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Q: Collaborative Agreements for Nurse Practitioners ( Answered 2 out of 5 stars,   1 Comment )
Subject: Collaborative Agreements for Nurse Practitioners
Category: Health > Medicine
Asked by: mavik-ga
List Price: $20.00
Posted: 18 Jun 2002 20:29 PDT
Expires: 18 Jul 2002 20:29 PDT
Question ID: 28831
Which states do not require nurse practitioners to enter into a
collaborative agreement with a physician in order to practice?
Subject: Re: Collaborative Agreements for Nurse Practitioners
Answered By: weisstho-ga on 18 Jun 2002 21:24 PDT
Rated:2 out of 5 stars
Dear mavik,

States where Nurse Practitioners have Prescriptive Authority,
according to the American Academy of Nurse Practitioners, , include:

Washington (state)
New Mexico
New Hampshire
District of Columbia

The remaining states require some level of collaboration in order to

In case you require them, here is the contact information for the
above states:
ALASKA: Alaska Board of Nursing, Department of Commerce and Economic
Development, Div. of Occupational Licensing, 3601 C Street , Suite
722, Anchorage, Alaska 99503, PH (907) 269-8161  FAX: (907) 269-8196
ARIZONA: Arizona State Board of Nursing, 1651 E. Morten Avenue, Suite
150, Phoenix, Arizona 85020, PH: (602) 255-5092                       
  FAX: (602) 331-8111
DISTRICT OF COLUMBIA: District of Columbia Board of Nursing, 825
N.Capitol Street, N.E.,RM 2224, Washington, DC 20002,                 
  PH: (202) 442-4778  FAX: (202) 442-9431
MAINE: Maine State Board of Nursing, State House Station #158,
Augusta, Maine 04333-0158, PH: (207) 287-1133  FAX: (207) 287-1149
MONTANA: Montana State Board of Nursing, 301 South Park, P.O. Box
200513, Helena, Montana 59620-0513, PH: (406) 444-2071             
FAX: (406) 8412343
NEW HAMPSHIRE: New Hampshire Board of Nursing, 78 Regional Drive, Bldg
B, Concord, New Hampshire 03302, PH: (603) 271-2323  FAX: (603)
NEW MEXICO: New Mexico Board of Nursing, 4206 Louisiana Blvd., NE,
Suite A, Albuquerque, New Mexico 87109, PH: (505) 841-8340  FAX: (505)
OREGON: Oregon State Board of Nursing, Suite 465, 800 NE Oregon
Street, Box 25, Portland, Oregon 97232, PH: (503) 731-4745         
FAX: (503) 731-4755
WASHINGTON: Washington State Nursing Care Quality Assurance
Commission, Dept. of Health, P.O. Box 47864, Olympia, Washington
98504-7864, PH: (360) 236-4740  FAX: (360) 236-4738
WISCONSIN: Wisconsin Dept. of Regulations & Licensing, 1400 East
Washington Avenue, P.O. Box 8935, Madison, Wisconsin 53708-8935, PH:
(608) 266-0145  FAX: (608) 261-7083

Further, the American Nurses Assocation
published a comprehensive table (though in 2000) showing “States
Recognizing Advanced Practice Under Independent Acts, Separate Titles
of Advance Practice Acts, or Regulations”
In addition, the National Council of State Boards of Nursing has a wonderful web site. Of particular interest
is their discussion of the progress of the Nurse Licensure Compact
which allows a nurse to have one license (in his or her state of
residency) and to practice in other states (both physical and
electronic), subject to each state's practice law and regulation.
Under mutual recognition, a nurse may practice across state lines
unless otherwise restricted.
See the map and table showing status of the states at

I hope this is exactly what you are looking for. If you require
additional information, please ask for clarification and I will get
right back to you.


Search Terms Used:

Request for Answer Clarification by mavik-ga on 19 Jun 2002 05:13 PDT
I did not ask which states grant prescriptive authority, with or
without collaboration.  Your answer to that question was incorrect
anyway -- Washington state requires a collaborative agreement, and
others on your list may, as well. I want to know exactly what I asked:
 which states require NO collaborative agreement for advanced practice
nurses to practice? In other words, where can nurse practitioners
practice independently?

Clarification of Answer by weisstho-ga on 19 Jun 2002 11:46 PDT
Thank you for requesting clarification.  I have a couple calls out for
which I am awaiting responses. As soon as I have concrete information,
I will be right back to you.

Clarification of Answer by weisstho-ga on 20 Jun 2002 12:30 PDT
I apologize for not hitting the ball square in the middle. I made the
mistake of equating independent practice with prescriptive authority,
reasoning that without such prescriptive authority the nurse
practitioner would be too severely restrained in the services he/she
would be able to offer; in other words, that prescriptive authority
went hand-in-hand with independent practice.

The information above is still the best I can find – I see that all of
the folks at the American Academy of Nurse Practitioners are at their
annual convention in Reno – I called both their Washington and Austin
offices by phone, four times, I finally got the word that they are all
out until next week.  :-/

You mentioned the State of Washington. A nurse practitioner, I
discovered subsequent to your reply, is able to practice independently
BUT may require a prescriptive “joint practice agreement.”

I was curious as to whether the information I had received from the
American Academy re. prescriptive collaboration was inaccurate, so I
called the State of Washington, Department of Health, Nursing Care
Quality Assurance Commission, , and
spoke with Chuck Kamiski who watches over the Nurse Practitioner
licensing and regulation.

First Chuck pointed out the Washington statutes that govern Nurse
Practitioners, which  are located here:

Washington requires a “JOINT PRACTICE AGREEMENT” which was explained
as an agreement where a physician is available to the Nurse Pract. to
consult as necessary Only Where The Nurse Practitioner Seeks to
Prescribe Schedule 2 Through 4 Meds.

Assuming that the nurse practitioner did not desire such prescriptive
authority, no collaborative or joint practice agreement is necessary.
That was Chuck’s position interpreting the Washington statutes.

In any case, I have reached the end of my resources, and I am sorry if
the answer does not satisfy your needs. Please feel free to contact
Google Answers if you feel justified in some sort of remedy.

I wish you the best in your search. And if I may, congratulations on
choosing a career field that is contributing so much to the health and
welfare of the American people.

mavik-ga rated this answer:2 out of 5 stars
The researcher never answered my question at all.  He or she was nice,
apologetic and provided lots of information, all of which I had access
to as a web researcher myself, and none of which was relevant to my
question.  The researcher had (and admitted) a misunderstanding of
what "practice independently" means, what nurse practitioners do, and
what a practitioner's value might be without prescriptive privilege. 
I don't want my money back, since I learned from the experience, but
will never again ask some amateur to do what I can do.

Subject: Re: Collaborative Agreements for Nurse Practitioners
From: sghrush-ga on 16 Jul 2004 00:29 PDT
The only thing I learned from this was that Washington requires a
"joint practice agreement" with schedule drugs.  Not worth the money. 
I agree.

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