State by State Requirements
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      3. State by State Requirements

      Collaborating in Connecticut

      Review the requirement’s to practice and collaborate as an NP in Connecticut

      State Regulations for Nurse Practitioners

      General

      • In which category does the state fall: NP independent practice, transition to independence, or collaboration required?
        • Transition to independence. APRNs must maintain CT licensure and collaborate for at least three years with a CT licensed physician (constituting no fewer than 2,000 hours of experience) before practicing independently.
          •  Such APRN shall maintain such documentation for a period of not less than three (3) years after completing such requirements and shall submit such documentation to the Department of Public Health for inspection not later than forty-five (45) days after a request made by the department for such documentation.
          • APRNs shall submit written notice to the Department of his or her intention to practice without a collaborative agreement after completing the requirements described above and prior to practicing without a collaborative agreement. Use the form here.
          • Regardless of whether an APRN is currently licensed in another state, an APRN must collaborate with a Connecticut licensed physician for the first three (3) years of licensed practice in Connecticut for a period of not less than three (3) years and for not less than two thousand (2,000) hours.

      Delegation Authority/Process

      • Is the agreement required?
        • Yes.
      • What form of agreement is required and its substance?
        • No state form required.
        • 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.
        • 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.
      • Where must the agreement be stored?
        • No restriction.
      • Does the agreement need to be filed with the state?
        • No. The Department of Public Health will not routinely collect copies of Collaborative Agreements, but NPs must provide the Department with such upon request.
      • Are there requirements to file the agreement after the initial filing?
        • No requirement.
      • Who must sign the agreement?
        • No specific requirement.
      • How often must the agreement be reviewed/reauthorized?
        • No requirement.
      • Qualifications for the collaborating provider (physician)
        • Physicians must have education, training, or relevant experience related to APRN’s work.
      • Qualifications for the NP
        • For general requirements, see here.
      • Is an alternate collaborating physician required?
        • No requirement.

      Collaboration Requirements

      • Are there ratios/limits on the number of NPs that a collaborator may supervise or enter into collaboration agreements?
        • No restriction.
      • Is there an express requirement to review a certain number/percentage of charts?
        • No restriction.
      • Is there a requirement to meet and, if so, how often and how?
        • No restriction.
      • Are there proximity or location-specific requirements?
        • No restriction.
      • Is remote supervision allowed/are there limitations on remote supervision?
        • No restriction.
      • Physician and NP filing requirements – outside of filing the collab agreement, must the physician and/or NP file any separate forms? (e.g., notice of delegation of prescriptive authority, notice of collaboration, notice to PDMP, etc.) NOTE: timing/frequency should be noted because the state may have requirements for initial filing and/or filing for updates, terminations, etc.
        • No separate forms required, outside of the collaboration agreement.
      •  What are the prescription requirements? (identifying collaborators on rxs, restrictions on certain categories of drugs that may or may not be scheduled [one area of concern right now is abortion-inducing medications], etc.)
        • No requirements.
      •     What are the requirements for controlled substance prescribing?
        •  The collaboration agreement must set forth which controlled substances the APRN may prescribe. Otherwise the same requirements apply for all practitioners in the state to prescribe controlled substances.

      Sources for Reference