Collaborative Practice Agreement · NP
Kentucky Collaborative Agreement for Prescriptive Authority (CAPA) for Nurse Practitioners
Required. The Collaborative Agreement for Prescriptive Authority (CAPA) is the written instrument Kentucky law names for a Nurse Practitioner working with a physician. Below: the board that governs it, what it must contain, and the terms it has to carry.
Diagnosis and treatment are never physician-supervised in KY — KBN's own legal opinion holds APRNs practice independently and are individually accountable. Only prescribing is agreement-gated, via two separately-timed, separately-exitable agreements (nonscheduled drugs vs. controlled substances) rather than one combined threshold.
Independent practice requires: ≥4 years prescribing nonscheduled legend drugs under a CAPA-NS in good standing exempts the NP from further CAPA-NS requirements (KRS 314.042); ≥4 years prescribing controlled substances under a separate CAPA-CS in good standing exempts the NP from further CAPA-CS requirements.
What a Kentucky Collaborative Agreement for Prescriptive Authority (CAPA) must contain
Governed by the Kentucky Board of Nursing and the Kentucky Board of Pharmacy. Each numbered item is a statutory requirement the agreement must satisfy.
Kentucky law does not require the Nurse Practitioner to practice under physician supervision for diagnosis or treatment. Prescribing, however, requires a written Collaborative Agreement for Prescriptive Authority ("CAPA") with the Physician under KRS 314.042: a CAPA for non-scheduled legend drugs ("CAPA-NS") for the Nurse Practitioner's first four (4) years of prescribing, after which the Nurse Practitioner may file notice with the Kentucky Board of Nursing and prescribe non-controlled legend drugs without a CAPA-NS; and a CAPA for controlled substances ("CAPA-CS"), required indefinitely for any Schedule II through V prescribing.
The Physician shall hold an active, unrestricted Kentucky medical license in the same or a similar specialty. While the CAPA-CS is in effect, the Physician and the Nurse Practitioner shall meet to review the Nurse Practitioner's reverse-KASPER report quarterly during the first year and biannually thereafter, and shall retain a written record of each meeting for one (1) year after the CAPA-CS expires. A current copy of each CAPA shall be kept on-site at every location where the Nurse Practitioner practices.
- The Collaborative Agreement for Prescriptive Authority (CAPA) on file also carries 1 scope, 1 education, 1 registration clauses, generated in the document itself.
Statutes and rules cited
- 201 KAR 2:220regulation
Establishes minimum requirements for the development and maintenance of collaborative care agreements between a pharmacist and a practitioner.
- KRS 315.010(4)statute
Chapter 315 definitions, including "collaborative care agreement."
Terms it has to carry
Ratio, proximity, chart review, meeting and prescribing terms the agreement has to carry, from the state's supervision rules.
Proximity
No proximity requirement
No physical-presence or availability standard is codified for clinical practice — diagnosis/treatment requires no supervising physician relationship at all. The CAPA-NS/CAPA-CS agreements themselves are paperwork/prescribing constructs; no mile/minute radius or on-site standard for the collaborating physician was found in KRS 314.042 or 201 KAR 20:057.
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
nonscheduled legend drugs, before 4 years under a CAPA-NS: Separate prescribing terms required · no controlled-substance authority
CAPA-NS required with a physician holding an active, unrestricted KY license in a same/similar specialty (KRS 314.042).
Schedule II–V controlled substances, before 4 years under a CAPA-CS: Separate prescribing terms required · controlled substances permitted
Requires individual DEA registration and KASPER (PDMP) master account enrollment in addition to a CAPA-CS with a physician in a same/similar specialty (KRS 314.042(11)).
after the applicable 4-year CAPA-NS/CAPA-CS threshold is met: Covered by the practice agreement · controlled substances permitted
The NP may notify KBN and discontinue the corresponding CAPA, prescribing independently within that drug category thereafter — the two categories are exited separately, not together.
Written agreement
Required
Branches by activity, not experience: an NP never needs any agreement to independently diagnose and treat patients. A written CAPA-NS is required only to prescribe nonscheduled legend drugs, and a separate CAPA-CS only to prescribe controlled substances — each can be independently discontinued after its own 4-year good-standing period (KRS 314.042).
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional LLC (KRS Ch. 275) or Professional Service Corporation (KRS Ch. 274) — 'nurses' are explicitly listed among the eligible professions in both chapters, so an NP may independently own a nursing-services PLLC/PSC. No physician ownership is required.
KY's PSC/PLLC statutes are commonly read to require single-profession ownership (KRS 274.015) rather than NC's/VA's explicit physician+APRN combination provisions — an NP-owned entity co-owned with a physician may not be a recognized single-PSC structure; treat as an open item pending KY-specific counsel.
About Kentucky's rules
KY's PSC/PLLC statutes (KRS Ch. 274, 275) are commonly read to restrict ownership to persons rendering the 'same or related' professional service — a physician generally cannot co-own a single PSC/PLLC with a PA or APRN, unlike NC/VA's explicit combination statutes. Secondary-sourced interpretation, not a confirmed ruling — verify before relying on it. Kentucky opted out of the federal Medicare CRNA supervision requirement in April 2012; facilities may still impose their own.
Other clinicians in Kentucky: see the state overview.