Requirements of Supervisory Practice Agreements

Regardless of the professional (NP or PA), a written supervisory agreement is required.  This document describing the practice arrangement is called “Collaborative Practice Agreement” (CPA) for NPs and “Supervisory Arrangement” for PAs.  It is a written document developed and agreed upon by the supervising physician and NP/PA that includes the drugs, devices, medical treatment, tests and procedures that may be prescribed, ordered and performed by the NP/PA, along with a pre-determined plan for emergency services.  A copy of the CPA or Supervisory Arrangement must be maintained at each practice site and reviewed annually.  Neither the NC Medical Board nor the Joint Subcommittee of the Medical Board and Board of Nursing require one specific format that the PA or NP must use.  However, each agreement must address how the NP/PA and supervising physician will operationalize NP/PA rules in that practice to comply with the administrative code/rules.

All Practice Agreements (CPA or Supervisory Arrangement) must include these common elements:

  1. General statements regarding what both parties (Physician and NP/PA) are agreeing to do
  2. Availability of Physician and arrangement for backup physician
  3. Population to be treated
  4. List of medications that can be prescribed including controlled substances
  5. Specific duties
  6. Emergency plans
  7. Quality improvement
  8. Mode of supervision

Examples of Supervisory Practice Agreements:

Sample Collaborative Practice Agreement for Physician Assistant

Sample Collaborative Practice Agreement for Nurse Practitioner

Requirements for Professional Licensure >>

Medical and Nursing Board Requirements >>

Hiring, Training, and Supervision >>

Liability Implications of Supervision >>

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