Hawaii bill would let psychologists prescribe meds on Big Island, Kauai

SB 847 would let selected clinical psychologists prescribe psychotropic drugs in Hawaii County and Kauai County under a tightly limited pilot program. Psychiatrist access is thin in those counties, and much of Hawaii is already a federal mental health professional shortage area.

The bill text set the pilot to begin July 1, 2028, and run for three years. Only clinical psychologists licensed under chapter 465 would qualify, and only patients ages 18 to 65 who are already under that psychologist’s care could receive prescriptions. The drugs would be limited by a formulary, and the prescriptions would have to be made under supervision by a physician or psychiatrist.

The bill also put the State Health Planning and Development Agency in charge of administering the pilot with the Board of Psychology, which would have to adopt rules before the program could operate. One amended version made prescriptions eligible for Medicaid reimbursement to the extent they would otherwise be covered if written by a psychiatrist.

Hawaii’s mental health workforce is uneven, and many residents on the Big Island and Kauai face long waits for specialty care. The Legislature found that prescriptive authority for psychologists is already used in federal facilities and in states including Colorado, Idaho, Illinois, Iowa, Louisiana, New Mexico and Utah.

The Hawaii Medical Association opposed the plan, arguing that psychologists are trained in assessment and psychotherapy but should not prescribe psychotropic drugs. The American Medical Association filed a strong objection as well, arguing that psychologists do not have a medical background. State Health Planning and Development Agency testimony acknowledged shortages of both psychiatrists and psychologists and opposition from psychiatrists, the AMA and HMA to psychiatrist prescribing.

SB 847 passed final reading in the Senate on May 6, 2026, and was enrolled to the governor on May 8, 2026.