This year several state legislatures debated legislation on prescriptive authority — the right for qualified psychologists to prescribe medications. Two states — New Mexico and Illinois —updated their existing prescriptive authority laws in ways that benefit prescribing psychologists.
In February, New Mexico’s law was amended to expand the pool of professionals who can serve as eligible supervisors for prescribing psychologists. Now, in addition to licensed physicians and psychiatrists, prescribing psychologists can be supervised by nurse practitioners, psychiatric nurse practitioners and clinical nurse specialists. That supervision can now be done through secure electronic communication, via telephone or by video conference, in addition to face-to face.
Those changes to the law make it easier for prescribing psychologists practicing in New Mexico to find supervisors, which is especially important for patients in rural areas where psychiatrists are in short supply.
Existing law required that prescribing psychologists in New Mexico coordinate with the patient’s primary care provider when prescribing medications. The state amended this provision to add physician assistants, clinical nurse specialists and advanced practice registered nurses to the definition of “primary-care provider.” The new law also specifies that “coordination with primary-care provider” does not have to be an in-person conversation but can include sending progress notes to the provider after visits. These amendments went into effect in February and those parts requiring new regulatory language (re: providers who can now supervise) must take effect no later than Jan. 1, 2020.
In Illinois, prescribing psychologists now have more options for training and practice. The legislature amended the state’s telehealth law by expanding the definition of “health-care professional” to include prescribing psychologists, a move that allows them to use telehealth for their pharmacological work.
The legislature also updated the existing prescriptive authority law to expand the settings where psychologists can complete clinical training rotations. Now, prescribing psychologists can train at medical centers, health-care facilities at state and federal prisons, hospital outpatient clinics, patient-centered (or family-centered) medical homes, women’s medical health centers and Federally Qualified Health Centers. The state also changed language related to training requirements, now requiring a standard 14-month practicum, rather than 36 credit hours, which could be confusing.
In both states, prescribing psychologists played an active role in changing the laws. Kevin Kinzie, executive director of the New Mexico Psychological Association, said the amendments to New Mexico’s existing prescriptive authority laws were drafted by a group of prescribing psychologists — most of whom are members of NMPA — and were supported by NMPA. Beth Rom-Rymer, PhD, said the Illinois Association of Prescribing Psychologists — where she serves as president and chief executive officer — wrote the legislation on broadening the training facilities for prescribing psychologists with support from the Illinois Psychological Association.
“It isn’t surprising to see early adopters of prescriptive authority, like New Mexico and Illinois, return to the legislature to modify and attune their RxP laws to better serve patients and the prescribing psychologists who treat them,” says Deborah Baker, JD, director of legal and regulatory policy at APA. New Mexico and Illinois enacted prescriptive authority legislation in 2002 and 2014 respectively. Louisiana, Iowa and Idaho have also adopted prescriptive authority laws.
With Illinois recently credentialing its first prescribing psychologist and both Iowa and Idaho poised to soon follow suit, Baker says more states will likely pursue prescriptive authority legislation in 2020.