With the PNCC no longer a member of the Union of Utrecht, the Union's International Bishops Conference asked the Episcopal Church, its ecumenical partner in the United States, to initiate discussions among various Old Catholics concerning how they identify as Old Catholics, the ecclesiology of various Old Catholic bodies, and whether these various churches ordain women. The Episcopal Church, after having gathered this information, reported to the IBC, the summary of the various experiences of those Old Catholic churches that responded. The report was given at the annual meeting of the IBC in August 2005. The IBC asked the Episcopal Church to host a consultation of these American bishops.

In May 2006, four American Old Catholic bishops gathered at the Bethsaida Spirituality Center in Queens Village, New York. These four bishops were the Most Rev. Peter Hickman, the Most Rv. Peter Paul Brennan, the Most Rev. Charles Leigh, and the Most Rev. Robert T. Fuentes. Along with these four bishops, also in attendance was the liaison of the Episcopal Church to the IBC, the Rt. Rev. Michie Klusmeyer, Bishop of West Virginia, the deputy for ecumenical and interfaith relations, Dr. Tom Ferguson, and Fr. Bjorn Marcussen, an Episcopal priest who had been ordained in the Old Catholic Church of Austria and who is an Old Catholic theologian. The IBC sent as a representative to this consulation, Fr. Gunther Esser, Director of Old Catholic Studies at the University of Bonn, Germany.

Key to the discussions was the ecclesiology of the Old Catholic Church, highlighted in the Preamble to the Statutes of the International Bishops Conference. After three days of discussions, the American bishops agreed to the formation of the Conference of North American Old Catholic Bishops, agreeing to pattern itself after the IBC. The CNAOCB has as its central goal the tangible, organic unity among American Old Catholic jurisdictions. The bishops also agreed to meet at least twice a year.

In November 2006, the bishops who remained engaged to the development and formation of the CNAOCB, met in Los Angeles, to develop the Conference's Unity Statement, to fashion its rules of order, and to set forth the criteria for joining the Conference itself. The Unity Statement, which incorporated the ecclesiological understanding of the Union of Utrecht and to which all members subscribe.