Senate Health & Welfare advances framework for psychologist prescribing specialty, asks OPR to draft rules

The Senate Health & Welfare committee on Feb. 11 reviewed H.237, a bill that would create a prescribing specialty for doctoral‑level psychologists and set training, supervision and prescribing limits for those clinicians.

The committee heard that eligibility would require completion of a designated postdoctoral psychopharmacology program and structured clinical rotations, that prescribing must occur under a written collaborative agreement, and that some controlled substances and injectable administration would be restricted.

Why it matters: The bill would expand the circumstances in which psychologists can prescribe psychotropic medications in Vermont, shifting the scope of practice for a professional group and creating new board‑regulated training and oversight obligations. Committee members pressed for clarity on what minimum education and supervisory safeguards would protect patients if prescribing authority is granted.

The bill and draft strike‑all presented by Katie of the Office of Legislative Council add definitions for "prescribing psychologists," "collaborating practitioners," and a postdoctoral curriculum. Dr. Rick Barnett of the Vermont Psychological Association told the committee the American Psychological Association "has a very formal designation process" and described "a designated 2‑year master's degree in clinical psychopharmacology" as the program referenced in the draft. "That is what's required; no one can get prescribing authority without going through that designated masters of science program," Barnett said.

Representatives of the Vermont Medical Society (VMS) urged the committee to give the Office of Professional Regulation (OPR) rulemaking authority to ensure Vermont adopts a uniform standard. "We wanted to give OPR rulemaking authority to deem, even above that, which met our Vermont standard of minimum training," Stephanie Withers, deputy director of the Vermont Medical Society, said.

The draft requires that prescribing psychologists hold a current doctoral license, complete an APA‑designated postdoctoral psychopharmacology program, finish at least 14 months of clinical rotations across multiple practice settings (the draft lists nine settings, including psychiatry, geriatrics and family medicine), and pass a national certifying exam "as determined by rule." The committee discussed narrowing some rotation settings to five practice settings where psychologists would commonly treat adult patients.

On prescribing mechanics, the draft would: require a written collaborative agreement filed with the board; limit a prescribing psychologist to drugs their collaborating practitioner typically prescribes; require that schedule II–V controlled substances be identified by brand or generic name; and prohibit administration of controlled substances by injection.

Committee members repeatedly asked how a prescribing psychologist would access a patient's full medical history. Dr. Barnett and OPR staff said shared electronic health records or explicit record‑sharing in collaborative agreements, along with pharmacy drug‑utilization reviews, were the key safeguards. "With the collaborative agreement, there's bound to be some rulemaking around how information is shared between providers," Dr. Barnett said.

Jennifer Coleman, director of the Office of Professional Regulation, asked that the bill's collaborating‑practitioner definition explicitly allow "another prescribing provider as approved by the board," noting that psychiatric advanced practice registered nurses with specialized mental‑health training should be eligible collaborators. Coleman said OPR would not forward a rule that allowed collaborators without "adequate training and expertise." The committee asked OPR to draft statutory language that would ensure collaborating providers have appropriate education and experience.

A committee member raised a central concern about patient safety: "Do we feel confident that abiding by this section … meets that competency level for actually prescribing medication?" OPR and other witnesses replied that the combination of designated postdoctoral training, supervised clinical rotations, collaborative agreements, and board rulemaking would set guardrails for safe practice.

The committee also discussed effective dates; staff said some implementation dates would be moved forward one year to allow time for rulemaking. OPR noted updating an effective date to 2029 in order to complete rule development.

Next steps: The committee agreed to incorporate the changes to section 3 of the draft, asked OPR to propose collaborating‑practitioner language, and scheduled a short follow‑up (to resume in Room 10 at 10:45) to review proposed statutory adjustments before placing H.237 in the hopper for final consideration.

The committee recessed after the exchange; no formal vote on the bill occurred during this session.