STAND. COM. REP. NO. 1241

Honolulu, Hawaii

RE:    H.B. No. 1456

       H.D. 2

       S.D. 1

Honorable Colleen Hanabusa

President of the Senate

Twenty-Fourth State Legislature

Regular Session of 2007

State of Hawaii

Madam:

     Your Committee on Health, to which was referred H.B. No. 1456, H.D. 2, entitled:

"A BILL FOR AN ACT RELATING TO PSYCHOLOGISTS,"

begs leave to report as follows:

     The purpose of this measure is to increase and improve access to therapeutic and pharmacological mental health care in rural areas of the State by allowing appropriately trained psychologists practicing in licensed health care clinics within federally designated medically underserved areas or mental health professional shortage areas to prescribe a limited array of psychotropic medications.

     Your Committee received testimony in support of this measure from the Hawaii Psychological Association, Mental Health America of Hawaii, Ho‘ola Lahui Hawai‘i, Na Pu‘uwai, and two individuals.  Your Committee received testimony in opposition to this measure from the Hawaii Psychiatric Medical Association, Hawaii Medical Association, and four individuals.  Comments on this measure were submitted by the Department of Health and one individual.

     Your Committee finds that individuals living in rural areas of the State need access to appropriate mental health care services.

     Your Committee further finds that allowing appropriately licensed and trained psychologists to prescribe psychotropic medications will address the urgent need for timely, appropriate, and cost-effective mental health and pharmacological services for an underserved population.  Federally qualified health centers are most in need of psychologists with prescriptive authority and allowing psychologists who work at these health centers would achieve the largest impact for individuals in need of these services.

     Your Committee further finds that the adequacy of training for psychologists and safety issues in prescribing psychotropic medications has been a recurring concern.  However, your Committee notes that the former Clinical Training Director of the Department of Defense Psychopharmacology Demonstration Project reviewed the training and curriculum outlined in S.B. No. 1004, S.D. 2, and H.B. No. 1456, H.D. 2, and found it to be essentially equivalent to the instruction and relevant experiences provided to the students in the Psychopharmacology Demonstration Project.

     In addition, the United States Navy and United States Air Force requirements for prescribing psychologists are equivalent to the requirements listed in this measure S.B. No. 1004, S.D. 2, and H.B. No. 1456, H.D. 2.

     Your Committee further finds that including the requirement that the prescribing psychologist be under physician supervision establishes an additional layer of protection, ensuring that individuals in need of mental health services and psychotropic medication receive safe and qualified health care.

     Your Committee amended this measure by deleting its contents and inserting the contents of S.B. No. 1004, S.D. 2, a similar measure that:

     (1)  Removes the definition "collaborative relationship";

     (2)  Clarifies that a "prescribing mental health professional" is a medically trained and licensed physician or psychiatrist;

     (3)  Removes "pharmaceutical" from the definition of "psychotropic medication";

     (4)  Removes the requirement that an accredited institution of higher learning be approved by the University of Hawaii John A. Burns School of Medicine or the Tripler Army Medical Center's psychiatry residency program;

     (5)  Raises the practicum experience requirement to include successful completion of twelve credit hours consisting of a supervised practicum of at least one year involving four hundred hours treating a diverse population of no fewer than one hundred patients with mental disorders;

     (6)  Requires a licensed healthcare provider who is experienced in the provision of psychopharmacotherapy to supervise the practicum;

     (7)  Requires the practicum to include at least two hours of weekly supervision by a supervisor who is not in the employ of the person being directed or supervised;

     (8)  Requires employment by a federally qualified health center, removing the language allowing employment at a licensed health clinic in a medically underserved area or a mental health professional shortage area;

     (9)  Removes the authority of a psychologist who holds a conditional or prescription certificate to order and review laboratory tests;

    (10)  Removes the Board of Psychology from the approval process of independent peer review;

    (11)  Requires a psychologist who holds a conditional or prescription certificate to maintain an ongoing collaborative relationship with the doctor of medicine who supervises the psychologist directly or by telecommunication;

    (12)  Clarifies that a psychologist holding a conditional or prescription certificate is prohibited from administering or prescribing a narcotic; and

    (13)  Changes the date the Hawaii State Health Planning and Development Agency is to report to the Legislature from 2011 to 2010.

     As affirmed by the record of votes of the members of your Committee on Health that is attached to this report, your Committee is in accord with the intent and purpose of H.B. No. 1456, H.D. 2, as amended herein, and recommends that it pass Second Reading in the form attached hereto as H.B. No. 1456, H.D. 2, S.D. 1, and be referred to the Committee on Commerce, Consumer Protection, and Affordable Housing.

Respectfully submitted on behalf of the members of the Committee on Health,

____________________________

DAVID Y. IGE, Chair