SB 847

THE SENATE
S.B. NO.
847
THIRTY-THIRD LEGISLATURE, 2025
S.D. 2
STATE OF HAWAII
H.D. 2
C.D. 1
A BILL FOR AN ACT
RELATING TO PSYCHOLOGISTS.
BE IT
ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
PART I
���� SECTION 1.�
The legislature finds that there is limited access to mental health care
treatment services for residents across the State. �The delivery of comprehensive, accessible, and
affordable mental health care has been demonstrably enhanced by collaborative
practice among licensed clinical psychologists with prescriptive authority and
medical doctors in federal facilities and programs and in states that have
authorized prescriptive authority for psychologists. �The legislature finds that providing limited
prescriptive authority to qualified, licensed clinical psychologists, subject
to supervision by a licensed medical doctor, could help make comprehensive
mental health care more accessible to medically underserved residents of the
State.� The legislature
acknowledges that the Health Resources and Services Administration of the
United States Department of Health and Human Services has officially designated
much of the State, including isolated rural locations and urban areas with high
population densities, as a mental health professional shortage area.� This designation highlights the critical need
for expansion of available mental health services and development of a corps of
mental health professionals to serve the currently unmet needs of Hawaii's
population.
���� The
legislature has previously authorized prescription privileges for advanced
practice registered nurses, optometrists, dentists, podiatrists, and physician
assistants.� These practitioners have
been granted prescriptive authority based on demonstration of specific
training, education, and practical competency.�
Education and training criteria, such as passage of national board
examinations and degree and minimum experience requirements, have worked well
to assure quality of services.�
Limitations on authority including the use of approved formularies,
limited practice areas, and prohibitions on accepting or distributing drug
samples have served to deter abuses in the system and to prevent the
inappropriate practice of general medicine.�
Prescriptive authority for non-physician practitioners with varying
types of limitations and supervision requirements has proven manageable and has
expanded access to important health care services for patients across the
State.
���� Clinical
psychologists with appropriate training have been allowed to prescribe
medications to active duty military personnel and their families in federal
facilities and the federal Indian health service program for years. �In recent years, Colorado, Idaho, Illinois, Iowa, Louisiana, New Mexico, and Utah have
adopted legislation authorizing prescriptive authority for appropriately
trained psychologists without regard to the service setting.
���� Since
2000, psychologists in Hawaii have received psychopharmacological training
through the Tripler Army Medical Center psychology training program. �These psychologists have actively collaborated
with primary care physicians to provide combined therapy and
psychopharmacological care to medically underserved patient populations at
eleven federally qualified health centers:�
Bay Clinic, Hana, Molokai, Kauai, Waianae, Kalihi-Palama, Waimanalo,
Koolauloa, West Hawaii, Kokua Kalihi Valley, and Waikiki, as well as a Native
Hawaiian health care system clinic located in a federally designated medically
underserved area on Molokai.
���� The
American Psychological Association has developed a model curriculum
for a master's degree in psychopharmacology for the education and training of
prescribing psychologists.� Independent
evaluations of the United States Department of Defense psychopharmacological demonstration
project by the United States General Accounting Office, now known as the
Government Accountability Office, and the American College of
Neuropsychopharmacology, as well as the experiences of
Idaho, Illinois, Iowa, Louisiana, and New Mexico, have demonstrated that
appropriately trained clinical psychologists can prescribe psychotropic
medications safely and effectively.
���� Accordingly,
the purpose of this Act is to:
���� (1)� Establish
a three-year pilot program to allow qualified psychologists under the
supervision of a supervising physician or psychiatrist to prescribe certain
psychotropic medications for the treatment of mental illness to patients
between the ages of eighteen and sixty-five who are under the psychologist's
care at a federally qualified health center located in the county of Kauai or
county of Hawaii; and
���� (2)� Require
the state health planning and development agency to submit a report to the
legislature to determine whether the pilot program should be expanded, made
permanent statewide, or terminated.
PART II
���� SECTION 2.�
(a)� There is established a
three-year pilot program to be administered by the state health planning and
development agency, in partnership with the board of psychology, to allow
clinical psychologists licensed pursuant to chapter 465, Hawaii Revised
Statutes, to prescribe psychotropic medications under the supervision of a
supervising physician or psychiatrist only to patients between the ages of
eighteen and sixty-five years who are being treated by the psychologist at a
federally qualified health center located in the county of Kauai or the county
of Hawaii; provided that psychotropic medications prescribed under this pilot
program shall be eligible for medicaid reimbursement to the extent such
prescriptions would otherwise be eligible if prescribed by a physician or psychiatrist.
���� (b)� A licensed clinical psychologist shall
be eligible to apply to participate in the pilot program established pursuant
to this Act if the psychologist:
���� (1)� Meets the requirements for licensure
set forth in section 465-7, Hawaii Revised Statutes;
���� (2)� Completed specialized education and
training in preparation for prescriptive practice approved by the American
Psychological Association and the board of psychology;
���� (3)� Has passed the Psychopharmacology
Examination for Psychologists or an equivalent national examination approved by
the board of psychology that is relevant to establishing competence for
prescriptive practice;
���� (4)� Is employed by, including as a contract
provider, a federally qualified health center as defined in title 42 United
States Code section 1396d located in the county of Kauai or county of Hawaii;
and
���� (5)� Meets any other requirements
established by the board of psychology.
���� (c)� The pilot program established pursuant to
this Act shall be a three-year program that shall allow participating
psychologists to prescribe psychotropic medications under a supervising
physician or psychiatrist.
���� (d)� The board of psychology shall adopt rules
pursuant to chapter 91, Hawaii Revised Statutes, to implement the purpose of this
Act.
���� (e)� The state health planning and development
agency shall submit a report of its findings and recommendations,
including any proposed legislation, on the pilot program to the legislature no
later than twenty days prior to the convening of the regular session of 2029.� The report shall include a recommendation on
whether to:
���� (1)� Expand
the pilot program to other underserved areas in the State;
���� (2)� Make
prescriptive authority for qualified psychologists permanent statewide; or
���� (3)� Permanently
end the pilot program.
���� (f)� For
the purposes of this Act:
���� "Prescriptive authority" means
the authority to prescribe, administer, discontinue, or distribute without
charge, drugs or controlled substances
recognized in or customarily used in the diagnosis, treatment, and management
of individuals with psychiatric, mental, cognitive, nervous, emotional, or
behavioral disorders, or other procedures directly related thereto within the
scope of practice of psychology in accordance with rules adopted by the board
of psychology.
���� "Psychopharmacology" means the use of psychoactive
drugs in the treatment and control of mental disorders or psychiatric disease.
���� "Psychotropic
medication" means only those agents related to the diagnosis and treatment
of mental and emotional disorders including controlled substances but not
including narcotics.
���� "Supervising
physician or psychiatrist" means a medically trained and licensed
physician or psychiatrist who accepts professional responsibility for the
provision of psychopharmacology by a psychologist certified to prescribe.
PART
III
���� SECTION 3.�
Section 329-1, Hawaii Revised Statutes, is amended as follows:
���� 1.�
By adding a new definition to be appropriately inserted and to read:
���� ""Psychologist certified to
prescribe" means a person approved by the board of psychology to
participate in the pilot program established pursuant to Act
   , Session Laws of Hawaii 2026, but who is not authorized to
request, receive, or sign for professional controlled substance samples."
���� 2.�
By amending the definition of "practitioner" to read:
���� ""Practitioner" means:
���� (1)� A physician, dentist, veterinarian, scientific
investigator, or other person licensed and registered under section 329-32 to
distribute, dispense, or conduct research with respect to a controlled
substance in the course of professional practice or research in this State;
���� (2)� An
advanced practice registered nurse with prescriptive authority licensed and
registered under section 329-32 to prescribe and administer controlled
substances in the course of professional practice in this State;
���� (3)� A
licensed midwife practicing as a certified midwife registered under section
329-32 to prescribe and administer controlled substances in the course of
professional practice in this State; [[and]]
���� (4)� A licensed psychologist certified to
prescribe and registered under section 329-32 to prescribe and dispense
controlled substances in accordance with the requirements and limitations of
the pilot program established pursuant to Act    , Session Laws of
Hawaii 2026; and
��� [[(4)]] (5)� A pharmacy, hospital, or other institution
licensed, registered, or otherwise permitted to distribute, dispense, conduct
research with respect to or to administer a controlled substance in the course
of professional practice or research in this State."
PART IV
���� SECTION 4.�
Statutory material to be repealed is bracketed and stricken.� New statutory material is underscored.
���� SECTION 5.�
This Act shall take effect upon its approval.
Report Title:
SHPDA;
Board of Psychology; Prescriptive Authority; Clinical Psychologists; Pilot
Program; Supervising Physician or Psychiatrist; Federally Qualified Health
Centers; County of Kauai; County of Hawaii; Rules; Report
Description:
Establishes
a three-year pilot program in the County of Kauai and County of Hawaii to allow
qualified psychologists under the supervision of a supervising physician or psychiatrist
limited authority to prescribe certain psychotropic medications to patients
between the ages of 18 and 65 years under the care of the psychologist.� Requires the Board of Psychology to adopt
rules.� Requires the State Health
Planning and Development Agency to report to the Legislature.� (CD1)
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.