A bill that would authorize psychologists to prescribe medications has garnered some support from Hawaii senators.
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The Senate Committee on Health and Human Services passed Senate Bill 677 during a public hearing on Monday. The bill would authorize and establish procedures and criteria for prescriptive authority for clinical psychologists who meet specific education, training, and registration requirements.
Dr. Lee Evslin, a retired primary care physician who served as CEO of Kauai Medical Clinic for 15 years, testified in support of SB 677, noting that the state has a shortage of primary care physicians and psychiatrists—providers currently permitted to prescribe medications.
“Across the nation, we have increasing depression, anxiety, and other psychological conditions,” Evslin said. “A 10-15 minute visit at the office of a primary care physician is often not the optimal place to do a psychiatric evaluation. And yet we provide the bulk of medications for depression and anxiety in rural areas. When you have a shortage, that condition gets even worse. Those visits get shorter, it gets harder to get in to see somebody. Bills like this provide prescriptive permission for psychologists with longer visits [available].”
Dr. Cecilia Gay said she was trained at the Hawaii School of Professional Psychology in Honolulu, but she moved away from Hawaii in 2016.
“Now I’m in Colorado,” Gay said. “But I will come back if you allow psychologists to prescribe. I went to school for two-and-a-half years, I was trained by psychiatrists, by medical doctors, by nurse practitioners. We’re trained, we’re qualified, we can do this.”
Dr. Iqbal Ahmed, a geriatric psychiatrist, testified in opposition to SB 677, citing safety concerns.
“People say there are not adverse effects,” Ahmed said. “The fact of the matter is [there are] serious adverse effects. The real medical need is for more medical providers who can provide therapy and other psychological services. Psychological therapy works as well, if not better than, medications for things such as anxiety, depression, and (post-traumatic stress disorder). No other country in the world allows for psychologists to prescribe medications. There’s a good reason for that.”
Dr. Jeffrey Singer, a general surgeon in Phoenix, noted that the Department of Defense trained clinical psychologists to prescribe psychiatric medications to increase the workforce of prescribing psychotherapists more than 30 years ago.
“Today, prescribing psychotherapists practice in several federal agencies, five states, and Guam,” Singer said. “The evidence shows that psychologists prescribe as safely as, and possibly more conservatively, than psychiatrists. Hawaii lawmakers can help increase access to medically-assisted mental health services by licensing prescribing psychologists without spending any taxpayer dollars.”
The bill passed in the committee, with three votes supporting it, one (Republican Sen. Brenton Awa) against it, and one (Sen. Maile S.L. Shimabukuro) excused from voting.
If enacted, SB 677 would require the Board of Psychology to accept applications for prescriptive authority privilege beginning on July 1st. It would need to be approved by another committee before being presented to the Senate for a final vote.