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ARIZONA STATE SENATE
Fifty-Seventh Legislature, First Regular Session
psychologists; prescribing authority
Purpose
Beginning January 1, 2027, allows a licensed psychologist to apply for a prescription license to enter into a collaborative prescription agreement with a licensed physician to prescribe psychotropic medication to treat mental health and substance use disorders.
Background
The Board of Psychologist Examiners (Board) is the state regulatory body that oversees the professions of psychology and behavior analysis. The Board licenses individuals to practice psychology and behavior analysis, provides information about licensees to the public, investigates complaints of unprofessional conduct and administers disciplinary actions (A.R.S. § 32-2063).
In order to become licensed as a psychologist, an applicant must demonstrate that they have: 1) met the education and training qualifications for licensure; 2) passed any required examination or examinations; 3) a professional record free of any prior action or conduct that constitutes grounds for disciplinary action against a licensee; 4) not had a license or certificate to practice psychology refused, revoked, suspended or restricted by a state, territory, district or country for reasons that relate to unprofessional conduct; 5) not surrendered a license in another regulatory jurisdiction while under investigation for unprofessional conduct; 6) no complaints, allegations or investigations pending relating to unprofessional conduct in another regulatory jurisdiction; and 7) obtained a fingerprint clearance card (A.R.S. § 32-2071.01).
The practice of psychology is the psychological assessment, diagnosis, treatment or correction of mental, emotional, behavioral or psychological abilities, illnesses or disorders. Psychologists are not authorized to engage in the practice of medicine authorized for a medical, osteopathic or homeopathic physician but may diagnose, treat and correct human conditions ordinarily within the scope of practice of a psychologist (A.R.S. §§ 32-2061 and 32-2076).
If establishing initial and renewal licensure fees for a prescription license results in a change in Board revenues otherwise directed to the state General Fund, there may be a fiscal impact to the state General Fund.
Provisions
Psychologists Prescription License
1. Allows, beginning January 1, 2027, a licensed psychologist to apply to the Board for a prescription license on a Board-approved form.
2. Requires the applying psychologist to include with the application evidence satisfactory to the Board that the applicant meets all the following requirements:
a) completion of a doctoral program in psychology from an accredited institution of higher education or professional school, or, if the program was not accredited at the time of the applicant's graduation the program meets the statutory professional standards;
b) holds a current license to practice psychology in Arizona;
c) passed a national certification examination approved by the Board that includes testing on integrating clinical pharmacology with the practice of psychology; and
d) successfully complete an organized program of graduate-level education that included in-person components, that is approved by the Board in consultation with the Arizona Medical Board (AMB) and the Arizona Board of Osteopathic Examiners in Medicine and Surgery (ABOE), and that consists of at least the following core areas of instruction:
i. biological foundations of psychopharmacology;
ii. neuroscience;
iii. neuropharmacology;
iv. clinical pharmacology;
v. professional issues and practice management;
vi. treatment issues in psychopharmacology, including affective disorders, psychotic disorders and anxiety disorders; and
vii. appropriate and relevant physical and laboratory assessments.
e) successfully completed undergraduate biomedical coursework, including, at a minimum, the following subject areas:
i. chemistry I and II;
ii. organic chemistry or biochemistry;
iii. anatomy and physiology or physiology;
iv. general biology I and II; and
v. microbiology.
f) is certified by each of the applicant's supervising physicians as having successfully completed a practicum that is approved by the Board that consists of at least 1,900 hours total over the course of at least 24 months in clinical assessment and pathophysiology under the supervision of a physician with at least 1,000 hours meeting all the following criteria:
i. be supervised by one or a combination of psychiatrists or other appropriately trained physicians who are determined by the Board to be sufficient to competently train the applicant in treating various patient populations as determined by the Board;
ii. involve patient populations of which the majority are not incarcerated; and
iii. be supervised in person.
g) has malpractice insurance sufficient to satisfy the rules adopted by the Board that will cover the applicant up to $1,000,000 per incident and $3,000,000 per year or as otherwise approved by the Board; and
h) pays the prescription license fee as prescribed by the Board in rule.
3. Requires the Board to issue a conditional approval for a prescription license if the Board finds that the applicant meets the outlined statutory requirements.
4. Prohibits a psychologist from prescribing medications with a conditional prescription license.
5. Allows the applicant, once the conditional approval for a prescription license is granted by the Board, to initiate a collaborative prescription agreement with a collaborating physician.
6. Requires a prescribing psychologist to have a collaborative prescription agreement in place to prescribe medication.
7. Requires the applicant, once the collaborative prescription agreement with a collaborating physician has been established, to file the collaborative prescription agreement with the Board for approval.
8. Requires the Board, on approval of the collaborative prescription agreement, to forward a copy of the approved collaborative prescription agreement to the collaborating physician's regulatory board within 10 business days.
9. States that a prescribing psychologist's prescription license is valid for two years.
10. Allows the prescribing psychologist to renew the prescription license at the end of the two-year period.
11. Requires the psychologist to pay a prescription license renewal fee as prescribed by the Board in rule at the time the prescribing psychologist applies to renew the prescription license.
Collaborating Physicians
12. Allows a physician, subject to the rules adopted by the AMB or the ABOE, to enter into a collaborative prescription agreement with a prescribing psychologist.
13. Limits a collaborating physician to be party to only four collaborative prescriptions agreements at any time.
Collaborative Prescription Agreements
14. Requires a collaborative prescription agreement for all prescribing psychologists with a prescription license issued in accordance with statute.
15. Requires a collaborative prescription agreement to meet all of the following:
a) be in writing;
b) describe the working relationship between the prescribing psychologist and the collaborating physician and detail how the collaborating physician will ensure that the prescribing psychologist meets the requirements of the collaborative prescription agreement;
c) identify by brand name or generic name the psychotropic medication that the prescribing psychologist may prescribe;
d) the psychotropic medication listed in the collaborative prescription agreement may be only medication that the collaborating physician generally provides to the collaborating physician's patients to treat mental health and substance use disorders in the normal course of the collaborating physician's clinical practice;
e) promote the exercise of professional judgement by the prescribing psychologist consistent with the prescribing psychologist's training, education and experience;
f) identify whether the prescribing psychologist has the authority to order laboratory testing, imaging and medical tests necessary before prescribing medication, during the period of prescribing medication and at the end of a period of prescription medication;
g) identify whether the prescribing psychologists has the authority to administer psychotropic medication injections;
h) provide methods, frequency and guidelines for communication between the collaborating physician and the prescribing psychologist, including in-person, electronic and telephonic communications, except the collaboration physician is not required to be personally present at the place where the prescribing psychologist renders services;
i) provide for adequate collaboration between the collaborating physician and the prescribing psychologist as determined the Board in consultation with the AMB and the ABOE;
j) address the termination of changes to the collaborative prescription agreement; and
k) contain the national provider identifier number of both the prescribing psychologist and the collaborating physician.
16. Prohibits the collaborative prescription agreement from restricting third-party payment sources accepted by the prescribing psychologist unless there is an employment relationship between the collaborating physician and the prescribing psychologist.
17. Allows a collaborative prescription agreement to be terminated by either the prescribing psychologist or the collaborating physician.
18. Requires the prescribing psychologist to notify the Board and the collaborating physician's regulatory board at least 30 days before a collaborative prescription agreement is terminated.
19. Stipulates that, if the collaborative prescription agreement is terminated by either party, the prescribing psychologist's prescribing license remains active with the Board pending a new collaborative agreement.
20. Prohibits a prescribing psychologist from prescribing medications until a new collaborative prescription agreement is filed with the Board and the new collaborating physician's regulatory board.
Prescription Requirements, Limits and Disclosures
21. Requires each prescription written by a prescribing psychologist to meet all the following requirements:
a) comply with applicable state and federal laws;
b) indicate that the prescription is issued by a prescribing psychologist; and
c) include the prescribing psychologist's board-assigned identification number.
22. Applies the following limitations to the prescribing psychologist when prescribing psychotropic medications that are controlled substances:
a) the prescribing psychologist may prescribe and administer stimulants to treat attention deficit hyperactivity disorder regardless of the stimulant schedule classification if the medication is included in the collaborative prescription agreement; and
b) the prescribing psychologist may prescribe Schedule II controlled substances for substance use disorder in accordance with statutory requirements only if the population is identified in the collaborative prescription agreement.
23. Specifies that a collaborating physician is not liable for the acts of a prescribing psychologist unless the injury or loss arises from an act under the direction and control of the collaborating physician.
24. Prohibits a prescribing psychologist from delegating prescribing authority to any other person.
25. Requires a prescribing psychologist maintain in a patient's records details of all prescriptions the prescribing psychologist provides for that patient.
26. Requires each prescribing psychologist to file with the Board, in the form and manner determined by the Board, all individual Federal Drug Enforcement Administration (DEA) registrations and numbers.
27. Requires the Board maintain current records on prescribing psychologists and make the DEA registration and numbers available to the AMB and the ABOE on request.
28. Allows a prescribing psychologist to prescribe only to a patient with whom the prescribing psychologist has an established psychologist-patient relationship.
29. Requires a prescribing psychologist to continue providing clinical services throughout the period of prescribed medication.
30. Prohibits a prescribing psychologist from prescribing for persons who are any of the following:
a) under 18 years old;
b) over 65 years old;
c) pregnant; or
d) medically complex, as determined by the collaborating physician.
31. Requires a prescribing psychologist to ask each patient for information regarding the patient's primary health care practitioner during intake.
32. Requires the prescribing psychologist provide information to the patient's primary health care practitioner, if one is identified, regarding any prescription the prescribing psychologist issues to the patient within 24 hours after issuing the prescription.
33. States that a prescribing psychologist is not required to give prior notice to or obtain prior approval from a patient's primary health care practitioner to prescribe psychotropic medication to a patient with whom the prescribing psychologist has established a psychologist-patient relationship.
34. Requires the prescribing psychologist to disclose to each patient to whom the prescribing psychologist prescribes a psychotropic medication that the prescribing psychologist is not a physician licensed to practice medicine.
35. Requires the disclosure be in writing, signed by the patient and kept in the patient's record on file with the prescribing psychologist.
Continuing Requirements and Education
36. Allows a prescribing psychologist to prescribe psychotropic medication under a collaborative prescription agreement if the prescribing psychologist continues to meet the following:
a) holds a current license in good standing to practice psychology in Arizona as in accordance with statute;
b) maintains malpractice insurance as required by statute; and
c) completes at least 40 hours of continuing education every two years in the areas of pharmacology and psychopharmacology as required by the Board in addition to the continuing education required to maintain a license to practice psychology.
Oversight
37. Requires the AMB and the ABOE to investigate any charge that involves prescribing by a prescribing psychologist and recommend to the Board whether the AMB or ABOE believes the prescribing psychologist engaged in unprofessional conduct related to prescribing or providing incompetent medical care based on the prescribing psychologist's collaborative prescription agreement.
38. Requires the Board to refer any complaint involving prescribing by a prescribing psychologist to the collaborating physician's regulatory board.
39. Requires the Board to receive recommendations and pursue action based on the recommendations from either the AMB or the ABOE regarding matters related to prescribing by a prescribing psychologist.
40. States that the Board maintains the right to investigate the portion of a complaint referred to the AMB or the ABOE that involves the licensed practice of psychology in accordance with statute.
41. Allows the Board to act on the prescribing psychologist's license if the prescribing psychologist fails to meet the requirements outlined in statute.
42. Requires the Board enter into an interagency agreement to allow the Board to reimburse the AMB and the ABOE for any costs associated with administering or regulating a prescribing psychologist or a physician who is a party to a collaboration agreement.
Miscellaneous
43. Exempts the Board, the AMB and the ABOE from rulemaking requirements for two years.
44. Defines collaborating physician as a physician who is licensed by the AMB or the ABOE and who is party to a collaborative prescription agreement in accordance with statute statutory requirements.
45. Defines collaborative prescription agreement as an agreement between a collaborating physician and a prescribing psychologist that allows the prescribing psychologist to prescribe psychotropic medication in accordance with statutory requirements.
46. Defines prescribing psychologist as a psychologist who holds a valid prescription license.
47. Defines prescription license as a document that is issued by the Board to a psychologist who meets the statutory requirements for licensure and that allows the psychologist who has a collaborative prescription agreement with a collaborating physician to prescribe psychotropic medication in accordance with statutory requirements.
48. Defines psychotropic medication as a controlled substance or dangerous drug that may be dispensed or administered only with a prescription, that is limited to those agents related to diagnosing and treating or managing mental, nervous, emotional, behavioral, substance use or cognitive disorders, including managing or protecting from side effects that are a direct result of those agent, and whose use is consistent with the standards of practice for clinical psychopharmacology.
49. Excludes, from the definition of psychotropic medication, a narcotic drug.
50. Defines terms.
51. Makes technical and conforming changes.
52. Becomes effective on the general effective date.
Prepared by Senate Research
February 11, 2025
JT/KP/ci