Delegation Agreement · PA
Connecticut Written Delegation Agreement for Physician Assistants
Required. The Written Delegation Agreement is the written instrument Connecticut law names for a Physician Assistant working with a physician. Below: the board that governs it, what it must contain, and the terms it has to carry.
No independent-practice pathway exists for PAs in Connecticut. A 2019 bill (H.B. 6942) proposing to replace 'supervision' with 'collaboration' did not become law — current statute (§20-12a) still uses supervision/supervising-physician language throughout. Connecticut did eliminate any numeric PA-per-physician ratio cap in 2018 (P.A. 18-168).
What a Connecticut Written Delegation Agreement must contain
Governed by the Connecticut Medical Examining Board and the Connecticut Commission of Pharmacy. Each numbered item is a statutory requirement the agreement must satisfy.
The Physician Assistant ("PA") shall practice pursuant to a written delegation agreement with the Physician, as required by Conn. Gen. Stat. § 20-12b. The delegation agreement shall describe the professional relationship between the Parties, identify the medical services delegated to the Physician Assistant, address documentation procedures for controlled-substance prescribing, and establish a process for evaluating the Physician Assistant's performance.
Connecticut law does not fix a numerical limit on the number of Physician Assistants with whom a physician may enter into a delegation agreement.
- The Written Delegation Agreement on file also carries 1 scope, 1 education, 1 registration clauses, generated in the document itself.
Terms it has to carry
Ratio, proximity, chart review, meeting and prescribing terms the agreement has to carry, from the state's supervision rules.
Proximity
Available remotely (no on-site requirement)
Supervision requires 'continuous availability of direct communication either in person or by radio, telephone or telecommunications' between PA and supervising physician, plus personal review at the PA's practice location 'on a regular basis as necessary' — no mile/minute radius or on-site standard is codified (§20-12a(7)).
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Annually
The supervising physician must review the written delegation agreement not less than annually and revise it to reflect any change in the professional relationship, delegated medical services, or performance-evaluation process (§20-12d(a)). The agreement itself must also separately specify how often the physician will personally review the PA's charts/performance, but that cadence is left to the agreement, not fixed by statute.
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
The delegation agreement must specify the manner and frequency of the physician's review of the PA's Schedule II/III prescribing — no statewide percentage or cadence is codified.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional Service Corporation under Conn. Gen. Stat. § 33-182a — shareholders must be individuals licensed to render the same professional service as the corporation; physicians and PAs may co-own a PSC that renders both services, but non-licensees may not hold equity.
This ownership rule is legally distinct from the clinical supervisory arrangement above — the supervising physician need not be an owner of the entity the PA practices through.
Legal sources for these rules (5)
- Conn. Gen. Stat. § 20-12a — Physician Assistants. Definitions.
- Conn. Gen. Stat. § 20-12b — Physician Assistant License
- Conn. Gen. Stat. § 20-12d — Medical Functions Performed by Physician Assistants. Prescriptive Authority.
- P.A. 18-168 — eliminated the numeric PA-per-physician ratio restrictionsecondary
- Conn. Gen. Stat. § 33-182a — Professional Service Corporations. Definitions.secondary
About Connecticut's rules
NP, CNS, and CRNA are all licensed as a single 'advanced practice registered nurse' category (§20-94a) sharing an identical 3-year/2,000-hour collaboration-to-independence pathway (§20-87a); CT does not statutorily distinguish PMHNP or CNS scope from general NP. CNMs are licensed separately (Ch. 377), with no written collaborative-agreement requirement. No provider type below has a codified supervision ratio cap, chart-review percentage, or on-site proximity radius outside CRNA's surgery-specific carve-out.
Other clinicians in Connecticut: see the state overview.