District of Columbia

Prior authorization requirements are up to the discretion of the state Medicaid program or insurance company.

The District of Columbia credentials two types of addiction counselors. A Certified Addiction Counselor I requires an associate degree and 500 hours of supervised experience. A Certified Addiction Counselor II requires a bachelor’s degree and 180 of supervised experience. D.C. Mun. Reg. Chapter 87 and District of Columbia Board of Professional Counseling Licensing

In the District of Columbia, licensed professional counselors (LPCs) conduct assessments for the purpose of determining treatment goals and objectives and assist clients through a professional relationship to achieve effective mental, emotional, physical, social, educational or career development and adjustment throughout the life span. Diagnostic ability is not outlined in statute. D.C. Municipal Regs. §17-6699

The certification standards for peer specialists are established by the municipal government. The municipal regulations include requirements for peer specialist qualifications, core competencies, training and examination, continuing education, revocation, and supervision. D.C. Mun. Regs. tit. 22, § A73, et seq

Full independent practice and prescriptive authority.

A CNM is a registered nurse prepared in a formal educational program to assume an expanded role in providing health care in the area of nurse midwifery services. CNMs, when functioning within the authorized scope of practice, are qualified to assume primary responsibility for the care of their patients. This practice incorporates the use of independent judgment as well as collaborative interaction with physicians or osteopaths.

A CNM shall have authority to prescribe legend drugs and controlled substances. D.C. Municipal Regs. §17-58

Full independent practice and prescriptive authority.

An NP trained in an educational program and certified by a recognized national certification organization to provide healthcare services who, when functioning within the authorized scope of practice, is qualified to assume primary responsibility for the care of patients. D.C. Municipal Regs. §17-5999.1

An NP may independently prescribe prescription drugs and Schedules II-V controlled substances. Prescriptions for drugs must comply with all applicable District of Columbia and federal laws. D.C. Municipal Regs. §17-5909

Advanced practice nurses may sign medical orders for scope of treatment (MOST). D.C. Code Ann. §21-2221.01-2221.15

NPs are not explicitly recognized in state policy as primary care providers.

Optometrists may only examine, diagnose and treat conditions of the visual system. D.C. Code Ann. §3–1201.02(10)(A)

Optometrists may only administer an epinephrine autoinjector for treatment of anaphylaxis. D.C. Code Ann. §3–1201.02(10)(A)

Optometrists may not prescribe controlled substances. D.C. Code Ann. §3–1201.02(10)(A)

The District of Columbia does not allow dental hygienists to practice with direct access.

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

The District of Columbia does not explicitly allow for the practice of teledentistry.

The District of Columbia has not enacted legislation allowing pharmacists to administer the COVID-19 vaccine. However, the federal PREP Act does allow pharmacists to administer the COVID-19 vaccine through the duration of the public health emergency.

The District of Columbia 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. Code of The District of Columbia §3–1202.08

The District of Columbia does not allow pharmacists to prescribe tobacco cessation aids.

Collaboration allowed with a physician for practice and prescriptive authority.

“Practice by physician assistants” means the performance, in collaboration with a licensed physician or osteopath, of acts of medical diagnosis and treatment, prescription, preventive health care, and other functions which are authorized by the Board of Medicine. D.C. CODE ANN. § 3-1201.02(13)

A written delegation agreement that lists delegated functions, practice sites and supervisors must be signed by the supervising physician(s) and the PA. D.C. MUN. REGS. tit. 17, § 4911

All PAs may perform those duties and responsibilities, including the ordering, prescribing, dispensing and administration of drugs and medical devices that are delegated by their supervising physician(s). Each prescription must bear the name of the supervising physician and PA. D.C. MUN. REGS. tit. 17, § 4999.1

Statute limits the number of PAs a physician may supervise.

A physician shall not actively supervise more than four (4) on-duty PAs at one time. D.C. MUN. REGS. tit. 17, § 4914.10

The District of Columbia does not currently have any provisions related to chart review or co-signatures.

Statute allows adaptable proximity.

A PA may perform health care tasks as long as the supervising physician is available by electronic communications or has designated a substitute supervising physician. D.C. MUN. REGS. tit. 17, § 4916

A written delegation agreement between the supervising physician and the physician assistant (PA) delegates functions, practice sites and supervisors.  The PA may perform health care tasks delegated by the supervising physician that are within the PA’s skills.  D.C. Municipal Regs. §17-4911, D.C. Municipal Regs. §17-4915