CNS · Delaware
Collaborative Practice Agreement for Clinical Nurse Specialists in Delaware
Yes, a written physician agreement is required. Delaware does not name a specific instrument.
Same statewide APRN transition rule as NP/CRNA/CNM (24 Del.C. § 1906(20); 24 DE Admin. Code 1900 § 8.0) — unlike Virginia, Delaware's CNS independence turns on the same hours/experience threshold as other APRN roles, not on a prescribing/non-prescribing scope distinction; this uniform treatment across roles is an inference, not independently confirmed for CNS specifically.
Independent practice requires: ≥2 years of collaborative practice; ≥4,000 hours of clinical practice with a physician or experienced APRN.
What the collaboration must look like
The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.
Proximity
below the 2-year/4,000-hour transition threshold: Available remotely (no on-site requirement)
No codified mile/minute radius or on-site requirement found.
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
Covered by the practice agreement · controlled substances permitted
Prescriptive authority is granted generically upon APRN licensure; whether Delaware CNS practice commonly includes independent prescribing in the way NP/CNM practice does was not separately confirmed in this research pass.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional (service) corporation under 8 Del.C. Ch. 6, owned by nursing licensees; non-licensees may not hold equity.
Legal sources for these rules (2)
What a collaborating physician costs here
Typical monthly cost in Delaware
$500 – $600
Estimate for one Clinical Nurse Specialist. Standard-tier state.
About Delaware's rules
Delaware grants full independent practice to APRNs (NP/CRNA/CNM/CNS) after a uniform 2-year/4,000-hour transition period (24 Del.C. § 1906(20); 24 DE Admin. Code 1900 § 8.0) — this research pass treats that rule as applying identically across all four APRN roles; confirm role-specific nuance with the Board of Nursing before relying on it. PAs have no independent-practice pathway.
Other clinicians in Delaware: see the state overview.