Bill Text: IA HF2334 | 2015-2016 | 86th General Assembly | Introduced
Bill Title: A bill for an act relating to prescription authority for certain psychologists and making penalties applicable. (Formerly HSB 503)
Spectrum: Committee Bill
Status: (Introduced - Dead) 2016-04-25 - Withdrawn. H.J. 746. [HF2334 Detail]
Download: Iowa-2015-HF2334-Introduced.html
House File 2334 - Introduced HOUSE FILE BY COMMITTEE ON HUMAN RESOURCES (SUCCESSOR TO HSB 503) A BILL FOR 1 An Act relating to prescription authority for certain 2 psychologists and making penalties applicable. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: TLSB 5086HV (2) 86 rh/nh PAG LIN 1 1 Section 1. Section 123.3, subsection 35, Code 2016, is 1 2 amended to read as follows: 1 3 35. "Pharmacy" means a drug store in which drugs and 1 4 medicines are exposed for sale and sold at retail, or in which 1 5 prescriptions of licensed physicians and surgeons, dentists, 1 6 prescribing psychologists, or veterinarians are compounded and 1 7 sold by a registered pharmacist. 1 8 Sec. 2. Section 124.101, subsection 26, paragraph a, Code 1 9 2016, is amended to read as follows: 1 10 a. A physician, dentist, podiatric physician, prescribing 1 11 psychologist, veterinarian, scientific investigator or 1 12 other person licensed, registered, or otherwise permitted to 1 13 distribute, dispense, conduct research with respect to, or to 1 14 administer a controlled substance in the course of professional 1 15 practice or research in this state. 1 16 Sec. 3. Section 147.107, subsections 1 and 2, Code 2016, are 1 17 amended to read as follows: 1 18 1. A person, other than a pharmacist, physician, 1 19 dentist, podiatric physician, prescribing psychologist, or 1 20 veterinarian who dispenses as an incident to the practice of 1 21 the practitioner's profession, shall not dispense prescription 1 22 drugs or controlled substances. 1 23 2. a. A pharmacist, physician, dentist,orpodiatric 1 24 physician, or prescribing psychologist who dispenses 1 25 prescription drugs, including but not limited to controlled 1 26 substances, for human use, may delegate nonjudgmental 1 27 dispensing functions to staff assistants only when verification 1 28 of the accuracy and completeness of the dispensing is 1 29 determined by the pharmacist or practitioner in the 1 30 pharmacist's or practitioner's physical presence. However, the 1 31 physical presence requirement does not apply when a pharmacist 1 32 or practitioner is utilizing an automated dispensing system or 1 33 when a pharmacist is utilizing a tech=check=tech program, as 1 34 defined in section 155A.3. When using an automated dispensing 1 35 system the pharmacist or practitioner shall utilize an 2 1 internal quality control assurance plan that ensures accuracy 2 2 for dispensing. When using a tech=check=tech program the 2 3 pharmacist shall utilize an internal quality control assurance 2 4 plan, in accordance with rules adopted by the board of 2 5 pharmacy, that ensures accuracy for dispensing. Verification 2 6 of automated dispensing and tech=check=tech accuracy and 2 7 completeness remains the responsibility of the pharmacist or 2 8 practitioner and shall be determined in accordance with rules 2 9 adopted by the board of pharmacy, the board of medicine, the 2 10 dental board,andthe board of podiatry, and the board of 2 11 psychology for their respective licensees. 2 12 b. A dentist, physician,orpodiatric physician, or 2 13 prescribing psychologist who dispenses prescription drugs, 2 14 other than drug samples, pursuant to this subsection, shall 2 15 report the fact that they dispense prescription drugs with the 2 16 practitioner's respective board at least biennially. 2 17 c. A physician, dentist,orpodiatric physician, or 2 18 prescribing psychologist who dispenses prescription drugs, 2 19 other than drug samples, pursuant to this subsection, shall 2 20 offer to provide the patient with a written prescription that 2 21 may be dispensed from a pharmacy of the patient's choice or 2 22 offer to transmit the prescription orally, electronically, or 2 23 by facsimile in accordance with section 155A.27 to a pharmacy 2 24 of the patient's choice. 2 25 Sec. 4. NEW SECTION. 148.13A Board authority over 2 26 physicians supervising certain psychologists. 2 27 The board of medicine shall establish by rule specific 2 28 procedures for consulting with and considering the advice of 2 29 the board of psychology in determining whether to initiate 2 30 a disciplinary proceeding under chapter 17A against a 2 31 licensed physician in a matter involving the supervision of a 2 32 psychologist prescribing medication pursuant to a conditional 2 33 prescription certificate under chapter 154B. 2 34 Sec. 5. Section 154B.1, Code 2016, is amended to read as 2 35 follows: 3 1 154B.1DefinitionDefinitions. 3 2 As used in this chapter, unless the context otherwise 3 3 requires: 3 4 1. "Board" means the board of psychology created under 3 5 chapter 147. 3 6 2. "Collaborative practice agreement" means a written 3 7 agreement between a prescribing psychologist and a licensed 3 8 physician that establishes clinical protocols, practice 3 9 guidelines, and care plans relevant to the scope of the 3 10 collaborative practice. 3 11 3. "Collaborative relationship" means a cooperative 3 12 working relationship between a prescribing psychologist or a 3 13 psychologist with a conditional prescription certificate and a 3 14 licensed physician in the provision of patient care, including 3 15 diagnosis and cooperation in the management and delivery of 3 16 physical and mental health care. 3 17 4. "Conditional prescription certificate" means a document 3 18 issued by the board to a licensed psychologist that permits 3 19 the holder to prescribe psychotropic medication under the 3 20 supervision of a licensed physician pursuant to this chapter. 3 21 5. "Practice of psychology" means the application of 3 22 established principles of learning, motivation, perception, 3 23 thinking, and emotional relations to problems of behavior 3 24 adjustment, group relations, and behavior modification, 3 25 by persons trained in psychology for compensation or other 3 26 personal gain. The application of principles includes,but 3 27 is not limited to: Counseling and the use of psychological 3 28 remedial measures with persons, in groups or individually, 3 29 with adjustment or emotional problems in the areas of work, 3 30 family, school, and personal relationships; measuring and 3 31 testing personality, intelligence, aptitudes, public opinion, 3 32 attitudes, and skills; and the teaching of such subject matter, 3 33 and the conducting of research on the problems relating to 3 34 human behavior. 3 35 6. "Prescribing psychologist" means a licensed psychologist 4 1 who holds a valid prescription certificate. 4 2 7. "Prescription certificate" means a document issued by the 4 3 board to a licensed psychologist that permits the holder to 4 4 prescribe psychotropic medication pursuant to this chapter. 4 5 8. "Psychotropic medication" means a controlled substance 4 6 or dangerous drug that shall not be dispensed or administered 4 7 without a prescription and that has been approved by the 4 8 federal food and drug administration for the treatment of 4 9 mental disorders, as defined by the most current diagnostic 4 10 and statistical manual of mental disorders published by the 4 11 American psychiatric association or the most current version 4 12 of the international classification of diseases, and that is 4 13 listed as a psychotherapeutic agent in the American hospital 4 14 formulary service. "Psychotropic medication" does not include 4 15 narcotics. 4 16 Sec. 6. NEW SECTION. 154B.9 Drugs ==== medicine. 4 17 1. Except as provided in subsections 2 and 3, a psychologist 4 18 shall not administer or prescribe drugs or medicine. 4 19 2. A licensed psychologist holding a conditional 4 20 prescription certificate may prescribe psychotropic medication 4 21 under the supervision of a licensed physician pursuant to this 4 22 chapter. 4 23 3. A prescribing psychologist may prescribe psychotropic 4 24 medication pursuant to this chapter. 4 25 Sec. 7. NEW SECTION. 154B.10 Conditional prescription 4 26 certificate. 4 27 1. An applicant for a conditional prescription certificate 4 28 shall be granted a certificate by the board if the applicant 4 29 satisfies all of the following requirements: 4 30 a. Holds a current license to practice psychology in this 4 31 state. 4 32 b. Completed pharmacological training from an institution 4 33 approved by the board or from a provider of continuing 4 34 education approved by the board. 4 35 c. Passed a national certification examination approved by 5 1 the board that tested the applicant's knowledge of pharmacology 5 2 in the diagnosis, care, and treatment of mental disorders. 5 3 d. Within five years immediately preceding the date of 5 4 application, successfully completed an organized program of 5 5 education consisting of intensive didactic instruction of no 5 6 fewer than four hundred fifty classroom hours in at least the 5 7 following core areas of instruction: 5 8 (1) Neuroscience. 5 9 (2) Pharmacology. 5 10 (3) Psychopharmacology. 5 11 (4) Physiology. 5 12 (5) Appropriate and relevant physical and laboratory 5 13 assessment. 5 14 e. Within five years immediately preceding the date of 5 15 application, has been certified by the applicant's supervising 5 16 psychiatrist or physician as having successfully completed 5 17 a supervised and relevant clinical experience of no less 5 18 than an eighty=hour practicum in clinical assessment and 5 19 pathophysiology and an additional supervised practicum of at 5 20 least four hundred hours treating no fewer than one hundred 5 21 patients with mental disorders. The practica shall have been 5 22 supervised by a psychiatrist or other appropriately trained 5 23 physician. The board shall determine whether the practica is 5 24 sufficient to competently train the applicant in the treatment 5 25 of a diverse patient population. 5 26 f. Possesses malpractice insurance that will cover the 5 27 applicant during the period the conditional prescription 5 28 certificate is in effect. 5 29 g. Meets all other requirements, as determined by rules 5 30 adopted by the board, for obtaining a conditional prescription 5 31 certificate. 5 32 2. A conditional prescription certificate is valid for four 5 33 years, at the end of which the holder may apply again pursuant 5 34 to the provisions of subsection 1. 5 35 3. A psychologist with a conditional prescription 6 1 certificate may prescribe psychotropic medication under the 6 2 supervision of a licensed physician subject to all of the 6 3 following conditions: 6 4 a. The psychologist shall continue to hold a current license 6 5 to practice psychology in this state and continue to maintain 6 6 malpractice insurance. 6 7 b. The psychologist shall inform the board of the name of 6 8 the physician under whose supervision the psychologist will 6 9 prescribe psychotropic medication and promptly inform the board 6 10 of any change of the supervising physician. 6 11 c. A physician supervising a psychologist prescribing 6 12 psychotropic medication pursuant to a conditional prescription 6 13 certificate shall be subject to disciplinary action pursuant to 6 14 section 148.13A for the acts and omissions of the psychologist 6 15 while under the physician's supervision. This provision 6 16 does not relieve the psychologist from liability for the 6 17 psychologist's acts and omissions. 6 18 Sec. 8. NEW SECTION. 154B.11 Prescription certificate. 6 19 1. An applicant for a prescription certificate shall be 6 20 granted a certificate by the board if the applicant satisfies 6 21 all of the following requirements: 6 22 a. Possesses a conditional prescription certificate and has 6 23 successfully completed two years of prescribing psychotropic 6 24 medication as certified by the supervising licensed physician. 6 25 An applicant for a prescription certificate who specializes 6 26 in the psychological care of children, elderly persons, or 6 27 persons with comorbid psychological conditions shall complete 6 28 at least one year prescribing psychotropic medications to such 6 29 populations as certified by the supervising licensed physician. 6 30 b. Holds a current license to practice psychology in this 6 31 state. 6 32 c. Possesses malpractice insurance that will cover the 6 33 applicant as a prescribing psychologist. 6 34 d. Meets all other requirements, as determined by rules 6 35 adopted by the board, for obtaining a prescription certificate. 7 1 2. A psychologist with a prescription certificate may 7 2 prescribe psychotropic medication pursuant to the provisions of 7 3 this chapter subject to the following conditions: 7 4 a. The psychologist continues to hold a current license to 7 5 practice psychology in this state and maintains malpractice 7 6 insurance. 7 7 b. The psychologist annually satisfies the continuing 7 8 education requirements for prescribing psychologists, as 7 9 determined by the board, which shall be no fewer than twenty 7 10 hours each year. 7 11 c. The psychologist has entered into a collaborative 7 12 practice agreement with a licensed physician. 7 13 Sec. 9. NEW SECTION. 154B.12 Prescribing practices. 7 14 1. A prescribing psychologist or a psychologist with 7 15 a conditional prescription certificate may administer and 7 16 prescribe psychotropic medication within the scope of the 7 17 psychologist's profession, including the ordering and review of 7 18 laboratory tests in conjunction with the prescription, for the 7 19 treatment of mental disorders. 7 20 2. When prescribing psychotropic medication for a 7 21 patient, the prescribing psychologist or the psychologist 7 22 with a conditional prescription certificate shall maintain 7 23 an ongoing collaborative relationship with the licensed 7 24 physician who oversees the patient's general medical care to 7 25 ensure that necessary medical examinations are conducted, 7 26 the psychotropic medication is appropriate for the patient's 7 27 medical condition, and significant changes in the patient's 7 28 medical or psychological condition are discussed. 7 29 3. A prescription written by a prescribing psychologist or a 7 30 psychologist with a conditional prescription certificate shall 7 31 meet all of the following requirements: 7 32 a. Comply with applicable state and federal laws. 7 33 b. Be identified as issued by the psychologist as 7 34 "psychologist certified to prescribe". 7 35 c. Include the psychologist's board=assigned identification 8 1 number. 8 2 4. A prescribing psychologist or a psychologist with 8 3 a conditional prescription certificate shall not delegate 8 4 prescriptive authority to any other person. Records of all 8 5 prescriptions shall be maintained in patient records. 8 6 5. When authorized to prescribe controlled substances, a 8 7 prescribing psychologist or a psychologist with a conditional 8 8 prescription certificate shall file with the board in a 8 9 timely manner all individual federal drug enforcement agency 8 10 registration and numbers. The board shall maintain current 8 11 records on every psychologist, including federal registration 8 12 and numbers. 8 13 Sec. 10. NEW SECTION. 154B.13 Board duties regarding 8 14 prescription certificates and conditional prescription 8 15 certificates. 8 16 1. The board shall adopt rules providing for the 8 17 procedures to obtain a conditional prescription certificate, 8 18 a prescription certificate, and a renewal of a prescription 8 19 certificate. The board may set reasonable application and 8 20 renewal fees. 8 21 2. The board shall adopt rules establishing the grounds for 8 22 denial, suspension, or revocation of conditional prescription 8 23 certificates and prescription certificates, including a 8 24 provision for suspension or revocation of a license to practice 8 25 psychology upon the suspension or revocation of a certificate. 8 26 3. The board shall provide to the board of pharmacy an 8 27 annual list of prescribing psychologists and psychologists 8 28 with conditional prescription certificates that contains 8 29 the information agreed upon between the board and the board 8 30 of pharmacy. The board shall promptly notify the board of 8 31 pharmacy of psychologists who are added to or removed from the 8 32 list. 8 33 4. The board shall adopt other rules as necessary to 8 34 administer this chapter. 8 35 5. The board shall consult with the board of medicine in 9 1 developing rules to carry out this chapter. 9 2 Sec. 11. Section 155A.3, subsection 35, Code 2016, is 9 3 amended to read as follows: 9 4 35. "Practitioner" means a physician, dentist, podiatric 9 5 physician, prescribing psychologist, veterinarian, or other 9 6 person licensed or registered to distribute or dispense a 9 7 prescription drug or device in the course of professional 9 8 practice in this state or a person licensed by another state 9 9 in a health field in which, under Iowa law, licensees in this 9 10 state may legally prescribe drugs. 9 11 Sec. 12. Section 155A.23, subsection 1, paragraph c, Code 9 12 2016, is amended to read as follows: 9 13 c. For the purpose of obtaining a prescription drug or 9 14 device, falsely assuming the title of or claiming to be 9 15 a manufacturer, wholesaler, pharmacist, pharmacy owner, 9 16 physician, dentist, podiatric physician, prescribing 9 17 psychologist, veterinarian, or other authorized person. 9 18 Sec. 13. Section 155A.24, subsection 14, Code 2016, is 9 19 amended to read as follows: 9 20 14. This section does not prevent a licensed practitioner of 9 21 medicine, dentistry, podiatry, nursing, psychology, veterinary 9 22 medicine, optometry, or pharmacy from acts necessary in the 9 23 ethical and legal performance of the practitioner's profession. 9 24 EXPLANATION 9 25 The inclusion of this explanation does not constitute agreement with 9 26 the explanation's substance by the members of the general assembly. 9 27 This bill grants prescription authority to certain licensed 9 28 psychologists under Code chapter 154B. 9 29 The bill adds definitions of "board", "collaborative 9 30 practice agreement", "collaborative relationship", "conditional 9 31 prescription certificate", "prescribing psychologist", 9 32 "prescription certificate", and "psychotropic medication" to 9 33 the Code chapter. 9 34 The bill allows a licensed psychologist holding a 9 35 conditional prescription certificate and a prescribing 10 1 psychologist, defined as a licensed psychologist who holds 10 2 a valid prescription certificate, to prescribe psychotropic 10 3 medication. However, the psychologist holding a conditional 10 4 prescription certificate may only prescribe psychotropic 10 5 medication under the supervision of a licensed physician. 10 6 The bill sets the requirements for a psychologist to obtain 10 7 a conditional prescription certificate or a prescription 10 8 certificate. A conditional prescription certificate is 10 9 valid for four years and a psychologist may reapply for 10 10 the certificate. To receive a prescription certificate, 10 11 a psychologist must complete two years of prescribing 10 12 psychotropic medication as supervised by a licensed physician 10 13 and an applicant who specializes in the psychological care 10 14 of children, elderly persons, or persons with comorbid 10 15 psychological conditions shall have at least one year 10 16 prescribing psychotropic medications to such populations. A 10 17 psychologist with a prescription certificate may prescribe 10 18 psychotropic medication under the provisions of the bill 10 19 subject to certain conditions including that the psychologist 10 20 has entered into a collaborative practice agreement with a 10 21 licensed physician. The licensed physician may be subject 10 22 to disciplinary action for the acts and omissions of the 10 23 psychologist under the physician's supervision. A psychologist 10 24 must maintain licensure as a psychologist and malpractice 10 25 insurance to retain the prescription certificate or the 10 26 conditional prescription certificate. 10 27 The bill provides that a prescribing psychologist or 10 28 psychologist with a conditional prescription certificate may 10 29 administer and prescribe psychotropic medication within the 10 30 scope of the person's profession. The prescribing psychologist 10 31 or psychologist with a conditional prescription certificate 10 32 must maintain a relationship with the patient's licensed 10 33 physician when prescribing psychotropic medication for the 10 34 patient. 10 35 The bill states that a prescription written by a 11 1 prescribing psychologist or a psychologist with a conditional 11 2 prescription certificate must comply with state and federal 11 3 law, be identified as issued by a "psychologist certified to 11 4 prescribe", and include the psychologist's board=assigned 11 5 identification number. A prescribing psychologist or 11 6 psychologist with a conditional prescription certificate 11 7 may not delegate the prescriptive authority to any other 11 8 person, and records of the prescriptions must be maintained 11 9 in the patient's records. The prescribing psychologist or 11 10 psychologist with a conditional prescription certificate must 11 11 also file federal drug enforcement agency registrations and 11 12 numbers with the board. 11 13 The bill instructs the board of psychology in consultation 11 14 with the board of medicine to adopt rules providing for 11 15 the procedures for obtaining a conditional prescription 11 16 certificate, a prescription certificate, and a renewal of 11 17 a prescription certificate; setting reasonable application 11 18 and renewal fees; and regarding the denial, suspension, 11 19 or revocation of conditional prescription certificates and 11 20 prescription certificates. The board must provide the board of 11 21 pharmacy with an annual list of prescribing psychologists and 11 22 psychologists with conditional prescription certificates and 11 23 promptly notify the board of pharmacy of psychologists who are 11 24 added to or removed from the list. 11 25 A prescribing psychologist may be subject to criminal and 11 26 civil penalties and licensing sanctions under Code chapters 11 27 124, 147, 154B, and 155A. 11 28 The bill makes conforming changes in Code chapters 123, 124, 11 29 147, and 155A. LSB 5086HV (2) 86 rh/nh
