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General Assembly Raised Bill No. 966
January Session, 2019
LCO No. 4942
Referred to Committee on PUBLIC HEALTH
Introduced by:
(PH)
AN ACT CONCERNING TH E PRESCRIPTIVE AUTHORITY OF
PSYCHOLOGISTS.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. (NEW) (Effective October 1, 2019) (a) As used in this 1
section: 2
(1) "Clinical preceptorship" means a mentored experience in which a 3
primary care provider gives personal instruction, training and 4
supervision; 5
(2) "Primary care provider" means a physician licensed pursuant to 6
chapter 370 of the general statutes, advanced practice registered nurse 7
licensed pursuant to chapter 378 of the general statutes or physician 8
assistant licensed pursuant to chapter 370 of the general statutes who 9
provides primary care services. 10
(b) A psychologist licensed under chapter 383 of the general statutes 11
may apply to the Department of Public Health for certification to 12
prescribe, administer and dispense, without charge, drugs and 13
controlled substances in schedule II, III, IV or V. Each psychologist 14 Raised Bill No. 966
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seeking certification to prescribe shall submit to the department proof 15
of (1) a license to practice under chapter 383 of the general statutes, (2) 16
successful completion of a master's degree program in clinical 17
psychopharmacology approved by the department and with an 18
appropriate number of hours in didactic instruction as determined by 19
the department, (3) successful completion of an examination in 20
psychopharmacology approved by the department, and (4) completion 21
of not less than eighty hours of clinical preceptorship with a primary 22
care provider. 23
(c) Upon receiving certification to prescribe, administer and 24
dispense drugs and controlled substances pursuant to subsection (b) of 25
this section, a psychologist shall engage in a supervised clinical 26
practice, for at least one year and not less than one thousand hours, 27
under the direct supervision of a physician licensed pursuant to 28
chapter 370 of the general statutes who is certified in psychiatry by the 29
American Board of Psychiatry and Neurology, or an advanced practice 30
registered nurse licensed pursuant to chapter 378 of the general 31
statutes who is certified as a psychiatric and mental health clinical 32
nurse specialist or nurse practitioner by the American Nurses 33
Credentialing Center. Prior to engaging in the supervised clinical 34
practice, the psychologist and the supervising physician or advanced 35
practice registered nurse shall establish (1) the frequency at which the 36
psychologist's practice and performance will be reviewed, (2) a plan 37
for patient care coverage in the psychologist's absence, and (3) 38
methods to review patient outcomes and disclose the supervisory 39
relationship to the patient. Such supervised clinical practice by the 40
psychologist shall include (A) experience with direct prescription drug 41
treatment or management services for at least one hundred patients 42
and not less than four hundred hours, (B) documentation of all cases, 43
(C) evaluations by the supervising physician or advanced practice 44
registered nurse of the psychologist's competency in his or her practice 45
and of his or her clinical performance, and (D) experience with a broad 46
spectrum of psychiatric, psychological, mental health, cognitive, 47
nervous, emotional, substance use and behavioral disorders and 48 Raised Bill No. 966
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diagnoses. 49
(d) A psychologist who (1) is certified to prescribe, administer and 50
dispense drugs and controlled substances pursuant to subsection (b) of 51
this section, (2) has maintained such certification for at least one year, 52
and (3) has engaged in a supervised clinical practice in accordance 53
with the provisions of subsection (c) of this section, may (A) prescribe, 54
administer and dispense, without charge, drugs and controlled 55
substances in schedule II, III, IV or V relevant to the practice of 56
psychology and customarily used in the diagnosis, treatment and 57
management of persons with psychiatric, psychological, mental health, 58
cognitive, nervous, emotional, substance use or behavioral disorders, 59
and (B) order laboratory, physical and diagnostic tests for the purposes 60
of diagnosing a patient and providing the appropriate pharmacologic 61
management of the patient's disorder. Such psychologist shall 62
maintain a record of all prescriptions issued to a patient in the patient's 63
medical record and coordinate care of a patient with the patient's 64
primary care provider. No such psychologist may delegate the 65
authority to prescribe drugs and controlled substances to any other 66
person. Each prescription issued by a psychologist under this 67
subsection shall contain the signature, name, address and license 68
number of the psychologist and comply with all state and federal laws. 69
(e) A psychologist certified to prescribe, administer and dispense 70
drugs and controlled substances pursuant to subsection (b) of this 71
section and applying to the department for a renewal of such 72
certification shall, in addition to satisfying the continuing education 73
requirements set forth in section 20-191c of the general statutes, 74
complete a minimum of forty hours of continuing education in clinical 75
pharmacology, neuropharmacology, clinical psychopharmacology and 76
medically assisted substance use disorder treatment. 77
(f) The Department of Public Health may adopt regulations in 78
accordance with the provisions of chapter 54 of the general statutes to 79
carry out the provisions of this section. 80 Raised Bill No. 966
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Sec. 2. Subdivision (3) of section 20-14c of the general statutes is 81
repealed and the following is substituted in lieu thereof (Effective 82
October 1, 2019): 83
(3) "Prescribing practitioner" means a physician, dentist, podiatrist, 84
optometrist, physician assistant, advanced practice registered nurse, 85
nurse-midwife, [or] veterinarian or psychologist licensed by the state 86
[of Connecticut] and authorized to prescribe medication within the 87
scope of such person's practice. 88
Sec. 3. Section 21a-252 of the general statutes is repealed and the 89
following is substituted in lieu thereof (Effective October 1, 2019): 90
(a) A physician licensed pursuant to chapter 370, in good faith and 91
in the course of the physician's professional practice only, may 92
prescribe, administer and dispense controlled substances, or may 93
cause the same to be administered by a physician assistant, nurse or 94
intern under the physician's direction and supervision, for 95
demonstrable physical or mental disorders but not for drug 96
dependence except in accordance with state and federal laws and 97
regulations adopted thereunder. Notwithstanding the provisions of 98
this subsection the Department of Consumer Protection may approve 99
protocols allowing the dispensing of take-home doses of methadone, 100
by a registered nurse or licensed practical nurse, to outpatients in duly 101
licensed substance abuse treatment facilities. Such dispensing shall be 102
done pursuant to the order of a licensed prescribing practitioner and 103
using computerized dispensing equipment into which bulk supplies of 104
methadone are dispensed by a pharmacist. The quantity of methadone 105
dispensed by such nurse shall not exceed at any one time that amount 106
allowed under federal or state statutes or regulations governing the 107
treatment of drug dependent patients. The Department of Consumer 108
Protection shall conduct inspections of such treatment facilities to 109
ensure that the computerized dispensing equipment and related 110
dispensing procedures documented in the approved protocols are 111
adhered to. 112 Raised Bill No. 966
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(b) A dentist licensed pursuant to chapter 379, in good faith and in 113
the course of the dentist's professional practice only, may prescribe, 114
administer or dispense controlled substances, or may cause the same 115
to be administered by a nurse under the dentist's direction and 116
supervision, to the extent permitted by the federal Controlled 117
Substances Act, federal food and drug laws and state laws and 118
regulations relating to dentistry. 119
(c) A podiatrist licensed pursuant to chapter 375, in good faith and 120
in the course of the podiatrist's professional practice only, may 121
prescribe, administer and dispense controlled substances in schedules 122
II, III, IV or V, or may cause the same to be administered by a nurse 123
under the podiatrist's direction and supervision, to the extent 124
permitted by the federal Controlled Substances Act, the federal food 125
and drug laws and state laws and regulations relating to podiatry. 126
(d) A veterinarian licensed pursuant to chapter 384, in good faith in 127
the course of the veterinarian's professional practice only, and not for 128
use by a human being, may prescribe, administer and dispense 129
controlled substances, and may cause them to be administered by an 130
assistant or orderly under the veterinarian's direction and supervision, 131
to the extent permitted by the federal Controlled Substances Act, the 132
federal food and drug laws and state laws and regulations relating to 133
veterinary medicine. 134
(e) An advanced practice registered nurse licensed pursuant to 135
[section 20-94a] chapter 378, in good faith and in the course of such 136
nurse's professional practice only, may prescribe, dispense, and 137
administer controlled substances in schedule II, III, IV or V, or may 138
cause the same to be administered by a registered nurse or licensed 139
practical nurse under the advanced practice registered nurse's 140
direction and supervision, to the extent permitted by the federal 141
Controlled Substances Act, the federal food and drug laws and state 142
laws and regulations relating to advanced nursing practice. 143
(f) A nurse-midwife licensed [under] pursuant to chapter 377, in 144 Raised Bill No. 966
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good faith and in the course of the nurse-midwife's professional 145
practice only, may prescribe, dispense, and administer controlled 146
substances in schedules II, III, IV and V, or may cause the same to be 147
administered by a registered nurse or licensed practical nurse under 148
the nurse-midwife's direction and supervision, to the extent permitted 149
by the federal Controlled Substances Act, the federal food and drug 150
laws and state laws. 151
(g) A physician assistant licensed pursuant to [section 20-12b] 152
chapter 370, in good faith and in the course of the physician assistant's 153
professional practice only, may prescribe, dispense, and administer 154
controlled substances in schedule II, III, IV or V, or may cause the same 155
to be administered by a registered nurse or licensed practical nurse 156
who is acting under a physician's direction, to the extent permitted by 157
the federal Controlled Substances Act, the federal food and drug laws 158
and state laws and regulations relating to physician assistant practice. 159
(h) An optometrist licensed pursuant to chapter 380 and authorized 160
to practice advanced optometrical care, in good faith and in the course 161
of the optometrist's professional practice only and who is duly 162
authorized by section 20-127, may prescribe, administer or dispense 163
controlled substances in schedule II, III, IV or V to the extent permitted 164
by the federal Controlled Substances Act, the federal food and drug 165
laws and state laws and regulations relating to optometry. 166
(i) A psychologist licensed pursuant to chapter 383 and certified to 167
prescribe, administer and dispense controlled substances pursuant to 168
section 1 of this act, in good faith and in the course of the 169
psychologist's professional practice only, may prescribe, dispense and 170
administer controlled substances in schedule II, III, IV or V, to the 171
extent permitted by the federal Controlled Substances Act, the federal 172
food and drug laws and state laws and regulations relating to 173
psychology. 174
(j) Any person who has obtained directly from a physician, dentist, 175
podiatrist, optometrist, veterinarian, physician assistant, advanced 176 Raised Bill No. 966
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practice registered nurse, [or] nurse-midwife or psychologist any 177
controlled substance for self-administration or administration to a 178
patient during the absence of such physician, dentist, podiatrist, 179
optometrist, veterinarian, physician assistant, advanced practice 180
registered nurse, [or] nurse-midwife or psychologist shall return to 181
such physician, dentist, podiatrist, optometrist, veterinarian, physician 182
assistant, advanced practice registered nurse, [or] nurse-midwife or 183
psychologist any unused portion of such controlled substance, when it 184
is no longer required by the person or the patient, or may surrender 185
such controlled substance to the Commissioner of Consumer 186
Protection for proper disposition. 187
[(j)] (k) (1) A prescribing practitioner, as defined in section 20-14c, as 188
amended by this act, shall not, except in an emergency, prescribe, 189
dispense or administer controlled substances in schedules II to IV, 190
inclusive, to a member of his or her immediate family. For purposes of 191
this section, "immediate family member" means a spouse, parent, 192
child, sibling, parent-in-law, son or daughter-in-law, brother or sister-193
in-law, step-parent, step-child, step-sibling or other relative residing in 194
the same residence as the prescribing practitioner and shall not include 195
an animal in the residence. In an emergency, a prescribing practitioner 196
may prescribe, dispense or administer not more than a seventy-two-197
hour supply of such controlled substances to an immediate family 198
member only when there is no other qualified prescribing practitioner 199
available. 200
(2) A prescribing practitioner who prescribes, dispenses or 201
administers any controlled substance to a member of his or her 202
immediate family pursuant to subdivision (1) of this subsection shall 203
perform an assessment for the care and treatment of the patient, 204
medically evaluate the patient's need for such controlled substance and 205
document such assessment and need in the normal course of his or her 206
business. The prescribing practitioner shall document the emergency 207
that gave rise to the prescription, dispensing or administering of such 208
controlled substance to the immediate family member. 209 Raised Bill No. 966
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[(k)] (l) A prescribing practitioner, as defined in section 20-14c, as 210
amended by this act, shall not, except in an emergency, prescribe, 211
dispense or administer controlled substances in schedules II to IV, 212
inclusive, for his or her own use. In an emergency, a prescribing 213
practitioner may prescribe, dispense or administer not more than a 214
seventy-two-hour emergency supply of such controlled substances for 215
self-use only when there is no other qualified prescribing practitioner 216
available. 217
This act shall take effect as follows and shall amend the following
sections:
Section 1 October 1, 2019 New section
Sec. 2 October 1, 2019 20-14c(3)
Sec. 3 October 1, 2019 21a-252
Statement of Purpose:
To allow licensed psychologists to apply for certification from the
Department of Public Health to prescribe, administer and dispense
drugs and controlled substances.
[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline,
except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is
not underlined.]