PA Scope of Practice Series: California

Physician assistant (PA) scope of practice laws vary throughout the United States. Some have full, reduced, or restricted practice authority. Locum tenens PAs should pay attention to this series, where we outline physician assistant scope of practice by state.Here we are looking at the California physician assistant scope of practice. If you are looking for employment with Barton Associates, check out our physician assistant jobs in California.

Key Takeaways

Generally, the physician assistant scope of practice in California is more restrictive for PAs than in other states. The state dictates the majority of scope requirements, which does not allow the PA to practice independently.

Recent legislation has laxed the regulations for PAs. Physician assistants can practice with more autonomy overall. But they still work under a supervising physician. The state of California is a desirable travel destination, especially for locum tenens physician assistants.

Can physician assistants practice independently in California?

No, PAs in California must have a practice agreement with at least one licensed physician. These written agreements outline the policies, procedures, and the level of supervision required for the PA to practice. There have been changes to California legislature which relaxes some of the requirements for PAs.

Gov. Newsom signed Senate Bill 697 (SB 697) in 2019. This bill relaxed chart review and physician signature requirements. It also allowed physicians to create practice agreements with their PAs, as opposed to service agreements. This grants more freedom and flexibility to both parties when providing medical care.

PAs must have an active license in the state of California to practice. If you do not have a California license, it is possible to obtain one within, on average, 12-16 weeks. Here at Barton Associates, we have a dedicated licensing team that will assist you through the process.

Medical Staff Membership: Reduced

PAs in California generally do not qualify for medical staff membership. They fall under the Advanced Practice Professionals (APPs) category. An example is the University of California San Francisco Medical Center. While APPs are held to the same conduct as members, they are not eligible for medical staff membership.

Autonomous Practice: Reduced

Generally, PAs in California do not have autonomous practice authority. The facility approves a PA’s scope of practice in the facility based on criteria. These medical services include, but not limited to, the PA’s experience, education, and physician delegation.

• The state of California sets the PA scope of practice laws/regulations. But this key element gives the practice the sole determination of the scope of which they will allow the PA to practice.

PAs require physician collaboration to practice. This ensures the authorization and licensure of the medical team.

Because of SB 697, California does not require on-site or in-person physician oversight. It redefines “supervision” to not require the physical presence of the physician. Although they should be available through electronic communication.

Although there are no requirements for in-person supervision, there are required meetings for medical records. This meeting will go over 10 records per month for 10 months per year or 5% within 30 days of employment. This changes to 20% of the medical records within seven days if the patient receives schedule-II prescription.

Primary Care Provider: Reduced

PAs can practice as primary care providers under a practice agreement with a physician. They may be able to provide patient care and perform the majority of the basic procedures. But they may still have to report back to their supervising physician.

Physician Assistant Salary: $153,960

The Bureau of Labor Statistics reports that the annual mean wage for physician assistants was $153,960 as of May 2023.

Independently Prescribe Schedule II Drugs: Full

Yes, a physician assistant can prescribe schedule II-V controlled medications. A PA can prescribe medication within the bounds of their practice agreement.

• Examples of schedule II-V controlled substances include oxycodone, fentanyl, and hydromorphone, as well as all non-controlled medication.

Order Physical Therapy: Full

PAs can order physical therapy for their patients. They may still be subject to any supervision or practice agreements with their physician. Generally, there are no barriers for them to do so.

Sign Death Certificates: Restricted

Both PAs and nurse practitioners (NPs) cannot sign death certificates in California. Only the attending physician may sign death certificates. If they are unavailable then a covering physician may sign it.

POLST/POST/MOLST/MOST/COLST: Full

PAs have authorization to sign Physician Orders for Life-Sustaining Treatment (POLST) forms in California.

• POLST, or Physician Orders for Life-Sustaining Treatment, is a medical form that travels with the patient. They are for communicating your wishes as medical orders.

Editor’s Note: This article was originally written by the Barton Team in January 2022. It was updated by Desirae Sin in June 2024 to reflect current information.

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