Report Title:

Psychologists; Prescriptive Authority

 

Description:

Grants prescriptive authority to psychologists certified in psychopharmacology. Establishes certification criteria. Establishes a joint formulary advisory committee.

THE SENATE

S.B. NO.

590

TWENTY-FIRST LEGISLATURE, 2001

 

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

relating to psychologists.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The legislature finds that the delivery of comprehensive, accessible, and affordable medical care can be enhanced by providing adequately trained nonphysician medical professionals with appropriately limited prescriptive authority. Accordingly, the legislature has recently provided for limited prescriptive authority for advanced practice registered nurses in Act 277, Session Laws of Hawaii 1994, and for optometrists in Act 71, Session Laws of Hawaii 1996. Other nonphysicians, including dentists and podiatrists, are also permitted prescriptive authority. In addition, appropriately certified psychologists working in federal facilities in Hawaii are currently prescribing to veterans and active duty personnel and their dependents.

Reliance upon a physician to provide a prescription often results in unnecessary delay, expense, inconvenience and even, in remote areas or when physicians are unavailable, nontreatment. The provision of limited prescriptive authority to the abovementioned healthcare professionals has proven to effectively address or alleviate these problems within these professionals' fields of competence and training.

Licensed psychologists are licensed health professionals with more than seven years of study and three thousand hours of postgraduate supervised practice in the diagnosis and treatment of mental health illnesses. However, absent a physician's license, they are currently not permitted to prescribe psychoactive medication. Patients who would benefit from such medication must consult and pay for another provider prior to obtaining a prescription. Many people seeking mental health treatment are from diverse cultural backgrounds and due to the stigma of mental health problems are reluctant to seek treatment. Having established a relationship with a psychologist, it is a further intrusion of the patient's privacy to demand that they see yet another provider for needed medications. This is of particular concern to the State in that timely access to the accurate diagnosis and effective treatment of emotional and behavioral disorders may contribute substantially to satisfying to the State's responsibilities to Hawaii's children and needy adults in rural and underserved areas who have great difficulty gaining access to care. Current inefficiencies delay timely and effective access to necessary diagnosis and medication and raise costs.

The American Psychological Association has established a nationally recognized curriculum for the training and certification of licensed psychologists in the use of psychopharmacological agents to ease the suffering of people with mental health problems. Independent evaluations by the General Accounting Office and the American College of Neuropsychopharmacology have concluded that appropriately trained prescribing psychologists provide competent quality health care.

Accordingly, the purpose of this Act is to provide appropriately trained and supervised licensed psychologists with limited prescriptive authority similar to that recently provided advanced practice registered nurses and optometrists.

SECTION 2. Chapter 465, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§465-    Psychopharmacology certified psychologists; scope; qualifications; recertification; advisory committee. (a) The use and prescription of psychotherapeutic pharmaceutical agents for the treatment and management of mental disorders as established by the joint formulary advisory committee and rules adopted by the board shall be authorized only for psychologists licensed under this chapter:

(1) Who meet the requirements of a psychopharmacology certified psychologist as established in this section; and

(2) Whose patients have been medically cleared pursuant to the written approval of a licensed physician for treatment with psychopharmacological agents.

(b) Upon application, the board shall certify a psychologist in psychopharmacology if the psychologist:

(1) Holds a current unencumbered license as a psychologist in this State or in any other state with equal or greater licensing requirements;

(2) Has completed a program of psychopharmacology coursework in accordance with standards approved by the American Psychological Association, as amended; provided that the board may establish additional requirements;

(3) Has passed a national examination approved by the American Psychological Association, as amended; provided that the board may establish additional requirements;

(4) Has obtained supervised practical experience as follows:

(A) A minimum total of one thousand five hundred hours of treatment have been administered to a minimum of one hundred patients;

(B) The supervised practical experience has been obtained within two years of the completion of certified coursework, unless otherwise allowed by the board due to special circumstances;

(C) The ratio of supervision time to direct service has been sufficient to ensure adequate learning and has included at least one hour per week of formal, face-to-face, individual supervision;

(D) Supervision has consisted of direct, formal contact with a senior professional who is responsible for the educational development and guidance of the supervisee, excluding class work, practicum experience, or other course-related experience;

(E) The applicant has received supervision with respect to the applicant's direct provision of psychology health services to individuals; provided that the applicant's personal growth experience (e.g. personal therapy) and supervision of others do not meet this requirement; and

(F) The applicant's supervisors meet the following criteria:

(i) The supervisors are licensed, certified, or registered for practice in their respective professions;

(ii) The professional qualification of each direct supervisor is appropriate to the services rendered; provided that the applicant must provide the board with the current vita for each supervisor who is not a psychologist; and

(iii) The supervisor at the time of supervision was not in a dual relationship with the applicant supervisee (e.g., as a spouse, relative, or therapist).

(c) Certification in psychopharmacology shall be renewed biennially and shall require proof of completion of continuing education coursework in the diagnosis, treatment, and management of mental conditions.

(d) The board shall establish a joint formulary advisory committee composed of:

(1) Two licensed psychologists:

(2) Two licensed pharmacists;

(3) Two licensed physicians; and

(4) One public member.

The joint formulary advisory committee shall recommend applicable formulary and formulary prescribing parameters for persons certified under this section. The board shall adopt by rule the formulary and formulary prescribing parameters."

SECTION 3. The board of psychology shall convene a volunteer working group to develop specific criteria for section 465- (b) and (c), Hawaii Revised Statutes, in section 2 of this Act and shall submit a report to the legislature regarding its efforts no later than twenty days before the convening of the regular session of 2002.

SECTION 4. New statutory material is underscored.

SECTION 5. This Act shall take effect on July 1, 2002; provided that section 465- (d), Hawaii Revised Statutes, in section 2 of this Act shall take effect on July 1, 2001.

INTRODUCED BY:

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