STAND. COM. REP. NO.  1379

 

Honolulu, Hawaii

                , 2019

 

RE:   S.B. No. 819

      S.D. 2

      H.D. 1

 

 

 

 

Honorable Scott K. Saiki

Speaker, House of Representatives

Thirtieth State Legislature

Regular Session of 2019

State of Hawaii

 

Sir:

 

     Your Committee on Health, to which was referred S.B. No. 819, S.D. 2, entitled:

 

"A BILL FOR AN ACT RELATING TO PRESCRIPTIVE AUTHORITY FOR CERTAIN CLINICAL PSYCHOLOGISTS,"

 

begs leave to report as follows:

 

     The purpose of this measure is to grant prescriptive authority for certain clinical psychologists who meet specific education, training, and registration requirements.

 

     Hawaii Psychological Association, American Psychological Association, Common Chord Psychology, North Shore Mental Health, The Catalyst Group, LLC, Psychological Wellness Services of Hawaii, Alakai Na Keiki, Inc., Oahu County Committee on Legislative Priorities of the Democratic Party of Hawaii, and numerous individuals testified in support of this measure.  The University of Hawaii at Hilo Daniel K. Inouye College of Pharmacy, American Psychiatric Association, Hawaii Medical Association, and two individuals provided testimony in opposition to this measure.  The Board of Psychology provided comments.

 

     Your Committee recognizes the serious shortfall in qualified mental health professionals with prescriptive authority.  Your Committee further recognizes that 5 states have enacted legislation granting prescriptive authority to licensed psychologists who meet certain statutory criteria.

 

     Your Committee finds that in Iowa, a licensed psychologist may obtain a conditional prescription certificate to prescribe non-narcotic psychotropic medication if the psychologist has completed board approved pharmacological training; passed a national examination approved by the state's Board of Psychology and Board of Medicine; obtained a postdoctoral Master of Science degree in clinical psychopharmacology within 5 years immediately preceding the date of application for a certificate, and within the 5 years immediately preceding the date of application; and received certification by a supervising physician as having successfully completed a supervised and relevant clinical experience in clinical assessment and pathophysiology, as well as a supervised practicum in treating patients with mental disorders.

 

     Your Committee finds that in Illinois, a psychologist may obtain a prescribing psychologist license if the psychologist has obtained certain minimum undergraduate biomedical prerequisite coursework; a minimum of 60 credit hours of certain specific types of didactic coursework; a full-time practicum of 14 months of supervised clinical training of at least 36 credit hours, including a research project, and rotations in certain types of medical specialties; successfully completed a National Certifying Exam; and meets all other requirements to obtain a prescribing psychologist license.  The prescribing psychologist must also maintain a current license, satisfy continuing education requirements, and maintain a written collaborative agreement with a collaborating physician.

 

     Your Committee also finds that in New Mexico, a licensed psychologist may prescribe psychotropic medication from a statutorily restricted formulary if the psychologist has successfully completed psychopharmacological training from an institution of higher education approved by the state Board of Psychology and Board of Medical Examiners; obtained a passing score on a board approved national certification exam; obtained no fewer than 450 classroom hours in certain practice areas within 5 years preceding the date of application; and, within 5 years preceding the date of application, a certification by the applicant's supervising psychiatrist or physician that the applicant has completed an 80-hour practicum in clinical assessment and pathophysiology and 400 hours of supervised practicum treating no fewer than 100 patients.

 

     Your Committee additionally finds that in Louisiana, a psychologist can obtain a medical psychology license and prescribe psychotropic medication if the psychologist, in addition to all other necessary licenses and requirements for a medical psychology license, has obtained a postdoctoral master's degree in clinical psychopharmacology for a regionally accredited institution; passed a board approved national examination in psychopharmacology; and annually completed a minimum of 20 hours of continuing education relevant to the practice of medical psychology.  There are additional educational and practice requirements should a medical psychologist desire to obtain an advanced practice certificate.

 

     Your Committee further finds that trained psychologists are currently permitted to prescribe psychotropic medication in the federal Departments of the Army, Navy, Air Force, Indian Health Service, and Public Health Service.

 

     Finally, your Committee finds that the State has previously granted prescriptive authority to medical professions other than physicians.  In general, the State has done this by expanding the definition of "practitioner" for the purposes of the Uniform Controlled Substances Act.  In the case of advanced practice registered nurses, the State vested the granting of prescriptive authority for advanced practice registered nurses in the state Board of Nursing and allowed, by statute, for advanced practice registered nurses to prescribe from a formulary that consists of over the counter drugs, legend drugs, and controlled substances.  In contrast, in the case of pharmacists, the State has restricted the formulary for which pharmacists have prescriptive authority to vaccinations for children, contraceptive supplies, and opioid antagonists.  Your Committee finds that, should this measure move forward, the State has ample precedent to look towards for crafting a mechanism to grant qualified clinical psychologists prescriptive authority.

 

     Your Committee has amended this measure by making technical, nonsubstantive amendments for the purpose of clarity, consistency, and style.


     As affirmed by the record of votes of the members of your Committee on Health that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 819, S.D. 2, as amended herein, and recommends that it pass Second Reading in the form attached hereto as S.B. No. 819, S.D. 2, H.D. 1, and be referred to your Committee on Consumer Protection & Commerce.

 

 

Respectfully submitted on behalf of the members of the Committee on Health,

 

 

 

 

____________________________

JOHN M. MIZUNO, Chair