Missouri gets a jump on prescriptive authority legislation

by Public Relations Staff

January 16, 2008 — In organized psychology’s ongoing quest to obtain prescriptive authority for qualified practitioners, Missouri got an early start on legislative activity in 2008. Sen. Jack Goodman already has filed a bill, while Rep. Danielle Moore intends to introduce companion legislation soon in the Missouri House. The bill is backed by the Missouri Psychological Association and a patient coalition known as the Missouri Families for Access to Comprehensive Treatment.

Supporters of the coalition say it can take as long as eight months for patients in rural Missouri to see a psychiatrist. The state has fewer than 400 licensed psychiatrists, many of whom opt out of Medicare and the state’s Medicaid system. General practitioners, who fill the gap by prescribing approximately 80 percent of psychotropic medications, have only about eight weeks of training in mental health, according to research by the Missouri Psychological Association.

"Across the country, it’s taking longer and becoming more difficult for people suffering from mental health disorders to see a psychiatrist, particularly in rural areas. When psychologists obtain further training and authority to prescribe medications, patients benefit by gaining access to a greater variety of treatment options from a single practitioner," said Dan Abrahamson, Ph.D., assistant executive director for state advocacy in the American Psychological Association Practice Directorate.

Missouri’s proposed law mandates that prescriptive authority shall only be given to psychologists who complete a postdoctorate masters in psychopharmacology, pass a national qualifying exam in psychopharmacology, fulfill a one-year fellowship and a one-year collaborative practice agreement with a physician, and maintain an ongoing referral agreement with a physician.

"Passage of this bill will result in affordable comprehensive care for patients, with one provider combining appropriate psychotherapy and, if necessary, medication, " said Missouri Psychological Association President Mark Skrade, PsyD.

At this time, the Practice Directorate expects as many as eight other states, including Tennessee and Hawaii, to pursue prescriptive authority legislation this year. At least 22 state, provincial and territorial psychological associations now have active task forces and committees to seek such legislation.

Psychologists in the U.S. Department of Defense have been prescribing for more than 10 years without incident, while qualified psychologists in Louisiana and New Mexico have been doing so for nearly three years.

The Practice Directorate and the Committee for the Advancement of Professional Practice (CAPP) continue to help a number of states work toward achieving and implementing legislation that gives qualified licensed psychologists the authority to prescribe psychotropic medications. Support from the national level for state psychological associations includes CAPP grants and close consultation with state psychology leaders.