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Source: APApractice.org
Another First: New Mexico Implements Prescriptive Authority Law
by State Advocacy and Legal and Regulatory Affairs Staff
January 18, 2005 -- New Mexico recently became the first state to implement a law allowing licensed psychologists with the appropriate training and certification to prescribe psychotropic medications. The regulations to activate the law were filed with the states record center in December 2004 and took effect on January 7.
Whenthe regulations were filed, psychology advocates said work remained in clarifying the scope of medications that qualified psychologists would be allowed to prescribethe
formulary.
This is an historic day in the sense that for the first time in the country's history,
rules and regulations have been filed allowing appropriately trained psychologists to
prescribe psychotropic medications, said E. Mario Marquez, PhD, the legislative chair
of the New Mexico Psychological Association (NMPA). New Mexico prescribing
psychologists are paving the way for the other states to provide a new means of
offering quality mental health care.
The new regulations
The regulations were developed by a joint committee of physicians and
psychologists. To receive a prescribing certificate in New Mexico, psychologists must
complete at least 450 hours of coursework, an 80-hour practicum in clinical
assessment and pathophysiology, and a 400-hour, 100-patient practicum under
physician supervision. They also must pass a national certification examination, the
Psychopharmacology Examination for Psychologists. The academic component
includes psychopharmacology, neuroanatomy, neurophysiology, clinical
pharmacology, pathophysiology, pharmacotherapeutics, pharmacoepidemiology and
physical and lab assessments.
After completing these requirements, psychologists licensed to practice in New
Mexico are eligible for a two-year conditional prescription certificate allowing them to
prescribe under supervision of a physician. At the end of two years, if the supervisor
approves and the psychologist's prescribing records pass an independent peer
review, the psychologist can apply to prescribe independently. Only at that point will
prescribing psychologists work independently, albeit in close collaboration with the
patients physician.
There are more than 40 psychologists in New Mexico who already have completed
the training or are currently enrolled in a training program, says Elaine LeVine, PhD,
director of the Southwestern Institute for the Advancement of Psychotherapy/New
Mexico State University Collaborative, a New Mexico psychopharmacology training
program for psychologists. These psychologists are very experienced practitioners
who also completed seven years of doctoral training including two years of
supervised practice in order to become licensed as psychologists before undertaking
the extensive training in psychopharmacology.
The collaboration provisions of the regulations codify good clinical practice, said Russ
Newman, PhD, JD, APAs executive director for professional practice. For example,
the regulations call not only for psychologist-prescribers to initiate contact with
patients physicians when medication is warranted, but also for physicians to contact
patients psychologists when changes in the patients medical condition might affect
psychologists treatment.
Psychology advocates say the prescriptive authority law represents an important
step toward providing comprehensive mental-health care to New Mexico residents,
who face serious access-to-care challenges; seeing a psychiatrist can take up to five
months and a lengthy commute.
Pressing for Clarification
At press time, psychology advocates of the legislation were working to clarify the
statutory definition of formulary included in the regulations. Advocates planned to
ask the New Mexico legislature to approve a revised definition of psychotropic
medication that would allow psychologists to prescribe off-label drugs that are in
common and proper use for mental health conditions when appropriate. This plan did
not delay the regulations taking effect on January 7.
Proponents assert that the revision would clearly allow prescribing psychologists to
follow usual and customary best practices by allowing them access to the full
complement of medications necessary to manage mental disorders. As currently
written, the formulary only allows prescribing psychologists to prescribe those
psychotropics specifically approved by the Food and Drug Administration for mental
health disorders, thereby excluding any off-label uses that have become customary
practice in the treatment of these disorders. Psychology anticipates opposition in the
upcoming legislative session as psychiatry reportedly has spent $100,000 on a
lobbying campaign in New Mexico to undermine implementation of the law and to
ultimately repeal it.
New Mexico was the first state to pass a prescribing law for psychologists in March
2002, following the passage of similar legislation by the U.S. territory of Guam in
1998. Louisiana passed similar legislation in 2004. At press time, the regulations to
implement the Louisiana law had been published for review and comment and were
the subject of a public hearing by the Louisiana State Board of Examiners of
Psychologists.
Another First: New Mexico Implements Prescriptive Authority Law
by State Advocacy and Legal and Regulatory Affairs Staff
January 18, 2005 -- New Mexico recently became the first state to implement a law allowing licensed psychologists with the appropriate training and certification to prescribe psychotropic medications. The regulations to activate the law were filed with the states record center in December 2004 and took effect on January 7.
Whenthe regulations were filed, psychology advocates said work remained in clarifying the scope of medications that qualified psychologists would be allowed to prescribethe
formulary.
This is an historic day in the sense that for the first time in the country's history,
rules and regulations have been filed allowing appropriately trained psychologists to
prescribe psychotropic medications, said E. Mario Marquez, PhD, the legislative chair
of the New Mexico Psychological Association (NMPA). New Mexico prescribing
psychologists are paving the way for the other states to provide a new means of
offering quality mental health care.
The new regulations
The regulations were developed by a joint committee of physicians and
psychologists. To receive a prescribing certificate in New Mexico, psychologists must
complete at least 450 hours of coursework, an 80-hour practicum in clinical
assessment and pathophysiology, and a 400-hour, 100-patient practicum under
physician supervision. They also must pass a national certification examination, the
Psychopharmacology Examination for Psychologists. The academic component
includes psychopharmacology, neuroanatomy, neurophysiology, clinical
pharmacology, pathophysiology, pharmacotherapeutics, pharmacoepidemiology and
physical and lab assessments.
After completing these requirements, psychologists licensed to practice in New
Mexico are eligible for a two-year conditional prescription certificate allowing them to
prescribe under supervision of a physician. At the end of two years, if the supervisor
approves and the psychologist's prescribing records pass an independent peer
review, the psychologist can apply to prescribe independently. Only at that point will
prescribing psychologists work independently, albeit in close collaboration with the
patients physician.
There are more than 40 psychologists in New Mexico who already have completed
the training or are currently enrolled in a training program, says Elaine LeVine, PhD,
director of the Southwestern Institute for the Advancement of Psychotherapy/New
Mexico State University Collaborative, a New Mexico psychopharmacology training
program for psychologists. These psychologists are very experienced practitioners
who also completed seven years of doctoral training including two years of
supervised practice in order to become licensed as psychologists before undertaking
the extensive training in psychopharmacology.
The collaboration provisions of the regulations codify good clinical practice, said Russ
Newman, PhD, JD, APAs executive director for professional practice. For example,
the regulations call not only for psychologist-prescribers to initiate contact with
patients physicians when medication is warranted, but also for physicians to contact
patients psychologists when changes in the patients medical condition might affect
psychologists treatment.
Psychology advocates say the prescriptive authority law represents an important
step toward providing comprehensive mental-health care to New Mexico residents,
who face serious access-to-care challenges; seeing a psychiatrist can take up to five
months and a lengthy commute.
Pressing for Clarification
At press time, psychology advocates of the legislation were working to clarify the
statutory definition of formulary included in the regulations. Advocates planned to
ask the New Mexico legislature to approve a revised definition of psychotropic
medication that would allow psychologists to prescribe off-label drugs that are in
common and proper use for mental health conditions when appropriate. This plan did
not delay the regulations taking effect on January 7.
Proponents assert that the revision would clearly allow prescribing psychologists to
follow usual and customary best practices by allowing them access to the full
complement of medications necessary to manage mental disorders. As currently
written, the formulary only allows prescribing psychologists to prescribe those
psychotropics specifically approved by the Food and Drug Administration for mental
health disorders, thereby excluding any off-label uses that have become customary
practice in the treatment of these disorders. Psychology anticipates opposition in the
upcoming legislative session as psychiatry reportedly has spent $100,000 on a
lobbying campaign in New Mexico to undermine implementation of the law and to
ultimately repeal it.
New Mexico was the first state to pass a prescribing law for psychologists in March
2002, following the passage of similar legislation by the U.S. territory of Guam in
1998. Louisiana passed similar legislation in 2004. At press time, the regulations to
implement the Louisiana law had been published for review and comment and were
the subject of a public hearing by the Louisiana State Board of Examiners of
Psychologists.
