Alabama Administrative Code Chapter 610-X-4 — Licensure

610 Alabama Board of Nursing

Ala. Admin. Code r. 610-X-4-.01 Definitions

(1) Application(s): Form(s) and process(es) for applicants seeking licensure by examination, endorsement, reinstatement, or renewal.

(a) Incomplete application: Missing requirements.

(b) Complete application: Meets requirements.

(c) Void application: Any incomplete application voided due to failure by the applicant to satisfy all requirements within one year of submission.

(2) Board Lapsed: Action by the Board to lapse a license until certain conditions are met.

(3) Continuing Education Earning Period: Period of time during which contact hours shall be accrued. Begins upon initial licensure or renewal of an individual nurse’s license during the renewal period and ends upon renewal of the individual nurse’s license during the next renewal period.

(4) Coordinated License Information System: A licensing integrated database and process for collecting, storing, and sharing nurse licensure and enforcement information that includes all multistate licensed registered nurses and multistate licensed practical/vocational nurses. The system includes all disciplinary history of each nurse, as administered by a nonprofit organization and controlled by licensing boards.

(5) Multistate License: A license to practice as a registered nurse or licensed practical nurse issued by a home state licensing board that allows a licensed nurse to practice in any state authorized to grant multistate licensure privileges under the Enhanced Nurse Licensure Compact. For purposes of these rules, the board shall recognize a valid multistate license as licensure to practice nursing in Alabama.

(6) Lapsed License: Failure of licensee to renew; does not require examination for reinstatement.

(7) Emergency: For purposes of this chapter, a declaration by the Governor of Alabama that an emergency impacting the public health, safety and welfare exists in Alabama.

(8) Endorsement: The process of application for and method of licensure for a registered or licensed practical/ vocational nurse originally licensed as a nurse in a jurisdiction other than Alabama.

(9) Supervision, Direct: Licensed registered nurse physically present in facility and readily accessible to designate or prescribe a course of action or to give procedural guidance, direction, and periodic evaluation.

(10) Verification: The process of verifying original or current licensure in Alabama. The verification process shall be defined by the Board.

(11) Primary Source Verification: Verification provided directly to the Board by the entity that is the original source of the document of educational credentials, certification, and/or licensure or an approved primary source organization recognized by the Board.

(12) Disaster: A serious disruption, occurring over a relatively short time, of the functioning of a community or a society involving widespread human, material, economic, or environmental loss and impacts, which exceeds the ability of the affected community or society to cope using its own resources.

(13) Public Health emergency: An emergency need for health care [medical] services to respond to a disaster or significant outbreak of an infectious disease, bioterrorist attack, or other significant or catastrophic event.

(14) Emergency Operation Plan: A facility specific plan developed as described by the Emergency Management Standards set forth by the Joint Commission, which outlines emergency structures and processes to respond toa range of emergencies varying in scale, duration, and cause.

(15) Home State: The party state which is the nurse’s primary state of residence.

(16) Party State: Any state that has adopted the compact.

(17) Remote State: A party state, other than the home state.

(18) Rap Back: An electronic repository. A rap back system allows for state law enforcement to automatically notify the BON of subsequent arrests of licensees whose fingerprints have been retained in a criminal history repository. Rap back eliminates the burden of requiring licensees to resubmit fingerprints upon renewal or reinstatement of licensure.

(19) Multistate Licensure Privilege: A legal authorization associated with a multistate license that allows the practice of nursing as a registered nurse or Multistate licensed practical nurse in any state participating in the Enhanced Nurse Licensure Compact.

(20) Single State license: A nurse license issued by a state participating in the Enhanced Nurse Licensure Compact that authorizes practice only within the issuing state and does not include a multistate licensure privilege to practice in any other state.

(21) Adverse Action: Any administrative, civil, equitable, or criminal action permitted by the law of a state which is imposed by a licensing board or other authority against a nurse, including actions against the license or multistate licensure privilege of an individual, including revocation, suspension, probation, monitoring of a licensee, limitations on the practice of the licensee, the bringing of a cease and desist action against the licensee, or any other encumbrance on licensure affecting the authorization of a nurse to practice.

(22) Alternative Program: A nondisciplinary monitoring program approved by a licensing board. The Voluntary Disciplinary Alternative Program (VDAP) is an alternative program.

(23) Credential Evaluation Service: an entity that assesses the educational credentials of graduates of nursing education programs located outside the jurisdiction of the United States and evaluates those credentials for equivalency to educational credentials of graduates educated within the jurisdiction of the United States.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §§34-21-2, 34-21-9.
• Filed September 29, 1982. Amended: Filed August 9, 1988; effective September 15, 1988. Amended: Filed: February 1, 1994; effective March 8, 1994. Repealed and New Rule: Filed November 26, 2007; effective December 31, 2007. Amended: Filed November 19, 2010; effective December 24, 2010. Amended: Filed March 20, 2018; effective May 4, 2018. Amended: Filed July 20, 2018; effective September 3, 2018. Amended: Filed January 22, 2019; effective March 8, 2019. Amended: Filed March 18, 2019; effective May 2, 2019. Amended: Filed July 25, 2019; effective September 9, 2019; operative January 1, 2020. Amended: Published November 29, 2019; effective January 13, 2020.

Ala. Admin. Code r. 610-X-4-.02 Qualifications Of Applicants For Licensure

(1) The applicant for licensure shall:

(a) Be a high school graduate or the equivalent, as determined by the Board.

(b) Be of good moral character. A criminal background check may be conducted by the Board at its discretion.

(c) A criminal fingerprint or other biometric-based background check shall be conducted prior to issuance of multistate licensure or application by endorsement.

(d) For registered nurse licensure, graduated or successfully completed all requirements for graduation from an approved registered nursing program in Alabama, or an approved registered nursing program located in another jurisdiction or territory that substantially meets the same educational criteria as Alabama programs. In the case of an applicant for licensure by endorsement, if the nursing education program did not include clinical experience sufficient to meet the same educational criteria as Alabama programs, the applicant’s continuing education and work experience in nursing may be considered, at the discretion of the Board.

(e) For practical nurse licensure, granted or successfully completed an approved practical nursing program in Alabama, or an approved practical nursing program located in another jurisdiction or territory that substantially meets the same educational criteria as Alabama programs.

1. In the case of an applicant for licensure by endorsement, if the nursing education program did not include clinical experience sufficient to meet the same educational criteria as Alabama programs, the applicant’s continuing education and work experience in nursing may be considered, at the discretion of the Board.

2. Education training and/or service completed through the Air Force Basic Medical Technician Corpsman Program (BMTCP) – 4N051-5 Skill Level or the ARMY LPN Program 68WM6 is acceptable as completion of an approved nursing program and meets the licensed practical nursing education requirement.

3. Students in prelicensure Registered Nurse programs who have successfully completed all didactic coursework, skills, and clinical learning experiences necessary to fulfill the requirements of a Practical Nursing program may be eligible to apply for the NCLEX-PN for licensure as a practical nurse by education equivalency, at the discretion of the Board.

(i) Following a review of the applicant’s transcript to verify completion of all required clinical learning experiences, skills, and theory, the Board may authorize the applicant to sit for the NCLEX-PN exam, at its discretion, provided that the student must successfully complete an ABN-approved course on LPN scope of practice prior to receiving approval to sitting for the NCLEX-PN.

(2) An applicant shall provide a valid social security number prior to the Board issuing a license.

(3) Be a citizen or legal resident of the United States. Individuals who are not legally present in the United States are not eligible for licensure.

(4) In the event that a nurse holding an Alabama single state license elects to apply for an Alabama multistate license, the licensee shall provide evidence of having earned sufficient continuing education credit. The continuing education credit requirement shall be prorated.

(5) In the case of applicants for initial multistate licensure or initial licensure by endorsement, submit fingerprints or other biometric data for the purpose of obtaining criminal history record information from the Federal Bureau of Investigation and the Alabama Law Enforcement Agency or its successor entity. The application must be on file with the board prior to submission of fingerprints or other biometric data.

(6) In addition to all other requirements for licensure as a registered nurse or licensed practical nurse, an applicant for a multistate license shall satisfy the following requirements:

(a) If a graduate of a foreign prelicensure education program not taught in English or if English is not the native language of the applicant, successfully passed an English proficiency examination that includes the components of reading, speaking, writing, and listening.

(b) Is eligible for or holds an active, unencumbered license.

(c) Has not been convicted or found guilty, or has entered into an agreed disposition, of a felony offense under applicable state or federal criminal law.

(d) Has not been convicted or found guilty, or has entered into an agreed disposition, of a misdemeanor offense related to the practice of nursing as determined on a case-by-case basis.

(e) Is not currently enrolled in an alternative program.

(f) Is subject to self-disclosure requirements regarding current participation in an alternative program.

(g) Has a valid United States Social Security number.

(7) An applicant who is ineligible for or is denied a multistate license may be eligible for single state licensure, at the discretion of the Board.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §§34-21-20, 34-21-21, 34-21-22.
• Filed September 29, 1982. Amended: Filed August 9, 1988; effective September 15, 1988. Amended: Filed: February 1, 1994; effective March 8, 1994. Repealed and New Rule: Filed May 29, 2001; effective July 3, 2001. Repealed and New Rule: Filed September 29, 2004; effective November 1, 2004. Amended: Filed November 26, 2007; effective December 31, 2007. Amended: Filed November 19, 2010; effective December 24, 2010. Amended: Filed November 21, 2016; effective January 5, 2017. Amended: Filed July 20, 2018; effective September 3, 2018. Amended: Filed July 25, 2019; effective September 9, 2019; operative January 1, 2020. Amended: Published November 30, 2021; effective January 14, 2022. Amended: Published July 29, 2022; effective September 12, 2022.
• Editor's note: Rule 610-X-4-.01 was renumbered to 610-X-4-.02 as per certification filed November 26, 2007.

Ala. Admin. Code r. 610-X-4-.03 Licensure By Examination

(1) The Board shall determine the official examination for licensure.

(2) Each individual seeking entry into practice as a licensed nurse in Alabama shall give official evidence of having met a passing standard on the Board-designated official licensing examination.

(3) Applicants for Alabama multistate licensure shall declare Alabama the home state of residence. Each such applicant must provide evidence of residence in Alabama.

(4) Examination performance for each applicant shall be measured as provided by the Board-approved testing service. In the event that examination data are lost or destroyed through circumstances beyond the control of the Board, the applicant shall be required to retake the examination in order to meet requirements for licensure.

(5) A Pass-Fail designation shall be recorded as the official result. An applicant who fails the licensing examination shall not be licensed and is not authorized to practice nursing in Alabama.

(6) Official results shall be released by the Board to the applicant and the program from which the applicant graduated. Results may be released electronically or by mail at the Board’s discretion. The Board may also, at its discretion, enter into data sharing agreements with other entities of the State of Alabama. The Board shall not otherwise release individual examination results without written authorization from the applicant or licensee.

(7) An applicant who fails the licensing examination in another jurisdiction or territory shall not be eligible for licensure by examination in Alabama until eligibility has been established by the original jurisdiction or territory.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §34-21-22.
• Filed September 29, 1982. Amended: Filed February 17, 1984; effective March 24, 1984. Amended: Filed February 1, 1994; effective March 8, 1994. Repealed and New Rule: Filed May 29, 2001; effective July 3, 2001. Repealed and New Rule: Filed September 29, 2004; effective November 1, 2004. Amended: Filed November 26, 2007; effective December 31, 2007. Amended: Filed November 21, 2016; effective January 5, 2017. Amended: Filed July 25, 2019; effective September 9, 2019; operative January 1, 2020. Amended: Published January 31, 2025; effective March 17, 2025.
• Editor's note: Rule 610-X-4-.02 was renumbered to 610-X-4-.03 as per certification filed November 26, 2007.

Ala. Admin. Code r. 610-X-4-.04 Application Process For Licensure By Examination

(1) The applicant shall submit to the Board an electronic completed application and the required fee(s).

(2) The applicant for multistate licensure shall provide evidence of legal residence in Alabama. This evidence may include, but is not limited to, a current:

(a) driver’s license with a home address;

(b) voter registration card with a home address;

(c) federal income tax return with a primary state of residence declaration;

(d) military form no. 2058 (state of legal residence certificate); or

(e) W2 form from the United States government or any bureau, division, or agency thereof, indicating residence.

(3) A primary source official school transcript shall be submitted to the Board and shall indicate the date of completion of the program and/or date degree/certificate was conferred.

(4) Multistate applicants shall be referred to a local approved agency where fingerprint or other biometric-based information is collected for state and federal criminal background checks. The state and federal results are transmitted to the Board. The Board will participate in the Federal Bureau of Investigation Rap Back system, or an entity performing a similar function, if available.

(5) The Board shall determine the applicant’s eligibility to take the licensing examination.

(6) If the applicant for licensure by examination is issued a license during the renewal period for that license type, the license shall expire at the end of the next license period.

(7) Following a determination by Board staff that the first-time applicant for licensure by examination is eligible, the Board shall issue a nonrenewable temporary permit to practice nursing.

(a) The temporary permit is valid for a period of time determined by the Board.

(b) The temporary permit allows the applicant for licensure by examination to practice and use the title Nursing Graduate-PN Program (NG-PNP) or Nursing Graduate-RN Program (NG-RNP), as appropriate, subject to the following stipulations.

1. The Nursing Graduate must function under direct supervision of a currently licensed registered nurse.

2. The Nursing Graduate shall not assume nor be assigned charge responsibilities.

3. Nursing Graduates holding temporary permits shall practice only in Alabama.

4. A temporary permit issued by a party state other than Alabama does not grant the holder a multistate licensure privilege.

(c) A temporary permit issued by the Board to an applicant for licensure by examination shall immediately become null and void if one of the following conditions is met:

1. The applicant fails the licensing examination.

2. The expiration date on the permit is reached.

3. A license is issued.

4. The applicant is denied licensure.

(d) The applicant who receives a temporary permit is required to:

1. Provide every employer evidence of the temporary permit for visual inspection.

2. Provide to an employer validation of a current license upon receipt of the official license notice.

3. Inform the employer of denial of licensure.

4. Immediately inform the employer of failure of the licensing examination.

(e) The Board shall issue notice of denial of licensure. Receipt of notice is presumed within five calendar days of mailing.

(f) An applicant who is ineligible for or is denied a multistate license may be eligible for single state licensure, at the discretion of the Board.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §§34-21-21, 34-21-22.
• Filed September 29, 1982. Amended: Filed February 1, 1994; effective March 8, 1994. Repealed and New Rule: Filed May 29, 2001; effective July 3, 2001. Repealed and New Rule: Filed September 29, 2004; effective November 1, 2004. Amended: Filed November 26, 2007; effective December 31, 2007. Amended: Filed November 19, 2010; effective December 24, 2010. Amended: Filed April 22, 2016; effective June 6, 2016. Amended: Filed November 21, 2016; effective January 5, 2017. Amended: Filed July 25, 2019; effective September 9, 2019; operative January 1, 2020. Amended: Published November 29, 2019; effective January 13, 2020. Amended: Published September 29, 2023; effective November 13, 2023.
• Editor's note: Rule 610-X-4-.03 was renumbered to 610-X-4-.04 as per certification filed November 26, 2007.

Ala. Admin. Code r. 610-X-4-.05 Applicant Request For Special Accommodation(s)

(1) An applicant for licensure by examination who is otherwise qualified shall not be deprived of the opportunity to take the examination solely by reason of disability.

(2) Written requests for modification of the procedures for administering the examination shall be submitted to the Board at the time of application for licensure. The written request shall include:

(a) An evaluation of the disability by the applicant's licensed physician or licensed psychologist, including the diagnosis from the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), if appropriate.

(b) A statement from the director of the nursing education program addressing any accommodations made during the nursing education program.

(c) The specific accommodation being requested.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §34-21-2(j)(6); Title II of the Americans with Disabilities Act.
• Filed September 29, 1982. Amended: Filed September 18, 1985; effective October 24, 1985. Amended: Filed June 22, 1990; effective July 30, 1990. Amended: Filed February 1, 1994; effective March 8, 1994. Repealed and New Rule: Filed May 29, 2001; effective July 3, 2001. Repealed and New Rule: Filed September 29, 2004; effective November 1, 2004. Amended: Filed November 26, 2007; effective December 31, 2007. Amended: Filed November 19, 2010; effective December 24, 2010. Amended: Filed November 21, 2016; effective January 5, 2017. Amended: Published November 30, 2023; effective January 14, 2024.
• Editor's note: Rule 610-X-4-.04 was renumbered to 610-X-4-.05 as per certification filed November 26, 2007.

Ala. Admin. Code r. 610-X-4-.06 Graduates Of Foreign Nursing Schools

The applicant educated in a nursing education program outside of the jurisdiction of the United States shall:

(1) Submit a completed electronic application and required fee(s).

(2) Be required to pass the same licensure examination as applicants for licensure by examination in Alabama, unless the applicant has been licensed in another state by examination.

(3) Be a graduate of a nursing education program approved by the proper authorities in the country where the program is located.

(4) Correct any educational deficiencies by taking additional courses, as directed by the Board.

(5) Have completed secondary school or its equivalent.

(6) Provide a certified course-by-course report from a credential evaluation service acceptable to the Board, verifying that the applicant:

(a) Has earned educational credentials equivalent to graduation from a governmentally accredited/approved, post-secondary general nursing program.

(b) Received both theory and clinical education in each of the following: nursing care of the adult which includes both medical and surgical nursing, maternal/infant nursing, nursing care of children, and psychiatric/mental health nursing.

(7) In the case of an applicant for licensure by examination, the applicant must provide certification that the applicant has achieved an approved score on an English proficiency test acceptable to the Board, unless a substantial portion of the applicant’s nursing program of study, as determined by the Board, was conducted in English. At-home or online testing is not sufficient to satisfy this requirement.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §§34-21-21, 34-21-22.
• Filed September 29, 1982. Amended: Filed February 1, 1994; effective March 8, 1994. Repealed and New Rule: Filed May 29, 2001; effective July 3, 2001. Repealed and New Rule: Filed September 29, 2004; effective November 1, 2004. Amended: Filed November 26, 2007; effective December 31, 2007. Amended: Filed November 19, 2010; effective December 24, 2010. Amended: Filed March 18, 2019; effective May 2, 2019. Amended: Published January 31, 2022; effective March 17, 2022.
• Editor's note: Rule 610-X-4-.05 was renumbered to 610-X-4-.06 as per certification filed November 26, 2007.

Ala. Admin. Code r. 610-X-4-.07 Licensure By Endorsement

(1) The applicant for licensure by endorsement shall:

(a) Have been duly licensed as a registered nurse or licensed practical/vocational nurse under the laws of another state or territory and shall meet the requirements for the licensure examination.

1. The Board may deny consideration of an applicant who has a revoked license in another jurisdiction.

2. The Board may deny consideration of an applicant who has a suspended license in another jurisdiction.

(b) Provide for official verification of licensure from original state of licensure or from a board recognized primary source.

(c) Submit primary source evidence of completion of a nursing education program that included theoretical and clinical experience appropriate to the type of program. If the nursing education program did not include clinical experience, the applicant’s continuing education and work experience in nursing may be considered at the discretion of the Board.

(d) Submit evidence of completion of twenty-four contact hours of approved continuing education. The Board shall not consider continuing education credits that were earned more than twenty-four months prior to application. Contact hours earned for initial licensure by endorsement may not be used toward the continuing education requirement for the next license renewal period.

(e) Submit a complete electronic application and required fees.

(f) Initial applicants for licensure by endorsement shall be referred to a local approved agency where fingerprint or other biometric-based information is collected for state and federal criminal background checks. The state and federal results are transmitted to the Board. The Board will participant in the Federal Bureau of Investigation Rap Back system, or an entity performing a similar function if available.

(2) Following a determination by Board staff that the first-time applicant for licensure by endorsement is eligible, the Board shall issue a nonrenewable temporary permit to practice nursing. Temporary permits shall be valid in Alabama only.

(a) If the applicant has an active license issued by another state or territory, a notarized copy of the license or of primary source verification of the license is acceptable as initial proof of licensure to obtain a temporary permit.

(b) If the applicant was previously duly licensed by another state or a territory but at the time of application for licensure by endorsement into Alabama has a lapsed license, a temporary permit may not be issued.

(3) A licensed nurse licensed by endorsement during the continuing education earning period shall:

(a) Accrue for the first license renewal one contact hour for each calendar month remaining in the license period.

(b) Meet requirements for continuing education in accordance with other stipulations for license renewal set forth in these rules.

(4) If the applicant for licensure by endorsement is issued a license during the renewal period for that license type, the license shall expire at the end of the next license period.

(5) The applicant for multistate licensure shall provide evidence of legal residence in Alabama. This evidence may include, but is not limited to, a current:

(a) driver’s license with a home address;

(b) voter registration card with a home address;

(c) federal income tax return with a primary state of residence declaration;

(d) military form no. 2058 (state of legal residence certificate); or

(e) W2 form from the United States government or any bureau, division, or agency thereof, indicating residence.

(6) A multistate licensed nurse who is changing primary state of residence to Alabama may continue to practice under the former home state’s multistate license until he or she is issued an Alabama single state or multistate license.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §§34-21-21, 34-21-22.
• New Rule: Filed May 29, 2001; effective July 3, 2001. Repealed and New Rule: Filed September 29, 2004; effective November 1, 2004. Amended: Filed November 26, 2007; effective December 31, 2007. Amended: Filed June 19, 2009; effective July 24, 2009. Amended: Filed November 19, 2010; effective December 24, 2010. Amended: Filed April 22, 2016; effective June 6, 2016. Amended: Filed November 21, 2016; effective January 5, 2017. Amended: Filed March 20, 2018; effective May 4, 2018. Amended: Filed July 20, 2018; effective September 3, 2018. Amended: Filed July 25, 2019; effective September 9, 2019; operative January 1, 2020. Amended: Published September 29, 2023; effective November 13, 2023.
• Editor's note: Rule 610-X-4-.06 was renumbered to 610-X-4-.07 and original Rule 610-X-4-.07, Temporary Permits, was repealed as per certification filed November 26, 2007; effective December 31, 2007.

Ala. Admin. Code r. 610-X-4-.08 Renewal Of License

(1) License Periods:

(a) The Alabama single state registered nurse license shall be valid for two years beginning January 1 of each odd-numbered year and expiring December 31 of each even-numbered year.

(b) The Alabama multistate registered nurse license shall be valid for two years beginning January 1 of each even-numbered year and expiring December 31 of each odd-numbered year.

(c) All practical nurse licenses shall be valid for two years beginning January 1 of each even-numbered year and expiring December 31 of each odd-numbered year.

(2) Continuing Education Earning Period: Period of time during which contact hours shall be accrued. Begins upon initial licensure or renewal of an individual nurse’s license during the renewal period and ends upon renewal of the individual nurse’s license during the next renewal period.

(3) Renewal of License

(a) Beginning in 2022, the renewal period shall be from 8:00 a.m. on September 1 to 4:30 p.m. on December 31 of the year the license expires.

(b) Renewal notices may be transmitted electronically.

(c) To be eligible for renewal, the applicant shall:

1. Hold a valid, active Alabama license.

2. Submit a completed electronic renewal application and required fee(s).

3. Meet continuing education requirements.

(i) A licensed nurse shall, for the first license renewal, earn four contact hours of Board-provided continuing education related to statutory and administrative frameworks for nursing regulation, scope of practice, and standards of practice and one contact hour for each calendar month remaining in the earning period up to a maximum of 24 contact hours including the four hours of Board-provided continuing education referenced in the section.

(ii) A licensed nurse shall earn in each earning period not less than 24 contact hours of Board-approved or Board-recognized continuing education as a condition for renewal of license for the subsequent license period.

(iii) Failure to meet the continuing education requirement shall be cause for the license to lapse.

(4) An active license is required to practice nursing. The licensee shall have evidence of the active license available for employer inspection by January 1 of the new license period.

(5) Failure to receive the renewal application or notice shall not relieve the licensee of the responsibility of renewing the license by the expiration date.

(6) Any license not renewed as of December 31 of the renewal period shall lapse. Any individual who practices with a lapsed license shall be subject to penalties established under 610-X-8.

(7) Advanced practice nurses holding Alabama RN licenses shall renew approval to practice at the time of license renewal. Advanced practice nurses holding multistate RN licenses issued by party states shall renew approval to practice between September 1 and December 31 of odd-numbered years. Failure to meet the requirements of Chapter 610-X-5 or Chapter 610-X-9, as applicable, shall result in lapse of the advanced practice approval. The advanced practice approval shall expire prior to the RN license if the advanced practice nurse’s national certification expires during the license period.

(a) Alabama-1icensed Certified Registered Nurse Practitioners (CRNP) and Certified Nurse Midwives (CNM) with prescriptive authority shall earn, as part of the required twenty-four (24) Board-approved or Board-recognized continuing education contact hours for license renewal, six contact hours of pharmacology content specific to prescriptive practice in the approved area for collaborative practice. Graduate pharmacology academic credit earned during the nurse practitioner or nurse midwife educational program prior to initial approval as a CRNP or CNM does not qualify as pharmacology continuing education for renewal of approval as a CRNP or CNM.

(b) Alabama-1icensed Certified Registered Nurse Anesthetists (CRNA) shall earn, as part of the required twenty-four (24) Board-approved or Board-recognized continuing education contact hours for license renewal, six contact hours of pharmacology. Graduate pharmacology academic credit earned during the nurse anesthetist educational program prior to initial approval as a CRNA does not qualify as pharmacology continuing education for renewal of approval as a CRNA.

(c) Alabama-1icensed Clinical Nurse Specialists (CNSs) shall earn, as part of the required twenty-four (24) Board-approved or Board-recognized continuing education contact hours for license renewal, six contact hours of pharmacology. Graduate pharmacology academic credit earned during the clinical nurse specialist program prior to initial approval as a CNS does not qualify as pharmacology continuing education for renewal of approval as a CNS.

(d) If one year or less remains in the license period at the time of initial approval, continuing education contact hours specific to pharmacology are not required for the first advanced practice renewal.

(e) If the applicant for advanced practice approval holding an Alabama single state RN license is granted approval during the renewal period for single state licensed registered nurses, the approval will expire at the end of the next even-numbered year license period or the national certification period, whichever comes first.

(f) If the applicant for advanced practice approval holding a multistate registered nurse license is granted approval during the renewal period for multistate licensed registered nurses, the approval will expire at the end of the next odd-numbered year license period or the national certification period, whichever comes first.

(8) No later than June 30, 2020, Alabama-approved advanced practice nurses holding multistate licenses issued by party states other than Alabama shall notify the Board of their home state licensure status. Such nurses shall not be required to renew advanced practice approval in 2020; advanced practice approval must be renewed between September 1 and December 31 of every odd-numbered year thereafter.

(9) If an advanced practice nurse holding a multistate registered nurse license issued by a party state other than Alabama fails to maintain RN licensure in his or her home state, the advanced practice approval shall immediately lapse.

(10) Beginning January 1, 2020, and ending July 1, 2020, any eligible licensed practical nurse holding an Alabama single state license may elect to pay a one-time fee to convert the single state license to a multistate license. Following conversion, the multistate license shall be subject to all conditions of multistate licensure. Conversion from single state to multistate licensure shall not occur after July 1, 2020.

(11) A licensed nurse may apply to convert his or her single state license to a multistate license during the single state license renewal period; however, the conversion application is not complete until all elements of the application are received by the Board, including, but not limited to, the criminal history record information report and required continuing education. If the application for conversion to a multistate license filed during the single state license renewal period is not complete prior to the end of the single state license renewal period, but the nurse’s application otherwise satisfies all requirements for renewal of the nurse’s single state license, the single state license may be renewed, at the discretion of the Board, pending completion of the conversion process.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §34-21-23; Act 89-243.
• Filed September 29, 1982. Amended: Filed August 9, 1988; effective September 15, 1988. Amended: Filed February 15, 1991; effective March 22, 1991. Repealed and New Rule: Filed May 29, 2001; effective July 3, 2001. Repealed and New Rule: Filed September 29, 2004; effective November 1, 2004. Amended: Filed November 26, 2007; effective December 31, 2007. Amended: Filed May 16, 2008; effective June 20, 2008. Amended: Filed June 19, 2009; effective July 24, 2009. Amended: Filed November 19, 2010; effective December 24, 2010. Amended: Filed April 22, 2016; effective June 6, 2016. Amended: Filed November 21, 2016; effective January 5, 2017. Amended: Filed March 20, 2018; effective May 4, 2018. Amended: Filed July 20, 2018; effective September 3, 2018. Amended: Filed January 22, 2019; effective March 8, 2019. Amended: Filed July 25, 2019; effective September 9, 2019; operative January 1, 2020. Amended: Filed January 31, 2020; effective March 16, 2020. Amended: Published November 30, 2020; effective January 14, 2021. Amended: Published November 30, 2021; effective January 14, 2022. Amended: Published July 29, 2022; effective September 12, 2022.

Ala. Admin. Code r. 610-X-4-.09 Special Provisions For Actively Deployed Licensed Nurses

(1) When a licensed nurse who is actively serving in the military is deployed during the biennial renewal period, the license shall not lapse, provided that the following conditions are met:

(a) The license was active at the time of deployment.

(b) The licensee provides the Board a copy of the military activation or deployment orders, or other proof of active military service, in advance of deployment.

(c) The licensee renews the license no later than December 31 of the next year following return from deployment.

(2) In the event that a licensed nurse fails to notify the Board prior to deployment, the license shall lapse, if not renewed. However, the license may be reinstated or renewed without penalty or payment of the reinstatement or late renewal fee(s) under the following conditions:

(a) The license was active at the time of deployment.

(b) The application for reinstatement or renewal is made while still in the armed services or no later than six months after discharge from active service or return to inactive military status.

(c) A copy of the military activation orders or other proof of active military service accompanies the application.

(d) The renewal fee is paid.

(e) If the required continuing education contact hours were not earned for renewal during the earning period, the licensed nurse shall be required to complete the required continuing education hours needed for renewal no later than six months after discharge from active service, return to inactive military status, or return from deployment.

(3) The continuing education contact hours used for renewal may not be used for the next license renewal.

(4) The continuing education contact hours for the next license renewal may not be prorated.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §31-12A-4; §34-21-2(j)(1); 34-21-23.
• New Rule: Filed September 29, 2004; effective November 1, 2004. Amended: Filed November 21, 2016; effective January 5, 2017. Amended: Published November 30, 2023; effective January 14, 2024.

Ala. Admin. Code r. 610-X-4-.10 Reinstatement Of A Lapsed License

A lapsed license may be reinstated upon submission of an electronic completed application and compliance with the following:

(1) Payment of current renewal and reinstatement fees, outstanding fees, and fines.

(2) Evidence of completion of twenty-four contact hours of approved continuing education within the twenty-four months preceding application.

(a) Contact hours earned for reinstatement of a lapsed license may not be used toward the continuing education requirement for the next license renewal.

(b) A licensed nurse whose license is reinstated shall accrue for license renewal one contact hour for each calendar month remaining in the license period.

(c) If the reinstatement of a lapsed license occurs during the renewal period for that license type, the expiration of the license shall be the end of the next license period.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §34-21-2; Act 89-243.
• Filed September 29, 1982. Amended: Filed June 6, 1986; effective July 11, 1986. Amended: Filed June 22, 1990; effective July 30, 1990. Amended: Filed February 15, 1991; effective March 22, 1991. Amended: Filed February 1, 1994; effective March 8, 1994. Repealed and New Rule: Filed May 29, 2001; effective July 3, 2001. Repealed and New Rule: Filed September 29, 2004; effective November 1, 2004. Amended: Filed November 26, 2007; effective December 31, 2007. Amended: Filed June 19, 2009; effective July 24, 2009. Amended: Filed November 19, 2010; effective December 24, 2010. Amended: Filed November 21, 2016; effective January 5, 2017. Amended: Filed July 20, 2018; effective September 3, 2018.

Ala. Admin. Code r. 610-X-4-.11 Notice Requirements

(1) The applicant, or licensed nurse shall notify the Board in writing of any requested name change. Appropriate legal documents shall be submitted prior to changing the name of the licensee on the license. The legal documents required for a name change are one of the following:

(a) Marriage certificate.

(b) Divorce decree substantiating the name change

(c) Probate court records effecting a legal name change.

(2) The applicant or licensed nurse shall notify the Board office in writing of any change in the reported address. The address of record is the last known address provided by the applicant or licensed nurse.

(3) The Board’s notice to the licensed nurse of selection for audit of continuing education records is presumed received within five (5) days of mailing or electronic transmission to the address of record.

(4) Advanced practice nurses, as defined by statute and regulation, shall submit to the Board, immediately upon receipt:

(a) Evidence of authorization to test for the initial certification examination if requesting provisional approval for advanced practice nursing.

(b) Evidence of current national certification by a Board-recognized national certifying body:

1. Upon successful completion of the initial certification examination.

2. Upon recertification by a Board-recognized national certifying body.

(c) Notice of termination of an approved collaborative practice, if applicable.

(5) Current national certification by a Board-recognized certifying body is a prerequisite for approval to practice as a certified registered nurse practitioner, certified nurse midwife, certified registered nurse anesthetist, or clinical nurse specialist. Failure to provide evidence by primary source verification of current national certification prior to the expiration of existing certification on file with the Board shall result in lapse of approval to practice as an advanced practice nurse and may result in disciplinary action pursuant to Chapter 610-X-8.

(6) The Board’s notice to the advanced practice nurse of approval to practice may be:

(a) A letter or other document granting provisional, temporary, or interim approval.

(b) A letter or other document granting full approval.

(7) Practicing as an advanced practice nurse subsequent to the expiration date of the advanced practice approval shall result in disciplinary action pursuant to Chapter 610-X-8. Failure to submit evidence to the Board of meeting the requirements of Chapter 610-X-5 or Chapter 610-X-9, as applicable, shall result in lapse of the advance practice approval.

(8) Any nurse holding a multistate license issued by another state who becomes a resident of Alabama shall be required to notify the board of the change in state of primary residence and file an application for licensure by endorsement in Alabama, within sixty (60) days of the change having occurred.

(9) Any nurse holding advanced practice approval in Alabama who holds a multistate license issued by another state shall notify the board of a change in state of primary residence, within thirty (30) days of the change having occurred.

(10) Upon a change in the position of Chief Nursing Officer or Director of Nursing in a licensed healthcare facility, the person assuming the role shall notify the board in writing of the change within ninety (90) days of assuming the role.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, 34-21-123(c).
• Filed September 29, 1982. Amended: Filed February 15, 1991; effective March 22, 1991. Repealed and New Rule: Filed May 29, 2001; effective July 3, 2001. Repealed and New Rule: Filed September 29, 2004; effective November 1, 2004. Amended: Filed March 24, 2006; effective April 28, 2006. Amended: Filed November 26, 2007; effective December 31, 2007. Amended: Filed November 19, 2010; effective December 24, 2010. Amended: Filed April 22, 2016; effective June 6, 2016. Amended: Filed November 21, 2016; effective January 5, 2017. Amended: Filed March 20, 2018; effective May 4, 2018. Amended: Filed July 20, 2018; effective September 3, 2018. Amended: Filed July 25, 2019; effective September 9, 2019; operative January 1, 2020. Amended: Published April 30, 2024; effective June 14, 2024. Amended: Published April 30, 2025; effective June 14, 2025.

Ala. Admin. Code r. 610-X-4-.12 Lost Continuing Education Card

The licensee shall promptly report, in writing, the loss of a continuing education card to the Board. A duplicate continuing education card requires an electronic completed application and appropriate fee(s).

History

• Authority: Code of Ala. 1975, §34-21-23.
• Filed February 15, 1991; effective March 22, 1991. Repealed and New Rule: Filed May 29, 2001; effective July 3, 2001. Repealed and New Rule: Filed September 29, 2004; effective November 1, 2004. Amended: Filed November 19, 2010; effective December 24, 2010. Amended: Filed April 22, 2016; effective June 6, 2016.

Ala. Admin. Code r. 610-X-4-.13 Verification Of Alabama Licensure

(1) The Board obtains primary source verification directly from educational programs or an organization recognized by the United States Department of Education prior to issuing a license.

(2) Upon receipt of an electronic written request and payment of the required fee, the Board’s designee shall provide written verification of Alabama licensure.

(3) The Board provides primary source verification to employers of nurses through an online subscription service and through license look-up services. Organizations that do not employ licensed nurses but subscribe to the online verification service are not designated primary source agents of the Board for verification purposes.

(4) Upon request and payment of appropriate fees by a nurse holding a multistate license issued by the board, the board shall provide a verification report including all data regarding the nurse maintained by the coordinated licensure information system, unless:

(a) Such information is not otherwise available to the board, or

(b) The information is not available to the nurse under the laws of the state contributing the information to the coordinated licensure information system; or

(c) The information has been designated as available only to other boards of nursing by the state contributing the information to the coordinated licensure information system.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §34-21-2(1).
• Filed September 29, 1982. Amended: Filed February 17, 1984; effective March 24, 1984. Repealed and New Rule: Filed May 29, 2001; effective July 3, 2001. Repealed and New Rule: Filed September 29, 2004; effective November 1, 2004. Amended: Filed November 19, 2010; effective December 24, 2010. Amended: Filed May 23, 2011. Effective June 27, 2011. Amended: Filed November 21, 2016; effective January 5, 2017. Amended: Filed March 20, 2018; effective May 4, 2018. Amended: Filed July 25, 2019; effective September 9, 2019; operative January 1, 2020.

Ala. Admin. Code r. 610-X-4-.14 Fees

(1) Fees and fines are non-refundable.

(2) Fees are valid for 12 months from date of receipt.

(3) Fees and fines may be paid by electronic means using a credit or debit card, if available. Other means of payment may be cashier’s check, business check, money order, or certified check. The board may, at its discretion and subject to established guidelines, require that a single fee be paid by a combination of both electronic and other means.

(4) Personal checks are only acceptable when the individual applicant or licensed nurse’s name is imprinted on the check. Personal checks that are not acceptable forms of payment are:

(a) Counter checks.

(b) Third-party checks.

(c) On out-of-state banks.

(d) Fees for license verification and Voluntary Disciplinary Alternative Program (VDAP).

(e) Fines.

(5) Payment, regardless of method, that is not honored by the financial institution may result in disciplinary action and reporting to the appropriate authorities for prosecution.

(6) At its discretion, the Board may require that a fee or fine be paid using certified funds.

(7) The statutory bad check charge applies to any personal check returned by the financial institution for insufficient funds.

(8) The Board shall set fees and charges annually. At each September meeting of the Board, the previous schedule of fees and charges shall be automatically readopted unless the Board proposes a revised schedule.

(9) The following schedule of fees and charges apply:

Single State Licensure by Examination or Endorsement: $125.00

Multistate Licensure by Examination or Endorsement: $225.00

Disaster Temporary Permit: 25.00

Biennial Renewal of Single State RN or LPN license: 100.00

Biennial Renewal of Multistate RN or LPN license: 200.00

Initial Approval for Advanced Practice: 175.00

Certificate of Qualification (Eligible for Collaborative Practice): 100.00

Add Collaborative Practice: 75.00

Biennial Approval of Advanced Practice: 75.00

Student Nurse Apprentice Permit 50.00

New Nursing Education Program Fee: 1,500.00

Out of State Program Conducting Clinical in Alabama $500.00

Initial and Renewal, Continuing Education Provider: 400.00

Reinstatement of Lapsed Single State License: 250.00

Reinstatement of Lapsed Multistate License: 350.00

Reinstatement of Lapsed Advanced Practice Approval: 75.00

Reinstatement of Lapsed Advanced Practice Approval (Non-Alabama MSL RN): 150.00

Reinstatement of Lapsed Continuing Education Provider: 500.00

Reinstatement of Suspended License: 250.00

Reinstatement of Revoked License: 750.00

NST-C Permit by Examination or Endorsement $50.00

Biennial Renewal of NST-C permit $50.00

Reinstatement of a lapsed, revoked, or suspended NST-C permit $75.00

MAC Permit by Examination or Endorsement $50.00

Biennial Renewal of MAC permit $50.00

Reinstatement of a lapsed, revoked or suspended MAC permit $75.00

Late Continuing Education Audit Fee 1st Time: 150.00 2nd Time: 300.00 Three or more times: 600.00

Coordinated Licensing Information System Report: 50.00

Voluntary Disciplinary Alternative Program: up to $1,000.00

Duplicate continuing education card: 25.00

Non-Nurses Verification of License: 50.00

Public Records Requests:

Document retrieval and preparation:

$5.00 for the first hour or any portion thereof

$20.00 per each additional hour or any portion thereof per page fees:

$0.50 per page for copies produced on standard 8.5 X 11 paper

Actual costs:

Any costs incurred while processing or responding to a request, including but not limited to hardware necessary for producing electronic records, specialty paper, and costs incurred to search electronic databases.

Resend Mail Fee: 25.00

Group Online License Verification Service (annual fee): Level I: 100.00 Level II: 750.00 Level III: 1,500.00 Level IV: 2000.00

Processing Subpoena: 10.00

Miscellaneous: up to $100.00

Consultation (per day): up to $500.00

Statutory Bad Check Charge: Maximum allowed by law

Reactivation of retired single rate license within two years of retired status: 600.00

Reactivation of retired multistate license within two years of retired status: 700.00

Reactivation of retired single rate license following two years of retired status: 250.00

Reactivation of retired multistate license following two years of retired status: 350.00

Registration for continuing education courses provided by the Board: Up to $100.00

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §§34-21-2(j)(22), 34-21-24.
• Filed September 9, 1982. Repealed and New Rule: May 29, 2001; effective July 3, 2001. Amended: Filed January 29, 2002; effective March 5, 2002. Amended: Filed November 18, 2002; effective December 23, 2002. Amended: Filed November 20, 2003; effective December 25, 2003. Repealed and New Rule: Filed September 29, 2004; effective November 1, 2004. Amended: Filed November 17, 2006; effective December 22, 2006; operative January 1, 2007. Amended: Filed November 26, 2007; effective December 31, 2007. Amended: Filed November 21, 2008; December 26, 2008. Amended: Filed November 19, 2010; effective December 24, 2010. Amended: Filed November 19, 2012; effective December 24, 2012. Amended: Filed November 18, 2013; effective December 23, 2013. Repealed and New Rule: Filed November 24, 2014; effective December 29, 2014. Amended: Filed April 22, 2016; effective June 6, 2016. Amended: Filed November 21, 2016; effective January 5, 2017. Amended: Filed January 22, 2018; effective March 8, 2018. Amended: Filed March 20, 2018; effective May 4, 2018. Amended: Filed March 18, 2019; effective May 2, 2019. Amended: Filed July 25, 2019; effective September 9, 2019; operative January 1, 2020. Amended: Published January 31, 2020; effective March 16, 2020. Amended: Published April 30, 2020; effective June 14, 2020. Amended: Published June 30, 2020; effective August 14, 2020. Amended: Published November 30, 2020; effective January 14, 2021. Amended: Published November 30, 2020; effective January 14, 2021. Amended: Published May 31, 2023; effective July 15, 2023. Amended: Published July 31, 2023; effective November 13, 2023. Amended: Published January 31, 2024; effective March 16, 2024. Amended: Published July 31, 2024; effective September 14, 2024.

Ala. Admin. Code r. 610-X-4-.15 Annual Report Of Employing Agencies

(1) No later than January 31 of each year, each employing agency’s director of nursing or other appropriate authority shall submit an annual report that includes all persons employed as licensed nurses, including, but not limited to, personnel practicing nursing in Alabama under a multistate license, a single state license, or multistate licensure privilege, according to guidelines provided by the Board. Subscription to the Board’s group online license service shall serve as the annual report of employing agencies.

(2) Healthcare organizations that employ multistate licensees shall verify licensure through the Coordinated License Information system. The Board shall provide access to the Coordinated License Information System through its website.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §34-21-2(6).
• Filed September 29, 1982. Repealed and New Rule: Filed May 29, 2001; effective July 3, 2001. Repealed and New Rule: Filed September 29, 2004; effective November 1, 2004. Amended: Filed November 19, 2010; effective December 24, 2010. Amended: Filed November 21, 2016; effective January 5, 2017. Amended: Filed July 25, 2019; effective September 9, 2019; operative January 1, 2020. Amended: Published January 31, 2022; effective March 17, 2022.
• Editor's note: The previous Chapter 610-X-4, Licensure (contained 19 rules) was repealed in its entirety and replaced with new Chapter 610-X-4, Licensure as per certification filed May 29, 2001; effective July 3, 2001.

Ala. Admin. Code r. 610-X-4-.16 Special Circumstances

(1) In the event the Governor proclaims a state of emergency impacting any part of Alabama, Code of Ala. 1975 Section 34-21-6 applies for the first thirty (30) days. An individual licensed to practice as a registered nurse or licensed practical nurse in another state may provide emergency assistance in Alabama for up to thirty (30) days subject to verification of licensure in the state where licensed, provided that the nurse has successfully passed the board selected nurse licensure examination required for licensure in Alabama. Any organization or individual who provides employment or volunteer opportunities for the licensed nurse providing nursing services is responsible to ensure the validity of the nursing license.

(2) Should an emergency continue past thirty days, a temporary permit to practice as a registered nurse or licensed practical nurse in Alabama for ninety (90) days is required. An application for an emergency temporary permit to practice as a registered nurse or licensed practical nurse is required to be submitted to the Board electronically. Applicants for temporary permits are required to demonstrate that they have successfully completed the board selected nurse licensure examination required for licensure in Alabama.

(3) In the event of a state or nationally declared emergency in a jurisdiction outside Alabama, any individual licensed in the jurisdiction where the emergency occurred may apply electronically for a Disaster Temporary Permit to practice as a registered nurse or licensed practical nurse in Alabama in the manner prescribed by the Board. The Disaster Temporary Permit shall be valid for not more than ninety (90) days. Applicants for disaster temporary permits are required to demonstrate that they have successfully completed the board selected nurse licensure examination required for licensure in Alabama.

(4) Any individual licensed to practice as a registered nurse or licensed practical nurse in another state is required to have an Alabama license if educational or consultative services extend beyond 30 calendar days in one year, unless the individual holds a valid multistate license issued by a party state other than Alabama.

(a) Providing nursing care at a camp in Alabama for longer than seven (7) days within a calendar year requires a license to practice nursing in Alabama.

(b) Providing nursing care to and accompanying students from another state to Alabama for longer than seven (7) days within a calendar year requires a license to practice nursing in Alabama, unless the individual holds a valid multistate license issued by a party state other than Alabama.

(c) Providing preparational services for an out of state organ transplant team is considered consultative services for the purposes of this rule.

(d) Gratuitous Vaccine Administration with a Retired, Inactive, or Lapsed License

1. Any individual holding an Alabama nursing license in a “retired,” “inactive” or “lapsed” status may administer vaccines in Alabama without compensation during a declared state or national pandemic, provided that the license is otherwise in good standing, has not been revoked or voluntarily surrendered, and was not encumbered at the time the license became retired, inactive or lapsed. A nurse so qualified is authorized to administer vaccines necessitated by the public health emergency. A nurse so qualified may administer authorized vaccines via the following routes of administration: oral intranasal, and subcutaneous, intradermal, or intramuscular injections, pursuant to a valid order or prescription by a legally authorized prescriber. Gratuitous vaccine administration is restricted to practice without compensation and does not include any other practice or nursing for compensation.

2. Any entity that seeks to utilize the gratuitous vaccine administration services authorized in this section shall first verify licensure status of the nurse in every jurisdiction where the nurse holds or has held a registered nurse or where the nurse holds or has held a registered nurse or licensed practical or vocational nurse license. The nurse:

(i) Must not have had a nursing license revoked or voluntarily surrendered in any state, territory, or country.

(ii) Must not have had a suspended, probated, or otherwise encumbered license immediately prior to the time the license became lapsed, inactive, or retired.

(5) Telephonic or electronic services used to communicate with patients and provide direction regarding nursing and medical care require an active license to practice nursing in Alabama, or a valid multistate RN or LPN license issued by a party state other than Alabama, or a valid multistate RN or LPN license issued by a party state other than Alabama.

(6) A licensed nurse who retires or ceases nursing practice for any reason and has no intention to practice in the future may apply to the Board for an inactive license with a “retired” status.

(a) The license will remain inactive unless the licensee reactivates the license.

(b) Continuing education is not required to maintain an inactive license.

(c) In order to reactivate an inactive license, the applicant shall submit an electronic application, pay the required fees, and submit 24 contact hours of continuing education earned within two years of the date of the application.

(d) A nurse currently participating in the Voluntary Disciplinary Alternative Program or holding licenses currently encumbered pursuant to discipline by the Board shall not be eligible to inactivate or retire the license.

(e) If an applicant or an inactive license is currently the subject of an investigation or a pending disciplinary proceeding with the Board, the nurse shall not be eligible to inactivate or retire the license.

(7) In the event of a national emergency duly declared by federal officials, or in the event of a natural disaster or state of emergency duly proclaimed by the Governor, a certified registered nurse practitioner or certified nurse midwife may provide emergency treatment without immediate physician collaboration to patients within the affected areas of the state, provided that the treatment is within the individual's scope of education, training, and approved protocol. The certified registered nurse practitioner or certified nurse midwife in such circumstance shall make reasonable efforts to inform the collaborating physician of the location and type of emergency services being provided and shall act in conformance with the direction of local physicians. The authority granted under this paragraph shall extend only for the duration of the declared national emergency or state emergency or natural disaster.

(8) In the event that a licensed healthcare facility activates its emergency operation plan in response to a public health emergency, a licensed nurse or advanced practice nurse may act within such alternative standards of care delivery as are authorized by the Governor’s Proclamation and alternative standards and scope of practice as are provided in the emergency operations plan, provided that any such practice is within the scope of practice, education, training, and national certification of the licensed nurse or advanced practice nurse and congruent with any limits imposed in the Code of Alabama and not addressed by the Governor’s Proclamation. A certified registered nurse practitioner or certified nurse midwife may provide emergency treatment without immediate physician collaboration to patients within the affected areas of the public health emergency, provided that the treatment is within the individual's scope of education, training, and approved protocol. The certified registered nurse practitioner or certified nurse midwife in such circumstance shall make reasonable efforts to inform the collaborating physician of the location and type of emergency services being provided and shall act in conformance with the direction of local physicians. The authorization provided in this section shall be effective only for the duration of time during which the Governor’s Proclamation and emergency operation plan are active.

(9) In the event that a licensed healthcare facility activates its emergency operation plan in response to a community disaster, a licensed nurse or advanced practice nurse may act within such alternative clinical models or clinical department utilization as are provided in the emergency operations plan, provided that any such practice is within the scope of practice, education, training, and national certification of the licensed nurse or advanced practice nurse and congruent with any limits imposed in the Code of Alabama. A certified registered nurse practitioner or certified nurse midwife may provide emergency treatment without immediate physician collaboration to patients within the affected areas of the community disaster, provided that the treatment is within the individual's scope of education, training, and approved protocol. The certified registered nurse practitioner or certified nurse midwife in such circumstance shall make reasonable efforts to inform the collaborating physician of the location and type of emergency services being provided and shall act in conformance with the direction of local physicians. The authorization provided in this section shall be effective only for the duration of time during which the emergency operation plan is active.

(10) Any applicant for initial licensure who possesses an active, unencumbered license in another state and who is the eligible spouse of a service member or other qualified individual, as defined in Section 31-1-6, Code of Ala. 1975, shall:

(a) Be eligible to apply for a service member spouse temporary permit, which shall be valid for 365 days.

(b) Be exempt from payment of the initial licensure fee provided for in Section 610-X-4-.14 of these rules.

(c) The applicant is required to substantiate his or her eligibility by providing the following:

1. A marriage certificate substantiating marriage to the service member.

2. Official documentation of the qualified service member or other qualified individual’s relocation to the state.

(11) Any applicant for initial approval as a certified registered nurse anesthetist or clinical nurse specialist, or any applicant for an initial certificate of qualification as a certified registered nurse practitioner or certified nurse midwife, who is approved to practice advanced practice nursing in another state and is the eligible spouse of a service member or other qualified individual, as defined in Section 31-1-6, Code of Ala. 1975, shall:

(a) Be eligible to apply for service member spouse temporary advanced practice approval, which shall be valid for 365 days.

(b) Be exempt from payment of the initial advanced practice approval or certificate of qualification fee provided for in Section 610-X-4-.14 of these rules.

(c) The applicant is required to substantiate his or her eligibility by providing the following:

1. A marriage certificate substantiating marriage to the service member.

2. Official documentation of the qualified service member or other qualified individual’s relocation to the state.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §34-21-6.
• New Rule: Filed November 26, 2007; effective December 31, 2007. Amended: Filed November 19, 2010; effective December 24, 2010. Amended: Filed April 22, 2016; effective June 6, 2016. Amended: Filed November 21, 2016; effective January 5, 2017. Amended: Filed January 22, 2018; effective March 8, 2018. Amended: Filed July 20, 2018; effective September 3, 2018. Amended: Filed September 27, 2018; effective November 11, 2018. Amended: Filed January 22, 2019; effective March 8, 2019. Amended: Filed March 18, 2019; effective May 2, 2019. Amended: Published September 30, 2019; effective November 14, 2019. Amended: Published January 31, 2020; effective March 16, 2020. Amended: Published September 30, 2020; effective November 14, 2020. Amended: Published February 26, 2021; effective April 12, 2021. Amended: Published July 29, 2022; effective September 12, 2022.

Ala. Admin. Code r. 610-X-4-.17 Multistate Licensure Privilege

(1) The holder of a multistate licensure privilege practicing in Alabama shall comply with the practice laws of the state in which the client is located at the time the service is provided. The practice of nursing is not limited to patient care, and shall include all nursing practice.

(2) The practice of nursing in Alabama under a multistate licensure privilege shall subject the nurse to the jurisdiction of the Alabama Board of Nursing, Alabama courts, and the laws of the party state in which the client is located at the time service is provided.

(3) If adverse action is taken by the home state against the multistate license of a nurse, the nurse’s multistate licensure privilege to practice in Alabama shall be deactivated until all encumbrances have been removed from the multistate license. Deactivation of a multistate licensure privilege based on this section occurs by operation of law.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §34-21-2(6).
• New Rule: Filed July 25, 2019; effective September 9, 2019; operative January 1, 2020.

Ala. Admin. Code r. 610-X-4-.18 Coordinated Licensure Information System

(1) Regarding all licensed registered nurses and licensed practical nurses, the board shall participate in the coordinated licensure information system, to include licensure and disciplinary history of each nurse.

(2) The board shall promptly report to the coordinated licensure information system an adverse action, any current significant investigative information, denials of applications with the reasons for the denials, and the nurse’s current participation in the Voluntary Disciplinary Alternative Program, if applicable.

(a) Information regarding the participation of a licensee in the Voluntary Disciplinary Alternative Program shall be made available solely to other state boards of nursing and shall not be disclosed to the public by the coordinated licensure information system.

(b) Upon successful completion of the Voluntary Disciplinary Alternative Program, all information regarding participation of the licensee in the Voluntary Disciplinary Alternative Program shall be expunged from the coordinated licensure information system.

(3) Nonpublic or confidential data submitted to the coordinated licensure information system by the board may not be distributed to any nonparty state, organization, person, or entity, or any foreign government or an agent, entity, or representative of a foreign government, without the express written approval of the board.

History

• Author: Alabama Board of Nursing
• Authority: Code of Ala. 1975, §34-21-2(6).
• New Rule: Filed July 25, 2019; effective September 9, 2019; operative January 1, 2020.