This is straight from the AAMC protocols regarding how adcoms should treat applicants. Just note that nowadays, these are nothing but suggestions. Schools can do whatever they want, so don't take anything for granted and be sure to check with each school to make sure you know what their expectations are.
- On or before April 30, permit ALL applicants (except for EDP applicants):
- A minimum of two weeks to respond to their acceptance offer.
- To hold acceptance offers or a waitlist position from any other schools or programs without penalty (i.e. scholarships).
- After April 30:
- Permit all applicants:
- A minimum of five business days to respond to an acceptance offer. This may be reduced to a minimum of two business days within 30 days of the start of orientation.
- To submit a statement of intent, a deposit, or both.
So, theoretically, your state school should offer you are least a week or two to make a decision. That would give you the freedom to keep your present PTE while figuring out what to do. As long as your state school doesn't require you to select PTE, the other school won't be able to see the state school acceptance. You don't need their permission to hold it any more than you would if you were called off a WL on 5/2. You just need to know what the state school's deadline is to make a decision, since that's your new deadline to reduce to one A.