Prescriptive authority

SB 993 (Aanestad and Calderon), legislation which would authorize prescriptive authority for appropriately-trained psychologists, was held for further study and review in the Senate Committee on Business, Professions, and Economic Development on April 23, 2007. Senator Mark Ridley-Thomas, the Committee’s Chair, suggested that the Committee hold a hearing in Fall 2007 to discuss the issue of access to mental health services and the role of psychologists in solving the mental health crisis in California.

SB 993 is sponsored by the California Psychological Association (CPA), the American Federation of State, County, and Municipal Employees (AFSCME) Local 2620/Bargaining Unit 19, the National Alliance of Professional Psychology Providers (NAPPP), and the Service Employees International Union (SEIU). SB 993 is joint-authored by Senator Sam Aanestad (R-Grass Valley) and Senator Ron Calderon (D-Montebello), and co-authored by Senators Alan Lowenthal, Ph.D., Gloria Romero, Ph.D. and Jack Scott.

CPA and all co-sponsors of the bill strongly argued that the debate surrounding health care reform in California, the lack of access to affordable psychiatric services in the community, and the deterioration of services in California’s state hospitals and prison system made passage of this bill critical and timely. The legislation clearly outlined the proposed required training that would qualify appropriately trained psychologists for a license authorizing them to prescribe medications relevant to the mental disorders that fall within their scope of practice. Representatives from the California Medical Association, the California Psychiatric Association, and NAMI California testified that psychologists lack the medical training to safely prescribe medication, and that the bill would NOT increase access to consumers in need. Some Senators on the Committee suggested that the bill should more fully address access issues and M.D. collaboration in the future. These are some of the concepts we will be considering as we move forward in the legislative process.

Senator Leland Yee, a psychologist and State Senator representing San Francisco and San Mateo counties, requested that all parties (psychologists and psychiatrists) make an effort to meet and discuss a possible compromise on the bill. He stated his opinion that psychologists are behavioral scientists and not physical scientists, and expressed his belief that the bill would fail to increase access since he predicted that prescribing psychologists would charge as much as psychiatrists for their services and that they would not practice in underserved areas.

We were honored to have DOD Prescribing Psychologist Dr. John Sexton, New Mexico Prescribing Child Psychologist Dr. Mario Marquez, and CPA President-Elect Dr. Miguel Gallardo testify in favor of the bill. Dr. Paul Guest, a psychologist at Patton Sate Hospital also provided testimony for the bill. We also received the support of the California Primary Care Association, which represents 600 clinics throughout the State, and the California Narcotic Officers Association.

A BIG Thank You to each and every person who took the time to send an e-mail, fax a letter, or make a phone call in support of SB 993. Senate offices reported that there were HUNDREDS of letters of support from psychologists clogging EVERY fax machine–we should be proud of ourselves for the outstanding grassroots support generated for this important legislation.

CPA knows that prescriptive authority is a tough fight, but we have laid a good foundation this year! Your help now is critical in order to maintain this momentum and continue our efforts to achieve this important step for the patients we serve! The debate does not end here…we are at the beginning of a long, sustained campaign to make prescriptive authority a reality in California. For more information, please contact Amanda Levy at alevy@cpapsych.org or (916) 286-7979, ext. 106.

Additional information:

Y According to the National Institute of Mental Health, 1 in 4 people suffer from a diagnosable mental illness and 1 in 17 people suffer from a severe mental illness in any given year.

Y The lack of access to Psychiatrists in the community has made this issue more critical than ever-there are 11 counties in California without a single psychiatrist, and an additional 17 counties that have five or less psychiatrists.

Y The severe, long-term shortages of psychiatrists have caused the cost of psychiatrists’ services to skyrocket with no change in sight.

Y The state and local public sectors are in an uncontrolled price battle to find psychiatrists who don’t exist. In the community, patients, Medi-Cal and health plans are unable to find psychiatrists at an affordable cost who are available.

Y The lack of access to psychiatrists have resulted in over 80% of psychotropic medication being prescribed by general practitioners (non-psychiatrists) with limited training in mental health and limited time with their patients.

CRISIS IN STATE FACILITIES:

  1. California Prisons, with over 32,000 mentally ill inmates reported a 67% vacancy rate for psychiatrists in September 2006. The prison system is under control of a Federal Court Receiver, who has begun offering up to $300K per psychiatrist. Psychiatrists continue to leave county mental health and the California Department of Mental Health to go to the prisons, creating another crisis in the public sector.
  2. The California Department of Mental Health with 6,500 mentally ill patients reported a 40% vacancy rate for psychiatrists in February 2007. Atascadero State Hospital has only 9 psychiatrists on staff for over 1300 patients. The vacancies are growing with no end in sight.
  3. An answer to the growing vacancies and compromised patient care: Allow appropriately-trained psychologists to prescribe medication. It’s been done elsewhere and has been proven to be safe.

SAFETY:

  1. Prescribing psychologists in other states and the military have an unblemished record of prescribing safely. Opponents of this bill have no evidence to support any claim about problems with safety.
  2. The psychologists within the Department of Defense have seen over 160.000 patients with NO DEATHS or ADVERSE OUTCOMES.
  3. Louisiana and New Mexico psychologists written over 40.000 prescriptions without incident.
  4. Psychologists employ a behavioral approach and their prescribing patterns have demonstrated that they prescribe LESS MEDICATIONS to FEWER PATIENTS with the SUCCESSFUL OUTCOMES.

CPA, which has a long history and keen interest in advancing prescriptive authority for psychologists, will keep all interested parties informed of developments in this legislative battle that will most certainly require significant commitment and resources. Your help now is critical in order to achieve this important step for the patients we serve!

For more information, please contact Amanda Levy at alevy@cpapsych.org or (916) 286-7979, ext. 106.

Contact Us!
3835 North Freeway Blvd, Suite 240
Sacramento, California 95834
Ph: (916) 286-7979 Fax: (916) 286-7971
© 2007 California Psychological Association

http://www.cpapsych.org/displaycommon.cfm?an=1&subarticlenbr=136

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