Louisiana Medical Psychologists Gain Prescriptive Authority

By Glenn Ally, Ph.D.
September 1, 2004



After 10 days of consideration, Louisiana Gov. Kathleen Babineaux Blanco on May 6 signed House Bill 1426 into law, granting Louisiana medical psychologists the authority to prescribe psychotropic medications.

Her signature was the culmination of a decade of hard and persistent work by a core of dedicated psychologists. The bill was strongly supported by the Louisiana Psychological Association, the Louisiana Academy of Medical Psychologists and the American Psychological Association (APA).

The movement for prescriptive authority, spanning a decade in Louisiana, has been led from conception to completion by John Bolter, Ph.D., and James Quillin, Ph.D. Bolter not only conceived the idea, he was instrumental in developing the curriculum, securing an approved masters degree university program, lobbying legislators and presenting each bill before the legislature.

Quillin has been the master orchestrator of the political movement aimed at making his vision a reality. He assembled and directed a cadre of psychologists who were willing to sacrifice time, energy and money in order to accomplish this vision. He developed a strategic political plan and tirelessly executed that plan to its completion. Although it may have seemed like an overnight success, this arduous process was indeed the product of the entire 10 years.

Louisiana’s first RxP bill was introduced in 1997. Though it passed the House Health & Welfare Committee, the bill languished. A second bill was introduced in 1999 and passed both House and Senate Health & Welfare Committees. However, after several state legislatures passed resolutions condemning APA for certain published articles (the “Dr. Laura” story), our bill was withdrawn.

Another bill was introduced in 2001 but did not fare well. The next opportunity, 2003, was an election year and friendly legislators requested we not introduce a bill that year. Respecting our friends’ wishes, we started gearing up for 2004.

Our bill was introduced in the upper chamber by Senate President Donald “Doc” Hines, M.D., and in the House by Speaker Joe R. Salter in April. First, the bill had to be heard before Health & Welfare Committees in both the House and Senate. The bill was introduced to the Senate H&W Committee by Hines and presented by Bolter, Anita Brown, Ph.D., and Carolyn Baker, M.D. Brown you may recognize as a Department of Defense Pharmacology program graduate. Baker is a neurologist.

The opponents presented testimony from two psychiatrists and a pediatrician. After debate the bill was voted out of committee 4-3 in favor.

Even before the Senate H&W vote had been completed, the presenting team raced across the Capitol building to the House where the committee was already hearing our bill. Again, Bolter, Brown and Baker presented our side, and again the two psychiatrists and pediatrician presented the opposing side.

After some debate and spirited questioning of the opponents by State Rep. Monica Walker and others on the committee, the final vote was 12 to 5 in favor.

On April 19, HB 1426 moved to the House floor. Introduced by Speaker Salter, the microphone was turned over to State Rep. William Daniel, a strong supporter, to field questions from the House floor. He did a superb job in presenting the bill and defending it from unfriendly amendments. To simply say that our bill passed on a vote of 63 to 31 would be an injustice to the psychologists who worked tirelessly over that week and over an entire decade preparing legislators to make it happen. As we were watching the proceedings, Dr. Bolter leaned over and said, “Guys, we are watching history being made.”

Excitement was building and it was on to the Senate. April 21 was a day of emotional ups and downs as the bill was lobbied intensely by both sides. During the night of April 20, some of our favorable votes were not as strong as we previously thought. Our straw poll count indicated we might not have enough votes. Previously, we had counted 23 favorable votes and 20 votes are required to pass a bill.

Sen. Hines began talking to senators the evening of April 20 and by the end of the evening, we were back to a favorable count. However, when the bill came up for consideration, a few of our supporters were missing. The lobbying teams scurried to find those who were supportive and to get them to the chamber to vote. After debate and attempts at unfriendly amendments by the opposition, the vote was called — 21 in favor, 16 opposed. It passed with one vote to spare.

While the reaction by the lobbying team in the Senate chamber was a subdued elation, we filed out of the chamber into the rotunda where the emotion of the moment burst. As we hugged each other and placed calls to spread the news, many others came to congratulate us. Even a few of the 13 lobbyists hired by the opposition came over to offer their congratulations.

But, it was not over.

There were some technical difficulties with the bill and it had to go back to the House for a vote of concurrence. Normally, this could take a day or two and there was concern with additional time the opposing lobbying team would mount another attack. Our amazing lobbyists, Jim Nickel and Bud Courson, managed to get the bill heard just moments after the favorable vote in the Senate.

So as to not alert our opposition, we all stayed on the Senate side “celebrating” which seemed to keep the opposing lobbyists there to watch.

We were in contact with the House side by telephone. When the bill was about to be taken out of order and considered, we left the Senate side and rushed to the House. The vote was 68 in favor and 30 opposed.

It was done! The bill had passed the legislature virtually the way we had written it.

There was just one last hurdle. We needed the governor’s signature.

During the 2003 gubernatorial campaign, she had pledged to reform health care in Louisiana and made it known she would take a slow and deliberate approach in doing so. Gov. Blanco considered the bill for the full 10 days allowed under Louisiana’s constitution.

During that time, she received a steady stream of faxes, e-mails and telephone calls from both sides of the issue and from across the country. She had an audience with representatives of the opposition and meetings with the Speaker of the House and President of the Senate. Those were the most tense and longest 10 days our lobbying team had to endure.

Then, true to her campaign promise to improve access to quality health care in Louisiana, the governor signed the medical psychology bill, HB 1426, into law.
CE
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Glenn Ally, Ph.D., is a clinical neuropsychologist who is now a medical psychologist as well. He has been in private practice in Lafayette, La. for the past 25 years. He is the Louisiana Delegate to APA Council and is active in Divisions 42, 55, 31, and 40. He can be contacted by email at gaally@aol.com

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