HCS HB 536 -- PRESCRIBING PSYCHOLOGISTS

SPONSOR:  Wasson (Dixon)

COMMITTEE ACTION:  Voted "do pass" by the Special Committee on
Professional Registration and Licensing by a vote of 9 to 5.

This substitute authorizes the licensure of prescribing
psychologists under the State Committee of Psychologists in the
Division of Professional Registration within the Department of
Insurance, Financial Institutions and Professional Registration.
Persons licensed as prescribing psychologists will be authorized
to prescribe certain Schedule II stimulants and Schedule IV
tranquilizers or any other psychological treatment or laboratory
test as it relates to the practice of psychology, excluding
electrical convulsive therapy.  A licensed prescribing
psychologist cannot purchase, administer, or dispense medication.

Prescribing psychologist licenses will only be issued to licensed
psychologists who meet certain criteria established in the
substitute.  These requirements include completing 400 hours of
didactic educational training recommended by the American
Psychological Association or completing a post-doctoral master
degree in psychopharmacology; completing a one-year fellowship,
with weekly supervision by a physician and maintaining a
full-time caseload of patients during the year with duties of
medication management, psychological evaluations, and therapeutic
services; and passing a national examination testing competency
to engage in the practice of prescriptive authority.  The
division may establish rules creating additional requirements
based on current educational guidelines stated in the American
Psychological Association's publication of Recommended
Postdoctoral Training in Psychopharmacology for Prescription
Privileges.

After receiving his or her license to prescribe, a psychologist
must enter into a collaborative practice agreement with a
licensed physician.  The State Board of Registration for the
Healing Arts and the State Committee of Psychologists are
required to establish joint rules to govern the use of
collaborate practice arrangements, but the rules must be limited
to specifying geographic areas to be covered and the methods of
treatment but not mandate particular requirements for the review
of the services.

A psychologist holding prescribing authorization is required to
maintain appropriate medical liability insurance and complete at
least 20 hours of psychopharmacology continuing education credit
within the two-year period preceding a license renewal in
addition to the general 40-hour continuing education requirement.

Pharmacists are authorized to fill prescriptions written by
licensed prescribing psychologists.

FISCAL NOTE:  Estimated Cost on General Revenue Fund of Unknown
less than $100,000 in FY 2010, Unknown less than $35,000 in FY
2011, and Unknown greater than $35,000 in FY 2012.  No impact on
Other State Funds in FY 2010, FY 2011, and FY 2012.

PROPONENTS:  Supporters say that adequate mental health care
should not be a luxury.  There is a severe problem with access to
mental health services in Missouri, especially in the rural
areas.  It is becoming more and more difficult for people to see
psychiatrists, and many people are using the emergency room for
mental health services.  By allowing psychologists to prescribe,
persons with mental illnesses will receive the care and treatment
they need.

Testifying for the bill were Representative Dixon; Roy Holand,
M.D.; Donna McArthur; Danny Moore; Dr. Deborah Onkan; and John
Howell.

OPPONENTS:  Those who oppose the bill say the standard of care is
lowered by allowing psychologists to prescribe.  The bill will
allow psychologists to practice medicine.  The majority of
psychologists are practicing in the metropolitan areas, and they
will continue to do so.  The bill will not provide better access
to care in the rural communities.

Testifying against the bill were Dr. Jo Ellen Ryall; Dr. John
Collins; Dr. Justin Puckett; Dr. Lawernce Kuhn; Dr. Jack
Croughan; Dr. Paul Simon; Missouri Association of Osteopathic
Physicians and Surgeons; and Eastern Missouri Psychiatric
Society.

Missouri House of Representatives
95th General Assembly, 1st Regular Session
Last Updated November 17, 2009 at 9:25 am