SSB 5112
In CommitteeSenate
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, aiming to increase access to mental health care by expanding the scope of practice for qualified psychologists. It establishes strict education, training, and oversight requirements, including collaboration with medical providers and limitations on prescribing certain drugs like opioids (except for opioid use disorder treatment).
- Creates a new 'prescribing psychologist' certification that allows licensed psychologists who meet specific education, training, and examination requirements to prescribe psychotropic medications.
- Sets rigorous training standards, including a master’s degree in clinical psychopharmacology (at least 400 contact hours), 80 hours of supervised physical assessment, and a 500-hour clinical prescribing fellowship with at least 100 patients.
- Limits prescribing authority to psychotropic medications used for 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 Board of Psychology to include one expert in psychiatric prescribing (e.g., a prescribing psychologist, physician, or psychiatric nurse practitioner) and updates board rules for certifying, renewing, and disciplining prescribing psychologists.
- Includes sunset provisions: Sections 6 and 8 expire October 1, 2025, and Sections 12 and 13 (related to nurse delegation) expire June 30, 2027, and take effect June 30, 2027, respectively.
Who is affected
- Psychologists — Psychologists in Washington who meet the new training and certification requirements can become authorized to prescribe psychotropic medications, expanding their scope of practice.
- Patients with mental health conditions — Patients in Washington—especially those in underserved areas or with limited access to psychiatrists—may gain improved access to mental health care and medication management through psychologists with prescriptive authority.
- Medical providers — Medical providers (e.g., physicians, nurse practitioners) may need to establish collaborative relationships with prescribing psychologists to ensure coordinated medical oversight for patients receiving psychotropic medications.
- State agencies and licensing boards — The Washington State Department of Health and the Board of Psychology will be responsible for implementing, administering, and overseeing the new certification process, including rulemaking, licensing, and enforcement.
Pro/Con Analysis
Stronger case for benefits
Potential Benefits (5)
Addresses a critical access gap: Washington has only ~150 psychiatrists for ~1.3 million adults with mental illness, and 55% of those needing care receive none; allowing psychologists to prescribe expands access to medication-based mental health treatment—especially in rural and underserved communities—where psychiatrists are scarce.
HealthcarePeopleRef: Sec. 1 (Findings)Establishes rigorous, evidence-based training standards (400+ contact hours in psychopharmacology, 80 hours physical assessment, 500-hour fellowship), modeled on successful DoD and Indian Health Service programs, ensuring safe and competent prescribing while reducing risks of misdiagnosis or adverse drug events.
HealthcarePeopleRef: Sec. 3(2)(c)–(l) & Sec. 4(1)May reduce out-of-pocket costs for patients by expanding access to lower-cost mental health providers (psychologists typically bill at lower rates than psychiatrists), and allows dually licensed professionals (e.g., MD/PhD) to obtain certification by waiver, accelerating workforce expansion.
HealthcarePeopleRef: Sec. 1 (Findings) & Sec. 3(4)Creates a pathway for credentialing by endorsement for psychologists trained in federal programs (e.g., DoD), enabling rapid integration of experienced prescribing psychologists into the state workforce without duplicative training.
HealthcarePeopleRef: Sec. 1 (Findings) & Sec. 3(5)Improves continuity of care by mandating collaboration with medical providers for general health oversight, reducing the risk of missing medical conditions that mimic or interact with psychiatric symptoms—especially important for patients on multiple psychotropic medications.
Public SafetyPeopleRef: Sec. 1 (Findings) & Sec. 4(2)
Potential Concerns (5)
Requires prescribing psychologists to maintain an ongoing collaborative relationship with a medical provider for general medical oversight, which may improve patient safety through interdisciplinary coordination but could create logistical barriers to care in rural or provider-shortage areas where such collaboration is difficult to arrange.
Public SafetyRef: Sec. 4(2)Prohibits prescribing psychologists from prescribing most opioids, except for opioid use disorder treatment, which reduces risk of misuse and diversion but may limit treatment options for patients with complex pain conditions who would otherwise benefit from integrated mental health and pain management.
Public SafetyRef: Sec. 4(3)Requires a 500-hour clinical prescribing fellowship with at least 100 patients under supervision, which ensures robust training but may significantly delay implementation and increase time-to-credentialing, potentially slowing access gains for patients in underserved areas.
HealthcareRef: Sec. 3(2)(e)Amends Board composition to include one expert in psychiatric prescribing, which enhances board expertise but adds administrative complexity to board operations and could slow rulemaking or disciplinary processes during early implementation.
Local GovernmentRef: Sec. 5Expands nurse delegation authority to include administration of medications under the direction of a *prescribing psychologist*, which increases scope of practice for nurses and supports team-based care but introduces new supervisory responsibilities and potential liability concerns for RNs in community-based and home settings.
HealthcareRef: Sec. 12 & 13 (amending RCW 18.79.260)
Who Is Most Affected
Psychologists who complete the new certification gain expanded scope of practice, higher earning potential, and greater autonomy in treatment planning. However, they must invest 1–2 years and $20K–$40K in additional training, and face increased liability exposure and supervision requirements.
Patients in rural, low-income, or underserved communities stand to gain significantly—especially those with depression, anxiety, PTSD, or bipolar disorder—by gaining access to integrated mental health and medication management without long wait times or travel to specialists.
Physicians, nurse practitioners, and other medical providers may face increased administrative burden from collaborative oversight responsibilities, but also benefit from reduced referral backlogs and improved team-based care coordination. Some may resist scope creep, fearing loss of control over pharmacotherapy.
The Department of Health and Board of Psychology will face startup costs for rulemaking, licensing, and oversight, but no new ongoing appropriation is required due to fee-based funding. The board’s new expert member improves regulatory capacity but increases complexity.