Print Friendly SENATE BILL NO. 1145 – Midwifery voluntary license act
SENATE BILL NO. 1145
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S1145.................................................by HEALTH AND WELFARE
MIDWIFERY - Adds to and amends existing law relating to midwifery to
provide legislative purpose and intent; to define terms; to provide that
parental rights regarding delivery methods are not modified; to set forth
scope of practice; to establish the Board of Midwifery and to set forth
membership and meeting criteria; to establish a formulary committee; to
provide board powers and duties; to provide for fees; to set forth
qualifications for voluntary licensure; to provide for license standards
for applicants from other jurisdictions; to provide for investigations,
hearings and subpoenas; to provide for disciplinary action by the board; to
provide a license denial or revocation procedure; to provide enforcement
penalties; and to provide immunity.
02/12 Senate intro - 1st rdg - to printing
02/13 Rpt prt - to Health/Wel
]]]] LEGISLATURE OF THE STATE OF IDAHO ]]]]
Fifty-ninth Legislature First Regular Session - 2007
IN THE SENATE
SENATE BILL NO. 1145
BY HEALTH AND WELFARE COMMITTEE
1 AN ACT
2 RELATING TO MIDWIFERY; AMENDING TITLE 54, IDAHO CODE, BY THE ADDITION OF A NEW
3 CHAPTER 13, TITLE 54, IDAHO CODE, TO PROVIDE LEGISLATIVE PURPOSE AND
4 INTENT, TO DEFINE TERMS, TO PROVIDE THAT PARENTAL RIGHTS REGARDING DELIV-
5 ERY METHODS ARE NOT MODIFIED, TO SET FORTH SCOPE OF PRACTICE, TO PROVIDE
6 FOR DISCLOSURE AND RECORDKEEPING, TO ESTABLISH THE BOARD OF MIDWIFERY AND
7 TO SET FORTH MEMBERSHIP AND MEETING CRITERIA, TO ESTABLISH A FORMULARY
8 COMMITTEE, TO PROVIDE BOARD POWERS AND DUTIES, TO PROVIDE FOR FEES, TO SET
9 FORTH QUALIFICATIONS FOR VOLUNTARY LICENSURE, TO PROVIDE FOR LICENSE STAN-
10 DARDS FOR APPLICANTS FROM OTHER JURISDICTIONS, TO PROVIDE FOR INVESTIGA-
11 TIONS, HEARINGS AND SUBPOENAS, TO PROVIDE FOR DISCIPLINARY ACTION BY THE
12 BOARD, TO PROVIDE A LICENSE DENIAL OR REVOCATION PROCEDURE, TO PROVIDE
13 ENFORCEMENT PENALTIES AND TO PROVIDE IMMUNITY; AND AMENDING SECTIONS
14 67-2601 AND 67-2602, IDAHO CODE, TO PROVIDE REFERENCE TO THE BOARD OF MID-
16 Be It Enacted by the Legislature of the State of Idaho:
17 SECTION 1. That Title 54, Idaho Code, be, and the same is hereby amended
18 by the addition thereto of a NEW CHAPTER, to be known and designated as Chap-
19 ter 13, Title 54, Idaho Code, and to read as follows:
20 CHAPTER 13
21 IDAHO MIDWIFERY VOLUNTARY LICENSURE ACT
22 54-1301. LEGISLATIVE PURPOSE AND INTENT. It is the intent of the Idaho
23 legislature that nothing in this chapter shall require a license for the prac-
24 tice of midwifery in this state. The voluntary licensure provisions of this
25 chapter are intended to enhance maternity care options for Idaho's families
26 and to provide a mechanism for validating the qualifications of midwives who
27 seek licensure.
28 54-1302. DEFINITIONS. As used in this chapter, the following terms have
29 the meanings as stated:
30 (1) "Board" means the board of midwifery as created pursuant to section
31 54-1306, Idaho Code.
32 (2) "Department" means the Idaho department of self-governing agencies.
33 (3) "Midwifery" means the practice of providing antepartum, intrapartum,
34 postpartum and well-woman care to women and newborn infants in a variety of
36 (4) "Midwives Alliance of North America" or "MANA" means the interna-
37 tional professional organization established in 1982 for all midwives.
38 (5) "North American Registry of Midwives" or "NARM" means the interna-
39 tional certification agency that establishes and administers certification for
40 the certified professional midwife credential.
1 54-1303. PARENTAL RIGHTS. Nothing in this chapter shall abridge, limit or
2 otherwise modify the rights of parents to choose the manner of delivery for
3 their baby.
4 54-1304. SCOPE OF PRACTICE. (1) Licensed midwives may obtain and use cer-
5 tain legend drugs and devices as are found to be a usual and normal part of
6 safe midwifery practice by the formulary committee of the board of midwifery.
7 Such drugs and devices may include, but are not limited to:
8 (a) Newborn antibiotic eye prophylaxis;
9 (b) Antihemorrhagic agents used for the control of postpartum hemorrhage;
10 (c) Intravenous fluids for stabilization of the woman;
11 (d) Emergency oxygen and bag-valve mask for resuscitation;
12 (e) Vitamin "K" for the prevention of hemorrhagic disease of the newborn;
13 (f) "RhoGAM" for the prevention of Rh sensitization;
14 (g) Antibiotics for the treatment of group B streptococcus (GBS); and
15 (h) Local anesthetic for repair of lacerations and emergency episiotomy.
16 (2) The licensed midwife, when properly trained to do so, may cut and
17 suture an emergency episiotomy as necessary, and may suture a first or second
18 degree laceration.
19 (3) As determined by the board, the licensed midwife may obtain routine
20 antepartum and/or postpartum laboratory work and diagnostics including, but
21 not limited to, vaginal cultures, Pap smears, and ultrasound.
22 (4) Licensed midwives are eligible to receive third party reimbursement.
23 54-1305. DISCLOSURE -- RECORDKEEPING. (1) A licensed midwife shall pro-
24 vide clients with the following in a form provided by the board:
25 (a) Information concerning both the benefits and risks of midwifery care
26 in the setting of the client's choice;
27 (b) The licensed midwife's training and experience;
28 (c) Information concerning how to obtain a copy of the rules promulgated
29 under this chapter;
30 (d) The NARM job analysis and MANA essential documents;
31 (e) Instructions for filing complaints with the board of midwifery; and
32 (f) Information regarding whether or not the licensed midwife has mal-
33 practice insurance.
34 (2) Prior to initiating care, the licensed midwife shall obtain a signed
35 informed consent agreement for each client acknowledging receipt of the infor-
36 mation specified in subsection (1) of this section. The licensed midwife shall
37 maintain a record of the signed informed consent agreement for a minimum of
38 three (3) years. If the disclosure information changes, then the licensed mid-
39 wife has a duty to repeat the disclosure if a client obtains services after
40 the change.
41 54-1306. BOARD OF MIDWIFERY. (1) There is hereby established in the
42 department of self-governing agencies, bureau of occupational licenses, the
43 board of midwifery.
44 (2) The board shall consist of five (5) members, four (4) of whom shall
45 be licensed pursuant to this chapter and one (1) of whom shall be a member of
46 the public with an interest in the rights of clients of midwifery services.
47 (3) One (1) member of the initial board shall be appointed for a one (1)
48 year term of office, one (1) member of the initial board shall be appointed
49 for a two (2) year term of office, one (1) member of the initial board shall
50 be appointed for a three (3) year term of office, one (1) member shall be
51 appointed for a four (4) year term of office, and one (1) member of the ini-
52 tial board shall be appointed for a five (5) year term of office. Thereafter,
1 the term of office for each member shall be five (5) years.
2 (4) Appointments to the board shall be made by the governor from nomina-
3 tions received from the Idaho midwifery council, which shall nominate persons
4 qualified for each position to be filled.
5 (5) The four (4) members of the board who are licensed midwives shall be
6 licensed pursuant to this chapter, practicing within the state of Idaho for
7 the duration of their appointment and shall have been practitioners within the
8 state of Idaho for a minimum of two (2) years immediately preceding appoint-
10 (6) The initial four (4) licensed midwife members of the board shall be
11 persons with at least two (2) years of experience in the practice of midwifery
12 who are eligible to become licensed pursuant to this chapter. In the event of
13 death, resignation or removal of any member before the expiration of the term
14 to which appointed, the vacancy shall be filled for the unexpired portion of
15 the term in the same manner as the original appointment.
16 (7) The governor may remove any member of the board for cause, prior to
17 the expiration of the member's term.
18 (8) The board, within thirty (30) days after its appointment, and at
19 least annually thereafter, shall hold a meeting and elect a chairperson. The
20 board may hold additional meetings at the call of the chairperson or at the
21 written request of any two (2) members of the board. In addition to the formu-
22 lary committee established in subsection (9) of this section, the board may
23 appoint such committees as it considers necessary to carry out its duties. A
24 majority of the board shall constitute a quorum.
25 (9) The board shall establish a formulary committee to make recommenda-
26 tions to the board regarding legend drugs and devices appropriate for the
27 practice of licensed midwives as well as recommended guidelines for the use of
28 such drugs and devices. The committee shall consist of five (5) members as
30 (a) Three (3) licensed midwives, provided that the initial three (3)
31 licensed midwife members shall be persons who, though not yet licensed,
32 have at least two (2) years of experience in the practice of midwifery and
33 who are eligible to become licensed pursuant to this chapter, and provided
34 further that one (1) such licensed midwife may also be a member of the
36 (b) One (1) licensed pharmacist; and
37 (c) One (1) licensed physician who has professional experience consulting
38 for and collaborating with midwives.
39 54-1307. POWERS AND DUTIES OF THE BOARD. The board shall have the author-
40 ity to:
41 (1) Determine the qualifications of persons applying for licensure pursu-
42 ant to this chapter and to define, by rule, the appropriate scope of practice
43 for midwifery in this state, provided however, that the scope of practice may
44 not exceed that defined in section 54-1304, Idaho Code;
45 (2) Adopt such rules as are necessary for the administration of this
46 chapter, including standards of professional conduct;
47 (3) Conduct investigations and examinations and hold hearings;
48 (4) Collect fees and other funds as prescribed by this chapter;
49 (5) Provide such other services and perform such other functions as are
50 necessary and desirable to fulfill its purposes; and
51 (6) Establish the minimum amount and type of continuing education to be
52 required annually for each licensed midwife seeking licensure renewal.
53 54-1308. FEES. (1) All fees received under the provisions of this chapter
1 shall be paid to the department of self-governing agencies, bureau of occupa-
2 tional licenses, and deposited in the state treasury to the credit of the
3 occupational licenses fund. All costs and expenses incurred under the provi-
4 sions of this chapter shall be a charge against and paid from said fund. In no
5 case shall any salary, expense or other obligation of the board be charged
6 against the general fund.
7 (2) The fee for licensure shall not exceed five hundred dollars ($500).
8 54-1309. QUALIFICATIONS FOR VOLUNTARY LICENSURE. (1) To be eligible to
9 practice as a licensed midwife in the state of Idaho, the applicant shall:
10 (a) Provide proof, on a form provided by the board, of current and con-
11 tinued certification as a certified professional midwife by NARM or any
12 successor organization;
13 (b) Provide proof, on a form provided by the board, of current and con-
14 tinued adult, infant and child CPR and neonatal resuscitation certifica-
16 (c) Be physically and mentally capable of safely practicing midwifery
17 with or without reasonable accommodation;
18 (d) Have never had a license to practice midwifery or other health care
19 license, registration or certificate refused, revoked or suspended by any
20 other state or country for reasons that relate to the applicant's ability
21 to skillfully and safely practice midwifery or other health care profes-
22 sion unless that license, registration or certification has been restored
23 to good standing by that state or country;
24 (e) File with the board a board-approved disclosure form stating the
25 degrees, training, experience, credentials and the health care services
26 the midwife is board approved to provide; and
27 (f) File a board-approved application and pay the licensing fees.
28 (2) Licensed midwives shall not be required to maintain malpractice
29 insurance coverage.
30 54-1310. LICENSE STANDARDS FOR OTHER JURISDICTION APPLICANTS. The board
31 shall establish by rule the standards for licensure of applicants licensed in
32 another jurisdiction. However, the standards for endorsement of licensure
33 shall not be less than those required for licensure in the state of Idaho.
34 54-1311. INVESTIGATION -- HEARING -- SUBPOENA. (1) The board shall be
35 empowered to investigate, or cause to be investigated, all complaints regard-
36 ing any conduct prohibited by this chapter.
37 (2) The board may conduct hearings to assist with investigations, to
38 determine whether grounds exist for suspension, revocation or denial of a
39 license or to fulfill its responsibilities under this chapter as the board
40 determines necessary.
41 (3) The board may subpoena witnesses, administer oaths in any hearing or
42 disciplinary proceeding and compel, by subpoena duces tecum, the production of
43 papers and records.
44 54-1312. DISCIPLINARY ACTION. The board may suspend, revoke or refuse to
45 issue or renew a license on any of the following grounds:
46 (1) The employment of fraud, misrepresentation or the concealment of
47 material facts in obtaining a license under this chapter or in connection with
48 services rendered as a licensed midwife;
49 (2) A legal finding of mental incompetence;
50 (3) Aiding or abetting a person, not duly licensed under this chapter, in
51 claiming to be a licensed midwife;
1 (4) Any negligence, incompetence or misconduct in the performance of mid-
3 (5) Conviction of any crime involving moral turpitude or the entering of
4 a plea of guilty or the finding of guilt by a jury or court of a commission of
5 a felony or a crime involving moral turpitude;
6 (6) Practicing as a licensed midwife when physical or mental abilities
7 are impaired by the use of controlled substances or other drugs, chemicals or
9 (7) Failure of the midwife to maintain his or her professional premises
10 in a clean and sanitary condition;
11 (8) Any other good cause, relevant to qualifications to practice as a
12 licensed midwife. The board may not suspend, revoke or refuse to issue or
13 renew a license based on the findings that a licensee's practice is unconven-
14 tional in the absence of demonstrable harm to a patient and the patient has
15 signed a waiver to the effect that the treatment or device is considered
17 54-1313. LICENSE DENIAL OR REVOCATION PROCEDURE. When the board proposes
18 to refuse to issue or renew a license, or proposes to revoke or suspend a
19 license, opportunity for a hearing shall be pursuant to the provisions of
20 chapter 52, title 67, Idaho Code.
21 54-1314. ENFORCEMENT PENALTIES. (1) Every person who knowingly holds him-
22 self or herself out as a licensed midwife in this state without such licensure
23 is guilty of a misdemeanor. A person convicted of a second or subsequent
24 offense shall be guilty of a felony and shall be imprisoned in the state
25 prison for a period not to exceed five (5) years, or shall be fined not more
26 than ten thousand dollars ($10,000) or shall be punished by both such fine and
28 (2) Provided the board determines in good faith that a person is holding
29 himself or herself out as a licensed midwife in violation of this chapter, the
30 board may seek an injunction, provided it has given thirty (30) days' prior
31 written notice to cease and desist against any person who does not comply with
32 such notice and who holds himself or herself out as a licensed midwife in
33 violation of this chapter and may, in the event a permanent injunction is
34 entered against such person, be entitled to all costs and fees incurred by the
35 board in seeking the injunction.
36 54-1315. IMMUNITY. No licensed health care provider or facility shall be
37 liable for any injury resulting from an act or omission by a licensed midwife,
38 even if the health care provider or facility has consulted with or accepted a
39 referral from the licensed midwife.
40 SECTION 2. That Section 67-2601, Idaho Code, be, and the same is hereby
41 amended to read as follows:
42 67-2601. DEPARTMENT CREATED -- ORGANIZATION -- DIRECTOR -- BUREAU OF
43 OCCUPATIONAL LICENSES CREATED. (1) There is hereby created the department of
44 self-governing agencies. The department shall, for the purposes of section 20,
45 article IV of the constitution of the state of Idaho, be an executive depart-
46 ment of the state government.
47 (2) The department shall consist of the following:
48 (a) Agricultural commodity commissions: Idaho apple commission, as pro-
49 vided by chapter 36, title 22, Idaho Code; Idaho bean commission, as pro-
50 vided by chapter 29, title 22, Idaho Code; Idaho beef council, as provided
1 by chapter 29, title 25, Idaho Code; Idaho cherry commission, as provided
2 by chapter 37, title 22, Idaho Code; Idaho dairy products commission, as
3 provided by chapter 31, title 25, Idaho Code; Idaho pea and lentil commis-
4 sion, as provided by chapter 35, title 22, Idaho Code; Idaho potato com-
5 mission, as provided by chapter 12, title 22, Idaho Code; Idaho prune com-
6 mission, as provided by chapter 30, title 22, Idaho Code; the Idaho wheat
7 commission, as provided by chapter 33, title 22, Idaho Code; and the Idaho
8 aquaculture commission, as provided by chapter 44, title 22, Idaho Code.
9 (b) Professional and occupational licensing boards: Idaho state board of
10 certified public accountancy, as provided by chapter 2, title 54, Idaho
11 Code; board of acupuncture, as provided by chapter 47, title 54, Idaho
12 Code; board of architectural examiners, as provided by chapter 3, title
13 54, Idaho Code; office of the state athletic director, as provided by
14 chapter 4, title 54, Idaho Code; board of barber examiners, as provided by
15 chapter 5, title 54, Idaho Code; board of commissioners of the Idaho state
16 bar, as provided by chapter 4, title 3, Idaho Code; board of chiropractic
17 physicians, as provided by chapter 7, title 54, Idaho Code; Idaho board of
18 cosmetology, as provided by chapter 8, title 54, Idaho Code; Idaho coun-
19 selor licensing board, as provided by chapter 34, title 54, Idaho Code;
20 state board of dentistry, as provided by chapter 9, title 54, Idaho Code;
21 state board of denturitry, as provided by chapter 33, title 54, Idaho
22 Code; state board of engineering examiners, as provided by chapter 12,
23 title 54, Idaho Code; state board for registration of professional geolo-
24 gists, as provided by chapter 28, title 54, Idaho Code; speech and hearing
25 services licensure board, as provided by chapter 29, title 54, Idaho Code;
26 Idaho physical therapy licensure board, as provided by chapter 22, title
27 54, Idaho Code; Idaho state board of landscape architects, as provided by
28 chapter 30, title 54, Idaho Code; liquefied petroleum gas safety board, as
29 provided by chapter 53, title 54, Idaho Code; state board of medicine, as
30 provided by chapter 18, title 54, Idaho Code; state board of morticians,
31 as provided by chapter 11, title 54, Idaho Code; board of naturopathic
32 medical examiners, as provided by chapter 51, title 54, Idaho Code; board
33 of midwifery, as provided by chapter 13, title 54, Idaho Code; board of
34 nurses, as provided by chapter 14, title 54, Idaho Code; board of examin-
35 ers of nursing home administrators, as provided by chapter 16, title 54,
36 Idaho Code; state board of optometry, as provided by chapter 15, title 54,
37 Idaho Code; Idaho outfitters and guides board, as provided by chapter 21,
38 title 36, Idaho Code; board of pharmacy, as provided by chapter 17, title
39 54, Idaho Code; state board of podiatry, as provided by chapter 6, title
40 54, Idaho Code; Idaho state board of psychologist examiners, as provided
41 by chapter 23, title 54, Idaho Code; Idaho real estate commission, as pro-
42 vided by chapter 20, title 54, Idaho Code; real estate appraiser board, as
43 provided by chapter 41, title 54, Idaho Code; board of social work examin-
44 ers, as provided by chapter 32, title 54, Idaho Code; the board of veteri-
45 nary medicine, as provided by chapter 21, title 54, Idaho Code; the board
46 of examiners of residential care facility administrators, as provided by
47 chapter 42, title 54, Idaho Code; and the board of drinking water and
48 wastewater professionals, as provided by chapter 24, title 54, Idaho Code.
49 (c) The board of examiners, pursuant to section 67-2001, Idaho Code.
50 (d) The division of building safety, to be headed by a division adminis-
51 trator and comprised of five (5) bureaus: plumbing, electrical, buildings,
52 public works contractor licensing, and logging and industrial safety. The
53 division administrator, deputy administrators and bureau chiefs shall be
54 nonclassified employees exempt from the provisions of chapter 53, title
55 67, Idaho Code.
1 (i) The administrator of the division shall administer the provi-
2 sions of chapter 40, title 39, Idaho Code, relating to manufactured
3 homes; chapter 41, title 39, Idaho Code, relating to modular build-
4 ings; chapter 21, title 44, Idaho Code, relating to manufactured home
5 dealer and installer licensing; chapter 22, title 44, Idaho Code,
6 relating to manufactured home installation; chapter 25, title 44,
7 Idaho Code, relating to mobile home rehabilitation; chapter 10, title
8 54, Idaho Code, relating to electrical contractors and journeymen;
9 chapter 19, title 54, Idaho Code, relating to licensing of public
10 works contractors; chapter 26, title 54, Idaho Code, relating to
11 plumbing and plumbers; chapter 19, title 54, Idaho Code, relating to
12 public works contractor licensing; chapter 50, title 54, Idaho Code,
13 relating to heating, ventilation and air conditioning systems; and
14 shall perform such additional duties as are imposed upon him by law.
15 (ii) The division administrator shall cooperate with the industrial
16 commission and aid and assist the commission in its administration of
17 sections 72-720, 72-721 and 72-723, Idaho Code, and at the request of
18 the commission shall make inspection of appliances, tools, equipment,
19 machinery, practices or conditions, and make a written report to the
20 commission. The administrator shall make recommendations to the com-
21 mission to aid the commission in its administration of sections
22 72-720, 72-721 and 72-723, Idaho Code, provided however, that nothing
23 herein shall be construed as transferring to the administrator any of
24 the authority or powers now vested in the industrial commission.
25 (e) The division of veterans services to be headed by a division adminis-
26 trator who shall be a nonclassified employee exempt from the provisions of
27 chapter 53, title 67, Idaho Code. The administrator of the division shall
28 administer the provisions of chapter 2, title 65, Idaho Code, and chapter
29 9, title 66, Idaho Code, with the advice of the veterans affairs commis-
30 sion established under chapter 2, title 65, Idaho Code, and shall perform
31 such additional duties as are imposed upon him by law.
32 (3) The bureau of occupational licenses is hereby created within the
33 department of self-governing agencies.
34 SECTION 3. That Section 67-2602, Idaho Code, be, and the same is hereby
35 amended to read as follows:
36 67-2602. BUREAU OF OCCUPATIONAL LICENSES. (1) The bureau of occupational
37 licenses created in the department of self-governing agencies by section
38 67-2601, Idaho Code, shall be empowered, by written agreement between the
39 bureau and each agency for which it provides administrative or other services
40 as provided by law, to provide such services for the board of acupuncture,
41 board of architectural examiners, board of barber examiners, board of chiro-
42 practic physicians, board of cosmetology, counselor licensing board, state
43 board of denturitry, speech and hearing services licensure board, physical
44 therapy licensure board, board of landscape architects, liquefied petroleum
45 gas safety board, board of midwifery, board of morticians, board of
46 naturopathic medical examiners, board of examiners of nursing home administra-
47 tors, board of optometry, board of podiatrists, board of psychologist examin-
48 ers, real estate appraiser board, board of examiners of residential care
49 facility administrators, board of social work examiners, and such other pro-
50 fessional and occupational licensing boards or commodity commissions as may
51 request such services. The bureau may charge a reasonable fee for such ser-
52 vices provided any agency not otherwise provided for by law and shall maintain
53 proper accounting methods for all funds under its jurisdiction.
1 (2) Notwithstanding the statutes governing specific boards, for any board
2 that contracts with the bureau of occupational licenses, each board member
3 shall hold office until a successor has been duly appointed and qualified.
4 (3) The department of self-governing agencies, by and through the bureau
5 of occupational licenses, shall be empowered to provide administrative or
6 other services for the administration of chapter 48, title 54, Idaho Code, to
7 issue, suspend, revoke or refuse to renew licenses and certificates, to issue
8 subpoenas, to prescribe and impose fees and to assess administrative penalties
9 pursuant to the provisions of chapter 48, title 54, Idaho Code.
STATEMENT OF PURPOSE
The purpose of this bill is to establish a framework for voluntary
licensure of midwives in Idaho. The voluntary licensure provisions of
this bill are intended to enhance maternity care options for Idaho s
families and to provide a mechanism for validating the qualifications
of midwives who seek this voluntary licensure.
The legislation allows for license fees up to $ 500.00 per midwife. It
is estimated that initially 25 to 30 midwives might participate and at
the $ 500.00 fee that should adequately cover the costs of
establishing the Board and administration of the program at the Bureau
of Occupational Licenses.
Name: Idaho Midwifery Council Barbara Rawlings, President
Phone: 208 267 0936
Sen. Shawn Keough
Rep. Ken Roberts
Rep. Dick Harwood
Rep. Marge Chadderdon
Rep. JoAn Wood
Rep. Paul Shepherd
208 332 1000
STATEMENT OF PURPOSE/FISCAL NOTE S 1145