The document discusses the evolving role of prescribing psychologists in healthcare, detailing the requirements for prescriptive authority across different states, including training, collaboration with medical professionals, and conditional prescribing periods. It highlights the positive impacts of prescribing psychologists on patient care and access to mental health services, suggesting a significant potential for increasing the number of prescribing psychologists in the coming years. Additionally, it outlines strategies for passing and implementing prescriptive authority legislation at the state level.

1. The Revolution in Healthcare:
How Prescribing Psychologists are
Changing the Landscape
August 23, 2024
Beth N. Rom-Rymer, Ph.D.
Candidate for APA President-Elect 2024
Founder, CEO and President
Illinois Association of Prescribing Psychologists (IAPP)
Founder and Co-Chair
International Movement of Psychologists with Prescriptive Authority
(IMPAP)
Co-Founder and President, Association of Jewish Psychologists (2023-)
Member, APA Board of Directors (2018-2019)
Past Chair, APA Council Leadership Team (2019)
Past President (2011-2012, 2013-2014)
Illinois Psychological Association

2. GUAM
An established Collaborative Practice Agreement (CPA) for a prescribing psychologist must include:
1. A detailed description of the prescribing psychologist’s scope of practice, signed by the collaborating physician; and a list of psychotropic drugs,
to which the collaborating physician attests that the clinical psychologist is competent to prescribe. These medications, then, may be routinely
ordered and prescribed.
2. The designation of an alternate physician during the absence of the named collaborative physician.
3. The approval and signature of the Presidents of the following three (3) boards: Board of Allied Health Examiners, Board of Medical Examiners,
and the Board of Examiners for Pharmacy.
4. The possession of a current Guam Control Substances Registration issued by the Controlled Substances Program, Division of Environmental
Health, Department of Public Health and Social Services.
5. The possession of a valid Federal Drug Enforcement Administration (DEA) certificate.
6. Proof of completion of a nationally and professionally accepted pharmaceutical curriculum (for eg., the MSCP curriculum) as recognized by the
Board of Allied Health Examiners.
7. Proof of the passage of a certifying exam in psychopharmacology (the PEP), developed by a nationally recognized institution, and approved by
the Board of Allied Health Examiners.

3. New Mexico
New Mexico requires a two-year conditional prescribing period and two practical:
1. An 80-hour physical assessment practicum with a physician; and
2. A practicum evaluating and treating 100 patients for a minimum of 400 hours (from
a range of backgrounds and over various stages of the therapeutic process) under
the supervision of a co-located physician.
Once the conditional prescribing period has been completed and it has been
successfully evaluated by the supervising physician and the Psychology Licensing
Board, the prescribing psychologist receives a Certificate as a fully independent
Prescribing Psychologist.

4. Louisiana
Louisiana requires a three-year conditional prescribing period for the Medical Psychologist or MP. For these three years, the MP will practice “in
collaboration with” two licensed physicians.
The practice must include a minimum of one hundred patients, including twenty five or more patients in which the prescribing psychologist
prescribes all of the major psychotropics and another twenty-five or more patients, for whom the prescribing psychologist prescribes the major
antidepressants.
Conditional medical psychologists shall prescribe only in consultation and collaboration with the patient's primary or attending physician, and
with the concurrence of that physician. This concurrence occurs annually.
Conditional medical psychologists shall also re-consult with the patient's physician prior to making major changes in the patient's medication
treatment protocol. The medical psychologist and the physician shall document the consultation in the patient's medical record.
In the event a patient does not have a primary or attending physician, the conditional medical psychologist shall not prescribe for that patient.
Completion of a minimum of 100 hours of continuing medical education during the conditional prescribing period.
With the recommendation of the Medical Psychology Advisory Committee, after the 3-year conditional prescribing period has been completed,
the medical psychologist will receive a Certificate of Advanced Practice from the Louisiana Medical Board and practices fully independently.

5. IOWA
Iowa requires a two-year period of conditional prescribing, that must be certified by the supervising licensed physician
1. An applicant for prescription certificate who specializes in the psychological care of children, elderly persons, or
persons with comorbid psychological conditions shall complete at least one year of prescribing psychotropic
medications to these populations (usually the second year of the conditional prescribing period).
2. The rules for conditional prescribing psychologists are decided, jointly, by the Board of Medicine and the Board of
Psychology.
3. The continuing education requirements are no fewer than 20 hours each year.
4. After the conditional period has been completed, there must be a consultative or collaborative practice agreement
with a licensed physician (not necessarily a psychiatrist).
5. A prescribing psychologist or a psychologist with a conditional prescription certificate cannot delegate prescriptive
authority to any other person.

6. IDAHO
Idaho requires a two-year period of conditional prescribing, that must be certified by
the supervising physician.
1. Prescribing psychologists who prescribe for pediatric or geriatric populations shall
have completed at least (1) year of satisfactory prescribing to these populations as
attested to by the supervising physician or physicians, with specialized training
and experience with these populations.
2. Independent prescribers, who have completed their conditional prescribing
period, must collaborate with their patients’ licensed medical providers.

7. COLORADO
Colorado requires a two-year period of conditional prescribing, that must be certified by the
supervising physician.
1. Has completed a doctoral program in psychology;
2. Has completed an MSCP;
3. Has passed the PEP 2;
4. Has completed a supervised and relevant clinical experience approved by the Board;
5. Has successfully undergone a process of independent peer review;
6. Holds a current license in good standing;
7. Maintains the required malpractice insurance; and
8. Annually completes at least 40 hours of continuing education every 2 years;
9. Independent prescribers, who have completed their conditional prescribing period, must
collaborate with their patients’ licensed medical providers.

8. Public Act 98-0668
Educational Requirements:
the three-legged stool
Core graduate MSCP coursework (30 credits or 460 contact hours) in clinical
psychopharmacology:
a. Clinical Biochemistry (1.6 credits)
b. Neurochemistry (1.6 credits)
c. Neurophysiology (1.6 credits)
d. Neuroanatomy/Neuropathology (2.4 credits)
e. Clinical Medicine/Pathophysiology (4 credits)
f. Pharmacology (2 credits)
g. Clinical Pharmacology (2 credits)
h. Psychopharmacology of: Depression, Psychosis, Bipolar Disorder, Drug/drug
interactions (3.2 credits)

9. Public Act 98-0668
Educational Requirements:
the three-legged stool
Core graduate MSCP coursework (30 credits or 460 contact hours) in clinical
psychopharmacology:
i. Special Populations: Child Psychopharmacology, Gender and Ethnic Issues,
Geriatric Psychopharmacology, Chronic Pain, Chronic Illness, PTSD, and Borderline
Personality Disorder (4 credits)
j. Chemical Dependence (.8 credits)
k. Physical Assessment (2.4 credits)
l. Introduction to Molecular Nutrition and its Place in Psychopharmacology (.8 credits)
m. Pharmacotherapeutics: Research Issues, Ethical and Legal Issues,
Psychotherapy/Pharmacotherapy Interactions (2.4 credits)
n. Case Seminar (.8 credits)

10. Public Act 98-0668
Educational Requirements
the three-legged stool:
1. Undergraduate courses in the hard sciences (to be taken as part of an
undergraduate curriculum for a B.S. or B.A. degree):
a. 2 semesters of a chemistry sequence with lab or a biochemistry
sequence with lab
b. 1 semester of microbiology with lab
c. 1 semester of general biology for science majors or cell and molecular
biology
d. 1 semester of physiology
e. 1 semester of human anatomy
f. 1 semester of physiology and anatomy
g. medical terminology (class or proficiency)

11. Public Act 98-0668
Educational Requirements:
the three-legged stool
3. Medical Rotation Practicum:
a. Emergency Medicine
b. Family Medicine
c. Internal Medicine
d. Geriatrics
e. Pediatrics
f. Psychiatry
g. Obstetrics and Gynecology
h. Surgery
i. One elective of program participant’s choice

12. The Primary Care Prescribing Psychologist
David S. Shearer, S. Cory Harmon, Brian M. Seavey, Alvin Y. Tiu
 95.6% of providers reported “consultation with a prescribing psychologist ‘to be helpful;’”
 93.6% of providers reported “confidence in the ability of the prescribing psychologist to make
appropriate referral decisions;”
 95.7% of providers opined that prescribing psychologists “were able to prescribe appropriate
medications and dosages;”
 97.9% of providers believed that prescribing psychologists had “adequate knowledge of
medical terminology;”
 87.2% of providers indicated that patient care “had improved as a result of an embedded
prescribing psychologists;” and

13. The Primary Care Prescribing Psychologist
David S. Shearer, S. Cory Harmon, Brian M. Seavey, Alvin Y. Tiu (2012)
 93.6% of providers believed that it was “safe to refer their patients to prescribing psychologists for
psychotropic medication management.”
 “Out of five potential benefits of an embedded prescribing psychologist, the greatest number of respondents,
87.2%, identified improved patient access to Behavioral Health care as having a ‘large benefit.’”
 “74.5% of providers identified improved patient care and improved access to psychopharmacologic
consultation as being large benefits.”
 “93.6% viewed prescribing psychologists as ‘similarly skilled’ or ‘more skilled’ when compared to other mental
health prescribers.”
 When asked for additional comments, providers wrote: “Having a prescribing psychologist readily available in
the Clinic is invaluable. Even if I don’t go to consult him/her, the knowledge hat they are there gives me a
tremendous confidence boost.”

14. Prescriptive Authority Legislation
The Impact of the Law
1. Healthcare is forever changed in Illinois. Prescribing
psychologists are coming to be seen as providing healthcare in
every private and public health setting. Prescribing
psychologists will become strong leaders in healthcare throughout
the state.
2. From the date of the implementation of our law, prescribing
psychologists are and will continue to be a significant force in
treating the underserved and the most at-risk vulnerable members
of our community.
3. Prescribing psychologists have the potential to increase access to
care by 100% within the next twenty years. There are currently
1100 psychiatrists and 5,000 licensed clinical psychologists in
Illinois. There can be 1,000 prescribing psychologists by 2042.

15. Prescriptive Authority Legislation
The Impact of the Law
4. Forever more, students, passionate about psychology
and strong in the hard sciences, will understand that by taking
a strong undergraduate curriculum in the sciences, they will
be prepared for a career as a prescribing psychologist.
5. Graduate programs in clinical psychology will begin,
and have already begun, to offer a track in clinical
psychopharmacology for their students.
6. The medical rotations offer prescribing psychologist
trainees the opportunity to become an integral part of the
medical community while retaining their identity as
superbly trained psychologists.

16. Prescriptive Authority Legislation
The Impact of the Law
7. In the Department of Corrections, prescribing psychologists
will be given an opportunity to train and to provide much needed
care.
8. Nationally, at least 10 other states are actively pursuing Prescriptive
Authority legislation: Hawai’i, Washington State, Arizona, Utah,
Oklahoma, Texas, Nebraska, Michigan, Ohio, Florida,
Pennsylvania, Vermont. There are also strong Prescriptive
Authority legislative advocates in California and New York.
9. Iowa passed its prescriptive authority law in 2016; Idaho passed its
prescriptive authority law in 2017; Colorado passed its prescriptive
authority law in 2023; Utah passed its prescriptive authority law in
2024.

17. Prescriptive Authority Legislation
Keys to Passing RxP Legislation
1. Support a strong leader and leadership group in your State
Psychological Association to collaboratively lead this initiative.
2. Raise significant funds.
3. Work with a high caliber, well-connected lobbying firm.
4. Identify passionate and powerful legislative sponsors.
5. Partner with your psychological community throughout your state
and organize your business community around this legislative
solution to the current mental health crisis, in part attributable to
the Covid pandemic.
6. Ally with important other third party groups in your state,
including NAMI, law enforcement, powerful religious institutions,
large and established social service organizations, medical
professionals.

18. Prescriptive Authority Legislation
Keys to the Implementation of a Prescribing Authority Law
1. Support the building of a strong infrastructure in your State Psychological
Association to sustain the growth of statewide prescriptive authority.
2. Sustain the engagement of the business community in this legislative endeavor.
3. Continue to raise significant funds for ongoing legislative support for
prescriptive authority.
4. Sustain the support of the lobbying group that was critical to the successful
passage of the prescriptive authority law.
5. Sustain relationships with your powerful legislative allies.
6. Support the creation of a strong statewide communications network among all
psychologists in the state.
7. Sustain and build your relationships with the important third party groups in
your state, including NAMI, law enforcement, powerful religious institutions,
large and established social service organizations, medical professionals,
especially including psychiatrists and hospital CEO’s.