House File 2334 H-8216 Amend House File 2334 as follows: 1 1. By striking everything after the enacting clause 2 and inserting: 3 < Section 1. Section 123.3, subsection 35, Code 4 2016, is amended to read as follows: 5 35. “Pharmacy” means a drug store in which drugs 6 and medicines are exposed for sale and sold at retail, 7 or in which prescriptions of licensed physicians and 8 surgeons, dentists, prescribing psychologists, or 9 veterinarians are compounded and sold by a registered 10 pharmacist. 11 Sec. 2. Section 124.101, subsection 26, paragraph 12 a, Code 2016, is amended to read as follows: 13 a. A physician, dentist, podiatric physician, 14 prescribing psychologist, veterinarian, scientific 15 investigator or other person licensed, registered , or 16 otherwise permitted to distribute, dispense, conduct 17 research with respect to , or to administer a controlled 18 substance in the course of professional practice or 19 research in this state. 20 Sec. 3. Section 147.107, subsections 1 and 2, Code 21 2016, are amended to read as follows: 22 1. A person, other than a pharmacist, physician, 23 dentist, podiatric physician, prescribing psychologist, 24 or veterinarian who dispenses as an incident to the 25 practice of the practitioner’s profession, shall not 26 dispense prescription drugs or controlled substances. 27 2. a. A pharmacist, physician, dentist, or 28 podiatric physician , or prescribing psychologist 29 who dispenses prescription drugs, including but not 30 limited to controlled substances, for human use, may 31 delegate nonjudgmental dispensing functions to staff 32 assistants only when verification of the accuracy 33 and completeness of the dispensing is determined by 34 the pharmacist or practitioner in the pharmacist’s 35 -1- HF2334.3492 (1) 86 (amending this HF 2334 to CONFORM to SF 2188) rh/nh 1/ 11 #1.

or practitioner’s physical presence. However, the 1 physical presence requirement does not apply when a 2 pharmacist or practitioner is utilizing an automated 3 dispensing system or when a pharmacist is utilizing 4 a tech-check-tech program, as defined in section 5 155A.3 . When using an automated dispensing system the 6 pharmacist or practitioner shall utilize an internal 7 quality control assurance plan that ensures accuracy 8 for dispensing. When using a tech-check-tech program 9 the pharmacist shall utilize an internal quality 10 control assurance plan, in accordance with rules 11 adopted by the board of pharmacy, that ensures accuracy 12 for dispensing. Verification of automated dispensing 13 and tech-check-tech accuracy and completeness remains 14 the responsibility of the pharmacist or practitioner 15 and shall be determined in accordance with rules 16 adopted by the board of pharmacy, the board of 17 medicine, the dental board, and the board of podiatry , 18 and the board of psychology for their respective 19 licensees. 20 b. A dentist, physician, or podiatric physician , 21 or prescribing psychologist who dispenses prescription 22 drugs, other than drug samples, pursuant to this 23 subsection , shall report the fact that they dispense 24 prescription drugs with the practitioner’s respective 25 board at least biennially. 26 c. A physician, dentist, or podiatric physician , 27 or prescribing psychologist who dispenses prescription 28 drugs, other than drug samples, pursuant to this 29 subsection , shall offer to provide the patient with 30 a written prescription that may be dispensed from a 31 pharmacy of the patient’s choice or offer to transmit 32 the prescription orally, electronically, or by 33 facsimile in accordance with section 155A.27 to a 34 pharmacy of the patient’s choice. 35 -2- HF2334.3492 (1) 86 (amending this HF 2334 to CONFORM to SF 2188) rh/nh 2/ 11

Sec. 4. NEW SECTION . 148.13A Board authority over 1 physicians supervising certain psychologists. 2 The board of medicine shall, in consultation with 3 the board of psychology, establish by rule all of the 4 following: 5 1. Specific minimum standards for the appropriate 6 supervision of a psychologist prescribing medication 7 pursuant to a conditional prescription certificate 8 under chapter 154B. Such standards shall include 9 requiring a physician serving as a supervising 10 licensed physician to notify the board of medicine 11 of the identity of the psychologist the physician 12 is supervising and any change in the status of the 13 supervisory relationship. 14 2. The process for initiating and conducting 15 disciplinary proceedings under chapter 17A if a 16 licensed physician fails to adequately supervise a 17 psychologist prescribing psychotropic medications 18 pursuant to a prescription certificate under 19 chapter 154B. The rule shall take into account 20 the deliberations of the board in making such a 21 determination. 22 Sec. 5. Section 154B.1, Code 2016, is amended to 23 read as follows: 24 154B.1 Definition Definitions . 25 As used in this chapter, unless the context 26 otherwise requires: 27 1. “Board” means the board of psychology created 28 under chapter 147. 29 2. “Collaborative practice agreement” means a 30 written agreement between a prescribing psychologist 31 and a licensed physician that establishes clinical 32 protocols, practice guidelines, and care plans 33 relevant to the scope of the collaborative practice. 34 The practice guidelines may include limitations 35 -3- HF2334.3492 (1) 86 (amending this HF 2334 to CONFORM to SF 2188) rh/nh 3/ 11

on the prescribing of psychotropic medications by 1 psychologists and protocols for prescribing to special 2 populations including patients who are less than 3 seventeen years of age or over sixty-five years of 4 age, patients who are pregnant, and patients with 5 serious medical conditions including but not limited to 6 heart disease, cancer, stroke, seizures, and patients 7 with developmental disabilities and intellectual 8 disabilities. 9 3. “Collaborative relationship” means a cooperative 10 working relationship between a prescribing psychologist 11 or a psychologist with a conditional prescription 12 certificate and a licensed physician in the provision 13 of patient care, including diagnosis and cooperation 14 in the management and delivery of physical and mental 15 health care. 16 4. “Conditional prescription certificate” means a 17 document issued by the board to a licensed psychologist 18 that permits the holder to prescribe psychotropic 19 medication under the supervision of a licensed 20 physician pursuant to this chapter. 21 5. “Practice of psychology” means the application 22 of established principles of learning, motivation, 23 perception, thinking, and emotional relations to 24 problems of behavior adjustment, group relations, and 25 behavior modification, by persons trained in psychology 26 for compensation or other personal gain. The 27 application of principles includes , but is not limited 28 to: Counseling and the use of psychological remedial 29 measures with persons, in groups or individually, with 30 adjustment or emotional problems in the areas of work, 31 family, school , and personal relationships; measuring 32 and testing personality, intelligence, aptitudes, 33 public opinion, attitudes, and skills; and the teaching 34 of such subject matter, and the conducting of research 35 -4- HF2334.3492 (1) 86 (amending this HF 2334 to CONFORM to SF 2188) rh/nh 4/ 11

on the problems relating to human behavior. 1 6. “Prescribing psychologist” means a licensed 2 psychologist who holds a valid prescription 3 certificate. 4 7. “Prescription certificate” means a document 5 issued by the board to a licensed psychologist that 6 permits the holder to prescribe psychotropic medication 7 pursuant to this chapter. 8 8. “Psychotropic medication” means a controlled 9 substance or dangerous drug that shall not be 10 dispensed or administered without a prescription 11 and that has been approved by the federal food and 12 drug administration for the treatment of mental 13 disorders, as defined by the most current diagnostic 14 and statistical manual of mental disorders published 15 by the American psychiatric association or the most 16 current version of the international classification of 17 diseases, and that is listed as a psychotherapeutic 18 agent in the American hospital formulary service. 19 “Psychotropic medication” does not include narcotics. 20 Sec. 6. NEW SECTION . 154B.9 Drugs —— medicine. 21 1. Except as provided in subsections 2 and 3, a 22 psychologist shall not administer or prescribe drugs 23 or medicine. 24 2. A licensed psychologist holding a conditional 25 prescription certificate may prescribe psychotropic 26 medication under the supervision of a licensed 27 physician pursuant to this chapter. 28 3. A prescribing psychologist may prescribe 29 psychotropic medication pursuant to this chapter. 30 Sec. 7. NEW SECTION . 154B.10 Conditional 31 prescription certificate. 32 1. An applicant for a conditional prescription 33 certificate shall be granted a certificate by the 34 board if the applicant satisfies all of the following 35 -5- HF2334.3492 (1) 86 (amending this HF 2334 to CONFORM to SF 2188) rh/nh 5/ 11

requirements: 1 a. Holds a current license to practice psychology 2 in this state. 3 b. Completed pharmacological training from an 4 institution approved by the board or from a provider of 5 continuing education approved by the board. 6 c. Passed a national certification examination 7 approved by the board that tested the applicant’s 8 knowledge of pharmacology in the diagnosis, care, and 9 treatment of mental disorders. 10 d. Within five years immediately preceding the date 11 of application, successfully completed a post-doctoral 12 master of science degree in clinical psychopharmacology 13 approved by the board of psychology. The program 14 shall at a minimum include coursework in neuroscience, 15 pharmacology, psychopharmacology, physiology, and 16 appropriate and relevant physical and laboratory 17 assessments. 18 e. Within five years immediately preceding the date 19 of application, has been certified by the applicant’s 20 supervising physician as having successfully completed 21 a supervised and relevant clinical experience of 22 no less than an eighty-hour practicum in clinical 23 assessment and pathophysiology and an additional 24 supervised practicum of at least four hundred hours 25 treating no fewer than one hundred patients with mental 26 disorders. The practica shall have been supervised 27 by a trained physician. The board shall determine 28 whether the practica is sufficient to competently train 29 the applicant in the treatment of a diverse patient 30 population. 31 f. Possesses malpractice insurance that will 32 cover the applicant during the period the conditional 33 prescription certificate is in effect. 34 g. Meets all other requirements, as determined by 35 -6- HF2334.3492 (1) 86 (amending this HF 2334 to CONFORM to SF 2188) rh/nh 6/ 11

rules adopted by the board, for obtaining a conditional 1 prescription certificate. 2 2. A conditional prescription certificate is valid 3 for four years, at the end of which the holder may 4 apply again pursuant to the provisions of subsection 1. 5 3. A psychologist with a conditional prescription 6 certificate may prescribe psychotropic medication under 7 the supervision of a licensed physician subject to all 8 of the following conditions: 9 a. The psychologist shall continue to hold a 10 current license to practice psychology in this state 11 and continue to maintain malpractice insurance. 12 b. The psychologist shall inform the board of 13 the name of the physician under whose supervision the 14 psychologist will prescribe psychotropic medication 15 and promptly inform the board of any change of the 16 supervising physician. 17 c. A physician supervising a psychologist 18 prescribing psychotropic medication pursuant to a 19 conditional prescription certificate shall be subject 20 to disciplinary action pursuant to section 148.13A 21 for the acts and omissions of the psychologist while 22 under the physician’s supervision. This provision does 23 not relieve the psychologist from liability for the 24 psychologist’s acts and omissions. 25 Sec. 8. NEW SECTION . 154B.11 Prescription 26 certificate. 27 1. An applicant for a prescription certificate 28 shall be granted a certificate by the board if the 29 applicant satisfies all of the following requirements: 30 a. Possesses a conditional prescription certificate 31 and has successfully completed two years of prescribing 32 psychotropic medication as certified by the supervising 33 licensed physician. An applicant for a prescription 34 certificate who specializes in the psychological care 35 -7- HF2334.3492 (1) 86 (amending this HF 2334 to CONFORM to SF 2188) rh/nh 7/ 11

of children, elderly persons, or persons with comorbid 1 psychological conditions shall complete at least one 2 year prescribing psychotropic medications to such 3 populations as certified by the supervising licensed 4 physician. 5 b. Holds a current license to practice psychology 6 in this state. 7 c. Possesses malpractice insurance that will cover 8 the applicant as a prescribing psychologist. 9 d. Meets all other requirements, as determined 10 by rules adopted by the board, for obtaining a 11 prescription certificate. 12 2. A psychologist with a prescription certificate 13 may prescribe psychotropic medication pursuant to the 14 provisions of this chapter subject to the following 15 conditions: 16 a. The psychologist continues to hold a current 17 license to practice psychology in this state and 18 maintains malpractice insurance. 19 b. The psychologist annually satisfies the 20 continuing education requirements for prescribing 21 psychologists, as determined by the board, which shall 22 be no fewer than twenty hours each year. 23 c. The psychologist has entered into a 24 collaborative practice agreement with a licensed 25 physician. 26 Sec. 9. NEW SECTION . 154B.12 Prescribing 27 practices. 28 1. A prescribing psychologist or a psychologist 29 with a conditional prescription certificate may 30 administer and prescribe psychotropic medication 31 within the scope of the psychologist’s profession, 32 including the ordering and review of laboratory tests 33 in conjunction with the prescription, for the treatment 34 of mental disorders. 35 -8- HF2334.3492 (1) 86 (amending this HF 2334 to CONFORM to SF 2188) rh/nh 8/ 11

2. When prescribing psychotropic medication 1 for a patient, the prescribing psychologist or 2 the psychologist with a conditional prescription 3 certificate shall maintain an ongoing collaborative 4 relationship with the licensed physician who oversees 5 the patient’s general medical care to ensure that 6 necessary medical examinations are conducted, the 7 psychotropic medication is appropriate for the 8 patient’s medical condition, and significant changes in 9 the patient’s medical or psychological condition are 10 discussed. 11 3. A prescription written by a prescribing 12 psychologist or a psychologist with a conditional 13 prescription certificate shall meet all of the 14 following requirements: 15 a. Comply with applicable state and federal laws. 16 b. Be identified as issued by the psychologist as 17 “psychologist certified to prescribe”. 18 c. Include the psychologist’s board-assigned 19 identification number. 20 4. A prescribing psychologist or a psychologist 21 with a conditional prescription certificate shall not 22 delegate prescriptive authority to any other person. 23 Records of all prescriptions shall be maintained in 24 patient records. 25 5. When authorized to prescribe controlled 26 substances, a prescribing psychologist or a 27 psychologist with a conditional prescription 28 certificate shall file with the board in a timely 29 manner all individual federal drug enforcement agency 30 registration and numbers. The board shall maintain 31 current records on every psychologist, including 32 federal registration and numbers. 33 Sec. 10. NEW SECTION . 154B.13 Board duties 34 regarding prescription certificates and conditional 35 -9- HF2334.3492 (1) 86 (amending this HF 2334 to CONFORM to SF 2188) rh/nh 9/ 11

prescription certificates. 1 1. The board shall, in consultation with the board 2 of medicine, adopt rules to carry out the provisions 3 of this chapter relating to prescribing psychologists. 4 The rules shall include but not be limited to all of 5 the following: 6 a. Procedures to obtain a conditional prescription 7 certificate, a prescription certificate, and a renewal 8 of a prescription certificate. The board may set 9 reasonable application and renewal fees. 10 b. Grounds for the denial, suspension, or 11 revocation of a conditional prescription certificate 12 and a prescription certificate, including a provision 13 for suspension or revocation of a license to 14 practice psychology upon suspension of a conditional 15 prescription certificate and a prescription 16 certificate. 17 c. The provision of an annual list of psychologists 18 with prescription certificates and psychologists with 19 conditional prescription certificates that contains 20 the information agreed to between the board and the 21 board of medicine. The board shall promptly notify the 22 board of medicine of psychologists who are added to or 23 removed from the list. 24 d. Any other rules necessary for the administration 25 of this chapter. 26 2. The board shall appoint a prescribing 27 psychologist rules subcommittee comprised of a 28 psychologist appointed by the board, a physician 29 appointed by the board of medicine, and a member of the 30 public appointed by the director of public health to 31 develop rules for consideration by the board pursuant 32 to this section. 33 Sec. 11. Section 155A.3, subsection 35, Code 2016, 34 is amended to read as follows: 35 -10- HF2334.3492 (1) 86 (amending this HF 2334 to CONFORM to SF 2188) rh/nh 10/ 11

35. “Practitioner” means a physician, dentist, 1 podiatric physician, prescribing psychologist, 2 veterinarian, or other person licensed or registered to 3 distribute or dispense a prescription drug or device in 4 the course of professional practice in this state or 5 a person licensed by another state in a health field 6 in which, under Iowa law, licensees in this state may 7 legally prescribe drugs. 8 Sec. 12. Section 155A.23, subsection 1, paragraph 9 c, Code 2016, is amended to read as follows: 10 c. For the purpose of obtaining a prescription drug 11 or device, falsely assuming the title of or claiming 12 to be a manufacturer, wholesaler, pharmacist, pharmacy 13 owner, physician, dentist, podiatric physician, 14 prescribing psychologist, veterinarian, or other 15 authorized person. 16 Sec. 13. Section 155A.24, subsection 14, Code 2016, 17 is amended to read as follows: 18 14. This section does not prevent a licensed 19 practitioner of medicine, dentistry, podiatry, 20 nursing, psychology, veterinary medicine, optometry, or 21 pharmacy from acts necessary in the ethical and legal 22 performance of the practitioner’s profession. > 23 ______________________________ L. MILLER of Scott -11- HF2334.3492 (1) 86 (amending this HF 2334 to CONFORM to SF 2188) rh/nh 11/ 11