HB 1124
In CommitteeHouse
Prescribing psychologists
Establishing a prescribing psychologist certification in Washington state.
This status may be delayed. See Action History below for the latest updates.
How does a bill become law?
- Introduced: The bill is filed and assigned a number.
- Committee: A subject-matter committee holds hearings, takes public testimony, and decides whether to advance the bill.
- Floor Vote: The full chamber (House or Senate) debates and votes on the bill.
- Opposite Chamber: The bill repeats the committee and floor vote process in the other chamber.
- Governor: The Governor reviews the bill and decides whether to sign or veto it.
- Signed: The bill has been signed into law.
AI Analysis
This bill creates a new certification for psychologists in Washington to prescribe psychotropic medications after completing specialized training and supervised experience. It aims to expand access to mental health care, especially in underserved areas, by allowing qualified psychologists to provide medication management as part of mental health treatment.
- Creates a new 'prescribing psychologist' certification for licensed psychologists who complete specialized training in psychopharmacology, including a master’s degree in clinical psychopharmacology, 80 hours of supervised physical assessment training, and a 500-hour clinical fellowship.
- Limits prescriptive authority to psychotropic medications used to treat mental, emotional, cognitive, and behavioral disorders; explicitly prohibits prescribing opioid medications except for treatment of opioid use disorder.
- Requires prescribing psychologists to maintain an ongoing collaborative relationship with a medical provider overseeing the patient’s general medical care.
- Amends the composition of the Washington State Board of Psychology to include one expert on psychiatric prescribing (e.g., a prescribing psychologist, physician, or psychiatric nurse practitioner).
- Allows for certification by endorsement for psychologists already certified in other states or trained through federal programs like the Department of Defense.
Who is affected
- Licensed psychologists in Washington — Psychologists licensed in Washington who meet the new training and experience requirements can apply for a new 'prescribing psychologist' certification, allowing them to prescribe certain mental health medications.
- Residents seeking mental health treatment — Patients in Washington may gain improved access to mental health care, especially in areas with shortages of psychiatrists or primary care providers, as psychologists with prescriptive authority can provide medication management as part of mental health treatment.
- Medical providers who collaborate with prescribing psychologists — Medical providers (e.g., physicians, nurse practitioners) must establish and maintain a collaborative relationship with prescribing psychologists to oversee patients' general medical care when psychotropic medications are prescribed.
- State regulatory agencies (Board of Psychology and Department of Health) — The Washington State Board of Psychology and Department of Health will be responsible for implementing and overseeing the new certification process, including rulemaking, licensing, and enforcement.
Pro/Con Analysis
Stronger case for benefits
Potential Benefits (5)
Expanding prescriptive authority to qualified psychologists will significantly increase access to integrated mental health care—especially in rural and underserved areas where psychiatrists are scarce—reducing wait times and enabling earlier intervention.
HealthcarePeopleRef: Sec. 2(5) & Sec. 3The endorsement pathway for psychologists certified in other states or trained in federal programs (e.g., DoD) will accelerate workforce expansion by allowing experienced providers to join Washington’s system without duplicative training, directly benefiting patients in shortage areas.
HealthcarePeopleRef: Sec. 2(5) & Sec. 3(5)Limiting prescriptive authority to psychotropic medications (excluding opioids except for OUD) and requiring supervision of general medical care reduces risk of misuse and ensures patient safety, while maintaining accountability through recordkeeping and no delegation provisions.
Public SafetyPeopleRef: Sec. 4(1) & Sec. 4(6)Including an expert on psychiatric prescribing on the Board of Psychology improves regulatory expertise and ensures policy decisions reflect current scope-of-practice realities, enhancing public protection and responsiveness to evolving mental health needs.
Local GovernmentPeopleRef: Sec. 5 (Board composition)The bill’s findings explicitly cite high unmet mental health needs (over half of adults with mental illness receiving no treatment) and projected physician shortages, providing strong justification for scope expansion and aligning with evidence from DoD, Indian Health Service, and other states with similar programs.
HealthcarePeopleRef: Sec. 2(1)–(5) (Findings)
Potential Concerns (5)
Mandating a collaborative relationship with a medical provider for every patient receiving psychotropic medication may create administrative burden and potential delays in care, especially in rural or provider-scarce areas where finding a collaborating physician or NP is already difficult.
Public SafetyPeopleRef: Sec. 4(2)The prohibition on prescribing opioids—except for opioid use disorder treatment—may limit clinical flexibility for prescribing psychologists managing complex comorbid pain and mental health conditions, potentially forcing patients to seek care from less familiar providers and fragmenting treatment.
Public SafetyPeopleRef: Sec. 4(3)Adding one expert on psychiatric prescribing to the nine-member Board of Psychology increases board complexity and may require additional staff support for rulemaking and oversight, though the fiscal impact statement indicates no significant new spending.
Local GovernmentRef: Sec. 5 (Board composition change)The 500-hour clinical fellowship and 100-patient requirement may be a significant barrier for many practicing psychologists, especially those in solo practice or without access to supervised fellowship slots, potentially limiting participation to those affiliated with large health systems or academic institutions.
HealthcarePeopleRef: Sec. 3(2)(f)Requiring a master’s degree in clinical psychopharmacology (minimum 400 contact hours over two years) adds time and financial cost to career pathways, which may disproportionately burden psychologists without employer tuition assistance or those in lower-income regions.
EducationPeopleRef: Sec. 3(2)(c)
Who Is Most Affected
Psychologists who complete the new certification gain expanded scope and potential for higher compensation, especially those in underserved areas or integrated care settings. However, those unable or unwilling to pursue the credential may face competitive disadvantage.
Patients in mental health provider shortages (rural, low-income, communities of color) stand to gain significantly from improved access to integrated medication and therapy. However, those in areas with robust psychiatrist availability may see little change.
Medical providers (MDs, NPs) will need to establish and maintain collaborative agreements, which may increase administrative workload but could improve care coordination and reduce burden from routine psych med management, allowing them to focus on complex medical cases.
The Department of Health and Board of Psychology will gain new regulatory responsibilities, requiring rulemaking and oversight capacity. However, fee-funded implementation and no significant new spending reduce fiscal strain.
Large health systems and academic medical centers with fellowship training infrastructure will benefit most from workforce expansion, while small private practices may struggle with training costs and collaboration logistics.