Collaborating in Iowa

Review this information to understand how to successfully and compliantly collaborate in Iowa.

State Regulations for Nurse Practitioners


General

  • In which category does the state fall: NP independent practice, transition to independence, or collaboration required?
    • NP Independent Practice.

Delegation Authority/Process

  • Is an agreement required?
    • N/A
  • What form of agreement is required and what are the requirements for the substance of the agreement?
    • N/A
  • Where must the agreement be stored?
    • N/A
  • Does the agreement need to be filed with the state?
    • N/A
  • Are there requirements to file the agreement after the initial filing?
    • N/A
  • Who must sign the agreement?
    • N/A
  • How often must the agreement be reviewed/reauthorized?
    • N/A

Qualifications and Collaboration Requirements

  • What are the qualifications for the collaborating provider?
    • N/A
  • What are the qualifications for the NP?
    • Refer to 655 IAC 7.2.
  • Is an alternate collaborating physician required?
    • N/A

Collaboration Requirements

  • Are there ratios/limits on the number of NPs that a collaborator may supervise or enter into collaboration agreements?
    • N/A
  • Is there an express requirement to review a certain number/percentage of charts?
    • N/A
  • Is there a requirement to meet and, if so, how often and how?
    • N/A
  • Are there proximity requirements?
    • N/A
  • Are there location-specific requirements?
    • N/A
  • Is remote supervision allowed/are there limitations on remote supervision?
    • N/A
  • Physician and NP filing requirements
    • N/A

Filing Requirements and Prescription Guidelines

  • What are the prescription requirements?
    • N/A
  • What are the requirements for controlled substance prescribing?
    •  In addition to following the standards of practice for treating a patient described in rule 655-7.5(17A,147,152), an ARNP who prescribes or administers a controlled substance shall practice in accordance with the following:
      • The health history shall include a personal and family substance abuse risk assessment, or the documented rationale for not performing the assessment.
      • The health record must include documentation of the presence of one or more recognized indications for the use of a controlled substance.
      • An ARNP is encouraged to utilize a treatment agreement if continuously prescribing one or more controlled substances.
      • Throughout the course of the patient's treatment, the ARNP shall provide ongoing education that includes, but is not limited to, the risks of using a controlled substance, and information regarding addiction, physical dependence, substance abuse, and tolerance, or document the rationale for not providing the education.
      • An ARNP shall maintain an active Drug Enforcement Administration (DEA) registration and an active controlled substances Act (CSA) registration to dispense, prescribe, or administer controlled substances, when required by the DEA and the board of pharmacy.
      • An ARNP shall not prescribe a controlled substance to the ARNP's self or to a family member unless the prescribing occurs in a clinical setting when an emergency situation arises and when there is no other qualified practitioner available to the patient.
      • The board may discipline an ARNP for prescribing opioids in dosage amounts that exceed what would be prescribed by a reasonably prudent ARNP in a similar practice.
      • An ARNP who has prescribed opioids to a patient during the renewal cycle is required to complete a minimum of two contact hours of continuing education regarding the U.S. Centers for Disease Control and Prevention guideline for prescribing opioids for chronic pain, including recommendations on limitations on dosages and the length of prescriptions, risk factors for abuse, and nonopioid and nonpharmacologic therapy options, as a condition of license renewal every three years. These hours may count towards the 36 contact hours required for license renewal. The ARNP shall maintain documentation of these hours, which may be subject to audit.

Sources for Reference