Bill Text: IA SF2188 | 2015-2016 | 86th General Assembly | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

---

Bill Title: A bill for an act relating to prescription authority for certain psychologists and making penalties applicable. (Formerly SF 2075.)

Spectrum: Committee Bill

Status: (Enrolled - Dead) 2016-04-29 - Sent to Governor. S.J. 0. [SF2188 Detail]

Download: Iowa-2015-SF2188-Amended.html

---

Senate File 2188 - Reprinted




                                 SENATE FILE       
                                 BY  COMMITTEE ON HUMAN
                                     RESOURCES

                                 (SUCCESSOR TO SF 2075)
       (As Amended and Passed by the Senate April 7, 2016)

                                      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:
    SF 2188 (7) 86
    rh/nh/jh

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, or podiatric
  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, and the board of podiatry, and the board of
  2 11 psychology for their respective licensees.
  2 12    b.  A dentist, physician, or podiatric 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, or podiatric 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, in consultation with the board
  2 28 of psychology, establish by rule all of the following:
  2 29    1.  Specific minimum standards for the appropriate
  2 30 supervision of a psychologist prescribing medication pursuant
  2 31 to a conditional prescription certificate under chapter 154B.
  2 32  Such standards shall include requiring a physician serving
  2 33 as a supervising licensed physician to notify the board of
  2 34 medicine of the identity of the psychologist the physician is
  2 35 supervising and any change in the status of the supervisory
  3  1 relationship.
  3  2    2.  The process for initiating and conducting disciplinary
  3  3 proceedings under chapter 17A if a licensed physician
  3  4 fails to adequately supervise a psychologist prescribing
  3  5 psychotropic medications pursuant to a prescription certificate
  3  6 under chapter 154B.  The rule shall take into account the
  3  7 deliberations of the board in making such a determination.
  3  8    Sec. 5.  Section 154B.1, Code 2016, is amended to read as
  3  9 follows:
  3 10    154B.1  Definition Definitions.
  3 11    As used in this chapter, unless the context otherwise
  3 12 requires:
  3 13    1.  "Board" means the board of psychology created under
  3 14 chapter 147.
  3 15    2.  "Collaborative practice agreement" means a written
  3 16 agreement between a prescribing psychologist and a licensed
  3 17 physician that establishes clinical protocols, practice
  3 18 guidelines, and care plans relevant to the scope of the
  3 19 collaborative practice. The practice guidelines may include
  3 20 limitations on the prescribing of psychotropic medications
  3 21 by psychologists and protocols for prescribing to special
  3 22 populations including patients who are less than seventeen
  3 23 years of age or over sixty=five years of age, patients who
  3 24 are pregnant, and patients with serious medical conditions
  3 25 including but not limited to heart disease, cancer, stroke,
  3 26 seizures, and patients with developmental disabilities and
  3 27 intellectual disabilities.
  3 28    3.  "Collaborative relationship" means a cooperative
  3 29 working relationship between a prescribing psychologist or a
  3 30 psychologist with a conditional prescription certificate and a
  3 31 licensed physician in the provision of patient care, including
  3 32 diagnosis and cooperation in the management and delivery of
  3 33 physical and mental health care.
  3 34    4.  "Conditional prescription certificate" means a document
  3 35 issued by the board to a licensed psychologist that permits
  4  1 the holder to prescribe psychotropic medication under the
  4  2 supervision of a licensed physician pursuant to this chapter.
  4  3    5.  "Practice of psychology" means the application of
  4  4 established principles of learning, motivation, perception,
  4  5 thinking, and emotional relations to problems of behavior
  4  6 adjustment, group relations, and behavior modification,
  4  7 by persons trained in psychology for compensation or other
  4  8 personal gain. The application of principles includes, but
  4  9 is not limited to:  Counseling and the use of psychological
  4 10 remedial measures with persons, in groups or individually,
  4 11 with adjustment or emotional problems in the areas of work,
  4 12 family, school, and personal relationships; measuring and
  4 13 testing personality, intelligence, aptitudes, public opinion,
  4 14 attitudes, and skills; and the teaching of such subject matter,
  4 15 and the conducting of research on the problems relating to
  4 16 human behavior.
  4 17    6.  "Prescribing psychologist" means a licensed psychologist
  4 18 who holds a valid prescription certificate.
  4 19    7.  "Prescription certificate" means a document issued by the
  4 20 board to a licensed psychologist that permits the holder to
  4 21 prescribe psychotropic medication pursuant to this chapter.
  4 22    8.  "Psychotropic medication" means a controlled substance
  4 23 or dangerous drug that shall not be dispensed or administered
  4 24 without a prescription and that has been approved by the
  4 25 federal food and drug administration for the treatment of
  4 26 mental disorders, as defined by the most current diagnostic
  4 27 and statistical manual of mental disorders published by the
  4 28 American psychiatric association or the most current version
  4 29 of the international classification of diseases, and that is
  4 30 listed as a psychotherapeutic agent in the American hospital
  4 31 formulary service. "Psychotropic medication" does not include
  4 32 narcotics.
  4 33    Sec. 6.  NEW SECTION.  154B.9  Drugs ==== medicine.
  4 34    1.  Except as provided in subsections 2 and 3, a psychologist
  4 35 shall not administer or prescribe drugs or medicine.
  5  1    2.  A licensed psychologist holding a conditional
  5  2 prescription certificate may prescribe psychotropic medication
  5  3 under the supervision of a licensed physician pursuant to this
  5  4 chapter.
  5  5    3.  A prescribing psychologist may prescribe psychotropic
  5  6 medication pursuant to this chapter.
  5  7    Sec. 7.  NEW SECTION.  154B.10  Conditional prescription
  5  8 certificate.
  5  9    1.  An applicant for a conditional prescription certificate
  5 10 shall be granted a certificate by the board if the applicant
  5 11 satisfies all of the following requirements:
  5 12    a.  Holds a current license to practice psychology in this
  5 13 state.
  5 14    b.  Completed pharmacological training from an institution
  5 15 approved by the board or from a provider of continuing
  5 16 education approved by the board.
  5 17    c.  Passed a national certification examination approved by
  5 18 the board that tested the applicant's knowledge of pharmacology
  5 19 in the diagnosis, care, and treatment of mental disorders.
  5 20    d.  Within five years immediately preceding the date of
  5 21 application, successfully completed a post=doctoral master of
  5 22 science degree in clinical psychopharmacology approved by the
  5 23 board of psychology.  The program shall at a minimum include
  5 24 coursework in neuroscience, pharmacology, psychopharmacology,
  5 25 physiology, and appropriate and relevant physical and
  5 26 laboratory assessments.
  5 27    e.  Within five years immediately preceding the date of
  5 28 application, has been certified by the applicant's supervising
  5 29 physician as having successfully completed a supervised and
  5 30 relevant clinical experience of no less than an eighty=hour
  5 31 practicum in clinical assessment and pathophysiology and an
  5 32 additional supervised practicum of at least four hundred
  5 33 hours treating no fewer than one hundred patients with mental
  5 34 disorders.  The practica shall have been supervised by a
  5 35 trained physician.  The board shall determine whether the
  6  1 practica is sufficient to competently train the applicant in
  6  2 the treatment of a diverse patient population.
  6  3    f.  Possesses malpractice insurance that will cover the
  6  4 applicant during the period the conditional prescription
  6  5 certificate is in effect.
  6  6    g.  Meets all other requirements, as determined by rules
  6  7 adopted by the board, for obtaining a conditional prescription
  6  8 certificate.
  6  9    2.  A conditional prescription certificate is valid for four
  6 10 years, at the end of which the holder may apply again pursuant
  6 11 to the provisions of subsection 1.
  6 12    3.  A psychologist with a conditional prescription
  6 13 certificate may prescribe psychotropic medication under the
  6 14 supervision of a licensed physician subject to all of the
  6 15 following conditions:
  6 16    a.  The psychologist shall continue to hold a current license
  6 17 to practice psychology in this state and continue to maintain
  6 18 malpractice insurance.
  6 19    b.  The psychologist shall inform the board of the name of
  6 20 the physician under whose supervision the psychologist will
  6 21 prescribe psychotropic medication and promptly inform the board
  6 22 of any change of the supervising physician.
  6 23    c.  A physician supervising a psychologist prescribing
  6 24 psychotropic medication pursuant to a conditional prescription
  6 25 certificate shall be subject to disciplinary action pursuant to
  6 26 section 148.13A for the acts and omissions of the psychologist
  6 27 while under the physician's supervision.  This provision
  6 28 does not relieve the psychologist from liability for the
  6 29 psychologist's acts and omissions.
  6 30    Sec. 8.  NEW SECTION.  154B.11  Prescription certificate.
  6 31    1.  An applicant for a prescription certificate shall be
  6 32 granted a certificate by the board if the applicant satisfies
  6 33 all of the following requirements:
  6 34    a.  Possesses a conditional prescription certificate and has
  6 35 successfully completed two years of prescribing psychotropic
  7  1 medication as certified by the supervising licensed physician.
  7  2 An applicant for a prescription certificate who specializes
  7  3 in the psychological care of children, elderly persons, or
  7  4 persons with comorbid psychological conditions shall complete
  7  5 at least one year prescribing psychotropic medications to such
  7  6 populations as certified by the supervising licensed physician.
  7  7    b.  Holds a current license to practice psychology in this
  7  8 state.
  7  9    c.  Possesses malpractice insurance that will cover the
  7 10 applicant as a prescribing psychologist.
  7 11    d.  Meets all other requirements, as determined by rules
  7 12 adopted by the board, for obtaining a prescription certificate.
  7 13    2.  A psychologist with a prescription certificate may
  7 14 prescribe psychotropic medication pursuant to the provisions of
  7 15 this chapter subject to the following conditions:
  7 16    a.  The psychologist continues to hold a current license to
  7 17 practice psychology in this state and maintains malpractice
  7 18 insurance.
  7 19    b.  The psychologist annually satisfies the continuing
  7 20 education requirements for prescribing psychologists, as
  7 21 determined by the board, which shall be no fewer than twenty
  7 22 hours each year.
  7 23    c.  The psychologist has entered into a collaborative
  7 24 practice agreement with a licensed physician.
  7 25    Sec. 9.  NEW SECTION.  154B.12  Prescribing practices.
  7 26    1.  A prescribing psychologist or a psychologist with
  7 27 a conditional prescription certificate may administer and
  7 28 prescribe psychotropic medication within the scope of the
  7 29 psychologist's profession, including the ordering and review of
  7 30 laboratory tests in conjunction with the prescription, for the
  7 31 treatment of mental disorders.
  7 32    2.  When prescribing psychotropic medication for a
  7 33 patient, the prescribing psychologist or the psychologist
  7 34 with a conditional prescription certificate shall maintain
  7 35 an ongoing collaborative relationship with the licensed
  8  1 physician who oversees the patient's general medical care to
  8  2 ensure that necessary medical examinations are conducted,
  8  3 the psychotropic medication is appropriate for the patient's
  8  4 medical condition, and significant changes in the patient's
  8  5 medical or psychological condition are discussed.
  8  6    3.  A prescription written by a prescribing psychologist or a
  8  7 psychologist with a conditional prescription certificate shall
  8  8 meet all of the following requirements:
  8  9    a.  Comply with applicable state and federal laws.
  8 10    b.  Be identified as issued by the psychologist as
  8 11 "psychologist certified to prescribe".
  8 12    c.  Include the psychologist's board=assigned identification
  8 13 number.
  8 14    4.  A prescribing psychologist or a psychologist with
  8 15 a conditional prescription certificate shall not delegate
  8 16 prescriptive authority to any other person.  Records of all
  8 17 prescriptions shall be maintained in patient records.
  8 18    5.  When authorized to prescribe controlled substances, a
  8 19 prescribing psychologist or a psychologist with a conditional
  8 20 prescription certificate shall file with the board in a
  8 21 timely manner all individual federal drug enforcement agency
  8 22 registration and numbers. The board shall maintain current
  8 23 records on every psychologist, including federal registration
  8 24 and numbers.
  8 25    Sec. 10.  NEW SECTION.  154B.13  Board duties regarding
  8 26 prescription certificates and conditional prescription
  8 27 certificates.
  8 28    1.  The board shall, in consultation with the board of
  8 29 medicine, adopt rules to carry out the provisions of this
  8 30 chapter relating to prescribing psychologists. The rules shall
  8 31 include but not be limited to all of the following:
  8 32    a.  Procedures to obtain a conditional prescription
  8 33 certificate, a prescription certificate, and a renewal of
  8 34 a prescription certificate.  The board may set reasonable
  8 35 application and renewal fees.
  9  1    b.  Grounds for the denial, suspension, or revocation of
  9  2 a conditional prescription certificate and a prescription
  9  3 certificate, including a provision for suspension or revocation
  9  4 of a license to practice psychology upon suspension of a
  9  5 conditional prescription certificate and a prescription
  9  6 certificate.
  9  7    c.  The provision of an annual list of psychologists with
  9  8 prescription certificates and psychologists with conditional
  9  9 prescription certificates that contains the information agreed
  9 10 to between the board and the board of medicine.  The board
  9 11 shall promptly notify the board of medicine of psychologists
  9 12 who are added to or removed from the list.
  9 13    d.  Any other rules necessary for the administration of this
  9 14 chapter.
  9 15    2.  The board shall appoint a prescribing psychologist rules
  9 16 subcommittee comprised of a psychologist appointed by the
  9 17 board, a physician appointed by the board of medicine, and a
  9 18 member of the public appointed by the director of public health
  9 19 to develop rules for consideration by the board pursuant to
  9 20 this section.
  9 21    Sec. 11.  Section 155A.3, subsection 35, Code 2016, is
  9 22 amended to read as follows:
  9 23    35.  "Practitioner" means a physician, dentist, podiatric
  9 24 physician, prescribing psychologist, veterinarian, or other
  9 25 person licensed or registered to distribute or dispense a
  9 26 prescription drug or device in the course of professional
  9 27 practice in this state or a person licensed by another state
  9 28 in a health field in which, under Iowa law, licensees in this
  9 29 state may legally prescribe drugs.
  9 30    Sec. 12.  Section 155A.23, subsection 1, paragraph c, Code
  9 31 2016, is amended to read as follows:
  9 32    c.  For the purpose of obtaining a prescription drug or
  9 33 device, falsely assuming the title of or claiming to be
  9 34 a manufacturer, wholesaler, pharmacist, pharmacy owner,
  9 35 physician, dentist, podiatric physician, prescribing
 10  1 psychologist, veterinarian, or other authorized person.
 10  2    Sec. 13.  Section 155A.24, subsection 14, Code 2016, is
 10  3 amended to read as follows:
 10  4    14.  This section does not prevent a licensed practitioner of
 10  5 medicine, dentistry, podiatry, nursing, psychology, veterinary
 10  6 medicine, optometry, or pharmacy from acts necessary in the
 10  7 ethical and legal performance of the practitioner's profession.
       SF 2188 (7) 86
       rh/nh/jh