Collaborative Practice Agreement · PharmD
North Dakota Collaborative Practice Agreement for Pharmacists
Recognized but not required in every case. The Collaborative Practice Agreement is the written instrument North Dakota law names for a Pharmacist working with a physician. Below: the board that governs it, what it must contain, and the terms it has to carry.
Uniquely tiered: § 43-15-31.6 grants pharmacists real independent prescribing for an enumerated list of conditions/devices with no physician agreement, while broader drug-therapy initiation/modification outside that list requires the written collaborative agreement under § 43-15-31.4 — see agreementRequiredNote.
Independent practice requires: prescribing only from the specific statutory list of conditions/devices under N.D. Cent. Code § 43-15-31.6 (lice, cold sores, motion sickness, hypoglycemia, influenza/strep/COVID-19 after a positive point-of-care test, PEP, travel medicine after CE, emergency epinephrine/diphenhydramine, Lyme prophylaxis, certain devices) — this tier needs no physician agreement at all.
What a North Dakota Collaborative Practice Agreement must contain
Governed by the North Dakota State Board of Pharmacy. Each numbered item is a statutory requirement the agreement must satisfy.
North Dakota permits the Pharmacist ("Pharmacist") to practice under a collaborative practice agreement with the Physician, on a form approved by the North Dakota State Board of Pharmacy and the North Dakota Board of Medicine, which authorizes the Pharmacist to initiate or modify the patient's drug therapy within the scope described in the agreement. Absent such an agreement, the Pharmacist may practice under the Pharmacist's own pharmacist license but may not initiate or modify a patient's drug therapy on the Physician's behalf.
Source: N.D.C.C. § 43-15-31.4
A copy of the collaborative practice agreement, and any subsequent amendment approved by the boards, shall remain on file with the North Dakota State Board of Pharmacy and the North Dakota Board of Medicine.
- The Collaborative Practice Agreement on file also carries 1 scope, 1 education, 1 registration, 1 authority clauses, generated in the document itself.
Statutes and rules cited
- N.D.C.C. ch. 43-12.1statute
North Dakota Nurse Practice Act, governing Nurse Practitioner and Registered Nurse licensure and practice.
- N.D.C.C. ch. 43-17statute
North Dakota Physician Assistant practice act.
- N.D.C.C. § 43-15-31.4statute
Authorizes a pharmacist to initiate or modify a patient's drug therapy under a collaborative practice agreement with a practitioner.
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
Not codified — left to the agreement
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
collaborative-agreement tier (drug therapy initiation/modification beyond the independent list): Separate prescribing terms required · no controlled-substance authority
Requires shared access to the patient's medical record and immediate notification of the collaborating physician/APRN whenever the pharmacist initiates or modifies drug therapy (§ 43-15-31.4(5)). No controlled-substance authority found under this tier.
independent statutory list (§ 43-15-31.6): Covered by the practice agreement · no controlled-substance authority
Limited to the enumerated conditions/devices in § 43-15-31.6; requires a bona fide patient-pharmacist relationship, a maintained assessment protocol, and notifying the patient's PCP within 3 business days. Therapeutic substitution (§ 43-15-31.7) is separately authorized but expressly EXCLUDES Schedule II controlled substances, antidepressants, antipsychotics, chemotherapy agents, biologics, and narrow-therapeutic-index drugs.
Written agreement
Not required
False reflects the § 43-15-31.6 independent-list tier, which needs no agreement. Broader prescriptive practice — initiating/modifying drug therapy outside that enumerated list — requires a written collaborative agreement with a physician or APRN under § 43-15-31.4, executed either individually or via a medical-director/pharmacist-in-charge umbrella agreement covering multiple providers.
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — No pharmacist-ownership requirement was confirmed this research pass — ND's pharmacy-specific ownership statute was not independently pulled; treat as an open item pending direct citation.
Not independently verified against primary source this research pass.
Legal sources for these rules (4)
- N.D. Cent. Code § 43-15-31.4 — Limited prescriptive practices under collaborative agreement
- N.D. Cent. Code § 43-15-31.5 — Drug administration authority
- N.D. Cent. Code § 43-15-31.6 — Independent statutory prescriptive authority
- N.D. Cent. Code § 43-15-31.7 — Therapeutic substitution
About North Dakota's rules
H.B. 1175 (2019, eff. 2020) and a 2022 rule amendment repealed ND's old PA supervision-contract/ratio/countersignature model — PAs are now CONDITIONAL only below 4,000 practice hours or outside a qualifying facility. All four APRN roles (NP, CRNA, CNM, CNS) are FULL independent practice with no collaboration agreement of any kind.
Other clinicians in North Dakota: see the state overview.