I oppose the proposed fee increases for RN and APRN licensure. Greater than 60% increases in licensure fees are unreasonable. The fee increases could be a barrier for nurses from obtaining licensure and deter nurses from renewing their licenses, contributing to the shortage of nurses practicing in Virginia. I urge the Board to consider a lower, more reasonable increase. 

I oppose the increases because they seem to be too high. Everyone already has inflation that is 300% on many other things. Everyone is now struggling to make ends meet. These increases will hurt the nurses and nurse supportive roles more than help and could prevent graduating nurses from even making application to take their boards.  A much smaller increase would be understandable, but the percentage rates for each of these are way too much, too high. 

I oppose the proposed fee increase for obtaining and renewing nursing licenses in the Commonwealth of Virginia. Here are some notable mentions and comparisons of other states that RNs and APRNs may wish to move to if these proposed changes go into effect. I respectfully request the board consider removing the Board of Medicine from unnecessarily regulating APRN practice to reduce any unnecessary costs rather than having this come from the pockets of APRNs who already pay money to collaborating physicians. 

Virginia initial / renewal RN: $250 / $130 APRN: $250 / $130

• Virginia jointly regulates APRN practice by Board of medicine & board of nursing. There is no independent practice for CNS (APRN) and significant limits of scope of practice for all APRNs. I would never approve a 65% increase in RN renewal, 100% increase in APRN application and 65% increase for renewal unless there was promise that we are able to work at the top of our education and training. This is an unacceptable proposal unless significant changes are made.

Rhode Island RN: $135 / $135 APRN: $145 / $145 https://rules.sos.ri.gov/regulations/part/216-10-05-2

• higher cost of living & independent CNS practice authority

Washington State: RN $138 / $188 APRN: $130 / $130 https://nursing.wa.gov/licensing/nurse-license-fees

• higher cost of living and independent practice authority for CNS / APRN

New York RN: $143 / $73  https://www.op.nysed.gov/registration-renewal/online-registration-renewal

• higher cost of living

Florida RN: $110 / $75 APRN: $110 / $60

• https://floridasnursing.gov/licensing/

I am happy to discuss the importance of supporting our nursing professionals. I hope to keep this valuable human resource in the great Commonwealth of Virginia instead of driving them out due to high licensure fees.

Over a 60% increase in the fees associated with nursing licensure is much too high considering the increased cost of living and inflation. Placing this burden on already burdened professionals who struggle to make ends meet given the low pay for nurses is outrageous. There are a variety of other states that have higher cost of living with less fees for licensure. 

It is important that the Board of Health Professions take into consideration the need for a skilled professional nurse workforce for the near and distant future. We are in an age of potential loss of many skilled Baby Boomer nurses, which would compromise the health of Virginians. This licensing fee increase for both RNs and APRNs is not reasonable. 

Nurses are already underpaid and have to pay for supplies and uniforms out of pocket. Raising the fee only puts more burden on the nurses which may limit how many join or stay in the workforce and nurses are shortstaffed to begin with. 

The Virginia Board of Nursing is proposing astronomical fee increases for all licensed professionals. I read through the proposal and can see that there have been or will be salary increases of around 28% from FY2020 to 6/2025. The fees increases they are proposing are to the tune of 60-100% for most all of my fellow healthcare professionals

While considering the rising cost of living and a great deficit in salary increases in today's world these fee increases are extremely concerning to me and others in my profession. While I understand the mentioned 28% in salary increase and the ever-rising cost of operations; I ask myself if 60 to 100% is justifiable? I can speak on behalf of myself and can without any doubt say that I have not received 60-100% salary increase in the past few years nor do I expect it from a local nonprofit agency. I can also say that insurances both private and public such as Medicare and Medicaid are not reimbursing agencies 60-100% more so there is not any correlation to the fee increases with what is going into healthcare worker's or agency's pockets.

For states that border VA have fees around of $90 for RN, $40 for LPN and $90 for APRN Annually (WV), $100 for both RN/LPN, $50 for APRN Annually (NC) and $100 for LPNs/RNs and $110 for APRNs Annually (TN).

While I know this is currently at the state level, I am asking for your help in bringing awareness to the detrimental effects of these increases and advocating for a healthcare field that is already crumbling. The future of our communities and population will most definitely be negatively impacted by these.

This is ridiculous. $110 increase!?!

I do not support a one-year licensing fee increase as a budgetary remediation proposal for the $2,548,279 budget deficit. The deficit did not manifest in one year and cannot be corrected "on the backs" of licensees in one year.

Additionally, there is a disproportionate "double-dipping" option in the fee increases for Advanced Practice Registered Nurses (APRN) as APRNs hold 2 licenses. I do not support these increases.  APRNs will pay $230/2 years to renew their RN licenses and $130/2 years for their APRN licenses.  The fee increase proposal rationalizes: "The fees for APRNs are increased at a greater rate than practitioners... This is due to the higher earning potential of APRNs and a reflection of slightly lower current fees for this category". 

This calculation omits a formidable barrier to many APRNs who do not practice at a full scope of practice and cannot work in positions with a "higher earning potential." In addition to omitting scope of practice barriers, no rationalization of personal budgets is considered in this proposal either.  There is no data supporting that APRNs' personal budgets could withstand this double indemnity more than any other professions listed in the proposal. 

While expenditures are detailed in the 2024-2025 strategic plan for the VBON and licensure fees account for 92% of the budget, complaints, IT needs, salaries and employee benefits have shown the most significant increase in expenditures for the Board in FY24. VBON predicts this will likely continue. 

The board appears to be trying to minimize the need for additional program staff; however, information technology, expanding online renewals, expanding agency electronic records management, and standardizing processes will need further funding. 

Will drastic fee increases occur in subsequent annual DHP/VBON budget reviews?  I hope not, as many nurses are licensed in multiple states, and our closely bordered sister states look very welcoming. We (Virginia) may lose practicing RNs and APRNs due to the lesser licensing costs in other nearby states. 

I cannot think of a single industry where such a drastic increase in the licensing fee required for the license to work is considered as a plausible option. New graduate nurses are already coming in to the profession with mounting debt, and will have to find a way to pay an even higher initial licensing fee. Renewals are increased, and these fall within the first years of establishing a career. These newest nurses have barely begun to pay their student debt, build a savings account, or start retirement funds. They are living on an hourly wage that is already much lower than the promised base increases and wages of nurses in states around Virginia. 
This deficit is one from a change made 8 years ago. Logically, the expectation should be that a revenue loss would take at least 8 years if not longer to recover. A sustainable increase, continued market analysis of pay rates, and legislation to ensure positive changes in nursing practice should be the primary focus. 

I strongly oppose this increase. Nurses are grossly underpaid in this commonwealth with increasing cost of living. Increasing the fee to maintain our license in a profession we all worked extremely hard to obtain will lead to nurses opting to not renew their licenses. Some may even leave the field contributing to the growing nurse's shortage. 

After the strain the past several years has put on the nurses of Virginia and the whole country, increasing the fees associated with our license and making us pay more to continue to work a high-stress and low paying job is a slap in the face. This will further discourage nurses to continue to practice and deter people to enter this field. 

I oppose this increase fee and feel that it is inappropriate.

My name is Quin, and I am and Navy veteran and a soon-to-be graduating nursing student. I am writing to express my concerns about the proposed Fee Increase 2024 (18VAC90-19-30) for nursing licensure in Virginia, which includes massive increases to the fees for Registered Nurses (RNs) and Licensed Practical Nurses (LPNs). The nursing profession’s core is to give back and actively care for the people and the community; to care for our community, it is essential to care for our nurses in return. These fee increases will discourage potential nursing students from entering the profession or push current nurses out due to the rising financial strain. This could significantly affect those from poor communities aspiring to nursing, where the financial burden of licensure could deter them from pursuing or continuing their nursing careers. In light of these considerations, I respectfully request that you reconsider the proposed Fee Increase 2024. We should strive to make nursing education and licensure as accessible as possible to meet the growing demand for healthcare professionals.

I strongly oppose the proposed fee increases in Action 6414 / Stage 10416. As a soon-to-be nursing graduate, this proposal is particularly discouraging. New nurses are already burdened with student debt while entering a profession that demands a high level of training and responsibility yet often does not offer adequate compensation. Adding increased licensure fees only exacerbates the financial strain and may deter new graduates from staying in Virginia’s workforce.

With ongoing staffing shortages and rising workloads, the Board should be supporting nurses, not adding barriers. I urge you to reconsider and explore alternative funding solutions that do not place additional financial burdens on current and future nurses.

My name is Brandelyn Clements. I am a nursing student who will be graduating in May of 2025, and I oppose this increase fee and feel that it is inappropriate and unnecessary. 

I have been an RN for over 10 years and I think that increasing what we have to pay biennial, just in order to maintain our ability to be a RN in the state of Virginia, is uncalled for.  We are already in a deficit of Registered Nurses to employee our hospitals - I believe that this increase will either make RN hopefuls choose a different career path or cause already working RNs to leave healthcare. This will then create a bigger problem in the likely event that people will be more acutely ill with all the restrictions and removal of necessary access to healthcare that we are already seeing. 

Voicing my opposition as a resident, health care worker and ardent voter to the proposed fee increases for licensure. There is a mature understanding that over time a gradual increase is expected for related fees but the proposed hike of 64.2% is outrageous. I hope that our elected officials will listen to health care professionals that are their constituents, neighbors and care givers, to consider a significantly lower rate to help compensate for what appears to be serious financial deficits. Thank you in advance for your time and attention to this matter. 

I strongly oppose the fee increase for Board of Nursing professions. With the current nursing shortage, this fee increase is another barrier towards closing the gap.

this will deter further nurses from getting their renewals. i understand increasing by a little bit but 64% is insane. believe it or not there are nurses out there that would not be able to afford this. Seriously considering this could harm the already large staffing issues in hospitals across the state. 

I believe that as nurses in Virginia we are already under paid and to make us pay more to have our license renewed is absurd. I really hope you listen to our comments about this topic.

Why add another loop to jump through for nurses to be nurses?

60% of increase is too much and I can’t understand why fee increase needs. Virginia nurse’s salary is quite lower than other state, but if VBON wanna increase the fee, the average hourly wage and working environment improvement needs definitely. 
Now 140$ of fee is affordable. 

I strongly oppose to this change. It is a pointlessly harmful hindrance to our field.

Oppose! 

Please do not increase this, people’s livelihoods depend on this

I oppose 

I strongly oppose the increase of the fees for license renewal. The cost of renewing the license is already fairly steep, and increasing it seems almost pointless 

Oppose

I strongly oppose this increase. Why are we making it even harder for nurses to work? It makes no sense and adds another barrier for nurses maintaining their licenses. 

I strongly oppose this increase in the fee when renewing nursing licensures. This will not assist in retaining nurses in the field of healthcare and will increase turnover rates in nursing by increasing the requirements for nurses to keep their licenses. Nursing staff at all levels are underpaid and understaffed, thus, it is unfair to increase the fee to renew their license when those in the field are struggling already. 

I oppose this. 

I oppose this increase !

I oppose the renewal increase

This adds undue burden to nurses everywhere, not least of which are new grad nurses who are still struggling to establish themselves financially after nursing school. 

Nurse’s wage was not increased 60% for the renewal fee to be increasing. By increasing renewal fee 60% is absurd and not necessary! 

Why would anyone support an increase to the licensure renewal fee for a profession that is already underpaid and underserved? 

There aren't enough nurses as is. Increasing renewal fees will just be a barrier to current and future nurses.

Strongly oppose

Oppose the increase

The nursing profession already faces significant shortages and staffing issues, while at the same time, being grossly underpaid. So many nurses are leaving the bedside for advanced degrees or other careers altogether, and increasing fees for licensure renewal will only contribute to harsh feelings.

Too high of an increase

Strongly oppose

Strongly oppose, my wage doesn’t increase enough for this trash!!

Why is it that you ''need'' such a high level of increase over 50% really and on top of that why would you propose the group that makes the least have the highest increase. Do better this percentage is too high. 

I oppose this. 

Nurses/medical professionals are already enduring so much and are not paid enough for all the work that they do.  Increasing their fees by that much for maintaining their license is not right.   

I oppose this increase. 66.7% increased for LPN is crazy to pay when pay wages are staying the same. It's hard enough in nursing as is without extra fees.

I strongly oppose this motion. Cost of living is skyrocketing, inflation is running wild, and now you're raising prices on our license? Unconscionable. 

In what world is it fair to increase fees 60-100% for nurses? Nurses are grossly under paid as it is and with the increased cost of living and inflation, this is becoming ridiculous! 

Most employers do not assist nurses with the fees associated with maintaining licensure. With ongoing staffing shortages and rising workloads, the Board should be supporting nurses, not adding barriers. 

I really hope the board reconsiders other options instead of increasing fees drastically. 

Thank you for your consideration.