May 2, 2017
By Sharon Peters*
Earlier this month, Idaho became the fifth state to authorize clinical psychologists to prescribe medications.1 Idaho joins New Mexico, Louisiana, Illinois, and Iowa, in permitting certain psychologists to prescribe medications to their patients.
There are strong opinions both in support of, and in opposition to, psychologist prescribing laws—popularly called “RxP.” Supporters of RxP legislation argue that allowing psychologists to prescribe medications for mental health disorders will increase access to care. This is particularly true in rural areas where access to mental health care is scarce because there are a limited number of psychiatrists, who often have lengthy wait times. Additionally, supporters argue that RxP legislation will decrease the cost of care because patients will be able to consolidate their care and see a single provider for their mental health needs, a prescribing psychologist. Patients are often treated by psychologists who then refer their patients to a primary care physician who will prescribe the psychotropic medication.2 Allowing psychologists to provide the needed medication would streamline the process, making care less expensive.
Opponents of RxP legislation argue that psychologists do not possess the required medical knowledge and training that psychiatrists and non-psychiatrist physicians have, which puts patients at risk.3 They assert that the medical knowledge learned in medical school and residency is essential to the proper medical management of a patient’s mental health. Opponents argue that without this extensive training, prescribing psychologists are not prepared to manage and predict negative effects of psychiatric medications.4 Lastly, opponents argue that there is no data to support the claim that allowing psychologists to prescribe certain medications will increase access to mental health care in rural areas. They claim that there is little to no evidence that prescribing psychologists will move to rural areas to provide care to those patients.
There are a few states with pending RxP legislation:Oregon (HB 3355), Hawaii (SB 384 and HB767), and Texas (HB 593). Oregon passed RxP legislation in 2010, but the bill was vetoed. This year, a new RxP bill has been introduced, HB 3355. The bill would permit certain psychologists to prescribe psychotropic medications to their patients.5 Hawaii has introduced SB 384. Senate Bill 384 would authorize clinical psychologists who have met specific registration, education, and training requirements to prescribe medications to patients.6 On March 24, 2017, SB 384 passed its Second Reading in the House. Lastly, Texas has introduced HB 593, which would also allow psychologists who meet certain eligibility requirements to prescribe medications.7 On February 20, 2017, House Bill 593 was referred to the House Public Health Committee.
While states with RxP legislation are in the minority, there is an emerging trend among states to permit qualified psychologists to prescribe medications. This trend could continue in the coming months, and three more states could join the ranks of Idaho, New Mexico, Louisiana, Illinois, and Iowa.
*We would like to thank Sharon C. Peters (Lewis Brisbois Bisgaard & Smith LLP, Portland, OR) and Suzette E. Gordon (Bronx Partners for Healthy Communities, New York, NY) for respectively authoring and reviewing this email alert.
1 Idaho Becomes Fifth State to Allow Psychologists to Prescribe Medications, PR Newswire (Apr. 5, 2017), http://www.prnewswire.com/news-releases/idaho-becomes-fifth-state-to-allow-psychologists-to-prescribe-medications-300435166.html.
2 James Long, Jr., The Debate Over the Prescription Privilege for Psychologists and the Legal Issues Implicated, National Register of Health Service Psychologists, https://www.nationalregister.org/pub/the-national-register-report-pub/the-register-report-fall-2005/the-debate-over-the-prescription-privilege-for-psychologists-and-the-legal-issues-implicated/ (last visited Apr. 18, 2017).
5 Chris Gray, Kennemer Wants to Allow Specialized Psychologists to Prescribe Medication, The Lund Report (Apr. 7, 2017), https://www.thelundreport.org/content/kennemer-wants-allow-specialized-psychologists-prescribe-medication.
6 Hawaii State Legislature, http://www.capitol.hawaii.gov/measure_indiv.aspx?billtype=SB&billnumber=384 (last visited Apr. 18, 2017).
7 Texas Legislature, http://www.legis.state.tx.us/BillLookup/History.aspx?LegSess=85R&Bill=HB593 (last visited Apr. 18, 2017).