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S1412aa..............................................by JUDICIARY AND RULES
PHARMACISTS - Amends existing law relating to pharmacists to revise
definitions; to permit electronic signatures and transmission of
prescription drug orders; to permit prescription drug orders to be sent by
facsimile transmission from a health care facility to the prescription
department of a pharmacy; and to permit prescription drug orders to be
received by a pharmacist verbally or by facsimile transmission.
02/20 Senate intro - 1st rdg - to printing
02/21 Rpt prt - to Health/Wel
02/23 Rpt out - to 14th Ord
02/28 Rpt out amen - to engros
03/01 Rpt engros - 1st rdg - to 2nd rdg as amen
03/02 2nd rdg - to 3rd rdg as amen
03/06 3rd rdg as amen - PASSED - 33-0-2
AYES -- Andreason, Brandt, Broadsword, Bunderson, Burkett,
Burtenshaw, Cameron, Coiner, Compton, Corder, Darrington, Davis,
Fulcher, Gannon, Geddes, Goedde, Hill, Jorgenson, Kelly, Keough,
Langhorst, Little, Lodge, Marley, McGee, McKenzie, Pearce,
Richardson, Schroeder, Stegner, Sweet, Werk, Williams
NAYS -- None
Absent and excused -- Malepeai, Stennett
Floor Sponsor - Coiner
Title apvd - to House
03/07 House intro - 1st rdg - to Health/Wel
03/15 Rpt out - rec d/p - to 2nd rdg
03/16 2nd rdg - to 3rd rdg
03/24 3rd rdg - PASSED - 66-0-4
AYES -- Anderson, Andrus, Barraclough, Barrett, Bastian, Bayer,
Bedke, Bell, Bilbao, Black, Block, Boe, Bolz, Brackett, Cannon,
Chadderdon, Clark, Collins, Crow, Deal, Denney, Edmunson, Ellsworth,
Eskridge, Field(18), Field(23), Garrett, Hart, Harwood, Henbest,
Henderson, Jaquet, Kemp, Lake, LeFavour, Loertscher, Martinez,
Mathews, McGeachin, McKague, Miller, Moyle, Nielsen, Nonini,
Pasley-Stuart, Pence, Raybould, Ring, Ringo, Roberts, Rusche,
Rydalch, Sali, Sayler, Schaefer, Shepherd(2), Shepherd(8), Shirley,
Skippen, Smith(30), Smylie, Snodgrass, Stevenson, Wills, Wood, Mr.
Speaker
NAYS -- None
Absent and excused -- Bradford, Mitchell, Smith(24), Trail
Floor Sponsor - Loertscher
Title apvd - to Senate
03/27 To enrol
03/28 Rpt enrol - Pres signed
03/29 Sp signed
03/30 To Governor
03/31 Governor signed
Session Law Chapter 290
Effective: 03/31/06
]]]] LEGISLATURE OF THE STATE OF IDAHO ]]]]
Fifty-eighth Legislature Second Regular Session - 2006
IN THE SENATE
SENATE BILL NO. 1412
BY JUDICIARY AND RULES COMMITTEE
1 AN ACT
2 RELATING TO PHARMACISTS; AMENDING SECTION 54-1705, IDAHO CODE, TO REVISE DEF-
3 INITIONS AND TO MAKE TECHNICAL CORRECTIONS; AMENDING SECTION 54-1733,
4 IDAHO CODE, TO PERMIT ELECTRONIC SIGNATURES AND TRANSMISSION OF PRESCRIP-
5 TION DRUG ORDERS, TO PERMIT PRESCRIPTION DRUG ORDERS TO BE SENT BY FACSIM-
6 ILE TRANSMISSION FROM A HEALTH CARE FACILITY TO THE PRESCRIPTION DEPART-
7 MENT OF A PHARMACY, TO PERMIT PRESCRIPTION DRUG ORDERS TO BE RECEIVED BY A
8 PHARMACIST VERBALLY OR BY FACSIMILE; AMENDING SECTIONS 37-3201, 54-4702
9 AND 54-5110, IDAHO CODE, TO PROVIDE FOR CORRECT CODE CITATIONS; AND
10 DECLARING AN EMERGENCY.
11 Be It Enacted by the Legislature of the State of Idaho:
12 SECTION 1. That Section 54-1705, Idaho Code, be, and the same is hereby
13 amended to read as follows:
14 54-1705. DEFINITIONS. In this chapter:
15 (1) "Board of pharmacy" or "board" means the Idaho state board of phar-
16 macy.
17 (2) "Counseling or counsel" means the effective communication by the
18 pharmacist of information as set out in this chapter, to the patient or
19 caregiver, in order to improve therapeutic outcomes by maximizing proper use
20 of prescription medications and devices. Specific areas of counseling shall
21 include, but are not limited to:
22 (a) Name and strength and description of the medication;
23 (b) Route of administration, dosage, dosage form, continuity of therapy
24 and refill information;
25 (c) Special directions and precautions for preparation, administration,
26 storage and use by the patient as deemed necessary by the pharmacist;
27 (d) Side effects or adverse effects and interactions and therapeutic
28 contraindications that may be encountered, including their avoidance,
29 which may interfere with the proper use of the medication or device as was
30 intended by the prescriber, and the action required if they occur;
31 (e) Techniques for self-monitoring drug therapy; and
32 (f) Action to be taken in the event of a missed dose.
33 (3) "Deliver" or "delivery" means the actual, constructive or attempted
34 transfer of a drug or device from one (1) person to another, whether or not
35 for a consideration.
36 (4) "Device" means an instrument, apparatus, implement, machine, contriv-
37 ance, implant, invitro in vitro reagent or other similar related article
38 including any component part or accessory which is:
39 (a) Recognized in the official United States Pharmacopoeia or official
40 National Formulary, other drug compendia or any supplement to them;
41 (b) Intended for use in the diagnosis of disease or other conditions, or
42 the cure, mitigation, treatment or prevention of disease in man or other
43 animal;
2
1 (c) Intended to effect the structure or any function of the body of man
2 or other animal, and which does not achieve any of its principal intended
3 purposes through chemical action within or on the body of man or other
4 animal, and which is not dependent upon being metabolized for the achieve-
5 ment of any of its principal intended purposes.
6 (5) "Dispense" or "dispensing" means the preparation and delivery of a
7 prescription drug pursuant to a lawful order of a practitioner in a suitable
8 container appropriately labeled for subsequent administration to or use by a
9 patient or other individual entitled to receive the prescription drug.
10 (6) "Distribute" means the delivery of a drug other than by administering
11 or dispensing.
12 (7) "Drug" means:
13 (a) Articles recognized as drugs in the official United States Pharmaco-
14 poeia, official National Formulary, official Homeopathic Pharmacopoeia,
15 other drug compendia or any supplement to any of them;
16 (b) Articles intended for use in the diagnosis, cure, mitigation, treat-
17 ment or prevention of disease in man or other animal;
18 (c) Articles, other than food, intended to affect the structure or any
19 function of the body of man or other animals; and
20 (d) Articles intended for use as a component of any articles specified in
21 paragraph (a), (b) or (c) of this subsection.
22 (8) "Drug order" means a written order, in a hospital or other health
23 care institution, for an ultimate user of any drug or device issued and signed
24 by a practitioner, or an order transmitted by other means of communication
25 from a practitioner, which is immediately reduced to writing by a pharmacist,
26 registered nurse or other licensed health care practitioner authorized by the
27 hospital or institution. The order shall contain the name and bed number of
28 the patient, the name and strength or size of the drug or device, unless spec-
29 ified by individual institution policy or guideline, the amount to be dis-
30 pensed, either in quantity or days, adequate directions for the proper use of
31 the drug or device when it is administered to the patient, and the name of the
32 prescriber.
33 (9) "Drug outlet" means all pharmacies, nursing homes, residential or
34 assisted living facilities, convalescent homes, extended care facilities, drug
35 abuse treatment centers, penal institutions, hospitals, family planning clin-
36 ics, retail stores, wholesalers, manufacturers and mail order vendors with
37 facilities located in this state which are engaged in dispensing, delivery or
38 distribution of drugs and drug manufacturers and wholesalers with facilities
39 located outside the state, but doing business within this state.
40 (10) "Prospective drug review" includes, but is not limited to, the fol-
41 lowing activities:
42 (a) Evaluation of the prescription or medication order for:
43 1. Known allergies;
44 2. Rational therapy contraindications;
45 3. Reasonable dose and route of administration; and
46 4. Reasonable directions for use.
47 (b) Evaluation of the prescription or medication order for duplication of
48 therapy.
49 (c) Evaluation of the prescription or medication order for interactions:
50 1. Drug-drug;
51 2. Drug-food; and
52 3. Drug-disease.
53 (d) Evaluation of the prescription or medication order for proper utili-
54 zation:
55 1. Over or under utilization; and
3
1 2. Abuse/misuse.
2 (11) "Extern" means a bona fide student enrolled in an approved college of
3 pharmacy who has not received his first professional degree in pharmacy.
4 (121) "Externship" means a structured practical experience program in
5 pharmacy, approved by the board and administered by a college of pharmacy.
6 (12) "Health care facility" means a health care facility as defined in
7 section 54-1601, Idaho Code.
8 (13) "Intern" means any person who has completed a course of study at an
9 approved college of pharmacy, received the first professional degree in phar-
10 macy and is registered with the board as an intern. Interns must register with
11 the board prior to commencement of an internship program.
12 (14) "Internship" means a postgraduate practical experience program under
13 the supervision of a preceptor at a preceptor site.
14 (15) "Investigational or new drug" means any drug which is limited by
15 state or federal law to use under professional supervision of a practitioner
16 authorized by law to prescribe or administer such drug.
17 (16) "Labeling" means the process of preparing and affixing of a label to
18 any drug container, exclusive however, of the labeling by a manufacturer,
19 packer or distributor of a nonprescription drug or commercially packaged leg-
20 end drug or device. Any such label shall include all information required by
21 federal and state law or regulation.
22 (17) "Manufacture" means the production, preparation, propagation, com-
23 pounding, conversion or processing of a device or a drug, either directly or
24 indirectly by extraction from substances of natural origin or independently by
25 means of chemical synthesis or by a combination of extraction and chemical
26 synthesis and includes any packaging or repackaging of the substance or label-
27 ing or relabeling of its container, except that this term does not include the
28 preparation or compounding of a drug by an individual for his own use or the
29 preparation, compounding, packaging or labeling of a drug:
30 (a) By a pharmacist or practitioner as an incident to his administering
31 or dispensing of a drug in the course of his professional practice; or
32 (b) By a practitioner or by his authorization under his supervision for
33 the purpose of or as an incident to research, teaching or chemical analy-
34 sis and not for sale.
35 (18) "Manufacturer" means a person who by compounding, cultivating, har-
36 vesting, mixing or other process, produces or prepares legend drugs, and
37 includes persons who prepare such drugs in dosage forms by mixing, compound-
38 ing, encapsulating, entableting, or other process, or who packages or
39 repackages such drugs, but does not include pharmacists or practitioners in
40 the practice of their profession.
41 (19) "Nonprescription drugs" means medicines or drugs which may be sold
42 without a prescription and which are prepackaged for use by the consumer and
43 labeled in accordance with the requirements of the statutes and regulations of
44 this state and the federal government.
45 "Precursor" means a substance, other than a legend drug which is an imme-
46 diate chemical intermediate that can be processed or synthesized into a legend
47 drug, and is used or produced primarily for use in the manufacture of a legend
48 drug by persons other than persons licensed to manufacture such legend drugs
49 by the Idaho board of pharmacy, registered by the state board of health and
50 welfare, or licensed to practice pharmacy by the Idaho board of pharmacy.
51 (20) "Person" means an individual, corporation, partnership, association
52 or any other legal entity.
53 (21) "Pharmaceutical care" means drug therapy and other pharmaceutical
54 patient care services intended to achieve outcomes related to the cure or pre-
55 vention of a disease, elimination or reduction of a patient's symptoms, or
4
1 arresting or slowing of a disease process as defined in the rules of the
2 board.
3 (22) "Pharmacist" means an individual licensed by this state to engage in
4 the practice of pharmacy.
5 (23) "Pharmacy" means any facility, department or other place where pre-
6 scriptions are filled or compounded and are sold, dispensed, offered or dis-
7 played for sale, which has, as its principal purpose, the dispensing of drug
8 and health supplies intended for the general health, welfare and safety of the
9 public.
10 (24) "Practitioner" shall mean a physician, dentist, veterinarian, scien-
11 tific investigator or other person (other than a pharmacist) licensed in this
12 state and permitted by such license to dispense, conduct research with respect
13 to or administer drugs in the course of professional practice or research in
14 this state.
15 (25) "Precursor" means a substance, other than a legend drug which is an
16 immediate chemical intermediate that can be processed or synthesized into a
17 legend drug, and is used or produced primarily for use in the manufacture of a
18 legend drug by persons other than persons licensed to manufacture such legend
19 drugs by the Idaho board of pharmacy, registered by the state board of health
20 and welfare, or licensed to practice pharmacy by the Idaho board of pharmacy.
21 (26) "Preceptor" means a pharmacist licensed in the state and in good
22 standing, who supervises the internship training of a registered intern. The
23 preceptor shall be actively engaged in the practice of pharmacy on a full-time
24 employment basis at a registered preceptor site.
25 (267) "Preceptor site" means any training site for pharmacy interns and
26 externs registered with the board pursuant to board rule.
27 (278) "Prescription drug or legend drug" means a drug which, under federal
28 law is required, prior to being dispensed or delivered, to be labeled with one
29 (1) of the following statements:
30 (a) "Caution: Federal law prohibits dispensing without a prescription";
31 or
32 (b) "Rx Only"; or
33 (c) "Caution: Federal law restricts this drug to use by or on the order
34 of a licensed veterinarian";
35 or a drug which is required by any applicable federal or state law or regula-
36 tion to be dispensed on prescription only or is restricted to use by practi-
37 tioners only.
38 (289) "Prescription drug order" means a lawful written or verbal order of
39 a practitioner for a drug or device for an ultimate user of the drug or
40 device, issued and signed by a practitioner, or an order transmitted verbally
41 from a practitioner or the practitioner's agent to a pharmacist in a pharmacy,
42 or transmitted verbally from a practitioner and immediately reduced to writing
43 by a licensed practical nurse or licensed professional nurse in a health care
44 facility for a patient or resident of such facility.
45 (30) "Prospective drug review" includes, but is not limited to, the fol-
46 lowing activities:
47 (a) Evaluation of the prescription or medication order for:
48 (i) Known allergies;
49 (ii) Rational therapy contraindications;
50 (iii) Reasonable dose and route of administration; and
51 (iv) Reasonable directions for use.
52 (b) Evaluation of the prescription or medication order for duplication of
53 therapy.
54 (c) Evaluation of the prescription or medication order for interactions:
55 (i) Drug-drug;
5
1 (ii) Drug-food; and
2 (iii) Drug-disease.
3 (d) Evaluation of the prescription or medication order for proper utili-
4 zation:
5 (i) Over or under utilization; and
6 (ii) Abuse/misuse.
7 (29) "Nonprescription drugs" means medicines or drugs which may be sold
8 without a prescription and which are prepackaged for use by the consumer and
9 labeled in accordance with the requirements of the statutes and regulations of
10 this state and the federal government.
11 (301) "Record" means all papers, letters, memoranda, notes, prescriptions,
12 drug orders, invoices, statements, patient medication charts or files, comput-
13 erized records or other written indicia, documents or objects which are used
14 in any way in connection with the purchase, sale or handling of any drug or
15 device.
16 (312) "Sale" means every sale and includes:
17 (a) Manufacturing, processing, transporting, handling, packaging or any
18 other production, preparation or repackaging;
19 (b) Exposure, offer, or any other proffer;
20 (c) Holding, storing or any other possession;
21 (d) Dispensing, giving, delivering or any other supplying; and
22 (e) Applying, administering or any other usage.
23 (323) "Warehouseman" means a person who stores legend drugs for others and
24 who has no control over the disposition of such drugs except for the purpose
25 of such storage.
26 (334) "Wholesaler" means a person engaged in the business of distributing
27 legend drugs that he himself has not produced or prepared, to persons included
28 in any of the classes named in subsection (2)(a) through (f) of section
29 54-1734, Idaho Code.
30 SECTION 2. That Section 54-1733, Idaho Code, be, and the same is hereby
31 amended to read as follows:
32 54-1733. VALIDITY OF PRESCRIPTION DRUG ORDERS. (1) A prescription or drug
33 order for a legend drug is not valid unless it is issued for a legitimate med-
34 ical purpose by a practitioner acting in the usual course of his profession,
35 or by a physician, dentist, veterinarian, scientific investigator or other
36 person, other than a pharmacist, who is licensed in a jurisdiction other than
37 the state of Idaho and is permitted by such license to dispense, conduct
38 research with respect to or administer the prescribed legend drugs in the
39 course of his professional practice or research in such jurisdiction, so long
40 as the individual is acting within the jurisdiction, scope and authority of
41 his license when issuing the prescription or drug order.
42 (a) The prescription drug order may be signed and sent electronically
43 pursuant to chapter 50, title 28, Idaho Code.
44 (b) Transmission of prescription drug order. In addition to delivery of
45 the original signed written prescription to a licensed pharmacy:
46 (i) A prescription drug order that has been signed by the practi-
47 tioner may be received by a licensed pharmacy for dispensing purposes
48 through a facsimile transmission from the prescribing practitioner or
49 the practitioner's agent, or from a health care facility for a
50 patient or resident in such facility;
51 (ii) A prescription drug order may also be received by a licensed
52 pharmacy verbally from the practitioner, the practitioner's agent or
53 from a licensed practical nurse or licensed professional nurse in a
6
1 health care facility for a patient or resident in such facility;
2 (iii) A prescription drug order received verbally from the practitio-
3 ner by a licensed practical nurse or licensed professional nurse in a
4 licensed health care facility for a patient or resident in such
5 facility may also be sent by facsimile transmission from the health
6 care facility to a licensed pharmacy for dispensing purposes provided
7 the transmitted document includes the name of the prescriber issuing
8 the prescription drug order, the name and license number of the nurse
9 who transcribed the order and the name of the person who sent the
10 facsimile.
11 (2) It is unlawful for a practitioner to knowingly issue an invalid pre-
12 scription or drug order for a legend drug.
13 (3) It is unlawful for a pharmacist or veterinarian to knowingly fill an
14 invalid prescription or drug order for a legend drug.
15 SECTION 3. That Section 37-3201, Idaho Code, be, and the same is hereby
16 amended to read as follows:
17 37-3201. DEFINITIONS. As used in this chapter:
18 (1) "Code imprint" means a series of letters or numbers assigned by the
19 manufacturer or distributor to a specific drug, or marks or monograms unique
20 to the manufacturer or distributor of the drug, or both;
21 (2) "Distributor" means a person who distributes for resale a drug in
22 solid dosage form under his own label even though he is not the actual manu-
23 facturer of the drug;
24 (3) "Solid dosage form" means capsules or tablets intended for oral use;
25 (4) "Legend drug" means any drug defined by section 54-1705(278), Idaho
26 Code.
27 SECTION 4. That Section 54-4702, Idaho Code, be, and the same is hereby
28 amended to read as follows:
29 54-4702. DEFINITIONS. As used in this chapter:
30 (1) "Acupuncture" means that theory of health care developed from tradi-
31 tional and modern Oriental medical philosophies that employs diagnosis and
32 treatment of conditions of the human body based upon stimulation of specific
33 acupuncture points on meridians of the human body for the promotion, mainte-
34 nance, and restoration of health and for the prevention of disease. Therapies
35 within the scope of acupuncture include manual, mechanical, thermal, electri-
36 cal and electromagnetic treatment of such specific indicated points.
37 Adjunctive therapies included in, but not exclusive to, acupuncture include
38 herbal and nutritional treatments, therapeutic exercise and other therapies
39 based on traditional and modern Oriental medical theory.
40 (2) "Board" means the Idaho state board of acupuncture.
41 (3) "NCCAOM" means "National Certification Commission for Acupuncture
42 and Oriental Medicine."
43 (4) "Practice of acupuncture" means the insertion of acupuncture needles
44 and use of similar devices and therapies, including application of
45 moxibustion, to specific indicated points on the skin of the human body as
46 indicated pursuant to traditional and modern theories of Oriental medicine.
47 The "practice of acupuncture" does not include:
48 (a) surgery; or
49 (b) prescribing, dispensing or administering any prescription drug or
50 legend drug as defined in section 54-1705(278), Idaho Code.
7
1 SECTION 5. That Section 54-5110, Idaho Code, be, and the same is hereby
2 amended to read as follows:
3 54-5110. NATUROPATHIC MEDICAL FORMULARY COUNCIL ESTABLISHED. There is
4 hereby established a naturopathic medical formulary council, which is separate
5 and distinct from the board, to be composed of seven (7) members. Two (2) mem-
6 bers shall be naturopathic physicians licensed under this chapter, appointed
7 by the board of naturopathic medical examiners. Three (3) members shall be
8 pharmacists licensed under chapter 17, title 54, Idaho Code, appointed by
9 the board of naturopathic medical examiners from a list of nominees provided
10 by the Idaho state board of pharmacy. Two (2) members shall be physicians
11 licensed under chapter 18, title 54, Idaho Code, appointed by the board of
12 naturopathic medical examiners from a list of nominees provided by the Idaho
13 state board of medicine. The initial council shall be appointed as follows:
14 One (1) naturopathic physician shall be appointed for a one (1) year term; one
15 (1) physician licensed under chapter 18, title 54, Idaho Code, and one (1)
16 pharmacist shall be appointed for a two (2) year term; and two (2) pharma-
17 cists, one (1) naturopathic physician and one (1) physician licensed under
18 chapter 18, title 54, Idaho Code, shall be appointed for a three (3) year
19 term. Thereafter, the term of office shall be three (3) years. A quorum shall
20 consist of five (5) members and shall be required for any vote to be taken. It
21 shall be the duty of the naturopathic medical formulary council to establish a
22 formulary for use by naturopathic physicians, and immediately upon adoption or
23 revision of the formulary, the council shall transmit the approved formulary
24 to the board, which shall adopt the formulary by temporary rule. The formulary
25 will be reviewed annually by the council, or at any time at the request of the
26 board. The formulary list may not go beyond the scope of prescription medi-
27 cines and medical devices covered by approved naturopathic medical education
28 and training and existing naturopathic medical formularies, or board-approved
29 continuing education. The naturopathic medical formulary shall not include
30 medicines and devices that are inconsistent with the training provided by
31 approved naturopathic medical colleges. Nothing herein shall allow a
32 naturopathic physician to dispense, administer or prescribe any prescription
33 drug as defined in section 54-1705(278), Idaho Code, or medical device unless
34 such prescription drug or medical device is specifically included in the
35 naturopathic medical formulary.
36 SECTION 6. An emergency existing therefor, which emergency is hereby
37 declared to exist, this act shall be in full force and effect on and after its
38 passage and approval.
]]]] LEGISLATURE OF THE STATE OF IDAHO ]]]]
Fifty-eighth Legislature Second Regular Session - 2006
Moved by Coiner
Seconded by Darrington
IN THE SENATE
SENATE AMENDMENT TO S.B. NO. 1412
1 AMENDMENT TO SECTION 2
2 On page 5 of the printed bill, in line 52, delete "pharmacy" and insert:
3 "pharmacist".
]]]] LEGISLATURE OF THE STATE OF IDAHO ]]]]
Fifty-eighth Legislature Second Regular Session - 2006
IN THE SENATE
SENATE BILL NO. 1412, As Amended
BY JUDICIARY AND RULES COMMITTEE
1 AN ACT
2 RELATING TO PHARMACISTS; AMENDING SECTION 54-1705, IDAHO CODE, TO REVISE DEF-
3 INITIONS AND TO MAKE TECHNICAL CORRECTIONS; AMENDING SECTION 54-1733,
4 IDAHO CODE, TO PERMIT ELECTRONIC SIGNATURES AND TRANSMISSION OF PRESCRIP-
5 TION DRUG ORDERS, TO PERMIT PRESCRIPTION DRUG ORDERS TO BE SENT BY FACSIM-
6 ILE TRANSMISSION FROM A HEALTH CARE FACILITY TO THE PRESCRIPTION DEPART-
7 MENT OF A PHARMACY, TO PERMIT PRESCRIPTION DRUG ORDERS TO BE RECEIVED BY A
8 PHARMACIST VERBALLY OR BY FACSIMILE; AMENDING SECTIONS 37-3201, 54-4702
9 AND 54-5110, IDAHO CODE, TO PROVIDE FOR CORRECT CODE CITATIONS; AND
10 DECLARING AN EMERGENCY.
11 Be It Enacted by the Legislature of the State of Idaho:
12 SECTION 1. That Section 54-1705, Idaho Code, be, and the same is hereby
13 amended to read as follows:
14 54-1705. DEFINITIONS. In this chapter:
15 (1) "Board of pharmacy" or "board" means the Idaho state board of phar-
16 macy.
17 (2) "Counseling or counsel" means the effective communication by the
18 pharmacist of information as set out in this chapter, to the patient or
19 caregiver, in order to improve therapeutic outcomes by maximizing proper use
20 of prescription medications and devices. Specific areas of counseling shall
21 include, but are not limited to:
22 (a) Name and strength and description of the medication;
23 (b) Route of administration, dosage, dosage form, continuity of therapy
24 and refill information;
25 (c) Special directions and precautions for preparation, administration,
26 storage and use by the patient as deemed necessary by the pharmacist;
27 (d) Side effects or adverse effects and interactions and therapeutic
28 contraindications that may be encountered, including their avoidance,
29 which may interfere with the proper use of the medication or device as was
30 intended by the prescriber, and the action required if they occur;
31 (e) Techniques for self-monitoring drug therapy; and
32 (f) Action to be taken in the event of a missed dose.
33 (3) "Deliver" or "delivery" means the actual, constructive or attempted
34 transfer of a drug or device from one (1) person to another, whether or not
35 for a consideration.
36 (4) "Device" means an instrument, apparatus, implement, machine, contriv-
37 ance, implant, invitro in vitro reagent or other similar related article
38 including any component part or accessory which is:
39 (a) Recognized in the official United States Pharmacopoeia or official
40 National Formulary, other drug compendia or any supplement to them;
41 (b) Intended for use in the diagnosis of disease or other conditions, or
42 the cure, mitigation, treatment or prevention of disease in man or other
43 animal;
2
1 (c) Intended to effect the structure or any function of the body of man
2 or other animal, and which does not achieve any of its principal intended
3 purposes through chemical action within or on the body of man or other
4 animal, and which is not dependent upon being metabolized for the achieve-
5 ment of any of its principal intended purposes.
6 (5) "Dispense" or "dispensing" means the preparation and delivery of a
7 prescription drug pursuant to a lawful order of a practitioner in a suitable
8 container appropriately labeled for subsequent administration to or use by a
9 patient or other individual entitled to receive the prescription drug.
10 (6) "Distribute" means the delivery of a drug other than by administering
11 or dispensing.
12 (7) "Drug" means:
13 (a) Articles recognized as drugs in the official United States Pharmaco-
14 poeia, official National Formulary, official Homeopathic Pharmacopoeia,
15 other drug compendia or any supplement to any of them;
16 (b) Articles intended for use in the diagnosis, cure, mitigation, treat-
17 ment or prevention of disease in man or other animal;
18 (c) Articles, other than food, intended to affect the structure or any
19 function of the body of man or other animals; and
20 (d) Articles intended for use as a component of any articles specified in
21 paragraph (a), (b) or (c) of this subsection.
22 (8) "Drug order" means a written order, in a hospital or other health
23 care institution, for an ultimate user of any drug or device issued and signed
24 by a practitioner, or an order transmitted by other means of communication
25 from a practitioner, which is immediately reduced to writing by a pharmacist,
26 registered nurse or other licensed health care practitioner authorized by the
27 hospital or institution. The order shall contain the name and bed number of
28 the patient, the name and strength or size of the drug or device, unless spec-
29 ified by individual institution policy or guideline, the amount to be dis-
30 pensed, either in quantity or days, adequate directions for the proper use of
31 the drug or device when it is administered to the patient, and the name of the
32 prescriber.
33 (9) "Drug outlet" means all pharmacies, nursing homes, residential or
34 assisted living facilities, convalescent homes, extended care facilities, drug
35 abuse treatment centers, penal institutions, hospitals, family planning clin-
36 ics, retail stores, wholesalers, manufacturers and mail order vendors with
37 facilities located in this state which are engaged in dispensing, delivery or
38 distribution of drugs and drug manufacturers and wholesalers with facilities
39 located outside the state, but doing business within this state.
40 (10) "Prospective drug review" includes, but is not limited to, the fol-
41 lowing activities:
42 (a) Evaluation of the prescription or medication order for:
43 1. Known allergies;
44 2. Rational therapy contraindications;
45 3. Reasonable dose and route of administration; and
46 4. Reasonable directions for use.
47 (b) Evaluation of the prescription or medication order for duplication of
48 therapy.
49 (c) Evaluation of the prescription or medication order for interactions:
50 1. Drug-drug;
51 2. Drug-food; and
52 3. Drug-disease.
53 (d) Evaluation of the prescription or medication order for proper utili-
54 zation:
55 1. Over or under utilization; and
3
1 2. Abuse/misuse.
2 (11) "Extern" means a bona fide student enrolled in an approved college of
3 pharmacy who has not received his first professional degree in pharmacy.
4 (121) "Externship" means a structured practical experience program in
5 pharmacy, approved by the board and administered by a college of pharmacy.
6 (12) "Health care facility" means a health care facility as defined in
7 section 54-1601, Idaho Code.
8 (13) "Intern" means any person who has completed a course of study at an
9 approved college of pharmacy, received the first professional degree in phar-
10 macy and is registered with the board as an intern. Interns must register with
11 the board prior to commencement of an internship program.
12 (14) "Internship" means a postgraduate practical experience program under
13 the supervision of a preceptor at a preceptor site.
14 (15) "Investigational or new drug" means any drug which is limited by
15 state or federal law to use under professional supervision of a practitioner
16 authorized by law to prescribe or administer such drug.
17 (16) "Labeling" means the process of preparing and affixing of a label to
18 any drug container, exclusive however, of the labeling by a manufacturer,
19 packer or distributor of a nonprescription drug or commercially packaged leg-
20 end drug or device. Any such label shall include all information required by
21 federal and state law or regulation.
22 (17) "Manufacture" means the production, preparation, propagation, com-
23 pounding, conversion or processing of a device or a drug, either directly or
24 indirectly by extraction from substances of natural origin or independently by
25 means of chemical synthesis or by a combination of extraction and chemical
26 synthesis and includes any packaging or repackaging of the substance or label-
27 ing or relabeling of its container, except that this term does not include the
28 preparation or compounding of a drug by an individual for his own use or the
29 preparation, compounding, packaging or labeling of a drug:
30 (a) By a pharmacist or practitioner as an incident to his administering
31 or dispensing of a drug in the course of his professional practice; or
32 (b) By a practitioner or by his authorization under his supervision for
33 the purpose of or as an incident to research, teaching or chemical analy-
34 sis and not for sale.
35 (18) "Manufacturer" means a person who by compounding, cultivating, har-
36 vesting, mixing or other process, produces or prepares legend drugs, and
37 includes persons who prepare such drugs in dosage forms by mixing, compound-
38 ing, encapsulating, entableting, or other process, or who packages or
39 repackages such drugs, but does not include pharmacists or practitioners in
40 the practice of their profession.
41 (19) "Nonprescription drugs" means medicines or drugs which may be sold
42 without a prescription and which are prepackaged for use by the consumer and
43 labeled in accordance with the requirements of the statutes and regulations of
44 this state and the federal government.
45 "Precursor" means a substance, other than a legend drug which is an imme-
46 diate chemical intermediate that can be processed or synthesized into a legend
47 drug, and is used or produced primarily for use in the manufacture of a legend
48 drug by persons other than persons licensed to manufacture such legend drugs
49 by the Idaho board of pharmacy, registered by the state board of health and
50 welfare, or licensed to practice pharmacy by the Idaho board of pharmacy.
51 (20) "Person" means an individual, corporation, partnership, association
52 or any other legal entity.
53 (21) "Pharmaceutical care" means drug therapy and other pharmaceutical
54 patient care services intended to achieve outcomes related to the cure or pre-
55 vention of a disease, elimination or reduction of a patient's symptoms, or
4
1 arresting or slowing of a disease process as defined in the rules of the
2 board.
3 (22) "Pharmacist" means an individual licensed by this state to engage in
4 the practice of pharmacy.
5 (23) "Pharmacy" means any facility, department or other place where pre-
6 scriptions are filled or compounded and are sold, dispensed, offered or dis-
7 played for sale, which has, as its principal purpose, the dispensing of drug
8 and health supplies intended for the general health, welfare and safety of the
9 public.
10 (24) "Practitioner" shall mean a physician, dentist, veterinarian, scien-
11 tific investigator or other person (other than a pharmacist) licensed in this
12 state and permitted by such license to dispense, conduct research with respect
13 to or administer drugs in the course of professional practice or research in
14 this state.
15 (25) "Precursor" means a substance, other than a legend drug which is an
16 immediate chemical intermediate that can be processed or synthesized into a
17 legend drug, and is used or produced primarily for use in the manufacture of a
18 legend drug by persons other than persons licensed to manufacture such legend
19 drugs by the Idaho board of pharmacy, registered by the state board of health
20 and welfare, or licensed to practice pharmacy by the Idaho board of pharmacy.
21 (26) "Preceptor" means a pharmacist licensed in the state and in good
22 standing, who supervises the internship training of a registered intern. The
23 preceptor shall be actively engaged in the practice of pharmacy on a full-time
24 employment basis at a registered preceptor site.
25 (267) "Preceptor site" means any training site for pharmacy interns and
26 externs registered with the board pursuant to board rule.
27 (278) "Prescription drug or legend drug" means a drug which, under federal
28 law is required, prior to being dispensed or delivered, to be labeled with one
29 (1) of the following statements:
30 (a) "Caution: Federal law prohibits dispensing without a prescription";
31 or
32 (b) "Rx Only"; or
33 (c) "Caution: Federal law restricts this drug to use by or on the order
34 of a licensed veterinarian";
35 or a drug which is required by any applicable federal or state law or regula-
36 tion to be dispensed on prescription only or is restricted to use by practi-
37 tioners only.
38 (289) "Prescription drug order" means a lawful written or verbal order of
39 a practitioner for a drug or device for an ultimate user of the drug or
40 device, issued and signed by a practitioner, or an order transmitted verbally
41 from a practitioner or the practitioner's agent to a pharmacist in a pharmacy,
42 or transmitted verbally from a practitioner and immediately reduced to writing
43 by a licensed practical nurse or licensed professional nurse in a health care
44 facility for a patient or resident of such facility.
45 (30) "Prospective drug review" includes, but is not limited to, the fol-
46 lowing activities:
47 (a) Evaluation of the prescription or medication order for:
48 (i) Known allergies;
49 (ii) Rational therapy contraindications;
50 (iii) Reasonable dose and route of administration; and
51 (iv) Reasonable directions for use.
52 (b) Evaluation of the prescription or medication order for duplication of
53 therapy.
54 (c) Evaluation of the prescription or medication order for interactions:
55 (i) Drug-drug;
5
1 (ii) Drug-food; and
2 (iii) Drug-disease.
3 (d) Evaluation of the prescription or medication order for proper utili-
4 zation:
5 (i) Over or under utilization; and
6 (ii) Abuse/misuse.
7 (29) "Nonprescription drugs" means medicines or drugs which may be sold
8 without a prescription and which are prepackaged for use by the consumer and
9 labeled in accordance with the requirements of the statutes and regulations of
10 this state and the federal government.
11 (301) "Record" means all papers, letters, memoranda, notes, prescriptions,
12 drug orders, invoices, statements, patient medication charts or files, comput-
13 erized records or other written indicia, documents or objects which are used
14 in any way in connection with the purchase, sale or handling of any drug or
15 device.
16 (312) "Sale" means every sale and includes:
17 (a) Manufacturing, processing, transporting, handling, packaging or any
18 other production, preparation or repackaging;
19 (b) Exposure, offer, or any other proffer;
20 (c) Holding, storing or any other possession;
21 (d) Dispensing, giving, delivering or any other supplying; and
22 (e) Applying, administering or any other usage.
23 (323) "Warehouseman" means a person who stores legend drugs for others and
24 who has no control over the disposition of such drugs except for the purpose
25 of such storage.
26 (334) "Wholesaler" means a person engaged in the business of distributing
27 legend drugs that he himself has not produced or prepared, to persons included
28 in any of the classes named in subsection (2)(a) through (f) of section
29 54-1734, Idaho Code.
30 SECTION 2. That Section 54-1733, Idaho Code, be, and the same is hereby
31 amended to read as follows:
32 54-1733. VALIDITY OF PRESCRIPTION DRUG ORDERS. (1) A prescription or drug
33 order for a legend drug is not valid unless it is issued for a legitimate med-
34 ical purpose by a practitioner acting in the usual course of his profession,
35 or by a physician, dentist, veterinarian, scientific investigator or other
36 person, other than a pharmacist, who is licensed in a jurisdiction other than
37 the state of Idaho and is permitted by such license to dispense, conduct
38 research with respect to or administer the prescribed legend drugs in the
39 course of his professional practice or research in such jurisdiction, so long
40 as the individual is acting within the jurisdiction, scope and authority of
41 his license when issuing the prescription or drug order.
42 (a) The prescription drug order may be signed and sent electronically
43 pursuant to chapter 50, title 28, Idaho Code.
44 (b) Transmission of prescription drug order. In addition to delivery of
45 the original signed written prescription to a licensed pharmacy:
46 (i) A prescription drug order that has been signed by the practi-
47 tioner may be received by a licensed pharmacy for dispensing purposes
48 through a facsimile transmission from the prescribing practitioner or
49 the practitioner's agent, or from a health care facility for a
50 patient or resident in such facility;
51 (ii) A prescription drug order may also be received by a licensed
52 pharmacist verbally from the practitioner, the practitioner's agent
53 or from a licensed practical nurse or licensed professional nurse in
6
1 a health care facility for a patient or resident in such facility;
2 (iii) A prescription drug order received verbally from the practitio-
3 ner by a licensed practical nurse or licensed professional nurse in a
4 licensed health care facility for a patient or resident in such
5 facility may also be sent by facsimile transmission from the health
6 care facility to a licensed pharmacy for dispensing purposes provided
7 the transmitted document includes the name of the prescriber issuing
8 the prescription drug order, the name and license number of the nurse
9 who transcribed the order and the name of the person who sent the
10 facsimile.
11 (2) It is unlawful for a practitioner to knowingly issue an invalid pre-
12 scription or drug order for a legend drug.
13 (3) It is unlawful for a pharmacist or veterinarian to knowingly fill an
14 invalid prescription or drug order for a legend drug.
15 SECTION 3. That Section 37-3201, Idaho Code, be, and the same is hereby
16 amended to read as follows:
17 37-3201. DEFINITIONS. As used in this chapter:
18 (1) "Code imprint" means a series of letters or numbers assigned by the
19 manufacturer or distributor to a specific drug, or marks or monograms unique
20 to the manufacturer or distributor of the drug, or both;
21 (2) "Distributor" means a person who distributes for resale a drug in
22 solid dosage form under his own label even though he is not the actual manu-
23 facturer of the drug;
24 (3) "Solid dosage form" means capsules or tablets intended for oral use;
25 (4) "Legend drug" means any drug defined by section 54-1705(278), Idaho
26 Code.
27 SECTION 4. That Section 54-4702, Idaho Code, be, and the same is hereby
28 amended to read as follows:
29 54-4702. DEFINITIONS. As used in this chapter:
30 (1) "Acupuncture" means that theory of health care developed from tradi-
31 tional and modern Oriental medical philosophies that employs diagnosis and
32 treatment of conditions of the human body based upon stimulation of specific
33 acupuncture points on meridians of the human body for the promotion, mainte-
34 nance, and restoration of health and for the prevention of disease. Therapies
35 within the scope of acupuncture include manual, mechanical, thermal, electri-
36 cal and electromagnetic treatment of such specific indicated points.
37 Adjunctive therapies included in, but not exclusive to, acupuncture include
38 herbal and nutritional treatments, therapeutic exercise and other therapies
39 based on traditional and modern Oriental medical theory.
40 (2) "Board" means the Idaho state board of acupuncture.
41 (3) "NCCAOM" means "National Certification Commission for Acupuncture
42 and Oriental Medicine."
43 (4) "Practice of acupuncture" means the insertion of acupuncture needles
44 and use of similar devices and therapies, including application of
45 moxibustion, to specific indicated points on the skin of the human body as
46 indicated pursuant to traditional and modern theories of Oriental medicine.
47 The "practice of acupuncture" does not include:
48 (a) surgery; or
49 (b) prescribing, dispensing or administering any prescription drug or
50 legend drug as defined in section 54-1705(278), Idaho Code.
7
1 SECTION 5. That Section 54-5110, Idaho Code, be, and the same is hereby
2 amended to read as follows:
3 54-5110. NATUROPATHIC MEDICAL FORMULARY COUNCIL ESTABLISHED. There is
4 hereby established a naturopathic medical formulary council, which is separate
5 and distinct from the board, to be composed of seven (7) members. Two (2) mem-
6 bers shall be naturopathic physicians licensed under this chapter, appointed
7 by the board of naturopathic medical examiners. Three (3) members shall be
8 pharmacists licensed under chapter 17, title 54, Idaho Code, appointed by
9 the board of naturopathic medical examiners from a list of nominees provided
10 by the Idaho state board of pharmacy. Two (2) members shall be physicians
11 licensed under chapter 18, title 54, Idaho Code, appointed by the board of
12 naturopathic medical examiners from a list of nominees provided by the Idaho
13 state board of medicine. The initial council shall be appointed as follows:
14 One (1) naturopathic physician shall be appointed for a one (1) year term; one
15 (1) physician licensed under chapter 18, title 54, Idaho Code, and one (1)
16 pharmacist shall be appointed for a two (2) year term; and two (2) pharma-
17 cists, one (1) naturopathic physician and one (1) physician licensed under
18 chapter 18, title 54, Idaho Code, shall be appointed for a three (3) year
19 term. Thereafter, the term of office shall be three (3) years. A quorum shall
20 consist of five (5) members and shall be required for any vote to be taken. It
21 shall be the duty of the naturopathic medical formulary council to establish a
22 formulary for use by naturopathic physicians, and immediately upon adoption or
23 revision of the formulary, the council shall transmit the approved formulary
24 to the board, which shall adopt the formulary by temporary rule. The formulary
25 will be reviewed annually by the council, or at any time at the request of the
26 board. The formulary list may not go beyond the scope of prescription medi-
27 cines and medical devices covered by approved naturopathic medical education
28 and training and existing naturopathic medical formularies, or board-approved
29 continuing education. The naturopathic medical formulary shall not include
30 medicines and devices that are inconsistent with the training provided by
31 approved naturopathic medical colleges. Nothing herein shall allow a
32 naturopathic physician to dispense, administer or prescribe any prescription
33 drug as defined in section 54-1705(278), Idaho Code, or medical device unless
34 such prescription drug or medical device is specifically included in the
35 naturopathic medical formulary.
36 SECTION 6. An emergency existing therefor, which emergency is hereby
37 declared to exist, this act shall be in full force and effect on and after its
38 passage and approval.
STATEMENT OF PURPOSE
RS 15969C1
The purposes of this legislation is to provide procedures for
long-term care and assisted living facilities to fax and verbally
send prescription drug orders to a pharmacy when it has been so
ordered by a doctor. It also allows for electronic transmission
of prescriptions.
FISCAL NOTE
There is no fiscal impact to the general fund.
Contact
Name: Kris Ellis, Idaho Assisted Living Association
Phone: 250-3132
Name: Robert Vande Merwe, Idaho Health Care Association
Phone: 343-9735
STATEMENT OF PURPOSE/FISCAL NOTE S 1412