CNS · Hawaii
Supervision Agreement for Clinical Nurse Specialists in Hawaii
No. Clinical Nurse Specialists practice independently here. Hawaii does not require one.
Hawaii licenses CNSs as APRNs with the same independent-practice status as NP/CRNA/CNM (HRS § 457-8.5) — no collaborative-agreement requirement. CNS licensure requires either 600 practice hours over 2 years or 1,500 hours over 5 years, or recent graduation from a specialty program.
What the supervision 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-physician relationship required 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
Same separate-application framework as other APRNs (HRS § 457-8.6); whether Hawaii CNS practice commonly includes independent prescribing was not separately confirmed in this research pass.
Written agreement
Not required
Unconditional for clinical practice — same as the general `np` entry.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional corporation under HRS § 415A-9; non-licensees may not hold equity.
Legal sources for these rules (1)
What a supervising physician costs here
Typical monthly cost in Hawaii
$500 – $600
Estimate for one Clinical Nurse Specialist. 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.