Although the majority of states allow all licensed pharmacists to participate in collaborative agreements, 18 states require specific training or training. These requirements range from relatively easy requirements, such as in Massachusetts, which requires only a PharmD degree or a BSPharm degree plus 5 years of experience, to the most demanding ones, such as in Maryland, which requires a PharmD or equivalent training; Certification as a specialist or completion of a residence, certification or examination training approved by a board of directors; Defined clinical experience and documented training in relation to the conditions of illness administered. CPAs are a lobbying priority for professional pharmacy organizations. In January 2012, the American Pharmacists Association (APhA) brought together a consortium of pharmacy, medical and care professionals from 12 countries to discuss the integration of CPAs into daily clinical practice.  The consortium published a white paper entitled “Consortium Recommendations for Advancing Pharmacists” Patients Care Services and Collaborative Practice Agreements and summarized their recommendations.  In the keynote address at the 2013 APH annual meeting, Reid Blackwelder, president of the American Academy of Family Physics (AAFP)  called for a “collaborative vision of public health.”  In the most recent analysis, NASPA examined several new factors related to cooperation agreements, as well as the factors examined in previous work. These parameters included benefits that could be authorized under the agreement, which pharmacists and practitioners could conclude, among other things, when initiating an agreement, patient participation and documentation requirements. The guidelines and legal requirements for the constitution of the CPA are defined on the basis of the state.  The federal government approved the CPAs in 1995.  Washington was the first state to pass laws allowing formal formation of CPAs. In 1979, Washington changed the practice of pharmaceutical requirements that provide for the formation of “collaborative drug therapy agreements.” [Citation required] Since February 2016, 48 states and Washington D.C have passed laws that allow the availability of CPAs.  The only two states that do not allow cpAs to be made available are Alabama and Delaware.  Alabama pharmacists hoped that a CPA law, House Bill 494, would be passed in 2015.
 The bill was introduced by Alabama House Of Representatives Representative Ron Johnson, but died in committee.  Among the terms used for services provided under a cooperation agreement is: CDTM is an extension of the traditional pharmacist practice that allows pharmacists to manage drug-related problems (DOP), focused on a collaborative and interdisciplinary approach to pharmacy practice in the health field. The conditions of a CPA are defined by the pharmacist and the cooperating physician, although models exist online. CPAs may be specific to a patient population of interest to both parties, a specific clinical situation or disease, and/or a factual protocol for managing the drug treatment of patients under CPA. CPAs have been the subject of intensive debate in pharmacy and medicine. The Pharmacist Status Act, introduced march 11, 2014 in the U.S. House of Representatives (H.R. 4190), defers the scope of statements for benefits that a pharmacist can provide and be compensated.
This legislation has paid even greater attention to the understanding of state variability in what pharmacists practice entails. In this context, the National Alliance of State Pharmacy Associations (NASPA) expanded the results of research conducted in early 2013 to further examine the variability between the provisions of government cooperation agreements.