House File 2334 - IntroducedA Bill ForAn Act 1relating to prescription authority for certain
2psychologists and making penalties applicable.
1   Section 1.  Section 123.3, subsection 35, Code 2016, is
2amended to read as follows:
   335.  “Pharmacy” means a drug store in which drugs and
4medicines are exposed for sale and sold at retail, or in which
5prescriptions of licensed physicians and surgeons, dentists,
 6prescribing psychologists, or veterinarians are compounded and
7sold by a registered pharmacist.
8   Sec. 2.  Section 124.101, subsection 26, paragraph a, Code
92016, is amended to read as follows:
   10a.  A physician, dentist, podiatric physician, prescribing
veterinarian, scientific investigator or
12other person licensed, registered, or otherwise permitted to
13distribute, dispense, conduct research with respect to, or to
14administer a controlled substance in the course of professional
15practice or research in this state.
16   Sec. 3.  Section 147.107, subsections 1 and 2, Code 2016, are
17amended to read as follows:
   181.  A person, other than a pharmacist, physician,
19dentist, podiatric physician, prescribing psychologist, or
20veterinarian who dispenses as an incident to the practice of
21the practitioner’s profession, shall not dispense prescription
22drugs or controlled substances.
   232.  a.  A pharmacist, physician, dentist, or podiatric
24physician, or prescribing psychologist who dispenses
25prescription drugs, including but not limited to controlled
26substances, for human use, may delegate nonjudgmental
27dispensing functions to staff assistants only when verification
28of the accuracy and completeness of the dispensing is
29determined by the pharmacist or practitioner in the
30pharmacist’s or practitioner’s physical presence. However, the
31physical presence requirement does not apply when a pharmacist
32or practitioner is utilizing an automated dispensing system or
33when a pharmacist is utilizing a tech-check-tech program, as
34defined in section 155A.3. When using an automated dispensing
35system the pharmacist or practitioner shall utilize an
-1-1internal quality control assurance plan that ensures accuracy
2for dispensing. When using a tech-check-tech program the
3pharmacist shall utilize an internal quality control assurance
4plan, in accordance with rules adopted by the board of
5pharmacy, that ensures accuracy for dispensing. Verification
6of automated dispensing and tech-check-tech accuracy and
7completeness remains the responsibility of the pharmacist or
8practitioner and shall be determined in accordance with rules
9adopted by the board of pharmacy, the board of medicine, the
10dental board, and the board of podiatry, and the board of
for their respective licensees.
   12b.  A dentist, physician, or podiatric physician, or
13prescribing psychologist
who dispenses prescription drugs,
14other than drug samples, pursuant to this subsection, shall
15report the fact that they dispense prescription drugs with the
16practitioner’s respective board at least biennially.
   17c.  A physician, dentist, or podiatric physician, or
18prescribing psychologist
who dispenses prescription drugs,
19other than drug samples, pursuant to this subsection, shall
20offer to provide the patient with a written prescription that
21may be dispensed from a pharmacy of the patient’s choice or
22offer to transmit the prescription orally, electronically, or
23by facsimile in accordance with section 155A.27 to a pharmacy
24of the patient’s choice.
25   Sec. 4.  NEW SECTION.  148.13A  Board authority over
26physicians supervising certain psychologists.
   27The board of medicine shall establish by rule specific
28procedures for consulting with and considering the advice of
29the board of psychology in determining whether to initiate
30a disciplinary proceeding under chapter 17A against a
31licensed physician in a matter involving the supervision of a
32psychologist prescribing medication pursuant to a conditional
33prescription certificate under chapter 154B.
34   Sec. 5.  Section 154B.1, Code 2016, is amended to read as
-2-   1154B.1  Definition Definitions.
   2As used in this chapter, unless the context otherwise
   41.  “Board” means the board of psychology created under
5chapter 147.
   62.  “Collaborative practice agreement” means a written
7agreement between a prescribing psychologist and a licensed
8physician that establishes clinical protocols, practice
9guidelines, and care plans relevant to the scope of the
10collaborative practice.
   113.  “Collaborative relationship” means a cooperative
12working relationship between a prescribing psychologist or a
13psychologist with a conditional prescription certificate and a
14licensed physician in the provision of patient care, including
15diagnosis and cooperation in the management and delivery of
16physical and mental health care.
   174.  “Conditional prescription certificate” means a document
18issued by the board to a licensed psychologist that permits
19the holder to prescribe psychotropic medication under the
20supervision of a licensed physician pursuant to this chapter.
   215.  “Practice of psychology” means the application of
22established principles of learning, motivation, perception,
23thinking, and emotional relations to problems of behavior
24adjustment, group relations, and behavior modification,
25by persons trained in psychology for compensation or other
26personal gain. The application of principles includes, but
27is not limited to: Counseling and the use of psychological
28remedial measures with persons, in groups or individually,
29with adjustment or emotional problems in the areas of work,
30family, school, and personal relationships; measuring and
31testing personality, intelligence, aptitudes, public opinion,
32attitudes, and skills; and the teaching of such subject matter,
33and the conducting of research on the problems relating to
34human behavior.
   356.  “Prescribing psychologist” means a licensed psychologist
-3-1who holds a valid prescription certificate.
   27.  “Prescription certificate” means a document issued by the
3board to a licensed psychologist that permits the holder to
4prescribe psychotropic medication pursuant to this chapter.
   58.  “Psychotropic medication” means a controlled substance
6or dangerous drug that shall not be dispensed or administered
7without a prescription and that has been approved by the
8federal food and drug administration for the treatment of
9mental disorders, as defined by the most current diagnostic
10and statistical manual of mental disorders published by the
11American psychiatric association or the most current version
12of the international classification of diseases, and that is
13listed as a psychotherapeutic agent in the American hospital
14formulary service. “Psychotropic medication” does not include
16   Sec. 6.  NEW SECTION.  154B.9  Drugs —— medicine.
   171.  Except as provided in subsections 2 and 3, a psychologist
18shall not administer or prescribe drugs or medicine.
   192.  A licensed psychologist holding a conditional
20prescription certificate may prescribe psychotropic medication
21under the supervision of a licensed physician pursuant to this
   233.  A prescribing psychologist may prescribe psychotropic
24medication pursuant to this chapter.
25   Sec. 7.  NEW SECTION.  154B.10  Conditional prescription
   271.  An applicant for a conditional prescription certificate
28shall be granted a certificate by the board if the applicant
29satisfies all of the following requirements:
   30a.  Holds a current license to practice psychology in this
   32b.  Completed pharmacological training from an institution
33approved by the board or from a provider of continuing
34education approved by the board.
   35c.  Passed a national certification examination approved by
-4-1the board that tested the applicant’s knowledge of pharmacology
2in the diagnosis, care, and treatment of mental disorders.
   3d.  Within five years immediately preceding the date of
4application, successfully completed an organized program of
5education consisting of intensive didactic instruction of no
6fewer than four hundred fifty classroom hours in at least the
7following core areas of instruction:
   8(1)  Neuroscience.
   9(2)  Pharmacology.
   10(3)  Psychopharmacology.
   11(4)  Physiology.
   12(5)  Appropriate and relevant physical and laboratory
   14e.  Within five years immediately preceding the date of
15application, has been certified by the applicant’s supervising
16psychiatrist or physician as having successfully completed
17a supervised and relevant clinical experience of no less
18than an eighty-hour practicum in clinical assessment and
19pathophysiology and an additional supervised practicum of at
20least four hundred hours treating no fewer than one hundred
21patients with mental disorders. The practica shall have been
22supervised by a psychiatrist or other appropriately trained
23physician. The board shall determine whether the practica is
24sufficient to competently train the applicant in the treatment
25of a diverse patient population.
   26f.  Possesses malpractice insurance that will cover the
27applicant during the period the conditional prescription
28certificate is in effect.
   29g.  Meets all other requirements, as determined by rules
30adopted by the board, for obtaining a conditional prescription
   322.  A conditional prescription certificate is valid for four
33years, at the end of which the holder may apply again pursuant
34to the provisions of subsection 1.
   353.  A psychologist with a conditional prescription
-5-1certificate may prescribe psychotropic medication under the
2supervision of a licensed physician subject to all of the
3following conditions:
   4a.  The psychologist shall continue to hold a current license
5to practice psychology in this state and continue to maintain
6malpractice insurance.
   7b.  The psychologist shall inform the board of the name of
8the physician under whose supervision the psychologist will
9prescribe psychotropic medication and promptly inform the board
10of any change of the supervising physician.
   11c.  A physician supervising a psychologist prescribing
12psychotropic medication pursuant to a conditional prescription
13certificate shall be subject to disciplinary action pursuant to
14section 148.13A for the acts and omissions of the psychologist
15while under the physician’s supervision. This provision
16does not relieve the psychologist from liability for the
17psychologist’s acts and omissions.
18   Sec. 8.  NEW SECTION.  154B.11  Prescription certificate.
   191.  An applicant for a prescription certificate shall be
20granted a certificate by the board if the applicant satisfies
21all of the following requirements:
   22a.  Possesses a conditional prescription certificate and has
23successfully completed two years of prescribing psychotropic
24medication as certified by the supervising licensed physician.
25An applicant for a prescription certificate who specializes
26in the psychological care of children, elderly persons, or
27persons with comorbid psychological conditions shall complete
28at least one year prescribing psychotropic medications to such
29populations as certified by the supervising licensed physician.
   30b.  Holds a current license to practice psychology in this
   32c.  Possesses malpractice insurance that will cover the
33applicant as a prescribing psychologist.
   34d.  Meets all other requirements, as determined by rules
35adopted by the board, for obtaining a prescription certificate.
   12.  A psychologist with a prescription certificate may
2prescribe psychotropic medication pursuant to the provisions of
3this chapter subject to the following conditions:
   4a.  The psychologist continues to hold a current license to
5practice psychology in this state and maintains malpractice
   7b.  The psychologist annually satisfies the continuing
8education requirements for prescribing psychologists, as
9determined by the board, which shall be no fewer than twenty
10hours each year.
   11c.  The psychologist has entered into a collaborative
12practice agreement with a licensed physician.
13   Sec. 9.  NEW SECTION.  154B.12  Prescribing practices.
   141.  A prescribing psychologist or a psychologist with
15a conditional prescription certificate may administer and
16prescribe psychotropic medication within the scope of the
17psychologist’s profession, including the ordering and review of
18laboratory tests in conjunction with the prescription, for the
19treatment of mental disorders.
   202.  When prescribing psychotropic medication for a
21patient, the prescribing psychologist or the psychologist
22with a conditional prescription certificate shall maintain
23an ongoing collaborative relationship with the licensed
24physician who oversees the patient’s general medical care to
25ensure that necessary medical examinations are conducted,
26the psychotropic medication is appropriate for the patient’s
27medical condition, and significant changes in the patient’s
28medical or psychological condition are discussed.
   293.  A prescription written by a prescribing psychologist or a
30psychologist with a conditional prescription certificate shall
31meet all of the following requirements:
   32a.  Comply with applicable state and federal laws.
   33b.  Be identified as issued by the psychologist as
34“psychologist certified to prescribe”.
   35c.  Include the psychologist’s board-assigned identification
   24.  A prescribing psychologist or a psychologist with
3a conditional prescription certificate shall not delegate
4prescriptive authority to any other person. Records of all
5prescriptions shall be maintained in patient records.
   65.  When authorized to prescribe controlled substances, a
7prescribing psychologist or a psychologist with a conditional
8prescription certificate shall file with the board in a
9timely manner all individual federal drug enforcement agency
10registration and numbers. The board shall maintain current
11records on every psychologist, including federal registration
12and numbers.
13   Sec. 10.  NEW SECTION.  154B.13  Board duties regarding
14prescription certificates and conditional prescription
   161.  The board shall adopt rules providing for the
17procedures to obtain a conditional prescription certificate,
18a prescription certificate, and a renewal of a prescription
19certificate. The board may set reasonable application and
20renewal fees.
   212.  The board shall adopt rules establishing the grounds for
22denial, suspension, or revocation of conditional prescription
23certificates and prescription certificates, including a
24provision for suspension or revocation of a license to practice
25psychology upon the suspension or revocation of a certificate.
   263.  The board shall provide to the board of pharmacy an
27annual list of prescribing psychologists and psychologists
28with conditional prescription certificates that contains
29the information agreed upon between the board and the board
30of pharmacy. The board shall promptly notify the board of
31pharmacy of psychologists who are added to or removed from the
   334.  The board shall adopt other rules as necessary to
34administer this chapter.
   355.  The board shall consult with the board of medicine in
-8-1developing rules to carry out this chapter.
2   Sec. 11.  Section 155A.3, subsection 35, Code 2016, is
3amended to read as follows:
   435.  “Practitioner” means a physician, dentist, podiatric
5physician, prescribing psychologist, veterinarian, or other
6person licensed or registered to distribute or dispense a
7prescription drug or device in the course of professional
8practice in this state or a person licensed by another state
9in a health field in which, under Iowa law, licensees in this
10state may legally prescribe drugs.
11   Sec. 12.  Section 155A.23, subsection 1, paragraph c, Code
122016, is amended to read as follows:
   13c.  For the purpose of obtaining a prescription drug or
14device, falsely assuming the title of or claiming to be
15a manufacturer, wholesaler, pharmacist, pharmacy owner,
16physician, dentist, podiatric physician, prescribing
veterinarian, or other authorized person.
18   Sec. 13.  Section 155A.24, subsection 14, Code 2016, is
19amended to read as follows:
   2014.  This section does not prevent a licensed practitioner of
21medicine, dentistry, podiatry, nursing, psychology, veterinary
22medicine, optometry, or pharmacy from acts necessary in the
23ethical and legal performance of the practitioner’s profession.
25The inclusion of this explanation does not constitute agreement with
26the explanation’s substance by the members of the general assembly.
   27This bill grants prescription authority to certain licensed
28psychologists under Code chapter 154B.
   29The bill adds definitions of “board”, “collaborative
30practice agreement”, “collaborative relationship”, “conditional
31prescription certificate”, “prescribing psychologist”,
32“prescription certificate”, and “psychotropic medication” to
33the Code chapter.
   34The bill allows a licensed psychologist holding a
35conditional prescription certificate and a prescribing
-9-1psychologist, defined as a licensed psychologist who holds
2a valid prescription certificate, to prescribe psychotropic
3medication. However, the psychologist holding a conditional
4prescription certificate may only prescribe psychotropic
5medication under the supervision of a licensed physician.
   6The bill sets the requirements for a psychologist to obtain
7a conditional prescription certificate or a prescription
8certificate. A conditional prescription certificate is
9valid for four years and a psychologist may reapply for
10the certificate. To receive a prescription certificate,
11a psychologist must complete two years of prescribing
12psychotropic medication as supervised by a licensed physician
13and an applicant who specializes in the psychological care
14of children, elderly persons, or persons with comorbid
15psychological conditions shall have at least one year
16prescribing psychotropic medications to such populations. A
17psychologist with a prescription certificate may prescribe
18psychotropic medication under the provisions of the bill
19subject to certain conditions including that the psychologist
20has entered into a collaborative practice agreement with a
21licensed physician. The licensed physician may be subject
22to disciplinary action for the acts and omissions of the
23psychologist under the physician’s supervision. A psychologist
24must maintain licensure as a psychologist and malpractice
25insurance to retain the prescription certificate or the
26conditional prescription certificate.
   27The bill provides that a prescribing psychologist or
28psychologist with a conditional prescription certificate may
29administer and prescribe psychotropic medication within the
30scope of the person’s profession. The prescribing psychologist
31or psychologist with a conditional prescription certificate
32must maintain a relationship with the patient’s licensed
33physician when prescribing psychotropic medication for the
   35The bill states that a prescription written by a
-10-1prescribing psychologist or a psychologist with a conditional
2prescription certificate must comply with state and federal
3law, be identified as issued by a “psychologist certified to
4prescribe”, and include the psychologist’s board-assigned
5identification number. A prescribing psychologist or
6psychologist with a conditional prescription certificate
7may not delegate the prescriptive authority to any other
8person, and records of the prescriptions must be maintained
9in the patient’s records. The prescribing psychologist or
10psychologist with a conditional prescription certificate must
11also file federal drug enforcement agency registrations and
12numbers with the board.
   13The bill instructs the board of psychology in consultation
14with the board of medicine to adopt rules providing for
15the procedures for obtaining a conditional prescription
16certificate, a prescription certificate, and a renewal of
17a prescription certificate; setting reasonable application
18and renewal fees; and regarding the denial, suspension,
19or revocation of conditional prescription certificates and
20prescription certificates. The board must provide the board of
21pharmacy with an annual list of prescribing psychologists and
22psychologists with conditional prescription certificates and
23promptly notify the board of pharmacy of psychologists who are
24added to or removed from the list.
   25A prescribing psychologist may be subject to criminal and
26civil penalties and licensing sanctions under Code chapters
27124, 147, 154B, and 155A.
   28The bill makes conforming changes in Code chapters 123, 124,
29147, and 155A.