Federal, state and local responses to COVID-19 are changing almost daily. To help PAs and other healthcare providers navigate through this dynamic environment, CAPA has assembled the latest news, research and developments surrounding COVID-19 that are most relevant to advanced practice providers. Click below for more information. You may also follow CAPA on social media for the latest developments.
Health care providers should contact their local/state health department immediately to notify them of patients with fever and lower respiratory illness who they suspect may have COVID-19. Local and state public health staff will determine if the patient meets the criteria for testing for COVID-19. The state and local health department will assist clinicians to collect, store, and ship specimens appropriately, including during afterhours or on weekends/holidays. Testing for other pathogens by the provider should be done as part of the initial evaluation but should not delay testing for COVID-19.
If a PA wishes to practice in any state, they would need to comply with licensure requirements for that state. There may be states that are waiving specific licensure requirements for PAs licensed in other states due to various orders or declarations related to COVID-19. However, that will depend on each individual state. PAs will need to look into the requirements for the state where they wish to volunteer. The FSMB has provided a good resource on states that have issued various waivers related to state licensure. http://www.fsmb.org/siteassets/advocacy/pdf/state-emergency-declarations-licensure-requirement-covid-19.pdf
If the hospital/practice allows the PA to volunteer, they may do so. But the PA still needs a supervising physician. While not specified in law, the volunteering PA ought to document everything, i.e. who the supervising physician is/was, and all the work they did with each patient – much like they would normally do in their daily practice. Under the emergency statute BPC, Section 3502.5, the PA does not need to have the hospital where they are volunteering draft up a new practice agreement. Having a supervising physician available complies with the statute. You may also sign up as a volunteer for your county using the following link: https://healthcarevolunteers.ca.gov/ If the county finds they need volunteers, they pull from the list of medical providers that have signed up via this website.
There do not appear to be any laws or regulations in California dictating the specificity of telehealth apps that PAs can use. Distant site practitioners who can furnish and get payment for covered telehealth services can include physicians, nurse practitioners, physician assistants, nurse midwives, certified nurse anesthetists, clinical psychologists, clinical social workers, registered dietitians, and nutrition professionals. https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet
We recommend that you show the information below with the appropriate legal advisors within your facility to determine your scope. We have included an excerpt from the California Business and Professions Code regarding medical services during a state of emergency:
BPC, Section 3502.5 Excerpt from the PA Practice Act
Notwithstanding any other provision of law, a physician assistant may perform those medical services permitted pursuant to Section 3502 during any state of war emergency, state of emergency, or state of local emergency, as defined in Section 8558 of the Government Code, and at the request of a responsible federal, state, or local official or agency, or pursuant to the terms of a mutual aid operation plan established and approved pursuant to the California Emergency Services Act (Chapter 7 (commencing with Section 8550) of Division 1 of Title 2 of the Government Code), regardless of whether the physician assistant’s approved supervising physician is available to supervise the physician assistant, so long as a licensed physician is available to render the appropriate supervision. “Appropriate supervision” shall not require the personal or electronic availability of a supervising physician if that availability is not possible or practical due to the emergency. The local health officers and their designees may act as supervising physicians during emergencies without being subject to approval by the Medical Board of California. At all times, the local health officers or their designees supervising the physician assistants shall be licensed physicians and surgeons. Supervising physicians acting pursuant to this section shall not be subject to the limitation on the number of physician assistants supervised under Section 3516.