Collaborative Agreement
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PharmD · pathways

Where Pharmacists can practice independently, and what it takes

Three groups: full authority from licensure, conditional authority after a defined transition period, and supervision for the life of the practice.

Full practice authority (1)

Independent from licensure. A physician relationship is optional here.

Conditional independence (6)

Authority arrives after a transition period the statute defines. The conditions below are the feed's summary; each state page has the full rule and its source.

StateConditions for independent practice
CaliforniaAdvanced Practice Pharmacist (APh) recognition (Bus. & Prof. Code §4210): 2 of 3 criteria — board-recognized specialty certification, an accredited postgraduate residency (≥50% direct patient care), or ≥1 year of clinical services under a collaborative practice agreement — unlocks broader §4052.6 scope (assessments, ordering/interpreting tests, initiating/adjusting/discontinuing drug therapy); OR statutory furnishing authority (Bus. & Prof. Code §4052 and numbered subsections) available to ANY licensed pharmacist under a STATEWIDE protocol jointly developed by the Board of Pharmacy and Medical Board — not an individual physician relationship — covering naloxone (§4052.01), PrEP (§4052.02), PEP (§4052.03), hormonal contraceptives (§4052.3), and other enumerated categories (travel medications, immunizations, smoking-cessation products, epinephrine)
FloridaCertified under §465.1865 (collaborative pharmacy practice, chronic conditions) or §465.1895 (2020 'test and treat,' minor conditions), each requiring an executed written agreement/protocol with a supervising Ch. 458/459 physician
GeorgiaCertified for Drug Therapy Modification (O.C.G.A. §§ 26-4-50, 43-34-24) — physician must first diagnose and issue a written order/protocol; pharmacist adjusts only within that patient-specific protocol; OR certified for vaccine administration under a physician-issued protocol (§ 43-34-26.1) or, for pharmacy technicians specifically, under a supervising pharmacist for certain adult vaccines (§ 26-4-52); OR (eff. 7/1/2026) certified to prescribe/dispense PrEP/PEP under a statewide Board of Pharmacy protocol with physician oversight (S.B. 195, 2025-26 session); OR (protocol expected eff. 1/1/2027) certified to dispense hormonal contraceptives under a joint DPH/Board of Pharmacy protocol (H.B. 1138, signed 5/11/2026)
North Dakotaprescribing only from the specific statutory list of conditions/devices under N.D. Cent. Code § 43-15-31.6 (lice, cold sores, motion sickness, hypoglycemia, influenza/strep/COVID-19 after a positive point-of-care test, PEP, travel medicine after CE, emergency epinephrine/diphenhydramine, Lyme prophylaxis, certain devices) — this tier needs no physician agreement at all
New YorkCertified under §6801-a Collaborative Drug Therapy Management (CDTM) — facility-limited to teaching hospitals, general hospitals, and nursing homes with an on-site pharmacy; requires SED-approved credentialing (PharmD/MS + 2 yrs incl. 1 yr clinical, or BS + 3 of last 7 yrs incl. 1 yr clinical) plus residency training or board certification; OR certified as an immunizer (§§6801/6802/6909) with an SED certificate of administration, acting under a patient-specific physician/NP order OR a non-patient-specific statewide Commissioner standing order during public health threats
OhioConsult Agreement (Ohio Rev. Code §4729.39, OAC 4729:1-6-02) — per-patient, per-diagnosis drug therapy management with a physician/PA/CNS/CNM/CNP who already has an ongoing relationship with that patient for that diagnosis; valid up to 2 years; OR immunization authority (§4729.41) for ages ≥13 under a physician-established protocol; OR naloxone dispensing (§4729.44) under a physician- or local-health-board-established protocol (no statewide standing order in Ohio); OR (eff. 1/1/2026) epinephrine dispensing without a prescription (§4729.47) under a protocol established by a physician OR — per the 2025 'Global Signature' law, SB 196 — a CNM/CNS/CNP

Supervision required (45)

No experience- or hours-based pathway. The physician agreement lasts for the life of the practice.

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