North Carolina

North Carolina credentials two types of addiction counselors. A Certified Substance Abuse Counselor requires, at minimum, a high school diploma, 270 hours of relevant education courses and 6,000 hours of experience. A Licensed Clinical Addictions Specialist requires a master’s degree and there are multiple paths to achieve the credential depending on education, experience and additional credentials. N.C. Gen. Stat. §90-113.30 and North Carolina Substance Abuse Professional Practice Board

Licensed professional counselors assist individuals, groups, and families through the counseling relationship by evaluating and treating mental disorders and other conditions. Counselors use of a combination of clinical mental health and human development principles, methods, diagnostic procedures, treatment plans and other psychotherapeutic techniques, to develop an understanding of personal problems, to define goals, and to plan action reflecting the client’s interests, abilities, aptitudes and mental health needs. N.C. Gen. Stat. §90-330(3)

As of August 2018, 188 NPs in North Carolina have received a federal waiver to treat opioid dependency with buprenorphine-containing products. Consistent with their prescriptive authority and with proper training or appropriate experience NPs can receive a federal waiver to dispense buprenorphine-containing products, as long as the collaborating or supervising physician is certified, trained, or permitted to treat and manage patients with opioid use disorder. N.C. Admin. Code §21-36.0809

As of August 2018, 81 PAs in North Carolina have received a federal waiver to treat opioid dependency with buprenorphine-containing products. A North Carolina PA may prescribe controlled substances as delegated by a written supervisory agreement with a supervising physician. North Carolina PAs with proper training or appropriate experience can receive a federal waiver to dispense buprenorphine-containing products, as long as the collaborating or supervising physician is certified, trained, or permitted to treat and manage patients with opioid use disorder. N.C. Admin. Code §21.32S.0212

The standards for the certification of peer support specialists, including experience, training, and supervision requirements, are developed and administered by a third-party, non-profit certification provider.

Physician relationship required.

A midwife may practice midwifery in a hospital or non-hospital setting and shall practice under the supervision of a physician licensed to practice medicine who is actively engaged in the practice of obstetrics.

A CNM is authorized to prescribe Schedules II-V if it is outlined in a collaborative practice agreement with the supervising physician. N.C. Admin. Code §21-36 .0809

Collaborative practice agreement required between the NP and the supervising physician.

The agreement must establish minimum standards of consultation and must be reviewed yearly. N.C. Admin. Code §21-36.0810

The drugs and devices an NP may prescribe must be outlined in the collaborative practice agreement. Schedules II-V controlled substances may be prescribed if outlined in the agreement. N.C. Admin. Code §21-36.0809

NPs are authorized to sign medical orders for scope of treatment forms. NC Gen. Stat. §90-21.17

NPs are not explicitly recognized in state policy as primary care providers.

Optometrists may only perform procedures related to foreign body removal and the examination, evaluation, diagnosis and treatment of the human eye. Additional allowable procedures may be authorized by statute and/or rule. N.C. Stat. Ann. §90-114

Optometrists may use injectables to treat abnormal conditions of the human eye and administer the COVID-19 vaccine. N.C. Stat. Ann. §90-114 and E.O. 211

Optometrists may prescribe Schedule III-V controlled substances and also Schedule II hydrocodone or hydrocodone combination medications. N.C. Stat. Ann. §90-114

North Carolina does not allow dental hygienists to practice with direct access.

Statute does not identify dental therapists as an oral health provider.

Teledentistry services may be delivered by a licensed dentist or a licensed dental hygienist who is under the supervision of a licensed dentist. Licensees shall comply with all rules of professional conduct and applicable State and federal law relevant to licensed dentists and licensed dental hygienists when delivering teledentistry services. N.C. Gen. Stat. §90-30.2

North Carolina has not enacted legislation allowing pharmacists to administer the COVID-19 vaccine. However, the federal PREP Act does allow pharmacists to administer the COVID-19 vaccine through the duration of the public health emergency.

North Carolina does not allow pharmacists to modify prescriptions.

An immunizing pharmacist may dispense, deliver or administer self-administered oral or transdermal contraceptives after the patient completes an assessment consistent with the Centers for Disease Control and Prevention’s United States Medical Eligibility Criteria (US MEC) for Contraceptive Use. An immunizing pharmacist shall not dispense, deliver or administer ulipristal acetate for emergency contraception without  a prescription from a prescriber licensed under this chapter. The immunizing pharmacist must maintain a record of medication administered to the patient in a patient profile and within 72 hours after administration of the medication, notify any primary care provider identified by the patient. Additional required documentation and counseling is identified in statute.  NC Gen. Stat. §90-85.15B

An immunizing pharmacist may dispense, deliver or administer Nicotine replacement therapy that is approved by the United States Food and Drug Administration. The immunizing pharmacist must maintain a record of medication administered to the patient in a patient profile and within 72 hours after administration of the medication, notify any primary care provider identified by the patient. Additional required documentation and counseling is identified in statute.  NC Gen. Stat. §90-85.15B

A physician assistant may perform medical acts, tasks, or functions under the continuous supervision of a physician. The supervising physician does not need to be onsite at the time and place that the services are rendered. N.C. Admin. Code §21.32S.0213

A PA may prescribe drugs, devices and controlled substances if delegated in the written supervisory agreement. N.C. Admin. Code §21.32S.0212

The PA and the supervising physician determine the PA’s scope of practice on-site. The delegation of medical tasks must be appropriate to the skills of the supervising physician as well as the PA’s level of competence. N.C. Admin. Code §21.32S.0212