Vermont panel hears competing views on bill to let psychologists prescribe psychotropic drugs

Members of the Vermont House Committee on Health Care heard two hours of testimony on H.237, a bill that would create a pathway for doctoral-level psychologists to obtain prescriptive authority for psychotropic medications after completing additional coursework, supervised clinical practice and certification.

The bill has drawn sharply different views from clinicians. Stephanie Winters, deputy director of the Vermont Medical Society, said the society and associated physician groups have long engaged with the issue and remain concerned the bill “would not provide adequate clinical training to expand [psychologists'] scope to include prescriptive authority while adequately protecting the public.” Winters urged lawmakers to consult the Office of Professional Regulation and the National Alliance on Mental Illness, and to consider alternatives that expand access without changing psychologists’ scope.

Dr. Lisa Catapano Friedman, a psychiatrist and president of the Vermont Psychiatric Association, described prescribing psychotropic medicines as medically complex and argued the bill’s training requirements are too limited. “Prescribing is not simple. Prescribing is not just, ‘oh, this is a psychiatric illness. Here’s a psychiatric medication. Check the box,’” Dr. Catapano Friedman said, citing cases in which nonpsychiatric medical problems mimicked psychiatric conditions or interacted dangerously with medications.

Supporters of H.237, including Rick Barnett, legislative chair for the Vermont Psychological Association, said the measure is designed as a collaborative model and noted it has been considered in the Legislature for several years. “This is the ninth consecutive year of [a prescribing psychologists] bill has been in this building,” Barnett told the committee, urging lawmakers to adopt robust training standards rather than reject the concept outright.

Why it matters: lawmakers must weigh patient safety, workforce shortages and rural access. Proponents say additional prescribers could help fill gaps in areas with few psychiatrists; opponents say medical training and breadth of clinical experience are required to manage medication risks, drug–disease interactions and complex diagnoses.

Testimony and evidence cited several specific points for lawmakers to consider. Winters told the committee states that have granted prescriptive authority reported limited uptake: she recited approximate counts of prescribing psychologists in other states (for example, Louisiana and New Mexico had higher counts) and said national totals remain low. Dr. Catapano Friedman and others flagged several drafting concerns in the current bill, including broad language about who may serve as a “collaborative practitioner,” the scope of excluded patient groups (the draft excludes patients younger than 18, older than 80 and pregnant people), and the bill’s unspecified processes for annual competency evaluation and supervision.

Several witnesses and committee members discussed alternatives and complements to expanding prescriptive authority. Winters and Dr. Catapano Friedman both praised collaborative care models, Medicaid and primary-care supports, and a federally grant-funded Consultation and Psychiatry Access Program (Vermont CPAP) for youth and perinatal care; Winters noted federal grant funding for CPAP will end and that the program will seek state funding in a coming fiscal year. Barnett and others said supervised placements for training could occur in nursing homes and primary-care practices and urged the committee to consider more prescriptive educational requirements if the bill moves forward.

The committee did not vote on H.237 during the hearing. Several committee members acknowledged the draft will change after input from witnesses and Office of Professional Regulation reviews. One committee member reminded witnesses the bill language before the committee is not final and that experts are asked to help craft workable statutory text.

Closing: witnesses offered to submit suggested edits to the committee staff. Lawmakers signaled continued review and deliberation; no formal action or vote was recorded at the hearing.