(A) Upon issuance of a provisional certificate to prescribe, the physician assistant is authorized to participate in a provisional period of physician-delegated prescriptive authority.
(B) The provisional period shall be conducted under the supervision of one or more supervising physicians with whom the physician assistant has a board-approved supervisory agreement.
(1) One supervising physician shall be designated as the primary supervising physician and shall have the primary responsibility for verifying the provisional period.
(2) The primary supervising physician shall, at all times during the provisional period, hold a certificate to practice medicine and surgery issued by the board pursuant to Chapter 4731. of the Revised Code that is not subject to restrictions, limitations, or probationary conditions and an unrestricted registration with the federal drug enforcement administration.
(C) The provisional period shall require a minimum of one thousand hours and a maximum of one thousand eight hundred hours, and last for at least six months but not longer than twelve months, except when a supervising physician has extended the provisional period for no longer than another twelve months.
(1) The first five hundred hours of the provisional period shall be under the on-site supervision, as that term is defined in rule 4730-1-01 of the Administrative Code, of one or more supervising physicians.
(2) The remaining hours of the provisional period may be conducted under off-site supervision, as that term is defined in rule 4730-1-01 of the Administrative Code, or the level of supervision specified by the supervising physician. With the consent of the supervising physician, physician assistants who have been granted physician delegated prescriptive authority in another jurisdiction may show proof of having met this requirement by providing an affidavit from their supervising physician licensed in that state that authorizes physician-delegated prescriptive authority for physician assistants stating that the physician assistant has completed one thousand hours of supervised prescribing.
(D) During the course of the provisional period, each supervising physician who supervises the physician assistant in the exercise of physician-delegated prescriptive authority shall review and evaluate the physician assistant's competence, knowledge, and skill in pharmacokinetic principles and the application of these principles to the physician assistant's area of practice. The review and evaluation shall be documented by the supervising physician's signing of patient charts in a legible manner. In lieu of signing the patient charts, the supervising physician may document the review and evaluation by the use of an electronically generated signature provided that reasonable measures have been taken to prevent the unauthorized use of the electronically generated signature.
(1) During the first five hundred hours of the provisional period, the review and evaluation shall be completed and documented on every chart by each supervising physician who provided supervision within a reasonable period of time after the physician assistant rendered service to a patient.
(2) During the remainder of the provisional period, the review and evaluation shall be completed and documented on at least fifty percent of the patient charts by each supervising physician who provided supervision within a reasonable period of time after the physician assistant rendered service to a patient.
(E) Provisional period hours completed under the supervision of a primary supervising physician may be transferred to a provisional period under a subsequent primary supervising physician pursuant to the following criteria:
(1) Provisional period hours completed under the supervision of a primary supervising physician may be transferred, not more than one time, when both of the following criteria are met:
(a) The initial primary supervising physician provides written verification of the activities and number of hours successfully completed during the provisional period by the physician assistant; and
(b) The subsequent primary supervising physician approves the transfer of the provisional period hours.
(2) Provisional period hours completed under the supervision of the subsequent primary supervising physician may be transferred to a provisional period under a third primary supervising physician only upon the board's approval when all of the following conditions are met:
(a) The subsequent primary supervising physician provides both of the following:
(i) Written verification of the activities and number of hours successfully completed during the provisional period to date; and
(ii) Written explanation of why the transfer of provisional period hours is being requested;
(b) The third primary supervising physician approves the transfer of the provisional period hours;
(c) The failure to transfer the hours would result in undue hardship to the physician assistant; and
(d) The granting of the transfer would not jeopardize patient care.
(F) Successful completion of the provisional period requires that both of the following requirements be met:
(1) The physician assistant completed the provisional period in accordance with this rule; and
(2) The primary supervising physician certifies to the board that the physician assistant is capable of consistently making prescriptive decisions in accordance with the minimal standards of care.
(G) The primary supervising physician shall notify the board, on forms prescribed by the board, of any of the following:
(1) That the physician assistant successfully completed the provisional period;
(2) That the physician assistant's provisional period is being extended, including the number of additional hours and/or time period of the extension; or
(3) That the physician assistant did not successfully complete the provisional period and the provisional period is not being extended.
(H) Upon receipt of notice from the primary supervising physician that the physician assistant did not successfully complete the provisional period, the board shall immediately revoke the provisional certificate to prescribe. The revocation of the provisional certificate to prescribe based upon notice that the provisional period was not successfully completed is not subject to hearing rights or appeal under Chapter 119. of the Revised Code.
(I) A provisional certificate to prescribe shall be considered to be valid for up to one year after issuance, except that the provisional certificate may, upon the report of the primary supervising physician pursuant to paragraph (G)(2) of this rule, be extended in accordance with the number of additional hours and/or time period specified in the notice submitted by the supervising physician.
Prior History: (Effective:
R.C. 119.032 review dates: 10/31/2012
Promulgated Under: 119.03
Statutory Authority: 4730.07, 4730.39
Rule Amplifies: 4730.45)