BILL NUMBER: SB 822 AMENDED
BILL TEXT
AMENDED IN SENATE MARCH 28, 2007
INTRODUCED BY Senator Aanestad
( Coauthors: Senators Romero
and Lowenthal )
FEBRUARY 23, 2007
An act to amend Section 2914.3 of Sections
2902, 2904, 2960, 4040, 4502, 4502.1, and 4502.2 of, and to add
Sections 2949, 2949.2, 2949.3, 2949.4, and 2949.5 to, the
Business and Professions Code, relating to psychology.
LEGISLATIVE COUNSEL'S DIGEST
SB 822, as amended, Aanestad. Psychology.
The Psychology Licensing Law provides for the licensure and
regulation of psychologists by the Board of Psychology, and the
Pharmacy Law provides for the regulation of prescription drug and
medical device dispensing by the California State Board of Pharmacy.
The Psychology Licensing Law provides that the practice of psychology
does not include the prescribing of drugs and does not authorize a
psychologist to prescribe drugs or write prescriptions. Existing law
additionally makes a violation of its provisions a crime and
unprofessional conduct, constituting grounds for disciplinary action
by the Board of Psychology.
This bill would revise these provisions to authorize a certified
prescribing psychologist, as defined, to prescribe drugs for the
treatment of disorders related to the practice of a certified
psychologist if certain requirements are met. This bill would require
the Board of Psychology to establish and administer a certification
process to grant licensed psychologists the authority to write
prescriptions, and would require an applicant for certification as a
prescribing psychologist to meet specified education and training
requirements, including requirements of clinical competency, and
passing a nationally recognized examination approved and administered
by the board. The bill would require the board to charge fees for
the issuance and renewal of a certificate to cover the costs of
administering the certification process and the examination, and
would provide for the deposit of these fees in the Psychology Fund.
The bill would require the board to establish requirements for the
renewal of a certificate, including continuing education
requirements, and to provide certain information to the California
State Board of Pharmacy, including a list of psychologists certified
to prescribe drugs. The bill would also require an approved education
or training program to meet specified requirements, including
providing certain reports to the board.
This bill would include as unprofessional conduct, subject to
disciplinary action by the board, a violation of particular
provisions of law relating to the prescribing of drugs.
By adding these provisions, this bill would impose a
state-mandated local program by creating new crimes.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
Existing law provides for the licensure and regulation of the
practice of psychology by the Board of Psychology. Under existing
law, the board is required to encourage institutions offering
doctorate degree programs in psychology to include education and
training in psychopharmacology and related topics. Under existing
law, the board is also required to develop education and training
guidelines for psychologists whose practice includes patients who may
require psychopharmacological treatment.
This bill would make technical, nonsubstantive changes to those
provisions.
Vote: majority. Appropriation: no. Fiscal committee: no
yes . State-mandated local program: no
yes .
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature hereby finds and
declares all of the following:
(a) According to the National Institute for Mental Health, one in
four individuals suffer from a diagnosable mental illness in a given
year, and one in 17 suffers from a severe mental illness.
(b) According to the American Board of Medical Specialties
Directory of Board Certified Medical Specialists, there are 11
California counties with no psychiatrist and an additional 17
California counties with five or fewer psychiatrists in residence.
(c) Currently, there are 49 counties that have areas that are
eligible for designation as California Health Professional Shortage
Areas for mental health treatment, based upon the national definition
of areas that have fewer than one psychiatrist for every 30,000
residents, which represents nearly 85 percent of the counties in the
state.
(d) According to the American Journal of Psychiatry, more than 80
percent of all psychotropic drug prescriptions are written by
nonpsychiatrists with limited training in mental health.
(e) Californians living in rural areas face unique and challenging
mental health and family problems, and they are often underserved by
health care practitioners. Psychologists practicing with primary
care groups have been effective in addressing the mental health
problems of rural Californians.
(f) California's prison and state operated mental health
facilities have experienced severe shortages of psychiatrists, with
systemwide vacancies for the California Department of Corrections and
Rehabilitation (CDCR) at 67 percent in September 2006, and for the
State Department of Mental Health at 40 percent in February 2007.
(g) As a result of the severe shortages, patient care has been
compromised and CDCR, with over 32,000 mentally ill patients, is in
federal receivership for poor health and mental health care.
(h) In 1990, the Public Citizen Health Research Group published a
report entitled "Care of the Seriously Mentally Ill, A Rating of
State Programs." The Public Citizen Health Research Group recommended
that psychologists, physician assistants, and nurse practitioners be
allowed to obtain additional training and to prescribe medications
to help meet the needs of mentally ill persons.
(i) The Legislature, in order to increase the availability of
services to patients, has placed into law the authority for
optometrists, dentists, naturopaths, and nurse practitioners to
prescribe or order medications in a limited capacity. The Legislature
has also extended authority for physician assistants to administer
medications, and transmit prescriptions for medications, to patients
upon the order of a physician and surgeon or within a specified
protocol.
(j) Since 1978, when psychologists were statutorily granted the
right to serve on hospital medical staffs, psychologists have become
increasingly important in overseeing care for mentally ill and
disordered patients in health care facilities.
(k) As a prerequisite to licensure, clinical psychologists are
required to obtain more specific education and training in the
identification of mental disorders and illnesses than any other
mental health care professional.
(l) Section 2914.3 of the Business and Professions Code directed
the Board of Psychology to develop guidelines for psychologists to
discuss medication management with their patients and the patient's
physician or licensed prescriber.
(m) Psychologists are trained to assess behavioral and cognitive
changes in a scientific manner. This knowledge, combined with the
ability to discontinue inappropriate medication, ensures
psychologists will be better trained to contribute to the welfare of
all mentally ill and disordered persons, including the elderly and
the groups who have limited access to care.
(n) Psychologists have been prescribing medication in the United
States Department of Defense since 1991, and have seen over 160,000
patients with no deaths and no adverse outcomes.
(o) Psychologists are authorized to prescribe medication in New
Mexico, Louisiana, and the United States territory of Guam, and have
written over 40,000 prescriptions with no deaths and no adverse
outcomes.
(p) In order to meet the increasing demands for services to
mentally ill and disordered persons in California, it is the intent
of the Legislature to support a program whereby psychologists who
choose to receive the appropriate education and training may
prescribe medications for their patients who require that treatment.
SEC. 2. Section 2902 of the Business
and Professions Code is amended to read:
2902. As used in this chapter, unless the context clearly
requires otherwise and except as in this chapter expressly otherwise
provided , the following definitions apply:
(a) "Licensed psychologist" means an individual to whom a license
has been issued pursuant to the provisions of this chapter, which
license is in force and has not been suspended or revoked.
(b) "Board" means the Board of Psychology.
(c) A person represents himself or herself to be a psychologist
when the person holds himself or herself out to the public by any
title or description of services incorporating the words "psychology,"
"psychological," "psychologist," "psychology consultation,"
"psychology consultant," "psychometry," "psychometrics" or
"psychometrist," "psychotherapy," "psychotherapist," "psychoanalysis,"
or "psychoanalyst," or when the person holds himself or herself out
to be trained, experienced, or an expert in the field of psychology.
(d) "Accredited," as used with reference to academic institutions,
means the University of California, the California State University,
an institution that is accredited under Section 94761 of the
Education Code, or an institution that is located in
another state and that is accredited by a national or an
applicable regional accrediting agency recognized by the United
States Department of Education.
(e) "Approved," as used with reference to academic institutions,
means an institution having "approval to operate", as
defined in Section 94718 approved under Section 94800
of the Education Code.
(f) "Prescriptive authority" means the authority to prescribe,
discontinue, order, administer or dispense without charge, drugs or
controlled substances recognized for, or customarily used in, the
inpatient or outpatient diagnosis, treatment, or evaluation and
management of individuals with psychiatric, mental, cognitive,
nervous, emotional, addictive, developmental, or behavioral
disorders, and to order or utilize other procedures, consultations,
devices, and tests related thereto in accordance with rules and
regulations adopted by the Board of Psychology.
(g) "Health service provider" means a licensed psychologist who is
duly trained and experienced in the delivery of preventive,
assessment, diagnostic, and therapeutic intervention services
relative to the psychological and physical health of consumers and
who has done all of the following:
(1) Completed scientific and professional training resulting in a
doctoral degree in psychology from a regionally accredited school or,
before January 1, 2003, from a state-approved school.
(2) Completed an internship and supervised experience in health
care settings.
(3) Been licensed as a psychologist at the independent practice
level.
(h) "Prescribing psychologist" means a health service provider who
has received from the board, pursuant to Section 2949, a valid
certificate granting prescriptive authority, and whose certificate
has not been revoked or suspended.
(i) "Drug" has the same meaning as provided in Section 4025, and
includes controlled substances and dangerous drugs, as defined in
Sections 4021 and 4022, respectively.
(j) "Device" has the same meaning as provided in Section 4023, and
includes dangerous devices, as defined in Section 4022.
(k) "Prescription" has the same meaning as provided in Sections
4040 and 4070.
SEC. 3. Section 2904 of the Business
and Professions Code is amended to read:
2904. The practice of psychology shall not include
prescribing drugs, performing surgery or administering
electroconvulsive therapy. any of the following:
(a) Prescribing drugs, except for those prescribed by prescribing
psychologists, as defined in Section 2902, certified pursuant to
Section 2949.
(b) Performing surgery.
(c) Administering electroconvulsive therapy.
SEC. 4. Section 2949 is added to the
Business and Professions Code , to read:
2949. (a) The board shall establish and administer a
certification process to grant licensed psychologists prescriptive
authority. The board shall also develop a procedure for
psychologists-in-training to prescribe under the supervision and
license of a qualified prescriber. The board shall develop procedures
for certification, and shall develop procedures for the
administration of an appropriate, valid, nationally recognized
examination, such as the American Psychological Association Practice
Organization's College of Professional Psychology examination,
approved by the board. The board shall charge applicants reasonable
fees for the issuance of, and renewal of, a certificate in order to
cover the costs of administering the certification process and the
examination. These fees shall be deposited in the Psychology Fund.
(b) Each applicant for certification as a "prescribing
psychologist," as defined in subdivision (g) of Section 2902, shall
show by official transcript or other official evidence satisfactory
to the board that he or she has successfully completed both of the
following:
(1) An organized and planned sequence of psychopharmacological
training resulting in a Master's degree in psychopharmacology from a
regionally accredited institution of higher learning approved by the
board, or training from an approved provider of continuing education
that has been designated and approved by the board as providing an
organized and planned program of appropriate training consistent with
the American Psychological Association's (APA) training guidelines
for prescriptive authority. In its discretion, the board may certify
a psychologist from a federal or other state jurisdiction that has
authorized the psychologist to prescribe if the board determines that
the psychologist has practiced safely and effectively. Also, the
board may, in its discretion, certify a psychologist to practice as a
prescribing psychologist if the psychologist has lawfully prescribed
under another professional license that authorizes prescribing, and
the training and experience under the other license is consistent
with the training standards required for a prescribing psychologist.
At the discretion of the board, approved programs may give credit for
required didactic science courses taken at other educational
institutions that would meet the educational requirements of the
program. Coursework shall be consistent with the most current APA
training guidelines, and shall include education in all of the
following subjects:
(A) Basic science, including anatomy, physiology, and
biochemistry.
(B) Neurosciences, including neuroanatomy, neurophysiology, and
neurochemistry.
(C) Physical assessment and laboratory examinations, including the
following:
(i) Physical assessment.
(ii) Laboratory and radiological assessment.
(iii) Medical terminology and documentation.
(iv) Integration of the subjects in clauses (i) to (iii),
inclusive, through supervised clinical experience or laboratory
experience in conducting physical examinations, ordering psychometric
and laboratory tests, and understanding results and interpretation.
(D) Clinical medicine and pathophysiology, including the
following:
(i) Pathophysiology, with particular emphasis on cardiac, renal,
hepatic, neurologic, gastrointestinal, hematologic, dermatologic, and
endocrine systems.
(ii) Clinical medicine, with particular emphasis on signs,
symptoms, and treatment of disease states with behavioral and
psychiatric manifestations or comorbidities.
(iii) Differential diagnosis.
(iv) Clinical correlations.
(v) Chemical dependency and chronic pain management.
(vi) Integration of the subjects in clauses (i) to (v), inclusive,
through supervised clinical experience or laboratory experience in
taking medical history, assessment for differential diagnosis, and
review of systems.
(E) Clinical and research pharmacology and psychopharmacology,
including the following:
(i) Pharmacology.
(ii) Clinical pharmacology.
(iii) Pharmacogenetics.
(iv) Psychopharmacology.
(v) Developmental psychopharmacology.
(vi) Integration of the subjects in clauses (i) to (v), inclusive,
through supervised clinical experience or laboratory experience in
clinical medicine and ongoing treatment monitoring and evaluation.
(F) Clinical pharmacotherapeutics, including the following as
related to pharmacotherapeutics:
(i) Professional, ethical, and legal issues.
(ii) Combined therapies, such as psychotherapy and pharmocotherapy
interactions.
(iii) Computer-based aids to practice.
(iv) Pharmacoepidemiology.
(v) Integration of clauses (i) to (iv), inclusive, through
supervised clinical experience or laboratory experience in integrated
treatment planning and consultation and the implications of
treatment.
(G) Research, including the following:
(i) Methodology and design of psychopharmacological research.
(ii) Interpretation and evaluation of psychopharmalogical
research.
(iii) Federal Food and Drug Agency drug development and other
regulatory processes.
(2) Relevant supervised clinical experience to obtain competency
in prescribing and in psychopharmacological treatment of a diverse
patient population under the direction of qualified prescribers, as
determined by the board. The supervised clinical experience is
intended to be an intensive, closely supervised experience. Approved
programs shall commit to providing training courses and experiences
that encourage sensitivity to the interactions between
pharmacological and psychological interventions with the
developmental status, gender, health status, culture, and ethnicity
of patients. The supervised experience shall be an organized sequence
of education and training that provides an integrative approach to
learning, as well as the opportunity to assess competencies in skills
and applied knowledge. The intent of the supervised clinical
experience shall be both the following:
(A) To provide ongoing integration of didactic and applied
clinical knowledge throughout the learning sequence, including ample
opportunities for practical learning and clinical application of
skills.
(B) To provide opportunity for programs to assess formative and
summative clinical competency in skills and applied knowledge. The
clinical competencies targeted by this experience shall include all
of the following:
(i) Physical examination and mental status evaluation, including
knowledge and execution of elements and sequence of both
comprehensive and focused physical examination and mental status
evaluation, proper use of instruments used in physical examination,
such as stethoscopes and blood pressure measurement devices, and
scope of knowledge gained from physical examination and mental status
examination.
(ii) Review of systems, including knowledge and ability to
systematically describe the process of integrating information
learned from patient reports, signs, symptoms, and a review of each
of the major body systems.
(iii) Medical history interview and documentation, including the
ability to systematically conduct a patient clinical interview
producing a personal and family medical history, and to communicate
the findings in written and verbal form.
(iv) Assessment indications and interpretation, including the
ability to order and interpret appropriate tests, such as
psychometric, laboratory, and radiological tests, for the purpose of
making a differential diagnosis and for monitoring therapeutic and
adverse effects of treatment.
(v) Differential diagnosis, including use of appropriate
processes, including established diagnostic criteria such as ICD-9
and DSM-IV, to determine primary and alternate diagnoses.
(vi) Integrated treatment planning, including the ability to
identify and select, using all available data, the most appropriate
treatment alternatives and to sequence treatment within the larger
biopsychosocial context.
(vii) Consultation and collaboration, including understanding of
the parameters of the role of the prescribing psychologist or medical
psychologist and working with other professionals in an advisory or
collaborative manner to effect treatment of a patient.
(viii) Treatment management, including application, monitoring,
and modification, as needed, of treatment.
(d) The supervised clinical experience required subdivision (b)
should also meet the following requirements:
(1) The range of diagnostic categories, settings, and
developmental status, gender, health status, and ethnicity reflected
in the patients seen in connection with the supervised clinical
experience required by this section should be appropriate to the
current and anticipated practice of the trainee. It should allow the
trainee to gain exposure to acute, short-term, and maintenance
medication strategies.
(2) Prior to being granted certification as a prescribing
psychologist, a trainee shall obtain supervised clinical experience
with a sufficient range and number of patients in order to
demonstrate threshold performance levels for each of the competency
areas. In order to achieve the complex clinical competency skills
required for independent prescribing, a minimal number of supervised
patient contact hours shall be completed.
(3) A trainee shall only recommend or prescribe drugs or devices
in consultation with, or under the supervision of, a person with
demonstrated skill and experience in clinical psychopharmacology who
is authorized to recommend or prescribe the drugs or devices and in
accordance with other applicable laws.
(e) An approved program shall be subject to the following
requirements:
(1) The program shall provide the board with a report for each
applicant that includes all of the following information:
(A) The total number of supervised clinical experience hours that
students experience, separating face-to-face patient contacts versus
other clinical experiences, including each clinical competency
required.
(B) A description of the method and appropriate benchmarks for
assuring each clinical competency. Methods may include performing
basic physical examinations, case presentations, or patient
simulations based on actual patients and patients for whom the
trainee assumes direct psychological responsibility.
(2) The program shall provide final approval of the supervised
clinical experience of an applicant.
(3) Supervised clinical experience may be integrated into each
level of a trainee's education and training, provided in a final
summative practical experience, or provided in a combination of those
methods according to the design of the program.
(f) A trainee shall demonstrate competency in his or her ability
to integrate didactic learning and applied clinical skill in a
capstone competency evaluation prior to being certified as a
prescribing psychologist.
(g) A prescribing psychologist shall maintain competency through
continuing education over the lifespan of maintaining and practicing
in prescriptive authority or collaborative activities with other
prescribers.
SEC. 5. Section 2949.2 is added to the
Business and Professions Code , to read:
2949.2. (a) The board, shall set forth the requirements for
renewal of a certificate of a prescribing psychologist for each
license renewal period.
(b) Each applicant for renewal of a certificate for prescriptive
authority shall present evidence of having completed approved
mandatory continuing education in the area of psychopharmacology and
related prescribing practice as set forth by the board.
SEC. 6. Section 2949.3 is added to the
Business and Professions Code , to read:
2949.3. (a) Each prescribing psychologist shall comply with all
state and federal rules and regulations relating to the prescribing,
dispensing, and recordkeeping for drugs or devices, as defined in
Sections 4021, 4022, 4023, 4025, and 4055, and other applicable
provisions of law. If the board determines that it would facilitate
administration of the provisions governing prescribing psychologists
to identify a prescribing psychologist by another name that is
consistent with other jurisdictions, it may do so.
(b) A written order of a prescribing psychologist shall include
his or her prescribing identification number, which shall be assigned
by the board to any certified prescribing psychologist.
(c) A prescribing psychologist shall not delegate the prescribing
of medication to any other person except for a supervised trainee in
a recognized training program for prescribing psychologists.
(d) Records of all prescriptions shall be maintained in a
prescribing psychologists client records.
SEC. 7. Section 2949.4 is added to the
Business and Professions Code , to read:
2949.4. (a) The board shall annually transmit to the California
State Board of Pharmacy a list of prescribing psychologists
containing, at a minimum, all of the following information:
(1) The name of the prescribing psychologist.
(2) The unique identification number indicating certification of
the prescribing psychologist to prescribe.
(3) The effective date of prescribing psychologists prescriptive
authority.
(b) The board shall promptly forward to the California State Board
of Pharmacy the names and identification numbers of prescribing
psychologists added to or deleted from the annual list of
psychologists certified to prescribe.
(c) The board shall notify the California State Board of Pharmacy
in a timely manner upon termination, suspension, or reinstatement of
a psychologist's authority to prescribe.
SEC. 8. Section 2949.5 is added to the
Business and Professions Code , to read:
2949.5. Nothing in this chapter shall be construed to authorize a
prescribing psychologist to prescribe medications other than those
generally recognized for the treatment of disorders within the scope
of practice of a psychologist, as defined in Section 2903.
SEC. 9. Section 2960 of the Business
and Professions Code is amended to read:
2960. The board may refuse to issue any registration or license,
or may issue a registration or license with terms and conditions, or
may suspend or revoke the registration or license of any registrant
or licensee if the applicant, registrant, or licensee has been guilty
of unprofessional conduct. Unprofessional conduct shall include, but
not be limited to , all of the following :
(a) Conviction of a crime substantially related to the
qualifications, functions or duties of a psychologist or
psychological assistant.
(b) Use of any controlled substance as defined in Division 10
(commencing with Section 11000) of the Health and Safety Code, or
dangerous drug, or any alcoholic beverage to an extent or in a manner
dangerous to himself or herself, any other person, or the public, or
to an extent that this use impairs his or her ability to perform the
work of a psychologist with safety to the public.
(c) Fraudulently or neglectfully misrepresenting the type or
status of license or registration actually held.
(d) Impersonating another person holding a psychology license or
allowing another person to use his or her license or registration.
(e)
Using fraud or deception in applying for a license or registration or
in passing the examination provided for in this chapter.
(f) Paying, or offering to pay, accepting, or soliciting any
consideration, compensation, or remuneration, whether monetary or
otherwise, for the referral of clients.
(g) Violating Section 17500.
(h) Willful, unauthorized communication of information received in
professional confidence.
(i) Violating any rule of professional conduct promulgated by the
board and set forth in regulations duly adopted under this chapter.
(j) Being grossly negligent in the practice of his or her
profession.
(k) Violating any of the provisions of this chapter or regulations
duly adopted thereunder.
() The aiding or abetting of any person to engage in the unlawful
practice of psychology.
(m) The suspension, revocation or imposition of probationary
conditions by another state or country of a license or certificate to
practice psychology or as a psychological assistant issued by that
state or country to a person also holding a license or registration
issued under this chapter if the act for which the disciplinary
action was taken constitutes a violation of this section.
(n) The commission of any dishonest, corrupt, or fraudulent act.
(o) Any act of sexual abuse, or sexual relations with a patient or
former patient within two years following termination of therapy, or
sexual misconduct that is substantially related to the
qualifications, functions or duties of a psychologist or
psychological assistant or registered psychologist.
(p) Functioning outside of his or her particular field or fields
of competence as established by his or her education, training, and
experience.
(q) Willful failure to submit, on behalf of an applicant for
licensure, verification of supervised experience to the board.
(r) Repeated acts of negligence.
(s) Violating Section 2949.3.
SEC. 10. Section 4040 of the Business
and Professions Code is amended to read:
4040. (a) "Prescription" means an oral, written, or electronic
transmission order that is both of the following:
(1) Given individually for the person or persons for whom ordered
that includes all of the following:
(A) The name or names and address of the patient or patients.
(B) The name and quantity of the drug or device prescribed and the
directions for use.
(C) The date of issue.
(D) Either rubber stamped, typed, or printed by hand or typeset,
the name, address, and telephone number of the prescriber, his or her
license classification, and his or her federal registry number, if a
controlled substance is prescribed.
(E) A legible, clear notice of the condition for which the drug is
being prescribed, if requested by the patient or patients.
(F) If in writing, signed by the prescriber or health care
practitioner issuing the order , or the certified
nurse-midwife, nurse practitioner, physician assistant, or
naturopathic doctor who issues a drug order pursuant to Section
2746.51, 2836.1, 3502.1, or 3640.5, respectively, or the pharmacist
who issues a drug order pursuant to either subparagraph (D) of
paragraph (4) of, or clause (iv) of subparagraph (A) of paragraph (5)
of, subdivision (a) of Section 4052 .
(2) Issued by a physician, dentist, optometrist, podiatrist,
veterinarian, prescribing psychologist, or naturopathic
doctor pursuant to Section 3640.7 or, if a drug order is issued
pursuant to Section 2746.51, 2836.1, 3502.1, or 3460.5, by a
certified nurse-midwife, nurse practitioner, physician assistant, or
naturopathic doctor licensed in this state, or pursuant to either
subparagraph (D) of paragraph (4) of, or clause (iv) of subparagraph
(A) of paragraph (5) of, subdivision (a) of Section 4052 by a
pharmacist licensed in this state.
(b) Notwithstanding subdivision (a), a written order of the
prescriber for a dangerous drug, except for any Schedule II
controlled substance, that contains at least the name and signature
of the prescriber, the name or names and address of the
patient or patients in a manner consistent with paragraph
(3) of subdivision (b) of Section 11164 of the Health and Safety
Code, the name and quantity of the drug prescribed, directions for
use, and the date of issue may be treated as a prescription by the
dispensing pharmacist as long as any additional information required
by subdivision (a) is readily retrievable in the pharmacy. In the
event of a conflict between this subdivision and Section 11164 of the
Health and Safety Code, Section 11164 of the Health and Safety Code
shall prevail.
(c) "Electronic transmission prescription" includes both image and
data prescriptions. "Electronic image transmission prescription"
means any prescription order for which a facsimile of the order is
received by a pharmacy from a licensed prescriber. "Electronic data
transmission prescription" means any prescription order, other than
an electronic image transmission prescription, that is electronically
transmitted from a licensed prescriber to a pharmacy.
(d) The use of commonly used abbreviations shall not invalidate an
otherwise valid prescription.
(e) Nothing in the amendments made to this section (formerly
Section 4036) at the 1969 Regular Session of the Legislature shall be
construed as expanding or limiting the right that a chiropractor,
while acting within the scope of his or her license, may have to
prescribe a device.
SEC. 11. Section 4502 of the Business
and Professions Code is amended to read:
4502. As used in this chapter, "psychiatric technician" means any
person who, for compensation or personal profit, implements
procedures and techniques which involve understanding of cause and
effect and which are used in the care, treatment, and rehabilitation
of mentally ill, emotionally disturbed, or mentally retarded persons
and who has one or more of the following:
(a) Direct responsibility for administering or implementing
specific therapeutic procedures, techniques, treatments, or
medications with the aim of enabling recipients or patients to make
optimal use of their therapeutic regime, their social and personal
resources, and their residential care.
(b) Direct responsibility for the application of interpersonal and
technical skills in the observation and recognition of symptoms and
reactions of recipients or patients, for the accurate recording of
such symptoms and reactions, and for the carrying out of treatments
and medications as prescribed by a licensed physician and surgeon
or a , psychiatrist , or
prescribing psychologist .
The psychiatric technician in the performance of such procedures
and techniques is responsible to the director of the service in which
his duties are performed. The director may be a licensed physician
and surgeon, psychiatrist, psychologist, rehabilitation therapist,
social worker, registered nurse, or other professional personnel.
Nothing herein shall authorize a licensed psychiatric technician
to practice medicine or surgery or to undertake the prevention,
treatment or cure of disease, pain, injury, deformity, or mental or
physical condition in violation of the law.
SEC. 12. Section 4502.1 of the Business
and Professions Code is amended to read:
4502.1. A psychiatric technician, working in a mental health
facility or developmental disability facility, when prescribed by a
physician and surgeon or prescribing psychologist , may
administer medications by hypodermic injection.
SEC. 13. Section 4502.2 of the Business
and Professions Code is amended to read:
4502.2. A psychiatric technician, when prescribed by a physician
and surgeon or prescribing psychologist , may withdraw
blood from a patient with a mental illness or developmental
disability if the psychiatric technician has received certification
from the board that the psychiatric technician has completed a
prescribed course of instruction approved by the board or has
demonstrated competence to the satisfaction of the board.
SEC. 14. No reimbursement is required by this act
pursuant to Section 6 of Article XIII B of the California
Constitution because the only costs that may be incurred by a local
agency or school district will be incurred because this act creates a
new crime or infraction, eliminates a crime or infraction, or
changes the penalty for a crime or infraction, within the meaning of
Section 17556 of the Government Code, or changes the definition of a
crime within the meaning of Section 6 of Article XIII B of the
California Constitution.
SECTION 1. Section 2914.3 of the Business and
Professions Code is amended to read:
2914.3. (a) The board shall encourage institutions that offer a
doctorate degree program in psychology to include in their
biobehavioral curriculum, education and training in
psychopharmacology and related topics, including pharmacology and
clinical pharmacology.
(b) The board shall develop guidelines for the basic education and
training of psychologists whose practices include patients with
medical conditions and patients with mental and emotional disorders,
who may require psychopharmacological treatment and whose management
may require collaboration with physicians and other licensed
prescribers. In developing these guidelines for basic education and
training, the board shall consider, but not be limited to, all of the
following:
(1) The American Psychological Association's guidelines for
training in the biological bases of mental and emotional disorders.
(2) The necessary educational foundation for understanding the
biochemical and physiological bases for mental disorders.
(3) Evaluation of the response to psychotropic compounds,
including the effects and side effects.
(4) Competent basic practical and theoretical knowledge of
neuroanatomy, neurochemistry, and neurophysiology relevant to
research and clinical practice.
(5) Knowledge of the biological bases of psychopharmacology.
(6) The locus of action of psychoactive substances and mechanisms
by which these substances affect brain function and other systems of
the body.
(7) Knowledge of the psychopharmacology of classes of drugs
commonly used to treat mental disorders.
(8) Drugs that are commonly abused that may or may not have
therapeutic uses.
(9) Education of patients and significant support persons in the
risks, benefits, and treatment alternatives to medication.
(10) Appropriate collaboration or consultation with physicians or
other prescribers to include the assessment of the need for
additional treatment that may include medication or other medical
evaluation and treatment and the patient's mental capacity to consent
to additional treatment to enhance both the physical and the mental
status of the persons being treated.
(11) Knowledge of signs that warrant consideration for referral to
a physician.
(c) This section is intended to provide for training of clinical
psychologists to improve the ability of clinical psychologists to
collaborate with physicians. It is not intended to provide for
training psychologists to prescribe medication. Nothing in this
section is intended to expand the scope of licensure of
psychologists.