State flag California Scope of Practice Policy: State Profile

Education Required for Addiction Counselor Credentialing

California only credentials drug abuse treatment facilities. Individuals who wish to practice as an addiction counselor must receive a credential from an approved certification board. Each board requires the individual to complete education and experience requirements. The various credentials require a high school degree or higher. 9 Cal. Code of Reg. § 13035 and Cal. Health and Safety Code §11833

Licensed Professional Counselor Ability to Diagnose

Licensed professional clinical counselors in California may provide counseling interventions and psychotherapeutic techniques to identify and remediate cognitive, mental, and emotional issues, including personal growth, adjustment to disability, crisis intervention, and psychosocial and environmental problems. Diagnostic ability is not outlined in statute. Cal. Business and Professions Code §4999.20

Number of Nurse Practitioners Prescribing Buprenorphine

As of August 2018, 294 NPs in Caifornia have received a federal waiver to treat opioid dependency with buprenorphine-containing products. California law makes clear that NPs are not prohibited from furnishing buprenorphine-containing products as long as they do so in compliance with federal law meaning that a California NP, with proper training or appropriate experience and consistent with their prescriptive authority, can receive a federal waiver to dispense buprenorphine-containing products, as long as the collaborating or supervising physician is certified, trained, or permitted to treat and manage patients with opioid use disorder. Cal. Bus. & Prof. Code §2836.1 and Cal. Bus. & Prof. Code §2836.4

Number of Physician Assistants Prescribing Buprenorphine

As of August 2018, 102 PAs in California have received a federal waiver to treat opioid dependency with buprenorphine-containing products. California PAs may prescribe drugs and Schedules II-V controlled substances as delegated by a supervising physician. With proper training or appropriate experience a PA in California can receive a federal waiver to dispense buprenorphine-containing products, as long as the supervising physician is certified, trained, or permitted to treat and manage patients with opioid use disorder. Cal. Bus. & Prof. Code §3502.1

Peer Support Specialist Certification or Credentialing Authority

There are currently no statutory or regulatory requirements for the certification of peer support specialists. Some non-profit organizations provide credentialing programs involving education, experience requirements, and examinations.

Practice Authority

Nurse practitioners must have a standardized procedure or protocol in place that must be developed and approved by the supervising physician. Cal. Bus & Prof Code §2836.1.

Prescriptive Authority

Drugs or devices furnished by the NP must be ordered in accordance with the policies and protocols set forth in the agreement with the supervising physician. The NP may furnish drugs and devices within the NP’s area of practice. Physician involvement is required when the NP is furnishing Schedule II or III controlled substances, and a patient-specific protocol is required. Cal. Bus. & Prof. Code §2836.1

Nurse Practitioner as a Primary Care Provider

NPs are recognized in state policy as primary care providers. Primary care provider means a person responsible for coordinating and providing primary care to members, within the scope of their license to practice, for initiating referrals and for maintaining continuity of care. A primary care provider may be a primary care physician or nonphysician medical practitioner including a nurse practitioner, certified nurse midwife or physician assistant. 22 CCR §53810(gg)

Dental Hygienists with Direct Access

Registered dental hygienists in alternative practice (RDHAPs) must have a documented relationship with at least one licensed dentist for referrals, consultations, and emergency services. They are authorized to provide any services that do not require direct supervision of a dentist in personal residences of the homebound, nursing homes, hospitals, residential care facilities, schools, and other underserved areas. RDHAPs can provide services independently for 18 months, after which the patient must be seen by a licensed dentist or physician. The dentist may write a prescription valid for two years authorizing the RDHAP to continue providing dental hygiene services.Cal. Bus. & Prof. Code §1911, Cal. Bus. & Prof. §1922-1931

Dental Therapists

Statute does not identify dental therapists as an oral health provider.

Practice of Teledentistry

California Medicaid will reimburse for live video and store-and-forward teledentistry services. Cal. Welfare and Institutions Code §14132.72. and Denti-Cal Manual, Teledenistry, pg. 4-14

Prescription Adaptation

California does not allow pharmacists to modify prescriptions.

Prescription of Hormonal Contraceptives

A pharmacist must complete a training course in the subject area of hormonal contraception drug therapy and must include instruction in specific content areas. A written protocol for hormonal contraception drug therapy must be approved by the Board of Pharmacy. 16 Cal. Code of Reg. §1746.1

Prescription of Tobacco Cessation Aids

A pharmacist must complete a training course in the subject area of tobacco cessation drug therapy and must include instruction in specific content areas. A written protocol for tobacco cessation drug therapy must be approved by the Board of Pharmacy. 16 Cal. Code of Reg. §1746.1

Supervision Requirements

Supervision is determined at the practice level between the supervising physician and the PA. Written guidelines must be established between the PA and the physician to determine adequate supervision. Cal. Bus. & Prof. Code 3502(c)

Prescriptive Authority for Physician Assistants

A PA may prescribe drugs and Schedules II-V controlled substances with supervision and delegation from a physician. Cal. Bus. & Prof. Code §3502.1

Scope of Practice Determination

A PA may perform medical services as delegated by the supervising physician at the practice level. Cal. Bus. & Prof. Code §3502

California SOP Legislation

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