Education Required for Addiction Counselor Credentialing

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

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Licensed Professional Counselor Ability to Diagnose

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)

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Number of Nurse Practitioners Prescribing Buprenorphine

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

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Number of Physician Assistants Prescribing Buprenorphine

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

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Peer Support Specialist Certification or Credentialing Authority

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.

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Authority to Sign POLST Forms

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

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Practice Authority

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

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Prescriptive Authority

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

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Nurse Practitioner as a Primary Care Provider

NPs are recognized in state policy as primary care providers. Primary care means preventive, diagnostic, treatment, consultant, referral and other services rendered by physicians, physician assistants and nurse practitioners. N.C. Admin. Code §10A.39A.0102

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Authority to perform ophthalmic procedures

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

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Injectable Authority

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

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Prescription of controlled substances

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

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Dental Hygienists with Direct Access

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

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Dental Therapists

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

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Practice of Teledentistry

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. (Bill enacted in 2021. Statute not yet updated)

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Administration of COVID-19 Vaccine

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.

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Prescription Adaptation

North Carolina does not allow pharmacists to modify prescriptions.

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Prescription of Hormonal Contraceptives

North Carolina does not allow pharmacists to prescribe hormonal contraceptives.

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Prescription of Tobacco Cessation Aids

North Carolina does not allow pharmacists to prescribe tobacco cessation aids.

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Supervision Requirements

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

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Prescriptive Authority for Physician Assistants

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

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Scope of Practice Determination

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

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