State Overview: Northern Mariana Islands

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Diagnostic ability is not outlined in statute but is defined in administrative code.

Licensed professional counselors assess and diagnose patients using counseling and psychotherapy methods to treat mental and emotional disorders. Commonwealth Admin. Code § 185-10-4601(k)

Physician relationship required for practice and prescriptive authority.

The practice of nurse-midwifery constitutes the furthering or undertaking by any certified person, under the supervision of a licensed physician and surgeon who has current practice or training in obstetrics, to assist a woman in childbirth so long as progress meets criteria accepted as normal. All complications shall be referred to a physician immediately.

Written protocols shall be developed by the nurse-midwife and agreed upon by the physician or protocols may be jointly developed by the nurse-midwife and the physician. Northern Mariana Islands Admin. Code § 185-20.2

Full independent practice and prescriptive authority.

NPs may practice independently from a physician or in collaboration with a physician. Northern Mariana Islands Admin. Code § 185-20.2

NPs may prescribe drugs, devices and Schedule II-V controlled substances if prescriptive authority is granted by the Commonwealth Board of Nurse Examiners. Northern Mariana Islands Admin. Code § 185-20.2

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NPs are recognized in state policy as primary care provider. Northern Mariana Islands Admin. Code § 185-20.2

Full independent practice and prescriptive authority.

CRNAs may practice independently from a physician or in collaboration with a physician. Northern Mariana Islands Admin. Code § 2304(a)(7)

CRNAs may prescribe drugs, devices and Schedule II-V controlled substances if prescriptive authority is granted by the Commonwealth Board of Nurse Examiners. Commonwealth Admin. Code § 185-20.1-415

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Dental hygienists may not deliver services independent of a dentist except if they are employed by the Commonwealth Healthcare Corporation may independently provide educational and preventive oral health services if the services are provided as part of a public oral health program for children. Northern Mariana Islands Admin. Code §185-10

Dental therapists must work under the supervision of a dentist and may provide certain preventative and restorative services. Northern Mariana Islands Admin. Code § 185-10

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The physician assistant may only provide those medical services which:

1. He/she is competent to perform as determined by the supervising physician;
2. Are consistent with his or her education, training, and experience; and
3. Are delegated in writing by the supervising physician responsible for the patients cared for by the physician assistant.

A supervising physician shall delegate to a physician assistant only those tasks or procedures consistent with the supervising physician's specialty or usual and customary practice.
185 Northern Mariana Islands Admin. Code §185-10-4115

The supervising physician may allow the physician assistant to make prescription drug orders, prescribe, dispense, and/or administer medications and medical devices to the extent described in the written practice agreement. In general this includes Schedule III-V and Schedule II may be requested if certain requirements are met. 185 Northern Mariana Islands Admin. Code §185-10-4130

A supervising physician shall petition the Board if he or she wishes to supervise more than two full-time physician assistants or the equivalent of two full-time physician assistants.
185 Northern Mariana Islands Admin. Code §185-10-4125(a)(7)

The practice agreement, at a minimum, shall:

Provide for the supervising physician's review and signature of records, as follows:

• (i) A minimum of 5% of all patient encounters by the physician assistant that do not involve a controlled substance will be reviewed and signed within thirty calendar days;
• (ii) A minimum of 10% of all patient encounters by the physician assistant that involve a prescription drug order, prescribing, dispensing or administering of Schedule III-V controlled substances must be reviewed and signed within thirty calendar days;
• (iii) A minimum of 15% of all patient encounters by the physician assistant that involve a Schedule II controlled substance must be reviewed and signed within seven days; and
• (iv) The Board may require that up to 100% of all patient encounters by a physician assistant be reviewed and signed by a supervising physician.
• (6) Describe the method by which a supervising physician will comply with the chart review requirements. The Board, may, at any time, request proof of compliance with this chart review requirement. Non-compliance may result in termination by the Board of a practice agreement;

185 Northern Mariana Islands Admin. Code §185-10-4120(a)(5),(6)

The Commonwealth of the Northern Mariana Islands does not explicitly allow adaptable proximity.

The supervising physician may delegate the services a PA may perform. The medical services must consistent with the PAs education, training and experience. Northern Mariana Islands Admin. Code §185-10