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Panel reviews H237 to allow prescribing by doctoral-level psychologists under collaborative agreements
Summary
A legislative committee reviewed H237, which would authorize a prescribing specialty for doctoral-level psychologists working under collaborative agreements with psychiatrists. Staff described training, scope limits, $100 initial specialty fee and reporting requirements; senators pressed for medical justification on age cutoffs and patient-continuity safeguards.
A legislative committee on Tuesday reviewed House bill H237, a draft that would authorize a prescribing specialty for doctoral-level psychologists working in a documented collaborative relationship with a psychiatrist.
Legislative staff said the bill adds definitions to the psychologists chapter (Title 26), establishes a ‘‘prescribing psychologist’’ specialty, and requires collaborative written agreements filed with the board of psychologists. ‘‘They would collaborate with a psychiatrist and they'd be able to prescribe the same types of medications that the psychiatrist regularly prescribes,’’ said Katie, a legislative staff member who walked the panel through the draft.
Staff described the credentialing and training pathway in the bill: eligibility requires a current doctoral-level psychology license, completion of a postdoctoral psychopharmacology program designated by the American Psychological Association (or successor), a national certifying exam, and a period of clinical rotations across multiple practice settings. The draft sets minimum clinical-rotation time and practice-setting requirements and limits the prescriptive authority to conditions recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Prescriptive authority would exclude dispensing, administering, or prescribing for patients younger than 18, patients over an upper-age cutoff listed in the draft, and pregnant patients; the bill also prohibits injection administration in this authority.
On fiscal matters, staff reported the draft contemplates a $100 initial fee for the prescribing specialty, no renewal fees, and estimated start-up costs on the order of a few thousand dollars that the agency could absorb; the bill does not request a separate appropriation. Staff also described an endorsement pathway that could allow candidates who hold comparable prescribing authority in another U.S. or Canadian jurisdiction to be granted the specialty without examination if the director finds substantial equivalence.
Committee members pushed staff for evidence and justification. Several members said the draft’s age cutoffs—specifically the exclusion of patients beyond the upper-age threshold in the text—appeared arbitrary and requested documentation of any medical basis for those limits. A committee member who opposed the draft in earlier consideration said, ‘‘I voted against this because I wasn't comfortable,’’ and asked whether prescribing would be limited to patients the psychologist regularly treats. "If you can prescribe for someone you're not seeing regularly, that opens up the potential for abuse," the member added.
Staff said the draft does not clearly require an ongoing therapist–patient relationship as a prerequisite to prescribing, and the committee asked staff to seek clarifications and testimony from stakeholders, including the psychologist association and medical experts. The panel also noted a reporting requirement added in Senate Health and Welfare: the Office of Professional Regulation (OPR) must report to the policy committees on the number of psychologists with the prescribing specialty, the availability of collaborative practitioners, and whether qualifications should be updated to expand access while assuring public protection.
Members noted limited national uptake of the credential; staff cited national estimates that a few hundred individuals have obtained similar prescribing qualifications and said the change could improve access in rural areas with psychiatrist shortages, while also posing risks that the committee asked staff to quantify.
The committee scheduled OPR to testify later and asked staff to follow up on the age-limit rationale, clinical-rotation language, patient-continuity safeguards and whether additional guardrails for controlled substances are advisable. No formal vote was taken at the meeting; committee members agreed to request further information and witnesses before deciding whether to pursue hearings or amendments.
