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Update on RxP in Iowa

Iowa holds its place in psychology history as the fourth state to pass legislation that allows psychologists to prescribe medication after additional education and experiential training. The initial legislation was signed into law in 2016 and administrative rules were finalized in February 2019, which opened the door to begin licensing prescribing psychologists in Iowa.

On April 28, 2023 Governor Kim Reyolds of Iowa signed HF. 183 into law. This legislation had passed the Iowa House 95-0 and the Iowa Senate 50-0, receiving excellent support from both sides of the aisle. This law removes several barriers in our original RxP law. Introducing RxP laws in any state often includes some compromises that need to be addressed in the future, which was the case with our law in Iowa. I am happy to report the following barriers were removed:

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RxP's Shining Light

On behalf of the psychopharmacology committee, please note recent attention for the RxP movement by Dr. Beth Rom-Rymer (our Illinois neighbor), as highlighted in a recent newsletter from former APA President Pat DeLeon. 

Beth Rom-Rymer, who came in second in this year’s APA Presidential race: “South Africa – Throughout my early training and professional career, I have sought to form international partnerships.  The richness of these cultural, linguistic relationships continually advance my work.  In October of this year, I had the remarkable opportunity to travel to South Africa to speak on a panel, focused on Prescriptive Authority (RxP), with the leaders of the RxP movement in South Africa, Joachim Mureriwa and Thabiso Rapapali.  It was thrilling to speak to an overflow crowd of South African psychologists, all eager to train to become prescribing psychologists.  The need for more accessible and comprehensive mental health treatment is at crisis proportions in South Africa as it is in the US.  A global perspective will serve as a foundation for the future of psychology and APA.  It is critical that we approach our numerous international partnerships with an attitude of collaborative science, flexibility, and honesty, via a commitment to reciprocity and respect and a desire to learn from our global partners, as well as contribute.  My experience in South Africa personified this philosophy.  I was embraced by my colleagues and gained a richness in experience that could only be realized by international collaboration.  I have been transformed by my experience.

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The Steadily Maturing RxP Agenda

Iowa is pleased to have three conditional prescribing psychologists! This status means they have completed their MSCP, passed the PEP, completed their clinical contacts and their 400/100 practicum and are prescribing with supervision. During this period of supervision, if they want to prescribe to special populations (defined in our law as under the age of 18, older than 65, pregnant, etc.) this is the time when they would acquire supervision specific to those populations. A fourth candidate is just waiting for his application to be approved before being granted his certificate so Iowa may have four by the time this is published—and, he just did succeed! There are two other candidates diligently working on their clinical assessment and practicum hours (Iowa law still uses the previous designation language as it wasn’t updated until after our law was passed) and hopefully will have their certificate(s) by the end of this year.

We continue to assess the climate of our legislature to determine when it might be a good time to look at altering some of the original language of our law. As with most states, we were unable to get the law to read exactly how we wanted it and now are hoping to be able to fine tune some language in the future. Iowa’s legislative session for 2022 will come to a close by the end of April at the latest so we’re looking at legislative session 2023 at the earliest.

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Chasing RxP: From Davenport to Clarinda

We have all been through at least one of those experiences where you get to the end and look back and say, “I am glad I did that but I would never want to do it again.” Completing the requirements to become a prescribing psychologist (RxP) to licensure has certainly not been one of those experiences. If I had the time, I would do all the training over again as there is so much useful information to learn. From the first day of psychopharmacology class in January of 2017 to the first day I was legally able to write a prescription, which was June 21st, 2021, each milestone along the way has been very enjoyable. There was not a single time I thought, “What the heck have I gotten myself into?”

I attended undergraduate at the University of Nebraska-Lincoln in the 1990s. While trying to build a resume for application to graduate school I worked at the clinic of Dr. Matthew Nessetti, who was one of the early presidents of Division 55 (Society for Prescribing Psychology). It was from his energy and enthusiasm about psychopharmacology and his vision for the future of psychologists being able to practice medicine, that I too became excited for RxP before I ever set foot into graduate school. That is when the chase began. 

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My Road to RxP - FDU

Before beginning graduate school in counseling psychology, I had been actively discerning the psychiatry route versus the psychology path. I have always been fascinated with the biological aspects of mental health, but psychotherapy was (and remains) my first love. When I learned that virtually no psychiatrists still practice psychotherapy (and even fewer practice it as their primary treatment), I knew psychiatry was not the right fit for me. While I grieved being able to integrate prescribing into my practice, I foreclosed on that option and moved on.

While I was early in graduate school, I became aware that New Mexico and Louisiana had granted prescribing authority to psychologists. I am somewhat obsessive when it comes to reading about topics of interest, and I immediately read any article, journal, or book I could find on prescribing psychology (commonly abbreviated RxP). The more I learned, the more interested I became. I even wrote a paper in my Ethics course on the topic, considering the implications for professional identity and ethical practice.

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My Road to RxP - NMSU

This is the first in a multi-part series where psychologists describe their journeys to pursuing prescriptive authority in Iowa.  

My road to becoming a prescribing psychologist really started many, many miles ago when I was in graduate school. Even way back then, in the early 1990s, I found a class on psychopharmacology taught by a local psychiatrist fascinating and the information was very useful in my early practice. Fast forward to the 2000s, when IPA first had members interested in pursuing advocacy for prescriptive authority. Through the years, I worked with Dr. Bethe Lonning and Dr. Greg Febbraro to advocate for the law granting us the right to prescribe medication with a limited formulary and additional training after our doctoral degrees. I completed the Farleigh Dickinson University Master of Science in Clinical Psychopharmacology (MSCP) program, graduating in 2011. I passed the Psychopharmacology Examination for Psychologists (PEP) in 2012. It would seem like that’s where my road would end, at a happy RxP place- but no! After helping to pass the legislation granting prescriptive authority for psychologists in Iowa in 2016, it took three years for us to negotiate rules to support the law with the Board of Medicine. The rules were not finalized until 2019, meaning that my 5-year window from the time of graduation to the time to apply for a conditional license was already passed.

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