NP · Hawaii
Collaborative Practice Agreement for Nurse Practitioners in Hawaii
No. Nurse Practitioners practice independently here. Hawaii does not require one.
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 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
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)
What a collaborating physician costs here
Typical monthly cost in Hawaii
$500 – $600
Estimate for one Nurse Practitioner. Standard-tier state.
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.