RELATING TO PSYCHOLOGISTS.

SB847

THE SENATE

S.B. NO.

847

THIRTY-THIRD LEGISLATURE, 2025

STATE OF HAWAII

A BILL FOR AN ACT

RELATING
TO PSYCHOLOGISTS
.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

����
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 Hawai
ʻ
i'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 Hawai
ʻ
i
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, Moloka
ʻ
i,
Kaua
ʻ
i,
Wai
ʻ
anae,
Kalihi-Palama, Waimānalo, Ko
ʻ
olauloa,
West Hawai
ʻ
i,
Kōkua Kalihi Valley, and Waikiki, as well as a native Hawaiian health care
system clinic located in a federally designated medically underserved area on
Moloka
ʻ
i.

����
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 allow qualified psychologists to prescribe
psychotropic medications for the treatment of mental illness to patients under
the psychologist's care in certain circumstances.

����
SECTION 2.
�

Chapter 465, Hawaii Revised Statutes, is amended by adding a new part to
be appropriately designated and to read as follows:

"
Part
.

�
PRESCRIPTION CERTIFICATION

����
�465-
�
Definitions.
�

As used in this part:

����
"Board"
means
the
board of psychology established under section 465-4.

����
"
Clinical

experience" means a period of supervised clinical training and practice involving
clinical diagnoses and interventions that are conducted and supervised as part
of a training program.

����
"Laboratory test" means any laboratory blood or urine
drug screen test necessary to monitor the general health of a patient receiving
psychotropic medication.

����
"Narcotics"
means natural and synthetic opioid analgesics, and their derivatives, used to
relieve pain.

����
"
Prescription
"
means an order for a drug, laboratory test, or medicine, device, or treatment,
as defined by state law.

����
"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.

����
"Psychiatrist" means a medical doctor licensed to
practice medicine pursuant to chapter 453 who has completed and successfully
passed a specialized four-year residency program in the practice of psychiatry.

����
"
Psychologist

certified to prescribe" means a licensed, doctoral-level clinical psychologist
who has:

����
(1)
�
Completed specialized education and
training in preparation for prescriptive practice;

����
(2)
�
Passed the Psychopharmacological
Examination for Psychologists or an equivalent national examination accepted by
the board relevant to establishing competence for prescribing; and

����
(3)
�
Received from the board a current
certificate granting prescriptive authority that has not been revoked or
suspended.

����
"Psychopharmacology"
means the use of psychoactive drugs in the treatment or 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" means a medically trained and licensed physician or
psychiatrist who accepts professional responsibility for the provision of
psychopharmacology by a psychologist certified to prescribe.

����
�465-
�
Conditional prescription certificate;
application.
�
(a)
�
A psychologist who applies for a conditional
prescription certificate shall demonstrate all of the following by official
transcript or other official evidence satisfactory to the board:

����
(1)
�
A current clinical license in good
standing to practice psychology in the State;

����
(2)
�
Consistent with established policies of
the American Psychological Association for educating and training psychologists
in preparation for prescriptive authority:

���������
(A)
�
A master's degree in psychopharmacology
that reflects an organized sequence of study in an organized program offering
intensive didactic and practical education, and includes the following core
areas of instruction: basic life sciences, neurosciences, clinical and research
pharmacology and psychopharmacology, clinical medicine and pathophysiology,
physical assessment and laboratory examinations, clinical pharmacotherapeutics,
research, and professional, ethical and legal issues; and

���������
(B)
�
Relevant clinical experience sufficient
to attain competency in the psychopharmacological treatment of a diverse
patient population under the direction of a supervising physician that consists
of not less than two years and involves at least four hundred hours treating a
diverse population of not fewer than one hundred patients with mental disorders
including at least two hours of weekly on-site supervision per year by a
supervising physician who is not employed by the psychologist being directed or
supervised;

����
(3)
�
Successful completion of the
Psychopharmacological Examination for Psychologists or an equivalent national
examination relevant to establishing competence for prescribing as approved by
the board;

����
(4)
�
A federal Drug Enforcement
Administration registration number for limited use as restricted by state law;

����
(5)
�
Malpractice insurance sufficient to
satisfy the rules adopted by the board, which covers the applicant during the
period the conditional prescription certificate is in effect;

����
(6)
�
Completion of all other requirements,
as determined by rules adopted by the board pursuant to chapter 91, for
obtaining a conditional prescription certificate; and

����
(7)
�
Employment, including by

contract, and an intent to practice the
prescriptive authority at a federally qualified health center as defined in
title 42 United States Code section 1396d.

����
(b)
�
The board shall issue a conditional
prescription certificate if it finds that the applicant has met all of the
requirements of subsection (a).

����
(c)
�
The conditional prescription certificate
shall be immediately relinquished by the psychologist if the psychologist no
longer meets the requirements of subsection (a).

����
�465‑
�
Conditional prescription certificate; powers,
duties, and responsibilities.
�

(a)
�
A psychologist holding a
conditional prescription certificate shall:

����
(1)
�
Hold a current license to practice
psychology in the State and maintain malpractice insurance;

����
(2)
�
Complete the first year of practice
under a conditional prescription certificate under the direction of a
supervising physician who is not employed by the psychologist being directed or
supervised; provided that supervision pursuant to this paragraph shall include
training in diagnostic laboratory tests, diagnostic imaging, and
electroencephalogram tests;

����
(3)
�
Inform
the board of the name of the supervising physician under whose supervision the
psychologist will prescribe psychotropic medication; provided that the
psychologist shall promptly inform the board of any change of the supervising
physician; and

����
(4)
�
Maintain an ongoing collaborative
relationship pursuant to subsection (c) with the doctors of medicine who
oversee the general medical care of the psychologist's patients.

����
(b)
�
A psychologist holding a conditional
prescription certificate shall be authorized 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 and relevant to the practice of psychology, or other
procedures directly related thereto within the scope of practice of psychology
in accordance with rules adopted by the board.
�
The authorization to prescribe shall be
limited to prescriptions for patients under the care of the psychologist at federally
qualified health centers as defined in title 42 United States Code section
1396d and identified to the board as the psychologist's practice location.

����
(c)
�
When prescribing psychotropic medication for
a patient, a psychologist holding a conditional prescription certificate shall
maintain an ongoing collaborative relationship with the doctors of medicine who
oversee the general medical care of the psychologist's patients to ensure that:

����
(1)
�
Necessary medical examinations are
conducted;

����
(2)
�
The psychotropic medication is
appropriate for the patient's medical condition; and

����
(3)
�
Significant changes in the patient's
medical or psychological condition are discussed.

����
(d)
�
A prescription for psychotropic medication written
by a psychologist holding a conditional prescription certificate shall:

����
(1)
�
Comply with applicable state and
federal laws;

����
(2)
�
Be identified as issued by a "psychologist
certified to prescribe"; and

����
(3)
�
Include the psychologist's board number
or the identification number assigned by the department of commerce and
consumer affairs.

����
(e)
�

A psychologist holding a conditional prescription certificate shall not
delegate prescriptive authority to any

person.
�
Records of all prescriptions shall be
maintained in the prescribing psychologist's patient records.

����
�465-
�
Prescription certificate.
�
(a)
�
A
psychologist who applies for a prescription certificate shall demonstrate all
of the following by official transcript or other official evidence satisfactory
to the board:

����
(1)
�
A conditional prescription certificate,
which includes successful completion of two years of prescribing psychotropic
medication as certified by a supervising physician;

����
(2)
�
A current license in good standing to
practice psychology in the State;

����
(3)
�
Malpractice insurance sufficient to
satisfy the rules adopted by the board, that will cover the applicant as a
prescribing psychologist; and

����
(4)
�
Completion of all other requirements,
as determined by rules adopted by the board pursuant to chapter 91, for
obtaining a prescription certificate.

����
(b)
�
The board shall issue a prescription
certificate if it finds that the applicant has met all of the requirements of
subsection (a).

����
(c)
�
A psychologist with a prescription
certificate may prescribe psychotropic medication to any patient under the
psychologist's care for whom psychotropic medication is clinically indicated if
the psychologist:

����
(1)
�
Holds a current license to practice
psychology in the State and maintains malpractice insurance;

����
(2)
�
Annually satisfies the continuing
education requirements for prescribing psychologists recommended by the
American Psychological Association, which shall be not less than twenty hours
each year, at least half of which shall be in pharmacology or
psychopharmacology; and

����
(3)
�
Maintains an ongoing collaborative
relationship directly or by telecommunication with the doctors of medicine who
oversee the general medical care of the psychologist's patients to ensure that:

���������
(A)
�
Necessary medical examinations are
conducted;

���������
(B)
�
Psychotropic medication prescribed is
appropriate for the patient's medical condition;

���������
(C)
�
Significant changes in the patient's
medical or psychological condition are discussed; and

���������
(D)
�
The psychologist prescribes only
psychotropic medications to patients under the care of the psychologist at a
federally qualified health center that is identified to the board as the
psychologist's practice location.

����
(d)
�
The prescription certificate shall be
immediately relinquished by the psychologist if the psychologist no longer
meets the requirements of subsection (c).

����
�465-
�
Administration.
�
(a)
�

The board may adopt rules pursuant to chapter 91 to further implement
the procedures set forth in this part to obtain a conditional prescription
certificate or a prescription certificate and to renew a conditional
prescription certificate or prescription certificate.
�
The board may set reasonable application and
renewal fees.

����
(b)
�
The board shall adopt rules pursuant to
chapter 91 establishing the grounds for denial, suspension, or revocation of
conditional prescription certificates and prescription certificates, including
provisions for suspension or revocation of a license to practice psychology
upon suspension or revocation of a conditional prescription certificate or
prescription certificate.
�
Actions of
denial, suspension, or revocation of a conditional prescription certificate or
a prescription certificate shall be in accordance with this chapter.

����
(c)
�
The board shall maintain current records on
every prescribing psychologist, including federal Drug Enforcement
Administration registration numbers.

����
(d)
�
The board shall provide to the board of
pharmacy an annual list of psychologists holding a conditional prescription
certificate or prescription certificate that contains the information agreed
upon between the board and the board of pharmacy.
�
The board shall promptly provide the board of
pharmacy with the names of any psychologists who are added to or deleted from
the list.

����
�465-
�
Narcotics and controlled substance samples
prohibited.
�
Notwithstanding any
other provision of this chapter to the contrary, a psychologist holding a
conditional prescription certificate or prescription certificate shall not administer
or prescribe any narcotic and shall not request, receive, or sign for
professional controlled substance samples."

����
SECTION 3.
�

Section
329-1, Hawaii Revised Statutes, is
amended to read as follows:

����
1.
�

By adding a new definition to be appropriately inserted and to read:

����
"
"Psychologist certified to
prescribe" means a person licensed under part
of chapter 465, who is registered under this chapter to administer or prescribe
psychotropic medication to patients under the person's care at a federally
qualified health center, 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; [
and
]

����
(3)
�
A psychologist certified to
prescribe who is licensed and registered under section 329-32 to prescribe and
dispense controlled substances in accordance with the requirements and
limitations of part of chapter 465; and

���
[
(3)
]

(4)
�
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."

����
SECTION 4.
�

Chapter 465, Hawaii Revised Statutes, is amended by designating sections
465-1 to 465-15 as part I, and inserting a title before section 465-1 to read
as follows:

"PART I.
�
GENERAL PROVISIONS."

����
SECTION 5.
�

Section 465-3, Hawaii Revised Statutes, is amended to read as follows:

����
"
�465-3
�
Exemptions.
�
(a)
�

This chapter shall not apply to:

����
(1)
�
Any person teaching, lecturing,
consulting, or engaging in research in psychology insofar as the activities are
performed as part of or are dependent upon employment in a college or
university; provided that the person shall not engage in the practice of
psychology outside the responsibilities of the person's employment;

����
(2)
�
Any person who performs any, or any
combination of the professional services defined as the practice of psychology
under the direction of a licensed psychologist in accordance with rules adopted
by the board; provided that the person may use the term "psychological
assistant", but shall not identify the person's self as a psychologist or
imply that the person is licensed to practice psychology;

����
(3)
�
Any person employed by a local, state,
or federal government agency in a school psychologist or psychological examiner
position, or a position that does not involve diagnostic or treatment services,
but only at those times when that person is carrying out the functions of such
government employment;

����
(4)
�
Any person who is a student of
psychology, a psychological intern, or a resident in psychology preparing for
the profession of psychology under supervision in a training institution or
facility and who is designated by a title as "psychology trainee",
"psychology student", "psychology intern", or
"psychology resident", that indicates the person's training status;
provided that the person shall not identify the person's self as a psychologist
or imply that the person is licensed to practice psychology;

����
(5)
�
Any person who is a member of another
profession licensed under the laws of this jurisdiction to render or advertise
services, including psychotherapy, within the scope of practice as defined in
the statutes or rules regulating the person's professional practice; provided
that, notwithstanding section 465-1, the person does not represent the person's
self to be a psychologist or does not represent that the person is licensed to
practice psychology;

����
(6)
�
Any person who is a member of a mental
health profession not requiring licensure; provided that the person functions
only within the person's professional capacities; and provided further that the
person does not represent the person to be a psychologist, or the person's
services as psychological;

����
(7)
�
Any person who is a duly recognized
member of the clergy; provided that the person functions only within the
person's capacities as a member of the clergy; and provided further that the
person does not represent the person to be a psychologist, or the person's
services as psychological;

����
(8)
�
Any psychologist employed by the United
States Department of Defense, while engaged in the discharge of the
psychologist's official duty and providing direct telehealth support or
services, as defined in section 431:10A-116.3, to neighbor island beneficiaries
within a Hawaii National Guard armory on the island of Kauai, Hawaii, Molokai,
or Maui; provided that the psychologist employed by the United States
Department of Defense is credentialed by Tripler Army Medical Center; or

����
(9)
�
Any supervisee of a licensed
psychologist as defined in section 465D‑7.

����
(b)
�

Nothing in this chapter shall in any way restrict any person from
carrying on any of the psychological activities as defined in section 465-1;
provided that [
such
]
the
person does not offer psychological
services as defined in this chapter except as [
such
]
the

activities are incidental to the person's lawful occupational purpose.

����
(c)
�

A person may use the title of industrial/organizational psychologist,
provided that the person registers with the board, and:

����
(1)
�
Is
professionally competent in the practice of industrial/organizational
psychology; [
and
]

����
(2)
�
Holds
a doctoral degree from an accredited institution of higher education with
training and education in industrial/organizational psychology, satisfactory to
the board; and

����
(3)
�
Provides
psychological service or consultation to organizations [
which
]
that

does not involve the delivery or supervision of direct psychological services
to individuals or groups of individuals, without regard to the source or extent
of payment for services rendered.

����
(d)
�

Nothing in this chapter shall prevent the provision of expert testimony
by a psychologist who is otherwise exempted by this chapter.

����
[
(e)
�

Nothing in this chapter shall be construed as permitting the
administration or prescription of drugs, or in any way engaging in the practice
of medicine as defined in the laws of the State.
]"

����
SECTION 6.
�

Statutory material to be repealed is bracketed and stricken.
�
New statutory material is underscored.

����
SECTION 7.
�

This Act shall take effect upon its approval.

INTRODUCED BY:

_____________________________

Report Title:

Prescriptive
Authority; Psychologists

Description:

Allows
qualified psychologists limited authority to prescribe psychotropic medications
to patients under the care of the psychologist in certain circumstances.

The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.