Updated: Illinois prescriptive authority law enacted
On June 25, the governor of Illinois signed landmark legislation (SB 2187) authorizing licensed clinical psychologists, with advanced, specialized training, to prescribe certain medications for the treatment of mental health disorders. Illinois is the third state in the country to grant prescription privileges to psychologists, joining New Mexico and Louisiana.
“Obtaining prescriptive authority for qualified, licensed psychologists will help fill the nationwide need for access to comprehensive, quality mental health care,” says APA Executive Director for Professional Practice Katherine C. Nordal, PhD. “We’re excited to see another state take this important step.”
Illinois Senate Bill 2187 was introduced by Senator Don Harmon (D), President Pro Tem of the Illinois Senate, Senator Dave Syverson (R), Rep. John E. Bradley (D), and Rep. Raymond Poe (R). The bill passed in the Illinois House 94-21-0 with a concurrence vote in the Illinois Senate 57-0. The legislation will be sent by the end of June to Governor Pat Quinn (D) for approval. The governor then has 60 days to consider the bill.
The Illinois Psychological Association (IPA) negotiated an eleventh-hour agreement with the state medical, psychiatric and nursing organizations and the bill had key support across the state and strong proponents in the General Assembly.
Dr. Terrence J. Koller, PhD (far right) with Senator Dave Syverson (second from right) and the IPA lobbying team.
Psychology advocates hail the victory as the culmination of several years of tireless and diligent advocacy by IPA under the leadership of President Beth N. Rom-Rymer, PhD. Notably, Illinois is also home to the American Medical Association and internationally renowned medical research centers.
“The rhetoric used against us was fierce and unrelenting,” says Dr. Rom-Rymer. “What brought the state medical and psychiatric societies to the negotiating table were the psychologists' successive legislative victories in both the Senate and the House, the steady growth of psychology’s support from state labor unions and other influential groups, and our steadfastness in staying the course.”
The negotiated agreement allows for collaborative work among the key providers of mental health in the state of Illinois. Although there are significant constraints in the current bill, IPA is confident that, as psychologist providers demonstrate safe and effective prescribing, those constraints will be lifted, just as they have been for advanced nurse practitioners, optometrists and other non-physician prescribers.
The legislation currently stipulates that licensed clinical psychologists in Illinois who want to prescribe must successfully complete advanced education and training in psychopharmacology as well as supervised clinical training in medical rotations, such as emergency medicine, psychiatry, family medicine and internal medicine.
In addition, the current legislation stipulates a collaborative practice agreement between prescribing psychologists and physicians and does not permit psychologists to prescribe for children, adolescents, or seniors age 66 or older, or patients who are pregnant, have serious medical conditions or developmental/intellectual disabilities. The formulary for prescribing psychologists in Illinois does not currently include benzodiazepines and narcotics.
SB 2187 will allow psychology graduate students anywhere in the country to begin their training in clinical psychopharmacology at the predoctoral level and apply for prescriptive authority in Illinois once they complete their doctoral requirements as well as the requirements for the didactic and clinical training in psychopharmacology.
Giving prescriptive authority to licensed clinical psychologists with advanced, specialized training in clinical psychopharmacology will improve access to care and expand options for Illinois residents seeking treatment for mental health conditions. "With state resources stretched to the limit, psychiatrists and other mental health professionals are in short supply," says Dr. Rom-Rymer, adding that the demand for mental health services far exceeds the capabilities of the existing provider network. “This law will help ease the enormous pressure on the state system.”
More than 50 Illinois counties have no inpatient psychiatric services in their hospitals. Another 24 counties have no hospitals at all. Yet 614,000 Illinois residents currently need treatment for serious mental illness. The unmet need is greatest with people who need help the most: underserved low-income, rural and minority populations.
The next steps will be for the Illinois Clinical Psychologists' Licensing and Disciplinary Board to begin drafting rules to implement the prescriptive authority provisions established by the new law. In addition to the seven current members of the licensing board, the director of the Illinois Department of Financial and Professional Regulation will appoint two prescribing psychologists, a psychiatrist and a primary care physician or a family practice physician to the board. The two licensed prescribing psychologist members of the board and the two physician members of the board shall only deliberate and make recommendations related to the licensure and discipline of prescribing psychologists.
"The quest for prescriptive authority is a journey,” says Dr. Rom-Rymer, “The Illinois Psychological Association has cut away the brush and the brambles and has created a road. Still, we have many more miles to go before we sleep."