Legislative Session 2006 in Review

The Hawaii Psychological Association (HPA) continues to make steady progress to secure prescriptive authority (RxP) for psychologists who work in medically underserved areas across the state. Psychologists employed in federally qualified health centers and other Native Hawaiian clinics have maintained support from physicians, other allied health professionals, and associations (for eg., the Hawaii Primary Care Association and the Hawaii Medical Services Administration, as the largest health insurance company in the state) because of their work within these primary care settings where psychiatrists are scarce and mental health needs are vast. More legislative support was gained during the past 2006 session through the work of Rep. Josh Green, M.D. (D-Kona), an emergency room physician who lives and practices in rural West Hawaii (Big Island), and serves as the vice-chair for the House Health Committee. Representative Green’s unique contributions, derived from the combination of a health practitioner’s understanding with legislative experience, provided tremendous help in sustaining this year’s bill (H.B. 2589) through the House Health and Consumer Protection Committee hearings, where lively debates were heard as both proponents and opponents delivered testimony that kept hearings in session for at least 2-3 hours. H.B. 2589 passed successfully out of the House for the first time in Hawaii’s RxP history with a 29-21 vote (1 excused).

The RxP bill continued on in the Senate with slightly more of a challenge: it had been killed during the 2005 session in a floor vote that resulted in gridlock (12 aye, 12 no, 1 excused). The senator who had not been present for the vote later indicated that he would have voted in support but fell ill the day of the vote; as luck would have it, this was his first and only vote absence during his 13 year tenure as a state senator. The Senate champion for the bill remains Senator Roz Baker, Chair of the Health Committee and vice-chair of the Senate Consumer Protection Committee, who fought valiantly for the bill and refused to allow psychiatry to embellish their testimony with “outrageous and melodramatic” claims. Unfortunately, the Chair of the Senate Consumer Protection Committee, Senator Ron Menor, was unshakable in his final decision to not move the bill out of his committee. What did result was a committee approved resolution, SCR 113, which calls for a study to be conducted by the Legislative Reference Bureau (LRB). The rationale for the study is to rescue the bill from yet more obstacles from the opposition. The training curriculum and patient safety data will be, again, examined and presented by an objective legislative body. This should discourage the medical establishment’s fact distortions that confuse lawmakers and other groups (i.e., consumer advocates) and frighten them away from voting for the bill.

The Next Steps

The HPA RxP Committee has already provided the LRB with all the relevant materials to help document the history and legitimacy of the training curriculum and its proven success as indicated by various reports and articles written about the Department of Defense’s Psychopharmacology Demonstration Project. Understanding the nature of this study, committee representatives have been in contact with those in charge of the study to offer assistance as requested, however, remain respectful of the process in order that the final report issued will serve its intended purpose to provide an objective appraisal of the issues that surround the Hawaii RxP legislation. It’s reinforcing to know that the action to complete this study has begun, since the final report will play a significant role in the next legislative session scheduled to reconvene in January, 2007.

The Hawaii political scene is also facing an election year which can only be characterized as tumultuous. No less than 12 candidates, 6 of whom currently serve in the State Legislature, are vying for the U.S. Congressional seat, which is to be vacated by Representative Ed Case. Adding to the chaos is that 5 of the 6 candidates have nothing to lose as, under Hawaii law, they are allowed to hold their current state elected offices while seeking election to a national seat. The unwanted fallout of this election anomaly is that important political issues have taken a backseat to grandiose campaign promises and political deal-making.

Call for Support

In the lessons learned category, HPA now realizes that we can no longer sit on the sidelines of Hawaii’s political games. We are humbly asking for financial support at a local and national level as we prepare to fill our coffers in preparation for the upcoming elections and the 2007 legislative session. It is in 2007 that we are fervently hoping to join the ranks of New Mexico and Louisiana by becoming the third state to obtain prescriptive authority for psychologists. Donations, large and small, are welcome, payable to HI-PSY PAC. These donations can be mailed to Hawaii Psychological Association, ATTN: Carol Parker, 1188 Bishop St., Ste. 912, Honolulu, HI 96813.

Jill Oliveira, Ph.D. and Robin Miyamoto, Psy.D.
Hawaii Psychological Association
Co-chairs, RxP Committee