Prescriptive Authority for Psychologists in Iowa
Brief History
IPA began exploring the possibility of pursuing prescriptive authority for psychologists in 2004. After extensive surveying of membership, discussion with members at all career stages, and generation of committee strategic plan, legislation was first filed in Iowa in 2013. Prescriptive authority legislation passed and was signed into law in Iowa by Governor Terry Branstad in May 2016. Members (particularly Bethe Lonning and Brenda Payne) worked tirelessly in collaboration with the Boards of Psychology and Medicine on the Administrative Rules, which were finalized in February 2019.
In This Section
Training in Iowa
Iowa has two opportunities in the state for training. In 2019, NMSU’s training program (Partnerships help NMSU psychopharmacology program thrive during COVID-19) came to Iowa in collaboration with St. Ambrose University in Davenport, IA. Specifically this training would involve sections of the mandatory classes on pathophysiology and physical assessment to be given at SAU. Please see the link for NMSU below for more information. In the fall of 2022, Drake University in Des Moines, IA began an MSCP program through their College of Pharmacy. Please see the link for the Drake program below for more information.
You may contact Dr. Bethe Lonning, Chair of IPA’s Psychopharmacology Committee for more information, and members may view her presentation to the IPA membership on Prescriptive Authority.
Features of Iowa Law
- Based on the New Mexico legislation
- Requires a post-doctoral master’s degree in clinical psychopharmacology. The law does not have ‘APA designation’ written in it as this was not acceptable to those who opposed the law.
- Requires practicum and 2 years of supervision. The second year of supervision was in response to those concerned about prescribing to special populations such as children, the elderly and pregnant women. The second year of the supervision is to focus on prescribing to those populations if the psychologist desires to have those populations as part of their practice.
- Requires an ongoing collaborative practice agreement with a prescribing physician.
- The supervising and collaborative physicians are not limited to psychiatrists.
Education
- Applicants will possess a post-doctoral master of science degree in clinical psychopharmacology from an APA designated program.
- The degree shall be a minimum of 30 credit hours not including practicum
- A minimum of 1/3 of the coursework must be completed in a live interactive format
Clinical Experience and Practicum
- Clinical training involves direct observation of physician in addition to supervised and independent practice
- Minimum of 600 patient encounters to be completed by the end of practicum.
- Competency in reaching milestones of health history, physical exam and neurological exam must be demonstrated
- Psychologist will observe, evaluate and treat patients encompassing a range of ages and a variety of diagnoses. At least 100 hours of the 400 hours must be completed in a psychiatric setting, and at least 100 hours of the 400 hours must be completed in a primary care or community mental health setting
- Competencies evaluating in the following domains: physical exam, review of systems, medical history review, assessment indications and interpretations, differential diagnosis, integrated treatment planning, consultation and collaboration, treatment management, and appropriate medical documentation
Supervised Practice
- Completion of a minimum of 2 years of supervised practice with a minimum of 300 patients diagnosed with a mental health disorder and pharmacological intervention is considered for treatment. A minimum of 100 patients will be treated with psychotropic medication during this time period. Additional specifications required if treating special populations (e.g., children, elderly patients, patients with serious medical conditions).
- Prescribing psychologists will consult with the primary care physician of patients. Patients must have a designated primary care physician for a psychologist to be able to prescribe to them.
- A prescribing psychologist will have a collaborative practice agreement with a physician at all times.
Physician Supervision
Several disciplines in medicine are eligible to provide supervision to prescribing psychologist candidates. A list of them can be found in the original law found here (SF2188). An update to the original law occurred in 2023 and can be found here (HF183).
Supervising a prescribing psychologist takes a different approach than supervising other disciplines. These candidates are licensed psychologists and are practicing in the field. Their practicum requires 400 hours with 100 different patients. During the time of practicum, candidates are also to complete 600 patient contacts to meet their physical assessment requirement. These 600 patient contacts do not need to be 600 separate patients nor do they need to have a mental health diagnosis—many candidates complete this portion of training while they are completing their practicum. Often candidates are in the physician’s office only 1 day/week until their requirements are met.
The specific milestones and requirements for physicians can be found here. Prescribing psychologist candidates will have any paperwork necessary for completion and will keep track of their own hours/patients. Supervising physicians will only need to attest to the Board of Behavioral Health that supervision occurred and all requirements by law were met. This attestation occurs when the candidate applies for their conditional prescribing certificate. The complete set of joint administrative rules is available here.
Here are some comments from physicians who have supervised candidates and a link to an article regarding this supervision:
“I have provided supervision to a number of prescribing psychologist candidates over the past couple of years. I have found them to be well-trained, eager to learn and accepting of feedback. We all know how overburdened our field is, and having prescribing psychologists in Iowa provides another much-needed option for Iowans seeking mental health care. I have had nothing but positive experiences working with these providers, and as a solo practitioner it has been invaluable to me to develop connections with and regularly review clinical case discussions with knowledgeable colleagues. The collaborative relationships that I have developed with these providers has additionally helped me to grow my own psychotherapy skills and to more effectively incorporate psychotherapeutic interventions into my medication management visits, as well as to stay current with more recent developments in our field. The time it has taken to provide supervision for the practicum/fellowship hours has not been a hardship to my practice nor has it taken significantly extra time. I have continued to supervise one of these providers under his conditional prescribing license. He has been diligent about maintaining communication with both myself and with his patients’ primary care physicians, and the time commitment has been minimal compared to the benefit I have received in terms of furthering my own knowledge and skills. I continue to be willing to provide this supervision as I believe that believe having prescribing psychologists will allow many Iowans increased access to competent, evidence-based mental health care.”
Please email Dr. Bethe Lonning, IPA’s Director for Professional Affairs, for more information or to connect with an RxP candidate for supervision.
If you’d like to receive more information or updates about the prescriptive authority movement in Iowa, please contact RxP chair Elizabeth Lonning!
Additional Resources
FDU, NMSU and Alliant have PEP review classes to assist in preparation to take the national exam. Some of the review programs are part of the program, others are separate. In addition, the resources listed below are study materials those who have taken the PEP suggest using for preparation:
- Kaplan & Sadock's Synopsis of Psychiatry (Behavioral Sciences/Clinical Psychiatry)
- APA Handbook of Clinical Psychopharmacology
- Massachusetts General Hospital Psychiatry Update & Board Preparation by Stern, Herman, & Rubin
- Stahl's Self-Assessment Examination in Psychiatry
- Prescribing Psychotropics: From Drug Interactions to Genetics by Aiken, Feder, & Carlat
dial.iowa.gov/licenses/medical/mental-health/psychology
*Once the conditional prescribing period is complete, please complete this application for submission to the Board of Psychology.
From the Iowa Board of Pharmacy:
Registration for the Iowa PMP requires that the applicant have a federal DEA registration number. Before an individual can get a DEA number, the individual must have an Iowa Controlled Substances Act (CSA) registration. Before the Iowa CSA registration is issued, the individual must be appropriately licensed by a professional licensing board and must have prescriptive authority.
The Pharmacy Board also confirmed that it has established a category in the PMP for psychologists and they will enable this category soon.
DEA = Drug Enforcement Agency
CSA = Controlled Substances Act
PMP = Prescription Monitoring Program—Iowa law requires registration in this