Lawmakers Seem Reluctant to Enact Scope-of-Practice Expansions

Bills that would grant psychologists prescription-writing authority are effectively dead for the current legislative sessions in Montana and Hawaii, joining bills defeated in Arizona and Utah. Similar legislation is still pending in New Jersey, Oregon, and Tennessee.

Staff in APA's Department of Government Relations (DGR) have been closely monitoring the various state prescribing bills. They also have been working with the state psychiatric associations, as well as allies such as the AMA, the National Alliance on Mental Illness (NAMI), and members of the Scope of Practice Partnership to defeat these bills and protect patients.

In Montana, the House Human Services Committee tabled Senate Bill 272 by a vote of 14 to 1. The lopsided vote is a strong indicator that the measure is dead for this legislative session. There is a procedure in Montana called a blast that can resurrect a bill and move it out of committee and straight to the full house. This procedure has been tried several times by supporters, but to no avail.

Hawaii has long been a key battle-ground over prescription privileges. Some form of legislation to give psychologists the authority to write scripts for psychotropic drugs has been proposed in the Hawaii legislature every year since 1985. Such legislation was passed in 2007, but vetoed by then Gov. Linda Lingle. This history made the latest Hawaii bill one of most closely watched in the nation. Senate Bill 597 was referred to the House Health Committee, where the chair announced that the bill would not be heard. This action would have killed the bill, except for a procedural rule allowing supporters to get a waiver to move the bill to the full House. Supporters had 20 days to secure the support of one-third of the House for the waiver. The deadline passed on March 30, killing the bill for the year.

This is the first year that a psychologist prescribing bill has been introduced in New Jersey. Assembly Bill 3745 was introduced relatively late in the legislative session and is still in the Regulated Professions Committee. Tim Martin, lobbyist for the New Jersey Psychiatric Association, told Psychiatric News that the "schedule doesn't bode well for this bill. The calendar is its biggest enemy." At this time the bill does not even have a counterpart in the state senate. The New Jersey Psychiatric Association has partnered with APA, the AMA, and the Medical Society of New Jersey to provide a steady stream of literature and facts to legislators in an effort to defeat the bill.

In Tennessee, a scope-of-practice bill was introduced in both legislative chambers, Senate Bill 0390 and House Bill 0749. The Senate has taken the lead on the bill, with no action to this point in the House Health and Human Resources Committee.

In speaking with the legislative representative of the Tennessee Psychiatric Association (TPA), Greg Keyser, M.D., Psychiatric News learned that members of TPA members and the Tennessee Medical Association spoke at a hearing of the Senate General Welfare, Health, and Human Resources Committee and subsequently the bill was "taken off notice." The bill could be brought back up, but at this point, said Keyser, "we feel fairly confident with where we are with the bill, at least in this legislative session." Bills in Tennessee carry over from one legislative year to the next, so APA continues to be vigilant about developments regarding this bill.

Oregon is the state currently receiving the most attention by opponents and proponents alike of extending prescribing authority to psychologists. Just last year Oregon passed such a bill, but it was vetoed by then Gov. Ted Kulongoski. That bill was passed during a special legislative session, and Kulongoski noted in his veto statement that he did not believe there was "opportunity for citizens and interested stakeholders to be adequately involved in the development of those proposed major policy changes."

This year's legislation, House Bill 3523, was passed by the Health Committee on April 14. The bill is now in the House Ways and Means Committee pending action. As of press time, the schedule for further action had not been set.