S.F. 2188 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 5086SV (4) 86 rh/nh 1/ 11

S.F. 2188 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, in consultation with the board 27 of psychology, establish by rule specific minimum standards 28 for the appropriate supervision of a psychologist prescribing 29 medication pursuant to a conditional prescription certificate 30 under chapter 154B. 31 Sec. 5. Section 154B.1, Code 2016, is amended to read as 32 follows: 33 154B.1 Definition Definitions . 34 As used in this chapter, unless the context otherwise 35 -2- LSB 5086SV (4) 86 rh/nh 2/ 11

S.F. 2188 requires: 1 1. “Board” means the board of psychology created under 2 chapter 147. 3 2. “Collaborative practice agreement” means a written 4 agreement between a prescribing psychologist and a licensed 5 physician that establishes clinical protocols, practice 6 guidelines, and care plans relevant to the scope of the 7 collaborative practice. 8 3. “Collaborative relationship” means a cooperative 9 working relationship between a prescribing psychologist or a 10 psychologist with a conditional prescription certificate and a 11 licensed physician in the provision of patient care, including 12 diagnosis and cooperation in the management and delivery of 13 physical and mental health care. 14 4. “Conditional prescription certificate” means a document 15 issued by the board to a licensed psychologist that permits 16 the holder to prescribe psychotropic medication under the 17 supervision of a licensed physician pursuant to this chapter. 18 5. “Practice of psychology” means the application of 19 established principles of learning, motivation, perception, 20 thinking, and emotional relations to problems of behavior 21 adjustment, group relations, and behavior modification, 22 by persons trained in psychology for compensation or other 23 personal gain. The application of principles includes , but 24 is not limited to: Counseling and the use of psychological 25 remedial measures with persons, in groups or individually, 26 with adjustment or emotional problems in the areas of work, 27 family, school , and personal relationships; measuring and 28 testing personality, intelligence, aptitudes, public opinion, 29 attitudes, and skills; and the teaching of such subject matter, 30 and the conducting of research on the problems relating to 31 human behavior. 32 6. “Prescribing psychologist” means a licensed psychologist 33 who holds a valid prescription certificate. 34 7. “Prescription certificate” means a document issued by the 35 -3- LSB 5086SV (4) 86 rh/nh 3/ 11

S.F. 2188 board to a licensed psychologist that permits the holder to 1 prescribe psychotropic medication pursuant to this chapter. 2 8. “Psychotropic medication” means a controlled substance 3 or dangerous drug that shall not be dispensed or administered 4 without a prescription and that has been approved by the 5 federal food and drug administration for the treatment of 6 mental disorders, as defined by the most current diagnostic 7 and statistical manual of mental disorders published by the 8 American psychiatric association or the most current version 9 of the international classification of diseases, and that is 10 listed as a psychotherapeutic agent in the American hospital 11 formulary service. “Psychotropic medication” does not include 12 narcotics. 13 Sec. 6. NEW SECTION . 154B.9 Drugs —— medicine. 14 1. Except as provided in subsections 2 and 3, a psychologist 15 shall not administer or prescribe drugs or medicine. 16 2. A licensed psychologist holding a conditional 17 prescription certificate may prescribe psychotropic medication 18 under the supervision of a licensed physician pursuant to this 19 chapter. 20 3. A prescribing psychologist may prescribe psychotropic 21 medication pursuant to this chapter. 22 Sec. 7. NEW SECTION . 154B.10 Conditional prescription 23 certificate. 24 1. An applicant for a conditional prescription certificate 25 shall be granted a certificate by the board if the applicant 26 satisfies all of the following requirements: 27 a. Holds a current license to practice psychology in this 28 state. 29 b. Completed pharmacological training from an institution 30 approved by the board or from a provider of continuing 31 education approved by the board. 32 c. Passed a national certification examination approved by 33 the board that tested the applicant’s knowledge of pharmacology 34 in the diagnosis, care, and treatment of mental disorders. 35 -4- LSB 5086SV (4) 86 rh/nh 4/ 11

S.F. 2188 d. Within five years immediately preceding the date of 1 application, successfully completed an organized program of 2 education consisting of intensive didactic instruction of no 3 fewer than four hundred fifty classroom hours in at least the 4 following core areas of instruction: 5 (1) Neuroscience. 6 (2) Pharmacology. 7 (3) Psychopharmacology. 8 (4) Physiology. 9 (5) Appropriate and relevant physical and laboratory 10 assessment. 11 e. Within five years immediately preceding the date of 12 application, has been certified by the applicant’s supervising 13 physician as having successfully completed a supervised and 14 relevant clinical experience of no less than an eighty-hour 15 practicum in clinical assessment and pathophysiology and an 16 additional supervised practicum of at least four hundred 17 hours treating no fewer than one hundred patients with mental 18 disorders. The practica shall have been supervised by a 19 trained physician. The board shall determine whether the 20 practica is sufficient to competently train the applicant in 21 the treatment of a diverse patient population. 22 f. Possesses malpractice insurance that will cover the 23 applicant during the period the conditional prescription 24 certificate is in effect. 25 g. Meets all other requirements, as determined by rules 26 adopted by the board, for obtaining a conditional prescription 27 certificate. 28 2. A conditional prescription certificate is valid for four 29 years, at the end of which the holder may apply again pursuant 30 to the provisions of subsection 1. 31 3. A psychologist with a conditional prescription 32 certificate may prescribe psychotropic medication under the 33 supervision of a licensed physician subject to all of the 34 following conditions: 35 -5- LSB 5086SV (4) 86 rh/nh 5/ 11

S.F. 2188 a. The psychologist shall continue to hold a current license 1 to practice psychology in this state and continue to maintain 2 malpractice insurance. 3 b. The psychologist shall inform the board of the name of 4 the physician under whose supervision the psychologist will 5 prescribe psychotropic medication and promptly inform the board 6 of any change of the supervising physician. 7 c. A physician supervising a psychologist prescribing 8 psychotropic medication pursuant to a conditional prescription 9 certificate shall be subject to disciplinary action pursuant to 10 section 148.13A for the acts and omissions of the psychologist 11 while under the physician’s supervision. This provision 12 does not relieve the psychologist from liability for the 13 psychologist’s acts and omissions. 14 Sec. 8. NEW SECTION . 154B.11 Prescription certificate. 15 1. An applicant for a prescription certificate shall be 16 granted a certificate by the board if the applicant satisfies 17 all of the following requirements: 18 a. Possesses a conditional prescription certificate and has 19 successfully completed two years of prescribing psychotropic 20 medication as certified by the supervising licensed physician. 21 An applicant for a prescription certificate who specializes 22 in the psychological care of children, elderly persons, or 23 persons with comorbid psychological conditions shall complete 24 at least one year prescribing psychotropic medications to such 25 populations as certified by the supervising licensed physician. 26 b. Holds a current license to practice psychology in this 27 state. 28 c. Possesses malpractice insurance that will cover the 29 applicant as a prescribing psychologist. 30 d. Meets all other requirements, as determined by rules 31 adopted by the board, for obtaining a prescription certificate. 32 2. A psychologist with a prescription certificate may 33 prescribe psychotropic medication pursuant to the provisions of 34 this chapter subject to the following conditions: 35 -6- LSB 5086SV (4) 86 rh/nh 6/ 11

S.F. 2188 a. The psychologist continues to hold a current license to 1 practice psychology in this state and maintains malpractice 2 insurance. 3 b. The psychologist annually satisfies the continuing 4 education requirements for prescribing psychologists, as 5 determined by the board, which shall be no fewer than twenty 6 hours each year. 7 c. The psychologist has entered into a collaborative 8 practice agreement with a licensed physician. 9 Sec. 9. NEW SECTION . 154B.12 Prescribing practices. 10 1. A prescribing psychologist or a psychologist with 11 a conditional prescription certificate may administer and 12 prescribe psychotropic medication within the scope of the 13 psychologist’s profession, including the ordering and review of 14 laboratory tests in conjunction with the prescription, for the 15 treatment of mental disorders. 16 2. When prescribing psychotropic medication for a 17 patient, the prescribing psychologist or the psychologist 18 with a conditional prescription certificate shall maintain 19 an ongoing collaborative relationship with the licensed 20 physician who oversees the patient’s general medical care to 21 ensure that necessary medical examinations are conducted, 22 the psychotropic medication is appropriate for the patient’s 23 medical condition, and significant changes in the patient’s 24 medical or psychological condition are discussed. 25 3. A prescription written by a prescribing psychologist or a 26 psychologist with a conditional prescription certificate shall 27 meet all of the following requirements: 28 a. Comply with applicable state and federal laws. 29 b. Be identified as issued by the psychologist as 30 “psychologist certified to prescribe”. 31 c. Include the psychologist’s board-assigned identification 32 number. 33 4. A prescribing psychologist or a psychologist with 34 a conditional prescription certificate shall not delegate 35 -7- LSB 5086SV (4) 86 rh/nh 7/ 11

S.F. 2188 prescriptive authority to any other person. Records of all 1 prescriptions shall be maintained in patient records. 2 5. When authorized to prescribe controlled substances, a 3 prescribing psychologist or a psychologist with a conditional 4 prescription certificate shall file with the board in a 5 timely manner all individual federal drug enforcement agency 6 registration and numbers. The board shall maintain current 7 records on every psychologist, including federal registration 8 and numbers. 9 Sec. 10. NEW SECTION . 154B.13 Board duties regarding 10 prescription certificates and conditional prescription 11 certificates. 12 1. The board shall adopt rules providing for the 13 procedures to obtain a conditional prescription certificate, 14 a prescription certificate, and a renewal of a prescription 15 certificate. The board may set reasonable application and 16 renewal fees. 17 2. The board shall adopt rules establishing the grounds for 18 denial, suspension, or revocation of conditional prescription 19 certificates and prescription certificates, including a 20 provision for suspension or revocation of a license to practice 21 psychology upon the suspension or revocation of a certificate. 22 3. The board shall provide to the board of pharmacy an 23 annual list of prescribing psychologists and psychologists 24 with conditional prescription certificates that contains 25 the information agreed upon between the board and the board 26 of pharmacy. The board shall promptly notify the board of 27 pharmacy of psychologists who are added to or removed from the 28 list. 29 4. The board shall adopt other rules as necessary to 30 administer this chapter. 31 5. The board shall consult with the board of medicine in 32 developing rules to carry out this chapter. 33 Sec. 11. Section 155A.3, subsection 35, Code 2016, is 34 amended to read as follows: 35 -8- LSB 5086SV (4) 86 rh/nh 8/ 11

S.F. 2188 35. “Practitioner” means a physician, dentist, podiatric 1 physician, prescribing psychologist, veterinarian, or other 2 person licensed or registered to distribute or dispense a 3 prescription drug or device in the course of professional 4 practice in this state or a person licensed by another state 5 in a health field in which, under Iowa law, licensees in this 6 state may legally prescribe drugs. 7 Sec. 12. Section 155A.23, subsection 1, paragraph c, Code 8 2016, is amended to read as follows: 9 c. For the purpose of obtaining a prescription drug or 10 device, falsely assuming the title of or claiming to be 11 a manufacturer, wholesaler, pharmacist, pharmacy owner, 12 physician, dentist, podiatric physician, prescribing 13 psychologist, veterinarian, or other authorized person. 14 Sec. 13. Section 155A.24, subsection 14, Code 2016, is 15 amended to read as follows: 16 14. This section does not prevent a licensed practitioner of 17 medicine, dentistry, podiatry, nursing, psychology, veterinary 18 medicine, optometry, or pharmacy from acts necessary in the 19 ethical and legal performance of the practitioner’s profession. 20 EXPLANATION 21 The inclusion of this explanation does not constitute agreement with 22 the explanation’s substance by the members of the general assembly. 23 This bill grants prescription authority to certain licensed 24 psychologists under Code chapter 154B. 25 The bill adds definitions of “board”, “collaborative 26 practice agreement”, “collaborative relationship”, “conditional 27 prescription certificate”, “prescribing psychologist”, 28 “prescription certificate”, and “psychotropic medication” to 29 the Code chapter. 30 The bill allows a licensed psychologist holding a 31 conditional prescription certificate and a prescribing 32 psychologist, defined as a licensed psychologist who holds 33 a valid prescription certificate, to prescribe psychotropic 34 medication. However, the psychologist holding a conditional 35 -9- LSB 5086SV (4) 86 rh/nh 9/ 11

S.F. 2188 prescription certificate may only prescribe psychotropic 1 medication under the supervision of a licensed physician. 2 The bill sets the requirements for a psychologist to obtain 3 a conditional prescription certificate or a prescription 4 certificate. A conditional prescription certificate is 5 valid for four years and a psychologist may reapply for 6 the certificate. To receive a prescription certificate, 7 a psychologist must complete two years of prescribing 8 psychotropic medication as supervised by a licensed physician 9 and an applicant who specializes in the psychological care 10 of children, elderly persons, or persons with comorbid 11 psychological conditions shall have at least one year 12 prescribing psychotropic medications to such populations. A 13 psychologist with a prescription certificate may prescribe 14 psychotropic medication under the provisions of the bill 15 subject to certain conditions including that the psychologist 16 has entered into a collaborative practice agreement with a 17 licensed physician. The licensed physician may be subject 18 to disciplinary action for the acts and omissions of the 19 psychologist under the physician’s supervision. A psychologist 20 must maintain licensure as a psychologist and malpractice 21 insurance to retain the prescription certificate or the 22 conditional prescription certificate. 23 The bill provides that a prescribing psychologist or 24 psychologist with a conditional prescription certificate may 25 administer and prescribe psychotropic medication within the 26 scope of the person’s profession. The prescribing psychologist 27 or psychologist with a conditional prescription certificate 28 must maintain a relationship with the patient’s licensed 29 physician when prescribing psychotropic medication for the 30 patient. 31 The bill states that a prescription written by a 32 prescribing psychologist or a psychologist with a conditional 33 prescription certificate must comply with state and federal 34 law, be identified as issued by a “psychologist certified to 35 -10- LSB 5086SV (4) 86 rh/nh 10/ 11

S.F. 2188 prescribe”, and include the psychologist’s board-assigned 1 identification number. A prescribing psychologist or 2 psychologist with a conditional prescription certificate 3 may not delegate the prescriptive authority to any other 4 person, and records of the prescriptions must be maintained 5 in the patient’s records. The prescribing psychologist or 6 psychologist with a conditional prescription certificate must 7 also file federal drug enforcement agency registrations and 8 numbers with the board. 9 The bill instructs the board of medicine, in consultation 10 with the board of psychology, to establish by rule minimum 11 standards for the appropriate supervision of a psychologist 12 prescribing medication pursuant to a conditional prescription 13 certificate. 14 The bill instructs the board of psychology in consultation 15 with the board of medicine to adopt rules providing for 16 the procedures for obtaining a conditional prescription 17 certificate, a prescription certificate, and a renewal of 18 a prescription certificate; setting reasonable application 19 and renewal fees; and regarding the denial, suspension, 20 or revocation of conditional prescription certificates and 21 prescription certificates. The board must provide the board of 22 pharmacy with an annual list of prescribing psychologists and 23 psychologists with conditional prescription certificates and 24 promptly notify the board of pharmacy of psychologists who are 25 added to or removed from the list. 26 A prescribing psychologist may be subject to criminal and 27 civil penalties and licensing sanctions under Code chapters 28 124, 147, 154B, and 155A. 29 The bill makes conforming changes in Code chapters 123, 124, 30 147, and 155A. 31 -11- LSB 5086SV (4) 86 rh/nh 11/ 11