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Importance of the Issue

It is anticipated that COVID-19 will continue to place increased demands on the Commonwealth’s health professional workforce that will require additional personnel, including for the administration of COVID-19 vaccines. Continuing both the authorization of out-of-state licensed professionals to provide care to the citizens of the Commonwealth and the availability of telehealth will assist in meeting that demand, as will allowing physician assistants to practice outside of a practice agreement and allowing licensed practical nurses to administer vaccines without supervision. Partnerships in vaccine administration between private and public entities will also expand our capacity to vaccinate. Allowing temporary nurse aides to qualify to transition into certified nurse aides will help address a key workforce need.



Therefore, by virtue of the authority vested in me by the Constitution of Virginia and §44-146.17 of the Code of Virginia, during the state of emergency declared in Amended Executive Order 51, I hereby order the following:

  1. Notwithstanding any contrary provision in Title 54.1 of the Code of Virginia, a license issued to a health care practitioner by another state, and in good standing with such state, shall be deemed to be an active license issued by the Commonwealth to provide health care or professional services as a health care practitioner of the same type for which such license is issued in another state. Such license is permissible, provided the health care practitioner is engaged by a hospital (or an affiliate of such hospital where both share the same corporate parent), licensed nursing facility, dialysis facility, the Virginia Department of Health (VDH), or a local or district health department for the purpose of assisting that facility with public health and medical disaster response operations. Hospitals, licensed nursing facilities, dialysis facilities, and health departments must submit to the applicable licensing authority each out-of-state health care practitioner’s name, license type, state of license, and license identification number within a reasonable time of such healthcare practitioner providing services at the applicable facility in the Commonwealth.
  2. Health care practitioners with an active license issued by another state may provide continuity of care to their current patients who are Virginia residents through telehealth services. Establishment of a relationship with a new patient requires a Virginia license unless pursuant to paragraph 1 of this Order.
  3. Physician assistants licensed in the Commonwealth of Virginia with two or more years of clinical experience may practice in their area of knowledge and expertise and may prescribe without a written or electronic practice agreement.
  4. A healthcare practitioner may use any non-public facing audio or remote communication product that is available to communicate with patients. This exercise of discretion applies to telehealth provided for any reason regardless of whether the telehealth service is related to the diagnosis and treatment of COVID-19.
  5. A licensed practical nurse may administer the COVID-19 vaccine without the supervision of a registered nurse or licensed medical practitioner.
  6. Licensed health professionals of health systems or hospitals whose scope of practice includes administration of the vaccine and who have administered the COVID-19 vaccine in the health system or hospital setting may administer the COVID-19 vaccine at any point of distribution held in collaboration between the health system or hospital and a local health department without additional training.
  7. A local health department may collaborate with a federal health facility, whether civilian or military, for the purpose of COVID-19 vaccine administration. Federal personnel whose scope of practice includes vaccination may serve with the Medical Reserve Corps after a training and skills assessment as required by VDH.
  8. Temporary nurse aides practicing in long term care facilities under the federal Public Health Emergency 1135 Waiver may be deemed eligible by the Board of Nursing to take the National Nurse Aide Assessment Program examination upon submission of a completed application, the employer’s written verification of competency and employment as a temporary nurse aide, and provided no other grounds exist under Virginia law to deny the application.

With the exception of healthcare practitioners volunteering with the Medical Reserve Corps, nothing in this Order designates the healthcare practitioners above as agents of the Commonwealth.

These actions are in concert with, and further the provisions of Amended Executive Order 51 in marshalling all resources and appropriate preparedness, response, and recovery measures to respond to the emergency.


Effective Date of this Executive Order

This Executive Order shall be effective immediately and shall remain in full force and effect for the duration of the state of emergency as declared in Amended Executive Order 51 unless sooner amended or rescinded by further executive order.

Given under my hand and under the Seal of the Commonwealth of Virginia, this 11th day of March, 2021.