Healthcare Resource
Hawaii CRNA License 2026: APRN Requirements, Practice Model, Salary
In brief
How to get your CRNA license in Hawaii 2026. Hawaii Board of Nursing APRN requirements, non-NLC endorsement process, collaborative practice model, and CRNA salary data for Honolulu and Maui.
Steps at a glance
Complete CRNA program and obtain NBCRNA certification
Graduate from a COA-accredited nurse anesthesia program and pass the NBCRNA NCE. Hawaii requires current CRNA national certification for APRN licensure.
Obtain Hawaii RN license
Hawaii is NOT a member of the Nurse Licensure Compact (NLC). All CRNAs practicing in Hawaii must hold a Hawaii-issued RN license. Apply by endorsement through the Hawaii Board of Nursing (pvl.ehawaii.gov). The endorsement process typically takes 6-10 weeks, begin immediately upon accepting a position offer.
Submit Hawaii Board of Nursing APRN application
After receiving your Hawaii RN license, apply for the Advanced Practice Registered Nursing (APRN) credential. Submit CRNA certification, Hawaii RN verification, anesthesia program documentation, and the $120 APRN application fee.
Practice under collaborative arrangement
Hawaii CRNAs practice under a collaborative arrangement with a physician in most settings. Major Honolulu hospitals use ACT or CRNA-collaborative models; outer island facilities (Maui, Big Island, Kauai) frequently rely on CRNA-only practice given limited physician supply.
In this article
Hawaii CRNAs are licensed as APRNs by the Hawaii Board of Nursing. Hawaii is not an NLC compact member, a Hawaii-issued RN license is required before applying for the APRN credential, adding 6-10 weeks to the licensure timeline. Hawaii is a reduced practice state with a collaborative arrangement requirement in most settings. Hawaii CRNA salaries are among the highest nominally, but the state's extreme cost of living (particularly housing and food) significantly reduces real purchasing power compared to mainland markets.
Practice Model
- Collaborative arrangement with physician required for most practice settings
- Hawaii has NOT opted out of federal Medicare CRNA supervision requirement
- ACT model: Queen's Medical Center, Straub Medical Center (Honolulu), Kapiolani Medical Center
- CRNA-independent (with arrangement): Maui Health (Maui), Hilo Medical Center, Kauai Veterans Memorial; outer islands are CRNA-dependent
- Outer islands (Maui, Big Island, Kauai, Molokai) have critical CRNA shortages and rely on CRNA-only models
Application Requirements
- Hawaii RN license (HI-issued; NLC compact licenses not valid, must apply by endorsement)
- Current NBCRNA certification
- Official nurse anesthesia program documentation
- Completed pvl.ehawaii.gov application + $120 fee
- Criminal background check via Hawaii Criminal Justice Data Center
Processing Timeline
Plan 12-18 weeks total for out-of-state CRNAs: 6-10 weeks for Hawaii RN endorsement followed by 6-10 weeks for APRN credentialing. Temporary authorization to practice is not routinely available. Start the RN endorsement immediately upon accepting a position.
CRNA Salary in Hawaii (2026)
| Market | Avg CRNA Salary | Notes |
|---|---|---|
| Honolulu (Oahu) | $220,000-$255,000 | Queen's, Kaiser, Straub, Kapiolani; high COL, housing median $850K+ |
| Maui | $225,000-$265,000 | Maui Health System; CRNA shortage; resort community; housing extremely expensive |
| Hilo (Big Island) | $215,000-$250,000 | Hilo Medical Center; CRNA-independent; lower COL than Maui or Oahu |
| Kauai | $220,000-$258,000 | Kauai Veterans Memorial; CRNA-only; critical shortage; housing stipends offered |
Cost of Living Note
Hawaii has the highest cost of living of any US state. Median home prices in Honolulu exceed $850,000; Maui median home prices exceed $1.2 million. A CRNA earning $240K in Hawaii has effective purchasing power closer to $155K-$170K nationally. Outer island positions often include housing assistance or subsidized housing that meaningfully improves the real compensation picture, factor this in when comparing offers.
Top Employers in Hawaii
- Queen's Health Systems, Honolulu; flagship academic medical center; ACT model at Queen's Medical Center
- Kaiser Permanente Hawaii, Oahu; integrated health system; CRNA positions across surgical service lines
- Maui Health (CommonSpirit), Maui; CRNA-dependent anesthesia across the island; persistent CRNA shortages
- Hawaii Health Systems Corporation (HHSC), State government system; Hilo, Kauai, Maui public hospitals; CRNA-independent model
- Kapiolani Medical Center, Honolulu; pediatric and women's specialty center; CRNA positions in peds anesthesia
What We See at Ava Health
Hawaii is a lifestyle destination for CRNAs who can tolerate the steep cost of living reduction, the nominal salary is compelling, the real purchasing power is not. The outer islands (Kauai, Molokai, Lanai) offer the best combination of compensation, COL, and lifestyle, many facilities provide housing as part of the employment package, which substantially improves the effective compensation picture. The 12-18 week licensure timeline is the primary friction; CRNAs considering Hawaii should begin the RN endorsement before accepting an offer.
Related: CRNA Salary by State 2026, NP License Hawaii 2026, CRNA License Alaska 2026.
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