Practice Guidelines Regarding Psychologists’ Involvement in Pharmacological Issues

These guidelines were developed by the American Psychological Association (APA) Division 55 (American Society for the Advancement of Pharmacotherapy) Task Force on Practice Guidelines. The task force was chaired by Robert E. McGrath. Task force members included Stanley Berman, Elaine LeVine, Elaine Mantell, Beth Rom–Rymer, Morgan Sammons, and James Quillin. Additional input on the guidelines was provided by Robert Ax, representing Division 18 (Psychologists in Public Service). None of the individuals involved in the development of this document has any personal investment in pharmaceutical products of any kind, nor did the developers receive any financial support for its creation.

The task force anticipates that these guidelines may deserve reconsideration in a relatively brief time frame, given anticipated changes in psychologists’ role in pharmacotherapy as well as changes in the perceptions and use of psychotropic medications. In particular, it is the belief of the members of the task force that future efforts should include consideration of whether some elements of the enclosed guidelines merit elevation to the level of practice standards. Accordingly, this document is scheduled to expire as APA policy in August 2014, five years after the date of its approval and adoption by the APA Council of Representatives. After this date, users are encouraged to contact the APA Practice Directorate to confirm whether this document remains in effect.

Correspondence concerning this article should be addressed to the Practice Directorate, American Psychological Association, 750 First Street, NE, Washington, DC 20002–4242.

Have General IPA Membership Dues or Contributions been used in the IPA – RxP Initiative?

No. The IPA Executive Committee and Council have been sensitive to Council and Member wishes that the funding for the RxP Initiative come from separate funding sources rather than from the general legislative fund. This is done so that members may choose to fund or not to fund the RxP initiative. The source of funding for the RxP effort is from monies contributed solely for the purpose of the RxP legislative effort. The RxP funding is not coming from any general IPA membership revenue stream. The details of the Treasurer’s Report are available to the IPA Executive Committee and the IPA Council. Any IPA member who wishes to know details about the IPA Treasurer’s Report should talk with any member of the IPA Executive Committee or the IPA Executive Director. IPA will follow established procedures for releasing budgetary information.

IPA RxP Intiative FAQ Summary

In summary, the issue of prescription privileges has been discussed at open monthly Legislative Committee meetings as posted in the quarterly newsletter sent to all IPA members. The results of the Committee meetings are brought to Council for discussion and vote. Elected IPA officers then pursue Council objectives based upon the results of any votes. As far back as 1991 there have been discussions, motions, and votes to pursue prescription privileges in Illinois at Quarterly Council meetings, in quarterly newsletters and, since at least 2006, at every All- Association meeting. All IPA meetings are open to any IPA member and dates and times are posted in the newsletter. Given the track record of psychologists who have attained prescriptive authority in other states and/or through employment in Federal agencies or in the Federal government, liability and insurance rates have not been at all adversely affected. In 2011 and 2012 prescription privileges have, as voted for by Council, been pursued with funding outside of typical IPA revenue streams and as such have been funded, either by a grant from APA or in specific funds raised by IPA leadership by outside contributions specifically earmarked for this purpose. Once the legislative agenda has been approved by the IPA Council, the IPA legislative agenda will be pursued aggressively by the IPA and its lobbyists.

Beth N. Rom-Rymer, Ph.D.
IPA President

Bruce E. Bonecutter, Ph.D.
Past IPA President
Past IPA Representative to APA Council
IPA Parliamentarian

Terrence Koller, Ph.D., ABPP
Past IPA President
IPA Executive Director

Steven Rothke, Ph.D., ABPP
Past IPA President
Chair, IPA Consulting Section
Chair, IPA By-Laws Committee

And in consultation with the following IPA officers:

Armand Cerbone, Ph.D.
IPA Past President
IPA Representative to APA Council

Randy Georgemiller, Ph.D.
IPA Past President
IPA Representative to APA Council

Blaine Lesnik, Psy.D.
IPA Membership Chair

Patricia Pimental, Psy.D., ABPN
IPA Past President
Chair, IPA Legislative Committee

Bob Rinaldi, Ph.D.
Chair, IPA RxP Subcommittee

Greg Sarlo, Ph.D.
IPA Immediate Past President

Joseph Troiani, Ph.D.
IPA Treasurer

Will members be informed of each step of the legislative process in Springfield, once an initiative, like RxP, has been thoroughly discussed and approved?

We entrust our legislative lobbyists, hired after careful due diligence by the IPA Executive Committee and IPA Council to help us pursue policy established by the IPA. Legislative meetings, hearings, and any other legislative action may or may not be announced publicly. The IPA leadership and the IPA lobbyists will make strategic decisions about appropriate times for public announcements. If individual IPA members disagree with IPA policy, they can take personal action as they so choose. The result of all legislative initiatives has been and will continue to be announced to the IPA membership in the various communication modalities described above.

How is our legislative initiative for prescriptive authority similar to the legislative initiative of social workers and licensed professional counselors for authority to conduct psychological testing and authority to seek insurance reimbursement for independent practice?

Our legislative initiative for prescriptive authority is very similar to the legislative initiative of other healthcare providers who are pushing to expand their scopes of practice. Scope of practice is dynamic. The world is changing and nothing stands still.

How will successful RxP legislation affect attacks against our license from the medical community?

The medical community does not attack our existing license. The medical community generally aims to prevent psychologists from expanding their scope of practice and has, in the past, unsuccessfully lobbied against our seeking licensure (over “registration”), unsuccessfully lobbied against our receiving insurance reimbursement, successfully lobbied against our using the word “diagnosis” instead of “classification” in our licensing act and successfully lobbied against our having hospital admitting privileges. The medical community is presently lobbying, and has lobbied in the past, against psychologists’ receiving prescriptive authority. Once we receive prescriptive authority, the medical community will come to accept our expanded scope of practice just as they have accepted the expanded scope of practice and prescriptive authority of optometrists, nurse practitioners, physician assistants, and other health professionals who have gained authority for practices that in earlier years had been the sole province of clinicians with medical degrees.

How do prescribing psychologists affect liability insurance premiums?

In states that have passed RxP legislation, liability insurance premiums have been raised 15% only for psychologists with licenses to prescribe who are insured by The Trust. To date, very few malpractice complaints have been filed against prescribing psychologists and most were dismissed, according to Dr. Jana Martin, CEO of The Trust. Non- prescribing psychologists have seen no increase in their rates. There has also been much testimony by prescribing psychologists throughout the country, including psychologists who prescribe on Indian reservations, psychologists who prescribe in the United States Public Health Service, psychologists who prescribe in the United States Coast Guard, psychologists who prescribe in United States military facilities throughout the world, and psychologists who prescribe in RxP states that corroborate this assertion for prescribing psychologists’ practicing over the past 30 years.

How will successful RxP legislation affect our current psychology license?

The passage of legislation authorizing psychologists who have specialized training in clinical psychopharmacology to prescribe medications would expand our licensing act. Thus, licensed psychologists who have 460 hours of specialized, didactic training in clinical psychopharmacology, 80 hours of physical assessment training, who have made recommendations for medication for 100 patients under close supervision from a prescribing health provider, who have passed the APA Psychopharmacology Exam for Psychologists (PEP), and have been approved by the Psychology Licensing Board in the Illinois Department of Financial and Professional Regulation will receive an additional license by the Psychology Licensing Board to prescribe medication.

Will there be other opportunities to discuss IPA’s RxP Initiative?

Elected IPA leadership does its best to communicate to the membership through specific processes. Items for discussion and action are first discussed in committee meetings, which anyone can attend. Committees then present any actionable items to Council where issues are discussed, debated and ultimately put to vote at quarterly Council meetings. The results of such votes and approved action items are then communicated to the entire membership in the member newsletter.

We invite all of you to our legislative update session and our all-Association meeting at the 2012 Annual Convention November 1st through 3rd. While the legislative update sessions at Convention are typically standing-room only events, our all-Association meetings tend to be less well attended. Please do consider attending both of these meetings a priority.