SFBAPA CME

Summary of California State Laws for the Practice of PAs:

1. You must have a “delegation of services agreement” with all supervising physicians on file and readily available for view should an auditor come to your practice setting. DSA templates are available at CAPA’s website or at CA State Medical Board. These must detail your scope of practice, any and all procedures you are able to perform, including the reading and interpretation of any diagnostic tests. A DSA must also contain the following:

2. You must have a protocol detailing the management of any and all patietns you may encounter. These can be individually written out (for each individual disease or problem you may encounter in your practice- be aware that you are not allowed to see any patients with complaints not covered by this list), or you can site references from which you will be formulating your management of specific problems. References will be immediately available at your locations of practice. This information will be contained in your practice agreement. This list is in ADDITION to the DSA, with these protocols documented in the DSA.

3. You will have a listing of any and all drugs which you are allowed to prescribe including the dose, route, and indication. This information will be contained in your practice agreement. You are NOT permitted to order any drugs not covered in this protocol.

4. You are required to consult the supervising physician for pre-authorization for each individual patient each time you order a controlled substance. All drug orders for Schedule II controlled substances must have a cosignature.

5. PAs do not have "prescriptive" priviliges in California. They are, instead, allowed to write drug orders where the supervising physician has given the PA permission to act as his agent in the order. Staff and pharmacists fufill the orders as if they were written by the supervising physician. Any and all drugs which the PA may order are written out in the DSA as discussed above.

6. Co-signature must be on all Schedule II drug orders. All charts must be reviewed and co-signed by the supervising physician within 30 days for PAs citing references in their DSAs which act as management protocols. The supervising physician must review and co-sign 10% of all PA charts for those PAs whose DSAs contain problem-specific protocols for patient management made up by the institution, hospital, supervising physician and/or PA.

	California State Practice Guidelines for PAs:
	SFBAPA has summarized practice laws in the state of CA for those who need. Please be advised the all PAs looking to practice in CA should not use this as a complete guideline, and should read the CA State PA Committee practice booklet in its entirety for complete laws. It is availble online, free here.
	Summary of California State Laws for the Practice of PAs: 1. You must have a “delegation of services agreement” with all supervising physicians on file and readily available for view should an auditor come to your practice setting. DSA templates are available at CAPA’s website or at CA State Medical Board. These must detail your scope of practice, any and all procedures you are able to perform, including the reading and interpretation of any diagnostic tests. A DSA must also contain the following: 2. You must have a protocol detailing the management of any and all patietns you may encounter. These can be individually written out (for each individual disease or problem you may encounter in your practice- be aware that you are not allowed to see any patients with complaints not covered by this list), or you can site references from which you will be formulating your management of specific problems. References will be immediately available at your locations of practice. This information will be contained in your practice agreement. This list is in ADDITION to the DSA, with these protocols documented in the DSA. 3. You will have a listing of any and all drugs which you are allowed to prescribe including the dose, route, and indication. This information will be contained in your practice agreement. You are NOT permitted to order any drugs not covered in this protocol. 4. You are required to consult the supervising physician for pre-authorization for each individual patient each time you order a controlled substance. All drug orders for Schedule II controlled substances must have a cosignature. 5. PAs do not have "prescriptive" priviliges in California. They are, instead, allowed to write drug orders where the supervising physician has given the PA permission to act as his agent in the order. Staff and pharmacists fufill the orders as if they were written by the supervising physician. Any and all drugs which the PA may order are written out in the DSA as discussed above. 6. Co-signature must be on all Schedule II drug orders. All charts must be reviewed and co-signed by the supervising physician within 30 days for PAs citing references in their DSAs which act as management protocols. The supervising physician must review and co-sign 10% of all PA charts for those PAs whose DSAs contain problem-specific protocols for patient management made up by the institution, hospital, supervising physician and/or PA.
	iRefer to physicianassistant.ca.gov for complete laws
	*** * * * *** Be sure that you have not only a DSA in your file, but a DSA which includes practice protocols or a list of reference texts which act as your treatment protocols for patient problems, and a list of drugs which you are allowed to write orders for. Any disease or drugs not included in these protocols you are not permitted to see. Also be familiar with billing and law concerning PAs. Billing for your serives is very different than billing incident-to the physician's services and makes a dramatic impact on your practice and restrictions especially when your supervising physician is not physically present in the office with you. AFP has a great atricle about this issue: http://www.aafp.org/fpm/20011100/23thei.html