Practice Agreement · NP
Nurse Practitioner Practice Agreement in Hawaii
Hawaii law does not require a Nurse Practitioner to hold a named agreement with a physician. Practices still use one to define the working relationship; here is what it covers and what the state does require.
Hawaii APRNs are licensed as independent practitioners with no collaborative-agreement or physician-supervision requirement (HRS § 457-8.5, as amended by Act 045 (2014) implementing the APRN Consensus Model). Prescriptive authority is a distinct, separate application — not automatic.
What a Nurse Practitioner practice agreement covers in Hawaii
Governed by the Hawaii Board of Nursing and the Hawaii Board of Pharmacy. Each numbered item is a statutory requirement the agreement must satisfy.
Hawaii does not require the Nurse Practitioner to enter into a supervision or collaboration agreement with a physician. The Nurse Practitioner practices and prescribes, including Schedule II through V controlled substances, under the Nurse Practitioner's own license, consistent with Haw. Rev. Stat. §§ 457-2.7 and 457-8.5.
This Agreement's terms regarding the Nurse Practitioner accordingly serve to define the working relationship, referral pathways, and any Medical Director oversight between the Parties, and are not themselves required by Hawaii law as a condition of the Nurse Practitioner's authority to practice.
- The agreement on file also carries 1 scope, 1 education, 1 registration clauses, generated in the document itself.
Statutes and rules cited
- Haw. Rev. Stat. § 461-1statute
Defines 'collaborative agreement' and enumerates specific pharmacist functions performable under a Board-approved collaborative agreement (e.g., initiating emergency contraception drug therapy, dispensing an opioid antagonist).
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 supervising/collaborating physician relationship is required at all for clinical practice (HRS § 457-8.5).
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
Separate prescribing terms required · controlled substances permitted
Prescriptive authority (including the exclusionary formulary/controlled substances) requires a separate Board of Nursing application demonstrating advanced pharmacology training; it is not automatic upon APRN licensure and renews every 2 years (HRS § 457-8.6). 'separateAgreementRequired' here reflects that separate application, not a physician agreement.
Written agreement
Not required
Unconditional for clinical practice — Hawaii NPs never need a physician agreement to practice their full scope. Prescriptive authority is a separate Board of Nursing application (HRS § 457-8.6), not a physician-agreement gate.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional corporation under HRS § 415A-9 — nurses are among the healthcare professions explicitly eligible to form a professional corporation; non-licensees may not hold equity.
Legal sources for these rules (2)
About Hawaii's rules
Hawaii grants APRNs (NP/CRNA/CNM/CNS) full independent practice with no collaborative-agreement requirement (HRS § 457-8.5); prescriptive authority is a separate application, not automatic. Hawaii has no general corporate-practice-of-medicine statute — HRS § 415A-9 requires professional-corporation shareholders to be licensed, but doesn't clearly resolve multi-discipline (e.g. physician+APRN) ownership.
Other clinicians in Hawaii: see the state overview.