10/13/2026

HB 963 Spotlight: Permitting PAs to Sign Documents Within Their Scope of Practice

Ohio House Bill 963 seeks to align state law with modern PA education and practice, for the benefit of Ohio patients and healthcare teams alike.

This article is part of a series focusing on the 14 actions within HB 963 that modernize PA practice in Ohio.

Action:

Permit PAs to sign documents that are within the scope of their supervising physicians.

Rationale:

PAs should be authorized to sign necessary medical documents within their scope. This ensures timely care, particularly in mental health and emergencies, where PAs may be the first provider available.

In many care settings, the PA is the first provider a patient sees, and sometimes the only one immediately available. They evaluate the patient, make the clinical assessment, and begin treatment. But when a form requires a signature that Ohio law does not permit PAs to sign, that work can stall until another provider is located to confirm a decision the PA has already made.

In a mental health crisis or an emergency, a delay can mean a patient in distress waits longer for the next step in their care, and a stretched care team spends time on a formality instead of on patients.

Ohio PA Amelia C. Toomey PA-C, DMSc, describes the need this way:

"In rural communities, where access to mental health care is already limited, unnecessary administrative barriers can have life-or-death consequences. I care for children, adolescents, and adults with high-acuity psychiatric needs, including psychosis, suicidality, and other life-threatening conditions, in communities where mental health resources are scarce. There are times when an emergency involuntary hold is necessary to keep a patient alive and connect them with the level of care they need.

Allowing a PA to initiate that hold does not reduce safety, it improves it. It allows the treating clinician to act immediately and ensures the patient receives an additional evaluation by a higher level of care team, reducing risk and creating another layer of clinical assessment. Requiring a physician who may not know or have evaluated the patient to provide an arbitrary sign-off can delay that process without adding meaningful clinical value. As a psychiatric PA, assessing risk, determining the need for emergency intervention, and protecting patients in crisis are well within my training and scope of practice. Allowing PAs to initiate emergency involuntary holds would remove a critical barrier to timely psychiatric care, strengthen patient safety, and, quite simply, could save lives.”

Ohio PA Mike Czajka, MPAS, PA-C, CAQ-Psych, shares this concern:

"As a PA with 12 years of experience treating serious mental illness, I routinely perform suicide risk assessments, initiate safety plans, and manage complex psychiatric prescribing. PAs possess the rigorous clinical training, diagnostic expertise, and hands-on experience necessary to navigate acute psychiatric crises. However, current Ohio law prevents PAs from signing an application for involuntary admission. This legal restriction forces redundant evaluations and unnecessary administrative handoffs, creating critical delays in care when a patient requires immediate psychiatric stabilization to remain safe."

Another example of documentation relates to death certificates. Allowing PAs to sign death certificates in all settings means families aren’t left waiting for another provider to be located when the PA who cared for their loved one is ready and qualified to sign. It speeds up the funeral and burial arrangements that families can’t move forward on without that document, sparing them added stress at an already painful time.

Ohio PA Theresa Lohn, PA-C, MPAS adds her perspective:

"Working in a hospital setting, it is immensely important to utilize our full scope of practice collaborating with our physician colleagues. This includes providing timely, efficient, and kind care for patients and families in extreme stressful situations, including in death. Giving families and loved ones timely closure at the end of life is important. PAs have the training and knowledge to pronounce death, and as the immediate providers of care, our ability to do so it important. Because our education and training provides this knowledge, if we are not allowed to care for patients in these ways, it is just one more barrier in the healthcare system."

Authorizing PAs to sign documents within the scope of their supervising physicians aligns the paperwork with the care they’re already delivering, so patients and their families, particularly in mental health and emergency settings, aren’t left waiting. Learn more about this and other aspects of House Bill 963, and how you can advocate for PA practice advancement, today.