Relating To Prescriptive Authority For Clinical Psychologists.
SB708 would create a new statutory framework in Hawaii allowing certain clinical psychologists to obtain prescriptive authority privilege to prescribe and administer limited psychotropic medications. The bill establishes a new part in chapter 465, Hawaii Revised Statutes, defining “prescribing psychologist,” setting education, training, supervised clinical experience, examination, renewal, and continuing education requirements, and directing the Board of Psychology to administer the program, adopt rules, and develop an exclusionary formulary. Applications would begin July 1, 2026, and the bill also requires a report to the Legislature before the 2026 session on implementation and related issues.
The measure is aimed at expanding access to mental health treatment in response to shortages of psychiatrists and primary care physicians, especially on the neighbor islands. It authorizes prescribing psychologists to issue prescriptions only for psychotropic medications within a limited scope, while excluding Schedule I, II, and most Schedule III controlled substances, opiates, and narcotic drugs, with specific exceptions for ADHD stimulants and buprenorphine for opioid use disorder. The bill also requires collaboration with a patient’s primary care provider in most cases and imposes additional safeguards for patients who are forensically encumbered or have serious mental illness under Department of Health jurisdiction.
SB708 would amend chapters 465, 329, and 346 of the Hawaii Revised Statutes to recognize prescribing psychologists as a new category of practitioner for limited psychotropic prescribing, and to conform controlled-substance and pharmacy rules to that new authority. It would also clarify that the Board of Psychology, rather than the medical board, would oversee credentialing, renewal, rulemaking, and discipline for this privilege, while the Department of Commerce and Consumer Affairs would administer appropriated funds for implementation. The bill would not broadly expand psychologists into the practice of medicine, but it would create a narrow, regulated prescribing role with reporting, collaboration, and formulary restrictions.
The bill’s findings and structure indicate a generally supportive policy approach focused on improving access to mental health care, reducing treatment gaps, and addressing workforce shortages. The absence of committee transcripts or recorded votes means there is no documented public debate in the provided materials, but the bill itself reflects a strong legislative interest in expanding treatment capacity while maintaining oversight and limits. Its inclusion of training standards, collaboration requirements, and an exclusionary formulary suggests an effort to balance access with caution.
The main points of potential contention are the scope of prescribing authority and the safeguards attached to it. Supporters are likely to emphasize access to care, especially in underserved areas, while opponents or skeptics may question whether psychologists should prescribe medication at all, whether the training requirements are sufficient, and whether collaboration with primary care providers will be workable in practice. Additional concerns may arise around the exceptions allowing ADHD stimulants and buprenorphine, the handling of patients with serious mental illness or forensic involvement, and the bill’s reliance on future board rules and an appropriated but unspecified funding amount.