H.F. 2334 Section 1. Section 123.3, subsection 35, Code 2016, is 1 amended to read as follows: 2 35. “Pharmacy” means a drug store in which drugs and 3 medicines are exposed for sale and sold at retail, or in which 4 prescriptions of licensed physicians and surgeons, dentists, 5 prescribing psychologists, or veterinarians are compounded and 6 sold by a registered pharmacist. 7 Sec. 2. Section 124.101, subsection 26, paragraph a, Code 8 2016, is amended to read as follows: 9 a. A physician, dentist, podiatric physician, prescribing 10 psychologist, veterinarian, scientific investigator or 11 other person licensed, registered , or otherwise permitted to 12 distribute, dispense, conduct research with respect to , or to 13 administer a controlled substance in the course of professional 14 practice or research in this state. 15 Sec. 3. Section 147.107, subsections 1 and 2, Code 2016, are 16 amended to read as follows: 17 1. A person, other than a pharmacist, physician, 18 dentist, podiatric physician, prescribing psychologist, or 19 veterinarian who dispenses as an incident to the practice of 20 the practitioner’s profession, shall not dispense prescription 21 drugs or controlled substances. 22 2. a. A pharmacist, physician, dentist, or podiatric 23 physician , or prescribing psychologist who dispenses 24 prescription drugs, including but not limited to controlled 25 substances, for human use, may delegate nonjudgmental 26 dispensing functions to staff assistants only when verification 27 of the accuracy and completeness of the dispensing is 28 determined by the pharmacist or practitioner in the 29 pharmacist’s or practitioner’s physical presence. However, the 30 physical presence requirement does not apply when a pharmacist 31 or practitioner is utilizing an automated dispensing system or 32 when a pharmacist is utilizing a tech-check-tech program, as 33 defined in section 155A.3 . When using an automated dispensing 34 system the pharmacist or practitioner shall utilize an 35 -1- LSB 5086HV (2) 86 rh/nh 1/ 11

H.F. 2334 internal quality control assurance plan that ensures accuracy 1 for dispensing. When using a tech-check-tech program the 2 pharmacist shall utilize an internal quality control assurance 3 plan, in accordance with rules adopted by the board of 4 pharmacy, that ensures accuracy for dispensing. Verification 5 of automated dispensing and tech-check-tech accuracy and 6 completeness remains the responsibility of the pharmacist or 7 practitioner and shall be determined in accordance with rules 8 adopted by the board of pharmacy, the board of medicine, the 9 dental board, and the board of podiatry , and the board of 10 psychology for their respective licensees. 11 b. A dentist, physician, or podiatric physician , or 12 prescribing psychologist who dispenses prescription drugs, 13 other than drug samples, pursuant to this subsection , shall 14 report the fact that they dispense prescription drugs with the 15 practitioner’s respective board at least biennially. 16 c. A physician, dentist, or podiatric physician , or 17 prescribing psychologist who dispenses prescription drugs, 18 other than drug samples, pursuant to this subsection , shall 19 offer to provide the patient with a written prescription that 20 may be dispensed from a pharmacy of the patient’s choice or 21 offer to transmit the prescription orally, electronically, or 22 by facsimile in accordance with section 155A.27 to a pharmacy 23 of the patient’s choice. 24 Sec. 4. NEW SECTION . 148.13A Board authority over 25 physicians supervising certain psychologists. 26 The board of medicine shall establish by rule specific 27 procedures for consulting with and considering the advice of 28 the board of psychology in determining whether to initiate 29 a disciplinary proceeding under chapter 17A against a 30 licensed physician in a matter involving the supervision of a 31 psychologist prescribing medication pursuant to a conditional 32 prescription certificate under chapter 154B. 33 Sec. 5. Section 154B.1, Code 2016, is amended to read as 34 follows: 35 -2- LSB 5086HV (2) 86 rh/nh 2/ 11

H.F. 2334 154B.1 Definition Definitions . 1 As used in this chapter, unless the context otherwise 2 requires: 3 1. “Board” means the board of psychology created under 4 chapter 147. 5 2. “Collaborative practice agreement” means a written 6 agreement between a prescribing psychologist and a licensed 7 physician that establishes clinical protocols, practice 8 guidelines, and care plans relevant to the scope of the 9 collaborative practice. 10 3. “Collaborative relationship” means a cooperative 11 working relationship between a prescribing psychologist or a 12 psychologist with a conditional prescription certificate and a 13 licensed physician in the provision of patient care, including 14 diagnosis and cooperation in the management and delivery of 15 physical and mental health care. 16 4. “Conditional prescription certificate” means a document 17 issued by the board to a licensed psychologist that permits 18 the holder to prescribe psychotropic medication under the 19 supervision of a licensed physician pursuant to this chapter. 20 5. “Practice of psychology” means the application of 21 established principles of learning, motivation, perception, 22 thinking, and emotional relations to problems of behavior 23 adjustment, group relations, and behavior modification, 24 by persons trained in psychology for compensation or other 25 personal gain. The application of principles includes , but 26 is not limited to: Counseling and the use of psychological 27 remedial measures with persons, in groups or individually, 28 with adjustment or emotional problems in the areas of work, 29 family, school , and personal relationships; measuring and 30 testing personality, intelligence, aptitudes, public opinion, 31 attitudes, and skills; and the teaching of such subject matter, 32 and the conducting of research on the problems relating to 33 human behavior. 34 6. “Prescribing psychologist” means a licensed psychologist 35 -3- LSB 5086HV (2) 86 rh/nh 3/ 11

H.F. 2334 who holds a valid prescription certificate. 1 7. “Prescription certificate” means a document issued by the 2 board to a licensed psychologist that permits the holder to 3 prescribe psychotropic medication pursuant to this chapter. 4 8. “Psychotropic medication” means a controlled substance 5 or dangerous drug that shall not be dispensed or administered 6 without a prescription and that has been approved by the 7 federal food and drug administration for the treatment of 8 mental disorders, as defined by the most current diagnostic 9 and statistical manual of mental disorders published by the 10 American psychiatric association or the most current version 11 of the international classification of diseases, and that is 12 listed as a psychotherapeutic agent in the American hospital 13 formulary service. “Psychotropic medication” does not include 14 narcotics. 15 Sec. 6. NEW SECTION . 154B.9 Drugs —— medicine. 16 1. Except as provided in subsections 2 and 3, a psychologist 17 shall not administer or prescribe drugs or medicine. 18 2. A licensed psychologist holding a conditional 19 prescription certificate may prescribe psychotropic medication 20 under the supervision of a licensed physician pursuant to this 21 chapter. 22 3. A prescribing psychologist may prescribe psychotropic 23 medication pursuant to this chapter. 24 Sec. 7. NEW SECTION . 154B.10 Conditional prescription 25 certificate. 26 1. An applicant for a conditional prescription certificate 27 shall be granted a certificate by the board if the applicant 28 satisfies all of the following requirements: 29 a. Holds a current license to practice psychology in this 30 state. 31 b. Completed pharmacological training from an institution 32 approved by the board or from a provider of continuing 33 education approved by the board. 34 c. Passed a national certification examination approved by 35 -4- LSB 5086HV (2) 86 rh/nh 4/ 11

H.F. 2334 the board that tested the applicant’s knowledge of pharmacology 1 in the diagnosis, care, and treatment of mental disorders. 2 d. Within five years immediately preceding the date of 3 application, successfully completed an organized program of 4 education consisting of intensive didactic instruction of no 5 fewer than four hundred fifty classroom hours in at least the 6 following core areas of instruction: 7 (1) Neuroscience. 8 (2) Pharmacology. 9 (3) Psychopharmacology. 10 (4) Physiology. 11 (5) Appropriate and relevant physical and laboratory 12 assessment. 13 e. Within five years immediately preceding the date of 14 application, has been certified by the applicant’s supervising 15 psychiatrist or physician as having successfully completed 16 a supervised and relevant clinical experience of no less 17 than an eighty-hour practicum in clinical assessment and 18 pathophysiology and an additional supervised practicum of at 19 least four hundred hours treating no fewer than one hundred 20 patients with mental disorders. The practica shall have been 21 supervised by a psychiatrist or other appropriately trained 22 physician. The board shall determine whether the practica is 23 sufficient to competently train the applicant in the treatment 24 of a diverse patient population. 25 f. Possesses malpractice insurance that will cover the 26 applicant during the period the conditional prescription 27 certificate is in effect. 28 g. Meets all other requirements, as determined by rules 29 adopted by the board, for obtaining a conditional prescription 30 certificate. 31 2. A conditional prescription certificate is valid for four 32 years, at the end of which the holder may apply again pursuant 33 to the provisions of subsection 1. 34 3. A psychologist with a conditional prescription 35 -5- LSB 5086HV (2) 86 rh/nh 5/ 11

H.F. 2334 certificate may prescribe psychotropic medication under the 1 supervision of a licensed physician subject to all of the 2 following conditions: 3 a. The psychologist shall continue to hold a current license 4 to practice psychology in this state and continue to maintain 5 malpractice insurance. 6 b. The psychologist shall inform the board of the name of 7 the physician under whose supervision the psychologist will 8 prescribe psychotropic medication and promptly inform the board 9 of any change of the supervising physician. 10 c. A physician supervising a psychologist prescribing 11 psychotropic medication pursuant to a conditional prescription 12 certificate shall be subject to disciplinary action pursuant to 13 section 148.13A for the acts and omissions of the psychologist 14 while under the physician’s supervision. This provision 15 does not relieve the psychologist from liability for the 16 psychologist’s acts and omissions. 17 Sec. 8. NEW SECTION . 154B.11 Prescription certificate. 18 1. An applicant for a prescription certificate shall be 19 granted a certificate by the board if the applicant satisfies 20 all of the following requirements: 21 a. Possesses a conditional prescription certificate and has 22 successfully completed two years of prescribing psychotropic 23 medication as certified by the supervising licensed physician. 24 An applicant for a prescription certificate who specializes 25 in the psychological care of children, elderly persons, or 26 persons with comorbid psychological conditions shall complete 27 at least one year prescribing psychotropic medications to such 28 populations as certified by the supervising licensed physician. 29 b. Holds a current license to practice psychology in this 30 state. 31 c. Possesses malpractice insurance that will cover the 32 applicant as a prescribing psychologist. 33 d. Meets all other requirements, as determined by rules 34 adopted by the board, for obtaining a prescription certificate. 35 -6- LSB 5086HV (2) 86 rh/nh 6/ 11

H.F. 2334 2. A psychologist with a prescription certificate may 1 prescribe psychotropic medication pursuant to the provisions of 2 this chapter subject to the following conditions: 3 a. The psychologist continues to hold a current license to 4 practice psychology in this state and maintains malpractice 5 insurance. 6 b. The psychologist annually satisfies the continuing 7 education requirements for prescribing psychologists, as 8 determined by the board, which shall be no fewer than twenty 9 hours each year. 10 c. The psychologist has entered into a collaborative 11 practice agreement with a licensed physician. 12 Sec. 9. NEW SECTION . 154B.12 Prescribing practices. 13 1. A prescribing psychologist or a psychologist with 14 a conditional prescription certificate may administer and 15 prescribe psychotropic medication within the scope of the 16 psychologist’s profession, including the ordering and review of 17 laboratory tests in conjunction with the prescription, for the 18 treatment of mental disorders. 19 2. When prescribing psychotropic medication for a 20 patient, the prescribing psychologist or the psychologist 21 with a conditional prescription certificate shall maintain 22 an ongoing collaborative relationship with the licensed 23 physician who oversees the patient’s general medical care to 24 ensure that necessary medical examinations are conducted, 25 the psychotropic medication is appropriate for the patient’s 26 medical condition, and significant changes in the patient’s 27 medical or psychological condition are discussed. 28 3. A prescription written by a prescribing psychologist or a 29 psychologist with a conditional prescription certificate shall 30 meet all of the following requirements: 31 a. Comply with applicable state and federal laws. 32 b. Be identified as issued by the psychologist as 33 “psychologist certified to prescribe”. 34 c. Include the psychologist’s board-assigned identification 35 -7- LSB 5086HV (2) 86 rh/nh 7/ 11

H.F. 2334 number. 1 4. A prescribing psychologist or a psychologist with 2 a conditional prescription certificate shall not delegate 3 prescriptive authority to any other person. Records of all 4 prescriptions shall be maintained in patient records. 5 5. When authorized to prescribe controlled substances, a 6 prescribing psychologist or a psychologist with a conditional 7 prescription certificate shall file with the board in a 8 timely manner all individual federal drug enforcement agency 9 registration and numbers. The board shall maintain current 10 records on every psychologist, including federal registration 11 and numbers. 12 Sec. 10. NEW SECTION . 154B.13 Board duties regarding 13 prescription certificates and conditional prescription 14 certificates. 15 1. The board shall adopt rules providing for the 16 procedures to obtain a conditional prescription certificate, 17 a prescription certificate, and a renewal of a prescription 18 certificate. The board may set reasonable application and 19 renewal fees. 20 2. The board shall adopt rules establishing the grounds for 21 denial, suspension, or revocation of conditional prescription 22 certificates and prescription certificates, including a 23 provision for suspension or revocation of a license to practice 24 psychology upon the suspension or revocation of a certificate. 25 3. The board shall provide to the board of pharmacy an 26 annual list of prescribing psychologists and psychologists 27 with conditional prescription certificates that contains 28 the information agreed upon between the board and the board 29 of pharmacy. The board shall promptly notify the board of 30 pharmacy of psychologists who are added to or removed from the 31 list. 32 4. The board shall adopt other rules as necessary to 33 administer this chapter. 34 5. The board shall consult with the board of medicine in 35 -8- LSB 5086HV (2) 86 rh/nh 8/ 11

H.F. 2334 developing rules to carry out this chapter. 1 Sec. 11. Section 155A.3, subsection 35, Code 2016, is 2 amended to read as follows: 3 35. “Practitioner” means a physician, dentist, podiatric 4 physician, prescribing psychologist, veterinarian, or other 5 person licensed or registered to distribute or dispense a 6 prescription drug or device in the course of professional 7 practice in this state or a person licensed by another state 8 in a health field in which, under Iowa law, licensees in this 9 state may legally prescribe drugs. 10 Sec. 12. Section 155A.23, subsection 1, paragraph c, Code 11 2016, is amended to read as follows: 12 c. For the purpose of obtaining a prescription drug or 13 device, falsely assuming the title of or claiming to be 14 a manufacturer, wholesaler, pharmacist, pharmacy owner, 15 physician, dentist, podiatric physician, prescribing 16 psychologist, veterinarian, or other authorized person. 17 Sec. 13. Section 155A.24, subsection 14, Code 2016, is 18 amended to read as follows: 19 14. This section does not prevent a licensed practitioner of 20 medicine, dentistry, podiatry, nursing, psychology, veterinary 21 medicine, optometry, or pharmacy from acts necessary in the 22 ethical and legal performance of the practitioner’s profession. 23 EXPLANATION 24 The inclusion of this explanation does not constitute agreement with 25 the explanation’s substance by the members of the general assembly. 26 This bill grants prescription authority to certain licensed 27 psychologists under Code chapter 154B. 28 The bill adds definitions of “board”, “collaborative 29 practice agreement”, “collaborative relationship”, “conditional 30 prescription certificate”, “prescribing psychologist”, 31 “prescription certificate”, and “psychotropic medication” to 32 the Code chapter. 33 The bill allows a licensed psychologist holding a 34 conditional prescription certificate and a prescribing 35 -9- LSB 5086HV (2) 86 rh/nh 9/ 11

H.F. 2334 psychologist, defined as a licensed psychologist who holds 1 a valid prescription certificate, to prescribe psychotropic 2 medication. However, the psychologist holding a conditional 3 prescription certificate may only prescribe psychotropic 4 medication under the supervision of a licensed physician. 5 The bill sets the requirements for a psychologist to obtain 6 a conditional prescription certificate or a prescription 7 certificate. A conditional prescription certificate is 8 valid for four years and a psychologist may reapply for 9 the certificate. To receive a prescription certificate, 10 a psychologist must complete two years of prescribing 11 psychotropic medication as supervised by a licensed physician 12 and an applicant who specializes in the psychological care 13 of children, elderly persons, or persons with comorbid 14 psychological conditions shall have at least one year 15 prescribing psychotropic medications to such populations. A 16 psychologist with a prescription certificate may prescribe 17 psychotropic medication under the provisions of the bill 18 subject to certain conditions including that the psychologist 19 has entered into a collaborative practice agreement with a 20 licensed physician. The licensed physician may be subject 21 to disciplinary action for the acts and omissions of the 22 psychologist under the physician’s supervision. A psychologist 23 must maintain licensure as a psychologist and malpractice 24 insurance to retain the prescription certificate or the 25 conditional prescription certificate. 26 The bill provides that a prescribing psychologist or 27 psychologist with a conditional prescription certificate may 28 administer and prescribe psychotropic medication within the 29 scope of the person’s profession. The prescribing psychologist 30 or psychologist with a conditional prescription certificate 31 must maintain a relationship with the patient’s licensed 32 physician when prescribing psychotropic medication for the 33 patient. 34 The bill states that a prescription written by a 35 -10- LSB 5086HV (2) 86 rh/nh 10/ 11

H.F. 2334 prescribing psychologist or a psychologist with a conditional 1 prescription certificate must comply with state and federal 2 law, be identified as issued by a “psychologist certified to 3 prescribe”, and include the psychologist’s board-assigned 4 identification number. A prescribing psychologist or 5 psychologist with a conditional prescription certificate 6 may not delegate the prescriptive authority to any other 7 person, and records of the prescriptions must be maintained 8 in the patient’s records. The prescribing psychologist or 9 psychologist with a conditional prescription certificate must 10 also file federal drug enforcement agency registrations and 11 numbers with the board. 12 The bill instructs the board of psychology in consultation 13 with the board of medicine to adopt rules providing for 14 the procedures for obtaining a conditional prescription 15 certificate, a prescription certificate, and a renewal of 16 a prescription certificate; setting reasonable application 17 and renewal fees; and regarding the denial, suspension, 18 or revocation of conditional prescription certificates and 19 prescription certificates. The board must provide the board of 20 pharmacy with an annual list of prescribing psychologists and 21 psychologists with conditional prescription certificates and 22 promptly notify the board of pharmacy of psychologists who are 23 added to or removed from the list. 24 A prescribing psychologist may be subject to criminal and 25 civil penalties and licensing sanctions under Code chapters 26 124, 147, 154B, and 155A. 27 The bill makes conforming changes in Code chapters 123, 124, 28 147, and 155A. 29 -11- LSB 5086HV (2) 86 rh/nh 11/ 11