California psychologists win state hospital privileges

By John Thomas Associate Editor
July 1, 2005



Fifteen years after the California Supreme Court ruled that psychologists have full hospital privileges, the state’s Department of Health Services issued new regulations extending those rights to psychologists at acute care state hospitals.

The regulations specifically allowing psychologists to admit, transfer and discharge patients and order procedures related to the care of mentally ill patients also follows several laws and three study commissions that ordered the California Department of Mental Health to implement the 1990 State Supreme Court ruling in Capp v. Rank.

“This is a decisive victory for the patients of psychologists in public service,” said David Lechuga, Ph.D., president of the California Psychological Association (CPA). “It is also a satisfying victory for all citizens of California when the thousands of patients in California’s state hospitals experience an increase in the quality of their care.”

Bill Safarjan, Ph.D., staff psychologist at Atascadero State Hospital, said the threat of a lawsuit to force the state to recognize the right of psychologists to practice independently and direct patient care was an important factor in convincing the Department of Health Services to issue the new regulations.

Safarjan heads Psychology Shield, a not-for-profit organization that planned to file a lawsuit forcing the state to comply with the court ruling and several state laws granting psychologists in state institutions full hospital privileges.

The first law giving psychologists hospital privileges was passed by the California State Legislature in 1978, which was upheld by the State Supreme Court in Capp v. Rank. But despite the court ruling and subsequent acts of the legislature, psychiatrists and the state’s medical establishment refused to comply. The most recent development was in 2002 when the California Department of Mental Health issued a special order that placed psychologists firmly under the clinical authority of psychiatrists and banned psychologists from being attending clinicians and from having primary responsibility for patient care.

Safarjan and Charles Faltz, Ph.D., director of professional affairs for the CPA, said Psychology Shield would continue to press state rule makers to extend the new regulations to intermediate care facilities and to write additional rules to achieve full enforcement of the law.

CPA president Lechuga added, “The new regulations will provide broader treatment options and more cost-efficient and higher quality patient care. This is a long overdue, but important step to providing quality care to some of our state’s most vulnerable citizens.”

The regulations are being challenged in a lawsuit filed by the California Psychiatric Association and the Union of Physicians and Dentists.

There are about 700 state-employed psychologists in California, with about 200 of them in the Department of Mental Health. About 350 are employed in the Department of Corrections and 150 in the Department of Developmental Services.

California psychologists already have hospital privileges in private hospitals.

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