RELATING TO PRESCRIPTIVE AUTHORITY FOR CLINICAL PSYCHOLOGISTS.
Summary
SB708 would create a new statutory framework in Hawaii authorizing certain clinical psychologists to obtain prescriptive authority privilege to prescribe and administer limited psychotropic medications. The bill defines “prescribing psychologist,” sets education, training, supervised clinical experience, examination, and continuing education requirements, and directs the Board of Psychology to establish forms, fees, rules, an exclusionary formulary, and application and renewal procedures. Applications would begin July 1, 2026, and the bill also requires a report to the Legislature before the 2026 session on implementation and related policy issues.
The bill is designed to expand access to mental health treatment by allowing specially trained psychologists to prescribe within a restricted scope and only under specified conditions. It limits prescribing to medications used for mental and emotional disorders, excludes Schedule I, II, and most Schedule III controlled substances, and generally requires collaboration with a patient’s primary care provider. It also creates special rules for patients who are forensically encumbered or who have serious mental illness and are under Department of Health jurisdiction, and it appropriates state funds to support implementation by the Board of Psychology and the Department of Commerce and Consumer Affairs.
Impact
SB708 would amend chapter 465 and related provisions in chapters 329 and 346 of the Hawaii Revised Statutes to recognize prescribing psychologists as a new category of practitioner and to integrate them into the state’s controlled-substances and pharmacy laws. It would also modify existing rules on prescription labeling, pharmacist dispensing, and psychotropic medication coverage to account for prescriptions written by these psychologists. In practical terms, the bill would expand the pool of licensed professionals able to prescribe certain mental health medications while preserving limits, collaboration requirements, and board oversight.
Sentiment
The overall sentiment reflected in the bill text is strongly supportive of expanding access to mental health care. The findings emphasize shortages of psychiatrists and primary care physicians, especially on the neighbor islands, and link untreated mental illness to homelessness, arrests, and suicide risk. The bill presents prescriptive authority for specially trained psychologists as a targeted workforce solution and cites other states and federal systems that already allow similar practice. No committee testimony or recorded votes were provided, so there is no additional public debate record to indicate opposition or support beyond the bill’s stated rationale.
Contention
The main policy tension in SB708 is between expanding access to care and maintaining safeguards around prescribing authority. The bill addresses this by requiring extensive training, supervised clinical experience, collaboration with primary care providers, and a board-created exclusionary formulary that bars most controlled substances and limits prescribing for younger patients. Another likely point of contention is whether psychologists should be allowed to prescribe at all, since the bill expressly amends existing law that otherwise states chapter 465 does not permit drug prescribing or the practice of medicine. The special provisions for forensic patients and those with serious mental illness may also draw scrutiny because they involve coordination with the Department of Health and additional treatment protocols.