## Facts

- Department of Health Services regulations historically required a psychiatrist to take charge of diagnosis and treatment for all patients admitted to psychiatric hospital units.
- The Legislature enacted Health & Safety Code § 1316.5 (1978), authorizing hospitals to include licensed psychologists on staff and to assign them professional responsibilities consistent with licensure and competence.
- In 1980, § 1316.5 was amended to require that, when both physicians and psychologists can lawfully perform a service offered by a hospital, the service may be performed by either “without discrimination.”
- In 1983, the Department issued regulations that continued to require psychiatrist control and barred psychologists from having primary responsibility for diagnosis and treatment of hospitalized psychiatric patients.
- Psychologists and their association sought declaratory relief, alleging the regulations conflicted with § 1316.5 and unlawfully restricted psychologists’ hospital practice.
- The trial court granted summary judgment for plaintiffs, declared key regulations invalid, and ordered the Department to adopt replacement regulations consistent with § 1316.5.
- The Court of Appeal reversed, construing the antidiscrimination language narrowly and upholding the psychiatrist-in-charge requirement.
- The California Supreme Court granted review.

## Issues

1. Whether Health & Safety Code § 1316.5 permits hospitals to allow licensed clinical psychologists to assume primary responsibility for diagnosis and treatment of hospitalized patients when within the scope of their licensure and competence.
2. Whether Department regulations requiring a psychiatrist to “take charge” of diagnosis and treatment for hospitalized psychiatric patients are invalid because they conflict with § 1316.5’s nondiscrimination requirement.

## Decision

- The California Supreme Court reversed the Court of Appeal and reinstated the trial court’s judgment.
- The Court held that hospitals may permit licensed clinical psychologists to assume primary responsibility for diagnosis and treatment of hospitalized patients to the extent those responsibilities fall within licensure and competence.
- The Court held the Department’s psychiatrist-control regulations invalid to the extent they categorically reserved primary responsibility to psychiatrists and prevented psychologists from providing services they are licensed to perform.
- The Court approved relief requiring replacement regulations consistent with § 1316.5.

## Legal Principles

- When a statute authorizes nondiscriminatory performance of hospital services by either physicians or psychologists, an agency may not impose categorical supervisory hierarchies that deny psychologists primary responsibility for services within their lawful scope of practice.
- An administrative agency may not adopt regulations that alter or amend a statute, or frustrate the Legislature’s policy choice expressed in statutory text.
- Health & Safety Code § 1316.5 does not expand psychologists’ licensure; it restricts hospital and regulatory discrimination in assigning responsibilities that psychologists are already licensed and competent to perform.
- Statutory “without discrimination” language can bar structural rules that reserve core clinical responsibility to one profession when the other is legally authorized to provide the same service.

## Conclusion

The Court held that § 1316.5 requires nondiscriminatory allocation of hospital mental health services that psychologists are licensed to perform, invalidating regulations that mandated psychiatrist control and barred psychologists from assuming primary responsibility within their lawful scope of practice.


Cal. Ass’n of Psychology Providers v. Rank, 51 Cal. 3d 1, 270 Cal. Rptr. 796, 793 P.2d 2 (Cal. 1990)