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Open StatesCaliforniaColoradoConnecticutDelawareDCFloridaGeorgiaIllinoisKentuckyMarylandMichiganNew YorkNorth CarolinaOhioPennsylvaniaTexasUtahVirginiaWashington
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Collab Required?YesNo/Transition to IndependenceTransition to Independence - applicationTransition to Independence - applicationNoTransition to Independence - applicationYes, with geographic restrictions. MD/NP must live w/in 50 miles of each otherTransition to Independence - applicationYesNo/Transition to independenceNoTransition to Independence - attestationYesYesYesYesNoYes/Transition to Independence - applicationNo
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Collab Communication RequirementNo guidanceN/AN/AN/AN/ANo guidanceN/AN/AN/AGenericGenericGenericNo guidanceN/AN/AN/A
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Collab Communication CitationSupervision of the NP performing an overlapping medical function is addressed in the standardized procedure and may vary from one procedure to another depending upon the judgment of those developing the standardized procedure. As an example, in one women’s clinic the supervision requirement for performing a cervical biopsy was that a physician must be physically present in the facility, immediately available in case of emergency. For all other standardized procedure functions, the supervision requirement was for a clinic physician to be available by phone.

Standardized procedures are developed through collaboration among administrators and health practitioners, including physicians and surgeons and nurses.

https://www.rn.ca.gov/pdfs/regulations/npr-b-23.pdf		NoneNoneGeneral Supervision – supervision whereby a practitioner currently licensed under Chapter 458, 459, or 466, F.S., authorizes procedures being carried out but need not be present when such procedures are performed. The APRN must be able to contact the practitioner when needed for consultation and advice either in person or by communication devices.
-- 64B9-4.001(13)

https://www.flrules.org/gateway/RuleNo.asp?title=ADMINISTRATIVE%20POLICIES%20PERTAINING%20TO%20CERTIFICATION%20OF%20ADVANCED%20PRACTICE%20REGISTERED%20NURSES&ID=64B9-4.001		The agreement shall contain a provision for immediate consultation, as defined in Rule 360-32-.01, between the APRN and the delegating physician.
http://rules.sos.ga.gov/GAC/360-32-.02

"Immediate consultation" means that the delegating physician shall be available for direct communication or by telephone or other telecommunications.
http://rules.sos.ga.gov/GAC/360-32-.01		The [collaborative agreement] shall describe the arrangement for collaboration and communication between the advanced practice registered nurse and the collaborating physician regarding the prescribing of nonscheduled legend drugs by the advanced practice registered nurse.
https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=48249		N/AN/AN/AThe primary or back-up supervising physician(s) and the nurse practitioner shall be continuously available to each other for consultation by direct communication or telecommunication.

http://reports.oah.state.nc.us/ncac/title%2021%20-%20occupational%20licensing%20boards%20and%20commissions/chapter%2036%20-%20nursing/21%20ncac%2036%20.0810.pdf		“Collaboration” means that one or more physicians with whom the NP has entered into a standard care arrangement are continuously available to communicate with the NP either in person or by radio, telephone, or other form of telecommunication.

http://codes.ohio.gov/orc/4723		Collaboration—A process in which a CRNP works with one or more physicians to deliver health care services within the scope of the CRNP’s expertise. The process includes the following:
(i) Immediate availability of a licensed physician to a CRNP through direct communications or by radio, telephone or telecommunications.
http://www.pacodeandbulletin.gov/secure/pacode/data/049/chapter21/049_0021.pdf		A prescriptive authority agreement must, at a minimum:
-provide a general plan for addressing consultation and referral;
-state the general process for communication and the sharing of information between the APRN and the physician related to the care and treatment of patients

https://texreg.sos.state.tx.us/public/readtac$ext.TacPage?sl=R&app=9&p_dir=&p_rloc=&p_tloc=&p_ploc=&pg=1&p_tac=&ti=22&pt=11&ch=222&rl=5		N/AN/AN/A
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Transition to Independence Requirements
- How long does the Transition to independence period last?		Transition to Independence - Mintz legal confirmed that the previous requirement that NPs enter into an “Articulated Plan” prior to prescribing was repealed in June 2020. The Board of Nursing’s website has not been updated to reflect this, but the codified regulations reflect the change, and the Board of Nursing confirmed that this is no longer a requirement.

That said, in order to obtain prescriptive authority, new NPs must complete a preceptorship and a mentorship. We confirmed with the Board of Nursing that this requirement does not apply to NPs licensed in other states who have at least 750 prescribing hours and are applying for licensure/prescriptive authority in Colorado, so this would likely only apply to nurses who are right out of school. 		Conn. Gen. Stat. § 20-87a.

(2) An advanced practice registered nurse having been issued a license pursuant to section 20-94a shall, for the first three years after having been issued such license, collaborate with a physician licensed to practice medicine in this state. In all settings, such advanced practice registered nurse may, in collaboration with a physician licensed to practice medicine in this state, prescribe, dispense and administer medical therapeutics and corrective measures and may request, sign for, receive and dispense drugs in the form of professional samples in accordance with sections 20-14c to 20-14e, inclusive, except such advanced practice registered nurse licensed pursuant to section 20-94a and maintaining current certification from the American Association of Nurse Anesthetists who is prescribing and administrating medical therapeutics during surgery may only do so if the physician who is medically directing the prescriptive activity is physically present in the institution, clinic or other setting where the surgery is being performed. For purposes of this subdivision, “collaboration” means a mutually agreed upon relationship between such advanced practice registered nurse and a physician who is educated, trained or has relevant experience that is related to the work of such advanced practice registered nurse. The collaboration shall address a reasonable and appropriate level of consultation and referral, coverage for the patient in the absence of such advanced practice registered nurse, a method to review patient outcomes and a method of disclosure of the relationship to the patient. Relative to the exercise of prescriptive authority, the collaboration between such advanced practice registered nurse and a physician shall be in writing and shall address the level of schedule II and III controlled substances that such advanced practice registered nurse may prescribe and provide a method to review patient outcomes, including, but not limited to, the review of medical therapeutics, corrective measures, laboratory tests and other diagnostic procedures that such advanced practice registered nurse may prescribe, dispense and administer.

(3) An advanced practice registered nurse having (A) been issued a license pursuant to section 20-94a, (B) maintained such license for a period of not less than three years, and (C) engaged in the performance of advanced practice level nursing activities in collaboration with a physician for a period of not less than three years and not less than two thousand hours in accordance with the provisions of subdivision (2) of this subsection, may, thereafter, alone or in collaboration with a physician or another health care provider licensed to practice in this state: (i) Perform the acts of diagnosis and treatment of alterations in health status, as described in subsection (a) of this section; and (ii) prescribe, dispense and administer medical therapeutics and corrective measures and dispense drugs in the form of professional samples as described in subdivision (2) of this subsection in all settings. Any advanced practice registered nurse electing to practice not in collaboration with a physician in accordance with the provisions of this subdivision shall maintain documentation of having engaged in the performance of advanced practice level nursing activities in collaboration with a physician for a period of not less than three years and not less than two thousand hours. Such advanced practice registered nurse shall maintain such documentation for a period of not less than three years after completing such requirements and shall submit such documentation to the Department of Public Health for inspection not later than forty-five days after a request made by the department for such documentation. Any such advanced practice registered nurse shall submit written notice to the Commissioner of Public Health of his or her intention to practice without collaboration with a physician after completing the requirements described in this subdivision and prior to beginning such practice. Not later than December first, annually, the Commissioner of Public Health shall publish on the department's Internet web site a list of such advanced practice registered nurses who are authorized to practice not in collaboration with a physician.

https://www.cga.ct.gov/current/pub/chap_378.htm#sec_20-87a		24 Del. C. §1902(k).

(m) “Independent practice” means practice and prescribing by an advanced practice registered nurse who is not subject to a collaborative agreement and works outside the employment of an established health-care organization, health-care delivery system, physician, podiatrist, or practice group owned by a physician or podiatrist. Independent practice shall be in an area substantially related to the population focus of the APRN’s education and certification.

http://delcode.delaware.gov/title24/c019/index.html

1900 Board of Nursing’s Rules and Regulations.

8.14.1 The Board of Nursing grants APRNs prescriptive authority when granting an initial license by direct application or endorsement. APRNs who have not practiced a minimum of 1500 hours in the past five years or 600 hours in the past two years must comply with 24 Del.C. §1918.
8.16.1 All new graduate APRNs are required to practice under a collaborative agreement for at least two years and 4,000 hours in the applicable role and population foci.
8.16.2 APRNs who have practiced for at least two years and 4,000 hours in the applicable role and population foci are not required to practice under a collaborative agreement.
8.16.3 APRNs who seek to obtain independent practice must demonstrate that they have practiced under a collaborative agreement for at least two years and 4,000 hours in the applicable role and population foci within an established health care organization, licensed health care delivery system, physician, podiatrist, or practice group before becoming eligible for independent practice. In order to practice independently, the APRN must apply to the APRN committee in accordance with the Board’s statute and regulations.
8.17.1 Only those APRNs granted independent practice by the Board may practice outside the employment of an established health care organization, licensed health care delivery system, physician, podiatrist, or practice group, and such independent practice shall be limited to an area substantially related to the role and population foci of the APRN’s education and certification.
8.17.2 In order to be granted independent practice, APRNs already practicing pursuant to a collaborative agreement as of July 1, 2015, shall submit a written application to the APRN Committee. The application shall be considered completed when the Division has received all of the following documentation:
8.17.2.1 Non-refundable application fee;
8.17.2.2 Completed application for independent practice;
8.17.2.3 Verification of Experience and Competency form from the APRN’s collaborator confirming that the applicant has practiced under a collaborative agreement within established health care organization, licensed health care delivery system, physician, podiatrist, or practice group for at least 2 years and a minimum of 4,000 full-time hours. The physician, podiatrist, or health-care delivery system party to the collaborative agreement must practice or have practiced in an area substantially related to the role and population foci of the APRN's education, certification, and planned independent practice;
8.17.2.4 Verification that the applicant has committed no acts which are grounds for disciplinary action as set forth in 24 Del.C. §1922. Any nurse who has not previously submitted a criminal background check will be required to do so in order to be eligible for independent practice. Applications of APRNs who have committed acts which are grounds for disciplinary action under 24 Del.C. §1922 will be evaluated on a case by case basis; and
8.17.3 APRNs who have not practiced for at least two years and 4,000 hours under a collaborative agreement in the applicable role and population foci as of July 1, 2015, shall submit all of the above upon completion of the requisite two years with at least 4,000 hours as well as a Verification of Compliance form from the APRN’s collaborator, confirming that the applicant has met all of the below listed benchmarks, metrics, and competencies in the APRN’s role and population foci.

https://regulations.delaware.gov/AdminCode/title24/1900.shtml		None464.003

(2) “Advanced or specialized nursing practice” means, in addition to the practice of professional nursing, the performance of advanced-level nursing acts approved by the board which, by virtue of postbasic specialized education, training, and experience, are appropriately performed by an advanced practice registered nurse. Within the context of advanced or specialized nursing practice, the advanced practice registered nurse may perform acts of nursing diagnosis and nursing treatment of alterations of the health status. The advanced practice registered nurse may also perform acts of medical diagnosis and treatment, prescription, and operation as authorized within the framework of an established supervisory protocol.

http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0464/Sections/0464.003.html

464.0123

(1) REGISTRATION.—The board shall register an advanced practice registered nurse as an autonomous advanced practice registered nurse if the applicant demonstrates that he or she:
(a) Holds an active, unencumbered license to practice advanced nursing under s. 464.012.
(b) Has not been subject to any disciplinary action as specified in s. 456.072 or s. 464.018 or any similar disciplinary action in another state or other territory or jurisdiction within the 5 years immediately preceding the registration request.
(c) Has completed, in any state, jurisdiction, or territory of the United States, at least 3,000 clinical practice hours, which may include clinical instructional hours provided by the applicant, within the 5 years immediately preceding the registration request while practicing as an advanced practice registered nurse under the supervision of an allopathic or osteopathic physician who held an active, unencumbered license issued by any state, jurisdiction, or territory of the United States during the period of such supervision. For purposes of this paragraph, “clinical instruction” means education provided by faculty in a clinical setting in a graduate program leading to a master’s or doctoral degree in a clinical nursing specialty area.
(d) Has completed within the past 5 years 3 graduate-level semester hours, or the equivalent, in differential diagnosis and 3 graduate-level semester hours, or the equivalent, in pharmacology.
(2)(a) An advanced practice registered nurse registered under this section must, by one of the following methods, demonstrate to the satisfaction of the board and the department financial responsibility to pay claims and costs ancillary thereto arising out of the rendering of, or the failure to render, nursing care, treatment, or services:
1. Obtaining and maintaining professional liability coverage in an amount not less than $100,000 per claim, with a minimum annual aggregate of not less than $300,000, from an authorized insurer as defined in s. 624.09, from a surplus lines insurer as defined in s. 626.914(2), from a risk retention group as defined in s. 627.942, from the Joint Underwriting Association established under s. 627.351(4), or through a plan of self-insurance as provided in s. 627.357; or
2. Obtaining and maintaining an unexpired, irrevocable letter of credit, established pursuant to chapter 675, in an amount of not less than $100,000 per claim, with a minimum aggregate availability of credit of not less than $300,000. The letter of credit must be payable to the advanced practice registered nurse as beneficiary upon presentment of a final judgment indicating liability and awarding damages to be paid by the advanced practice registered nurse or upon presentment of a settlement agreement signed by all parties to such agreement when such final judgment or settlement is a result of a claim arising out of the rendering of, or the failure to render, nursing care and services.
(b) The requirements of paragraph (a) do not apply to:
4. An advanced practice registered nurse who holds an active registration under this section and who is not engaged in autonomous practice as authorized under this section in this state. If such person initiates or resumes any practice as an autonomous advanced practice registered nurse, he or she must notify the department of such activity and fulfill the professional liability coverage requirements of paragraph (a).

http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0400-0499/0464/Sections/0464.0123.html		NoneSec. 65-43.

(a) An Illinois-licensed advanced practice registered nurse certified as a nurse practitioner, nurse midwife, or clinical nurse specialist shall be deemed by law to possess the ability to practice without a written collaborative agreement as set forth in this Section.
(b) An advanced practice registered nurse certified as a nurse midwife, clinical nurse specialist, or nurse practitioner who files with the Department a notarized attestation of completion of at least 250 hours of continuing education or training and at least 4,000 hours of clinical experience after first attaining national certification shall not require a written collaborative agreement, except as specified in subsection (c). Documentation of successful completion shall be provided to the Department upon request.
Continuing education or training hours required by subsection (b) shall be in the advanced practice registered nurse's area of certification as set forth by Department rule.
The clinical experience must be in the advanced practice registered nurse's area of certification. The clinical experience shall be in collaboration with a physician or physicians. Completion of the clinical experience must be attested to by the collaborating physician or physicians and the advanced practice registered nurse.
(c) The scope of practice of an advanced practice registered nurse with full practice authority includes:
(1) all matters included in subsection (c) of Section 65-30 of this Act;
(2) practicing without a written collaborative agreement in all practice settings consistent with national certification;
(3) authority to prescribe both legend drugs and Schedule II through V controlled substances; this authority includes prescription of, selection of, orders for, administration of, storage of, acceptance of samples of, and dispensing over the counter medications, legend drugs, and controlled substances categorized as any Schedule II through V controlled substances, as defined in Article II of the Illinois Controlled Substances Act, and other preparations, including, but not limited to, botanical and herbal remedies;
(4) prescribing benzodiazepines or Schedule II narcotic drugs, such as opioids, only in a consultation relationship with a physician; this consultation relationship shall be recorded in the Prescription Monitoring Program website, pursuant to Section 316 of the Illinois Controlled Substances Act, by the physician and advanced practice registered nurse with full practice authority and is not required to be filed with the Department; the specific Schedule II narcotic drug must be identified by either brand name or generic name; the specific Schedule II narcotic drug, such as an opioid, may be administered by oral dosage or topical or transdermal application; delivery by injection or other route of administration is not permitted; at least monthly, the advanced practice registered nurse and the physician must discuss the condition of any patients for whom a benzodiazepine or opioid is prescribed; nothing in this subsection shall be construed to require a prescription by an advanced practice registered nurse with full practice authority to require a physician name;
(5) authority to obtain an Illinois controlled substance license and a federal Drug Enforcement Administration number; and
(6) use of only local anesthetic.

https://www.ilga.gov/legislation/ilcs/ilcs4.asp?DocName=022500650HArt%2E+65&ActID=1312&ChapterID=24&SeqStart=16500000&SeqEnd=17850000		NoneCOMAR 10.27.07.01

(7) “Mentor” means a certified nurse practitioner or physician, licensed in Maryland, who:
(a) Has 3 or more years of clinical practice experience; and
(b) Will be available for advice, consultation, and collaboration, as needed, for 18 months beginning on the date an application is received by the Board from an applicant who has never been certified in this or any other State.

http://www.dsd.state.md.us/comar/comarhtml/10/10.27.07.01.htm		NoneNew York State Education Law §6902

b. Notwithstanding subparagraph (i) of paragraph (a) of this subdivision, a nurse practitioner, certified under section sixty-nine hundred ten of this article and practicing for more than three thousand six hundred hours may comply with this paragraph in lieu of complying with the requirements of paragraph (a) of this subdivision relating to collaboration with a physician, a written practice agreement and written practice protocols. A nurse practitioner complying with this paragraph shall have collaborative relationships with one or more licensed physicians qualified to collaborate in the specialty involved or a hospital, licensed under article twenty-eight of the public health law, that provides services through licensed physicians qualified to collaborate in the specialty involved and having privileges at such institution. As evidence that the nurse practitioner maintains collaborative relationships, the nurse practitioner shall complete and maintain a form, created by the department, to which the nurse practitioner shall attest, that describes such collaborative relationships. For purposes of this paragraph, "collaborative relationships" shall mean that the nurse practitioner shall communicate, whether in person, by telephone or through written (including electronic) means, with a licensed physician qualified to collaborate in the specialty involved or, in the case of a hospital, communicate with a licensed physician qualified to collaborate in the specialty involved and having privileges at such hospital, for the purposes of exchanging information, as needed, in order to provide comprehensive patient care and to make referrals as necessary. Such form shall also reflect the nurse practitioner's acknowledgement that if reasonable efforts to resolve any dispute that may arise with the collaborating physician or, in the case of a collaboration with a hospital, with a licensed physician qualified to collaborate in the specialty involved and having privileges at such hospital, about a patient's care are not successful, the recommendation of the physician shall prevail. Such form shall be updated as needed and may be subject to review by the department. The nurse practitioner shall maintain documentation that supports such collaborative relationships. Failure to comply with the requirements found in this paragraph by a nurse practitioner who is not complying with such provisions of paragraph (a) of this subdivision, shall be subject to professional misconduct provisions as set forth in article one hundred thirty of this title.

http://www.op.nysed.gov/prof/nurse/article139.htm		NoneNoneNoneNoneNone§ 54.1-2957.

I. A nurse practitioner, other than a nurse practitioner licensed by the Boards of Medicine and Nursing in the category of certified nurse midwife or certified registered nurse anesthetist, who has completed the equivalent of at least five years of full-time clinical experience as a licensed nurse practitioner, as determined by the Boards, may practice in the practice category in which he is certified and licensed without a written or electronic practice agreement upon receipt by the nurse practitioner of an attestation from the patient care team physician stating (i) that the patient care team physician has served as a patient care team physician on a patient care team with the nurse practitioner pursuant to a practice agreement meeting the requirements of this section and § 54.1-2957.01; (ii) that while a party to such practice agreement, the patient care team physician routinely practiced with a patient population and in a practice area included within the category for which the nurse practitioner was certified and licensed; and (iii) the period of time for which the patient care team physician practiced with the nurse practitioner under such a practice agreement. A copy of such attestation shall be submitted to the Boards together with a fee established by the Boards. Upon receipt of such attestation and verification that a nurse practitioner satisfies the requirements of this subsection, the Boards shall issue to the nurse practitioner a new license that includes a designation indicating that the nurse practitioner is authorized to practice without a practice agreement. In the event that a nurse practitioner is unable to obtain the attestation required by this subsection, the Boards may accept other evidence demonstrating that the applicant has met the requirements of this subsection in accordance with regulations adopted by the Boards.

A nurse practitioner authorized to practice without a practice agreement pursuant to this subsection shall (a) only practice within the scope of his clinical and professional training and limits of his knowledge and experience and consistent with the applicable standards of care, (b) consult and collaborate with other health care providers based on the clinical conditions of the patient to whom health care is provided, and (c) establish a plan for referral of complex medical cases and emergencies to physicians or other appropriate health care providers.

A nurse practitioner practicing without a practice agreement pursuant to this subsection shall obtain and maintain coverage by or shall be named insured on a professional liability insurance policy with limits equal to the current limitation on damages set forth in § 8.01-581.15.

https://law.lis.virginia.gov/vacode/title54.1/chapter29/section54.1-2957/		None
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Collab Under Independence RequirementsConn. Gen. Stat. § 20-87a.

For purposes of this subdivision, “collaboration” means a mutually agreed upon relationship between such advanced practice registered nurse and a physician who is educated, trained or has relevant experience that is related to the work of such advanced practice registered nurse. The collaboration shall address a reasonable and appropriate level of consultation and referral, coverage for the patient in the absence of such advanced practice registered nurse, a method to review patient outcomes and a method of disclosure of the relationship to the patient. Relative to the exercise of prescriptive authority, the collaboration between such advanced practice registered nurse and a physician shall be in writing and shall address the level of schedule II and III controlled substances that such advanced practice registered nurse may prescribe and provide a method to review patient outcomes, including, but not limited to, the review of medical therapeutics, corrective measures, laboratory tests and other diagnostic procedures that such advanced practice registered nurse may prescribe, dispense and administer.

https://www.cga.ct.gov/current/pub/chap_378.htm#sec_20-87a

Office of Legislative Research Research Report

For APRNs working in collaboration with a physician, the collaborative agreement must specify which Schedule II and III controlled substances the APRN may prescribe (they may also prescribe schedule IV or V controlled substances) (CGS §§ 20-87a(b)(2) & 20-94b). The law also specifies that a licensed APRN
maintaining current certification from the American Association of Nurse Anesthetists who is prescribing and administering medical therapeutics during surgery may do so only if the physician who is medically directing the prescriptive activity is physically present in the setting where the surgery is taking place (CGS § 20-87a(b)).

https://www.cga.ct.gov/2016/rpt/pdf/2016-R-0190.pdf		24 Del. C. § 1936

(a) A collaborative agreement must outline how the parties to the agreement will cooperate, coordinate, and consult pursuant to the Board of Nursing’s rules and regulations.
(b) All new APRN graduates and those nurses seeking to obtain independent practice must practice under a collaborative agreement for 2 years and a minimum of 4,000 full-time hours.
(c) An APRN already practicing under a collaborative agreement as of July 1, 2015, who seeks to obtain independent practice must resubmit the collaborative agreement to the APRN Committee in order to be granted credit for any hours accumulated and must otherwise comply with the relevant provisions of this chapter and the Board’s regulations.

http://delcode.delaware.gov/title24/c019/index.html

Board of Nursing FAQs
What is the collaborator’s responsibility?
Answer: To ensure APRN competency, the collaborator must agree to provide guidance and feedback on the delivery of patient care within your role and population foci. If you will be applying for independent practice authority, the following benchmarks, competencies, and metrics must be fulfilled:
You and the collaborator must discuss the delivery of patient care for at least 10% of your cases over a specific time period, two years or 4,000 hours.
At the conclusion of the collaboration, you and the collaborator must agree that you exercised safe and appropriate practice 95% of the time.
You must maintain a log. The collaborator must verify your log in writing.

https://dpr.delaware.gov/boards/nursing/faqs/		NoneFL Board of Nursing Updated Standards for Protocols: Physicians and ARNPs

A written protocol signed by all parties, representing the mutual agreement of the physician or dentist and the ARNP may include the following:
(a) General Data.
1. Signatures of individual parties to the protocol (At practice locations where multiple physicians or dentists are supervising the same ARNPs, the practice may delegate to one of the supervising physicians or dentists the authority to sign the protocol for the physicians or dentists listed on the protocol);
a. Name, address, ARNP certificate number, ARNP DEA number (if applicable);
b. Name, address, license number, and DEA number of the physician or dentist;
2. Nature of practice, practice location, including primary and satellite sites; and
3. Date developed and dates amended with signatures of all parties.
(b) Collaborative Practice Agreement.
1. A description of the duties of the ARNP.
2. A description of the duties of the physician or dentist (which shall include consultant and supervisory arrangements in case the physician or dentist is unavailable).
3. The management areas for which the ARNP is responsible, including
a. The conditions for which therapies may be initiated,
b. The treatments that may be initiated by the ARNP, depending on patient condition and judgment of the ARNP,
c. The drug therapies that the ARNP may prescribe, initiate, monitor, alter, or order.
4. A provision for annual review by the parties.
5. Specific conditions and a procedure for identifying conditions that require direct evaluation or specific consultation by the physician or dentist.

464.012(3), F.S. An advanced registered nurse practitioner shall perform those functions authorized in this section within the framework of an established protocol which must be maintained onsite at the location or locations at which an advanced registered nurse practitioner practices. In the case of multiple supervising physicians in the same group, an advanced registered nurse practitioner must enter into a supervisory protocol with at least one physician within the physician group practice.

The Nurse Practitioner who applies for a DEA registration should be prepared to submit a copy of the protocol via email or fax after the DEA has contacted you.

https://floridasnursing.gov/standards-for-protocols-physicians-and-arnps/		NoneSec. 65-35.

(a) A written collaborative agreement is required for all advanced practice registered nurses engaged in clinical practice prior to meeting the requirements of Section 65-43, except for advanced practice registered nurses who are privileged to practice in a hospital, hospital affiliate, or ambulatory surgical treatment center.
(a-5) If an advanced practice registered nurse engages in clinical practice outside of a hospital, hospital affiliate, or ambulatory surgical treatment center in which he or she is privileged to practice, the advanced practice registered nurse must have a written collaborative agreement, except as set forth in Section 65-43.
(b) A written collaborative agreement shall describe the relationship of the advanced practice registered nurse with the collaborating physician and shall describe the categories of care, treatment, or procedures to be provided by the advanced practice registered nurse. A collaborative agreement with a podiatric physician must be in accordance with subsection (c-5) or (c-15) of this Section. A collaborative agreement with a dentist must be in accordance with subsection (c-10) of this Section. A collaborative agreement with a podiatric physician must be in accordance with subsection (c-5) of this Section. Collaboration does not require an employment relationship between the collaborating physician and the advanced practice registered nurse.
The collaborative relationship under an agreement shall not be construed to require the personal presence of a collaborating physician at the place where services are rendered. Methods of communication shall be available for consultation with the collaborating physician in person or by telecommunications or electronic communications as set forth in the written agreement.
(b-5) Absent an employment relationship, a written collaborative agreement may not (1) restrict the categories of patients of an advanced practice registered nurse within the scope of the advanced practice registered nurses training and experience, (2) limit third party payors or government health programs, such as the medical assistance program or Medicare with which the advanced practice registered nurse contracts, or (3) limit the geographic area or practice location of the advanced practice registered nurse in this State.
(d) A copy of the signed, written collaborative agreement must be available to the Department upon request from both the advanced practice registered nurse and the collaborating physician, dentist, or podiatric physician.
(f) An advanced practice registered nurse shall inform each collaborating physician, dentist, or podiatric physician of all collaborative agreements he or she has signed and provide a copy of these to any collaborating physician, dentist, or podiatric physician upon request.

https://www.ilga.gov/legislation/ilcs/ilcs4.asp?DocName=022500650HArt%2E+65&ActID=1312&ChapterID=24&SeqStart=16500000&SeqEnd=17850000		NoneNoneNoneNew York State Education Law §6902

3. a. i. The practice of registered professional nursing by a nurse practitioner, certified under section six thousand nine hundred ten of this article, may include the diagnosis of illness and physical conditions and the performance of therapeutic and corrective measures within a specialty area of practice, in collaboration with a licensed physician qualified to collaborate in the specialty involved, provided such services are performed in accordance with a written practice agreement and written practice protocols except as permitted by paragraph (b) of this subdivision. The written practice agreement shall include explicit provisions for the resolution of any disagreement between the collaborating physician and the nurse practitioner regarding a matter of diagnosis or treatment that is within the scope of practice of both. To the extent the practice agreement does not so provide, then the collaborating physician's diagnosis or treatment shall prevail.
ii. Prescriptions for drugs, devices and immunizing agents may be issued by a nurse practitioner, under this paragraph and section six thousand nine hundred ten of this article, in accordance with the practice agreement and practice protocols except as permitted by paragraph (b) of this subdivision. The nurse practitioner shall obtain a certificate from the department upon successfully completing a program including an appropriate pharmacology component, or its equivalent, as established by the commissioner's regulations, prior to prescribing under this paragraph. The certificate issued under section six thousand nine hundred ten of this article shall state whether the nurse practitioner has successfully completed such a program or equivalent and is authorized to prescribe under this paragraph.
iii. Each practice agreement shall provide for patient records review by the collaborating physician in a timely fashion but in no event less often than every three months. The names of the nurse practitioner and the collaborating physician shall be clearly posted in the practice setting of the nurse practitioner.
iv. The practice protocol shall reflect current accepted medical and nursing practice. The protocols shall be filed with the department within ninety days of the commencement of the practice and may be updated periodically. The commissioner shall make regulations establishing the procedure for the review of protocols and the disposition of any issues arising from such review.
v. No physician shall enter into practice agreements with more than four nurse practitioners who are not located on the same physical premises as the collaborating physician.

http://www.op.nysed.gov/prof/nurse/article139.htm		NoneNoneNoneNoneNone§ 54.1-2957.

C. Every nurse practitioner other than a nurse practitioner licensed by the Boards of Medicine and Nursing as a certified nurse midwife or a certified registered nurse anesthetist or a nurse practitioner who meets the requirements of subsection I shall maintain appropriate collaboration and consultation, as evidenced in a written or electronic practice agreement, with at least one patient care team physician. A nurse practitioner who meets the requirements of subsection I may practice without a written or electronic practice agreement. A nurse practitioner who is licensed by the Boards of Medicine and Nursing as a certified nurse midwife shall practice pursuant to subsection H. A nurse practitioner who is a certified registered nurse anesthetists shall practice under the supervision of a licensed doctor of medicine, osteopathy, podiatry, or dentistry. A nurse practitioner who is appointed as a medical examiner pursuant to § 32.1-282 shall practice in collaboration with a licensed doctor of medicine or osteopathic medicine who has been appointed to serve as a medical examiner pursuant to § 32.1-282. Collaboration and consultation among nurse practitioners and patient care team physicians may be provided through telemedicine as described in § 38.2-3418.16. Physicians on patient care teams may require that a nurse practitioner be covered by a professional liability insurance policy with limits equal to the current limitation on damages set forth in § 8.01-581.15.
Service on a patient care team by a patient care team member shall not, by the existence of such service alone, establish or create liability for the actions or inactions of other team members.
D. The Boards of Medicine and Nursing shall jointly promulgate regulations specifying collaboration and consultation among physicians and nurse practitioners working as part of patient care teams that shall include the development of, and periodic review and revision of, a written or electronic practice agreement; guidelines for availability and ongoing communications that define consultation among the collaborating parties and the patient; and periodic joint evaluation of the services delivered. Practice agreements shall include provisions for (i) periodic review of health records, which may include visits to the site where health care is delivered, in the manner and at the frequency determined by the nurse practitioner and the patient care team physician and (ii) input from appropriate health care providers in complex clinical cases and patient emergencies and for referrals. Evidence of a practice agreement shall be maintained by a nurse practitioner and provided to the Boards upon request. For nurse practitioners providing care to patients within a hospital or health care system, the practice agreement may be included as part of documents delineating the nurse practitioner's clinical privileges or the electronic or written delineation of duties and responsibilities in collaboration and consultation with a patient care team physician.

https://law.lis.virginia.gov/vacode/title54.1/chapter29/section54.1-2957/		None
7
Special Notes•The NP does not have an additional scope of practice beyond the usual RN scope and must rely on standardized procedures for authorization to perform overlapping medical functions.
•Collab agreement should be updated/ reviewed periodically enough to ensure that "patients are receiving appropriate care"; Factors to consider when determining the update frequency include, but are not limited to, patient population and acuity, treatment modalities, and advances in pharmacology and diagnostic technology.
•To prescribe, NPs need a collab agreement AND a board-issued furnishing number		Collab must observe the NP “on-site” in Georgia at least quarterly (not via telecomm)
-Collab must review:
- 100% of patient records for patients receiving prescriptions for controlled substances
- 100% of patient records in which an adverse outcome has occurred, and
- 10% of all other patient records at least annually		NoneNP must submit a Notification of a CAP-NS agreement to The KY Board of Nursing.No formal written agreement required for the transition to practice period - NPs simply need to identify a mentor on their initial application for APRN licensure.Nonelaw changes 6/30/21: http://www.op.nysed.gov/prof/nurse/article139.htmSpecific medications must be listed in the collab agreement
-NP and collab must meet once a month for the first 6 months of the relationship, then once every 6 months (may be done via telecomm)		None-Collab agreement must also identify at least one substitute physicianThe agreement must outline which drugs and devices may be prescribed
- Agreements signed on or after 9/1/19 are less restrictive since face to face meetings are not required. The NP and physician must meet once a month in a manner the NP and physician agree on, which can be telecommunication.
- If the agreement was signed before Sept. 1, 2019: periodic face-to-face meetings between the NP and the physician at a location determined by the physician and NP.		NoneNPs must apply for "Autonomous practice"; license needs to have this for them NOT to need a collabAll NPs are required to complete a telemedicine training.

http://lawfilesext.leg.wa.gov/biennium/2019-20/Htm/Bills/Senate%20Bills/6061-S.htm
8
Controlled substance rules specifically for collabsYesPending time in practiceFor certain controlled substancesNoNoYesYes For certain substancesYesNoYesPending time in practiceYesYesYesYesPending time in practicePending time in practiceNo
9
Controlled substance regulations textBoard of Registered Nursing
Division 2. Healing Arts; Chapter 6. Nursing; Article 8. Nurse Practitioners
2836.1.

(c) (1) The standardized procedure or protocol covering the furnishing of drugs or devices shall specify which nurse practitioners may furnish or order drugs or devices, which drugs or devices may be furnished or ordered, under what circumstances, the extent of physician and surgeon supervision, the method of periodic review of the nurse practitioner's competence, including peer review, and review of the provisions of the standardized procedure.

(2) In addition to the requirements in paragraph (1), for Schedule II controlled substance protocols, the provision for furnishing Schedule II controlled substances shall address the diagnosis of the illness, injury, or condition for which the Schedule II controlled substance is to be furnished.

(f) (1) Drugs or devices furnished or ordered by a nurse practitioner may include Schedule II through Schedule V controlled substances under the California Uniform Controlled Substances Act (Division 10 (commencing with Section 11000) of the Health and Safety Code) and shall be further limited to those drugs agreed upon by the nurse practitioner and physician and surgeon and specified in the standardized procedure.

(2) When Schedule II or III controlled substances, as defined in Sections 11055 and 11056, respectively, of the Health and Safety Code, are furnished or ordered by a nurse practitioner, the controlled substances shall be furnished or ordered in accordance with a patient-specific protocol approved by the treating or supervising physician. A copy of the section of the nurse practitioner's standardized procedure relating to controlled substances shall be provided, upon request, to any licensed pharmacist who dispenses drugs or devices, when there is uncertainty about the nurse practitioner furnishing the order.

(g)(3) Nurse practitioners who are certified by the board and hold an active furnishing number, who are authorized through standardized procedures or protocols to furnish Schedule II controlled substances, and who are registered with the United States Drug Enforcement Administration, shall complete, as part of their continuing education requirements, a course including Schedule II controlled substances based on the standards developed by the board. The board shall establish the requirements for satisfactory completion of this subdivision.

2836.2.
Furnishing or ordering of drugs or devices by nurse practitioners is defined to mean the act of making a pharmaceutical agent or agents available to the patient in strict accordance with a standardized procedure. All nurse practitioners who are authorized pursuant to Section 2831.1 to furnish or issue drug orders for controlled substances shall register with the United States Drug Enforcement Administration.

https://www.rn.ca.gov/pdfs/regulations/bp2834-r.pdf		C.R.S. 12-255-111
(4) (a) An advanced practice registered nurse applying for prescriptive authority shall provide evidence to the board of the following:
(I) An appropriate graduate degree as determined by the board pursuant to section 12-255-111 (3)(a);
(II) Satisfactory completion of specific educational requirements in the use of controlled substances and prescription drugs, as established by the board, either as part of a degree program
or in addition to a degree program;
(III) National certification from a nationally recognized accrediting agency, as defined by the board by rule pursuant to section 12-255-111 (3)(b), unless the board grants an exception;
(IV) Professional liability insurance as required by section 12-255-113;
(V) Inclusion on the advanced practice registry pursuant to section 12-255-111; and
(VI) A signed attestation stating that the advanced practice registered nurse has completed at least three years of combined clinical work experience as a professional nurse or as an advanced practice registered nurse.
(b) Upon satisfaction of the requirements set forth in subsection (4)(a) of this section, the board may grant provisional prescriptive authority to an advanced practice registered nurse. The provisional prescriptive authority that is granted is limited to those patients and medications appropriate to the advanced practice registered nurse's role and population focus. In order to retain provisional prescriptive authority and obtain and retain full prescriptive authority pursuant to this subsection (4) for patients and medications appropriate for the advanced practice registered nurse's role and population focus, an advanced practice registered nurse shall satisfy the following requirements:
(I) (A) Once the provisional prescriptive authority is granted, the advanced practice registered nurse must obtain seven hundred fifty hours of documented experience in a mutually structured prescribing mentorship either with a physician or with an advanced practice registered nurse who has full prescriptive authority and experience in prescribing medications. The mentor must be practicing in Colorado and have education, training, experience, and an active practice that corresponds with the role and population focus of the advanced practice registered nurse.
(B) Remote communication with the mentor is permissible within the mentorship as long as the communication is synchronous. Synchronous communication does not include communication by e-mail.
(C) The physician or advanced practice registered nurse serving as a mentor shall not require payment or employment as a condition of entering into the mentorship relationship, but the mentor may request reimbursement of reasonable expenses and time spent as a result of the mentorship relationship.
(D) Upon successful completion of the mentorship period, the mentor shall provide the mentor's signature and attestation to verify that the advanced practice registered nurse has successfully completed the mentorship within the required period after the provisional prescriptive authority was granted.
(E) If an advanced practice registered nurse with provisional prescriptive authority fails to complete the mentorship required by this subsection (4)(b)(I) within three years or otherwise fails to demonstrate competence as determined by the board, the advanced practice registered nurse's provisional prescriptive authority expires for failure to comply with the statutory requirements.

https://drive.google.com/file/d/0B-K5DhxXxJZbOHRFaGVlV0xVSEk/view

3 CCR 716-1
1.15 Upon receiving Provisional Prescriptive Authority, the APRN is legally authorized to prescribe medications and controlled substances schedules II-V to patients appropriate to the APRN’s Role and, if applicable, Population Focus. Within three years of receiving Provisional Prescriptive Authority the APRN with Provisional Prescriptive Authority (hereinafter referred to as RXN-P)
must:
5. Complete a 750 hour Mentorship with a Physician or an Advanced Practice Registered Nurse with Full Prescriptive Authority and experience in prescribing medications. The Physician or APRN shall have education, training, experience and a practice that
corresponds with but need not be identical to the Role and, if applicable, population Focus of the RXN-P. If the RXN-P does not complete these additional requirements within three years of receiving Provisional Prescriptive Authority such authority will expire for failure to comply with statutory requirements.

MENTORSHIP REQUIREMENTS
1. To obtain Full Prescriptive Authority, the RXN-P must complete 750 hours of documented experience in a Mentorship. The Mentorship shall be conducted with either a Physician
Mentor or RXN Mentor [hereinafter referred to as Mentor(s)] as defined in Sections (C)(11) and (C)(12) of Rule 1.15, respectively. The Mentorship must be completed within three years after Provisional Prescriptive Authority is granted.
a. This Section (G) does not apply to the RXN-P with prescriptive authority and at least 750 hours of prescribing experience in another state, US jurisdiction or United States military applying for Full Prescriptive Authority as set forth in Section (J)(2) of Rule 1.15.
2. The Mentorship Agreement shall contain the following elements:
a. Is documented in writing and signed by the RXN-P and the Mentor(s).
b. Outlines a process, documentation, and frequency for ongoing Synchronous Communication, interaction and discussion of prescriptive practice throughout the Mentorship between the Mentor(s) and the RXN-P to provide for safe prescribing practice.
3. The Mentorship Agreement shall be retained for a period of three years by the RXN and the Mentor(s) following completion of the Mentorship and shall be available to the Board upon request.
4. The RXN-P and the Mentor(s) shall provide documentation of the successful completion of the Mentorship as requested by the RXN-P to complete an application to obtain Full Prescriptive Authority. The Mentor(s) shall not, without good cause, withhold his/her
signature or otherwise fail to attest to the completion of the Mentorship. Upon submission of the application and development of the Articulated Plan as set forth in Section (H) of Rule 1.15, the RXN- P may be granted Full Prescriptive Authority.
5. If a circumstance such as retirement, illness, relocation or other event precludes any Mentor from continuing in the Mentorship, the RXN-P shall secure a replacement Mentor and enter into a new, Mutually Structured Mentorship. Any hours accrued during the
period of time in which the RXN-P does not have a Mentor will not be credited toward completion of the 750 hour Mentorship.

The RXN-P or RXN must hold a valid DEA registration to prescribe controlled substances, Schedule II through V, and must adhere to all DEA requirements.

https://www.sos.state.co.us/CCR/GenerateRulePdf.do?ruleVersionId=9273&fileName=3%20CCR%20716-1

https://www.sos.state.co.us/CCR/GenerateRulePdf.do?ruleVersionId=9273&fileName=3%20CCR%20716-1		Office of Legislative Research Research Report

Concerning an APRN’s prescriptive authority, APRNs practicing without a collaborative agreement may prescribe schedule II, III, IV, or V controlled substances.

https://www.cga.ct.gov/2016/rpt/pdf/2016-R-0190.pdf

Relative to the exercise of prescriptive authority by newly licensed APRNs, the collaboration between an APRN and a physician shall be in writing and shall address the level of Schedule II and III controlled substances that the APRN may prescribe and provide a method to review patient outcomes, including, but not limited to, the review of medical therapeutics, corrective measures, laboratory tests and other diagnostic procedures that the APRN may prescribe, dispense and administer.

https://portal.ct.gov/DPH/Practitioner-Licensing--Investigations/APRN/APRN-Practice		1900 Board of Nursing’s Rules and Regulations.

8.14.4 APRNs may prescribe, administer, and dispense legend medications including Schedule II - V controlled substances, (as defined in the Controlled Substance Act and labeled in compliance with 24 Del.C. §2522, parenteral medications, medical therapeutics, devices and diagnostics.
8.14.4.1 Controlled Substances registration will be as follows:
8.14.4.2 APRNs must register with the Drug Enforcement Agency and use such DEA number for controlled substance prescriptions.
8.14.4.3 APRNs must register biennially with the Office of Narcotics and Dangerous Drugs in accordance with 16 Del.C. §4732(a).

https://regulations.delaware.gov/AdminCode/title24/1900.shtml		N/AFla. Stat. § 464.003(2)

(3) Within the established framework, an advanced practice registered nurse may:
(a) Prescribe, dispense, administer, or order any drug; however, an advanced practice registered nurse may prescribe or dispense a controlled substance as defined in s. 893.03 only if the advanced practice registered nurse has graduated from a program leading to a master’s or doctoral degree in a clinical nursing specialty area with training in specialized practitioner skills.

http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0400-0499/0464/Sections/0464.012.html		O.C.G.A. § 43-34-25

Provide that a patient who receives a prescription drug order for any controlled substance pursuant to a nurse protocol agreement shall be evaluated or examined by the delegating physician or other physician designated by the delegating physician pursuant to second sub-bullet above on at least a quarterly basis or at a more frequent interval as determined by the board (the delegating physician or other designated physician must review and sign 100% of patient records for patients receiving prescriptions for controlled substances to comply with the law).

Rule 360-32-.02

(5) The nurse protocol agreement shall identify the parameters under which the delegated act may be performed by the APRN, including but not limited to:
(c) Number of refills which may be ordered. Nothing in this Rule shall be construed to authorize an advanced practice registered nurse to issue a prescription drug order for a Schedule I or II controlled substance or authorize refills of any drug for more than 12 months from the date of the original order except in the case of oral contraceptives, hormone replacement therapy, or prenatal vitamins which may be refilled for a period of 24 months as provided in O.C.G.A. 43-34-25.
(d) Provide that a patient who receives a prescription drug order for any controlled substance pursuant to a nurse protocol agreement shall be evaluated or examined by the delegating physician or other physician designated by the delegating physician as provided in O.C.G.A. 43-34-25 on at least a quarterly basis or at a more frequent interval as consistent with the minimum acceptable standards of the practice of medicine as determined by the Board.
(6) The nurse protocol agreement shall require documentation by the APRN of those acts performed by the APRN that are specific to the medical acts authorized by the delegating physician and provide that, if the APRN has prescribing pursuant to the protocol agreement, each prescription shall be noted in the patient's medical record.
(a) If the protocol agreement delegates to the APRN to prescribe/order prescription drugs or devices, a copy of the prescription drug or device order delivered to the patient shall be maintained in the patient's medical file. For purposes of this paragraph a copy shall mean a duplicate prescription or a photocopy or electronic equivalent.
(b) If the protocol agreement delegates to the APRN to prescribe/order prescription drugs or devices, the protocol shall provide that the prescription/order shall be issued on a form which contains the following:
1. The name, address and telephone number of the delegating physician, the name of the APRN, the APRN's DEA number, if applicable, and the name and address of the patient, the drug or device prescribed, the number of refills and directions to the patient with regard to taking and dosage of the drug; and
2. The prescription shall be signed by the APRN and shall be on a form which shall include the names of the APRN and delegating physician who are parties to the nurse protocol agreement.
(7) (a) Unless the physician meets the requirements of paragraph (b), the nurse protocol agreement shall include a schedule for periodic review of patient records. The Board has determined that the minimum accepted standards of medical practice require the following:
1. In as much as O.C.G.A. 43-34-25 requires that a delegating physician or other designated physician evaluate or examine all patients who receive any controlled substance prescription pursuant to a nurse protocol agreement, a delegating physician or other designated physician must review and sign 100% of patient records for patients receiving prescriptions for controlled substances to comply with the law. Such review shall occur at least quarterly after issuance of the controlled substance prescription.

http://rules.sos.state.ga.us/gac/360-32-.02		Sec. 65-43.

(c) The scope of practice of an advanced practice registered nurse with full practice authority includes:
(4) prescribing benzodiazepines or Schedule II narcotic drugs, such as opioids, only in a consultation relationship with a physician; this consultation relationship shall be recorded in the Prescription Monitoring Program website, pursuant to Section 316 of the Illinois Controlled Substances Act, by the physician and advanced practice registered nurse with full practice authority and is not required to be filed with the Department; the specific Schedule II narcotic drug must be identified by either brand name or generic name; the specific Schedule II narcotic drug, such as an opioid, may be administered by oral dosage or topical or transdermal application; delivery by injection or other route of administration is not permitted; at least monthly, the advanced practice registered nurse and the physician must discuss the condition of any patients for whom a benzodiazepine or opioid is prescribed; nothing in this subsection shall be construed to require a prescription by an advanced practice registered nurse with full practice authority to require a physician name;

https://www.ilga.gov/legislation/ilcs/ilcs4.asp?DocName=022500650HArt%2E+65&ActID=1312&ChapterID=24&SeqStart=16500000&SeqEnd=17850000

Sec. 65-40.
(a) A collaborating physician may, but is not required to, delegate prescriptive authority to an advanced practice registered nurse as part of a written collaborative agreement. This authority may, but is not required to, include prescription of, selection of, orders for, administration of, storage of, acceptance of samples of, and dispensing over the counter medications, legend drugs, medical gases, and controlled substances categorized as any Schedule III through V controlled substances, as defined in Article II of the Illinois Controlled Substances Act, and other preparations, including, but not limited to, botanical and herbal remedies. The collaborating physician must have a valid current Illinois controlled substance license and federal registration to delegate authority to prescribe delegated controlled substances.
(b) To prescribe controlled substances under this Section, an advanced practice registered nurse must obtain a mid-level practitioner controlled substance license. Medication orders shall be reviewed periodically by the collaborating physician.
(c) The collaborating physician shall file with the Department and the Prescription Monitoring Program notice of delegation of prescriptive authority and termination of such delegation, in accordance with rules of the Department. Upon receipt of this notice delegating authority to prescribe any Schedule III through V controlled substances, the licensed advanced practice registered nurse shall be eligible to register for a mid-level practitioner controlled substance license under Section 303.05 of the Illinois Controlled Substances Act.
(d) In addition to the requirements of subsections (a), (b), and (c) of this Section, a collaborating physician may, but is not required to, delegate authority to an advanced practice registered nurse to prescribe any Schedule II controlled substances, if all of the following conditions apply:
(1) Specific Schedule II controlled substances by oral dosage or topical or transdermal application may be delegated, provided that the delegated Schedule II controlled substances are routinely prescribed by the collaborating physician. This delegation must identify the specific Schedule II controlled substances by either brand name or generic name. Schedule II controlled substances to be delivered by injection or other route of administration may not be delegated.
(2) Any delegation must be controlled substances that the collaborating physician prescribes.
(3) Any prescription must be limited to no more than a 30-day supply, with any continuation authorized only after prior approval of the collaborating physician.
(4) The advanced practice registered nurse must discuss the condition of any patients for whom a controlled substance is prescribed monthly with the delegating physician.
(5) The advanced practice registered nurse meets th education requirements of Section 303.05 of the Illinois Controlled Substances Act.

https://www.ilga.gov/legislation/ilcs/ilcs4.asp?DocName=022500650HArt%2E+65&ActID=1312&ChapterID=24&SeqStart=16500000&SeqEnd=17850000		Ky. Rev. Stat. Ann. § 314.042(8)(e)-(10)(e)

The advanced practice registered nurse (APRN) who is prescribing non-scheduled legend drugs and controlled substances and the collaborating physician shall be qualified in the same or in a similar specialty.

(8) (a) Except as authorized by KRS 314.196 and subsection (9) of this section, before an advanced practice registered nurse engages in the prescribing or dispensing of nonscheduled legend drugs as authorized by KRS 314.011(8), the advanced practice registered nurse shall enter into a written "Collaborative Agreement for the Advanced Practice Registered Nurse's Prescriptive Authority for Nonscheduled Legend Drugs" (CAPA-NS) with a physician
licensed in Kentucky that defines the scope of the prescriptive authority for nonscheduled legend drugs.
(b) The advanced practice registered nurse shall notify the Kentucky Board of Nursing of the existence of the CAPA-NS and the name of the collaborating physician and shall, upon request, furnish to the board or its staff a copy of the completed CAPA-NS. The Kentucky Board of Nursing shall notify the Kentucky Board of Medical Licensure that a CAPA-NS exists and furnish the
collaborating physician's name.
(c) The CAPA-NS shall be in writing and signed by both the advanced practice registered nurse and the collaborating physician. A copy of the completed collaborative agreement shall be available at each site where the advanced practice registered nurse is providing patient care.
(d) The CAPA-NS shall describe the arrangement for collaboration and communication between the advanced practice registered nurse and the collaborating physician regarding the prescribing of nonscheduled legend drugs by the advanced practice registered nurse.
(e) The advanced practice registered nurse who is prescribing nonscheduled legend drugs and the collaborating physician shall be qualified in the same or a similar specialty.
(f) The CAPA-NS is not intended to be a substitute for the exercise of professional judgment by the advanced practice registered nurse or by the collaborating physician.
(g) The CAPA-NS shall be reviewed and signed by both the advanced practice registered nurse and the collaborating physician and may be rescinded by either party upon written notice via registered mail to the other party, the Kentucky Board of Nursing, and the Kentucky Board of Medical Licensure.

https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=48249

KY Board of Nursing

Before the APRN is authorized to prescribe controlled substances to their patients/clients they must acquire a collaborative agreement (CAPA-CS) with a physician licensed in Kentucky in the same or similar practice. This collaborative agreement must meet the criteria established in KRS 314.042.

https://kbn.ky.gov/practice/Pages/APRNPresAuth.aspx		None333.17211a

A written agreement is only by required Michigan law if the physician will be delegating to the NP: (1) the prescribing of controlled substances listed in Schedules III to V or (2) the ordering, receipt and dispensing of complimentary starter dose drugs other than controlled substances.
Although neither the statutes nor the regulations appear to require a written agreement outside of these limited situations, during previous EBG outreach, local counsel noted that a collaboration agreement between the supervising physician and the NP may be required for billing/reimbursement purposes.

http://www.legislature.mi.gov/(S(tgeuoc552vfk0heepvz34j55))/documents/mcl/pdf/mcl-368-1978-15-172.pdf

Michigan Board of Medicine Rule 111.

(1) A physician may delegate the prescription of controlled substances listed in schedules 2 to 5 to a registered nurse who holds a specialty certification under section 17210 of the code, MCL 333.17210, with the exception of a nurse anesthetist, if the supervising physician establishes a written authorization that contains all of the following information:
• The name, license number, and signature of the supervising physician.
• The name, license number, and signature of the nurse practitioner or nurse midwife.
• The limitations or exceptions to the delegation.
• The effective date of the delegation.
(2) The supervising physician shall review and update a written authorization on an annual basis from the original date or the date of amendment, if amended. The supervising physician shall note the review date on the written authorization.
(3) The supervising physician shall maintain a written authorization at the supervising physician’s primary place of practice.
(4) The supervising physician shall provide a copy of the signed, written authorization to the nurse practitioner or nurse midwife.
(5) The supervising physician shall ensure that an amendment to the written authorization is in compliance with sub-rules(1), (2), (3), and (4) of this rule.
(6) A supervising physician shall not authorize a nurse practitioner or a nurse midwife to issue a prescription for a schedule 2 controlled substance with a quantity greater than a 30-day supply.
(7) A supervising physician shall not delegate the prescription of a drug or device individually, in combination, or in succession for a woman known to be pregnant with the intention of causing either a miscarriage or fetal death.

https://cdn.ymaws.com/micnp.org/resource/resmgr/resources_&_links/micnp_prescriptive_authority.pdf		139 N.Y.C.L.S. § 6902

3(a)(2) Prescriptions for drugs, devices and immunizing agents may be issued by a nurse practitioner, under this paragraph and section six thousand nine hundred ten of this article, in accordance with the practice agreement and practice protocols except as permitted by paragraph (b) of this subdivision. The nurse practitioner shall obtain a certificate from the department upon successfully completing a program including an appropriate pharmacology component, or its equivalent, as established by the commissioner's regulations, prior to prescribing under this paragraph. The certificate issued under section six thousand nine hundred ten of this article shall state whether the nurse practitioner has successfully completed such a program or equivalent and is authorized to prescribe under this paragraph.

http://www.op.nysed.gov/prof/nurse/article139.htm#		21 NCAC 32M .0109

(2) Controlled Substances (Schedules II, IIN, III, IIIN, IV, V) defined by the State and Federal Controlled Substances Acts may be procured, prescribed, or ordered as established in the collaborative practice agreement, providing all of the following requirements are met:
(A) the nurse practitioner has an assigned DEA number that is entered on each prescription for a controlled substance;
(B) refills may be issued consistent with Controlled Substance laws and regulations; and
(C) the supervising physician(s) possesses the same schedule(s) of controlled substances as the nurse practitioner's DEA registration.

http://reports.oah.state.nc.us/ncac/title%2021%20-%20occupational%20licensing%20boards%20and%20commissions/chapter%2032%20-%20north%20carolina%20medical%20board/subchapter%20m/subchapter%20m%20rules.html		Ohio Board of Nursing Exclusionary Formulary

The prescriptive authority of a Certified Nurse Practitioner, Clinical
Nurse Specialist or Certified Nurse Midwife shall not exceed the
prescriptive authority of the collaborating physician or podiatrist.

http://nursing.ohio.gov/wp-content/uploads/2019/08/Exclusionary_Formulary5.3.pdf

4723-9-10

(D) A clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner may prescribe any drug or therapeutic device in any form or route of administration if:
(1) The ability to prescribe the drug or therapeutic device is within the scope of practice in the advanced practice registered nurse's specialty area;
(2) The prescription is consistent with the terms of a standard care arrangement entered into with a collaborating physician;
(3) The prescription would not exceed the prescriptive authority of the collaborating physician, including restrictions imposed on the physician's practice by action of the United States drug enforcement administration or the state medical board, or by the state medical board rules, including but not limited to rule 4731-11-09 of the Administrative Code;
(4) The individual drug or subtype or therapeutic device is not one excluded by the exclusionary formulary set forth in paragraph (B) of this rule
(5) The prescription meets the requirements of state and federal law, including but not limited to this rule, and all prescription issuance rules adopted by agency 4729 of the Administrative Code;

http://codes.ohio.gov/oac/4723-9		49 P.A.C. § 21.284

(d) Restrictions on CRNP prescribing and dispensing practices are as follows:
(1) A CRNP may write a prescription for a Schedule II controlled substance for up to a 30-day supply as identified in the collaborative agreement.
(2) A CRNP may prescribe a Schedule III or IV controlled substance for up to a 90 day supply as identified in the collaborative agreement.

http://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/049/chapter21/s21.284.html&d=reduce		T.A.C. § 222.5

(c) A prescriptive authority agreement must, at a minimum:
(4) identify either:
(A) the types or categories of drugs or devices that may be ordered or prescribed; or
(B) the types of categories of drugs or devices that may not be ordered or prescribed

https://texreg.sos.state.tx.us/public/readtac$ext.TacPage?sl=R&app=9&p_dir=&p_rloc=&p_tloc=&p_ploc=&pg=1&p_tac=&ti=22&pt=11&ch=222&rl=5		(Utah Code Ann. 58-31b-102

(5) "Consultation and referral plan" means a written plan jointly developed by an advanced practice registered nurse and, except as provided in Subsection 58-31b-803(4), a consulting physician that permits the advanced practice registered nurse to prescribe Schedule II controlled substances in consultation with the consulting physician.
(6) "Consulting physician" means a physician and surgeon or osteopathic physician and surgeon licensed in accordance with this title who has agreed to consult with an advanced practice registered nurse with a controlled substance license, a DEA registration number, and who will be prescribing Schedule II controlled substances.

https://le.utah.gov/xcode/Title58/Chapter31B/58-31b-S102.html

58-31b-803

(3) An advanced practice registered nurse described in Subsection (4) may not prescribe or administer a Schedule II controlled substance unless the advanced practice registered nurse prescribes or administers Schedule II controlled substances in accordance with a consultation and referral plan.
(4) Subsection (3) applies to an advanced practice registered nurse who:
(a) (i) is engaged in independent solo practice; and
(ii) (A) has been licensed as an advanced practice registered nurse for less than one year; or
(B) has less than 2,000 hours of experience practicing as a licensed advanced practice registered nurse; or
(b) owns or operates a pain clinic.

https://le.utah.gov/xcode/Title58/Chapter31B/58-31b-S803.html?v=C58-31b-S803_2020051220200512		Code Va. § 54.1-2957.01

B. A nurse practitioner who does not meet the requirements for practice without a written or electronic practice agreement set forth in subsection I of § 54.1-2957 shall prescribe controlled substances or devices only if such prescribing is authorized by a written or electronic practice agreement entered into by the nurse practitioner and a patient care team physician. Such nurse practitioner shall provide to the Boards of Medicine and Nursing such evidence as the Boards may jointly require that the nurse practitioner has entered into and is, at the time of writing a prescription, a party to a written or electronic practice agreement with a patient care team physician that clearly states the prescriptive practices of the nurse practitioner. Such written or electronic practice agreements shall include the controlled substances the nurse practitioner is or is not authorized to prescribe and may restrict such prescriptive authority as described in the practice agreement. Evidence of a practice agreement shall be maintained by a nurse practitioner pursuant to § 54.1-2957. Practice agreements authorizing a nurse practitioner to prescribe controlled substances or devices pursuant to this section either shall be signed by the patient care team physician or shall clearly state the name of the patient care team physician who has entered into the practice agreement with the nurse practitioner.

It shall be unlawful for a nurse practitioner to prescribe controlled substances or devices pursuant to this section unless (i) such prescription is authorized by the written or electronic practice agreement or (ii) the nurse practitioner is authorized to practice without a written or electronic practice agreement pursuant to subsection I of § 54.1-2957.

https://law.lis.virginia.gov/vacode/title54.1/chapter29/section54.1-2957.01/

§ 54.1-2957

I. A nurse practitioner, other than a nurse practitioner licensed by the Boards of Medicine and Nursing in the category of certified nurse midwife or certified registered nurse anesthetist, who has completed the equivalent of at least five years of full-time clinical experience as a licensed nurse practitioner, as determined by the Boards, may practice in the practice category in which he is certified and licensed without a written or electronic practice agreement upon receipt by the nurse practitioner of an attestation from the patient care team physician stating (i) that the patient care team physician has served as a patient care team physician on a patient care team with the nurse practitioner pursuant to a practice agreement meeting the requirements of this section and § 54.1-2957.01; (ii) that while a party to such practice agreement, the patient care team physician routinely practiced with a patient population and in a practice area included within the category for which the nurse practitioner was certified and licensed; and (iii) the period of time for which the patient care team physician practiced with the nurse practitioner under such a practice agreement. A copy of such attestation shall be submitted to the Boards together with a fee established by the Boards. Upon receipt of such attestation and verification that a nurse practitioner satisfies the requirements of this subsection, the Boards shall issue to the nurse practitioner a new license that includes a designation indicating that the nurse practitioner is authorized to practice without a practice agreement. In the event that a nurse practitioner is unable to obtain the attestation required by this subsection, the Boards may accept other evidence demonstrating that the applicant has met the requirements of this subsection in accordance with regulations adopted by the Boards.

https://law.lis.virginia.gov/vacode/54.1-2957/		None
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Chart or oversight documentation required
- Meetings
- Chart reviews
- Physical proximity requirements		NoNo NoNoN/ANoYes NoNoNo N/ANoYesYesNoYesN/ANoN/A
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Does the collab need to be updated annually?No, periodically is fineYesNoNoN/ANoYes No No No N/ANoYesEvery 2 yearsEvery 2 yearsYesN/ANoN/A
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Do the collaborators work in the same/similar specialty?
NoYesNoYesN/ANoYes YesYesNo N/AYesNoYesNoNoN/ANoN/A
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Must the collab/related docs be submitted to the board?
NoNo NoYesN/AYesYesNoNo No N/AYesYesYesYesNoN/ANoN/A
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# of NPs/MD supervision4 - regardless of hours workedNo limitNo limitNo limitN/ANo limit4No limitNo limitNo limitNo limit4No limit3No limit7N/A6N/A
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Required Formshttps://www.rn.ca.gov/pdfs/regulations/npr-b-20.pdfhttps://dpo.colorado.gov/Nursing/APNApplications
https://drive.google.com/file/d/0BzKoVwvexVATcnZ4ZVV1R2ZKU1k/view
https://drive.google.com/file/d/0BzKoVwvexVATcDFuLUU3cC10U0k/view
https://drive.google.com/file/d/0BzKoVwvexVATakNoZW9QbHF1SVU/view
https://drive.google.com/file/d/0BzKoVwvexVATdUVfbWxXSGZUeFk/view

https://drive.google.com/file/d/0BzKoVwvexVATal94QXdLcU5UUXc/view		https://portal.ct.gov/-/media/Departments-and-Agencies/DPH/dph/practitioner_licensing_and_investigations/plis/nursing/aprn/APRNIndPracticepdf.pdf?la=en

https://www.elicense.ct.gov/Lookup/LicenseLookup.aspx 		https://dprfiles.delaware.gov/nursing/Collab_Agreement_Form1.pdf

https://dprfiles.delaware.gov/nursing/Collaborative_Agreement_Info.pdf

https://dprfiles.delaware.gov/nursing/APRN_Indep_Practice_App1.pdf

https://dprfiles.delaware.gov/nursing/Verif_of_Exp_and_Competency1.pdf		Nonehttps://floridasnursing.gov/applications/autonomous-aprn-registration.pdf

http://floridasnursing.gov/forms/arnp-protocol-sample.pdf

https://ww10.doh.state.fl.us/pub/medicine/PDF%20Forms%20on%20Web/APRN%20EMT%20Paramedic%20Protocol%20Form.pdf		https://medicalboard.georgia.gov/document/document/aprnprotocolagreementform-11172020pdf/download

https://medicalboard.georgia.gov/professionals/list-nurse-protocols-reviewed-board-prescribing-privileges

https://medicalboard.georgia.gov/professionals/applications-center/aprn-protocol-registration-forms 		https://www.illinois.gov/hfs/SiteCollectionDocuments/hfs3411c.pdf

https://www.idfpr.com/Renewals/Apply/Forms/APRN-FPA.pdf 		https://kbn.ky.gov/practice/Documents/Notification%20of%20a%20Collaborative%20Agreement%20for%20the%20APRNs%20Prescriptive%20Authority%20for%20Nonscheduled%20Legend%20Drugs%20(CAPA-NS).pdf

https://kbn.ky.gov/practice/Documents/Common%20CAPA-NS%20Form.pdf

https://kbn.ky.gov/apply/Documents/KBN%20Notification%20to%20Discontinue%20CAPA-NS%20After%20Four%20Years.pdf		https://mbon.maryland.gov/Documents/graduate_agreement.pdfhttps://www.michigan.gov/documents/mdch/Dch-1575-Nurse_Practitioner-Physician_Agreement-08-07_205314_7.pdfhttp://www.op.nysed.gov/prof/nurse/np4np.pdf

http://www.op.nysed.gov/prof/nurse/nurseformsnp.htm

http://www.op.nysed.gov/prof/nurse/np-sample-collaborative-agreement.pdf

http://www.op.nysed.gov/prof/nurse/np-npcr.pdf 		https://docs.google.com/document/d/1Qw9jzKXvzRiZI0CnUBa2_-mVXFLoaEZjRgWNVWDTOwA/edit

https://www.ncbon.com/vdownloads/nurse-practitioner/np-identification-doc-approval-or-subsequent-only.pdf

https://www.ncbon.com/practice-nurse-practitioner-collaborative-practice-guidelines
https://www.ohio-napnap.org/newsletters/current.pdf		https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Nursing/Pages/CRNP.aspx

https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Nursing/Documents/Applications%20and%20Forms/Prescriptive-Authority-Application.pdf		https://www.bon.texas.gov/faq_practice_aprn.aspNonehttps://www.license.dhp.virginia.gov/apply/Login.aspx

https://www.dhp.virginia.gov/media/dhpweb/docs/nursing/forms/NP_AutonomousPractice,.pdf 		https://www.doh.wa.gov/Portals/1/Documents/Pubs/669393.pdf
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Physician Liability for errors committed by NP?NoNo NONoN/ANoYesNoNoNoNoNoYesNoYesNoN/ANoN/A
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