ARIZONA HOUSE OF REPRESENTATIVES

Fifty-sixth Legislature

First Regular Session

Senate: HHS DP 6-1-0-0 | 3rd Read 18-11-1-0


SB 1457: psychologists; prescribing authority

Sponsor: Senator Shope, LD 16

Committee on Health & Human Services

Overview

Expands the scope of practice for licensed psychologists to allow them to prescribe psychotropic medication and any other medication approved by the U.S. Food and Drug Administration (FDA) to treat mental disorders if issued a prescribing certificate or conditional prescribing certificate by the Arizona State Board of Psychologists Examiners (Board). Sets certification and prescribing requirements for applicant psychologists and the Board.

History

The Board regulates psychologists and behavioral analysts in Arizona through licensure, providing information about licensees to the public and investigating and resolving complaints against licensees. The practice of psychology includes conducting psychological assessments, diagnosing, treating or correcting mental, emotional, behavioral or psychological abilities, illnesses or disorders. Currently, psychologists are not authorized to engage in any manner in the practice of medicine that is permitted by medical, osteopathic or homeopathic physicians to diagnose, treat and correct human conditions ordinarily within the scope of practicing psychologists.

Applicants for a psychologist license must demonstrate to the Board that they meet certain requirements, which include: 1) meeting education and training qualifications for licensure; 2) passing any required licensure examination or examinations; 3) having a professional record that indicates that they have not committed any act or engaged in any conduct that constitutes grounds for disciplinary action against a licensee; 4) has not had a license or certificate to practice psychology refused, revoked, suspended or restricted by a state, territory, district or county for reasons that relate to unprofessional conduct; 5) has not voluntarily surrendered a license in another regulatory jurisdiction in the U.S. or Canada while under investigation for conduct that relates to unprofessional conduct; 6) does not have a complaint, allegation or investigation pending before another jurisdiction in the U.S. or Canada that relates to unprofessional conduct; and 7) has applied for a fingerprint clearance card (A.R.S. §§ 32-2061, 32-2063, 32-2071, 32-2071.01 and 32-2076).

A Sunrise application was submitted November 1, 2022, requesting a scope of practice expansion for the psychology profession to permit certain qualified psychologists to prescribe medications as an additional service within the practice of psychology. Licensed prescribing psychologists would be granted this prescriptive authority only if they meet additional certification requirements, including demonstrating completion of a specific course of post-doctoral training in psychopharmacology, completion of supervised practice requirements in prescribing psychoactive medications and passage of the national Psychopharmacology Examination for Psychologists.

 

Provisions

Prescribing Authority and Procedures

1.   ☐ Prop 105 (45 votes)	     ☐ Prop 108 (40 votes)      ☐ Emergency (40 votes)	☐ Fiscal NoteAllows physicians, subject to rules adopted by the Arizona Medical Board (AMB) and the Arizona Board of Osteopathic Examiners (ABOE), to supervise licensed psychologists that hold a conditional prescription certificate to prescribe psychotropic medication and any other FDA approved medication to treat mental disorders. (Sec. 1, 2)

2.   Permits psychologists who hold a conditional prescription certificate to prescribe psychotropic medication and any other medication approved by the FDA to treat mental disorders under the supervision of a physician. (Sec. 4)

3.   Allows prescribing psychologists to prescribe psychotropic medication and any other medication approved by the FDA to treat mental disorders. (Sec. 4)

4.   Specifies that a prescribing psychologist or psychologist with a conditional prescription certificate may order and review laboratory tests in conjunction with the prescribed medication to treat mental disorders. (Sec. 4)

5.   Requires each prescription written by a prescribing psychologist or a psychologist with a conditional prescription certificate to:

a)   comply with applicable state and federal laws;

b)   indicate that the prescription is issued by a psychologist certified to prescribe; and

c)   include the psychologist's board-assigned identification number. (Sec. 4)

6.   Prohibits a prescribing psychologist or a psychologist with a conditional prescription certificate to delegate prescriptive authority to any other person. (Sec. 4)

7.   Requires records of all prescriptions to be maintained in patient records. (Sec. 4)

8.   Requires a prescribing psychologist or a psychologist with a conditional prescription certificate, if authorized to prescribe controlled substances, to file with the Board in a timely manner all individual U.S. Drug Enforcement Administration registrations and numbers.      (Sec. 4)

9.   Directs the Board, AMB and ABOE to maintain current records on each psychologist who has prescriptive authority, including federal registrations and numbers. (Sec. 4)

10.  Directs the Board to provide the Arizona State Board of Pharmacy (ASBP), AMB and ABOE an annual list of prescribing psychologist and psychologist with a conditional prescription certificate that contains the information agreed on between the boards. (Sec. 4)

11.  Requires the Board to promptly notify ASBP of psychologists who are added to or deleted from the list of prescribing psychologists. (Sec. 4)

Conditional Prescription Certificate

12.  Enables psychologists to apply to the Board for a conditional prescription certificate on a Board-approved form that includes satisfactory evidence that they meet all of the following requirements:

a)   completed a doctoral program in psychology from an accredited institution of higher education or professional school, or, if the program was not accredited at the time of the applicant's graduation, the program meets professional standards determined acceptable by the Board;

b)   holds a current license to practice psychology in Arizona;

c)   successfully completed pharmacological training from an institution of higher education or a provider of continuing education approved by the Board, AMB or ABOE in medicine and surgery;

d)   passed a national certification examination approved by the Board, AMB and ABOE in medicine and surgery that tests the applicant's knowledge of pharmacology in diagnosing, caring for and treating mental disorders;

e)   has malpractice insurance in place that satisfies the rules of the Board, AMB and ABOE in medicine and surgery that will cover the applicant during the period the conditional prescription certificate is in effect; and

f) has met all other requirements determined by the Board in rule for obtaining a conditional prescription certificate. (Sec. 4)

13.  Requires psychologists who are applying for a conditional prescription certificate, within five years immediately preceding the date of application certified by each of the applicant's supervising physicians, to have successfully completed an organized education program that is approved by the Board, AMB and ABOE in medicine and surgery that consists of didactic instruction of at least 450 classroom hours in at least all of the prescribed core areas.          (Sec. 4)

14.  Requires psychologists who are applying for a conditional prescription certificate, within five years immediately preceding the date of application certified by each of the applicant's supervising physicians, to have completed a supervised and relevant clinical experience approved by the Board, AMB and ABOE in medicine and surgery that includes:

a)   a practicum of at least 80 hours in clinical assessment and pathophysiology under the supervision of a physician; and

b)   an additional supervised practicum of at least 400 hours treating at least 100 patients with mental disorders supervised by any one or a combination of psychiatrists or other appropriately trained physicians determined by the Board, AMB and ABOE in medicine and surgery that is sufficient to competently train them in treating a diverse population. (Sec. 4)

15.  Requires the additional supervised practicum hours to be one-on-one and provided either in-person, telephonically or by video conference. (Sec. 4)

16.  Asserts that conditional prescription certificates are valid for a period of two years and that an applicant may reapply upon expiration of the certificate. (Sec. 4)

17.  Authorizes psychologists with a conditional prescription certificate to prescribe psychotropic medication under the supervision of a supervising physician under the following conditions:

a)   the psychologist continues to hold a current Arizona license to practice psychology and continues to maintain malpractice insurance;

b)   the psychologist notifies the Board of the name of their supervising physician; and

c)   the psychologist's supervising physician notifies their licensing board of the name of each psychologist under their supervision. (Sec. 4)

18.  Stipulates that a supervising physician is not liable for the acts of a psychologist under their supervision unless the injury or loss arises from an act under the direction and control of the supervising physician. (Sec. 4)

Prescription Certificate

19.  Allows psychologists to apply for a prescription certificate on a Board-approved form that includes satisfactory evidence that they meet all of the following requirements:

a)   has been issued a conditional prescription certificate and successfully completed two years of prescribing psychotropic medication and any other FDA-approved medication to treat mental disorders as certified by the supervising physician;

b)   successfully underwent a process of independent peer review approved by the Board, AMB and ABOE in medicine and surgery;

c)   holds a current license to practice psychology in Arizona;

d)   has malpractice insurance in place that is sufficient to satisfy the rules adopted by the Board and that covers the applicant as a prescribing psychologist; and

e)   all other requirements determined by the Board in rule for obtaining a prescription certificate. (Sec. 4)

20.  Allows psychologists with a prescription certificate to prescribe psychotropic medications and any other FDA-approved medications to treat mental disorders if they meet both of the following:

a)   continue to hold a current license to practice psychology in Arizona and maintain malpractice insurance; and

b)   annually satisfy the continuing education requirements for prescribing psychologists, as set by the Board, which must require at least 20 hours each year. (Sec. 4)

Collaborative Relationships

21.  Instructs a prescribing psychologist or psychologist with a conditional prescription certificate when prescribing psychotropic medication or any FDA-approved medication to maintain an ongoing collaborative relationship with the health care practitioner who oversees the patient's general medical care to ensure that:

a)   necessary medical examinations are conducted;

b)   the psychotropic medication or other prescribed medication is appropriate for the patient's medical condition; and

c)   significant changes in the patient's medical or psychological condition are discussed.   (Sec. 4)  

22.  Requires the ongoing collaborative relationship to be maintained pursuant to guidelines developed by the Board, AMB and ABOE in medicine and surgery to optimize patient care. (Sec. 4)

23.  Specifies that the Board, AMB and ABOE guidelines must ensure that the prescribing psychologist or the psychologist with a conditional prescription certificate and the health care practitioner coordinate and collaborate on the care of the patient to provide optimal care.    (Sec. 4)

24.  Clarifies that this does not require a prescribing psychologist or a psychologist with a conditional prescription certificate to give prior notice to or obtain prior approval from a health care practitioner to prescribe psychotropic medication or any other FDA-approved medication to treat mental disorders to a patient with whom the psychologist has established a psychologist-patient relationship. (Sec. 4)

25.  Directs the psychologist to provide written notice of the prescription to the patient's health care practitioner within 24 hours after issuing the prescription to the patient. (Sec. 4)

Miscellaneous

26.  Directs the Board to issue prescription certificates and conditional prescription certificates if the Board finds that applicants meet all prescribed requirements. (Sec. 4)

27.  Directs the Board to adopt rules that do all of the following:

a)   provide the procedures to be followed in obtaining a conditional prescription certificate, a prescription certificate and renewals of a prescription certificate;

b)   establish application and renewal fees; and

c)   establish the grounds for denial, suspension or revocation of issued conditional prescription certificates and prescription certificates, including a provision for suspending or revoking a license to practice psychology on the suspension or revocation of those certificates. (Sec. 4)

28.  Specifies that the denial, suspension or revocation of a conditional prescription certificate or prescription certificate must be in accordance with uniform administrative hearing procedures. (Sec. 4)

29.  Exempts the Board from rulemaking requirements for one year. (Sec. 9)

30.  Defines terms. (Sec. 3, 4)

31.  Makes technical and conforming changes. (Sec. 3, 5-8)

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