California

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. Cal. Health and Safety Code §11833

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

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

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

The law specifies that Medi-Cal Peer Support Specialist Certification Programs can be established either by counties, or an agency representing counties. The California Behavioral Health Directors’ Association has identified the California Mental Health Services Authority (CalMHSA) as the entity that will represent counties for the implementation of a State-approved Medi-Cal Peer Support Specialist Certification Program, to support consistency statewide. CalMHSA, on behalf of the counties they represent, and any other counties that seek to implement their own Medi-Cal Peer Support Specialist Certification Program, must adhere to the state standards set forth in Behavioral Health Information Notice (BHIN) 21-041. Cal. W&I §14045.14

Full independent practice authority for low-risk pregnancies but physician relationship required for prescriptive authority.

NMs may practice independently for “low-risk” pregnancies. The certificate to practice nurse midwifery authorizes the holder to attend cases of low-risk pregnancy and childbirth and to provide prenatal, intrapartum, and postpartum care, including interconception care, family planning care, and immediate care for the newborn.

If the pregnancy does not meet the definition of “low-risk,” a physician relationship is required. The NM must practice with a physician and surgeon under mutually agreed-upon policies and protocols that delineate the parameters for consultation, collaboration, referral, and the transfer of the patient’s care signed by both the NM and physician and surgeon. Cal. Bus. & Prof. Code §2746.5

NMs are authorized to provide and order drugs, and medical devices including controlled substances (Schedule II-V) only under the supervision of a physician and when directed by the standardized procedures or protocols developed by the supervising physician and the midwife. Cal. Bus. & Prof. Code §2746.51

Transition to independent practice and prescribing period required.

NPs may apply to practice independently after completing the transition to practice requirement of three years or 4,600 hours. Prior to three years or 4,600 hours, NPs must practice pursuant to standard operating procedures which specifies scope and extent of supervision. Cal. Bus. & Prof. Code §2836.1

If approved, the NP may independently prescribe, order, dispense, procure or furnish pharmacological agents including controlled substances. Schedules II-V are allowed but Schedule II authority requires the completion of extra continuing education requirements. Cal. Bus. & Prof. Code §2837

NPs are authorized to sign POLST forms under the supervision of a physician if its within the scope of practice authorized by law. Cal. Prob. Code §4780(c)

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 Cal. Code of Reg. §53810(gg)

Optometrists may only perform procedures related to foreign body removal and the examination, evaluation, diagnosis and treatment of the human eye. Additional allowable procedures are authorized by statute. Cal. Bus. & Prof. Code §2-7-3041

Optometrists may administer all pharmaceutical agents for the diagnosis and treatment of eye diseases, including epinephrine auto-injections to counter anaphylaxis. Optometrists may administer vaccines. Cal. Bus. & Prof. Code §2-7-3041(d) and Cal. Bus. & Prof. Code §2-7-3041(g)

Optometrists may prescribe Schedule III-V controlled substances and also Schedule II hydrocodone or hydrocodone combination medications. Cal. Bus. & Prof. Code §2-7-3059(e)

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 and Cal. Bus. & Prof. Code §1922-1931

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

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

Pharmacists may administer any COVID-19 vaccines approved or authorized by the federal Food and Drug Administration. Pharmacists may also administer vaccines listed on the routine immunization schedules recommended by the federal Advisory Committee on Immunization Practices and published by the federal Centers for Disease Control and Prevention (CDC) for persons three years of age and older.

Pharmacists must complete an immunization training program endorsed by the CDC or the Accreditation Council for Pharmacy Education, be certified in basic life support and comply with all state and federal recordkeeping and reporting requirements. Cal. Bus. & Prof. Code §4052.8

California does not allow pharmacists to modify prescriptions.

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

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. §1746.2

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)

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

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