COVID-19 Workforce Exemptions and Waivers


Federal Public Health Emergency

Extended January 16, 2022 through April 16, 2022

As a result of the ongoing Coronavirus Disease 2019 (COVID-19) pandemic, Secretary of Health and Human Services, Xavier Becerra, has renewed the nationwide public health emergency, issued under the authority of Section 319 of the Public Health Service Act, which has existed since January 27, 2020. The emergency declaration is effective January 16, 2022 and remains in effect for 90 days from the date of renewal.

Renewal of Determination That A Public Health Emergency Exists


Waivers for Nurse Aides

State Waiver

Chapter 11-94.1, HAR, Nursing Facilities

Authority: §11-94.1-2 Definitions: “Waiver” means an exemption to a rule.

Waiver: A certified nursing assistant (CNA) is defined herein, however, the rules do not specifically require the use of CNAs. Therefore, nurse aides (NA) may be employed by nursing facilities (skilled nursing facilities or intermediate care facility) to perform care to the extent they are trained and demonstrate competencies to perform the duties assigned.

OHCA Waivers

Federal Waiver

Training and Certification of Nurse Aides. CMS is waiving the requirements at 42 CFR 483.35(d) (with the exception of 42 CFR 483.35(d)(1)(i)), which require that a SNF and NF may not employ anyone for longer than four months unless they met the training and certification requirements under § 483.35(d). CMS is waiving these requirements to assist in potential staffing shortages seen with the COVID-19 pandemic. To ensure the health and safety of nursing home residents, CMS is not waiving 42 CFR § 483.35(d)(1)(i), which requires facilities to not use any individual working as a nurse aide for more than four months, on a full-time basis, unless that individual is competent to provide nursing and nursing related services. We further note that we are not waiving § 483.35(c), which requires facilities to ensure that nurse aides are able to demonstrate competency in skills and techniques necessary to care for residents’ needs, as identified through resident assessments, and described in the plan of care.


Waivers for Nurses and Nursing Students

Considerations for nurses licensed out-of-state or formerly licensed in Hawaii.

Extended January 26, 2022 through March 25, 2022

Pursuant to Governor Ige’s 4th Supplemental Proclamation, signed March 16th, 2020, and extended in the Emergency Proclamation Related to COVID-19 Omicron Variant, signed January 26th, 2022, nurses (LPN, RN, APRN-RX) who hold a current and active license out of state or who formerly held a Hawaii license, may work in Hawaii so long as they:

  • have never had their license revoked or suspended,

  • are hired by a state or county agency or facility, or by a hospital, including related clinics and rehabilitation hospitals, nursing home, hospice, pharmacy, clinical laboratory, or other health care entity, and

  • the employment is within the period of the emergency proclamation period.

Pages 14-15, Emergency Proclamation Related to COVID-19 Omicron Variant

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, clinical laboratory, or other health care entity.

Any entity making use of this exemption shall:

(1) register each medical professional working under this exemption with the Department of Commerce and Consumer Affairs (DCCA),

(2) verify there are no disciplinary actions, insurance claims or pending lawsuits against the registered professional; and

(3) indemnify the State for the actions or inactions of the registered medical professional.

All healthcare entities making use of the exemption must complete and file a registration form with DCCA in order to have certain medical professionals work in the State of Hawaii under the Governor’s most current EP. 

The registration form must be signed by an appropriate authorized healthcare entity representative and emailed to the appropriate board or program. 

Web address to instructions & registration form: http://cca.hawaii.gov/pvl/files/2021/11/Instructions-Registration-Form-Final.pdf.

Considerations for 2020 graduate nurses who have yet to become licensed.

Extended January 26, 2021 through March 25, 2022

Pursuant to Governor Ige’s Emergency Proclamation, signed April 16th, 2020, and extended in the Emergency Proclamation Related to COVID-19 Omicron Variant, signed January 26th, 2022, related to COVID, nursing graduates may work with a waiver to their license requirements if:

  • The employment is within the period of the emergency proclamation period; and

  • They graduated after May 1st, 2020; and

  • They graduated from an in-state nursing programs recognized by the Board of Nursing; and

    • University of Hawaii programs including Hawaii Community College, Kapiolani Community College, and Kauai Community College, UH Maui College, UH Hilo and UH Mānoa;

    • Hawaii Pacific University; and

    • Chaminade University

  • Individual to be employed to practice LPN or RN nursing must be under the supervision of a registered licensed practical nurse for LPN eligible individuals, or a registered nurse for RN eligible individuals, with the endorsement of the employing health care entity, or

  • Individual to be employed to practice APRN nursing must be with the endorsement of the employing health care entity.

Additional Employer Considerations

  • Employed roles should be appropriate to the recent graduate’s education, training, and experience, as determined by the facility in consultation with the facility’s nursing leadership.

  • Any recent graduate employed at or under these provisions at a health care facility is entitled to the same rights and immunities as provided by law for the employees of this state, as provided under this section, such as compensation, benefits, worker’s compensation, and liability protection.

Future licensure considerations

  • Any recent graduate who works within a facility during the public health emergency period must complete necessary requirements and apply for licensure when the public health emergency period has ended, including completing any application and paying relevant licensing fees.

  • Due to COVID-19 related delays in access to entry to practice exams, employers are strongly encouraged to provide leave on the day of any scheduled test to ensure that the employee hired under a license waiver may meet these license requirements.

Pages 14-15, Emergency Proclamation Related to COVID-19 Omicron Variant

Section 457-7, HRS, registered nurses; qualifications; licenses; fees; title; existing licensed nurses; verification of licenses; eligibility, to the extent necessary to waive the licensure and accompanying requirements so as to permit graduates, after May 1, 2020, of nursing education programs approved by the State Board of Nursing or a national accrediting body, to be employed to practice nursing under the supervision of a registered nurse, with the endorsement of the employing health care entity.

Section 457-8, HRS, licensed practical nurse; qualifications; license; fees; title; existing licensed nurses; verification of licenses; eligibility, to the extent necessary to waive the licensure and accompanying requirements so as to permit graduates, after May 1, 2020, of nursing education programs approved by the State Board of Nursing or a national accrediting body, to be employed to practice nursing under the supervision of a registered licensed practical nurse, with the endorsement of the employing health care entity.

Section 457-8.5, HRS, advanced practice registered nurse; qualifications; licensure; endorsement; fees; eligibility, to the extent necessary to waive the licensure and accompanying requirements so as to permit graduates, after May 1, 2020, of an accredited graduate-level education program preparing the nurse for one of the four recognized advanced practice registered nurse roles licensed by the State Board of Nursing, to be employed to practice as an advanced practice registered nurse, with the endorsement of the employing health care entity.