Bill describes when clinical nurse specialists may practice without agreements

Licensed clinical nurse specialists who do not prescribe controlled drugs or devices may practice without a written or electronic agreement. This applies within the practice category for which the specialist is certified and licensed. They must stay within their training and experience, follow care standards, consult other providers based on each patient's condition, and plan referrals for complex cases and emergencies.

A clinical nurse specialist who prescribes controlled drugs or devices may practice without an agreement after 1,000 hours and an attestation. This applies to licensed clinical nurse specialists who prescribe controlled drugs or devices. Before reaching 1,000 hours, the specialist must practice under an agreement with a physician or a prescribing clinical nurse specialist who has practiced for at least two years. The attestation must confirm consultation under an agreement and state how long it lasted. Once practicing without an agreement, the specialist must consult and refer patients to other providers as appropriate. The 1,000 hours must be work as a prescribing clinical nurse specialist.