indicate COVID-19 Reactivation Application.
    • If your license has been expired or inactive for FIVE or MORE years, there are no waivers at this time.  Go to www.dos.pa.gov/nurse to obtain a Reactivation Application.  Certificates of completion for the required continuing education must accompany the application AND reactivation and biennial renewal fees must be paid.  Mail the application, fee and any documents to the Board.

       

TEMPORARY PRACTICE PERMITS

  • RN, LPN, and Graduate Nurses do not have to apply for extensions of their RN, LPN, or graduate temporary permits.  All temporary and graduate permits that would normally expire during the next 90 days will be automatically extended for an additional 90 days.

    LICENSEE ACTION NEEDED
    • None.  Permits with expiration dates between March 21, 2020, and June 19, 2020, are being extended automatically for 90 days.
    • While the permits will remain ACTIVE in PALS through the 90-day extension, the expiration date will continue to reflect the original expiration date.
    • Graduate permit holders must be supervised by an RN.  Supervision requires that the RN be physically present in the area or unit where the permit holder is practicing. 
  • Nursing school graduates who: 
      • have been unable to sit for the licensure examinations due to cancellation of the examinations because of COVID-19, 
      • do not already have or never held a graduate permit, and o desire to assist in the COVID-19 response

        can apply for and practice with a graduate permit.  The Board is aware that a limited number of test sites have opened or will be opening in the United States shortly; however, because the number of graduates who may be able to test will be limited, a graduate permit is necessary in order to practice. 

        March 18, 2020 Press Release
        Pearson VUE Website
        COVID-19 Impact to NCLEX Candidates FAQs   


         
        GRADUATE ACTION NEEDED
    • Apply for a graduate permit at www.pals.pa.gov.
    • Graduate permit holders must be supervised by an RN.  Supervision requires that the RN be physically present in the area or unit where the permit holder is practicing.
    • Permits expire if the graduate permit holder fails the NCLEX®.
    • Graduates who have failed the NCLEX® previously are not eligible for a graduate permit.

       

RNs and LPNs LICENSED OUT OF STATE

  • Out-of-state RNs and LPNs who do not hold Pennsylvania licenses but desire to assist in the COVID-19 response may apply for a temporary practice permit and license.

    OUT-OF-STATE LICENSEE ACTION NEEDED
    • Apply for a temporary practice permit and license at www.pals.pa.gov.
      • If this is your first time using PALS, read the instructions under "How do I get started?"
      • Once you have created your account or have logged in to your account, scroll to

        "New Professional License" and click on "Apply for New License."  
      • Answer the survey questions.  Be sure the "Obtained By" indicates "Endorsement." 
      • Click "Next" from the survey.   
      • Once you have entered the Endorsement application, answer all questions and select YES that you would like to receive a Temporary Practice Permit. 
      • If you are unable to obtain Criminal History Record Checks (CHRCs) from states other than Pennsylvania due to the pandemic, upload a signed statement that the required CHRCs will be provided when available.  Note that a license cannot be issued until all required CHRCs are received.  A PA CHRC request will automatically be submitted to the PA State Police when the Endorsement application is submitted to the Board.    
    • Upon evaluation of your application, you will be emailed a Temporary Practice Permit.  
    • Before your license can be issued, all other administrative requirements will need to be completed.  

      Note:  If you have ever held a license or Temporary Practice Permit in Pennsylvania, please contact the Board at st-nurse@pa.gov.

       
  • Since some English language proficiency examinations have become unavailable due to the COVID-19 emergency, the requirement for English language proficiency testing for RNs and LPNs licensed out of state has been temporarily waived. 

    APPLICANT ACTION NEEDED:
    1. When the Emergency Declaration is lifted, if the applicant's nursing program was not conducted in English, proof of passing a Board-approved English language proficiency examination will be required in order to be issued a license.

       

LPNs

  • The requirement to demonstrate 1500 hours of education was waived for LPN licensure by endorsement where the LPN holds a current license in another state and graduated from a Board-approved PN program.
  • The requirement to demonstrate 1500 hours of education was waived for LPN licensure by examination if the applicant graduated from a Board-approved PN program.  

    APPLICANT ACTION NEEDED:
    • Apply for a license at www.pals.pa.gov.
    • An official transcript, received directly from the PN Program, must be submitted to the Board. 

       

CRNP CERTIFICATION

  • Out-of-state applicants for certification as a CRNP by endorsement in Pennsylvania who are active licensees of other states and have national certification will not have to meet the educational equivalency requirement.

    CRNP ACTION NEEDED
    • Apply for certification at www.pals.pa.gov.
    • An official transcript, received directly from the Program, must be submitted to the Board.
  • Since the Board-recognized national NP certification examinations are becoming unavailable during the COVID-19 emergency, applicants will not have to hold national certification in a Board-recognized specialty.

    CRNP ACTION NEEDED
    • Apply for certification at www.pals.pa.gov.
    • CRNPs will be required to hold National certification AFTER the Emergency Declaration has ended.  
    • CRNP certifications will not be renewed without evidence of current national certification AFTER the Emergency Declaration has ended.
    • The Board will apply the same procedure for recertifications.

 

COLLABORATIVE AGREEMENTS and PRESCRIPTIVE AUTHORITY 

The Professional Nursing Law and the Board's regulations address two agreements in connection with CRNPs: collaborative agreements and prescriptive authority collaborative agreements. Collaborative agreements set out the agreement between the collaborating physician and the CRNP defining the collaborative relationship in the areas delineated in Section 21.282a(b) of the Board's regulations.  Collaborative agreements are NOT filed with the Board.

Prescriptive authority collaborative agreements delineate the requirements of Section

21.285(a)(1)-(4) and (8) of the Board's regulations.  These agreements MUST be filed with the Board.

  • Additional Collaborative Agreements within the same Hospital/Health System - If a CRNP has a collaborative agreement with a physician in a hospital or health system, the CRNP may collaborate with other collaborating physician(s) within the same hospital or health system without written and signed collaborative agreements throughout the Emergency Declaration.   

    CRNP ACTION NEEDED:  
    • None, unless the CRNP desires to prescribe and/or dispense.  
    • If a CRNP has one active Pennsylvania Prescriptive Authority Collaborative Agreement (PACA), the CRNP is permitted to collaborate with a new Pennsylvania-licensed collaborating physician for up to 6 months from the date the prescriptive authority application is submitted to the Board.  Paper applications can be downloaded from the Board's website at www.dos.pa.gov/nurse.  (See "Additional PACAs" below for more information.)
  • Collaboration with Out-of-State Physicians - A CRNP may also collaborate with physicians who are licensed in other states.

    CRNP ACTION NEEDED
    • None, unless the CRNP desires to prescribe and/or dispense.  
    • If a CRNP has one active Pennsylvania PACA, the CRNP is permitted to collaborate with a new Pennsylvania-licensed collaborating physician for up to 6 months from the date the prescriptive authority application is submitted to the Board.  Paper applications can be downloaded from the Board's website at www.dos.pa.gov/nurse.  (See "Additional PACAs" below for more information.)
    • Collaborative agreements between the physician and the CRNP are required but are not filed with the Board.
  • Initial Applications for Prescriptive Authority - CRNP initial application for prescriptive authority will require the listing of only one collaborative physician and one substitute physician rather than the entire list of substitutes.

    CRNP ACTION NEEDED
    1. Initial applications for prescriptive authority can be downloaded from the Board's website at www.dos.pa.gov/nurse. 
  • Additional Applications for PACAs - If a CRNP has one active Pennsylvania PACA, the CRNP is permitted to collaborate with a new Pennsylvania-licensed collaborating physician for up to 6 months from the date the prescriptive authority application is submitted to the Board.  

    CRNP ACTION NEEDED
    • Although Board approval is not required in order to begin practicing under the new PACA, the CRNP must apply for an additional prescriptive authority. Paper applications can be downloaded from the Board's website at  www.dos.pa.gov/nurse. 
    • The CRNP and new collaborating physician must hold current unrestricted licenses in order to practice after submission of the application but without Board approval.  
    • Applications where the physician's license is on probation or where the physician holds an Active-Retired license must be reviewed by the Board for approval prior to being able to prescribe or dispense.
    • Only one collaborative physician and one substitute physician is required.
  • Changes to PACAs - Board approval for the following changes is not required once the change agreement is executed between the physician and the CRNP:
      • addition or deletion of drug categories,  o changes in controlled substances,  o deletion or addition of substitute physicians,  o changes to the circumstances and how often a physician will see a patient, and/or
      • termination of the PACA.

        CRNP ACTION NEEDED
    • Although Board approval is not required in order to enact the changes listed above, CRNPs must submit the changes to prescriptive authority to the Board within 60 days of the change.  Paper Change Forms can be downloaded from the Board's website at www.dos.pa.gov/nurse. 
    • Except for changes involving controlled substance prescribing authority, the Board will not acknowledge receipt of or approve the Change Forms during the Emergency Declaration.  After the Emergency Declaration is over, the Board will process the Change Forms.
  • Scope of Practice - More than 14,000 CRNPs can practice to their full capabilities and assist in the COVID-19 response without the usual requirement that they practice within a specific clinical specialty. They are also permitted to prescribe drugs outside of the established formulary. 

    CRNP ACTION NEEDED
    • None.  CRNPs holding active prescriptive authority approval may prescribe drugs outside of the formulary for that prescriptive authority approval during the Emergency Declaration. 
    • None.  CRNPs may practice outside their Board-designated clinical specialty area during the Emergency Declaration.

       

CRNAs

  • During the COVID-19 emergency, CRNAs may administer anesthesia in cooperation with a physician, instead of only with a surgeon or dentist. 
  • Since there are no certification examinations available during the emergency, the requirement that CRNA graduates need to ask the Board for authority to continue to practice prior to taking the first available examination was waived.

    CRNA ACTION NEEDED:

    ✓ None during the Emergency Declaration.  After the Emergency Declaration, the CRNA graduate will need to take the first available examination.

     

CNSs

• If a CNS has an active license in another state and current national certification, demonstration of educational equivalency will not be required during the Emergency Declaration.

CNS ACTION NEEDED:

  • Go to www.pals.pa.gov to apply for CNS certification.
  • An official transcript, received directly from the Program, must be submitted to the Board.

TELEMEDICINE

• In-state and out-of-state health care practitioners are permitted to treat patients via telemedicine during the emergency.

TELEMEDICINE PRACTITIONER ACTION NEEDED:

  1. Refer to www.dos.pa.gov to obtain additional details and the requirements that need to be fulfilled.

Please note that the Department of State is working with the Governor's Office, the Department of Health and the Department of Human Services to identify regulations and requirements that can be waived to give medical providers and facilities the flexibility they need to respond to COVID-19.  The Department of State website, www.dos.pa.gov, the State Board of Nursing website, www.dos.pa.gov/nurse, and this document will be updated regularly as additional waiver information becomes available.