Iowa Administrative Code › Agency 653 - Medicine Board › Chapter 19 - Prescribing Psychologists › Rule 653-19.11 - Standards of Practice-collaboration With a Prescribing Psychologist

Current through Register Vol. 47, No. 3, July 24, 2024
A collaborating physician shall be a person who is licensed to
				practice medicine and surgery or osteopathic medicine in Iowa, who regularly
				prescribes psychotropic medications for the treatment of mental disorders as
				part of the physician's normal course of practice, and who serves as a resource
				for a prescribing psychologist pursuant to a collaborative practice agreement.
				A collaborating physician shall be board-certified in family medicine, internal
				medicine, neurology, pediatrics, or psychiatry. A collaborating physician shall
				fully comply with the following standards of practice:
(1)
Collaboration.
A
			 collaborating physician shall provide appropriate collaboration with a
			 prescribing psychologist to achieve patient safety and optimal clinical
			 outcomes. A collaborating physician shall ensure that appropriate clinical
			 examinations and necessary testing are performed and that all
			 psychopharmacology services provided are appropriate for the patient's
			 condition. Collaboration may be in person or via electronic communications in
			 accordance with these rules. A prescribing psychologist may have more than one
			 collaborating physician.
(2)
Maximum number of prescribing psychologists.
A physician shall
			 not serve as a collaborating physician for more than two prescribing
			 psychologists at one time.
(3)
Initial assessment.
Prior to serving as a collaborating
			 physician, a physician shall assess a prescribing psychologist's relevant
			 education, training, experience, and competence.
(4)
Scope of practice.
A
			 collaborating physician shall ensure that all psychopharmacology services
			 provided by a prescribing psychologist are within the competence and scope of
			 practice of the collaborating physician and the prescribing
			 psychologist.
(5)
Prescriptive authority.
A collaborating physician shall ensure
			 that a prescribing psychologist only prescribes psychotropic medications for
			 the treatment of mental disorders.
(6)
Delegation.
A
			 collaborating physician shall ensure that a prescribing psychologist does not
			 delegate prescriptive authority to any other person.
(7)
Narcotics.
A
			 collaborating physician shall ensure that a prescribing psychologist does not
			 prescribe narcotics.
(8)
Active DEA andCSA registration.
A collaborating physician
			 shall ensure that a prescribing psychologist has an active DEA registration and
			 CSA registration at all times during the period of collaboration.
(9)
Patient populations.
A
			 collaborating physician shall ensure that a prescribing psychologist only
			 provides psychopharmacology services to patient populations within the
			 prescribing psychologist's education, training, experience, and competence. A
			 collaborating physician may establish limitations on the types of populations
			 to whom a prescribing psychologist may provide psychopharmacology services
			 based on the prescribing psychologist's education, training, experience, and
			 competence.
(10)
Psychotropic medications.
A collaborating physician shall
			 ensure that a prescribing psychologist only prescribes psychotropic medications
			 that are within the prescribing psychologist's education, training, experience,
			 and competence. A collaborating physician may establish limitations on the
			 types of psychotropic medications that a prescribing psychologist may prescribe
			 based on the prescribing psychologist's education, training, experience, and
			 competence.
(11)
Specialization.
A collaborating physician shall ensure that a
			 prescribing psychologist has completed at least one year of the required two
			 years of supervised practice with the respective population in accordance with
			 subrule 19.3(4) before the prescribing psychologist provides psychopharmacology
			 services to children (less than 17 years of age), elderly persons (over 65
			 years of age), or patients with serious medical conditions, including but not
			 limited to, heart disease, cancer, stroke, seizures, or comorbid psychological
			 conditions, or patients with developmental disabilities and intellectual
			 disabilities.
(12)
Informed
			 consent.
A collaborating physician shall ensure that a prescribing
			 psychologist obtains appropriate informed consent before a prescribing
			 psychologist provides psychopharmacology services to a patient.
(13)
Release of information.
A collaborating physician shall ensure that a prescribing
			 psychologist obtains a release of information authorizing the prescribing
			 psychologist to share information with the collaborating physician before the
			 prescribing psychologist provides psychopharmacology services to a
			 patient.
(14)
Primary care
			 physician.
A collaborating physician shall ensure that each patient
			 has a designated primary care physician before a prescribing psychologist
			 provides psychopharmacology services to a patient. A collaborating physician
			 shall ensure that a prescribing psychologist maintains a cooperative
			 relationship with the primary care physician who oversees a patient's general
			 medical care to ensure that necessary medical examinations are conducted, the
			 psychotropic medication is appropriate for the patient's medical condition, and
			 significant changes in the patient's medical or psychological condition are
			 discussed. A collaborating physician shall ensure that a prescribing
			 psychologist engages in appropriate consultation with a patient's designated
			 primary care physician while the prescribing psychologist is providing
			 psychopharmacology services to a patient.
(15)
Chart reviews.
A
			 collaborating physician shall personally review a representative sample of the
			 prescribing psychologist's patient charts.
(16)
Performance evaluations.
A collaborating physician shall regularly evaluate the clinical judgment,
			 skills and performance of a prescribing psychologist to safely provide
			 psychopharmacology services to patients and provide appropriate feedback to the
			 prescribing psychologist.
(17)
Collaborative practice
			 agreement.
Prior to serving as a collaborating physician for a
			 prescribing psychologist, the collaborating physician shall ensure that the
			 prescribing psychologist has a written collaborative practice agreement in
			 place. A template may be obtained from the boards of medicine and psychology.
			 The collaborative practice agreement shall define the nature and extent of the
			 collaborative relationship and outline specific parameters for review of the
			 collaborative relationship. The collaborative practice agreement shall take
			 into account the collaborating physician's and prescribing psychologist's
			 relevant education, training, experience, and competence and the nature and
			 scope of the psychopharmacology services to be provided. The collaborating
			 physician shall review the terms of the collaborative practice agreement with
			 the prescribing psychologist at least once each year. The collaborating
			 physician and prescribing psychologist shall each maintain a copy of the
			 collaborative practice agreement and provide a copy of the agreement to the
			 boards of medicine and psychology upon request. The collaborative practice
			 agreement shall include the following:
a.
Prescribing psychologist's information.
The name, license
			 number, DEA registration number, CSA registration number, address, telephone
			 number, email address, and practice locations of the prescribing
			 psychologist.
b.
Collaborating physician's information.
The name, license
			 number, DEA registration number, CSA registration number, address, telephone
			 number, email address, and practice locations of the collaborating
			 physician.
c.
Period of
			 collaboration.
The time period covered by the collaborative practice
			 agreement.
d.
Locations and
			 settings.
A description of the locations and settings where and with
			 whom collaborative practice will occur.
e.
Scope of practice.
A
			 description of the scope of practice of the collaborating physician and the
			 prescribing psychologist.
f.
Methods of communication.
A description of how the
			 collaborating physician and prescribing psychologist may communicate for
			 appropriate collaboration.
g.
Initial assessment.
A description of the steps the
			 collaborating physician has taken to assess a prescribing psychologist's
			 relevant education, training, experience, and competence prior to collaborating
			 with a prescribing psychologist.
h.
Limitations on psychotropic medications.
A description of any
			 limitations on the types of psychotropic medications the prescribing
			 psychologist may prescribe consistent with the collaborating physician's and
			 prescribing psychologist's relevant education, training, experience, and
			 competence.
i.
Limitations
			 on patient populations.
A description of any limitations on the types
			 of populations the prescribing psychologist may treat with psychotropic
			 medications consistent with the collaborating physician's and prescribing
			 psychologist's relevant education, training, experience, and
			 competence.
j.
Expectations
			 and responsibilities.
A description of the expectations and
			 responsibilities of the collaborative relationship.
k.
Specialization.
A
			 description of the specialized training the prescribing psychologist has
			 completed in order to provide psychopharmacology services to children (less
			 than 17 years of age), elderly persons (over 65 years of age), or patients with
			 serious medical conditions, including but not limited to, heart disease,
			 cancer, stroke, seizures, or comorbid psychological conditions, or patients
			 with developmental disabilities and intellectual disabilities in accordance
			 with subrule 19.3(4).
l.
Chart reviews.
A description of the steps the collaborating
			 physician has taken to personally review a representative sample of the
			 prescribing psychologist's patient charts.
m.
Consultation between the
			 collaborating physician and the primary care provider.
A requirement
			 that the collaborating physician consult with the patient's primary care
			 physician on a regular basis regarding the patient's psychotropic treatment
			 plan and any potential complications.
n.
Performance evaluations.
A description of the steps the collaborating physician has taken to regularly
			 evaluate the clinical judgment, skills and performance of the prescribing
			 psychologist to safely provide psychopharmacology services to patients and
			 provide appropriate feedback to the prescribing psychologist.
o.
Termination of the collaborative
			 practice agreement.
A provision describing how the collaborative
			 practice agreement may be terminated and the process for notifying affected
			 patients.
p.
Signatures.
Signatures of the collaborating physician and the
			 prescribing psychologist.