Senate Health and Welfare Committee Hears Testimony on H.237 to Let Doctoral Psychologists Prescribe

MONTPELIER, Vt. — The Senate Health and Welfare Committee on Monday received testimony on H.237, a bill that would give some doctoral‑level psychologists restricted authority to prescribe psychiatric medications after completing a designated postdoctoral psychopharmacology program and supervised clinical rotations.

The measure is aimed at expanding access to mental health care where psychiatric prescribers are scarce, but witnesses and regulators differed on whether the change would materially increase access. Supporters and the Office of Professional Regulation described added training and safeguards; medical and psychiatric groups urged caution and recommended bolstering collaborative, team‑based care instead.

Dr. Rick Barnett, a licensed psychologist and chair of the Vermont Psychological Association’s legislative committee, told the committee the bill is the result of a long effort and what he and supporters view as “a robust” training pathway. “This isn’t a quick fix. This is not a cure all. This is just a small change that we can make to help a few orphaned Vermonters get access to quality health care,” Barnett said. He said the current version increases supervised clinical rotation time and adds rotations in multiple medical specialties.

Stephanie Winters, deputy executive director of the Vermont Medical Society and executive director of the Vermont Psychiatric Association, told senators she and the organizations she represents remain concerned that authorizing prescribing for psychologists has not produced measurable increases in access where it has already been enacted. “There’s no evidence that authorizing psychologists to prescribe medications will actually increase access to needed mental health services in Vermont,” Winters said, citing low uptake by psychologists in other states and the availability of other prescribers and team‑based models.

Jennifer Cola, general counsel for the Office of Professional Regulation (OPR), said OPR’s January 2025 Sunrise review and subsequent study led the office to support a revised bill that emphasizes education, examination and experience. “We think that H.237 strikes a really good balance of having measures in place to ensure public protection,” Cola said, adding that OPR recommends strengthening rulemaking and delaying the statute’s later effective date to allow time for stakeholder rule development.

Key provisions discussed during testimony include: completion of a designated postdoctoral psychopharmacology program; a lengthy supervised clinical rotation requirement that the testimony describes moving from 14 months toward 18 months in multiple practice settings; a required written collaborative agreement with a collaborating practitioner; limits excluding prescribing for patients under 18, patients older than 80 and pregnant patients; and restrictions on controlled substances (the bill as discussed would require schedule‑2 through ‑5 drugs to be identified explicitly and would bar injectable controlled substances).

Witnesses described alternative steps to increase access to care without changing prescriptive authority, including expanding collaborative care models, loan repayment programs, reimbursement for inter‑provider consultation and the existing Vermont Consultation and Psychiatry Access Program for primary care. Winters recommended that, if the Legislature moves forward, the bill should require OPR rulemaking to set curricular details for postdoctoral programs.

Senators asked about telehealth, workforce distribution and whether prescribing psychologists would shift psychologists away from psychotherapy toward brief medication management. Barnett said the intent is to retain psychologists’ therapy‑first identity while adding the ability to prescribe when clinically appropriate: “The responsibility to prescribe is the responsibility or power to deprescribe,” he said.

No formal committee vote was taken during the hearing. OPR told the committee it plans broader mental health licensing statutory changes and asked the Legislature to set a later effective date to allow consolidated rulemaking; OPR suggested moving the implementation date from July 1, 2026, to January 1, 2028, to accommodate rulemaking and other administrative transitions.

The committee did not act on H.237 at the hearing. Lawmakers will consider the bill in subsequent meetings as OPR and stakeholder groups continue to refine curriculum, rotation and collaborative‑practice requirements.