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THE SENATE |
S.C.R. NO. |
113 |
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TWENTY-THIRD LEGISLATURE, 2006 |
S.D. 1 |
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STATE OF HAWAII |
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RESOLUTION
REQUESTING THE LEGISLATIVE REFERENCE BUREAU TO STUDY THE ISSUE OF AUTHORIZING PSYCHOLOGISTS WHO HAVE OBTAINED THE APPROPRIATE EDUCATION, TRAINING, AND EXPERIENCE TO PRESCRIBE A LIMITED FORMULARY OF PSYCHOTROPIC MEDICATIONS FOR THE TREATMENT OF MENTAL ILLNESS WHILE PRACTICING IN FEDERALLY QUALIFIED HEALTH CENTERS OR LICENSED HEALTH CLINICS LOCATE IN FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS OR IN MENTAL HEALTH PROFESSIONAL SHORTAGE AREAS.
WHEREAS, it has been stated by proponents of legislation proposing to confer prescriptive authority on clinical psychologists that there are not enough psychiatrists available to serve patients at federally qualified health centers in the State; and
WHEREAS, at the same time, there appear to be certain barriers to the hiring of psychiatrists at these federally qualified health centers; and
WHEREAS, it has been suggested by proponents of legislation proposing to confer prescriptive authority on clinical psychologists that, under certain conditions relating to obtaining appropriate education, training, and experience, clinical psychologists may be qualified to prescribe medications; and
WHEREAS, this view is strongly contradicted by those who believe that prescriptive authority to treat mental illness carries with it many inherent dangers to the health, safety, and well being of the public if that prescriptive authority is not retained and exercised only by medically trained and qualified psychiatrists; and
WHEREAS, these competing views need to be carefully examined; and
WHEREAS, it is in the interest of the health, safety, and well-being of the State to examine the pros and cons of the debate regarding the appropriateness of conferring prescriptive authority on clinical psychologists to treat mental illness in the State; now, therefore,
BE IT RESOLVED by the Senate of the Twenty-third Legislature of the State of Hawaii, Regular Session of 2006, the House of Representatives concurring, that the Legislative Reference Bureau is requested to study the issue of authorizing psychologists who have obtained the appropriate education, training, and experience to prescribe a limited formulary of psychotropic medications for the treatment of mental illness, while practicing in federally qualified health centers or licensed health clinics located in federally designated medically underserved areas or in mental health professional shortage areas; and
BE IT FURTHER RESOLVED that the Legislative Reference Bureau is requested to include in its study:
(1) A comparison of requisite educational requirements of psychologists versus psychiatrists, advanced practice nurse practitioners at the prescriptive level, optometrists, podiatrists, and physicians' assistants for what prescriptive authority they have and what medications they are allowed to prescribe, if any, and under what supervision;
(2) Evidence of patient safety where psychologists prescribe psychotropic medications or are responsible for the management of patient care that includes psychotropic medications;
(3) Trends in other states concerning conferring limited prescriptive authority on certain psychologists;
(4) A review of the arguments in support and in opposition to conferring limited prescriptive authority on certain psychologists;
(5) A review and description of barriers or obstacles, if any, to the hiring of psychiatrists at federally qualified health centers, such as the number of positions available, the funding available, the availability of psychiatrists to fill these positions, and the possible solutions to removing such barriers or obstacles; and
(6) A review of the program operated by the United States Department of Defense authorizing certain psychologists to prescribe a limited formulary of psychotropic medications, including a review of any evaluations for the program or statistics that might be available; and
BE IT FURTHER RESOLVED that the Hawaii Primary Care Association, the Hawaii Psychological Association, and the Hawaii Psychiatric Medical Association are requested to designate representatives authorized to speak on behalf of the organization who may be consulted by the Bureau with respect to the issues in this study, provided that the Bureau shall not be limited to consulting only with these representatives; and
BE IT FURTHER RESOLVED that the Legislative Reference Bureau is further requested to review experiences and studies in Hawaii and other states, including but not limited to Louisiana, New Mexico, and New York, that may have passed legislation allowing psychologists to prescribe, including problems relating to misdiagnosis and treatment of patients as a result of allowing psychologists to prescribe various medications; and
BE IT FURTHER RESOLVED that the Legislative Reference Bureau is requested to report its findings and recommendations to the Legislature not later than twenty days prior to the convening of the Regular Session of 2007; and
BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Acting Director of the Legislative Reference Bureau, the Chairperson of the Board of Psychology, the Chairperson of the Board of Medical Examiners, the Director of Health, and the Executive Directors of the Hawaii Primary Care Association, the Hawaii Psychological Association, and the Hawaii Psychiatric Medical Association.
Report Title:
Prescriptive Authority; Psychologists/Psychiatrists; Study