While we can all agree that ensuring healthcare providers meet all the requirements needed to care for patients is good and necessary, it’s also true that moving across state lines as an allied health professional can be tricky. Because the livelihood of these professionals depends on holding a legal and up-to-date license, fully understanding licensure requirements and knowing how to operate in this system is critical.
According to the National Conference of State Legislatures, 25% of careers currently require an occupational license or governmental endorsement to practice the profession. Many states and occupations now offer several options for transferring licenses or qualifying for multistate licenses, which can make this process less cumbersome for some people. Learn more about moving your healthcare license and find out more about allied health careers requiring licensure or certification.
How to Transfer a Healthcare License or Certification
When an allied health professional considers transferring their license or certification, they should understand that several factors determine their ability to do so and the ease in which it can be accomplished.
Which state you come from matters substantially as it dictated the requirements you went through in the first place. Some states may have more stringent qualification mandates, making it easier to receive credentialing in your new state. Your job area also matters significantly because each allied health profession sets its own licensure and certification requirements.
Because allied health professionals need the freedom to work in whatever part of the country they live in, some states have tried to make this process easier through reciprocity agreements, licensure compacts, and other types of arrangements.
Reciprocity & Endorsement
Given once a person completes their healthcare degree or area of study and successfully passes all examinations required by a governing career body and state of residence. The state then provides a license by endorsement, effectively stating that the governing body endorses this person as a practicing medical professional.
An agreement made among a group of states to make the process of a professional moving across state lines easier, providing they met the requirements of their previous location. States with reciprocal agreements don’t require newly arrived allied health professionals to take exams to receive their new license.
Careers that commonly provide reciprocity or licensure by endorsement include:
- Dental hygienists
- Licensed practical nurses
- Registered nurses
- Pharmacy technicians
- Physical therapy assistants
- Physician assistants
- Veterinary technicians
No database currently exists that serves as a one-stop-shop for each type of allied health professional to learn about reciprocity or licensure by endorsement agreements. If you want to determine whether your state engages in these types of arrangements, or which states those agreements have been made with, check with your state licensing board. Many state governments have separate and independent boards for the variety of allied health professions, making it easier to find the information pertinent to your needs.
Licensure compacts are agreements made between states to ensure allied health professionals don’t encounter negative consequences when trying to provide their services across state lines. Rather than requiring professionals in these roles to apply for a new, state-specific license each time they move and miss out on work while waiting for their new license to come through, a licensure compact provides one license that allows for practice in multiple states.
Not all states participate in licensure compacts, but numbers seem to be rising. The Nurse Licensure Compact (NLC), for instance, currently has 32 states and U.S. territories participating, with additional locations awaiting pending legislation to become an NLC state. Registered nurses, vocational nurses, and practical nurses who live in an NLC member-state and plan to move to another can easily cross state lines.
Licensure compacts, while most common in the world of nursing, are beginning to be used in a few other allied health professions. These currently include:
- Physical therapy
- Emergency management service providers
- Physician assistants
Additionally, the American Dental Hygienist Association is currently working on legislation to create a dental hygienist licensure compact program.
To receive a multistate license, which is the type of credential offered via licensure compact, states must set uniform licensure requirements to ensure every allied health professional licensed in each focus area or locale has met the same conditions. These requirements vary based on your chosen career, so it’s essential to check with your state board of licensure to learn about the specifics.
The National Council of State Boards of Nursing oversees the Nurse Licensure Compact (NLC) and sets specific uniform licensure requirements for nurses who want to obtain a multistate license. Some preconditions include:
- Graduating from a board-approved educational program
- Receiving passing scores on NCLEX examinations
- Passing all required background checks
- Holding an active and unencumbered license
By setting uniform requirements, states participating in a licensure compact can ensure medical professionals coming from other states meet the exact same specifications. This also makes it easier for new states to join licensure compacts, knowing that all existing members follow specific standards.
Some states are now starting to provide uniform licensure applications for physician assistants, while the emergency management services industry uses a national certification program to help with uniform licensure. Check with the state board that corresponds to your line of work to learn more about specific rules in your area.
Allied Health and Medical Licenses Requiring Transfer
Reciprocity, endorsements, and other agreements can offer a more streamlined, fast-track way of transferring a license from state to state for practice areas requiring this step. Still, it’s essential to understand the specifics of your chosen career. Explore some of the most common health careers requiring licensure or certification transfer below to help you assess the next steps, but always check with the licensing body in your state to receive the most up-to-date information.
- Registered Nurse
All registered nurses must hold an active and unencumbered license to practice. Still, many states participate in the Nurse Licensure Compact (NLC) agreement overseen by the National Council of State Boards of Nursing. With this agreement, you can hold one multistate license so long as you live and work in a compact state. If where you live is not one of the 32 states that has adopted the NCL, you may be able to apply for licensure by reciprocity or endorsement.
- Nurse Practitioner & Physician Assistant
Nurse practitioners and physician assistants must both hold credentials: NPs must possess a registered nursing license while PAs need physician assistant licensure. Advanced practice RNs (APRNs) currently cannot avail themselves of licensure compact, though legislation is in the works. Instead, they can apply for licensure by endorsement in participating states. The same is true for PAs. The American Academy of Physician Assistants provides substantial support around state licensing requirements.
- Certified Nursing Assistant
Requirements around certification of certified nursing assistants vary by state. While all states require CNAs to pass a competency examination and join a state registry, the titles used tend to vary by state. Some may be referred to as CNAs, while other states may use the terms nursing assistant or orderly. CNAs can apply for licensure by endorsement or a licensure compact through the Nurse Licensure Compact.
- Licensed Vocational Nurse
Also known as Licensed Practical Nurses, these professionals must hold licensure in all 50 states to practice. They can elect to participate in continuing education programs leading to certification if they so choose. As nurses, LVNs/LPNs can also take advantage of the Nurse Licensure Compact. If their state does not currently participate in the NLC, they can also cross participating state lines through license reciprocity or license by endorsement.
- Dental Hygienist
Dental hygienists in every state must hold licensure to practice, though licensure requirements are set by the individual state’s Board of Dental Examiners. No compact licensure agreement exists currently, though legislation is in the works. Certain states currently allow for licensure by credential endorsement. The American Dental Hygienists Association provides a comprehensive and regularly updated chart of where states stand on this matter.
- Dental Assistant
Regardless of where they live, dental assistants are not currently required to hold licensure or certification. However, many elect to study for and take the exam given by the Dental Assisting National Board’s Certified Dental Assistant credential. They must have participated in an accredited dental assistant training program and completed at least two years of full-time dental assisting work to sit for the exam.
- Medical Assistant
Medical assistants are not currently mandated to possess licensure or certification. However, many employers look for candidates who have received voluntary certification from one of several professional organizations, such as the American Association of Medical Assistants, that offers this credential. Because the certification is provided via an organization rather than a state, no type of process is required for moving credentials across state lines.
- Paramedic and EMT
Paramedics and emergency medical technicians working in all 50 states must hold licensure, though requirements for doing so vary by state. The National Registry of Emergency Medical Technicians also provides paramedic and EMT certifications. People with these certifications typically qualify for licensure in their state, but check with your board to be sure. Individuals with criminal histories typically cannot work in this field, so passing a background check is essential.
- Vet Tech
Veterinary technicians do not have standard requirements across all states, which is why these professionals need to check with their local boards on requirements. The majority of states typically require both technicians and technologists to receive a passing score on the Veterinarian Technician National Examination provided via the American Association of Veterinary State Boards.
- Physical Therapist
No matter where they live or hope to practice, every physical therapist must hold licensure. Requirements for receiving this credential vary by state, but each state requires applicants to pass the National Physical Therapy Examination provided by the Federation of State Boards of Physical Therapy. Most states also require physical therapists to take part in continuing education to qualify for license renewal.
- Physical Therapist Assistant
Pursuing a physical therapist assistant role requires either licensure or certification, depending on which state an individual resides. Most places use the National Physical Therapy Exam designed for physical therapist assistants and provided by the Federation of State Boards of Physical Therapy. Some states may also require applicants to pass a state-level exam on PT assistant laws and regulations.
Licensure & Certifications for Healthcare Careers
It’s not uncommon to be puzzled about the differences between licenses and certifications, especially given that both terms are often thrown around interchangeably. Substantial differences do exist, though these may be slightly different across various allied health professions. Learn more about the functions of each form of credentialing, and which careers may be more likely to use them, below.
Licensing in allied health professions can confuse even the most knowledgeable in the field, because states may use different terms to describe the same thing. According to the National Registry of Emergency Medical Technicians, occupations with a statutory or regulatory scope of practice definitions that mandate state authorization to practice are positions that must be licensed. Even if the licensing body calls it something else, the process provides the “legal effect of a license.”
Based on the concept that any entity providing a license must be a state-level or federal government agency, key points regarding healthcare licensing include:
Licenses are used in all medical and healthcare professions involving a practitioner offering professional services to a patient or client.
Psychologists, psychiatrists, nurses, dentists, dental hygienists, paramedics, physician assistants, physical therapists, and many other care providers are legally mandated to possess an active and unencumbered license to offer their services.
State boards of licensure also have the right to suspend, revoke, or deny the licensure of any allied health professional they deem unfit to work in that field.
The U.S. Department of Health defines certification as a credential issued by a “non-governmental organization [to] grant recognition to an individual who has met predetermined qualifications specified by that organization.” Many professional organizations and non-governmental groups provide certifications that help professionals in a given field demonstrate niche industry knowledge and stand out against their competition.
Key points regarding healthcare certification include:
Medical assistants are not required to possess certification, but many seek out credentialing through the American Association of Medical Assistants to meet employer, rather than state, hiring requirements.
In other industries, states rely on non-governmental agencies’ certification process to demonstrate industry competency and preparedness for work. Paramedics and EMTs must pass the National Registry of Emergency Medical Technicians’ certification exam to receive consideration for state licensure.
While certification from private entities is more often than not optional rather than required, pursuing a certification in your chosen area of work can benefit you in areas of promotions, increased salary, and respect in the field.