Enrichment Materials — Deep Dive Resources
Peer-reviewed evidence supporting collaborative practice models
Statutory and regulatory foundations governing collaborative practice
However, federal programs establish requirements that affect collaborative practice:
The Consensus Model recommends:
Adoption Status: As of 2026, 27+ states have adopted full practice authority consistent with the Consensus Model. Others maintain reduced or restricted practice frameworks.
The IMLC streamlines physician licensing across state lines but does NOT harmonize NP scope of practice rules. Key implications:
General principles:
Detailed requirements by practice authority category
| Schedule | Full Practice | Reduced Practice | Restricted Practice |
|---|---|---|---|
| II (e.g., stimulants) | Generally independent | May require collaboration | Physician involvement typical |
| III-V (e.g., buprenorphine) | Independent with DEA | Varies by state | May require co-signature |
| MOUD (X-waiver) | Independent prescribing | Generally permitted | May require oversight |
Note: Federal X-waiver requirements apply nationwide. State-specific restrictions may add additional requirements. Always verify current DEA and state regulations.
Interactive checklists for establishing and maintaining compliant collaboration
Sample language for collaborative practice agreements
This Collaborative Practice Agreement ("Agreement") is entered into between:
[PHYSICIAN NAME], MD/DO, License #[NUMBER], DEA #[NUMBER]
("Collaborating Physician")
and
[NP NAME], PMHNP-BC, License #[NUMBER], DEA #[NUMBER]
("Advanced Practice Registered Nurse")
Effective Date: [DATE]
Term: [ONE YEAR] with annual renewal
Termination: Either party may terminate with [30/60/90] days written notice.
The APRN is authorized to: • Conduct psychiatric evaluations and assessments • Diagnose mental health and substance use disorders • Develop and implement treatment plans • Prescribe medications per state law and this agreement • Provide psychotherapy and counseling services • Order and interpret laboratory and diagnostic tests • Refer patients to specialists and community resources The APRN is NOT authorized to: • [List specific exclusions based on state law and practice needs] • Manage medical conditions outside psychiatric scope • [Any other practice-specific limitations]
The APRN shall consult with the Collaborating Physician for: 1. First-episode psychosis or mania requiring hospitalization consideration 2. Clozapine initiation or management 3. Lithium initiation in patients with renal or thyroid comorbidity 4. MOUD in pregnancy (first trimester especially) 5. Involuntary commitment or emergency petition 6. Polypharmacy exceeding 4 psychotropics 7. Treatment-resistant depression considering ECT or ketamine 8. Diagnostic uncertainty after 3+ visits 9. Any adverse event requiring incident reporting 10. Patient with active malpractice history against prior provider [Customize based on practice needs and state requirements]
Chart Review: • Frequency: [10/15/20]% of APRN charts monthly • Method: [Random sampling / systematic review] • Documentation: Written or electronic sign-off with date Case Conference: • Frequency: [Weekly / Bi-weekly] • Duration: [30-60 minutes] • Documentation: Meeting minutes or attendance log Response Time: • Urgent clinical questions: Within [2] hours • Routine questions: Within [24] hours • Method: [Secure messaging / phone / in-person]
Disclaimer: This template is for educational purposes only. Have a healthcare attorney review and customize for your specific state, practice, and circumstances.
Resources to support collaborative practice implementation
Spreadsheet template for logging all physician consultations, including date, trigger, resolution, and time metrics.
Download Template →Excel/Google Sheets dashboard for tracking escalation frequency, response times, and adverse events over time.
Download Template →Multi-state practice tracking spreadsheet with requirements by state, last updated dates, and renewal reminders.
Download Template →Standardized form for documenting chart reviews, including findings, recommendations, and follow-up actions.
Download Template →Template for structuring weekly case conferences, including time allocations and documentation sections.
Download Template →Link to the authoritative source for state-by-state practice environment updates and regulatory changes.
Visit AANP →Complete citations for all sources cited in the guide and presentation
PMHNP Collaboration Best Practices — Enrichment Materials
Clinical Operations Guide | March 2026
This document is for educational purposes only and does not constitute legal advice. Consult a healthcare attorney for guidance specific to your practice and jurisdiction.